Prevalence and burden of chronic migraine in adolescents: results of the chronic daily headache in adolescents study (C-dAS)

(Headache 2011;51:693‐706) Objective.— To estimate the prevalence of chronic migraine (CM) among adolescents and to describe the epidemiologic profile, headache characteristics, disability, and healthcare utilization of adolescents with CM in the USA. Background.— Chronic daily headache (CDH) and CM occur in children and adolescents, but are poorly understood in these populations because their presentation is different from that in adults. It may be difficult to assign a definitive diagnosis to young people suffering from CDH because symptoms may fail to meet the criteria for one of the CDH subtypes. Methods.— A large sample of households with at least one resident aged 12 to 19 years was selected in balance with the US Census. Data were collected in 3 phases: (1) mailed questionnaire; (2) telephone interview; and (3) 30‐day interactive voice response system diary. CM prevalence was estimated by adapting the second edition of the International Classification of Headache Disorders criteria for CM to include pediatric migraine diagnostic criteria. The population was stratified for medication overuse. Medication overuse was defined as 15 or more days per month of acute medication use. Included in the study were measures of headache characteristics, headache impact (Headache Impact Test), disability (Pediatric Migraine Disability Assessment), and healthcare and medication use. Data are reported on subjects 12 to 17 years of age only. Results.— The US adolescent (12‐17 years) prevalence rate for CM was 0.79% (0.00‐1.70) excluding those with medication overuse and 1.75% (0.62‐2.89) when adolescents with medication overuse were included. The majority of adolescents with CM had Headache Impact Test scores greater than or equal to 60, indicating severe headache impact, and mean Pediatric Migraine Disability Assessment scores greater than 17, indicating severe headache and disability. The majority of adolescents with CM (approximately 60%) had not visited a healthcare provider in the previous year and less than one in 5 reported taking medications to prevent headaches during the last month. Conclusions.— Results suggest that CM occurs less frequently in adolescents than adults, but like adults, adolescents are severely burdened by the disorder. Data support an unmet medical need; however, the development of optimal criteria for diagnosing adolescents with CM is critical to fully understanding how medical needs can be met within this complex population.     

Contingency Management in Community Programs Treating Adolescent Substance Abuse: A Feasibility Study

PROBLEM: Adolescent substance abuse remains a public health problem, and more effective treatment approaches are needed. PURPOSE: The study aims to determine the feasibility and preliminary effectiveness of implementing a cost‐effective contingency management (CM) intervention in community substance abuse treatment for adolescents with marijuana use disorders. METHODS: Thirty‐one adolescents with primary marijuana use disorder enrolled in a community treatment were randomized into either a prize‐based CM intervention contingent when submitting negative urine drug screens (UDS) or a noncontingent control group. FINDINGS: There were no significant group differences in percent negative UDS, sustained negative UDS, or retention in treatment. CONCLUSIONS: CM was difficult to integrate into community treatment programs and did not seem to be an effective adjunct to standard community substance abuse treatment for adolescents with marijuana use disorders. Modifying the CM procedure for adolescents, changing staff attitudes toward CM, and/or combining CM with other evidence‐based psychosocial treatment may improve outcomes.     

Conditioned media from hypoxic‐cultured human dental pulp cells promotes bone healing during distraction osteogenesis

Distraction osteogenesis (DO) is a surgical procedure used to correct various skeletal disorders. Improving the technique by reducing the healing time would be of clinical relevance. The aim of this study was to determine the angiogenic and regenerative potential of conditioned media (CMs) collected from human dental pulp cells (hDPCs) grown under different culture conditions. CM collected from cells under hypoxia was used to improve bone healing and the DO procedure in vivo . The angiogenic potentials of CMs collected from hDPCs grown under normoxic (?Nor) and hypoxic (?Hyp) conditions were evaluated by quantitative PCR (VEGF‐A , angiopoietin‐1, angiopoietin‐2, interleukin‐6 (IL‐6 ) and CXCL12 ), ELISA assays (VEGF‐A, Ang‐2), tube‐formation and wound‐healing assays, using human umbilical vein endothelial cells. The results demonstrated that hypoxic CM had significantly higher angiogenic potential than normoxic CM. Human fetal osteoblasts (hFOBs) were exposed to CM, followed by alizarin red staining, to assess the osteogenic potential. It was found that CM did not enhance the mineralization capacity of hFOBs. DO was performed in the tibiae of 30 mice, followed by a local injection of 20 µl CM (CM–Nor and CM–Hyp groups) or serum‐free DMEM (control group) into the distraction zone every second day. The mice were sacrificed at days 13 and 27. The CM–Hyp treatment revealed a higher X‐ray density than the control group (p < 0.05). Our study suggests that the angiogenic effect promoted by hypoxic culture conditions is dependent on VEGF‐A and Ang‐2 released from hDPCs. Furthermore, CM–Hyp treatment may thus improve the DO procedure, accelerating bone healing. © 2015 The Authors. Journal of Tissue Engineering and Regenerative Medicine published by John Wiley & Sons, Ltd.     

