Exposure to alcohol among adolescent students and associated factors

OBJECTIVE

To describe the prevalence of alcohol consumption among adolescent school students and identify its individual and contextual associated factors.

METHODS

The present research used data from the 2009 National School Health Survey (PeNSE), which included a sample of 59,699 9^th grade students in Brazilian capitals and the Federal District. The association between regular alcohol consumption and independent explanatory variables was measured by means of the Pearson’s Chi-square test, with a 0.05 significance level. The explanatory variables were divided into four groups based on affinity (sociodemographic; school and family context; risk factors; and protection factors). A multivariate analysis was carried out for each group, always adjusting for age and sex. Variables with p < 0.10 were used in the final multivariate analysis model.

RESULTS

The highest alcohol consumption in the preceding 30 days was independently associated with pupils aged 15 years (OR = 1.46) and over, female (OR = 1.72), white, children of mothers with higher education, studying in private school, students who had tried smoking (OR = 1.72) and drug use (OR = 1.81), with regular tobacco consumption (OR = 2.16) and those who have had sexual intercourse (OR = 2.37). The factors related to family were skipping school without parental knowledge (OR = 1.49), parents not knowing what children do in their free time (OR = 1.34), having fewer meals with their parents (OR = 1.22), reporting that parents do not care (OR = 3.05), or care little (OR = 3.39) if they go home drunk, and having suffered domestic violence (OR = 1.36).

CONCLUSIONS

The results reinforce the importance of viewing alcohol consumption among adolescents as a complex, multifactorial and socially determined phenomenon.     

Anxiety,Self-Esteem and Coping with Stress in Secondary School Students in Relation to Involvement in Organized Sports

Aim

The objective of the study was to examine self-esteem, anxiety level and coping strategies among secondary school students in relation to their involvement in organized sports.

Methods

The sample included 280 Slovenian male and female secondary school students aged between 15 and 19 years. The participants completed The Adolescent Coping Scale, the Spielberger State-Trait Anxiety Inventory, and the PSDQ Selfesteem Scale.

Results

Participants engaged in organized sports exhibited higher self-esteem scores and lower anxiety scores in comparison to non-sport participants. Differences between the two groups have also been identified with respect to the use of certain coping strategies. Sport participants reported more productive coping than non-sport participants, which represents an active and problem-focused approach to dealing with everyday problems. Gender differences in the referred variables have also been studied, with female athletes exhibiting higher levels of anxiety than male athletes. Female participants were also found to use more non-productive coping than males, focused mainly on reducing emotional effects of stress.

Conclusions

Organized youth sports have an important role in improving and maintaining a favorable sense of self-worth, reducing anxiety, and promoting productive coping strategies in adolescents when dealing with everyday problems.     

Peer Reviewed: Co-use of Alcohol and Tobacco Among Ninth-Graders in Louisiana

Introduction

The co-use of alcohol and tobacco by adolescents is a public health problem that continues well into adulthood and results in negative behavioral, social, and health consequences. The purpose of this study was to examine the co-use of alcohol and tobacco among ninth-graders in south-central Louisiana.

Methods

We created a health habits survey to collect data from 4,750 ninth-grade students, mean age 15.4 years. Cross-sectional analysis used χ ², 1-way analysis of variance, and logistic regression methods.

Results

Almost 20% of students were co-users. Students who were white, performed poorly in school, did not expect to graduate high school, and had more discretionary money to spend were more likely to be co-users. Co-users had friends who got drunk weekly and were more likely to approve of alcohol use among friends than among adults. Significant differences in attitudes toward drinking and smoking were observed between co-users and nonusers. For adolescent drinkers, including girls, hard liquor was the preferred beverage.

Conclusion

These data for high school students are applicable for prevention strategies at a critical age when harmful health behaviors can mark the start of lifelong habits. Intervention efforts will be successful only if they account for multiple levels of influence.     

Early adulthood: an overlooked age group in national sodium reduction initiatives in South Korea

BACKGROUND/OBJECTIVES

South Korean''s sodium consumption level is more than twice the upper limit level suggested by the WHO. Steep increases in the prevalence of hypertension and cardiovascular disease in Korea necessitate more effective sodium reduction programs. This study was conducted in order to compare sodium intake-related eating behaviors and key psychosocial factors according to age group and gender.

