Sexual Fluidity: Implications for Population Research.

For the first time ever, national censuses have begun asking adults to report their sexual orientations. However, because such surveys provide only cross-sectional snapshots of populations, these data obscure one key complexity: that sexuality can be fluid, with sexual self-identification evolving over time. Drawing on unique, restricted-use data from the Population Assessment of Tobacco and Health, the current study documents the prevalence, correlates, and empirical consequences of sexual fluidity in the contemporary United States. Overall, about 1 in 11 American adults changed sexual identities over five annual surveys, including 6% of cisgender men, 11% of cisgender women, and 35% of gender minorities. Fluidity was particularly pronounced among young adults and among those who had ever identified as bisexual or "something else." Despite the frequency and patterning of sexual fluidity, accounting for fluidity did little to change observed patterns of disadvantage on three measures of sexual minority well-being: mental health, financial insecurity, and substance use. Given these facts, I argue that demographic research should foreground the complexities inherent in quantifying sexuality, focusing less on how many people "are" a given sexual orientation and more on the social dynamics that continue to produce sexual minority disadvantage.

Assessing target localization accuracy across different soft-tissue matching protocols using end-exhalation breath-hold cone-beam computed tomography in patients with pancreatic cancer.

The purpose of this study was to retrospectively assess target localization accuracy across different soft-tissue matching protocols using cone-beam computed tomography (CBCT) in a large sample of patients with pancreatic cancer and to estimate the optimal margin size for each protocol. Fifty-four consecutive patients with pancreatic cancer who underwent 15-fraction volumetric modulated arc therapy under the end-exhalation breath-hold condition were enrolled. Two soft-tissue matching protocols were used according to the resectability classification, including gross tumor volume (GTV) matching for potentially resectable tumors and planning target volume (PTV) matching for borderline resectable or unresectable tumors. The tolerance of the target localization error in both matching protocols was set to 5 mm in any direction. The optimal margin size for each soft-tissue matching protocol was calculated from the systematic and random errors of the inter- and intrafraction positional variations using the van Herk formula. The inter- and intrafraction positional variations of PTV matching were smaller than those of GTV matching. The percentage of target localization errors exceeding 5 mm in the first CBCT scan of each fraction in the superior-inferior direction was 12.6 and 4.8% for GTV and PTV matching, respectively. The optimal margin sizes for GTV and PTV matching were 3.7 and 2.7, 5.4 and 4.1 and 3.9 and 3.0 mm in the anterior-posterior, superior-inferior and left-right directions, respectively. Target localization accuracy in PTV matching was higher than that in GTV matching. By setting the tolerance of the target localization error, treatment can be successful within the planned margin size.

First use of cannabis compared to first use of alcohol and tobacco: Associations with single and poly-substance use behavior.

INTRODUCTION: Young adults report high rates of current cannabis use. The proliferation of legalized cannabis in the US has led to greater access and availability, causing cannabis to become the new "gateway" drug. This study examined the prevalence of trying cannabis before alcohol or tobacco and the association of initiation with cannabis first with single and poly-substance use in young adults. METHODS: METHODS: Data were analyzed from young adults (n=8062) in Waves 1 through 5 (2013-2019) of the Population Assessment of Tobacco and Health study who had ever tried alcohol, cannabis, or tobacco and provided age at first use of these substances. Weighted multivariable models examined associations between cannabis initiation before, at the same age, or after initiating alcohol or tobacco use with past 30-day substance use (alcohol, cannabis, tobacco, poly-substance use) in a subsequent wave (Waves 2-5). RESULTS: Initiating cannabis before alcohol and tobacco (6%) was rare. In adjusted regression models, initiating cannabis before alcohol and tobacco was associated with increased odds of past 30-day cannabis use, past 30-day tobacco use, and past 30-day polysubstance use and decreased odds of past 30-day alcohol use. Initiating cannabis at the same age as either alcohol or tobacco, or trying cannabis after these substances was associated with increased odds of all substance use outcomes. CONCLUSIONS: Cannabis initiation before alcohol and tobacco is uncommon and may even protect against future alcohol use. Deterring cannabis initiation with multiple substances could have public health benefits.

