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Background: An important life‐course event with respect to alcohol and cannabis use is turning 21 years of age, which may be associated with increases in use of these substances due to celebrations during the month and easier access to them on and following this birthday. We examined the trajectories of alcohol and cannabis use behaviors in the months leading up to, during, and following the 21st birthday month. We also examined whether the use trajectories vary by college status and baseline levels of use. Methods: We used data from 203 young adults recruited from the Greater Seattle region who turned 21 during the course of the study. Surveys were administered each month for 24 consecutive months. Measures included the typical number of drinks per week for the past month, the frequency of heavy episodic drinking, the number of cannabis use days, and any simultaneous alcohol and cannabis use. Multilevel spline models were run that estimated linear slopes over time at four intervals: (1) up to 1 month before the 21st birthday month; (2) from 1 month before to the month of the 21st birthday; (3) from the 21st birthday month to 1 month following; and (4) from 1 month following the 21st birthday month through all following months. Results: Alcohol use, generally, and simultaneous alcohol and cannabis use showed sharp increases from the month before the 21st birthday month to the 21st birthday month and decreases following the 21st birthday month. For cannabis use, there were significant increases in the months leading up to the 21st birthday and no other significant changes during other time intervals. Patterns differed by baseline substance use and college status. Conclusions: Findings from the current study have implications for the timing and personalization of prevention and intervention efforts. Event‐specific 21st birthday interventions may benefit from incorporating content targeting specific hazardous drinking behaviors in the month prior to the 21st birthday. [ABSTRACT FROM AUTHOR]

Background: Simultaneous alcohol and marijuana (SAM) use has been associated with greater alcohol use and consequences at the daily level, but limited research has examined SAM use in relation to marijuana use and its consequences. This study tested daily associations between SAM use and four outcomes: alcohol use (number of drinks), marijuana use (hours high), negative alcohol consequences, and negative marijuana consequences. Methods: A community sample of young adults [ages 18–25, mean (SD) = 21.61 (2.17) years] with recent alcohol and SAM use was recruited (N = 409; 50.9% female; 48.2% non‐Hispanic/Latinx White). Participants completed a baseline survey and six 2‐week bursts of daily surveys (81.1% of morning surveys completed) and reported on substance use and negative substance‐related consequences. Multilevel modeling was used to test the main aims and to explore each specific consequence. Results: Among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total negative alcohol‐related consequences than non‐SAM use days. Among days with any marijuana use, SAM use days were associated with more hours being high than non‐SAM use days. Exploratory models showed that SAM use was related to five specific alcohol‐related consequences and two specific marijuana‐related consequences. Conclusions: These findings build upon prior research by showing that SAM use days are linked to consuming more drinks, reporting more hours being high from marijuana, and experiencing more total alcohol‐related consequences even after controlling for the number of drinks, the number of hours high, any tobacco/nicotine use, and any other substance use. SAM use was also associated with a greater likelihood of experiencing some specific consequences related to alcohol and marijuana. The findings underscore the need for additional research on SAM use and marijuana‐related outcomes. The current study found that, among days with any alcohol use, SAM use days were associated with consuming more drinks and experiencing more total alcohol consequences and also experiencing some specific alcohol consequences. Among days with any marijuana use, SAM use days were associated with more hours high and experiencing some specific marijuana consequences. Findings build on prior research by showing effects of SAM use even after controlling for number of drinks, number of hours high, and other substance use. [ABSTRACT FROM AUTHOR]

Background: The contexts in which young adults drink alcohol play a salient role in alcohol‐related outcomes and negative consequences at an event‐level, but less is known about longitudinal risks. We collected longitudinal monthly data across 2 years on (a) daytime drinking, (b) pregaming/pre‐partying, and (c) playing drinking games. We then examined associations between drinking in these contexts and within‐person variability in alcohol consumption, consequences, and simultaneous alcohol and marijuana (SAM) use in a given month. We also examined the extent to which drinking in these contexts predicted hazardous drinking (using Alcohol Use Disorders Identification Test (AUDIT) scores) at a distal follow‐up timepoint, controlling for baseline AUDIT scores. Method: A community sample of 759 young adults (Mage = 21.1 years; 56.4% female) completed monthly surveys for 24 consecutive months and a distal 30‐month follow‐up. Multilevel models estimated within‐ and between‐person associations between drinking context frequencies (daytime drinking, pregaming, drinking games) and alcohol‐related outcomes (weekly consumption, consequences, SAM use). A single‐level negative binomial regression tested associations between drinking context frequency averages across a two‐year period and changes in AUDIT scores from baseline to a follow‐up 2.5 years later. Results: Over 75% of the sample of non‐abstaining young adults reported drinking in each of the three contexts at least once during the 24‐month period. Within‐persons, young adults reported greater consumption, more negative consequences, and increased likelihood of SAM use during months that they drank in these contexts more often than usual. Each context was associated with negative consequences, even when controlling for alcohol use frequency. More frequent daytime drinking and pregaming, but not drinking games, were associated with increases in AUDIT scores at the 30‐month follow‐up, suggesting that there are potential long‐term risks of drinking in these contexts. Conclusions: Findings suggest that daytime drinking, pregaming, and playing drinking games are high‐risk contexts in terms of month‐to‐month and long‐term risks. Additional research is needed on the various contexts in which young adults drink alcohol and the extent to which contextual factors interact with one another to amplify/reduce risks and harms. [ABSTRACT FROM AUTHOR]