SUBJECTS/METHODS

Using an online survey, a total of 1,564 adults (20-59 years old) considered to be geographically representative of South Korea were recruited and surveyed. The major outcomes were perceived behaviors, knowledge, intentions, and self-efficacy related to sodium intake.

RESULTS

The results show that perceived behavior and level of self-efficacy related to low sodium consumption differed by age and gender. Female participants showed better behavior and intention towards low sodium intake than male counterparts. Young participants in their 20s showed the lowest intention to change their current sodium intake as well as lowest self-efficacy measures.

CONCLUSIONS

Future sodium reduction interventions should be developed with tailored messages targeting different age and gender groups. Specifically, interventions can be planned and implemented at the college level or for workers in their early career to increase their intention and self-efficacy as a means of preventing future health complications associated with high sodium intake.     

Physical Activity,Sedentary Behavior and Substance Use among Adolescents in Slovenian Urban Area

Background

Studies of the relationship between leisure time physical activity, sedentary behaviour and substance use among adolescents report contradictory results. The aim of our study was to examine the association between self-reported leisure time physical activity, sedentary behaviour and alcohol, tobacco and cannabis use among adolescents in Slovenia.

Methods

Subjects consisted of 822 school children aged from 14 to 16 years, living in urban area of Ljubljana and Maribor. The data was collected using the EURO URHIS 2 survey. Logistic regressions were conducted to assess the correlation between the independent variables of physical activity; time spent watching television and using the computer, and each of the five substance use dependent variables.

Results

Frequency of daily smoking was significantly associated with leisure time physical activity, while alcohol and cannabis use were not. Watching TV ≥ 2 hours per day was associated with heavy episodic drinking in the past month, no associations were found for smoking and cannabis use. Using the computer ≥ 2 hours per day was positively associated with daily smoking, drinking alcohol in the past month, heavy episodic drinking in the past month and ever being intoxicated, while cannabis use was not.

Conclusions

These findings suggest that leisure time physical activity is associated with daily cigarette smoking, and leisure time sedentary behaviour is associated with alcohol and tobacco use among adolescents. The results of our study show the need for the formation of suitable preventive measures concerning reduced sitting time as well as leisure time physical activity targeted to adolescents.     

Age at Smoking Initiation in Slovenia

Background

Smoking is initiated mostly by adolescents and young adults. In Slovenia, we have limited data about this. The purpose of this paper is to show data on age at smoking initiation and differences in age at smoking initiation by gender, age groups, education, social class and geographical region among inhabitants of Slovenia.

Methods

We used data from the cross-sectional survey ‘Health-related behaviour 2012’ in Slovenian population aged from 25 to 74 years.

Results

4591 ever smokers, aged 25–74, that gave information about the age at smoking initiation were included in the analysis. At the age of 25 or less, smoking was initiated by 96.7% of Slovene ever smokers, at the age of 18 or less by 71.0%. The average age at smoking initiation was 17.7 years. Male ever smokers initiated smoking at an earlier age compared to female ones. Age at smoking initiation was decreasing in both male and female ever smokers, but was more pronounced in females. In male ever smokers, there were no differences in average smoking initiation age by education, self-reported social class and geographical regions, while in female ever smokers, there were significant differences in terms of education and geographical regions.

Conclusion

The initiation of smoking predominantly occurs in adolescents and young adults. Age at smoking initiation has decreased in recent decades. Our study confirms the importance of early and sustained smoking prevention programmes in youth and the importance of national comprehensive tobacco control programme with effective tobacco control measures to ban tobacco products marketing.     

Context of the beginning of tobacco use in different social groups

Objective

analyze contextual aspects of the beginning of tobacco use in different social groups, from everyday representations about the act of smoking.

Methods

five focus groups were conducted to promote discussion about the context of beginning of tobacco use, with groups of people who represented different patterns of social reproduction. The data analysis was based on the theory of social representations, which contextualizes how each group presents the tobacco consumption.

