Longitudinal associations between parental support and parental knowledge on behavioral and emotional problems in adolescents.

When testing longitudinal effects of parenting practices on adolescent adjustment, an integrated consideration of externalizing and internalizing behaviors is a gap in research. This study analyzed how parental support and parental knowledge directly and indirectly influence both antisocial behavior and emotional problems. The sample had 642 adolescents aged 12-15 (mean age = 12.49; 45.4% females) from Spain, who participated in a three-year long study. The results showed longitudinal bidirectional associations between parental support and parental knowledge. Only parental knowledge, however, directly predicted antisocial behavior and emotional problems. Parental support had an indirect effect on outcomes through the mediating effect of parental knowledge. This study has practical implications by indicating that increasing parental knowledge should be the target of educational-prevention programsS

Applicability of the Theory of Planned Behavior for Predicting Alcohol Use in Spanish Early Adolescents

According to the theory of planned behavior (TPB), intentions to perform a specific behavior are the result of attitudes, norms, and perceived control, and in turn, intentions and perceived control are the main predictors of the behavior. This study aimed to test the applicability of TPB in predicting alcohol use in normative pre-adolescents. The sample was composed of 755 Spanish adolescents aged 11 to 15 (M = 12.24; SD = 0.56), 47.1% females, from 12 state secondary schools in Spain. The results of path analysis indicate that positive attitudes towards alcohol, favorable norms towards alcohol, and offer vulnerability (perceived control) are significantly positively related to intentions to use alcohol as well as negatively related to actual behavioral control (i.e., actual strategies to avoid alcohol use). In turn, intentions to use and actual control predict higher alcohol frequency and heavy drinking. Significant indirect effects of these antecedents were found on alcohol outcomes through the mediation of intentions and actual control. The findings suggest that the validity and applicability of the TPB in normative pre-adolescents depend on the severity of alcohol use and point to a need to consider negative social influence in decision making processes in early adolescenceThis research was funded by the Global Center for Applied Health Research (GCAHR; Arizona State University) and supported by the Programa de Axudas á etapa posdoutoral da Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) and by FEDER/Ministerio de Ciencia, Innovación y Universidades—Agencia Estatal de Investigación (Grant PSI2015-65766-R)—under the Axuda para a consolidación e estruturación de unidades de investigación competitivas e outras accións de fomento nas universidades do SUG (GRC, 2018)S

Effectiveness of the mantente REAL program for preventing alcohol use in spanish adolescents

Mantente REAL is a school-based universal program to prevent drug use and other problematic behaviors specifically designed to be implemented in schools at the beginning of adolescence. This program, which is a culturally adapted version of the Keepin’ it REAL intervention, focuses on skills training for resisting social pressure to use drugs and improving psychosocial development. This study aims to evaluate the effectiveness of Mantente REAL on alcohol use in the Spanish context. The sample was composed of 755 adolescents from 12 state secondary schools in Spain, aged 11 to 15 (M = 12.24, SD = 0.56), 47.1% females. The 12 schools were randomly assigned to control and experimental groups, six to each condition. Pre-test and post-test questionnaires data were collected to evaluate the effectiveness of the program. The results indicated that a culturally adapted version of Mantente REAL was effective in preventing alcohol use among youth from northern and southern Spain. Students participating in the program demonstrated changes in the desired direction on alcohol frequency and intoxication episodes. Implications of these results regarding intervention programs aimed at preventing substance use in adolescence are discussed“Mantente REAL” es un programa universal que utiliza la escuela para prevenir el consumo de drogas y otras conductas problemáticas diseñado específicamente para ser implementado en las escuelas al comienzo de la adolescencia. Este programa, que es una versión culturalmente adaptada de la intervención Keepin’ it REAL, se centra en el entrenamiento de habilidades para resistir la presión social para consumir drogas y mejorar el desarrollo psicosocial. Este estudio tiene como objetivo evaluar la eficacia de “Mantente REAL” en el consumo de alcohol en el contexto español. La muestra estuvo compuesta por 755 adolescentes de 12 escuelas secundarias públicas en España, de 11 a 15 años (M = 12.24, DT = 0.56), el 47.1% mujeres. Las 12 escuelas fueron asignadas aleatoriamente a grupo control y experimental, seis en cada condición. Los datos se recopilaron a través de cuestionarios antes y después de la intervención para evaluar la eficacia del programa. Los resultados indicaron que la versión culturalmente adaptada de “Mantente REAL” fue eficaz para prevenir el consumo de alcohol entre los jóvenes del norte y sur de España. Los estudiantes que participaron en el programa demostraron cambios en la dirección deseada en la frecuencia del alcohol y los episodios de intoxicación. Se discuten las implicaciones de estos resultados con respecto a los programas de intervención destinados a prevenir el consumo de sustancias en la adolescenciaThis study was funded by the Global Center for Applied Health Research (Arizona State University) and supported by the Programa de Axudas á etapa posdoutoral da Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) and by FEDER/Ministerio de Ciencia, Innovación y Universidades – Agencia Estatal de Investigación (Grant PSI2015-65766-R) – under the Axuda para a consolidación e estruturación de unidades de investigación competitivas e outras accións de fomento nas universidades do SUG (GRC, 2018)S

Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction.

