Global Burden of Chronic Obstructive Pulmonary Disease Through 2050.

Importance: Chronic obstructive pulmonary disease (COPD) is a respiratory condition that is associated with significant health and economic burden worldwide. Previous studies assessed the global current-day prevalence of COPD, but to better facilitate resource planning and intervention development, long-term projections are needed. Objective: To assess the global burden of COPD through 2050, considering COPD risk factors. Design, Setting, and Participants: In this modeling study, historical data on COPD prevalence was extracted from a recent meta-analysis on 2019 global COPD prevalence, and 2010 to 2018 historical prevalence was estimated using random-effects meta-analytical models. COPD risk factor data were obtained from the Global Burden of Disease database. Main Outcomes and Measures: To project global COPD prevalence to 2050, generalized additive models were developed, including smoking prevalence, indoor and outdoor air pollution, and development indices as predictors, and stratified by age, sex, and World Bank region. Results: The models estimated that the number of COPD cases globally among those aged 25 years and older will increase by 23% from 2020 to 2050, approaching 600 million patients with COPD globally by 2050. Growth in the burden of COPD was projected to be the largest among women and in low- and middle-income regions. The number of female cases was projected to increase by 47.1% (vs a 9.4% increase for males), and the number of cases in low- and middle-income regions was expected to be more than double that of high-income regions by 2050. Conclusions and Relevance: In this modeling study of future COPD burden, projections indicated that COPD would continue to affect hundreds of millions of people globally, with disproportionate growth among females and in low-middle income regions through 2050. Further research, prevention, and advocacy are needed to address these issues so that adequate preparation and resource allocation can take place.

Screen time, impulsivity, neuropsychological functions and their relationship to growth in adolescent attention-deficit/hyperactivity disorder symptoms.

Previous longitudinal studies found significant associations between screen time and increase in attention-deficit/hyperactivity disorder (ADHD) symptoms, but the mechanisms mediating this association remain understudied. Thus, we used data from a 5-year population-based longitudinal cohort of nearly 4000 Canadian high school students, modeled using multivariate multilevel mediation, to investigate the association of screen time (i.e., social media, television, video games, computer use) with ADHD symptoms via different potential behavioral and neuropsychological mediators (i.e. impulsivity, response inhibition, working memory). We studied direct and indirect between-person, concurrent within-person, and lagged-within-person effects of screens on ADHD symptoms. Results showed that increases in screen time in a given year were associated with an exacerbation of ADHD symptoms within that same year (within-person association), over and above potential common vulnerability (between-person association). Impulsivity proved to be the most robust mediator in the association of screen time with ADHD symptoms at both between and within-person levels. Only social media use displayed a significant lagged-within-person association with ADHD symptoms mediated by impulsivity, indicating an enduring influence on behavior, which was further shown to be mediated by chained changes in response inhibition on a Go/No-Go task. These findings provide clinical implications of screen time and should be an important focus in the management and prevention of ADHD symptoms among adolescents.

Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study.

Objectives: Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design: This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results: Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (ß = -0.076, 95% CI = -0.037 to -0.018, P = .000), of sleep on cannabis use (ß = -.016, 95% CI = -0.025 to -0.006, P = .007), of sleep on PLEs (ß = -0.077, 95%CI = -0.014 to -0.051, P = .000), and of PLEs on sleep (ß = -0.027, 95% CI = -0.037 to -0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (ß = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (ß = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions: Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.

Personality-specific pathways from bullying victimization to adolescent alcohol use: a multilevel longitudinal moderated mediation analysis.

Bullying victimization is common in adolescence and has been associated with a broad variety of psychopathology and alcohol use. The present study assessed time-varying associations between bullying victimization and alcohol use through internalizing and externalizing symptoms and whether this indirect association throughout time is moderated by personality. This 5-year longitudinal study (3,800 grade 7 adolescents) used Bayesian multilevel moderated mediation models: independent variable was bullying victimization; moderators were four personality dimensions (anxiety sensitivity, hopelessness, impulsivity, and sensation seeking); internalizing symptoms (anxiety, depressive symptoms) and externalizing symptoms (conduct, hyperactivity problems) were the mediators; and alcohol use, the outcome. Results indicated significant between, within, and lagged effects on alcohol use through internalizing and externalizing symptoms. There were significant between and within effects on alcohol use through internalizing symptoms for adolescents with high anxiety sensitivity and hopelessness, and significant between, within, and lagged effects on alcohol use through externalizing symptoms for adolescents with high impulsivity and sensation seeking. These findings implicate two risk pathways that account for how bullying victimization enhances alcohol use risk and emphasize the importance of personality profiles that can shape the immediate and long-term consequences of victimization.

