Gateway to Curiosity: Medical Marijuana Ads and Intention and Use during Middle School

Abstract Over the past several years, medical marijuana has received increased attention in the media, and marijuana use has increased across the United States. Studies suggest that as marijuana has become more accessible and adults have become more tolerant regarding marijuana use, adolescents perceive marijuana as more beneficial and are more likely to use if they are living in an environment that is more tolerant of marijuana use. One factor that may influence adolescents' perceptions about marijuana and marijuana use is their exposure to advertising of this product. We surveyed 6 th -8 th grade youth in 2010 and 2011 in 16 middle schools in southern California (n= 8214; 50% male; 52% Hispanic; mean age = 13) and assessed exposure to advertising for medical marijuana, marijuana intentions and marijuana use. Cross-lagged regressions showed a reciprocal association of advertising exposure with marijuana use and intentions during middle school. Greater initial medical marijuana advertising exposure was significantly associated with a higher probability of marijuana use and stronger intentions to use one year later, and initial marijuana use and stronger intentions to use were associated with greater medical marijuana advertising exposure one year later. Prevention programs need to better explain medical marijuana to youth, providing information on the context for proper medical use of this drug and the potential harms from use during this developmental period. Furthermore, as this is a new frontier, it is important to consider regulating medical marijuana advertisements, as is currently done for alcohol and tobacco products. Keywords adolescents; medical marijuana; advertising; marijuana use Teen marijuana use is rising across the United States HHS Public Access Author Manuscript Author Manuscript Author Manuscript Author Manuscript risk youth found that most of these youth perceived marijuana use as "normal," with 90% voicing positive attitudes toward marijuana use In this study, we focus on advertising for medical marijuana. People who have a medical marijuana card typically have a doctor's recommendation to use marijuana, and are afforded some protection from arrest and criminal sanctions. Some studies have begun to assess how legalization of medical marijuana has affected attitudes toward marijuana. In a large study in Montana across several counties, Friese and Grube (2013) assessed 17,482 adolescents age 13-19 and examined the association between adolescent marijuana use and voter approval of medical marijuana and number of medical marijuana cards issued. They found that youth were more likely to report greater lifetime and past 30 day use of marijuana when they lived in counties with a higher percentage of voters approving legalization of medical marijuana; the number of medical marijuana cards was not related to marijuana use Exposure to medical marijuana advertising may be an important influence on adolescents' perceptions about marijuana and marijuana use. Many studies have shown, for example, that there is a strong association between alcohol advertising and subsequent drinking among youth Given the potential problems that marijuana use during adolescence can cause in later life, we need to better understand the factors that may affect intentions to use and initiation during this developmental period. We know of no prior research in this area; therefore, the current longitudinal study takes an important first look at the cross-lagged associations of advertising for medical marijuana on younger adolescents' intentions to use marijuana in the next six months and their actual marijuana use. We examined cross-lagged associations longitudinally because the reinforcing spirals model of media exposure and risk behavior has shown that exposure and behavior can mutually reinforce each other and potentially increase risk-taking behavior over time Method The sample comprised 6 th -8 th grade students initially recruited in 2008 in 16 middle schools across three school districts in southern California to evaluate the CHOICE substance use prevention program for middle school students (D 'Amico, et al., 2012). Schools were selected and matched to their nearest neighbor school based on the squared Euclidean distance measure, estimated using publicly available information on ethnic diversity, approximate size, and standardized test scores (D 'Amico, et al., 2012). Across all schools, 92% of parents returned a consent form at the baseline, and approximately 71% of parents gave permission for their