Background: Norm‐correcting interventions are an effective alcohol harm‐reduction approach, but innovation is needed to increase modest effect sizes. Recent social psychology research shows that individuals may be influenced by social norms that are increasing in prevalence. Contrary to static norms that reflect the current state of normative behavior, dynamic norms reflect behavioral norms that are shifting over time. This proof‐of‐concept study tested the utility of dynamic norms messages within norm‐correcting interventions. Method: Undergraduate student drinkers (N = 461; Mage = 19.97; 64.43% female) were randomly assigned to receive (a) dynamic norms messages highlighting a steady decrease over the past six years in heavy drinking among college students; (b) static norms messaging stating only the current norms; or (c) a control condition without normative information. Proximal outcomes assessed immediately following the experimental paradigm included intentions for total weekly drinks and heavy episodic drinking. Self‐reported information on alcohol use behavior was collected at 1‐month follow‐up. Results: Following the experimental paradigm, participants in the dynamic norms condition estimated that future drinking norms would decrease, while those in the static norms and control groups estimated that future drinking norms would increase. Participants in the dynamic norms condition reported lower intentions for weekly drinks and heavy episodic drinking than those in the static norms and control conditions. No significant differences between conditions were found on alcohol use indices reported at the 1‐month follow‐up. However, dynamic norms messaging had a favorable indirect effect on heavy episodic drinking intentions mediated through lower perceived future drinking norms. Conclusions: These findings provide proof‐of‐concept that dynamic norms messaging may be a prudent strategy for reducing alcohol use intentions, which can be integrated into or used alongside existing norm‐correcting strategies. [ABSTRACT FROM AUTHOR]

Background: Young adulthood is characterized by transitions into and out of social roles in multiple domains. Consistent with self‐medication models of alcohol use, the Transitions Overload Model (J Stud Alcohol Suppl, 14, 2002, 54) hypothesizes that one cause of increased alcohol use during young adulthood may be the stress of navigating simultaneous role transitions. This study examined the simultaneous occurrence of major developmental role transitions in the domains of education, employment, romantic relationships, and residential status and their associations with perceived stress, heavy episodic drinking (HED), and negative alcohol‐related consequences. Further, we extended the Transitions Overload Model to explore whether the number of transitions rated as having a negative impact on one's life was related to perceived stress, HED, and alcohol‐related consequences. Methods: A community sample of young adult drinkers (N = 767, 57% women, ages 18 to 25 years) in the Pacific Northwest provided monthly data across 2 years. Multilevel models were used to assess the average (between‐person) and month‐to‐month (within‐person) associations of role transitions with perceived stress, HED, and negative alcohol‐related consequences. Results: Although having more role transitions was positively associated with HED frequency and alcohol‐related consequences at both the between‐ and within‐person (monthly) levels, it was not associated with increased stress. The number of transitions rated as having a negative impact on one's life, however, was positively associated with stress. Thus, rather than the total number of transitions, it is the number of negatively perceived major developmental role transitions that is associated with perceived stress and increased risk for negative alcohol‐related consequences. Conclusions: Contrary to Transitions Overload Model assumptions, more transitions were not a significant predictor of more perceived stress; rather, the evaluation of the transition as negative was associated with stress and negative alcohol‐related outcomes. This distinction may help elucidate the etiology of stress and subsequent alcohol consequences and identify individuals at‐risk of these effects. [ABSTRACT FROM AUTHOR]

Background: Alcohol and marijuana are psychoactive substances commonly used by young adults and are independently associated with numerous acute and long‐term consequences. Many young adults engage in simultaneous alcohol and marijuana (SAM) use to cross‐fade (i.e., to enhance the effects of intoxication), although the extent to which alcohol use and alcohol‐related consequences increase on SAM occasions compared to alcohol‐only occasions is unclear. This study examines daily data among a sample of SAM users comparing SAM days to other days when young adults only used alcohol. Methods: A sample of 409 young adults (age 18 to 25; Mage = 21.6, SD = 2.2; 50.9% women) who reported SAM use in the past month completed 2 bursts of 14 days of daily surveys (28 days in total) assessing alcohol use, alcohol‐related consequences, and SAM use. Results: Multilevel models based on alcohol‐only and SAM days (n = 3,016 days; 391 individuals) indicated young adults drank more alcohol on SAM days compared to alcohol‐only days (with no marijuana use). Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences. The daily association between SAM use and positive consequences was statistically significant, after accounting for the amount of alcohol consumed; in contrast, the association between SAM use and negative consequences was diminished and nonsignificant. Conclusions: Among young adult SAM users, days with SAM use were associated with more alcohol use and positive consequences compared to days they only drank alcohol. Further examination of the motivational context for engaging in SAM use, as well as potential physiological interactions between alcohol and marijuana use on alcohol's effects, is warranted. Alcohol interventions might benefit from addressing increased alcohol use and alcohol‐related consequences as risks associated with SAM use. Many young adults engage in simultaneous alcohol and marijuana (SAM) use, although less is known about comparative risk of these days compared to days with alcohol‐only use. Multilevel models with two 14‐day bursts of daily data indicated young adults drank more alcohol on SAM days compared to alcohol‐only days. Similarly, days with SAM use were associated with more alcohol‐related positive and negative consequences, although the association with negative consequences was accounted for by the increase in alcohol use. [ABSTRACT FROM AUTHOR]