Prospective predictors of electronic nicotine delivery system initiation in tobacco naive young adults: A machine learning approach.

The use of electronic nicotine delivery systems (ENDS) is increasing among young adults. However, there are few studies regarding predictors of ENDS initiation in tobacco-naive young adults. Identifying the risk and protective factors of ENDS initiation that are specific to tobacco-naive young adults will enable the creation of targeted policies and prevention programs. This study used machine learning (ML) to create predictive models, identify risk and protective factors for ENDS initiation for tobacco-naive young adults, and the relationship between these predictors and the prediction of ENDS initiation. We used nationally representative data of tobacco-naive young adults in the U.S drawn from the Population Assessment of Tobacco and Health (PATH) longitudinal cohort survey. Respondents were young adults (18-24 years) who had never used any tobacco products in Wave 4 and who completed Waves 4 and 5 interviews. ML techniques were used to create models and determine predictors at 1-year follow-up from Wave 4 data. Among the 2,746 tobacco-naive young adults at baseline, 309 initiated ENDS use at 1-year follow-up. The top five prospective predictors of ENDS initiation were susceptibility to ENDS, increased days of physical exercise specifically designed to strengthen muscles, frequency of social media use, marijuana use and susceptibility to cigarettes. This study identified previously unreported and emerging predictors of ENDS initiation that warrant further investigation and provided comprehensive information on the predictors of ENDS initiation. Furthermore, this study showed that ML is a promising technique that can aid ENDS monitoring and prevention programs.

Development of a panel of U.S. adult tobacco users to inform tobacco regulatory science.

The National Panel of Tobacco Consumer Studies (TCS Panel) is a probability-based panel of about 4,000 U.S. adult cigarette, cigar, and smokeless tobacco users developed by the U.S. Food and Drug Administration's Center for Tobacco Products to conduct observational and experimental studies to inform tobacco regulatory activities. This paper describes the methods and characteristics of the current panel. The TCS Panel employed a stratified 4-stage sample design and in-person screening of U.S. sampled households. Selected eligible adults participated in an enrollment interview and completed a baseline survey assessing tobacco use behaviors to enroll in the Panel; 3,893 individuals were enrolled from September 2016-August 2017. Replenishment occurred from July 2019-December 2019 with 2,260 new members, for a current panel of 3,929 members. Demographic and tobacco use characteristics of the current panel were analyzed in 2020. Most demographic characteristics of the TCS Panel are similar to those of U.S. tobacco users in the 2018 National Health Interview Survey, suggesting a lack of systematic bias in the Panel. Small, but statistically significant, differences were observed in the proportion of 18- to 25-year-olds; high school diploma and bachelor's degree/higher; never married and married (p < 0.05 for all). The TCS Panel appears to be representative of U.S. cigarette, cigar, and smokeless tobacco users; such panels can be a feasible method for conducting tobacco regulatory science research. The TCS Panel has been used to field studies examining purchasing behaviors, receipt and use of free samples/coupons, and the impact of a hypothetical tobacco product standard.

The effect of race/ethnicity and adversities on smoking cessation among U.S. adult smokers.

