After detention, SUDs differed markedly by sex, race/ethnicity, and substance abused, and, contrary to stereotypes, did not disproportionately affect African Americans. Services to treat substance abuse--during incarceration and after release--would reach many people in need, and address health disparities in a highly vulnerable population.

Background-Though higher sedentary behavior (SB) with low light intensity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) are thought to increase risk for obesity, other data suggest excess weight may precede these behaviors in the causal pathway. We aimed to investigate 10-y bidirectional associations between SB and activity with weight. Methods-Analysis included 886 CARDIA participants (aged 38-50 years, 62% female, 38% black) with weight and accelerometry (≥4 d with ≥10 hr/d) collected in 2005-6 (ActiGraph 7164) and 2015-6 (ActiGraph wGT3X-BT). Accelerometer data were calibrated, harmonized, and expressed as counts per minute (cpm) and time-dependent intensity categories (min/day of SB, LPA, and MVPA; SB and MVPA were also separated into long-bout and short-bout categories). Linear regression models were constructed to estimate adjusted associations of baseline activity with 10-y change in weight and vice versa. When activity categories were the independent variables, standardized regression coefficients (βstd) estimated associations of replacing SB with a one SD increase in other categories, adjusted for accelerometer wear time. Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:

Objective Forced vital capacity (FVC) and carbon monoxide diffusion (DLCO) are used for systemic sclerosis-associated interstitial lung disease (SSc-ILD) screening. The study purpose was to determine the sensitivity, specificity, and negative predictive value (NPV) (proportion of true negative screening tests) of FVC and DLCO thresholds for SSc-ILD on chest high-resolution computed tomography (HRCT) scans. Methods Patients fulfilling American College of Rheumatology 2013 SSc criteria with a chest HRCT scan and pulmonary function tests (PFT) were studied. A thoracic radiologist quantified radiographic ILD. Optimal FVC and DLCO % predicted thresholds for ILD were identified using receiver operating characteristic curves. The FVC and DLCO combinations with greatest sensitivity and specificity were also determined. Sub-analysis was performed in patients with positive Scl-70 autoantibodies. Results 265 patients were studied. Of 188 (71%) with radiographic ILD, 59 out of 188 (31%) had “normal” FVC (≥80% predicted), and 65 out of 151 (43%) had “normal” DLCO (≥60% predicted). FVC <80% (sensitivity 0.69, specificity 0.74), and DLCO <62% (sensitivity 0.60, specificity 0.70) were optimal thresholds for radiographic SSc-ILD. All FVC and DLCO threshold combinations evaluated had NPV <0.70. The NPV for radiographic ILD for FVC <80% was lower in patients with positive Scl-70 autoantibody (NPV=0.05) compared to negative Scl-70 autoantibody (NPV=0.57). Conclusions Radiographic ILD is prevalent in SSc despite “normal” PFTs. No % predicted FVC or DLCO threshold combinations yielded high NPV for SSc-ILD screening. “Normal” FVC and DLCO in SSc patients, especially those with positive Scl-70 autoantibodies, should not obviate consideration of HRCT for ILD evaluation.

IMPORTANCE Although 13% to 20% of American adolescents experience a depressive episode annually, no scalable primary care model for adolescent depression prevention is currently available.OBJECTIVE To study whether competent adulthood transition with cognitive behavioral humanistic and interpersonal training (CATCH-IT) lowers the hazard for depression in at-risk adolescents identified in primary care, as compared with a general health education (HE) attention control. DESIGN, SETTING, AND PARTICIPANTSThis multicenter, randomized clinical trial, a phase 3 singleblind study, compares CATCH-IT with HE. Participants were enrolled from 2012 to 2016 and assessed at 2, 6, 12, 18, and 24 months postrandomization in a primary care setting. Eligible adolescents were aged 13 to 18 years with subsyndromal depression and/or history of depression and no current depression diagnosis or treatment. Of 2250 adolescents screened for eligibility, 446 participants completed the baseline interview, and 369 were randomized into CATCH-IT (n = 193) and HE (n = 176). INTERVENTIONS The internet-based intervention, CATCH-IT, is a 20-module (15 adolescent modules and 5 parent modules) online psychoeducation course that includes a parent program, supported by 3 motivational interviews. MAIN OUTCOMES AND MEASURES Time to event for depressive episode; depressive symptoms at 6 months. RESULTS Of 369 participants (mean [SD] age, 15.4 [1.5] years; 251 women [68%]) included in this trial, 193 were randomized into CATCH-IT and 176 into HE. Among these participants, 28% had both a past episode and subsyndromal depression; 12% had a past episode only, 59% had subsyndromal depression only, and 1% had borderline subsyndromal depression. The outcome of time to event favored CATCH-IT but was not significant with intention-to-treat analyses (unadjusted hazard ratio [HR], 0.59; 95% CI, 0.27-1.29; P = .18; adjusted HR, 0.53; 95% CI, 0.23-1.23; P = .14). Adolescents with higher baseline Center for Epidemiologic Studies Depression scale (CES-D 10 ) scores showed a significantly stronger effect of CATCH-IT on time to event relative to those with lower baseline scores (HR 0.82; 95% CI, 0.67-0.99; P = .04). For example, the hazard ratio for a CES-D 10 score of 15 was 0.20 (95% CI, 0.05-0.77), compared with a hazard ratio of 1.44 (95% CI, 0.41-5.03) for a CES-D 10 (continued) Key Points Questions Does an internet-based depression prevention program (competent adulthood transition with cognitive behavioral humanistic and interpersonal training) lower the hazard for depression in at-risk adolescents relative to health education attention control? Findings In this randomized clinical trial of adolescents with subsyndromal depression or history of depression randomized to receive internet-based behavioral humanistic interpersonal training or an internet-based general health education control, those who received the CATCH-IT intervention did not evidence fewer episodes of depression in the full intention-to-treat sample, but adolescents with subsyndromal depression may...

Key Points Question Are youths involved in the juvenile justice system who use, have access to, or have been injured by a firearm or threatened with a weapon during adolescence more likely to perpetrate firearm violence and own firearms in adulthood? Findings This cohort study of 1829 randomly selected youth newly detained in a temporary juvenile detention center found that 85% of males and 63% of females were involved with firearms as adolescents. Nearly all types of firearm involvement during adolescence were associated with increased odds of using and owning firearms during adulthood. Meaning These findings suggest that firearm use, access, injury, and being threatened with a weapon during adolescence may be risk factors for firearm perpetration and ownership in adulthood.