Pathways from adolescent screen time to eating related symptoms: a multilevel longitudinal mediation analysis through self-esteem.

OBJECTIVE: Screen time and self-esteem have been shown to be important correlates of eating disorders in adolescence. However, there is an absence of longitudinal studies that distinguish between time-varying factors, accounting for parallel developmental changes and common underlying vulnerability. DESIGN: A total of 3,801 adolescents were administered self-report measures, annually, over the course of 5 years. The association of screen time (social media use, television watching, video gaming) on eating related symptoms was analyzed using a longitudinal Bayesian multilevel path analysis framework. Self-esteem was examined as a mediating factor in this model. This study investigated direct and indirect associations at between-person, concurrent within-person, and lagged-within-person levels, while controlling for gender. RESULTS: The findings revealed that all types of screen time exposure were significantly associated with eating related symptoms at between and within-person levels. A significant association at the lagged-within person level was only revealed for social media use. Self-esteem was found to be a significant mediating factor between screen time and eating related symptoms. CONCLUSION: An increase in social media use one year was associated with increased of eating related symptoms two years later through lower self-esteem. Implications for prevention are discussed.

Improvement in symptom-related disruptions is associated with fewer days of short-acting beta-agonist use in asthma.

Significant indirect healthcare costs are related to uncontrolled asthma, including productivity loss. Days with short-acting beta-agonist (SABA) use is associated with symptom-related disruptions at work, home, and school. Digital self-management platforms may support fewer days with SABA medication use and may reduce symptom-related disruptions.

Associations Between Video Game Engagement and ADHD Symptoms in Early Adolescence.

OBJECTIVE: We aim to investigate the direction of causality of the association between adolescent video game playing and later development of ADHD symptoms using a population-based sample of Canadian Youth. METHOD: The present study is based on longitudinal cohort data (N = 1,467). Youth self-reported weekly hours of video game playing as well as ADHD symptoms at both 12 and 13 years of age. RESULTS: Cross-lagged panel model were estimated to examine how adolescent video game playing prospectively contributes to ADHD symptoms while simultaneously considering how adolescent ADHD symptoms may prospectively contribute to videogame playing. Analyses revealed a significant positive association between adolescent video games playing at age 12 and ADHD symptoms at age 13. Youth ADHD symptoms at age 12 did not predict video game use at age 13. CONCLUSION: Our results help clarify the direction of causality of the association between video game playing and ADHD symptoms and provide evidence that video game playing can represent a risk factor for the development of attention problems in early adolescence.

Developmental Associations Between Media Use and Adolescent Prosocial Behavior.

Youth today spend a tremendous amount of time with digital media. The purpose of the present study was to estimate developmental associations between screen media use between the ages of 15 and 17 and corresponding changes in prosocial behavior. Participants (N = 1,509) were part of the Quebec Longitudinal Study of Child Development, a population-based study of children born in the province of Quebec, Canada. Youth self-reported internet and video game use and television or movies/DVD viewing, as well as prosocial behavior at the ages of 15 and 17. Analyses were conducted using multilevel linear modelling to account for between-, within-, and lagged-person effects. Internet and video game use accounted for less prosocial behavior at the within-person and lagged-person levels. Television use also accounted for lagged-person effects in prosocial behavior. Finally, internet use and television viewing contributed to between person differences in prosocial behavior. Our study presents strong statistical evidence that media use during adolescence can undermine the development of prosocial behavior.

Kindergarten Readiness, Later Health, and Social Costs.