INTRODUCTION: Black and Hispanic individuals in the US experience more socioeconomic adversities that are associated with disparities in tobacco use and cessation than White individuals. This study examined if racial/ethnic differences in smoking abstinence were mediated by socioeconomic (SES) adversities. METHODS: Data from 7,101 established smokers were identified in Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health (PATH) and followed to Wave 4 (2016-2018). The study outcome was cigarette abstinence at Wave 4. The main independent variable was race/ethnicity (Non-Hispanic White [White], Non-Hispanic Black [Black] and Hispanic). The mediators were five measures of SES adversities (unemployment, poverty, difficulty with money, lower education level, lack of health insurance). A weighted Generalized Structural Equation Model (GSEM) was used to estimate the total, direct, and indirect effect of race/ethnicity on the odds of quitting mediated by the five SES adversities. This model was adjusted by study covariates, including health and smoking characteristics. RESULTS: The indirect effect of race/ethnicity on cessation showed that differences in quitting between Black and White individuals as well as Hispanic and White individuals were mediated by SES adversities. However, the differences in quitting between Hispanic and Black individuals were not mediated by SES adversities. Black and Hispanic individuals were less likely to quit than White individuals, but Hispanic individuals were more likely to quit than Black individuals. There were no direct effects between Black or Hispanic individuals compared to White individuals. Those with higher SES were more likely to quit compared to those with lower SES. DISCUSSION: Smoking abstinence is higher in White individuals compared to Black and Hispanic individuals and is mediated by SES adversities. However, smoking abstinence is higher among Hispanic individuals compared to Black individuals and it is not mediated by SES adversities. Future studies should consider the role of other factors, such as psychosocial support, racism, discrimination, and stress over the life course in explaining differences in smoking abstinence between Black and Hispanic individuals.

Longitudinal transition outcomes among adult dual users of e-cigarettes and cigarettes with the intention to quit in the United States: PATH Study (2013-2018).

Many adult dual users of e-cigarettes and cigarettes in the United States report using e-cigarettes with the intention to quit (ITQ) smoking. This study examined transition outcomes among adult dual users of e-cigarettes and cigarettes with the ITQ compared to mono cigarette smokers with ITQ. We conducted a longitudinal analysis of 3,542 adults aged ≥ 18 years with data from Waves 1 and 4 of the United States Population Assessment of Tobacco and Health study (2013-2018) between May 2021 and January 2022. Current dual users (e-cigarettes and cigarettes use on ≥ 20 days in the past month) with the ITQ were compared to current mono cigarette smokers with the ITQ for transition outcomes (cessation, mono e-cigarette, mono cigarette and dual use) three years later. We conducted multinomial logistic regression modeling adjusting for potential confounders and reported the adjusted relative risk ratios (aRRR) with 95% confidence intervals (CI) for the transition outcomes. Approximately 10.7% (7.8-14.3) of dual users with the ITQ (in 2013) reported cessation (no past-month use of any tobacco) three years later, compared to 16.1% (14.6-17.7) of mono cigarette smokers. Dual users were 83% and 79% less likely to transition to cessation (aRRR: 0.17, 95% CI:0.09-0.32) or mono cigarette use (0.21, 0.14-0.32), respectively, compared to mono cigarette smokers. Our findings show that in a real-world scenario, dual e-cigarette and cigarette use may hinder rather than facilitate smoking cessation among those interested in quitting. This needs consideration when assessing the population impact of e-cigarettes and their role in harm reduction.

Youth risk profiles and their prediction of distal cannabis and tobacco co-use in the Population Assessment of Tobacco Health (PATH).

Background: Co-use of cannabis and tobacco is common and increases negative behavioral, physical and mental health consequences. This study aimed to describe latent profiles of youth internalizing and externalizing problems, sensation seeking, and family environment in the US and their relationships with substance co-use. Methods: Data come from the Population Assessment of Tobacco Health (PATH). Using latent profile analysis with a distal outcome, we conducted a secondary data analysis examining relationships between latent profiles and the distal outcome of cannabis/tobacco use and co-use one year later. Participants were a nationally representative sample of youth ages 12-17 (N = 13,651). Results: We identified five youth subgroups: (1;11%) Family Risk, (2;32%) Family Protection with Very Low Internalizing, (3;21%) Family Protection with High Youth Risk, (4;24%) Family Protection with Moderate Youth Risk, (5;12%) Family Risk with High Youth Risk. Relationships between group membership and tobacco/cannabis outcomes, one year later, indicated that the least likely tobacco/cannabis users were the Family Protection with Very Low Internalizing class (no lifetime use probability (PR)=0.86, standard error (SE)=0.007; no 30-day use PR = 0.96, SE = 0.004). In contrast, the Family Risk with High Youth Risk class had the highest probability of both co-use (lifetime co-use PR = 0.33; SE = 0.014; 30-day co-use PR = 0.10; SE = 0.010) and single substance use (probability of lifetime single substance use PR = 0.30; SE = 0.013; 30-day single substance use PR = 0.24; SE = 0.014). Conclusions: A "protective but reactive" risk buffering pattern effect of family factors on youth factors was observed in that the lowest rates of co-use were observed in the three classes with family protection. These findings highlight the need for interventions addressing multiple domains and focusing on youth and family risk factors.

