Faculty Bibliography

Aim and objective Injunctive norms about smoking, the perceived approval or acceptability of smoking from friends or wider peer group, have rarely been studied outside the Western world. We investigated injunctive norms and the associations with smoking susceptibility in adolescents in Hong Kong, where most adolescents are negative towards smoking. Methods In 2017/18, 7031 Secondary 1-5 (US grade 7-11) students (48.9% boys; mean age 14.3, SD 1.7) were surveyed.Students reported the perceived approval of smoking from good friends (disapprove/neutral/approve) and the perception of whether most secondary school students accepted smoking (no/yes). Smoking susceptibility referred to the lack of a firm intention not to smoke in the next 12 months, when good friends smoked in front, or when a good friend offered a cigarette. Logistic regression yielded adjusted odds ratios (AORs) of smoking susceptibility for injunctive norms in never smokers, adjusting for sociodemographic characteristics and school clustering effect. Results Overall, 1.3%, 21.1% and 77.5% of students perceived approval, neutral response and disapproval of smoking from good friends, respectively. Some (5.8%) perceived that most students accepted smoking. In never smokers (n=6472, 92.5%), compared with perceived disapproval from good friends, perceived neutral response (AOR 3.58, 95% CI 2.86-4.50) and approval (5.41, 2.93-9.97) were associated with smoking susceptibility. The perception that most students accepted smoking was also associated with smoking susceptibility (2.73, 2.02-3.71). Conclusions Injunctive norms were associated with smoking susceptibility in Hong Kong never smoking adolescents. Addressing misperceptions of others' approval or acceptability of smoking may help prevent adolescent smoking. Funding General Research Fund (17629016), Research Grants Council of Hong Kong Special Administrative Region, China

INTRODUCTION/BACKGROUND:Self-reported tobacco use in the United Arab Emirates is among the highest in the region. Use of tobacco products other than cigarettes is widespread, but little is known about specific behavior use patterns. There have been no studies that have biochemically verified smoking status. METHODS:The UAE Healthy Future Study (UAEHFS) seeks to understand the causes of non-communicable diseases through a 20,000-person cohort study. During the study pilot, 517 Emirati nationals were recruited to complete a questionnaire, provide clinical measurements and biological samples. Complete smoking data were available for 428 participants. Validation of smoking status via cotinine testing was conducted based on complete questionnaire data and matching urine samples for 399 participants, using a cut-off of 200ng/ml to indicate active smoking status. RESULTS:Self-reported tobacco use was 36% among men and 3% among women in the sample. However, biochemical verification of smoking status revealed that 42% men and 9% of women were positive for cotinine indicating possible recent tobacco use. Dual and poly-use of tobacco products was fairly common with 32% and 6% of the sample reporting respectively. CONCLUSIONS:This is the first study in the region to biochemically verify tobacco use self-report data. Tobacco use in this study population was found to be higher than previously thought, especially among women. Misclassification of smoking status was more common than expected. Poly-tobacco use was also very common. Additional studies are needed to understand tobacco use behaviors and the extent to which people may be exposed to passive tobacco smoke. IMPLICATIONS/CONCLUSIONS:This study is the first in the region to biochemically verify self-reported smoking status.

OBJECTIVE:To determine if native English speakers (NES) perform differently compared to non-native English speakers (NNES) on a sideline-focused rapid number naming task. A secondary aim was to characterize objective differences in eye movement behaviour between cohorts. BACKGROUND:The King-Devick (KD) test is a rapid number-naming task in which numbers are read from left-to-right. This performance measure adds vision-based assessment to sideline concussion testing. Reading strategies differ by language. Concussion may also impact language and attention. Both factors may affect test performance. METHODS:Twenty-seven healthy  NNES and healthy NES performed a computerized KD test under high-resolution video-oculography.  NNES also performed a Bilingual Dominance Scale (BDS) questionnaire to weight linguistic preferences (i.e., reliance on non-English language(s)). RESULTS:Inter-saccadic intervals were significantly longer in  NNES (346.3 ± 78.3 ms vs. 286.1 ± 49.7 ms, p = 0.001), as were KD test times (54.4 ± 15.1 s vs. 43.8 ± 8.6 s, p = 0.002). Higher BDS scores, reflecting higher native language dominance, were associated with longer inter-saccadic intervals in  NNES. CONCLUSION/CONCLUSIONS:These findings have direct implications for the assessment of athlete performance on vision-based and other verbal sideline concussion tests; these results are particularly important given the international scope of sport. Pre-season baseline scores are essential to evaluation in the event of concussion, and performance of sideline tests in the athlete's native language should be considered to optimize both baseline and post-injury test accuracy.

BACKGROUND:School meals have the potential to improve diet quality for millions of students across the United States. OBJECTIVES:Evaluate the feasibility of the FAV5 program, which aims to strengthen school meals by increasing appeal of school meals and improving relationships within the team of child nutrition staff and with other staff/teachers at their schools. METHODS:Nutrition researchers facilitated partnerships between the following groups to develop and implement the FAV5 program: the child nutrition director (CND) and managers at seven elementary schools in a North Carolina county, teachers and principals at those schools, a chef, the North Carolina Department of Agriculture, and volunteers. RESULTS:The partnerships developed through the FAV5 program produced successful taste test events in seven elementary schools that generated enthusiasm around the school meals program and strengthened relationships. CONCLUSIONS:Engaging child nutrition staff and other community partners to plan and implement the FAV5 program in schools is feasible.

Approximately, 42% of the Kenyan population live below the poverty line. Rapid growth and urbanization of Kenya's population have resulted in a changing poverty and food security environment in high-density urban areas. Lack of basic food needs in Kenya affects approximately 34.8% rural population and 7.6% of its urban population. Using multi-community stakeholders such as teachers and community health workers (CHWs), this paper examined food insecurity and its consequences on caregiving practices and child development. A qualitative study design was utilized. Key informant interviews and focused-group discussions with four primary school teachers and three CHWs and a nurse in-charge working within Kariobangi and Kangemi were applied to elicit various perspectives from family-, school- and community-level challenges that influence caregiving practices and child development. Grounded theory method was applied for qualitative data sifting and thematic analysis. Our findings exposed various challenges at the school, family and the community levels that affect caregiving practices and consequent child development. School-level challenges included lack of adequate amenities for effective learning, food insecurity, absenteeism and mental health challenges. Family-level barriers included lack of parenting skills, financial constraints, domestic violence and lack of social support, while community challenges such as unemployment, poor living conditions, cultural practices, lack of social support and poor community follow-up mechanisms contributed to poor parenting practices and child development. Parenting practices and holistic child development strategies in resource poor settings should focus on parenting skills, food security, quality education and addressing parents and children's mental health challenges.