OBJECTIVES: To estimate associations between kindergarten readiness and academic, psychological, and health risks by end of high school. METHODS: This study is based on 966 Canadian children. At age 5, trained examiners assessed child number knowledge and receptive vocabulary. Teachers reported kindergarten classroom engagement. At age 17, participants reported academic grades, school connectedness, anxiety sensitivity, substance abuse, physical activity involvement, and height and weight. High school dropout risk was also estimated for each participant on the basis of grades, school engagement, and grade retention. RESULTS: Kindergarten math skills contributed to better end-of high school grades (ß = .17, P < .01) and lower dropout risk (ß = -.20, P < .001), whereas receptive vocabulary predicted lower anxiety sensitivity (ß = -.11, P < .01). Kindergarten classroom engagement predicted higher end of high school grades (ß = .17, P < .001), lower dropout risk (ß = -.20, P < .01), better school connectedness (ß = .15, P < .01), lower risk of substance abuse (ß = -.21, P < .001), and more physical activity involvement (ß = .09, P < .05). Kindergarten classroom engagement was also associated with a 65% reduction (odds ratio = 0.35) in the odds of being overweight at age of 17. Analyses were adjusted for key child (sex, weight per gestational age, nonverbal IQ, and internalizing and externalizing behaviors) and family (parental involvement, maternal depression and immigrant status, family configuration, and socioeconomic status) characteristics. CONCLUSIONS: Early childhood readiness forecasts a protective edge by emerging adulthood. With these findings, we build links between education and health indicators, suggesting that children who start school prepared gain a lifestyle advantage. Promoting kindergarten readiness could reduce the health burden generated by high school dropout.

Corrigendum: Cognitive Function Impairments Linked to Alcohol and Cannabis Use During Adolescence: A Study of Gender Differences.

[This corrects the article DOI: 10.3389/fnhum.2020.00095.].

Cognitive Function Impairments Linked to Alcohol and Cannabis Use During Adolescence: A Study of Gender Differences.

Major neurocognitive changes occur during adolescence, making this phase one of the most critical developmental periods of life. Furthermore, this phase in life is also the time in which youth substance use begins. Several studies have demonstrated the differential associations of alcohol and cannabis use concerning the neurocognitive functioning of both males and females. Past and contemporary literature on gender-specific effects in neuroscience of addiction is predominantly based on cross-sectional datasets and data that is limited in terms of measurement variability. Given the importance of gender-specific effects in addiction studies, and in order to address the two above-mentioned gaps in the literature, the present study aimed to compare neurocognitive functioning of male and female adolescents in the context of cannabis and alcohol use, while employing a longitudinal design with multiple repeated measurements. Participants were 3,826 high school students (47% female; mean age, 12.7), who were recruited from 31 high schools in the greater Montreal area. Participants were requested to complete annual surveys for five consecutive years, from 7th to 11th grade, assessing their alcohol/cannabis use and neurocognitive functioning (working memory, delayed recall memory, perceptual reasoning, and inhibition control). The analytical strategy focused on the longitudinal association between each predictor (female, male) and each of the outcomes (domains of neurocognitive functioning). Multilevel linear models assessed the association of alcohol and cannabis consumption and the four domains of neurocognitive functioning. Results revealed a gender by within-subject interaction, suggesting a weaker effect of yearly fluctuation of cannabis use on working memory among males compared to females. Our findings suggest a different pattern of neurocognitive impairment of female and male working memory after using cannabis over the course of adolescence. Early initiation of cannabis use potentially results in more spatial working memory deficits in female adolescents. This may negatively influence young females' capacity in academic settings and lead to significant impairment in adulthood, which critically decreases the individual's quality of life.

A longitudinal study on the relationship between screen time and adolescent alcohol use: The mediating role of social norms.

BACKGROUND AND AIMS: It has been proposed that increased screen time contributes to increasing rates of adolescents abstaining from alcohol use. We argue that this proposition depends on the extent to which a type of screen time promotes social norms. We examined whether social norms mediated the association between alcohol use and i) social media, ii) television, and iii) video gaming. DESIGN: Multilevel models distinguishing between two time-varying factors: between-person effects and within-person effects. We used data from a randomized-controlled trial examining the efficiency of a personality-targeted substance use programme. PARTICIPANTS: 3612 adolescents (47% female, mean age = 12.7, SD = 0.5 years) were recruited from 31 schools in the Greater Montreal area. MEASUREMENTS: We estimated the association between three types of screen time (social media, television, and video gaming), alcohol-related social norms, and alcohol use. FINDINGS: Social norms mediated the association between social media use and alcohol use at both the between-person (ß = 0.09, 95% CI = 0.08, 0.11, p = .000) and within-person level (ß = 0.02, 95% CI = 0.01, 0.03, p = .000) and association between television use and alcohol use at the within-person level (ß = 0.01, 95% CI = -0.004, 0.01, p = .000). Social norms did not mediate the association between video gaming and alcohol use. CONCLUSIONS: Alcohol-related social norms were shown to mediate the association between social media use, both at a correlational and longitudinal level, and the association between alcohol use and television use and alcohol use, at a longitudinal level, which may imply that these promote positive social norms towards alcohol use, subsequently increasing adolescents' drinking behaviour.