Nicotine/tobacco use disparities among transgender and gender diverse adults: Findings from wave 4 PATH data.

BACKGROUND: Transgender and Gender Diverse (TGD) populations have current cigarette/e-cigarette/cigar use rates ranging from 32.6% to 39.7%. Importantly, while some studies have reported tobacco use as significantly higher among TGD versus cisgender individuals in multivariate analyses, others have reported no significant differences. The present study used data from wave 4 of the Population Assessment of Tobacco and Health (PATH) study, a large, nationally representative U.S. study, to examine relationships among sociodemographic characteristics, internal and external factors, and tobacco use behaviors, with a focus on TGD individuals. METHODS: Data were from 33,628 adults from the PATH study's wave 4 (collected December 2016-January 2018). Multivariable logistic regression models examined differences in current tobacco use (cigarettes, electronic nicotine products, and cigars) between TGD and cisgender individuals through the replication of previous work using PATH data, as well as evaluating the role of other internal and external factors. RESULTS: TGD individuals were 2-3 times more likely than cisgender individuals to report current nicotine/tobacco use, even after adjustment for potential confounders. TGD individuals tended to have lower income and education and be more likely to endorse a sexual minority identity than their cisgender counterparts; meanwhile, lower income, less education, and lesbian/gay and bisexual identities were significant predictors of nicotine/tobacco use, independent of TGD identity. CONCLUSIONS: Present findings underscore the high rates of nicotine/tobacco use in the TGNC community and emphasize the necessity of TGD-focused research methods and measures, access to quality medical care, and policy aimed at minimizing marginalization and nicotine/tobacco use disparities experienced by TGD communities.

Haematological and biochemical reference intervals for wild green turtles (Chelonia mydas): a Bayesian approach for small sample sizes.

Animal health is directly linked to population viability, which may be impacted by anthropogenic disturbances and diseases. Reference intervals (RIs) for haematology and blood biochemistry are essential tools for the assessment of animal health. However, establishing and interpreting robust RIs for threatened species is often challenged by small sample sizes. Bayesian predictive modelling is well suited to sample size limitations, accounting for individual variation and interactions between influencing variables. We aimed to derive baseline RIs for green turtles (Chelonia mydas) across two foraging aggregations in North Queensland, Australia, using Bayesian generalized linear mixed-effects models (n = 97). The predicted RIs were contained within previously published values and had narrower credible intervals. Most analytes did not vary significantly with foraging ground (76%, 22/29), body mass (86%, 25/29) or curved carapace length (83%, 24/29). Length and body mass effects were found for eosinophils, heterophil:lymphocyte ratio, alkaline phosphatase, aspartate transaminase and urea. Significant differences between foraging grounds were found for albumin, cholesterol, potassium, total protein, triglycerides, uric acid and calcium:phosphorus ratio. We provide derived RIs for foraging green turtles, which will be helpful in future population health assessments and conservation efforts. Future RI studies on threatened species would benefit from adapting established veterinary and biomedical standards.

Psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS) for use in population studies involving Brazilian children aged 0-59 months

