The combined effects of adverse childhood experiences and neighborhood quality on child health and well-being.

BACKGROUND: Many studies have investigated the effects of adverse childhood experiences (ACEs) on the health, development, and well-being of children and adolescents. However, most studies have failed to examine whether childhood adversity and ecological factors interact to influence relevant health outcomes. OBJECTIVE: We used pooled data from the 2018-19 National Survey of Children's Health (n = 24,817) to assess the relationship between ACEs, neighborhood quality, and three domains of adolescent health and well-being: mental health (i.e., symptoms of anxiety problems and depression), neurodevelopmental health, and behavioral problems. METHODS: Nine types of ACEs were captured in the NSCH data. Logistic regression models were employed to explore the relationship between ACEs, neighborhood quality, and adolescent health and well-being. RESULTS: Our results indicate that ACEs are associated with each of these domains, with higher ACE scores associated with a higher risk of detrimental outcomes. Neighborhood disorder is also associated with several outcomes. Consistent with our expectations, in the presence of neighborhood disorder the association between higher ACEs exposure and behavior/conduct problems or neurodevelopmental disorders is larger. CONCLUSIONS: Our results have important implications for understanding how individual and contextual factors may combine to influence child health and behaviors, as well as offering policy recommendations that might help children who experience traumatic events.

Is social capital durable?: How family social bonds influence college enrollment and completion.

A large literature demonstrates that social capital has positive effects on outcomes for children, but we know little about whether social capital is durable, i.e., whether its effects persist long after its creation. We use two nationally representative data sets of U.S. high school students and structural equation modeling designed for binomial outcomes to examine the durability of returns to social capital created in the family on both college enrollment and college completion. Controlling for selected school characteristics, race, family, SES and other factors, results suggest that family social capital continues to have strong associations with outcomes increasingly distant from its creation. Family SES has a smaller but positive effect on both college enrollment and college completion. These findings suggest that social capital can be a durable good if formed in the family, and that family SES is also influential.

Measuring adverse childhood experiences with latent class trajectories.

BACKGROUND: Adverse childhood experiences (ACEs) are associated with several negative health and behavioral outcomes during adolescence, but most of the extant research has employed ACEs scores at one or two time points. Studies have not assessed whether latent class ACEs trajectories affect adolescent problem behaviors and conditions. OBJECTIVES: We used longitudinal data from the Fragile Families and Child Wellbeing Study (FFCWS, n = 3444) to assess ACEs at several time points and empirically developed latent class trajectories. We then examined the sociodemographic characteristics of youth who belonged to each trajectory group. We next evaluated whether the ACEs trajectories during childhood were associated with delinquent behavior, substance use, and symptoms of anxiety or depression. Finally, we explored whether closeness to mother buffered the impact of ACEs on these outcomes. METHODS: Eight types of ACEs were captured in the FFCWS data. ACE scores were assessed at year one, three, five, and nine, along with the outcomes during year 15. Trajectories were estimated with a semiparametric latent class models. RESULTS: The analysis revealed three latent trajectories during childhood: a low/none ACEs group, a medium exposure group, and a high exposure group. Adolescents in the high exposure group manifested a heightened risk of involvement in delinquent behaviors and substance use. They also reported more symptoms of anxiety and depression than their peers in the low/none and medium exposure groups. CONCLUSIONS: Repeated exposure to ACEs during childhood can have serious negative repercussions in the lives of adolescents, but maternal closeness may buffer their effects. Scholars should continue to examine the dynamics of ACEs exposure during childhood by using empirical approaches appropriate for identifying age-graded trajectories.

Family Structure, Unstructured Socializing, and Heavy Substance Use among Adolescents.

BACKGROUND: Psychoactive substance use is a transient behavior among many adolescents and diminishes as they mature, but some engage in heavy forms of substance use, which increases their risk of health and behavioral challenges. A consistent predictor of substance use among youth is family structure, with adolescents living in single-parent, stepparent, or no-parent families at higher risk than others of several forms of substance use. The objective of this research was to investigate whether unstructured socializing mediated the association between family structure and heavy alcohol or substance use. METHODS: Data from 30 nations (n = 65,737) were used to test the hypothesis using a generalized structural equation model and tests of mediation. RESULTS: The analysis furnished clear support for a mediation effect among adolescents living with a single parent but less support among those living with a stepparent or neither parent. CONCLUSION: The association between living in a single-parent household and heavy alcohol or other substance use was mediated largely by time spent outside the home with friends in unsupervised activities. Additional research that uses longitudinal data and more nuanced measures of family structure is needed to validate this finding.

