U.S. Trends in Adolescent Substance Use and Conduct Problems and Their Relation to Trends in Unstructured In-Person Socializing With Peers.

PURPOSE: This study examined whether national trends in unstructured in-person socializing with peers (i.e., socializing without goals or supervision) among adolescents could help explain recent declines in adolescent risk behaviors (e.g., substance use, fighting, theft). METHODS: The sample contained of 44,842 U.S. 12th-grade students (aged 17-18 years) from the Monitoring the Future survey (years 1999-2017). Analyses examined (1) prevalence trends, (2) latent factor structure of risk behaviors and unstructured in-person socializing, and (3) whether trends in the unstructured in-person socializing factor accounted for the relationship between time (i.e., survey year) and the risk behavior factor. RESULTS: Adolescent risk behaviors and unstructured in-person socializing declined by approximately 30% in the U.S., and both formed coherent latent factors. After adjusting for sociodemographics, declines in unstructured in-person socializing accounted for approximately 86% of declines in risk behaviors. CONCLUSIONS: The prevalence of risk behaviors and unstructured in-person socializing behaviors declined among U.S. 12th graders from 1999 to 2017. It is unknown whether such effects are directly causal and/or influenced by unmeasured variables. However, the results provide evidence that national declines in unstructured in-person socializing are a likely component of the explanation for national declines in adolescent risk behaviors.

Using mixed methods to understand women's parenting practices related to their child's outdoor play and physical activity among families living in diverse neighborhood environments.

A convergent parallel mixed methods design was used to understand parenting practices for outdoor play, their influence on adolescent's physical activity and outdoor play and the role of the neighborhood and child's sex. Adolescents (n = 263) and their parents completed questionnaires and wore accelerometers. Parents (n = 30) participated in in-depth interviews. Parenting practices were examined by neighborhood disadvantage and child's sex in quantitative (Chi-square and T-tests) and qualitative (comparative thematic analysis) samples. Multi-level linear mixed models examined the associations between parenting practices and two adolescent outcomes: physical activity and outdoor play. Parents in high disadvantage neighborhoods and of female adolescents imposed more restrictions on outdoor play. Restrictive parenting practices were negatively associated with outdoor play, but not physical activity. Policy and environment change that improves neighborhood conditions may be necessary to reduce parents' fear and lessen restrictions on outdoor play.

A clinical and immunological study of children with chronic hepatitis B virus infection.

AIM: To identify the clinical status and immunological profile of a cohort of children with chronic hepatitis B virus (HBV) infection to assess the short-term consequences of this infection. MATERIAL AND METHODS: This prospective case-control study included 30 children in the age range 1-15 years with positive HBsAg attending the Hepatology clinic of Alexandria University Children's Hospital. Twenty children received lamivudine (3 mg/kg, oral, once a day), and 10 children were lamivudine-resistant and received entecavir treatment (10-11 kg/0.3 mg to > 30 kg/1 mg). They were followed up every 3 months for 1 year. RESULTS: The study showed that 97% of the studied cases were discovered accidentally during routine investigations and only 3% presented by acute hepatitis. Ninety percent of them had family member infection with HBV, of which 70% were the mother. Eighty-seven percent of cases had no clinical signs, and only 13% of cases had hepatomegaly. All of the cases were HBsAg positive, 50% were HBeAg positive, 56.7% were HBeAb positive, 33.3% were HBcAb positive, and 100% were HBsAb negative. CONCLUSIONS: Most of children with HBV infection had associated family member infection and were accidentally discovered. Despite a marked decrease in HBV DNA level after treatment, there was no clearance of HBsAg and no HBsAb seroconversion. Screening for the HBsAb level in children with family members with HBV is recommended.

Neighborhood Influences on Women's Parenting Practices for Adolescents' Outdoor Play: A Qualitative Study.

Understanding factors that influence parenting decisions for outdoor play is necessary to promote physical activity during critical years for adolescent adjustment. This study explored physical and social environmental influences on parenting decisions and rules for their child's outdoor play using semistructured in-depth interviews with parents (n = 30, 29 of whom were mothers) of adolescents. Mothers from low- (n = 16) and high-disadvantage (n = 13) neighborhood environments were recruited to identify environmental factors that resulted in parenting decisions that either promoted or hindered outdoor play and identify differences across neighborhood types. Data were analyzed using a grounded theory approach. Mothers limit their child's independent play, as well as the location and time of outdoor play, due to both social and physical aspects of their neighborhood. Seven themes (safety, social norms, sense of control, social cohesion and neighborhood composition, walkability, and access to safe places for activity) were identified as influencers of parenting practices. Mothers in high-disadvantage neighborhoods reported facing greater neighborhood barriers to letting their child play outside without supervision. Physical and social neighborhood factors interact and differ in low- and high-disadvantage neighborhoods to influence parenting practices for adolescent's outdoor play. Community-level interventions should target both physical and social environmental factors and be tailored to the neighborhood and target population, in order to attenuate parental constraints on safe outdoor play and ultimately increase physical activity and facilitate adolescent adjustment among developing youth.