Abstract Objective: To analyze the psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS). Methods: This methodological study was comprised of two axes. The first one aimed to analyze the instrument's construct validity (discriminant and concurrent validity) and internal consistency, and the second one examined test-retest reliability, involving two different samples and procedures. For construct validity and internal consistency, the sample was recruited in Embu das Artes-SP, Brasilia-DF and Recife-PE during the immunization campaign in 2017, involving caregivers of 2005 children under 60 months of age (1295 under 36 and 710 from 37 to 59 months). For the test-retest analysis the sample consisted of 30 children aged 0-59 months old that attended daycare centers in Embu das Artes-SP in 2018. Results: Multivariate analyses of construct validity showed that the QAD-PIPAS was able to identify the association between the outcome (suspected child development delays) and expected risk and protective factors based on Nurturing Care Framework (OMS/UNICEF). A significant positive correlation was achieved between the scores of the QAD-PIPAS and CREDI in six of the eight age groups analyzed, with the most significant correlations being in the age groups from 25 to 30 and 31-36 months. Acceptable internal consistencies were identified in all age groups, with better performance above 36 months of age (Cronbach's alpha between 0.61 to 0.80). We also found an adequate test-retest reliability (global Kappa 0.81). Conclusion: The QAD-PIPAS showed evidence of construct validity and reliability to be used in population studies involving children aged 0-59 months during multi-vaccination campaigns in Brazil.

Cannabis use among cancer survivors in the United States: Analysis of a nationally representative sample.

BACKGROUND: Research on cannabis use among those with a history of cancer is limited. METHODS: Prevalence of past-year cannabis use among individuals with and without a cancer history and predictors of use within these 2 groups were determined using data from the Population Assessment of Tobacco and Health study, a nationally representative, longitudinal survey conducted in the United States (waves 1-4; 2013-2018). Discrete time survival analyses were used to estimate baseline (wave 1) predictors (physical health status, mental health status, pain, and demographic variables) on past-year engagement with cannabis within individuals who reported a cancer diagnosis at wave 1 (n = 1022) and individuals who reported never having cancer at any wave (n = 19,702). RESULTS: At the most recent survey, 8% of cancer survivors reported past-year cannabis use, compared with 15% of those without a cancer history. Across 4 time points, an estimated 3.8% of cancer survivors engaged with cannabis, as compared to 6.5% of those without a cancer history. Across both groups, older age and having health insurance were associated with lower likelihood of engaging in cannabis use, whereas greater levels of pain were associated with higher likelihood of engaging in cannabis use. Among those without a cancer history, being female, White, and having better mental health status were associated with lower likelihood of engaging in cannabis use. CONCLUSIONS: Although cannabis use prevalence is lower among cancer survivors, the reasons for use are not markedly different from those without a cancer history. Continued monitoring of use, reasons for use, and harms or benefits is warranted. LAY SUMMARY: Results from this study, which uses data from the Population Assessment of Tobacco and Health Study, indicate that cannabis use is generally increasing across cancer survivors and those without a history of cancer. Cancer survivors are using cannabis at slightly lower rates than those without a history of cancer. Factors related to pain seem to be more prevalent in cancer populations relative to the general population, and could be contributing to cannabis use within cancer survivor populations.

Intention to lose weight and use of electronic cigarettes among adolescents.

Electronic cigarette use among American adolescents is a major public health concern given the negative health consequences of nicotine in youth. Recent literature has shown that weight control may be one motivation for use in this population. This study examined associations between intention to lose weight and e-cigarette use among adolescents having overweight or obesity from an ethnically diverse sample of Texas youth by gender. We performed a cross-sectional analysis of a state representative sample of 9056 eighth and eleventh grade students from the 2015-2016 Texas School Physical Activity and Nutrition (Texas SPAN) study. Validated survey items assessed weight intentions and e-cigarette use. Staff collected anthropometric measures. Logistic regression analysis was conducted to assess the relationship between e-cigarette use and weight intentions with gender interaction, adjusting for grade, race/ethnicity, economic status, weight-behaviors and stratified by BMI class. More than half (50.9%) of the weighted sample were Hispanic and 12.5% were Non-Hispanic Black; 8.5% used e-cigarettes; and 50.0% intended to lose weight. Of the 40.2% of the sample having overweight or obesity, 82.9% intended to lose weight. Among respondents with obesity, use of e-cigarettes was significantly higher among males intending to lose weight than among females intending to lose weight (12% versus 6%, p = 0.007). These findings contrast with previous research suggesting that e-cigarette use in females is more likely to be motivated by an intent to lose weight. The ethnic diversity of the Texas SPAN population may explain this discrepancy.