Cumulative Stressors and Adolescent Substance Use: A Review of 21st-Century Literature.

The aim of this review is to assess empirical studies from the last 2 decades that have examined the association between cumulative stressors and adolescent substance use. Cumulative stressors were measured in these studies with adverse childhood experiences or adolescent stressful life events inventories. The 109 articles meeting the eligibility criteria that emerged from the review demonstrated a consistent, yet modest, association between cumulative stressors and adolescent substance use. Of note, several studies found that the associations were moderated or mediated by genetic factors related to cortisol regulation, intrapersonal factors such as low self-control, or interpersonal factors such as peer substance use. The review's findings thus suggest that efforts to reduce the effects of cumulative stressors on substance use could gainfully identify and target these risk moderators and mediators.

Social Learning, Social Bonds, Self-Control and Adolescent Nicotine Vaping.

OBJECTIVES: The aim of this study was to examine whether three theories of adolescent substance use-social learning, social bonding, and self-control-were useful for predicting adolescent nicotine vaping. Methods: The analysis utilized data on U.S. 8th and 10th grade students from the 2017 and 2018 Monitoring the Future (MTF) studies, repeated cross-sectional surveys that included 11,624 youth who responded to questions about past 12-month nicotine vaping. Measures from each of the three theories were used to predict the outcome using a zero-inflated negative binomial model. Results: The results demonstrated that variables from social learning and self-control theories were key predictors of nicotine vaping. Friends' substance use appeared as the most consequential predictor, followed by low self-control or higher risk-taking propensities. An interaction effect also suggested that friends' substance use had a stronger association with nicotine vaping among youth who reported higher self-control. Conclusions/Importance: The findings suggested that adolescent nicotine vaping is a consequence of social learning influences and low self-control. Future research should explore these and similar factors in more detail.

Cohabitation, Marijuana Use, and Heavy Alcohol Use in Young Adulthood.

BACKGROUND: Research on the association between cohabitation and substance use has been inconsistent, with some studies indicating an elevated risk among cohabiters and others finding either no difference in risk or a reduced risk of substance use. However, studies of this association have not utilized a causal modeling empirical framework. OBJECTIVES: The purpose of this research was to assess whether cohabitation has a causal effect on two forms of substance use among young adults: marijuana and heavy alcohol use. METHODS: Three waves of data from the National Survey of Youth and Religion (n = 2,202; 2002-2008), a representative sample of young adults in the United States, and an augmented inverse probability weighting (AIPW) model designed for multivalued treatment effects estimation, were used to assess the association between cohabitation and substance use. RESULTS: The findings indicated that cohabitation was associated with more frequent marijuana use only among females. Much of the effect of cohabitation, though, was due to previous factors, including substance use, that affected whether young adults cohabit or not. Moreover, there was no evidence that cohabitation had a causal impact on heavy alcohol use. Conclusions/Importance: There is little evidence that cohabitation has a causal impact on substance use in general. However, among young women, those who cohabited reported higher levels of marijuana use than those who remained single. Future research should address why this group is at particular risk of substance use.

Family Structure and Adolescent Substance Use: An International Perspective.

BACKGROUND: Numerous studies indicate that family structure is a key correlate of adolescent substance use. Yet there are some important limitations to this research. Studies have been conducted mainly in the United States, with relatively few studies that have compared family structure and youth substance use across nations. There is also a lack of recognition of the complexity of family types prevalent in contemporary global society. Moreover, there remains a need to consider personal, interpersonal, and macro-level characteristics that may help account for the association between family structure and youth substance use. OBJECTIVE: This study uses data from 37 countries to examine several models that purport to explain the association between family structure and substance use. METHODS: The data are from the 2005-2006 WHO-sponsored Health Behaviour in School-Aged Children (HBSC) (n = 193,202). Multilevel models, including linear, probit, and structural equation models (SEMs), were used to test several hypotheses. RESULTS: The results suggest that time spent with friends largely accounted for the association between specific types of family structures and frequency of alcohol use and getting drunk, but that cannabis use was negatively associated with living with both biological parents irrespective of other factors.

Conservative Protestantism and attitudes toward corporal punishment, 1986-2014.

