Breakthrough drug-eluting patch stops scar growth, reduces scar tissues

Scars — in particular keloid scars that result from overgrowth of skin tissue after injuries or surgeries — are unsightly and can even lead to disfigurement and psychological problems of affected patients. Individuals with darker pigmentation — in particular people with African, Hispanic or South-Asian genetic background — are more likely to develop this skin tissue disorder. Current therapy options, including surgery and injections of corticosteroids into scar tissues, are often ineffective, require clinical supervision and can be costly.A new invention by researchers from Nanyang Technological University in Singapore (reported in the current issue of TECHNOLOGY) provides a simple, affordable and — most importantly — highly effective way for patients to self-treat keloid scars. The team of scientists and engineers from NTU’s School of Chemical and Biomedical Engineering, in collaboration with clinicians from Singapore’s National Skin Centre, have developed a special patch made from polymers fabricated into microneedles, which are loaded with the US food and drug administration (FDA)-approved scar-reducing drug, 5-fluorouracil. Self-administered by patients, the microneedles attach the patch to scar tissue and allow sustained drug-release (one patch per night). The drug as well as the physical contact of the microneedles with the scar tissue contributes to the efficacy of the device, leading to the cessation of scar tissue growth and a considerable reduction of keloids as demonstrated in laboratory cultures and experiments with animals. “Most patients seek treatment due to disfigurement and/or pain or itch of scars,” says Assistant Professor Xu Chenjie from NTU who leads the study. “We wanted to develop a simple, convenient, and cost-effective device able to inhibit keloid growth in skin tissue and reduce the size of disfiguring scars,” adds Yuejun Kang, another key investigator in the study from NTU.”Self-administered treatment for keloid scars can reduce the economic burden on the healthcare system and provide a treatment option for patients who have limited access to medical care,” comments Professor Jeffrey Karp from Brigham and Women’s Hospital at Harvard Medical School, US, an expert on medical device design who was not involved in this study.Story Source:The above story is based on materials provided by World Scientific. Note: Materials may be edited for content and length.

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Number of babies mom has may play role in future cardiovascular health

Women who give birth to four or more children are much more likely to have evidence of plaque in their heart or thickening of their arteries — early signs of cardiovascular disease — compared with those having fewer pregnancies, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.While earlier studies have shown an association between several aspects of pregnancy — physiological changes, complications, number of pregnancies — and future heart disease risk, many questions remain about how pregnancy might affect cardiovascular risk. To better understand the potential link, researchers at the University of Texas Southwestern Medical Center set out to determine whether the number of live births is associated with early signs of cardiovascular disease.”This is not a recommendation for women to only have two or three children,” said Monika Sanghavi, M.D., chief cardiology fellow, University of Texas Southwestern Medical Center, and lead investigator of the study. This is the first study to look at two markers of subclinical atherosclerosis — a gradual narrowing and hardening of the arteries that can eventually block blood flow and lead to stroke and heart attack.”Our findings add to the growing body of evidence that the changes associated with pregnancy may provide insight into a woman’s future cardiovascular risk and deserves further attention.”The study included 1,644 women from the Dallas Heart Study, a multiethnic population-based cohort, who had both self-reported information about the number of live births and relevant imaging study data available. The average age at the time of analysis was 45 years and slightly more than half of the women (55 percent) were African-American. Coronary artery calcium (CAC) scores were measured using computed tomography imaging and aortic wall thickness (AWT) by magnetic resonance imaging to determine whether or not women had evidence of subclinical atherosclerosis in the heart and artery walls. CAC was positive if it was greater than 10 and AWT was abnormal if it was greater than the 75th percentile for age and gender. These tests were done as part of standard subject participation in the Dallas Heart Study.Using women who had two or three live births as a reference, women who had given birth to four or more children had an approximately two-fold increased risk of having abnormal CAC or AWT. This association remained even after adjusting for socioeconomic status, education, race and factors known to heighten the risk of cardiovascular disease. Women who had more babies were more likely to be older, Hispanic, have high blood pressure, higher body mass index and lower socioeconomic status.Curiously, women who had zero or just one live birth were also more likely to show evidence of subclinical atherosclerosis — revealing a U-shaped relationship.Authors say it is unclear why this might be the case. But Sanghavi and others speculate they may have captured some women in this group who have an underlying condition that prevents them from carrying a first or second pregnancy to term, which may also predispose them to cardiovascular disease or risk factors. …