Were Adolescent Sexual Offenders Children with Sexual Behavior Problems?

This article compares responses of three groups of incarcerated adolescents who admitted to sexual offending in an anonymous survey project on measures of trauma, sexual offending, the relationship between trauma and perpetration, and adjudication status. The first group admitted to sexual offending before the age of 12 only (n = 48), the second after the age of 12 only (n = 130), and the third before and after the age of 12 (n = 65). More than 46% of the sexually aggressive adolescents began their deviant behaviors before the age of 12. Level and complexity of perpetration acts were more severe for the continuous offenders than for the other groups. Victimization and perpetration were significantly correlated for all three groups. This study supports a social learning hypothesis for the development of sexual offending by adolescents. Implications for research and clinical practice are drawn.     

Synergic effects of VEGF‐A and SDF‐1 on the angiogenic properties of endothelial progenitor cells

Here we investigated the impact of hypoxic environment on the angiogenic properties of early‐outgrowth endothelial progenitor cells (EPCs), with particular focus on the role of secreted vascular endothelial growth factor‐A (VEGF‐A) and stromal derived factor‐1 (SDF‐1) in mediating these effects. We found that cultured EPCs secreted factors with paracrine effects on chemotaxis, migration, proliferation and tube formation of mature endothelial cells (ECs), and these properties were not affected by hypoxia. Depletion of VEGF‐A did not change the ability of EPC‐conditioned medium (CM) to promote EC migration and tube formation in vitro, suggesting that the pro‐angiogenic paracrine effects of EPCs did not totally rely on the presence of VEGF‐A. These findings were confirmed by in vivo experiments, on a mouse model of hind limb ischaemia, which showed that VEGF‐depleted EPC‐CM sustained tissue perfusion at the same level as complete EPC‐CM. However, concomitant deletion of VEGF‐A and SDF‐1 in EPC‐CM impaired the pro‐angiogenic properties of EPC‐CM, by inhibition of EC spreading in culture, tube‐like structure formation on Matrigel support, in vivo neovessels formation and ischaemic hind limb regeneration. Taken together, our data demonstrate that: (i) hypoxia does not affect the capacity of EPCs to support the angiogenic process; (ii) the absence of either VEGF‐A or SDF‐1 from EPC‐CM can be rescued by the presence of the other one, so that the overall angiogenic effects remain unchanged; and (iii) and the concomitant deletion of VEGF‐A and SDF‐1 from EPC‐CM impairs its pro‐angiogenic effect, both in vitro and in vivo. Copyright © 2016 John Wiley & Sons, Ltd.     

Caregiver self‐efficacy for managing behavioural problems of older people with dementia in Taiwan correlates with care receivers’ behavioural problems

Aims and objective. To investigate the relationship between family caregivers’ self‐efficacy for managing behavioural problems of older people with dementia and their behavioural problems in Taiwan. Background. Older people with dementia commonly have at least one behavioural problem, which caregivers complain is difficult to handle. To provide interventions that can help caregivers more effectively manage the behavioural problems of care receivers with dementia, caregivers’ self‐efficacy on managing behavioural problems must be assessed. However, it is not clear yet how these behavioural problems of older people with dementia may influence caregivers’ self‐efficacy for managing behavioural problems. Design. A prospective, correlational study. Method. Eighty dyads of older people with dementia and their family caregivers were recruited from neurological clinics of a medical centre in Taiwan. Care receivers were assessed for behavioural problems using the Chinese version of Cohen‐Mansfield Agitation Inventory, community form. Caregivers’ self‐efficacy for managing care receivers’ agitation was measured by the research team‐developed Agitation Management Self‐Efficacy Scale. Results. Caregiver self‐efficacy for managing behavioural problems was significantly and positively associated with more caregiver education, greater duration of caregiving and with care receivers’ less physically non‐aggressive behaviours. When caregiver characteristics were controlled for in hierarchical regression analysis, physically non‐aggressive behaviours explained 6% of the variance in caregiver self‐efficacy. Conclusions. Results of this study contradict the general belief that physically aggressive behaviours of elders with dementia are more difficult for family caregivers to handle than other behavioural problems. Clinicians need to address physically non‐aggressive problem behaviours. Relevance to clinical practice. Nurses could assess older patients with dementia for physically non‐aggressive behaviours and train less educated caregivers to improve their self‐efficacy for managing problem behaviours, thus enhancing the quality of life for both caregivers and care receivers.     