Cannabis, Vaping, and Respiratory Symptoms in a Probability Sample of U.S. Youth.

PURPOSE: The purpose of this study was to explore the association between respiratory symptoms among U.S. adolescents who were current (past 30-day) users of cigarettes, e-cigarettes, and/or cannabis, as well as lifetime users of cannabis with electronic nicotine delivery systems (ENDS). METHODS: Wave 4 from a national probability sample (N = 14,798) of adolescents (12-17 years) using Population Assessment of Tobacco and Health Study data was used for this study. Retention rate was 88.4%. RESULTS: The odds of indicating "wheezing or whistling" in the chest were roughly two times higher among those who had used cannabis in ENDS (adjusted odds ratio 1.81, 95% confidence interval 1.47-2.22); neither e-cigarettes nor cigarettes had a significant association with all five respiratory symptoms in the fully adjusted models. CONCLUSIONS: This study provides preliminary evidence that adolescents' cannabis use with ENDS may have negative health consequences. Lifetime cannabis use with ENDS was substantially associated with higher odds of respiratory symptoms.

Psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS) for use in population studies involving Brazilian children aged 0-59 months.

OBJECTIVE: To analyze the psychometric properties of the Child Development Assessment Questionnaire (QAD-PIPAS). METHODS: This methodological study was comprised of two axes. The first one aimed to analyze the instrument's construct validity (discriminant and concurrent validity) and internal consistency, and the second one examined test-retest reliability, involving two different samples and procedures. For construct validity and internal consistency, the sample was recruited in Embu das Artes-SP, Brasilia-DF and Recife-PE during the immunization campaign in 2017, involving caregivers of 2005 children under 60 months of age (1295 under 36 and 710 from 37 to 59 months). For the test-retest analysis the sample consisted of 30 children aged 0-59 months old that attended daycare centers in Embu das Artes-SP in 2018. RESULTS: Multivariate analyses of construct validity showed that the QAD-PIPAS was able to identify the association between the outcome (suspected child development delays) and expected risk and protective factors based on Nurturing Care Framework (OMS/UNICEF). A significant positive correlation was achieved between the scores of the QAD-PIPAS and CREDI in six of the eight age groups analyzed, with the most significant correlations being in the age groups from 25 to 30 and 31-36 months. Acceptable internal consistencies were identified in all age groups, with better performance above 36 months of age (Cronbach's alpha between 0.61 to 0.80). We also found an adequate test-retest reliability (global Kappa 0.81). CONCLUSION: The QAD-PIPAS showed evidence of construct validity and reliability to be used in population studies involving children aged 0-59 months during multi-vaccination campaigns in Brazil.

Latent class trajectories: U.S. adolescents' nicotine use and its association with nicotine dependence.

INTRODUCTION: Twenty-seven percent of adolescents used a nicotine/tobacco product in 2018. Our study analyzed three waves from the Population Assessment of Tobacco and Health (PATH) Study and examined adolescent nicotine/tobacco use trajectories over time to determine which latent classes were associated with symptoms of nicotine dependence. METHODS: The PATH Study used a four-stage, stratified area probability sample and annual household interviews with adolescents (12-17 years). Adolescents who indicated past 30-day nicotine/tobacco use at least once were included (n = 1101). We used latent class analysis (LCA) to identify nicotine/tobacco trajectories across three waves of PATH data and their association with six symptoms consistent with nicotine dependence from the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68). RESULTS: All types of past 30-day nicotine/tobacco use increased across the three waves. An LCA model fit was assessed using both the CIV and entropy measures in conjunction with the Vuong-Lo-Mendell-Rubin LRT. A five latent class solution had the lowest BIC value (BIC = 9784.272), and resulted in: (1) "Stable/consistent multiproduct use trajectory", (2) "Increasing cigarette use trajectory", (3) "Increasing e-cigarette use trajectory", (4) "Experimental (poly-nicotine/tobacco) use trajectory", and (5) "Increasing other nicotine/tobacco use trajectory". The most prevalent was the "Experimental (poly-nicotine/tobacco) use trajectory" (33.8%) although sex, race, and social class were associated with different trajectories. Those represented by the "Increasing cigarette use trajectory" (19.4%) reported significantly more past-year nicotine dependence symptoms (b = 1.73, p < 0.001) compared to the "Increasing e-cigarette use trajectory". Findings varied by sex and race. CONCLUSIONS: Results indicate that the relationship between e-cigarette use and other forms of nicotine/tobacco and substance use is complex and that adolescent nicotine/tobacco users are a heterogenous group with different risks for nicotine dependence. Findings can inform tailored prevention education and messaging for different groups of youth.