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Blacks, Hispanics, older people not benefitting equally from better colon cancer treatment

While new and better treatments have improved the odds of survival for patients diagnosed late stage colorectal cancer, that progress has been largely confined to non-Hispanic whites and Asians and those under age 65, according to a new study. American Cancer Society researchers led by Helmneh Sineshaw, M.D., MPH, find there have been no significant increases in survival rates for Hispanics and non-Hispanic blacks with metastatic colon cancer. The study, appearing in the January issue of Cancer Causes and Control, concludes that the findings underscore the need for concerted efforts to increase access to new treatments for minority groups and older patients, as well as a better understanding of the factors contributing to the disparities in survival.For their study, researchers analyzed data from the 13 population-based cancer registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program, which covers about 14 percent of the United States population. They looked at survival improvement for metastatic colorectal cancer across major ethnic groups and two broad age ranges (20-64 and over 65 years). Just fewer than 50,000 patients (49,893) were included in the analysis.The analysis found overall five-year survival rates increased significantly between 1992/1997 and 2004/2009 for non-Hispanic whites (9.8% to 15.7%) and for Asians (11.4% 17.7%). The increases were not statistically significant for non-Hispanic blacks (8.6% to 9.8%) or Hispanics (14.0% to 16.4%). And while survival rates increased significantly for those 65 and over for non-Hispanic whites, those increases were much smaller than the increase among those ages 20 to 64.The authors conclude that increases in survival from metastatic colorectal cancer, presumably from improvements in treatment, has been largely confined to younger non-Hispanic whites and Asians, and that there has been no statistically significant increase in survival for non-Hispanic blacks and Hispanics.”We know from previous studies that when people of any race get equal care they have similar outcomes,” said Dr. Sineshaw. “But studies show there are significant inequalities in the dissemination of new treatments, likely leading to the gaps in survival our analysis found. The reasons why ethnic minorities are not getting equal treatment are complicated, but likely include poorer health coming into the system and lower socioeconomic status, which clearly leads to barriers to good health care. …

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Seven new genetic regions linked to type 2 diabetes

Seven new genetic regions associated with type 2 diabetes have been identified in the largest study to date of the genetic basis of the disease.DNA data was brought together from more than 48,000 patients and 139,000 healthy controls from four different ethnic groups. The research was conducted by an international consortium of investigators from 20 countries on four continents, co-led by investigators from Oxford University’s Wellcome Trust Centre for Human Genetics.The majority of such ‘genome-wide association studies’ have been done in populations with European backgrounds. This research is notable for including DNA data from populations of Asian and Hispanic origin as well.The researchers believe that, as more genetic data increasingly become available from populations of South Asian ancestry and, particularly, African descent, it will be possible to map genes implicated in type 2 diabetes ever more closely.’One of the striking features of these data is how much of the genetic variation that influences diabetes is shared between major ethnic groups,’ says Wellcome Trust Senior Investigator Professor Mark McCarthy from the University of Oxford. ‘This has allowed us to combine data from more than 50 studies from across the globe to discover new genetic regions affecting risk of diabetes.’He adds: ‘The overlap in signals between populations of European, Asian and Hispanic origin argues that the risk regions we have found to date do not explain the clear differences in the patterns of diabetes between those groups.’Among the regions identified by the international research team are two, near the genes ARL15 and RREB1, that also show strong links to elevated levels of insulin and glucose in the body — two key characteristics of type 2 diabetes. This finding provides insights into the ways basic biochemical processes are involved in the risk of type 2 diabetes, the scientists say.The genome-wide association study looked at more than 3 million DNA variants to identify those that have a measurable impact on risk of type 2 diabetes. By combining DNA data from many tens of thousands of individuals, the consortium was able to detect, for the first time, regions where the effects on diabetes susceptibility are rather subtle.’Although the genetic effects may be small, each signal tells us something new about the biology of the disease,’ says first author Dr Anubha Mahajan of Oxford University. ‘These findings may lead us to new ways of thinking about the disease, with the aim ultimately of developing novel therapies to treat and prevent diabetes. There’s every reason to expect that drugs acting on these biological processes would have a far larger impact on an individual’s diabetes than the genetic effects we have discovered.’Principal investigator Dr Andrew Morris, also of the Wellcome Trust Centre for Human Genetics at Oxford University, says: ‘The findings of our study should also be relevant to other common human diseases. By combining genetic data from different ethnic groups, we would expect also to be able identify new DNA variants influencing risk of heart disease and some forms of cancer, for example, which are shared across ethnic groups. It has the potential to have a major impact on global public health.’Story Source:The above story is based on materials provided by University of Oxford. …