Research indicates that conservative Protestants are highly supportive of corporal punishment. Yet, Americans' support for this practice has waned during the past several decades. This study aggregates repeated cross-sectional data from the General Social Surveys (GSS) to consider three models that address whether attitudes toward spanking among conservative Protestants shifted relative to those of other Americans from 1986 to 2014. Although initial results reveal a growing gap between conservative Protestants and the broader American public, we find that average levels of support have remained most robust among less educated conservative Protestants, with some erosion among more highly educated conservative Protestants. Moreover, trends in variability suggest that conservative Protestants exhibit more cohesive support for this practice than do others. These results provide a window into the cultural contours of religious change and the social factors that facilitate such change.

Who Has the Advantage? Race and Sex Differences in Returns to Social Capital at Home and at School.

A growing body of literature suggests that social capital is a valuable resource for children and youth, and that returns to that capital can increase academic success. However, relatively little is known about whether youth from different backgrounds build social capital in the same way and whether they receive the same returns to that capital. We examine the creation of and returns to social capital in family and school settings on academic achievement, measured as standardized test scores, for white boys, black boys, white girls, and black girls who were seniors in high school in the United States. Our findings suggest that while youth in different groups build social capital in largely the same way, differences exist by race and sex as to how family social capital affects academic achievement. Girls obtain greater returns to family social capital than do boys, but no group receives significant returns to school social capital after controlling for individual- and school-level characteristics.

An Algorithm for the Initial Management of Nasal Trauma.

Nasal fractures are the most common of all facial skeletal injuries. Untreated, these fractures frequently lead to functional and aesthetic problems. Careful history and physical assessment are critical to determine the extent of injury and to determine proper management. Critical aspects of assessment are discussed, as is the role of imaging in management. The unique aspects of pediatric nasal fractures and their management are reviewed. Fractures are classified based on the degree of injury and the involvement of the septum. A simple treatment algorithm is provided to help guide the selection of optimal treatment techniques. A review of instrumentation and treatment techniques is provided. The goal of treatment is to restore the nose to its preinjury shape and function and to minimize the need for secondary septorhinoplasty.

Local density effects on individual production are dynamic: insights from natural stands of a perennial savanna grass.

Perennial grasses are a dominant component of grasslands, and provide important ecosystem services. However, most knowledge of grasslands' functioning and production comes from plot-level studies, and drivers of individual-level production remain poorly explored. Extrapolation from existing experiments is hampered by the fact that these are mostly concentrated on even-aged cohorts, and/or on the early stages of a plant's life cycle. Here we explored how local density regulates individual production in mono-specific natural grassland, focusing on adult individuals of a perennial savanna grass (Stipagrostis uniplumis). We found individual production to increase with individuals' size, but to decrease with neighbour abundance. A metric of neighbour abundance that considered size was superior to a metric based solely on the number of individuals. This finding is particularly important for studying competitive effects in natural populations, where plants are normally not even-sized. The inferred competition kernel, i.e. the function describing how competitive strength varies with spatial distance from a target plant, was hump-shaped, indicating strongest intraspecific competition at intermediate distances (10-30 cm). The spatial signature of competitive effects changed with time since fire; peak effects moved successively away from the target plant. Our results suggest that inferred competition kernels of long-lived plant populations may have shapes that differ from exponential or sigmoidal decreases. More generally, results underline that competition among neighbouring plants is dynamic. Studies that address density-dependent and density-independent (fire-related) population dynamics of perennial grasses in their fire-prone environment may thus shed new light on the functioning and production of grasslands.

Increasing maternal healthcare use in Rwanda: implications for child nutrition and survival.

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline.

Parenting style, religiosity, peer alcohol use, and adolescent heavy drinking.

OBJECTIVE: The purpose of this research was to examine the associations of parenting style, religiosity, and peer alcohol use with alcohol use and heavy drinking. METHOD: Structural equation modeling was used to estimate direct and indirect associations among 5,419 adolescents ages 12-14 years from the National Longitudinal Study of Youth 1997. RESULTS: Adolescents whose parents were authoritative were less likely to drink heavily than adolescents who experienced neglectful or indulgent parenting styles. Religiosity was negatively associated with heavy drinking after other relevant variables were controlled for. CONCLUSIONS: Authoritative parenting appears to have both direct and indirect negative associations with the risk of heavy drinking among adolescents. Authoritative parenting, where monitoring and support are above average, and religiosity might help deter adolescents from heavy drinking, even when adolescents experience peer environments where alcohol use is common. Authoritarian parenting, although it was not associated with heavy drinking, was positively associated with alcohol use and peer alcohol use, thus placing adolescents at some risk.

Do family dinners reduce the risk for early adolescent substance use? A propensity score analysis.

