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Background: With elexacaftor/tezacaftor/ivacaftor (ETI), children with cystic fibrosis (CwCF) are living healthier lives with a focus on typical developmental issues such as attention deficit/hyperactivity disorder (ADHD). This paper characterizes CwCF with ADHD within the first year of ETI treatment., Methods: This retrospective, observational analysis examines a subgroup of CwCF participating in a longitudinal study obtaining prospective data regarding the impact of ETI on mental health. All participants started on ETI were offered enrollment, with rolling enrollment as younger children became eligible. Clinical data regarding CF symptoms, mental health diagnoses, medications, changes in mental health symptoms and BMI were collected via chart review., Results: Before ETI, ADHD diagnoses were identified in 21 children; an additional 3 were diagnosed within the first year. Eleven children were treated with ADHD medication at ETI initiation; nine children did not use ADHD medication during the study period. In the 1-year follow-up, four children started ADHD medication. Of the 11 who started ETI on ADHD medication, five increased doses, three changed medications and/or decreased dose, and one discontinued medication. Two children experienced no changes to their treatment., Conclusion: Most CwCF on ADHD medication underwent changes in dosing and/or medication after ETI initiation. Several children were diagnosed with ADHD after starting ETI. The role of ETI in these recent diagnoses and treatment plans is unclear. Given the prevalence of pediatric ADHD diagnoses and the medication changes that were needed by this population, additional research is warranted to clarify the relationship between ETI and ADHD in CwCF., (© 2024 Wiley Periodicals LLC.)

Rationale: Limited published research is available on the impact of elexacaftor/tezacaftor/ivacaftor (ETI) beyond the initial few months postdrug initiation, especially for those who initiated therapy via individual investigational new drug application. The experiences of patients with cystic fibrosis (CF) experiencing severe lung disease were reviewed for significant improvements in clinical symptoms and quality of life., Objectives: To examine clinical outcomes 2 years post-ETI in patients with CF and advanced lung disease., Methods: This single center institutional review board-approved, retrospective chart review assessed clinical markers (percent predicted forced expiratory volume in 1 s, weight, sweat chloride), quality of life and computed tomography scans in patients with advanced lung disease who met criteria for compassionate use/expanded access program due to high risk of death or transplant need within 2 years., Results: Eighteen identified patients (ages 15-49 years) initiated drug between July and September 2019. Clinical markers indicated that therapy was well tolerated, not discontinued by any participant, and lab values did not indicate medical concern or discontinuation. Monitoring results indicated the safety of modulator therapy as there were no adverse clinical occurrences and all patients presented universal stabilization. There were no deaths and no transplants by the end of the study., Conclusions: This study focused on patients with CF eligible for modulator therapy and were initiated due to advanced lung disease. Initiation of modulator therapy was deemed safe and resulted in objective positive changes in nutrition, cough, FEV 1 , subjective reports of clinical status, level of activity, and a reduction in burden of treatment., (© 2023 Wiley Periodicals LLC.)

Background: Cystic Fibrosis (CF) and autism spectrum disorder (ASD) are life-long conditions with intense treatment burdens for patients and families. Patients with a concurrent diagnosis (CF-ASD) experience unique obstacles to CF care. This study describes the experiences of our multidisciplinary CF team in caring for patients with CF-ASD and provides insight into provider and parental perspectives on clinical management., Methods: This is a three-part qualitative study involving (1) retrospective chart review of patients with CF-ASD, (2) surveys with multidisciplinary care team members, and (3) semistructured interviews with caregivers of patients with CF-ASD. Challenges in clinical management of this specific cohort were compiled using data from chart review and care team surveys. Strategies to address these concerns were identified and rated by individual families based on relevance and practicality., Results: Within our CF center, 12 patients have an official diagnosis of ASD. Median age of patients with CF-ASD was 8.5 years (range 3-20 years), 67% were male, and 83% were on highly effective modulator therapy. Clinical barriers included sensory processing issues, environmental overstimulation, intolerance to procedures and to disrupted routines. Potentially impactful strategies include patient-specific coping plans, guided behavioral interventions, parental advocacy, and improved communication between the family and multidisciplinary team., Conclusion: Children with CF-ASD face extraordinary challenges beyond the experience of neurotypical children with CF. Increased awareness of this complex dual diagnosis will help providers be sensitive to the unique needs of these patients, help build consistent and trustworthy relationships with their families and deliver effective clinical care despite limitations., (© 2023 Wiley Periodicals LLC.)