child to participate in the original Author Manuscript Author Manuscript Author Manuscript Author Manuscript study. Ninety-four percent of consented students completed the baseline survey, which is higher or comparable to other school-based survey completion rates with this population We began to collect data on exposure to medical marijuana advertising at wave 4 because a proposition to legalize marijuana was being discussed in the California Senate in January 2010 and was added to the California ballot in November 2010 (California Proposition 19, also known as the Regulate, Control & Tax Cannabis Act). The mean age of the sample at this time was 13. Youth were ethnically and racially diverse (e.g., 52% Hispanic; 17% Asian) and rates of substance use across waves were comparable to national samples Surveys Responses were protected by a Certificate of Confidentiality from the National Institutes of Health; procedures were approved by the individual schools and the institution's internal review board. Covariates included age, gender, race/ethnicity, academic performance, and intervention status. Of note, there were no intervention effects on marijuana use, and initial intervention effects on alcohol use were no longer significant after wave 3 of the study (when we began collecting data on exposure to medical marijuana advertising); nonetheless, we controlled for CHOICE participation in the present analyses. Exposure to medical marijuana advertising: "In the past three months, how often have you seen advertisements for medical marijuana on billboards, in magazines, or somewhere else?" (response options ranged from 1=not at all to 7=every day). Advertising exposure was highly skewed and dichotomized as no exposure versus any exposure. Youth who were exposed reported seeing ads on average about once a month. Intention to smoke marijuana: "Do you think you will use any marijuana in the next six months?" (response options ranged from 1=definitely no to 4=definitely yes). Marijuana use: "During the past month, how many times did you use marijuana (pot, weed, grass, hash)?" (response options ranged from 1=0 days to 7=20 to 30 days). We dichotomized marijuana use into "any use" versus "no use" given that past month use rates were low, as expected for this age group, and models would not converge using the continuous measure. Results The analytic sample comprised 8,214 individuals who responded at waves 4 or 5. Maximum likelihood (ML) estimation was employed using Mplus 6.11 (Muthén & Muthén, 2011) with standard errors corrected for clustering at the school level. ML was used rather than the default WLSMV for several reasons. First, the assumptions that must be made when estimating models with missing data are more restrictive with WLSMV than with ML Twenty-two percent of adolescents at wave 4 and 30% at wave 5 reported seeing at least one advertisement for medical marijuana on billboards, in magazines, or somewhere else in the past three months. With regard to demographic and academic covariates, higher academic performance was associated with greater exposure to advertising (p < .01), being male (p = . 014), and Asian (relative to white; p < .01) were associated with being exposed to fewer advertisements. For marijuana use at wave 4, higher academic performance was associated with greater likelihood of use (p < .01) and being of Asian descent or other race was associated with lower likelihood of use (p < .01 and p = .03, respectively). For intentions to use, higher academic performance was associated with higher intentions (p < .01), and being of Asian descent (p < .01) was associated with lower intentions. For the cross-lagged regression models, at both waves, as expected, these younger adolescents reported fairly low levels of past month marijuana use (wave 4: 3.3%; wave 5: 4.8%) and low intentions to use in the next six months (wave 4: mean = 1.41, sd = 0.95; wave 5: mean = 1.48, sd = 0.98). Exposure to medical marijuana ads at wave 4 predicted stronger intentions to use (b = 0.73, SE=0.06, OR = 2.07, p < .001), and actual use (b = 0.79, SE = 0.25, OR = 2.20, p = .002) at wave 5. Thus, youth who reported seeing any ads for medical marijuana were twice as likely as youth who reported never seeing an ad to use marijuana and to report higher intentions to use marijuana one year later. Marijuana use at wave 4 (b = 1.07, SE = 0.10, OR = 2.92, p <.001) and intentions to use (b = 0.09, SE=0.03, OR = 1.09, p = 0.008) also predicted exposure to medical marijuana ads at wave 5. For example, youth who reported marijuana use were almost three times as likely to report seeing ads one year later