Results

the contexts of the beginning of tobacco use were diverse, according to patterns of social reproduction; there were common representations to all groups, but there were also unique representations of each social group. Tobacco is represented as indispensable for groups in unstable social reproduction situations, and as an instrument of pleasure and stress relief for those who can access other material assets.

Conclusions

the study contributed to exposing the concepts on tobacco consumption that are socially disseminated, which can serve as an instrument to planning programs and health actions.     

Using Social Network as a Recruiting Tool for Research on Substance Use in the Taipei Metropolitan Area: Study Design,Implementation, and Epidemiological Estimates

Background

This study aimed to evaluate the practical utility of respondent-driven sampling (RDS) among regular tobacco and alcohol users in Taipei, Taiwan.

Methods

RDS was implemented from 2007 to 2010 to recruit seed individuals who were 18 to 50 years old, regular tobacco and alcohol users, and currently residing in Taipei. Each respondent was asked to refer up to five friends known to be regular tobacco smokers and alcohol drinkers to participate in the present study. Information pertaining to drug use was collected using an audio computer-assisted self-interview instrument. RDSAT software was used for data analyses.

Results

The prevalence estimates of illegal-drug-using behaviors attained equilibrium after three to five recruitment waves. Nearly one-fifth of the participants had ever used illegal drugs, of whom over 60% were polydrug users. The RDS-adjusted prevalences of illegal-drug-using behaviors among early-onset smokers were all two or three times higher than those among late-onset smokers.

Conclusions

Our results provided an empirical basis for the practicality and feasibility of using RDS to estimate illegal drug use prevalence among regular tobacco and alcohol users.Key words: respondent-driven sampling (RDS), illegal drug use, computer-assisted self-interview     

The effects of the DASH diet education program with omega-3 fatty acid supplementation on metabolic syndrome parameters in elderly women with abdominal obesity

BACKGROUND/OBJECTIVES

The purpose of this study was to investigate the overall effects of a tailored Dietary Approaches to Stop Hypertension (DASH) nutritional intervention program which included omega-3 fatty acids supplementation, on dietary self-efficacy, dietary knowledge, and dietary behaviors in Korean elderly women with abdominal obesity. Furthermore, we investigated the effects of the program on metabolic syndrome parameters including the antioxidant capacities in these subjects.

SUBJECTS/METHODS

A randomized, controlled trial was conducted for 8 weeks. The experimental group (n = 21) received a weekly tailored nutritional program for 8 weeks and the control group (n = 18) received only one educational session. The clinical survey was conducted before and after the intervention period.

RESULTS

After the intervention, dietary self-efficacy (P = 0.023), frequency of fruit intake (P = 0.019), and dietary fiber intake (P = 0.044) were higher in the experimental group than in the control group. The oxidative stress (P < 0.001) was lower in the experimental group than in the control group. Moreover, low density lipoprotein (LDL) cholesterol (P = 0.023) had significantly decreased in the experimental group but not in the control group after the intervention.

CONCLUSIONS

The intervention program including omega-3 fatty acid supplementation had a positive effect on dietary self-efficacy, dietary behaviors, and oxidative stress among aged women with abdominal obesity.     

Drinking Patterns and Behavioral Consequences: A Cross-Sectional Study among Romanian University Students

Background

Alcohol/binge drinking among university students has become a major public health problem. Many of young students will be exposed to substantial changes in living arrangements, socialization groups and social activities during the transitional period.

Aim

The aim of this study was to analyse the alcohol consumption in Romanian university students, and to describe the behaviours occurring after drinking.

Methods

A cross-sectional study was conducted on 468 undergraduate students, from a university for medicine and law. Of these students, 35.5% were males and 64.5% were females. The mean age of students was 21.9 ± 3.22 years. Validated anonymous paper questionnaires were completed voluntary by the students. Questionnaires contained demographic items, six questions for determining the level of alcohol consumed in terms of quantity and frequency, and 19 statements or problems resulting from drinking.