Nearly Invisible: The Psychosocial and Health Needs of Women with Male Partners in Prison

Very little research has been conducted investigating the health status and social needs of women with incarcerated male partners, despite the large number of men from underserved communities who are currently incarcerated. Research with women who have incarcerated male partners has primarily focused on communicable disease risk and family interactions. Women with incarcerated partners are often mothering children who are at risk for early and repeated incarceration, behavioral problems, and poverty. Gaining a better understanding of the health and social needs, and the resources use of these women and their children may lead to developing policies and programs that help them better manage their health, as well as aid in strengthening their family relationships.     

Needs of South African adolescents orphaned by AIDS: evidence from photography and photo‐elicitation

THUPAYAGALE‐TSHWENEAGAE G. & MOKOMANE Z. (2013) Needs of South African adolescents orphaned by AIDS: evidence from photography and photo‐elicitation. International Nursing Review 60 , 88–95 Background: Available evidence shows that over half of all orphans under the age of 18 years are adolescents aged between 12 and 17 years. Despite this, the needs of adolescents orphaned by AIDS are seldom recognized or adequately addressed in policy and programmes. Instead, the focus tends to be on the needs of orphans and vulnerable children. However, there are several factors that render adolescent‐specific programmes important. Purpose: Using data from an urban area in South Africa, this paper illuminates the needs of adolescents orphaned by AIDS. Method: A phenomenological study using photography and photo‐elicitation was used with 15 adolescents aged between 14 and 18 years orphaned by AIDS. Results: The study participants captured different objects that were grouped under six broad themes: symbols of death, nature, people, past life, children and hope. The photographic component of the study was followed by photo‐elicitation. From the meanings the adolescents made of their images, the needs of adolescents orphaned by AIDS were discerned as love, care and acceptance, safety, and security and support. Conclusion: Overall, the results showed that adolescents orphaned by AIDS want to feel secure, safe, wanted by caregivers and to feel that caregivers support them in their grieving journey.     

Effectiveness of a 12‐week school‐based educational preventive programme on weight and fasting blood glucose in “at‐risk” adolescents of type 2 diabetes mellitus: Randomized controlled trial

To assess the effectiveness of a 12‐week school‐based educational preventive programme for type 2 diabetes by change in weight and fasting blood glucose level in Jordanian adolescents. Sixteen percent of Jordanian adults have obesity‐related type 2 diabetes and 5.6% of obese adolescents examined, however one‐third unexamined. Rates in Arabic countries will double in 20 years, but this can be prevented and reversed by controlling obesity. A single‐blinded randomized controlled trial was conducted in 2 unisex high schools in Irbid, Jordan, in 2012. Intervention and control participants, aged 12 to 18 years, were visibly overweight/obese. They were randomly allocated to the intervention (n = 205) or control (n = 196) groups. At‐risk students were assessed before and after the 12‐week intervention, for change in weight and fasting blood glucose level following preventive instruction and parent‐supported changes. Mean age of participants was 15.3 years with equal percentages of both males (49.4%) and females. Post intervention, the intervention group, demonstrated statistically significant reductions: mean difference of 3.3 kg in weight (P < .000) and 1.36 mg/dL (0.075 mmol/L) in fasting blood glucose (P < .000). School‐based early prevention intervention effectively reduced weight and fasting blood glucose in Jordanian at‐risk adolescents.     