Conversations about binge drinking among vocational community college students: the relation with drinking attitudes and intentions and the moderating role of conversation partner popularity.

Objective: The association between conversational valence (i.e. how positive/negative people perceive their conversations to be) and binge-drinking attitudes and intentions has been well established. However, too few studies have recognised a potential reciprocal association as well as the potential role of the conversation partner. In order to address these gaps, this study explored whether conversational valence and binge-drinking attitudes and intentions were reciprocally associated and whether this association was moderated by conversation partner popularity. Design: Vocational community college students (N = 112, Mage = 18.09) participated in a two-wave study (one month between the waves). Methods. Binge-drinking attitudes and intentions, and popularity were measured at baseline. At the second wave, conversational valence, and binge-drinking attitudes and intentions were assessed. Results: In revealing that only conversational valence was indicative of binge-drinking attitudes and intentions, it was shown that conversational valence and binge-drinking attitudes and intentions were not reciprocally associated. Furthermore, it was shown that conversation-partner popularity moderated the association between conversational valence and binge-drinking attitudes. Conclusion: Conversational valence was shown to be indicative of binge-drinking attitudes and intentions, and not vice versa. Furthermore, after talking to a popular conversation partner, adolescents' attitudes towards binge drinking became more positive.

Temporal Associations of Screen Time and Anxiety Symptoms Among Adolescents.

There are indications that screen time is associated with symptoms of anxiety in adolescents, but from a longitudinal perspective, the magnitude, specificity, and temporal precedence in this association are relatively under-explored. To address this gap, over the course of 4 years, we annually surveyed adolescents assessing their usage of various types of screen time per day and symptoms of anxiety.

Association of Screen Time and Depression in Adolescence.

IMPORTANCE: Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking. OBJECTIVE: To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals. DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018. MAIN OUTCOMES AND MEASURES: Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis. RESULTS: A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis. CONCLUSIONS AND RELEVANCE: Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.

Vocational Community College Students' Conversations about Binge Drinking.

The large amount of vocational community college students that continue showing binge-drinking behavior might be an indication that interventions targeting this behavior have not been hugely successful. It might be that these interventions targeted beliefs that are less or not related with vocational community college binge-drinking behavior. The aim of this study was to identify vocational community college students` salient beliefs about binge drinking. In the context of the integrative model of behavioral prediction, we applied deductive qualitative content analysis of conversations about binge drinking. The analysis of vocational community college students` conversations about binge drinking revealed a significant amount of salient beliefs, such as cognitive and affective outcome beliefs and efficacy beliefs. These beliefs may be important indicators of vocational community college students` binge drinking. Moreover, to our knowledge, this study was the first to reveal a new set of beliefs, namely social judgment beliefs (i.e., vocational community college students` judgments about their peers` binge-drinking behavior). We believe that our study yielded salient beliefs that may serve as input for future interventions targeting binge drinking among vocational community college students.

Is It More Feeling or Thinking? The Influence of Affective and Cognitive Attitude on Adolescents' Intention to Engage in Binge Drinking.

Previous work has revealed that interventions aiming to reduce adolescent binge drinking commonly focus on cognitive attitudes, but are insufficiently effective in changing binge-drinking intentions. The focus on these cognitive attitudes might be the reason for this insufficient success. That is, other work has revealed that affective attitudes have a stronger influence on binge-drinking intention than cognitive attitudes. However, this relation has so far only been found among traditional college students and pre-vocational school students, therewith neglecting another important population at risk, namely vocational community college students. This study examines whether affective attitudes are also significantly stronger influencers of binge-drinking intentions among vocational community college students. Using a sample of 298 vocational community college students (Mage = 17.63), the current study shows that affective attitudes were more strongly related to vocational community college students' intention to engage in binge drinking than cognitive attitudes. This finding indicates that the effectiveness of interventions targeting adolescent binge drinking can be improved by incorporating content elements concerning affective attitudes.