Results

The findings of the study showed that males drunk more units of alcohol/week than females (p<0.001). The prevalence of abstainers was 10.8% in males and 17.6% in women. Heavy drinkers (drinking 5 or more drinks more than once a week) were more common among male (19.3%) than among female students (16.2%). Most frequently, drinking behaviours are related to academic performance, and the possible link between poor academic performance and alcohol consumption appears tenuous and merits further investigation.

Conclusion

Effective intervention strategies should be implemented to prevent students’ alcohol consumption and adverse health and social consequences resulting from this behaviour.     

Alcohol consumption and abstention among pregnant Japanese women

Background

In order to clarify the alcohol consumption status of pregnant women in Japan and the characteristics of pregnant women who abstained from alcohol after their pregnancy had been confirmed, a nationwide questionnaire-based study of alcohol consumption behavior was performed. We also examined the factors associated with alcohol consumption during pregnancy and abstention after the confirmation of pregnancy.

Methods

After random sampling, 260 institutions participated in the survey; these were selected from a list of survey points fixed by the Japan Association of Obstetricians and Gynecologists. The study was conducted on pregnant women with confirmed pregnancies by using self-administered anonymous questionnaires during the period from February 1 through 14, 2002.

Results

Alcohol consumption during pregnancy was reported in 11.1% of the study participants, and abstention after the confirmation of pregnancy, in 76.9%. Significant associations were recognized between higher education and both alcohol consumption during pregnancy and abstention after pregnancy confirmation. Furthermore, alcohol consumption was significantly associated with parity, smoking, and shorter sleep duration, whereas abstention was significantly associated with less frequent alcohol consumption and knowledge regarding the risk of alcohol consumption.

Conclusion

The results clarified the factors associated with alcohol consumption during pregnancy and abstention after the confirmation of pregnancy in Japan.Key words: Alcohol Drinking, Temperance, Pregnancy, Pregnant Women     

Peer Reviewed: Obesity and Overweight Prevalence Among Adolescents With Disabilities

Introduction

We examined overweight and obesity prevalence among adolescents with disabilities by disability type (physical vs cognitive) and demographic factors (sex, age, race/ethnicity).

Methods

Parents (N = 662) of adolescents aged 12 to 18 years with disabilities from 49 states responded to an online survey from September 2008 through March 2009.

Results

Prevalence of obesity among adolescents with physical and cognitive disabilities (17.5%) was significantly higher compared with that among adolescents without disabilities (13.0%). Obesity prevalence was higher among males, 18-year-olds, and youths with cognitive disabilities than among females, younger adolescents, and youths with physical disabilities.

Conclusion

The higher prevalence of obesity among youths with disabilities compared with nondisabled youths, particularly in certain subgroups, requires further examination in future surveillance research.     

The Relationship Between Psychosocial Stress and Allergic Disease Among Children and Adolescents in Gwangyang Bay,Korea

Objectives

Stress is considered a causal factor in many diseases, allergic disease being one of them. The prevalence of allergic disease is increasing in Korea, but the relationship between allergic symptoms and stress is not empirically well known. We aimed to evaluate the relationship between allergy-related symptoms and stress in children and adolescents.

Methods

We investigated 698 children and adolescents living in Gwangyang Bay, Korea, using a multi-stage cluster sampling method. Using the International Study of Asthma and Allergies in Childhood and the Psychosocial Well-being Index, these subjects were surveyed on allergy-related symptoms and psychosocial stressors in their lives, respectively. We used a multivariate logistic analysis for odds ratios for the complaint rate of allergic symptoms, after adjusting for age, gender, household income, body mass index, and residence.

Results

After adjustments, lifetime rhinitis (odds ratio [OR], 1.024), rhinoconjunctivitis (OR, 1.090), diagnosis of itchy eczema (OR, 1.040), treatment of itchy eczema (OR, 1.049), 12-month allergic conjunctivitis (OR, 1.026), diagnosis of allergic conjunctivitis (OR, 1.031), and treatment of allergic conjunctivitis (OR, 1.034) were found to be significantly associated with stress.

Conclusions

Our results support the notion that there is a relationship between stress and allergic symptoms in children and adolescents. Further research into any causal relationship between stress and allergies, as well as preventative public health plans for decreasing stress in children and adolescents are needed.     

