Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Existential Anxiety in Adolescents: Prevalence, Structure, Association with Psychological Symptoms and Identity Development

Existential anxiety is hypothesized to be a core human issue in a great deal of theoretical and philosophical writing. However, little is known about the emergence of these concerns and their relation to emotional functioning in youth. The purpose of this study was to examine the phenomenon of existential anxiety in a sample of adolescents. Data on existential concerns, identity development and psychological symptoms were collected on a sample of 139 youth in grades 9–12. Results indicated that existential anxiety concerns have a theoretically consistent factor structure, are common among adolescents, and are associated with psychological symptoms, as well as identity issues. Results are discussed with regard to the importance of existential concerns in the lives of youth and the need for additional research.Received PhD from Florida International University. Interests are identity development including associated anxiety and distress, cross-national comparisons, and the development of identity interventions.Received PhD from Florida International University. Interests focus on the developmental psychopathology of anxiety and depression.Received PhD from the University of Arizona. Interests include a range of topics in developmental psychopathology, prevention, program evaluation, and research methodology.     

An analytical history of terrorism, 1945–2000

This paper traces the history of modern terrorism from the end of the Second World War to the beginning of the twenty-first century. It divides that history into three stylized waves: terrorism in the service of national liberation and ethnic separatism, left-wing terrorism, and Islamist terrorism. Adopting a constitutional political economy perspective, the paper argues that terrorism is rooted in the artificial nation-states created during the interwar period and suggests solutions grounded in liberal federalist constitutions and, perhaps, new political maps for the Middle East, Central Asia and other contemporary terrorist homelands.     

“Beggar thy Neighbor:” Testing for Free Riding in State-Level Endangered Species Expenditures

An important public policy question that remains unresolved iswhether devolution will enhance sensible policy making byexploiting informational asymmetries or, instead, trigger a``beggar thy neighbor'' response and stimulate free ridingamongst localities. We analyze this question within theframework of U.S. environmental policymaking by scrutinizing aunique panel data set on state-level endangered speciesexpenditure patterns. Our empirical estimates are consistentwith the notion that states free ride, which may lead to anexpenditure equilibrium that is not Pareto efficient.     

Whither Environmental Security in the Post–September 11th Era? Assessing the Legal, Organizational, and Policy Challenges for the National Security State

What are the implications of the war on terrorism for the progress made to date and the likely future of environmental security efforts in the national security state? To put the evolving post–September 11th environmental security challenge facing the U.S. military in perspective, this article begins with a synopsis of the doctrinal, tactical, operational, and regulatory dilemmas faced by the U.S. military in the post–Cold War era. Next, the article reviews how and why the 1990s bequeathed a set of misaligned administrative systems that make existing and future progress in balancing national security with environmental and natural resources protection extremely vulnerable to shifts in the political economy surrounding this issue in the post–September 11th era. The article concludes with a review of how September 11th has affected the patterns of politics surrounding this issue since those tragic events. Despite recent increases in the defense budget, this analysis suggests that conflict over this issue will continue, rendering structural realignment a daunting challenge and further complicating the integration of national security and environmental and natural resources responsibilities in the post–September 11th era.