Lesbian, gay, bisexual, and queer/questioning youth health disparities are well documented; however, study limitations restrict our understanding of how the temporal interplay among domains of sexuality (attraction, behavior, and identity) situate individuals to be more or less at risk for poor mental health and alcohol use across the transition to adulthood. Four waves of data from the National Longitudinal Study of Adolescent to Adult Health (n = 12,679; 51.29 % female) were used with repeated measures latent class analysis to estimate sexual trajectory groups designated by prospective reports of romantic attraction, sexual/romantic behavior, and sexual identity from adolescence to adulthood. Five unique trajectories emerged: two heterosexual groups (heterosexual early daters [58.37 %] and heterosexual later daters [29.83 %]) and three sexual minority groups (heteroflexible [6.44 %], later bisexually identified [3.32 %], and LG[B] identified [2.03 %]). These sexual trajectories differentiate risk for depressive symptomology, suicidal thoughts and behaviors, and alcohol use during adolescence and early adulthood. Groups where individuals first reported same-sex attraction and sexual minority identities in adulthood (heteroflexible and later bisexually identified) had similar levels of depression, suicidality, and greater substance use than those who largely reported same-sex attraction and behavior during adolescence (the LG[B] identified group). These later recognition groups showed greater risk for poor outcomes in waves where they also first reported these changes in attraction, behaviors, and identities. The emergence of three sexual minority groups reveal within-group differences in sexuality and sexual trajectories and how these experiences relate to risk and timing of risk across the transition to adulthood.

Some scholars assert that a hookup culture exists on college campuses and that individuals who attend college are socialized into a hookup script. This study examines hooking up among first-semester college men (N = 158), with specific attention to precollege heavy episodic drinking (i.e., binge drinking) and precollege hookup experience. We found that freshman men begin a pattern of hooking up well before attending college. After controlling for known correlates of hooking up, men had more hookup partners during their first semester at college if they engaged in greater levels of precollege binge drinking and had greater precollege hookup experience. Men were also more likely to have penetrative sex hookups (i.e., oral sex and/or intercourse) if they had done so prior to college. Precollege binge drinking and precollege hookup experience were also associated with unplanned sexual activity when drinking, and men were more likely to have unprotected sex when drinking during their first semester if they engaged in more frequent precollege binge drinking. Implications for intervention and future research are discussed.

This study examined the role of extradyadic involvement (EDI) in heterosexual dating relationships among young adult females (N = 539). A considerable percentage of participants (36 %) reported that they had engaged in an extradyadic emotional or sexual relationship within the last 2 months. Results from logistic regression analyses supported the general hypothesis that emotional and sexual EDI were both significantly associated with relationship dissolution. These associations remained strong even after controlling for participants' age, relationship duration, and relationship quality. The findings also showed that the strength of the association between acts of emotional or sexual extradyadic behaviors and relationship dissolution was linked to relationship quality, gender of the actor, and type of EDI (emotional vs. sexual). Specifically, compared to participants who reported poor relationship quality, those who reported high relationship quality were more likely to end the partnership if they reported emotional or sexual EDI. Findings suggest that individuals in higher quality relationships appear to have considerably more to lose in their relationship when emotional or sexual EDI occurs. This, in part, may be because the more satisfactory the relationship the more disillusionment one may feel when betrayed by their romantic partner. Overall, the present findings underscore the multifaceted nature of the relationships between EDI and relationship dissolution. We call for more research that rigorously examines what contextual factors influence young adults in dating relationships to dissolve relationships following EDI.

We examined the relationship between family structure and hooking up among emerging adults (N = 881) and the extent to which attachment moderated this relationship. Neither family structure nor number of structure transitions were related to the number of hookup partners in the past 12 months. Having an avoidant attachment, being an underclassman, consuming more alcohol, and not being in an exclusive relationship were related to having a greater number of hookup partners, and avoidant attachment was a stronger indicator of hooking up for men than for women. Among those who had hooked up in the past 12 months (63.8 %), family structure did not significantly differentiate those having a penetrative sex hookup (i.e., oral sex and/or intercourse) versus a non-penetrative sex hookup (i.e., kissing and/or sexual touching only). Findings were discussed in terms of their methodological implications for studying hookups, such as the collection of event level data and examining how family structure influences other correlates of hooking up.