Modifying effect of suicidal ideation on the relationship between asthma and cigarette use behaviors among Korean adolescents

Objectives

Although cigarette smoking is known to be related to the exacerbation of asthma symptoms, several studies have indicated that the prevalence of cigarette smoking among asthmatic adolescents is similar to or even higher than that among non-asthmatic adolescents. The aim of this study was to evaluate the relationship between asthma and cigarette use behaviors and whether or not the presence of suicidal ideation modifies this relationship among Korean adolescents.

Methods

We analyzed data from the 2008 Korea Youth Risk Behavior Web-based Survey, which included a nationally representative sample of middle and high school students. Multiple logistic regression models were used to calculate odd ratios and 95% confidence intervals of cigarette use behaviors among current asthmatics, former asthmatics, and non-asthmatics, after adjusting for gender, grade, school records, socioeconomic status, current alcohol use, and suicidal ideation.

Results

Of 75 238 study participants, 3.5% were current asthmatics and 4.5% were former asthmatics. Compared with non-asthmatics, asthmatics were more likely to report current cigarette use, frequent and heavy cigarette use, and cigarette use before 13 years of age. There were statistically significant interactions between asthma and suicidal ideation in cigarette use behaviors.

Conclusions

This study demonstrated that asthmatic adolescents are more likely than non-asthmatic adolescents to engage in cigarette use behaviors and the presence of suicidal ideation is an effect modifier of the relationship between asthma and cigarette use behaviors. Particular attention should be paid to the awareness of health risks of cigarette smoking and mental health problems among asthmatic adolescents.     

Age at Menarche Among In-School Adolescents in Sawla Town,South Ethiopia

Background

Although a declining trend in age at menarche has been observed in developed countries over decades commonly attributed to childhood excessive weight gain and sedentary life, little is known about this case in the developing countries.

Methods

A cross-sectional study design and multistage sampling was used to include 660 school adolescents for analysis. Data collection included weight and height measurements. Multinomial logistic regression analyses were done for early and late age of menarche, in reference to average age at menarche, to measure the association of age at menarche with some socio-demographic variables and body habits.

Results

The mean age at menarche was 13.9±1.2 years (95%CI, 13.8–14.0). The menarche ages ranged between 10 and 12 years for 10.5%, 13 and 14 years for 54.5%, and 15+ years for 35%. Low menarche age was independently associated with high calorie consumption, high protein diet, more coffee intake, low physical activity and parents'' low educational background. Low body mass index, low parents'' income, exercise, and Amhara ethnic background were associated with late menarche age.

Coclusion

The mean menarche age found in this study was higher than the report from developed countries. But, the proportion of adolescents with low menarche age was comparable with reports from developed countries. Inactive adolescents were more likely to see menarche earlier than average age. Healthy eating habits, regular exercise and nutrition education need to be promoted among school children.     

A longitudinal analysis of the lifetime cost of dementia

Objective

Estimate the lifetime cost of dementia to Medicare and Medicaid.

Data Source

1997–2005 Medicare Current Beneficiary Survey.

Study Design

A multistage analysis was conducted to first predict the probability of developing dementia by age and then predict the annual Medicare/Medicaid expenditures conditional on dementia status. A cohort-based simulation was conducted to estimate the lifetime cost of dementia.

Principal Findings

The average lifetime cost of dementia per patient for Medicare is approximately $12,000 (2005 dollars) and for Medicaid about $11,000. Dementia onset at older age leads to shorter duration and lower lifetime cost. Increased educational level leads to longer longevity, more dementia cases per cohort, but shorter duration, and lower lifetime cost per patient, which could offset the cost increase induced by more dementia cases. Increased body mass index leads to more dementia cases per cohort and higher lifetime cost per patient.

Conclusion

Net cost of dementia is lower than the estimates from cross-sectional studies. Promoting healthy lifestyle to reverse the obesity epidemic is a short-term priority to confront the epidemic of dementia in the near future. Promoting higher education among the younger generation is a long-term priority to mitigate the effect of population aging on the dementia epidemic in the distant future.