‘The self‐destruction force is so strong’: male survivors’ experience of suicidal thoughts following sexual violence

Suicidal thoughts are common among male sexual violence survivors. However, very few studies have focused specifically on this aspect. The purpose of this study was to explore the experience of male survivors themselves of suicidal thoughts following sexual violence within the framework of men and masculinity. The research methodology was The Vancouver School of Doing Phenomenology, and a total of 17 interviews were conducted with seven male survivors. The main findings of the study are that the source of the suicidal thoughts after sexual violence is based on an experienced strong self‐destruction force that involves almost unbearable and unexpressed suffering. The strong self‐destruction force appeared among other things in risk behaviour and negligence towards own life and health. Participants all agreed that the thought of suicide was a certain escape route, that is to be constantly trying to escape from oneself and inner suffering. Negative thoughts that were difficult to suppress developed into suicidal thoughts that developed into thinking about the best possible way to commit suicide. Shattered self‐esteem, shame and loneliness characterised the lives of participants, and they felt disgusting and worthless as human beings. Much self‐degradation was characteristic. Perceived common societal norms about male masculinity had major negative impact on participants, for example that they should not show emotions because they were men and therefore should not express emotional pain or disclose their traumas. This resulted in emotional silencing. Disclosing the violence proved extremely difficult for all participants, but they experienced a high level of positive energy following disclosure. Participants experienced lack of knowledge, understanding and appropriate support from healthcare professionals and felt that sexual violence survivors’ trauma history needed to be better explored within health care. It is important that professionals acquire knowledge and understanding of male sexual violence survivors, and their suicidal thoughts, and become able to provide trauma‐specific support.     

Dialectical Behavior Therapy in Adolescent Residential Treatment: Outcomes and Effectiveness

Dialectical Behavior Therapy (DBT), developed as outpatient treatment for adult women with self-harm spectrum behaviors (SHSB), has been effective in many adult settings, across various diagnoses. DBT was adapted for adolescents (DBT-A) and showed effectiveness in outpatient and hospital settings. Adolescents enter residential treatment with severe behavioral problems and emotional dysregulation; deficits that DBT-A addresses. A year-long treatment using DBT-A (n = 48, 46% male) in an adolescent residential setting with no exclusionary criteria regarding SHSB or diagnosis was examined using a pre–post design. Clinical functioning data was collected at admission and discharge, using Achenbach’s Youth Self Report (YSR), Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS), Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), and DBT-A skills questionnaire. DBT-A demonstrated excellent clinical utility to reduce number of diagnoses from admission (M = 3.13) to discharge (M = 1.33, d = 1.435), and symptom severity, over and above gender and SHSB, independent of primary diagnosis. Regarding perceived utility of DBT-A modules, adolescents were significantly more likely to report using Distress Tolerance skills (71.7%) than other DBT-A skills and to report that all skills will work if used (67.8%) rather than reporting that a particular skill is ineffective.     

Psychosocial,mechanical, and metabolic factors in adolescents’ musculoskeletal pain in multiple locations: A cross‐sectional study

Recent studies indicate that adolescents often experience musculoskeletal pains in two or more body locations. However, previous studies have mainly focused on localized pains, and the determinants of multiple musculoskeletal pains in adolescents are not well known. The present study was set to evaluate the role of psychosocial, mechanical, and metabolic factors in adolescents’ musculoskeletal pains in multiple locations. The study population consisted of the 1986 Northern Finland Birth Cohort; 15‐ to 16‐year‐old adolescents (n=6986), who responded to a mailed questionnaire in 2001. We assessed the associations of emotional and behavioral problems, physical activity, sitting time, sleeping time, overweight and smoking with musculoskeletal pains using multinomial logistic regression. Multiple pains were common, 23% of boys and 40% of girls reported feeling pain in at least three locations over the past 6 months. These pains were not only associated with anxious/depressed symptoms, withdrawn/depressed symptoms, somatic complaints, rule‐breaking and aggressive behavior, social problems, thought and attention problems, but also with high physical activity level, long sitting time, short sleeping time and smoking, among both boys and girls. In addition, pain in three to four locations associated with overweight in girls. A high number of psychosocial, mechanical and metabolic factors associated strongly with multiple pains. In conclusion, multiple musculoskeletal pains were strongly associated with psychosocial complaints, but also with mechanical and metabolic factors. Reported musculoskeletal pains in multiple locations in adolescence may have both peripheral (trauma, decreased regenerative ability) and central (sensitivity) causes.     