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Link strengthened between low fiber intake, increased cardiovascular risk

Oct. 18, 2013 — A new study published in the December issue of The American Journal of Medicine shows a significant association between low dietary fiber intake and cardiometabolic risks including metabolic syndrome, cardiovascular inflammation, and obesity. Surveillance data from 23,168 subjects in the National Health and Nutrition Examination Survey (NHANES) 1999-2010 was used to examine the role dietary fiber plays in heart health.In the current study investigators have taken a closer look at possible sex, age, racial/ethnic, and socioeconomic disparities in dietary fiber consumption, as well as examined the association between dietary fiber intake and various cardiometabolic risk factors.Dietary fiber, which previous studies have shown may assist in lowering blood pressure, cholesterol levels, and inflammation, is thought to play an important role in reducing cardiovascular risk. Despite this knowledge, investigators found that dietary fiber intake was consistently below recommended intake levels for NHANES participants.The Institute of Medicine defines recommended intake levels according to age and sex: 38g per day for men aged 19-50 years, 30g per day for men 50 and over, 25g for women aged 19-50 years, and 21g per day for women over 50. Using data from NHANES 1999-2010, the study reveals that the mean dietary fiber intake was only 16.2g per day across all demographics during that time period.”Our findings indicate that, among a nationally representative sample of nonpregnant US adults in NHANES 1999-2010, the consumption of dietary fiber was consistently below the recommended total adequate intake levels across survey years,” says senior investigator Cheryl R. Clark, MD, ScD, Center for Community Health and Health Equity, Brigham and Women’s Hospital and Harvard Medical School, Boston. “Our study also confirms persistent differences in dietary fiber intake among socioeconomic status and racial/ethnic subpopulations over time.”The research team found variations according to race and ethnicity, with Mexican-Americans consuming higher amounts of dietary fiber and non-Hispanic blacks consuming lower amounts of dietary fiber compared with non-Hispanic whites.The study highlights the importance of increasing dietary fiber intake for US adults by showing a correlation between low dietary fiber and an increased risk for cardiovascular risk. Participants with the highest prevalence of metabolic syndrome, inflammation, and obesity were in the lowest quintile of dietary fiber intake.”Overall, the prevalence of the metabolic syndrome, inflammation, and obesity each decreased with increasing quintiles of dietary fiber intake,” comments Clark. “Compared with participants in the lowest quintile of dietary fiber intake, participants in the highest quintile of dietary fiber intake had a statistically significant lower risk of having the metabolic syndrome, inflammation, and obesity.”This new data analysis emphasizes the importance of getting adults across diverse ethnicities to increase their dietary fiber intake in order to try and mitigate the risk for cardiovascular damage.”Low dietary fiber intake from 1999-2010 in the US and associations between higher dietary fiber and a lower prevalence of cardiometabolic risks suggest the need to develop new strategies and policies to increase dietary fiber intake,” adds Clark. “Additional research is needed to determine effective clinical and population-based strategies for improving fiber intake trends in diverse groups.”