One prominent pathway to sexual intimacy among college student populations is hooking up. Past research has largely compared men and women, with limited attention given to how men differ regarding involvement in hookups and their hookup behaviors. This study used a sample of 412 college men to examine the individual, social, relational, and family background correlates of (1) hooking up during a semester and (2) penetrative hookup encounters (e.g., oral sex, intercourse). Overall, 69% reported a hookup during the semester, with 73% of those who hooked up reporting penetrative hookups. Using logistic regression, men were more likely to hookup if they had an extraverted personality, were consuming more alcohol, and had previous hookup experience. They were less likely to hookup if they were more thoughtful about their relationship decisions and if they were in a stable, committed romantic relationship. Men also were more likely to engage in penetrative hookups only if they held more permissive attitudes towards sex and if they had previous penetrative hookup experience. Implications for intervention and research are discussed.

Using a sample of 200 emerging adult male college students, we examined how men varied in the meanings they gave to sex and their self-reported engagement in two types of casual sex relationships (hookups and friends with benefits). Using qualitative methods, we conducted a content analysis of men's written responses to a series of questions about the meanings they ascribed to sex (i.e., intercourse), their perceived connection between sex and commitment, and how they believed these meanings were related to their sexual behavior. Three groups of men emerged: Committers, Flexibles, and Recreationers. Groups were then compared on social desirability, demographic characteristics (e.g., race/ethnicity, year in school, religious service attendance), and self-reported casual sexual behaviors in the past 12 months. Analyses showed that men in the Flexibles and Recreationers groups engaged in significantly more hookups and had significantly more friends with benefits partners in the past 12 months than did men in the Committers group. Implications for relationship education intervention aimed at men and research on casual sex relationships are discussed.

Using qualitative content analysis from the written comments of 404 primarily heterosexual college students, we examined (1) their expectations for pornography use while married or in a committed long-term relationship and (2) variations by gender. Four prominent groups emerged. A majority of men (70.8 %) and almost half of women (45.5 %) reported circumstances (alone or with their partners) wherein pornography use was acceptable in a relationship and several conditions for, and consequences associated with, such use also emerged. Another group (22.3 % men; 26.2 % women) viewed pornography use as unacceptable because of being in a committed relationship whereas a third group (5.4 % men; 12.9 % women) reported that pornography use was unacceptable in any context or circumstance. A final group emerged of a few women (10.4 %) who stated that a partner's use of pornography was acceptable, but they did not expect to use it personally. Implications for relationship education among emerging adults and future research on pornography use within the context of romantic relationships are discussed.

We conducted a qualitative content analysis of written responses from 148 college men to questions about pregnancy resolution and marriage in the event of an unplanned pregnancy. We used Marsiglio's ( 1991 ) concepts of procreative consciousness and responsibility as a source of theoretical sensitivity during data analysis. Men's written comments were analyzed using a modified version of the grounded theory method of open, axial, and selective coding. Three distinct groups emerged: "I expect to raise my child" (86.5%); "I don't expect to raise the child" (10.1%); and "I expect to let my partner decide" (3.4%). Several subgroups also emerged among men who intended to raise the unplanned child: Yes, I expect to get married; "No, I don't expect to get married"; "I don't know if we'd marry"; and "My partner and I would coparent." Across subgroups, conditional variations and reasons underlying expectations were noted. Much variability was observed in men's descriptions of their procreative responsibility. A majority expressed high expectations for personal obligation and responsibility if involved in an unplanned pregnancy. Future research on men's sexual and reproductive health and procreative consciousness and responsibility are discussed.

We used latent growth curve modeling to examine the effectiveness of a relationship education intervention (Relationship U, or RU) on rates of extradyadic involvement in a sample of 380 college students in committed romantic relationships. RU is designed to be integrated into existing college courses; it educates students about partner selection, making healthy relationship transitions, communication skills, and the potentially negative consequences of cheating in romantic relationships and how to prevent its occurrence. Participants who received the intervention reported trajectories of less extradyadic involvement over time relative to control participants. Being female was not associated with less extradyadic involvement at baseline, but it did predict less extradyadic involvement over time across both intervention and control conditions. Implications for dissemination of relationship education are discussed.

The effect of birth order on self-concept was examined in a sample of adolescent boys and girls. Based upon self-theory, which suggests that the two main processes of self-concept formation (e.g., reflected appraisals and social comparisons) are affected by the power and role relationships associated with ordinal position in the family, several hypotheses were tested: (1) The self-evaluations of only and oldest children are more positive than those of younger siblings; (2) middle-borns have the lowest self-evaluations; (3) these relationships are affected by the sex and spacing of nearest sibling; and (4) the self-conceptions of oldest and only children are more similar to those of their parents than the self-conceptions of younger siblings and their parents. Using analysis of variance and several different measures of self-evaluation, very little support was found for any of these hypotheses. The strongest support was found for the hypothesis on middle-borns, but even these relationships were not large. Several explanations are offered for these weak and inconsistent findings.