Immigration is a frequently debated topic in American politics and media, yet little work examined children's understanding of this issue. In order to explore how children's understanding of immigration may differ based on their immigration experience, 261 elementary school-aged children (M = 9 years; SD = 1 year, 1 month) answered open-ended questions regarding why people move to the United States and why it should be legal or not. The sample consisted of 196 immigrants (first and second generation Latino/a immigrants) and 65 nonimmigrants (non-Latino/a children living in America for at least three generations). Children also rated possible explanations for societal antiimmigration attitudes. As predicted, Latino/a immigrant children explained immigration as a means of attaining concrete benefits for immigrants, such as improved education or jobs. They also referenced reuniting with family members in the U.S. Nonimmigrant children focused more on immigrants seeking American freedoms, reflecting the school-based curriculum explaining early European immigration to the U.S. Results reflect how differing experiences with immigration (direct or indirect) may influence perceptions towards immigration. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the associations between definitions of sarcopenia and clinical outcomes and the ability of the definitions to discriminate those with a high likelihood of having these outcomes from those with a low likelihood. DESIGN: Osteoporotic Fractures in Men Study. SETTING: Six clinical centers. PARTICIPANTS: Community-dwelling men aged 65 and older (N = 5,934). MEASUREMENTS: Sarcopenia definitions from the International Working Group, European Working Group on Sarcopenia in Older Persons, Foundation for the National Institutes of Health Sarcopenia Project, Baumgartner, and Newman were evaluated. Recurrent falls were defined as two or more self-reported falls in the year after baseline (n = 694, 11.9%). Incident hip fractures (n = 207, 3.5%) and deaths (n = 2,003, 34.1%) were confirmed according to central review of medical records over 9.8 years. Self-reported functional limitations were assessed at baseline and 4.6 years later. Logistic regression or proportional hazards models were used to estimate associations between sarcopenia and falls, hip fractures, and death. The discriminative ability of the sarcopenia definitions (vs reference models) for these outcomes was evaluated using area under the receiver operating characteristic curve or C-statistics. Referent models included age alone for falls, functional limitations and mortality, and age and bone mineral density for hip fractures. RESULTS: The association between sarcopenia according to the various definitions and risk of falls, functional limitations, and hip fractures was variable; all definitions were associated with greater risk of death, but none of the definitions materially changed discrimination based on the AUC and C-statistic when compared with reference models (change <1% in all models). CONCLUSION: Sarcopenia definitions as currently constructed did not consistently improve prediction of clinical outcomes in relatively healthy older men. [ABSTRACT FROM AUTHOR]

Objectives To determine whether older women with diabetes mellitus have a greater longitudinal decline in physical performance than those without and whether any decline differs according to insulin sensitizer use. Design Prospective cohort study. Setting Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela, Pennsylvania. Participants Community-dwelling women (mean age 78.5 ± 3.6) enrolled in the Study of Osteoporotic Fractures in 1997-98 and restudied 4.9 ± 0.6 years later (N = 2,864). Measurements Women were categorized as having no diabetes mellitus (n = 2,680) or having diabetes mellitus (n = 184). A prescription medication inventory was used to determine use of insulin sensitizers (metformin and thiazolidinedione). The outcomes were longitudinal changes in physical performance measures, including grip strength, usual walk speed, and rapid walk speed. Results Estimates from fully adjusted models showed that women with diabetes mellitus had greater declines in usual walk speed (−0.16 m/s, 95% confidence interval ( CI) = −0.19 to −0.14) and rapid walk speed (−0.21 m/s, 95% CI = −0.24 to −0.17) than those without (usual walk speed −0.11 m/s, 95% CI = −0.12 to −0.11, P < .001; rapid walk speed −0.15 m/s, 95% CI = −0.16 to −0.14; P = .005). Women with diabetes mellitus taking insulin sensitizers had less decline in usual walk speed than those not taking insulin sensitizers ( P < .001). Declines in grip strength did not differ significantly by diabetes mellitus status or insulin sensitizer use. Conclusion Older women with diabetes mellitus have a greater decline in walk speed, but not grip strength, than older women without diabetes mellitus. Clinical studies in older adults to determine whether diabetes mellitus treatments such as insulin sensitizers can prevent loss in walk speed and mobility are needed. [ABSTRACT FROM AUTHOR]