Less Time for Health: Parenting, Work, and Time-Intensive Health Behaviors among Married or Cohabiting Men and Women in the United States.

Time spent working or caring for children may reduce the time available for undertaking time-intensive health behaviors. We test competing perspectives about how work hours and the number of children of specific ages will be associated with married or cohabiting men's and women's sleep duration and physical activity. We use data from the 2004 to 2017 waves of the National Health Interview Survey (N = 154,580). In support of the "time availability" perspective, longer work hours and children of any age are associated with shorter sleep hours. However, in support of the "time deepening" perspective, additional hours of work beyond 40 hours per week and children over the age of five are not associated with reduced physical activity. Contrary to our expectations, we did not find gender differences in support of our theories. Our results suggest that the economy of time works differently for sleep and exercise.

Peer Network Processes in Adolescents' Health Lifestyles.

Combining theories of health lifestyles-interrelated health behaviors arising from group-based identities-with those of network and behavior change, we investigated network characteristics of health lifestyles and the role of influence and selection processes underlying these characteristics. We examined these questions in two high schools using longitudinal, complete friendship network data from the National Longitudinal Study of Adolescent to Adult Health. Latent class analyses characterized each school's predominant health lifestyles using several health behavior domains. School-specific stochastic actor-based models evaluated the bidirectional relationship between friendship networks and health lifestyles. Predominant lifestyles remained stable within schools over time, even as individuals transitioned between lifestyles. Friends displayed greater similarity in health lifestyles than nonfriend dyads. Similarities resulted primarily from teens' selection of friends with similar lifestyles but also from teens influencing their peers' lifestyles. This study demonstrates the salience of health lifestyles for adolescent development and friendship networks.

Adolescent Technology, Sleep, and Physical Activity Time in Two US Cohorts.

The advent of internet-enabled mobile digital devices has transformed US adolescent technology use over the last decade, yet little is known about how these changes map onto other health-related behaviors. We provide a national profile of how contemporary technology use fits into adolescents' daily health lifestyles compared to the previous generation, with particular attention to whether and for whom technology use displaces time spent in sleep or physical activity. Time diaries were collected from 11-17 year olds in 2002-03 (N=1,139) and 2014-16 (N=527) through the US Panel Study of Income Dynamics Child Development Supplement. Contemporary adolescents spent 40 minutes more per week in technology-focused activities, but their composition was more varied compared to the earlier cohort. Contemporary technology use was predictive of less time in physical activity, and adolescents engaged in frequent video game play spent less time in physical activity compared to peers with other technology use profiles.

Utilizing genome wide data to highlight the social behavioral pathways to health: The case of obesity and cardiovascular health among older adults.

We use genome-wide data from the 1992-2016 Health and Retirement Study (n = 12,090) to characterize obesity among older adults as genetically or socially oriented. To illustrate the significance of this approach for social epidemiological research, we deem those with the lowest genetic risk for obesity to be socially-behaviorally obese and obesity among those with the highest polygenic risk is characterized as genetically oriented. We then examine the association between obesity and four indicators of cardiovascular health (type-2 diabetes, hypertension, heart problems, and stroke) among those with low, average, and high genetic risk. Our results show that the association between obesity and cardiovascular health is significantly higher for those with the lowest genetic risk (e.g., social-behavioral obesity). We also demonstrate important sex differences such that this association is particularly strong for heart problems among men and hypertension and stroke among women. Our results further demonstrate the centrality of the social and behavioral determinants of health by utilizing detailed information across the human genome and add to both social and genetic epidemiology literatures.

Mortality and Obesity Among U.S. Older Adults: The Role of Polygenic Risk.

OBJECTIVES: To examine the relationship between obesity and mortality as a function of polygenic risk for obesity among older U.S. adults. METHOD: Using data from the 1994-2014 Health and Retirement Study in conjunction with genome-wide data, we evaluated the risk of mortality as a function of obesity classification, an individual's polygenic risk score (PGS) for obesity, and their interaction, stratified by sex. We conducted our analyses using cox proportional hazard models. RESULTS: Among those with an average PGS for obesity (8,143 [68.8%]), obese I (hazard ratio [HR] = 0.79, p = .336) adults show no difference in their risk for mortality and obese II/III (HR = 3.17, p = .000) adults present higher risk of mortality relative to non-obese adults. The interaction of obesity classification and PGS suggests that obese II/III respondents with low PGS in the total sample (HR = 2.71, p = .006) and among women (HR = 3.02, p = .023) are at significantly higher risk of death when compared to obese II/III respondents with average or high PGS. DISCUSSION: We posit that these findings suggest that the pathway to obesity, in this case, more socio-behavioral rather than genetic, may influence subsequent risk of death in older adults. We suggest that practitioners and population researchers be mindful of these pathways as to better identify and understand mortality risk.