The Hispanic Paradox: Race/Ethnicity and Nativity, Immigrant Enclave Residence and Cognitive Impairment Among Older US Adults

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137472/1/jgs14806.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137472/2/jgs14806_am.pd

Validation of the surgical fear questionnaire in adult patients waiting for elective surgery

Objectives: Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity and reliability of the SFQ. Methods: Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis. Results: EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity. Discussion: The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.This study was conducted with departmental funding and supported by a grant from The Netherlands Organisation for Scientific Research (Zon-MW, http://www.zonmw.nl/en/), grant no. 110000007. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Legal linked data ecosystems and the rule of law

This chapter introduces the notions of meta-rule of law and socio-legal ecosystems to both foster and regulate linked democracy. It explores the way of stimulating innovative regulations and building a regulatory quadrant for the rule of law. The chapter summarises briefly (i) the notions of responsive, better and smart regulation; (ii) requirements for legal interchange languages (legal interoperability); (iii) and cognitive ecology approaches. It shows how the protections of the substantive rule of law can be embedded into the semantic languages of the web of data and reflects on the conditions that make possible their enactment and implementation as a socio-legal ecosystem. The chapter suggests in the end a reusable multi-levelled meta-model and four notions of legal validity: positive, composite, formal, and ecological

Impact of phenolic-rich olive leaf extract on blood pressure, plasma lipids and inflammatory markers: a randomised controlled trial

Purpose Dietary polyphenols have been demonstrated to favourably modify a number of cardiovascular risk markers such as blood pressure (BP), endothelial function and plasma lipids. We conducted a randomised, double-blind, controlled, crossover trial to investigate the effects of a phenolic-rich olive leaf extract (OLE) on BP and a number of associated vascular and metabolic measures. Methods A total of 60 pre-hypertensive [systolic blood pressure (SBP): 121–140 mmHg; diastolic blood pressure (DBP): 81–90 mmHg] males [mean age 45 (±SD 12.7 years, BMI 26.7 (±3.21) kg/m2] consumed either OLE (136 mg oleuropein; 6 mg hydroxytyrosol) or a polyphenol-free control daily for 6 weeks before switching to the alternate arm after a 4-week washout. Results Daytime [−3.95 (±SD 11.48) mmHg, p = 0.027] and 24-h SBP [−3.33 (±SD 10.81) mmHg, p = 0.045] and daytime and 24-h DBP [−3.00 (±SD 8.54) mmHg, p = 0.025; −2.42 (±SD 7.61) mmHg, p = 0.039] were all significantly lower following OLE intake, relative to the control. Reductions in plasma total cholesterol [−0.32 (±SD 0.70) mmol/L, p = 0.002], LDL cholesterol [−0.19 (±SD 0.56) mmol/L, p = 0.017] and triglycerides [−0.18 (±SD 0.48), p = 0.008] were also induced by OLE compared to control, whilst a reduction in interleukin-8 [−0.63 (±SD 1.13) pg/ml; p = 0.026] was also detected. Other markers of inflammation, vascular function and glucose metabolism were not affected. Conclusion Our data support previous research, suggesting that OLE intake engenders hypotensive and lipid-lowering effects in vivo

Facial Identity Recognition in the Broader Autism Phenotype

Peer reviewedPublisher PD

Population genomics applications for conservation: the case of the tropical dry forest dweller Peromyscus melanophrys

Recent advances in genomic sequencing have opened new horizons in the study of population genetics and evolution in non-model organisms. However, very few population genomic studies have been performed on wild mammals to understand how the landscape affects the genetic structure of populations, useful information for the conservation of biodiversity. Here, we applied a genomic approach to evaluate the relationship between habitat features and genetic patterns at spatial and temporal scales in an endangered ecosystem, the Tropical Dry Forest (TDF). We studied populations of the Plateau deer mouse Peromyscus melanophrys to analyse its genomic diversity and structure in a TDF protected area in the Huautla Mountain Range (HMR), Mexico based on 8,209 SNPs obtained through Genotyping-by-Sequencing. At a spatial scale, we found a significant signature of isolation-by-distance, few significant differences in genetic diversity indices among study sites, and no significant differences between habitats with different levels of human perturbation. At a temporal scale, while genetic diversity levels fluctuated significantly over time, neither seasonality nor disturbance levels had a significant effect. Also, outlier analysis revealed loci potentially under selection. Our results suggest that the population genetics of P. melanophrys may be little impacted by anthropogenic disturbances, or by natural spatial and temporal habitat heterogeneity in our study area. The genome-wide approach adopted here provides data of value for conservation planning, and a baseline to be used as a reference for future studies on the effects of habitat fragmentation and seasonality in the HMR and in TDF

Finding Diagnostically Useful Patterns in Quantitative Phenotypic Data.

