Alcohol intoxication in four adolescents

Four teenagers, two boys aged 14 and almost 13 years and two girls aged 14.5 and 15 years, were hospitalised because acute alcohol intoxication was suspected. Three of them had only a single instance of excessive alcohol consumption, but the 13-year-old boy was admitted twice in three months due to alcohol intoxication. The blood alcohol concentration in these adolescents varied between 1.4 and 2.3 g/l. During admission the patients were treated symptomatically and there were no complications. Loss of consciousness occurs at lower blood alcohol concentrations in adolescents than in adults. There is also a greater risk of mild hypoglycaemia. In case of recurring excessive alcohol consumption, further psychosocial counselling is necessary.     

School performance and alcohol use problems in early adulthood: a longitudinal study

There is inconsistent evidence about the association between school performance and subsequent use of alcohol and alcohol problems in adolescents and young adults. This study examines whether school performance at 14 years is associated with drinking problems in early adulthood; and whether this association is explained by family and individual factors in childhood and adolescence. Data were from a 21-year follow-up of 3,478 Australian young adults from birth to the age of 21 years when data on use of alcohol were collected. Child school performance (CSP) was assessed at 14 years via self- and maternal report. Alcohol consumption at 21 years was measured via self-report, and alcohol abuse and dependence were assessed by the computerized version of Composite International Diagnostic Interview (CIDI-Auto). Potential confounding factors were prospectively measured between the child’s birth and age of 14 years. School performance at 14 years predicted young adults’ alcohol consumption and alcohol use disorders (AUDs). After controlling for confounding, children who had lower school performance had increased risk of drinking more than two glasses of alcohol per day in early adulthood (odds ratio = 1.7; 95% confidence interval: 1.1–2.6). There was a similar pattern of association between CSP and young adults’ alcohol abuse and dependence (AUD) measured by CIDI-Auto. Level of academic performance in high school children predicts their drinking problems as young adults, independently of a selected group of individual and family confounders. Exploration of the pathway linking school performance and alcohol problems in young people may help identify opportunities for preventive interventions.     

A suicide prevention program for Hopi youth

In recent years, Hopi Indians have been concerned about what they believe are rising suicide rates especially among teenagers and young adults. A review of 30 years of Hopi suicides reveals that: (a) although it is possible that rates are rising, it is more likely that they are relatively stable; (b) high age specific rates for those between 15 and 34 years of age is not a recent phenomenon; (c) the individuals at risk for suicide and for alcohol abuse are the children of parents who made traditionally disapproved marriages, i.e. intertribal, intermesa, and between clans of disparate social status. By labeling the parents as deviant the community creates 'primary' deviance in the second generation. To be successful, a suicide program must not be designed specifically for troubled adolescents. Nor can it identify the problem as caused by either acculturation or traditional culture. The proposed program and constraints placed upon its implementation are discussed.     

Physical activity patterns of kindergarten children in comparison to teenagers and young adults

BACKGROUND: Due to the increasing occurrence of obesity and low physical activity (PA) reported in school children there is a need to investigate PA patterns of preschool children. Our aim was to identify the PA of preschool children in comparison to the PA of teenagers and young adults. METHODS: PA of 104 Czech preschool children (aged 5-7 years), 1174 teenagers (aged 12-17 years) and 787 young adults (aged 18-24 years) was determined using Caltrac accelerometery. PA was evaluated on the basis of activity energy expenditure (AEE--kcal kg(-1) day(-1)). Subjects were monitored over 7 days to include a weekend. RESULTS: The AEE in preschool children was significantly higher in comparison to all age groups of teenagers and young adults during both weekdays and at the weekend (P<0.0001). On weekdays during leisure time, preschoolers were considerably more physically active than all categories of teenagers and young adults (P<0.001). Preschoolers show similarities in PA level between weekdays and weekends, unlike the older age groups. CONCLUSION: It seems to appear that organized daily PA (2x20 min of exercising on carpet, 50-70 min of walking outdoors) in preschool children along with enough space for spontaneous PA establishes prerequisites for their further healthy development.     

The ‘risk gradient’ in policy on children of drug and alcohol users: Framing young people as risky

Parental drug and alcohol problems can have a profound impact on children. There is a growing policy and practice focus on this topic in the UK. Most is concerned with children of primary school age and younger. Older children tend to be neglected in the debate, and young people of age 16 years and over are mostly absent from it. It is argued here that this reflects, and is reflected in, the construction of a ‘risk gradient’ in policy and practice. An analysis of Hidden Harm, the report of the Advisory Council on the Misuse of Drugs' inquiry into the impact of parental drug misuse, and related documents, is used to illustrate this. In the risk gradient, children are constructed as being at risk when younger, and becoming risky to themselves and others when older. The risk gradient stigmatizes young people as manifesters of risk, diminishes ongoing difficulties they face, and denies their coping strategies. The definition of risk as manifesting in institutional settings and services underscores this. It encourages a focus on parent – child risk transfer, to the detriment of other difficulties the child or young person may be facing, and renders the young person invisible when they leave service contexts. Finally, the culturally and legally established distinction between illicit drugs and alcohol tends to isolate families with alcohol problems. Most of the response to parental substance use has focused on illicit drugs, rendering the difficulties of young people affected by alcohol problems less visible except when they are manifesters of risk.     