Feasibility of a mHealth survey application for incarcerated and postrelease people living with HIV in a low‐resource setting

Mobile health (mHealth) holds considerable promise as a way to give people greater control of their health information, privacy, and sharing in the context of HIV research and clinical services. The purpose of this study was to determine the feasibility of an mHealth research application from the perspective of three stakeholder groups involved in an HIV clinical trial in Jakarta, Indonesia: (a) incarcerated people living with HIV (PLWH), (b) research assistants (RAs), and (c) research investigators. Incarcerated PLWH (n = 150) recruited from two large all‐male prisons completed questionnaires, including questions about mHealth acceptability, on an mHealth survey application using a proprietary data collection software development platform. RAs who administered questionnaires (n = 8) rated the usability of the software application using the system usability scale (SUS) and open‐ended questions. Research investigators (n = 2) completed in‐depth interviews, that were coded and analyzed using the technology acceptance model (TAM) as a conceptual framework. Over 90% of incarcerated PLWH felt the mHealth application offered adequate comfort, privacy, and accuracy in recording their responses. RAs' SUS scores ranged from 60% to 90% (M = 76.25) and they found the mHealth survey application challenging to learn, but highly satisfying. Compared with paper‐based data collection, researchers felt that electronic data collection led to improved accuracy and efficiency of data collection and the ability to monitor data collection remotely and in real time. The researchers perceived the learnability of the application as acceptable but required self‐instruction.     

Adolescents with implantable cardioverter defibrillators: a patient and parent perspective

Background: An implantable cardioverter defibrillator (ICD) is a device used in the treatment of individuals with life‐threatening cardiac conditions. These include genetic disorders such as long QT syndrome, hypertrophic cardiomyopathy, and Brugada syndrome, all of which have the propensity to cause sudden cardiac death. Adults with ICDs consistently report elevated levels of anxiety and depression, as well as negative lifestyle changes associated with the device. Compared to older ICD recipients, young patients face decades of life with the device and the long‐term impact and implications are important to consider. This research explores the experiences of adolescents living with an ICD. Parents of these adolescents were also included to explore the impact on them as the primary caregivers. Methods: A qualitative approach was chosen to explore the lived experience; semistructured interviews with six adolescents and six parents were conducted from which a number of key themes emerged. Results: The experiences described by participants included the restrictions adolescents face, the ICD shock experience, and ongoing challenges post‐ICD implantation. However, both adolescents and parents were able to adjust to life after receiving an ICD and described several benefits associated with having the device. Findings also emerged relating to communication between health professionals and adolescents, and the limitations adolescents impose on themselves post‐ICD implantation. Conclusion: These findings have important implications for clinical practice and may help guide medical management for adolescents with ICDs and their families. (PACE 2012; 35:62–72)     

Fucoidan‐induced osteogenic differentiation promotes angiogenesis by inducing vascular endothelial growth factor secretion and accelerates bone repair

Osteogenesis and angiogenesis, including cell–cell communication between blood vessel cells and bone cells, are essential for bone repair. Fucoidan is a chemical compound that has a variety of biological activities. It stimulates osteoblast differentiation in human mesenchymal stem cells (MSCs), which in turn induces angiogenesis. However, the mechanism by which this communication between osteoblasts and endothelial cells is mediated remains unclear. Thus, the aim of this study was to clarify the relationship between fucoidan‐induced osteoblastic differentiation in MSCs and angiogenesis in endothelial cells. First, the effect was confirmed of fucoidan on osteoblast differentiation in MSCs and obtained conditioned media from these cells (Fucoidan‐MSC‐CM). Next, the angiogenic activity of Fucoidan‐MSC‐CM was investigated and it was found that it stimulated angiogenesis, demonstrated by proliferation, tube formation, migration and sprout capillary formation in human umbilical vein endothelial cells. Messenger ribonucleic acid expression and protein secretion of vascular endothelial growth factor (VEGF) were dramatically increased during fucoidan‐induced osteoblast differentiation and that its angiogenic activities were reduced by a VEGF/VEGF receptor‐specific binding inhibitor. Furthermore, Fucoidan‐MSC‐CM increased the phosphorylation of mitogen‐activated protein kinase and PI3K/AKT/eNOS signalling pathway, and that its angiogenic effects were markedly suppressed by SB203580 and AKT 1/2 inhibitor. Finally, an in vivo study was conducted and it was found that fucoidan accelerated new blood vessel formation and partially promoted bone formation in a rabbit model of a calvarial bone defect. This is the first study to investigate the angiogenic effect of fucoidan‐induced osteoblastic differentiation through VEGF secretion, suggesting the therapeutic potential of fucoidan for enhancing bone repair.     

