Bonita F. Stanton

Medical Marijuana Laws and Marijuana Use Among U.S. Adolescents: Evidence From Michigan Youth Risk Behavior Surveillance Data

Research findings are inconsistent regarding a positive association between the passage of state medical marijuana laws (MML) and the adolescent access and the use of marijuana. We utilized a novel analytical approach to examine this issue with multiyear data from the 1997–2013 Youth Risk Behavior Surveillance System of the State of Michigan. After controlling for the historically declining trend in marijuana use prior to the passages of MML in Michigan, we found that marijuana use among adolescents had increased subsequent to the passage of state MML. The study findings suggest the need for considering the increased risk of marijuana use in adolescents, as more states have implemented laws permitting marijuana use.

Quantum changes in self-efficacy and condom-use intention among youth: A chained cusp catastrophe model

INTRODUCTION The complex relationships among HIV knowledge, condom-use skills, self-efficacy, peer influence and intention to use condoms have been rigorously investigated. However, studies guided by a linear behavior change model often explain only a limited amount of variances. This study aims to advance our understanding of the relationships through a nonlinear quantum change paradigm. METHODS Data (n = 1970, 40.61% male, mean age 16.94 ± 0.74) from a behavioral intervention program among high school students in the Bahamas were analyzed with a chained cusp catastrophe model in two steps. In the first step, self-efficacy was analyzed as the outcome with HIV knowledge/condom-use skills as asymmetry variables and peer influence as bifurcation variable. In the second step, condom-use intention was analyzed as the outcome while self-efficacy (outcome in the first step) was used as bifurcation variable allowing peer influence as bifurcation, and HIV knowledge/condom-use skills were included as asymmetry. Cusp modeling analysis was conducted along with equivalent linear models. RESULTS The cusp model performed better than the linear and logistic models. Cusp modeling analyses revealed that peer influence significantly bifurcated the relationships between HIV knowledge/condom-use skills and self-efficacy; while both self-efficacy and peer influence significantly bifurcated the relationship between HIV knowledge/condom-use skills and condom-use intention. CONCLUSION Our findings support the central role of self-efficacy and peer influence as two chains in bridging the complex quantum relationships between HIV knowledge/condom-use skills and condom-use intention among adolescents. The nonlinear cusp catastrophe modeling provided a new method to advance HIV behavioral research.

A Longitudinal Study of the Effect of Computers on the Cognitive Development of Low-Income African American Preschool Children

ABSTRACT Research Findings: The current study examined the impact of daily classroom computer use on the cognitive development of preschool children in 14 urban Head Start classrooms. The sample consisted of 208 predominantly African American low-income children with a mean age of 48.8 months. A quasi-experimental design was used in which 7 classrooms had computers and 7 classrooms served as the control. Assessments were made at baseline and at 6, 12, and 18 months. Hierarchical linear modeling was used to assess differences between the computer and control groups on cognitive developmental trajectories. Children in the computer condition displayed significantly greater increases in quantitative development than did children from the control condition. Practice or Policy: Children’s access to computers at home and at school has become increasingly prevalent. However, there is still a substantial disparity in access to technology between different socioeconomic groups. The preschool years may offer a promising opportunity to close this gap in access; however, little is known about the impact of computers on the developing minds of children, particularly those from low-income African American families. Findings from the current study suggest that daily use of computer centers in the Head Start classroom may benefit quantitative outcomes for young children.

Undiagnosed and Rare Childhood Diseases

As medical students and residents, we quickly gain experience and begin to recognize common disorders in our patients, and gradually, unusual manifestations of common disorders. Over time, as maturing pediatricians, we learn about and recognize uncommon disorders among the children for whom we care. And then one day, we come across a problem that we believe we have never before encountered—and are not sure we have even read about it. Or, we read about a disorder that we think we have never seen—and realize that we have seen it in one or more of our patients—but did not recognize it. In this issue of Pediatric Clinics of North America, the authors present in a logical and clear fashion unusual forms of common disorders and uncommon conditions that may mimic more common diseases. All of these conditions are important to contemplate in our differential diagnoses, and the articles help us to organize our thinking in this regard. I suspect that this issue will provide at least a few “ah-ha!” moments for each of us as we think about patients for whom we have cared over the years, especially those for whom no diagnosis seemed to fit quite right. This issue will provide fascinating—and helpful—reading for every pediatrician.