BACKGROUND: Although there is considerable evidence that the development of tobacco dependence (TD) and that of alcohol use disorder (AUD) are intertwined, less is known about the comorbid development of these disorders. The present study examines tobacco dependence and alcohol use disorder comorbidity in young adulthood within the context of romantic partner relationships.

METHODS: Data were drawn from the Seattle Social Development Project, a contemporary, ethnically diverse, and gender balanced longitudinal panel including 808 participants. A typological person-centered approach was used to assign participants to four outcome groups: no disorder, tobacco dependence (TD) only, alcohol use disorder (AUD) only, and comorbid (both). Multinomial logistic regression was used to determine the association between partner general and substance-specific environments and single or dual alcohol and tobacco use disorder diagnosis in young adulthood (ages 24-33, n=628). Previous heavy alcohol and tobacco use were controlled for, as were dispositional characteristics, gender, ethnicity, adult SES, and adult depression.

RESULTS: Greater partner conflict increased the likelihood of being comorbid compared to having TD only or AUD only. Having a smoking partner increased the likelihood of being comorbid compared to having AUD only, but having a drinking partner did not significantly distinguish being comorbid from having TD only.

CONCLUSIONS: Findings demonstrated the utility of a comorbidity-based, person-centered approach and the influence of general and tobacco-specific, but not alcohol-specific, partner environments on comorbid alcohol and tobacco use disorders in young adulthood.

This study examines leading health indicators for childrearing women with disabilities, including health-related quality of life, chronic health conditions, adverse and preventive health behaviors, health care access, and social and emotional support. The study analyzes aggregated data from the Washington State Behavioral Risk Factor Surveillance System (n = 28,629). The weighted prevalence of key health indicators of childrearing women with disabilities (aged 18-59) are compared with childrearing women without disabilities. A series of adjusted logistic regression analyses are applied, controlling for confounding variables. When compared to childrearing women without disabilities, childrearing women with disabilities are less likely to have a partner or spouse, report lower income and education levels and are older. Childrearing women with disabilities, compared to childrearing women without disabilities, report significantly lower health-related quality of life including poor general health (adjusted odds ratio[AOR] = 6.85; p < .001), frequent mental distress (AOR = 4.02; p < .001), and frequent poor physical health (AOR = 9.34; p < .001); higher prevalence of chronic health conditions, including arthritis, cardiovascular diseases, diabetes, asthma, high blood pressure and cholesterol, and obesity (the range of AORs = 1.59 to 5.65; p < .001); higher prevalence of adverse health behaviors including smoking (AOR = 2.14; p < .001) and lack of exercise (AOR = 1.61; p < .001); more financial barriers to health care (AOR = 2.11; p < .001) and lack of social and emotional support (AOR = 2.05; p < .001) while controlling for age, education, income, and relationship status. Based on population level data, the study reveals that childrearing women with disabilities experience elevated risks of health disparities across many key health indicators, many of which are preventable and modifiable. These findings underscore the importance of identifying contributing factors and developing interventions to improve the health and quality of life of childrearing women with disabilities.

Traditionally, Japan has been regarded as a country with low crime. Comparative research has given insights into the extent of similarities and differences in crime between America and Japan. The importance of these studies is the examination of whether Western-established criminological knowledge is applicable to non-Western societies like Japan. Unfortunately, comparative self-report studies involving Japan and investigating youth offending are scarce. The current study investigates risk factors and self-reports of violence from Osaka and Seattle male youths. The findings reveal that Japanese male youths self-report a higher prevalence of violence than Seattle male youths. Risk factors for violence, issues of comparability, and prevalence versus strength of relationships of risk factors are examined. It is concluded that the higher prevalence of violence in Osaka is primarily a function of the higher prevalence of troubled peers and risk taking. The findings call for replication of this type of comparative research.

Latent class transition models track how individuals move among latent classes through time, traditionally assuming a complete set of observations for each individual. In this paper, we develop group-based latent class transition models that allow for staggered entry and exit, common in surveys with rolling enrollment designs. Such models are conceptually similar to, but structurally distinct from, pattern mixture models of the missing data literature. We employ group-based latent class transition modeling to conduct an in-depth data analysis of recent trends in chronic disability among the U.S. elderly population. Using activities of daily living data from the National Long-Term Care Survey (NLTCS), 1982-2004, we estimate model parameters using the expectation-maximization algorithm, implemented in SAS PROC IML. Our findings indicate that declines in chronic disability prevalence, observed in the 1980s and 1990s, did not continue in the early 2000s as previous NLTCS cross-sectional analyses have indicated.

Contemporary HIV prevention efforts are increasingly focused on those already living with HIV/AIDS (i.e., “prevention with positives”). Key to these initiatives is research identifying the most risky behavioral targets. Using a longitudinal design, we examined socio-demographic and psychosocial factors that prospectively predicted unprotected anal intercourse (UAI) in a sample of 134 HIV-seropositive men who have sex with men (MSM) initiating, changing, or re-starting an antiretroviral therapy regimen as part of a behavioral intervention study. Computer-based questionnaires were given at baseline and 6¬†months. In a sequential logistic regression, baseline measures of UAI (step 1), socio-demographic factors such as Latino ethnicity (step 2), and psychosocial factors such as crystal methamphetamine use, greater life stress, and lower trait anxiety (step 3) were predictors of UAI at 6¬†months. Problem drinking was not a significant predictor. Prevention efforts among MSM living with HIV/AIDS might focus on multiple psychosocial targets, like decreasing their crystal methamphetamine use and teaching coping skills to deal with life stress.

IMPORTANCE: Community-based efforts to prevent adolescent problem behaviors are essential to promote public health and achieve collective impact community wide. OBJECTIVE To test whether the Communities That Care (CTC) prevention system reduced levels of risk and adolescent problem behaviors community wide 8 years after implementation of CTC.