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Sustaining Injuries on Construction Sites

Work in the construction industry is physically demanding and incredibly dangerous. Varied terrain, unpredictable weather, and ever-changing surroundings are a few of the many factors that can predispose to a construction-related injury. Falls from scaffolding or ladders, injury from falling debris, machinery accidents, and electrocution are all examples of what can happen when something goes wrong on a construction site, either as a result of an accident or due to negligence.It goes without saying that the injuries in the construction industry can be severe. Sprains, strains, broken bones, and even death can occur. When occupational injuries and illnesses are reported, one of the key measures of injury severity is the median number of days spent away from work per each injured case. According to the Bureau of Labor Statistics, in 2011, the construction industry ranked third, with a median number of 14 days spent away from work due to injury. Only the mining and transportation industries ranked higher.In addition, for many years, construction workers have experienced the highest number of fatal occupational injuries among workers in all industries. Despite a 42% decline in the number of fatal injuries in the industry since 2006, the Bureau of Labor Statistics reports that the private construction industry had the highest number of job-related fatalities in 2010, with a total of 774 deaths reported.It is possible that these numbers do not accurately represent the full scope of fatal accidents that occur in the construction industry. For example, many experts believe that the 42% decline in construction-related deaths is likely due to adverse economic conditions that have lowered recent demand for the services of the construction industry. In addition, a recent report from the Center for Construction Research and Training noted that the data published by the Bureau of Labor Statistics does not include self-employed or federal workers, who comprise roughly 25% of the U.S. …

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Controlling blood pressure, cholesterol may significantly cut heart disease risk

July 1, 2013 — Simultaneously controlling your high blood pressure and high cholesterol may cut your risk for heart disease by half or more, according to new research in the American Heart Association journal Circulation. Yet fewer than one in three people achieve this goal.Researchers also found:Prescribing medications to better manage blood pressure and cholesterol would greatly benefit people who are older, diabetic, have cardiovascular disease or are Hispanic or African-American. Going to the doctor at least twice a year could help. Undertreated high blood pressure and cholesterol affect millions of Americans — posing a major public health threat, said Brent M. Egan, M.D., lead study author and a professor of medicine and pharmacology at Medical University of South Carolina in Charleston, S.C.”The reality is, we know more than enough to prevent 75 percent of heart disease and strokes, but we’re not doing everything we could be doing or even doing it at a reasonable level,” he said. “We’ve made some gradual improvements over the years, but there is still a lot of progress to be made.”High blood pressure affects about 33 percent of the U.S. adult population and doubles the risk for heart disease. About 32 million Americans have dangerously high total blood cholesterol levels of 240 mg/dL or higher. Previous research indicates that treating high blood pressure reduces the risk of heart disease by 25 percent and treating high cholesterol in hypertensive patients can lower the risk by more than 35 percent, researchers said.The findings are based on data of more than 17,000 American adults who participated in the National Health and Nutrition Examination Surveys during in 1988-94, 1999-2004 and 2005-10. In addition to reviewing patients’ blood pressure and cholesterol levels, researchers considered race, age, insurance status, whether patients smoked, had diabetes, had diagnosed heart disease and/or chronic kidney disease, and if they visited a doctor every year.Cholesterol readings need closer attention, Egan said. …

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Hot flashes before menopause? It can happen

June 12, 2013 — More than half of middle-aged women who still have regular cycles have hot flashes. Asian and Hispanic women are less likely to have them than white women, but compared with previous studies, the figures are surprisingly high, showed a survey of some 1,500 women published online today in Menopause, the journal of The North American Menopause Society (NAMS).The survey, conducted by researchers at Group Health (a large healthcare system in the Pacific Northwest) and Fred Hutchinson Cancer Research Center in Seattle, Washington, consisted of a diverse group of women, including whites, blacks, Hawaiian/Pacific Islanders, women of mixed ethnicity, Vietnamese, Filipinos, Japanese, East Indians, Chinese, and other Asians. The women were 45 to 56 years old, had regular cycles, had no skipped periods, and were not taking hormones.A surprising 55% of them reported having hot flashes or night sweats. (Previous studies pegged the highest rates at below 50%.) The groups with the highest proportions reporting hot flashes or night sweats were Native Americans (67%) and black (61%) women, but the differences between these groups and white women weren’t statistically significant. Fifty-eight percent of white women, the largest ethnic group, reported having hot flashes or night sweats.Compared with them, Asian and Hispanic women were significantly less likely to have these symptoms. Among Asian women, 31% of Filipino, 26% of Japanese, 25% of East Indian, 23% of “other Asian,” and 18% of Chinese women reported having hot flashes or night sweats. Twenty-six percent of Hispanic women reported these symptoms.Interestingly, white women who had symptoms were more likely to include soy in their diet, and white women who never had symptoms were more likely to have no soy in their diet.This study should help ease a worry for women who have been surprised by hot flashes and night sweats while they are still having regular cycles. It doesn’t necessarily mean they are in menopause yet, and it’s perfectly normal. “Some women even have a hot flash the first couple of nights after childbirth,” said Dr. Margery Gass, NAMS Executive Director.