Why do young people sniff? An exploratory study of adolescent inhalant abuse from north India

Background: Inhalant abuse among adolescents is a growing problem worldwide including developing countries like India. It is important to understand the nature of adolescent inhalant abuse behaviour in order to counter the emerging problem.Aims: 1. To assess sociodemographic profile of treatment-seeking adolescents with inhalant abuse. 2. To explore inhalant abuse behaviour among treatment-seeking adolescents.Method: A 6-month long explorative study on 23 consecutive male adolescents seeking treatment for inhalant abuse (aged 13–18) in a tertiary de-addiction centre of India was conducted using a semi-structured questionnaire and a checklist to inquire about the perceived effect of inhalant abuse.Results: All adolescent males [mean age 16 (SD = 1.86) years] belonged to urban area and enjoyed adequate social support. “Sniffing” was the commonest route of inhalant abuse. Experimentation and peer pressure were the commonest reasons reported by adolescents for initiation (65.21%), whereas boldness (56%) was the commonest perceived effect of inhalant abuse.Conclusions: While experimentation and peer pressure contribute in initiation, perceived effects like boldness contribute in continuation of adolescent inhalant abuse in India. Increase in confidence and boldness is a much-desired effect in growing adolescents, and the abuse of inhalants reinforces the same.     

Self-rated health of Chinese adolescents: distribution and its associated factors

Scand J Caring Sci; 2011; 25; 780–786
Self‐rated health of Chinese adolescents: distribution and its associated factors Aim: Self‐rated health is a valid and relevant indicator of individuals’ and populations’ health status, and has been shown to be a critical predictor of some medical endpoints. The studies concentrating on Chinese adolescents’ self‐rated health were scarce. The present study aimed to understand the self‐rated health and its associated factors of Chinese adolescents. Methods: Ten schools including junior schools, senior schools and universities of Hefei in Anhui Province of China were randomly selected. A cross‐sectional survey was conducted to the selected 5226 students to investigate their demographic variables, sleep quality, self‐rated health and degree of depression, anxiety and loneliness. In terms of the instruments, Self‐rated Health Measurement Scale Version 1.0, Pittsburgh Sleep Quality Index, UCLA Loneliness Scale, Beck Depression Inventory, Self‐rating Anxiety Scale and the demographic survey were used in the present study. Results: The sleep quality, self‐rated health and degree of depression, anxiety and loneliness among different grade levels were different (p < 0.01 or <0.05). The multivariate analysis indicated that young age, poor sleep quality and high degree of depression, anxiety and loneliness were significantly associated with poor self‐rated health of adolescents. Conclusion: The adolescents’ poor self‐rated health may be attributed to many causes especially the psychological reasons. Future interventions that focus more on the inner causes may be the better steps to make adolescents healthy.     

Predictors of obesity in school‐aged Jordanian adolescents

Manal Ibrahim A‐K, Mousa Ali A‐H, Erika Sivarajan F. International Journal of Nursing Practice 2010; 16 : 397–405
Predictors of obesity in school‐aged Jordanian adolescents This cross‐sectional study aimed to estimate the frequency of overweight and obesity in adolescents as defined by the International Obesity Task Force, and to estimate the effect of sociodemographic and health behaviours (eating habits and physical activity) that predict obesity. A stratified (by gender) random sample of 518 adolescents, aged 15 or 16 years was obtained from eight public schools in Amman. In this sample 17.5% were overweight and 9.6% were obese. The predictors of obesity and overweight (excess weight) were: (i) fathers attained primary and secondary education; (ii) total monthly family income ≥ 300 (JD); (iii) working mothers; (iv) family size ≤ 6; and (v) having obese parents. Eating a low quality diet (chips, candy) was a significant dietary predictor of excess weight. The family variables found to be important predictors along with a low quality diet suggest that family interventions would be necessary in the control of adolescent excess weight.