A life course framework for understanding digital technology use in the transition to adulthood.

Rapid increases in young people's time spent using digital technology ("screen time") in the mobile internet era have led to anxiety about long-term effects. This mixed-method US study examines childhood experiences and contextual factors that shape screen time in the transition to adulthood. We recursively analyzed 56 qualitative interviews with young adults in a large metropolitan area in 2016-2018 and prospective longitudinal nationally representative survey data (PSID-CDS-2007 and PSID-TAS-2017) to articulate a conceptual framework of life course influences on young adults' time spent using digital technologies. Inductive qualitative analyses built an initial framework, which was assessed with quantitative data, then further refined with qualitative analyses. Young adults drew on life course perspectives when discussing influences on their current digital technology use. As they suggested, in quantitative analyses more frequent adolescent technology use and greater device access weakly predicted increased technology frequency. Current school enrollment and several current peer factors predicted technology time. Interviewees emphasized the influence of parenting around technology use during adolescence, but parenting did not predict young adult screen time in quantitative analyses. Further qualitative analyses suggested that instead of influencing current technology time, earlier parenting shaped current emotional responses and imagined future technology use. We found young adults' technology use frequency to be informed by earlier experiences but highly malleable. Past technology use and current social contexts matter, but only up to a point. Moving beyond time use to incorporate emotional responses and future plans can better capture how the life course shapes technology use.

Primary Arthroscopic Repair of the Anterior Cruciate Ligament: A Systematic Review of Clinical Outcomes.

PURPOSE: To describe the clinical outcomes after primary arthroscopic anterior cruciate ligament (ACL) repair. METHODS: A systematic review of the PubMed, Embase, and Cochrane Library databases was performed according to the PRISMA guidelines. All English-language literature published from 2000 to 2018 that reported the clinical outcomes after primary arthroscopic repair (AR) of complete tear of the ACL (without augmentation) with a minimum 2-year follow-up was reviewed by 2 independent reviewers. Outcomes included repair failure, reoperation, postoperative knee stability, and patient-reported outcomes. Descriptive statistics are presented. Study quality was evaluated with the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Nonrandomized Studies (MINORS) score. RESULTS: Six studies (2 level III, 4 level IV) were included. The mean MCMS was 62.2. The mean MINORS score for noncomparative studies was 11.8, and for comparative studies, 18. Six studies reported outcomes of 89 patients who underwent AR of the ACL from 2007 to 2016 (age, 8 to 67 years; follow-up, 24 to 110 months). All 6 studies included exclusively proximal avulsion tears. Overall, 0% to 25.0% of patients experienced repair failure (I2 = 23.7%; 95% confidence interval, 0% to 67.6%), and 0% to 20.0% of patients had a subsequent reoperation (I2 = 12.1%; 95% confidence interval, 0% to 77.7%). Similar inconsistent results were shown for postoperative knee stability measures and patient-reported outcomes. CONCLUSIONS: The literature on clinical outcomes of primary arthroscopic ACL repair is limited. The reported rates of repair failure and reoperation are highly inconsistent. Most studies report relatively high failure rates. LEVEL OF EVIDENCE: IV, systematic review of level III and IV studies.

Family Complexity, Siblings, and Children's Aggressive Behavior at School Entry.

As family structure in the United States has become increasingly dynamic and complex, children have become more likely to reside with step- or half-siblings through a variety of pathways. When these pathways are accounted for, more than one in six U.S. children live with a step- or half-sibling at age 4. We use data from the Early Childhood Longitudinal Study-Birth Cohort (N ~ 6,550) to assess the independent and joint influences of residing with a single parent or stepparent and with step- or half-siblings on children's aggressive behavior at school entry. The influences of parents' union status and complex sibship status on aggressive behavior are independent. Family resources partially explain the association between residing with an unpartnered mother and aggressive behavior regardless of sibship status. However, the resource hypothesis does not explain the association of complex sibship with aggressive behavior.