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Designated drivers don’t always abstain: One in three are impaired, study suggests

June 10, 2013 — Maybe better call that cab, after all: A new University of Florida study found that 35 percent of designated drivers had quaffed alcohol and most had blood-alcohol levels high enough to impair their driving.Adam Barry, an assistant professor of health education and behavior at UF, and his team interviewed and breath-tested more than 1,000 bar patrons in the downtown restaurant and bar district of a major university town in the Southeast. Of the designated drivers who had consumed alcohol, half recorded a blood-alcohol level higher than .05 percent — a recently recommended new threshold for drunken driving.”If you look at how people choose their designated drivers, oftentimes they’re chosen by who is least drunk or who has successfully driven intoxicated in the past — successful meaning got home in one piece … that’s disconcerting,” Barry said.The results are published in the July issue of the Journal of Studies on Alcohol and Drugs.The researchers recruited patrons as they left bars between 10 p.m. and 2:30 a.m. across six Friday nights before home football games in fall 2011. The mean age of the 1,071 people who agreed to be tested was 28. Most were white male college students, while 10 percent were Hispanic, 6 percent were Asian and 4 percent were African-American.After completing a 3-5 minute interview about demographic data and alcohol-related behaviors, participants then had their blood-alcohol content tested with a hand-held breath-testing instrument.The non-driving participants had significantly higher levels than the designated drivers, but 35 percent of the 165 self-identified designated drivers had been drinking. Seventeen percent of all those drivers tested had blood-alcohol levels between .02 and .049 percent, while 18 percent were at .05 percent or higher.The National Transportation Safety Board last month recommended all 50 states adopt a blood-alcohol content cutoff of 0.05 compared with the 0.08 standard used today to prosecute drunken driving. The American Medical Association made the same recommendation in the 1980s, Barry said.Barry said he doesn’t know why a designated driver would consume alcohol, but factors could include group dynamics or the driver’s belief that one or two drinks won’t impair his skills if he is an experienced drinker.Some field-based research suggests designated drivers might drink because the group did not consider who would drive before drinking commenced. Barry also suggested that it’s tricky for anyone to accurately evaluate their own sobriety.”That’s the insidious nature of alcohol — when you feel buzzed, you’re drunk,” he said.There is no universally accepted definition of a designated driver, according to the research. …

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Skin transplant offers new hope for vitiligo patients

May 30, 2012 — Henry Ford Hospital dermatologists say skin transplant surgery is safe and effective for restoring skin pigmentation caused by the skin disease vitligo.

In a first study of its kind in the United States, researchers followed 23 patients for up to six months after surgery and found that the treated area regained on average 43 percent of its natural skin color. In eight patients with localized vitiligo, the treated area regained on average 68 percent of its natural skin color.

The surgery involves using skin cells taken from healthy, normally pigmented areas of the body and transferring them to the damaged area of skin. It is performed under local anesthesia.

The study is published in the May edition of the Journal of the American Academy of Dermatology. “The results achieved in our study were of obvious significance to our patients,” says Iltefat Hamzavi, M.D., a senior staff physician in Henry Ford’s Department of Dermatology and the study’s senior author and principal investigator. “We believe this new treatment option offers hope to patients of color and those with vitiligo on one side of the body or in one area of the body.”

Vitiligo is a skin disease that causes the skin to lose color and develop white patches that vary in size and location. It affects about 1 in every 200 people in the United States, and is more noticeable in people with darker skin. Standard treatments include light therapy and topical medications.

Vitiligo develops when cells called melanocytes are killed by the body’s immune system, causing the area of skin to turn white because the cells no longer make pigment. While there is no cure, vitiligo can be treated and managed with light therapy, creams and topical medications.