The risks of early adolescent substance use on health and well-being are well documented. In recent years, several experts have claimed that a simple preventive measure for these behaviors is for families to share evening meals. In this study, we use data from the 1997 National Longitudinal Study of Youth (n = 5,419) to estimate propensity score models designed to match on a set of covariates and predict early adolescent substance use frequency and initiation. The results indicate that family dinners are not generally associated with alcohol or cigarette use or with drug use initiation. However, a continuous measure of family dinners is modestly associated with marijuana frequency, thus suggesting a potential causal impact. These results show that family dinners may help prevent one form of substance use in the short term but do not generally affect substance use initiation or alcohol and cigarette use.

Future trends and new materials.

The variety of products available as injectable fillers and neuromodulators continues to increase. New products are soon to be introduced in the United States that will enable the clinician to treat a greater array of esthetic problems and concerns. In addition, existing materials are being modified to allow for less painful treatments and easier product handling.

Parenting style, religiosity, peers, and adolescent heavy drinking.

OBJECTIVE: The purpose of this research was to examine whether authoritative, authoritarian, indulgent, and neglectful parenting styles were associated with adolescent alcohol use and heavy drinking, after controlling for peer use, religiosity, and other relevant variables. METHOD: Structural equation modeling was used to estimate direct and indirect associations of parenting style with alcohol use and heavy drinking among 4,983 adolescents in Grades 7-12. RESULTS: Adolescents whose parents were authoritative were less likely to drink heavily than adolescents from the other three parenting styles, and they were less likely to have close friends who used alcohol. In addition, religiosity was negatively associated with heavy drinking after controlling for other relevant variables. CONCLUSIONS: Authoritative parenting appears to have both direct and indirect associations with the risk of heavy drinking among adolescents. Authoritative parenting, where monitoring and support are above average, might help deter adolescents from heavy alcohol use, even when adolescents have friends who drink. In addition, the data suggest that the adolescent's choice of friends may be an intervening variable that helps explain the negative association between authoritative parenting and adolescent heavy drinking.

Seed ecology of an invasive alien species, Acacia longifolia (Fabaceae), in Portuguese dune ecosystems.

PREMISE OF THE STUDY: Worldwide, invasive plants threaten biodiversity, by disrupting habitats and ecosystem processes, and cause major economic losses. Invasiveness in plants is frequently associated with prolific production of seeds that accumulate in the soil. Knowledge of the extent and persistence of invasive seed banks helps explain invasion processes and enables management planning. A study of Acacia longifolia, an invasive species in Portuguese dune ecosystems, provides an informative example. • METHODS: Seed rain and dispersal (seed traps), the persistence of seeds in the soil (burial), and the extent of seed banks were measured and analyzed. • KEY RESULTS: Seed rain is concentrated under the canopy with about 12000 seeds · m(-2) falling annually. The number of seeds in the soil declined with time, with only 30% surviving after 75 mo. Losses were lowest at greater depths. Seed germinability was low (<12%), but viability was high (>85%) for surviving seeds. The seed bank under the canopy was approximately 1500 and 500 seeds · m(-2) in long- and recently invaded stands, respectively. Some seeds were found up to 7 m from the edge of stands, indicating that outside agencies facilitate dispersal. • CONCLUSIONS: Acacia longifolia produces large numbers of seeds, some of which are lost through germination, decay, and granivory. The remainder form vast and persistent seed banks that serve as a source of replenishment and make it difficult to control the invader once it is established. Control costs escalate as the duration of an invasion increases, highlighting the urgency of initiating and persevering with control efforts.

Are US mothers meeting the Healthy People 2010 breastfeeding targets for initiation, duration, and exclusivity? The 2003 and 2004 National Immunization Surveys.

Using data from the National Immunization Surveys (2003 and 2004), the authors model the influence of child, maternal, and state- or metropolitan-level factors on the initiation, duration, and exclusivity of breastfeeding to determine the characteristics of groups meeting the Healthy People 2010 targets. Analyses indicate that only children of college graduates meet the targets for breastfeeding at initiation, 6 months, and 12 months; no groups meet the target for exclusive breastfeeding. Results indicate a low prevalence of breastfeeding among children of single mothers, less educated mothers, participants in the Women, Children, and Infants program, and those living in nonwestern states and in areas of high newborn risk. Hispanic children, children of college graduates, and children living in the West consistently have higher odds of breastfeeding. Only the prevalence of breastfeeding early postpartum is near the Healthy People 2010 target of 75%, the percentages for 6 or 12 months and exclusive breastfeeding are well below.