Length measurement accuracy of adaptive resolution imaging sonar and a predictive model to assess adult Atlantic salmon (Salmo salar) into two size categories with long-range data in a river.

Imaging sonars are used around the world for fish population monitoring. The accuracy of the length measurements has been reported in multiple studies for relatively short (<15 m) ranges and high image resolution. However, imaging sonars are often used at longer ranges (i.e., >15 m) where the images produced from sonar returns become less detailed. The accuracy of the length measurements from the Adaptive Resolution Imaging Sonar (ARIS) was tested by releasing n = 69 known-sized adult Atlantic salmon (Salmo salar) directly into the sonar field at ranges between 15 and 29 m, and measuring their echoes manually by four users and semi-automatically using a computer workflow in Echoview software. Overall, the length measurements were very variable: compared to true (fork) lengths, the mean of differences varied between -9.9 cm and 7.8 cm in the human-generated datasets, and between -42.8 cm and -20 cm in the computer-generated dataset. In addition, the length measurements in different datasets were only in poor or moderate agreement with each other (intraclass correlation <0.61). Contrary to our expectations, the distance from the transducer or the subjectively assessed echo quality did not have an effect on the measurement accuracy in most of the datasets and when it did, the effect was not systematic between the datasets. Therefore, a size class and length prediction model was implemented in a Bayesian framework to group salmon into two size categories: One-Sea-Winter (<63 cm) and Multi-Sea-Winter (≥63 cm) groups. The model correctly predicted the size category in 83% of the fish in the computer-generated dataset and ranged from 68% to 74% in the human-generated datasets. We conclude that fish length measurements derived from long-range imaging sonar data should be used with caution, but post-processing can improve the usefulness of the data for specific purposes, such as adult Atlantic salmon population monitoring.

Measuring early childhood development in Brazil: validation of the Caregiver Reported Early Development Instruments (CREDI) / Medição do desenvolvimento na primeira infância no Brasil: validação dosInstrumentos sobre o Desenvolvimento na Primeira Infância Relatado por Cuidadores(CREDI)

Abstract Objective The present study aims to analyze the psychometric properties and general validity of the Caregiver Reported Early Development Instruments (CREDI) short form for the population-level assessment of early childhood development for Brazilian children under age 3. Method The study analyzed the acceptability, test-retest reliability, internal consistency and discriminant validity of the CREDI short-form tool. The study also analyzed the concurrent validity of the CREDI with a direct observational measure (Inter-American Development Bank's Regional Project on Child Development Indicators; PRIDI). The full sample includes 1,265 Brazilian caregivers of children from 0 to 35 months (678 of which comprising an in-person sample and 587 an online sample). Results Results from qualitative interviews suggest overall high rates of acceptability. Most of the items showed adequate test-retest reliability, with an average agreement of 84%. Cronbach's alpha suggested adequate internal consistency/inter-item reliability (α > 0.80) for the CREDI within each of the six age groups (0-5, 6-11, 12-17, 18-23, 24-29 and 30-35 months of age). Multivariate analyses of construct validity showed that a significant proportion of the variance in CREDI scores could be explained by child gender and family characteristics, most importantly caregiver-reported cognitive stimulation in the home (p < 0.0001). Regarding concurrent validity, scores on the CREDI were significantly correlated with overall PRIDI scores within the in-person sample at r = 0.46 (p < 0.001). Conclusions The results suggested that the CREDI short form is a valid, reliable, and acceptable measure of early childhood development for children under the age of 3 years in Brazil.