The surgery is known as melanocyte-keratinocyte transplantation, or MKTP, and is performed in Europe, Asia and the Middle East. It was performed at Henry Ford using the same technique developed by MKTP pioneer Sanjeev Mulekar, M.D., of the National Vitiligo Center in Saudi Arabia. Henry Ford is the first to perform MKTP in North America.

In Henry Ford’s study, 28 patients underwent surgery and ranged in age from 18 to 60. A total of 36 MKTP procedures were performed and researchers analyzed the outcomes of 29 of them. The procedure lasted 30 minutes to two hours and patients returned home the same day.

Of the 28 surgery patients, 23 were followed for up to six months after surgery. Eighteen patients received one treatment, four patients received two and one patient received three. The ethnicity of patients was Caucasian, South Asian, African American and Hispanic.

During MKTP, melanocyte cells, which produce pigment in the skin, hair and eyes, are harvested from an area of healthy skin and separated to make a skin cell mixture. This mixture then is applied to the treatment area and covered with a specially developed adhesive biologic dressing.

Treated areas included the hands, arms, legs, feet, face and stomach. The average size of the treated area during each procedure was 46 cm2, or roughly the size of a credit card.

The study was a collaboration between Henry Ford and the National Center for Vitiligo, Riyadh, Saudi Arabia, and funded by the Shahani Foundation based in Michigan.

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Increasing problem of prescription drug abuse among youth

May 28, 2013 — Young people are increasingly turning to prescription drugs to get high. Research out of the University of Cincinnati sheds new light on what could increase or lower that risk.

The research by Keith King, a University of Cincinnati professor of health promotion; Rebecca Vidourek, a UC assistant professor of health promotion; and Ashley Merianos, a graduate assistant in health promotion, is published in the current issue of the Journal of Primary Prevention.

The study focused on more than 54,000 7th- through 12th — grade students in schools across Greater Cincinnati, including the Tristate regions of Ohio, Kentucky and Indiana. The data was collected by the Coalition for a Drug Free Greater Cincinnati as part of the 2009-2010 Pride Survey on adolescent drug use in America.

A total of 13.7 percent of the students reported using prescription drugs — without a doctor’s prescription — in their lifetime. Males were more likely to abuse prescription drugs, as well as high school students, versus junior high school students. Among ethnicities studied, Hispanic students indicated they were more likely to use nonmedical prescription drugs compared with white and African-American students.

The study also found that pro-social behaviors, including strong connections with parents (and their advising on the dangers of drug use), reduced the students’ odds of abusing prescription drugs, along with positive connections to teachers and their schools. Connections with peers who disapproved of substance abuse also decreased student chances of abusing prescription medications. “Students at every grade level who reported high levels of parent and peer disapproval of use were at decreased odds for lifetime nonmedical prescription drug use,” according to the study.

On the other hand, the authors found that relationships with drug-using peers increase the risk of youth substance abuse. Peer use of alcohol, tobacco and marijuana were associated with increased use of nonmedical prescription drugs for all students.

“While much research has examined factors associated with overall substance use among youth, relatively few studies have specifically investigated risk factors, protective factors and sex/grade differences for youth involvement in nonmedical prescription use,” write the authors. “Identifying specific risk and protective factors for males, females, junior high and high school students would help to clarify prevention needs and enhance prevention programming.”

The study cites national research that indicates kids are turning to prescription drugs to get high under the mistaken notion that they’re safer than illicit drugs, yet national research has shown that even short-term use of non-prescribed, prescription medications can cause cardiovascular and respiratory distress, seizures and death.

The authors suggest future research should explore young people’s use of specific nonmedical prescription drugs.

Demographics of the Study

The study was close to evenly divided between male (49.4 percent) and female participants; 75 percent reported they were Caucasian; 14.4 percent African-American; 1.8 percent Hispanic/Latino; 2.4 percent Asian/Pacific Islander; 0.4 percent Native American; 4.1 percent multiracial and 1.5 percent selected “other” for ethnicity. Respondents were close to evenly distributed across 7th- through 12th-grades. Approximately two-thirds (62.4 percent) of participants reported living with both parents; 16.2 percent reported living with their mother only; 2.9 percent reported living with their father only.

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