DESIGN, SETTING, AND PARTICIPANTS: A community-randomized trial was performed in 24 small towns in 7 states, matched within state, assigned randomly to a control or intervention group in 2003. All fifth-grade students attending public schools in study communities in 2003-2004 who received consent from their parents to participate (76.4% of the eligible population) were included. A panel of 4407 fifth graders was surveyed through 12th grade, with 92.5% of the sample participating at the last follow-up.

INTERVENTIONS: A coalition of community stakeholders received training and technical assistance to install CTC, used epidemiologic data to identify elevated risk factors and depressed protective factors for adolescent problem behaviors in the community, and implemented tested and effective programs for youths aged 10 to 14 years as well as their families and schools to address their community’s elevated risks. MAIN OUTCOMES AND MEASURES Levels of targeted risk; sustained abstinence, and cumulative incidence by grade 12; and current prevalence of tobacco, alcohol, and other drug use, delinquency, and violence in 12th grade.

RESULTS: By spring of 12th grade, students in CTC communities were more likely than students in control communities to have abstained from any drug use (adjusted risk ratio [ARR]‚Äâ= 1.32; 95% CI, 1.06-1.63), drinking alcohol (ARR‚Äâ= 1.31; 95% CI, 1.09-1.58), smoking cigarettes (ARR‚Äâ= 1.13; 95% CI, 1.01-1.27), and engaging in delinquency (ARR‚Äâ= 1.18; 95% CI, 1.03-1.36). They were also less likely to ever have committed a violent act (ARR‚Äâ= 0.86; 95% CI, 0.76-0.98). There were no significant differences by intervention group in targeted risks, the prevalence of past-month or past-year substance use, or past-year delinquency or violence.

CONCLUSIONS AND RELEVANCE: Using the CTC system continued to prevent the initiation of adolescent problem behaviors through 12th grade, 8 years after implementation of CTC and 3 years after study-provided resources ended, but did not produce reductions in current levels of risk or current prevalence of problem behavior in 12th grade. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01088542.

Although research has consistently demonstrated that condom use self-efficacy significantly predicts condom use, there has been little investigation of whether acute alcohol intoxication moderates this relationship. Because alcohol intoxication is often associated with increased sexual risk taking, further examination of such moderating effects is warranted. Using a community sample of young heterosexual women (n=436) with a history of heavy episodic drinking, this alcohol administration experiment examined the effects of intoxication and condom use self-efficacy on women’s condom negotiation and future condom use intentions. After a questionnaire session, alcohol condition (control, .10% target peak BAL) was experimentally manipulated between subjects. Participants then read and responded to a hypothetical risky sexual decision-making scenario. SEM analyses revealed that alcohol intoxication directly decreased women’s intentions to use condoms in the future. Women with greater condom use self-efficacy had stronger intentions to engage in condom negotiation; however, this effect was moderated by intoxication. Specifically, the association between condom use self-efficacy and condom negotiation intentions was stronger for intoxicated women than for sober women. These novel findings regarding the synergistic effects of alcohol intoxication and condom use self-efficacy support continued prevention efforts aimed at strengthening women’s condom use self-efficacy, which may reduce even those sexual risk decisions made during states of intoxication.

A robust link between early sexual initiation and sexual risk-taking behavior is reported in previous studies. The relationship may not be causal, however, as the effect of common risk factors is often not considered. The current study examined whether early initiation was a key predictor of risky sexual behavior in the 20s and 30s, over and above co-occurring individual and environmental factors. Data were drawn from the Seattle Social Development Project, a longitudinal panel of 808 youth. Early predictors (ages 10 to 15) and sexual risk taking (ages 21 to 24 and 30 to 33) were assessed prospectively. Early sexual initiation (before age 15) was entered into a series of probit regressions that also included family, neighborhood, peer, and individual risk factors. Although a positive bivariate relation between early sexual initiation and sexual risk taking was observed at both ages, the link did not persist when co-occurring risk factors were included. Behavioral disinhibition and antisocial peer influences emerged as the strongest predictors of sexual risk over and above early sexual initiation. These results suggest that early sexual initiation must be considered in the context of common antecedents; public health policy aimed at delaying sexual intercourse alone is unlikely to substantially reduce sexual risk behavior in young adulthood.

The dwindling supply of antibiotics that remain effective against drug-resistant bacterial pathogens has precipitated efforts to identify new compounds that inhibit bacterial growth using untapped mechanisms of action. Here, we report both (1) a high-throughput screening methodology designed to discover chemical perturbants of the essential, yet unexploited, process of bacterial iron homeostasis, and (2) our findings from a small-molecule screen of more than 30,000 diverse small molecules that led to the identification and characterization of two spiro-indoline-thiadiazoles that disrupt iron homeostasis in bacteria. We show that these compounds are intracellular chelators with the capacity to exist in two isomeric states. Notably, these spiroheterocyles undergo a transition to an open merocyanine chelating form with antibacterial activity that is specifically induced in the presence of its transition-metal target.

Research and theory strongly support the importance of situational determinants of substance use as targets for intervention, but few studies have systematically examined situational use characteristics in marijuana dependent adults. The present study describes situational use of marijuana in a population of 87 marijuana dependent adults and reports relationships with outcomes of treatment. Use in negative affective situations was independently associated with psychological distress, maladaptive coping strategies, lower self-efficacy, and poorer outcomes post-treatment. The findings were consistent with research on using drugs to cope with negative affect providing evidence of convergence between two different methods of assessing high risk situations for substance use. The results support continued emphasis on coping with negative affect as a target in treatments for marijuana dependence.