Resumo Objetivo O presente estudo visa analisar as propriedades psicométricas e a validade geral do formulário curto dos Instrumentos sobre o Desenvolvimento na Primeira Infância Relatado por Cuidados (CREDI) para avaliação em nível populacional do desenvolvimento na primeira infância de crianças brasileiras com menos de três anos. Método O estudo analisou a aceitabilidade, a confiabilidade teste-reteste, a consistência interna e a validade discriminante da ferramenta CREDI. O estudo também analisou a validade concorrente do CREDI com uma medida observacional direta (Projeto Regional sobre os Indicadores de Desenvolvimento na Infância do Banco Interamericano de Desenvolvimento; PRIDI). A amostra total inclui 1.265 cuidadores brasileiros de crianças de 0 a 35 meses (678 em uma amostra presencial e 587 em uma amostra on-line). Resultados Os resultados das entrevistas qualitativas sugerem altas taxas gerais de aceitabilidade. A maior parte dos itens mostrou confiabilidade teste-reteste adequada, com concordância média de 84%. O coeficiente alfa de Cronbach sugeriu consistência interna/confiabilidade entre itens (α > 0,80) para o CREDI em cada uma das seis faixas etárias (0-5 α = 6-11, 12-17, 18-23, 24-29 e 30-35 meses de idade). As análises multivariadas da validade do constructo mostraram que uma proporção significativa da variação nas pontuações do CREDI pode ser explicada pelo sexo da criança e pelas características familiares, mais importante o estímulo cognitivo em casa relatado pelo cuidador (p < 0,0001). Com relação à validade concorrente, as pontuações do CREDI foram significativamente correlacionadas às pontuações gerais do PRIDI na amostra presencial em r = 0,46 (p < 0,001). Conclusões Os resultados sugerem que o formulário curto CREDI é uma medida válida, confiável e aceitável de desenvolvimento na primeira infância para crianças com menos de três anos no Brasil.

Prospective association of e-cigarette and cigarette use with alcohol use in two waves of the Population Assessment of Tobacco and Health.

BACKGROUND AND AIMS: Prior cross-sectional research finds that electronic cigarette (e-cigarette) use clusters with higher rates of harmful alcohol consumption in the United States adult population. The current study examined prospectively the association between e-cigarette use, cigarette use and the combined use of e-cigarettes and tobacco cigarettes and alcohol use outcomes. DESIGN: A nationally representative multi-wave cohort survey (wave 1: September 2013-December 2014, wave 2: October 2014-October 2015). SETTING: United States. PARTICIPANTS: A representative sample of civilian, non-institutionalized adults who completed waves 1 and 2 of the Population Assessment of Tobacco and Health survey (n = 26 427). MEASUREMENTS: Participants were categorized into exposure groups according to their e-cigarette and cigarette use during wave 1. Past 30-day alcohol use outcomes were (1) National Institute on Alcohol Abuse and Alcoholism (NIAAA)-defined hazardous alcohol use, (2) total alcohol drinks consumed and (3) alcohol-related consequences. FINDINGS: After controlling for socio-demographic risk factors and alcohol use at wave 1, all exposure groups showed higher odds of hazardous alcohol use [adjusted odds ratios (aORs) = 2.05-2.12, all P < 0.001] and reported higher past-month total drinks (B = 0.46-0.70, all P < 0.001) and more alcohol consequences (B = 0.63-0.89, all P ≤ 0.10) at wave 2 compared with non-users. Cigarette users (B = 0.24, P = 0.038) and dual e-cigarette/cigarette users (B = 0.32, P = 0.038) reported higher past-month total drinks compared with e-cigarette users. There was no conclusive evidence that non-daily use of e-cigarettes or cigarettes predicted poorer alcohol use outcomes compared with daily use. CONCLUSIONS: In the United States between 2013 and 2015, after adjustment for socio-demographic characteristics, cigarette and e-cigarette use were associated with alcohol use 1 year later.