Prostate cancer is a highly heritable disease with large disparities in incidence rates across ancestry populations. We conducted a multiancestry meta-analysis of prostate cancer genome-wide association studies (107,247 cases and 127,006 controls) and identified 86 new genetic risk variants independently associated with prostate cancer risk, bringing the total to 269 known risk variants. The top genetic risk score (GRS) decile was associated with odds ratios that ranged from 5.06 (95% confidence interval (CI), 4.84-5.29) for men of European ancestry to 3.74 (95% CI, 3.36-4.17) for men of African ancestry. Men of African ancestry were estimated to have a mean GRS that was 2.18-times higher (95% CI, 2.14-2.22), and men of East Asian ancestry 0.73-times lower (95% CI, 0.71-0.76), than men of European ancestry. These findings support the role of germline variation contributing to population differences in prostate cancer risk, with the GRS offering an approach for personalized risk prediction

Characterizing Prostate Cancer Risk Through Multi-Ancestry Genome-Wide Discovery of 187 Novel Risk Variants

The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups

Germline variation at 8q24 and prostate cancer risk in men of European ancestry

Chromosome 8q24 is a susceptibility locus for multiple cancers, including prostate cancer. Here we combine genetic data across the 8q24 susceptibility region from 71,535 prostate cancer cases and 52,935 controls of European ancestry to define the overall contribution of germline variation at 8q24 to prostate cancer risk. We identify 12 independent risk signals for prostate cancer (p < 4.28 × 10−15), including three risk variants that have yet to be reported. From a polygenic risk score (PRS) model, derived to assess the cumulative effect of risk variants at 8q24, men in the top 1% of the PRS have a 4-fold (95%CI = 3.62–4.40) greater risk compared to the population average. These 12 variants account for ~25% of what can be currently explained of the familial risk of prostate cancer by known genetic risk factors. These findings highlight the overwhelming contribution of germline variation at 8q24 on prostate cancer risk which has implications for population risk stratification

Fine-mapping of prostate cancer susceptibility loci in a large meta-analysis identifies candidate causal variants

Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Prostate cancer is a polygenic disease with a large heritable component. A number of common, low-penetrance prostate cancer risk loci have been identified through GWAS. Here we apply the Bayesian multivariate variable selection algorithm JAM to fine-map 84 prostate cancer susceptibility loci, using summary data from a large European ancestry meta-analysis. We observe evidence for multiple independent signals at 12 regions and 99 risk signals overall. Only 15 original GWAS tag SNPs remain among the catalogue of candidate variants identified; the remainder are replaced by more likely candidates. Biological annotation of our credible set of variants indicates significant enrichment within promoter and enhancer elements, and transcription factor-binding sites, including AR, ERG and FOXA1. In 40 regions at least one variant is colocalised with an eQTL in prostate cancer tissue. The refined set of candidate variants substantially increase the proportion of familial relative risk explained by these known susceptibility regions, which highlights the importance of fine-mapping studies and has implications for clinical risk profiling. © 2018 The Author(s).Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Effects of a youth substance use prevention program on stealing, fighting, and weapon use

Using a sample of sixth graders in 11 public schools in a large Southwestern city, this longitudinal study examined how a model substance use prevention program, keepin’ it REAL, that was implemented in 7th grade, influenced three other problem behaviors (fighting, weapon use, stealing), measured in 8th grade. Using a non-equivalent control group design, we compared 259 students in the intervention to 322 students in a treatment-as-usual condition. At baseline, 37% of the sample reported fighting in the last 30 days; 31% reported stealing in the last 30 days, and 16% reported using a weapon in the last 30 days. Regression analyses adjusted for students nested in schools through multi-level modeling and for missing data through multiple imputation. We found that at posttest the rates of all three behaviors were lower in the intervention group than the control group at posttest: 35% versus 37% got into a fight in the last 30 days; 24% versus 31% stole something in the last 30 days; and 16% versus 25% used a weapon in the last 30 days. The program impact for fighting and stealing was not statistically significant and involved minimal effect sizes. The program impact for weapon use was not statistically significant but had an effect size comparable to that for other problem behavior interventions. Promoting positive development via life skills may be a key to broadening program impact