Trio-based whole-exome sequence (WES) data have established confident genetic diagnoses in ∼40% of previously undiagnosed individuals recruited to the Deciphering Developmental Disorders (DDD) study. Here we aim to use the breadth of phenotypic information recorded in DDD to augment diagnosis and disease variant discovery in probands. Median Euclidean distances (mEuD) were employed as a simple measure of similarity of quantitative phenotypic data within sets of ≥10 individuals with plausibly causative de novo mutations (DNM) in 28 different developmental disorder genes. 13/28 (46.4%) showed significant similarity for growth or developmental milestone metrics, 10/28 (35.7%) showed similarity in HPO term usage, and 12/28 (43%) showed no phenotypic similarity. Pairwise comparisons of individuals with high-impact inherited variants to the 32 individuals with causative DNM in ANKRD11 using only growth z-scores highlighted 5 likely causative inherited variants and two unrecognized DNM resulting in an 18% diagnostic uplift for this gene. Using an independent approach, naive Bayes classification of growth and developmental data produced reasonably discriminative models for the 24 DNM genes with sufficiently complete data. An unsupervised naive Bayes classification of 6,993 probands with WES data and sufficient phenotypic information defined 23 in silico syndromes (ISSs) and was used to test a "phenotype first" approach to the discovery of causative genotypes using WES variants strictly filtered on allele frequency, mutation consequence, and evidence of constraint in humans. This highlighted heterozygous de novo nonsynonymous variants in SPTBN2 as causative in three DDD probands

Sustainability centres and fit: how centres work to integrate sustainability within business schools

For nearly as long as the topic of sustainable business has been taught and researched in business schools, proponents have warned about barriers to genuine integration in business school practices. This article examines how academic sustainability centres try to overcome barriers to integration by achieving technical, cultural and political fit with their environment (Ansari, Fiss, & Zajac, 2010). Based on survey and interview data, we theorise that technical, cultural and political fit are intricately related, and that these interrelations involve legitimacy, resources and collaboration effects. Our findings about sustainability centres offer novel insights on integrating sustainable business education given the interrelated nature of different types of fit and misfit. We further contribute to the literature on fit by highlighting that incompatibility between strategies to achieve different types of fit may act as a source of dynamism

Localization of type 1 diabetes susceptibility to the MHC class I genes HLA-B and HLA-A

The major histocompatibility complex (MHC) on chromosome 6 is associated with susceptibility to more common diseases than any other region of the human genome, including almost all disorders classified as autoimmune. In type 1 diabetes the major genetic susceptibility determinants have been mapped to the MHC class II genes HLA-DQB1 and HLA-DRB1 (refs 1-3), but these genes cannot completely explain the association between type 1 diabetes and the MHC region. Owing to the region's extreme gene density, the multiplicity of disease-associated alleles, strong associations between alleles, limited genotyping capability, and inadequate statistical approaches and sample sizes, which, and how many, loci within the MHC determine susceptibility remains unclear. Here, in several large type 1 diabetes data sets, we analyse a combined total of 1,729 polymorphisms, and apply statistical methods - recursive partitioning and regression - to pinpoint disease susceptibility to the MHC class I genes HLA-B and HLA-A (risk ratios >1.5; Pcombined = 2.01 × 10-19 and 2.35 × 10-13, respectively) in addition to the established associations of the MHC class II genes. Other loci with smaller and/or rarer effects might also be involved, but to find these, future searches must take into account both the HLA class II and class I genes and use even larger samples. Taken together with previous studies, we conclude that MHC-class-I-mediated events, principally involving HLA-B*39, contribute to the aetiology of type 1 diabetes. ©2007 Nature Publishing Group