Alkoholintoxikierte Kinder und Jugendliche in der Notfallversorgung Hamburger Krankenhäuser

By using an anonymous postcard reporting system, data of n=358 children, adolescents, and young adults who were treated in 26 emergency departments because of acute alcohol intoxication were collected. The aim of this study was to estimate the prevalence of acute alcohol intoxications in Hamburg, compare these data with the official hospital diagnosis register, and analyze the circumstances that led to the intoxication. A total of 358 cases were reported by the postcard system. Age ranged from 11–21 years, with 64.5% being 14–17 years old. Data were collected in the municipal area of Hamburg during the calendar year of 2008. The percentage of female patients was 65.6% in the age group from 11–17 years and decreased in the age group of patients being 18 years and older. A vast majority of patients were admitted by ambulance and were reported as being a“first offender”. On average, male patients showed a higher level of blood alcohol when being admitted (2.02‰) than female patients (1.76‰). The older the age group, the higher the blood alcohol level. Among drinking circumstances, the situation“drank together with friends” was most frequently reported. In comparison with the official hospital diagnosis register, prevalence was 31.6% higher. This could mean that the prevalence reported in the official hospital diagnosis register is an underestimation of the actual case numbers.     

Teenage alcohol and intoxication debut: the impact of family socialization factors, living area and participation in organized sports

The aim of the present study was to examine the age distribution of alcohol and intoxication debut and factors associated with this among a representative sample of Norwegian teenagers. A sample of 3368 teenagers aged 12-18 years was recruited from 34 Norwegian secondary schools to complete an 87-item questionnaire under examination conditions; 5.2% (168/3239) reported drinking alcohol for the first time when 10 years or younger, 25.2% (816/3239) when they were 13 years or younger and 60.1% (1948/3239) when 16 years or younger, with 39.9% having never drunk alcohol; 1.3% (44/3239) were first intoxicated by 10 years or younger, 12.8% (418/3239) when 13 years or younger and 37.5% (1649/3239) when 16 years or younger. Pupils with early alcohol or intoxication debut (<14 years) tended to come from single-parent families, from cities, experienced less family support and a more highly organized family life, reported more frequent peer and parental drinking, and did not participate in sports. They also showed a substantially elevated total yearly current alcohol consumption, compared to the group with alcohol debut at 14 years or later (8.1 and 2.5 l pure alcohol, respectively). Poor family support but high family organization, living in single-parent families and in cities, and more frequent parental and peer drinking are associated with early alcohol debut, whereas participation in organized sport activities may delay drinking and intoxication debut in teenagers. Sports organizations should be included in drinking prevention programmes.     

Alcohol policy and sexually transmitted disease rates--United States, 1981-1995

In the United States, adolescents and young adults are at higher risk for acquiring sexually transmitted diseases (STDs) than older adults. In addition, young persons who drink alcohol may be more likely than persons who abstain to participate in high-risk sexual activity, such as unprotected sexual intercourse or multiple sexual partners. If alcohol consumption promotes risky sexual behavior (disinhibition caused by the effects of alcohol), state government alcohol policies, such as alcohol taxation and minimum legal drinking age requirements, might reduce STD incidence among adolescents and young adults. Higher alcohol taxes and increases in the minimum legal drinking age have been associated with lower incidences of adverse alcohol-related health outcomes (e.g., motor-vehicle crash-related deaths, liver cirrhosis, suicide, and violent crime, including domestic violence). This report summarizes the findings of a study that suggest higher alcohol taxes and higher minimum legal drinking ages are associated with lower STD incidence among certain age groups.     

Sexual- und Verhütungsverhalten Jugendlicher und junger Erwachsener

The BZgA study “Youth Sexuality 2010” clarifies the changes that have occurred in the sexual and contraceptive behavior of teenagers and young adults over the last 30 years. Among young Germans, there is now more gender similarity regarding both the age at which intercourse first takes place and contraceptive behavior. The proportion of German teenagers who take no contraceptive precautions when they have intercourse for the first time is now 8%, a lower figure than ever previously recorded. Communication about contraception, both at home and between the partners, is making a substantial contribution to responsible contraceptive behavior on the part of teenagers and young adults. Alongside education about sexuality in the family and at school, there are also structural influences on the positive developments witnessed in Germany. And yet there are still target groups that are inadequately reached. Many migrants are less well informed about bodily processes, their contraceptive practice is not as good, and their religious background tends to exclude them from access to information. Disabled teenagers and young adults constitute a target group about which to date we have insufficient knowledge. Education and social deprivation continue to be important factors in the differences seen in sexual and contraceptive behavior. In this area, proactive efforts are necessary.     

Lower legal blood alcohol limits for young drivers.

To reduce the involvement of young drivers in alcohol-related crashes, 29 States and the District of Columbia have established lower legal blood alcohol limits for drivers younger than age 21 than for adult drivers. Of these, 12 lowered the legal limit for young people prior to 1991. To assess the impact, these 12 States were paired for comparison with 12 nearby States matched for legal drinking age and timing of changes in that law. Among drivers ages 15-20, fatal crashes involving a single vehicle at night are three times more likely than other fatal crashes to be alcohol-related. Whether the proportion of fatal crashes that involved single vehicles at night declined more among young drivers targeted by lower blood alcohol limits than among young drivers of the same age in comparison States was examined. The maximum available equal number of pre- and post-law years were compared in each pair of States. During the post-law period, the proportion of fatal crashes that involved single vehicles at night declined 16 percent among young drivers targeted by lower blood alcohol laws, whereas it rose 1 percent among drivers of the same age in comparison States where blood alcohol limits were not changed (P < .001). Among adults, the proportion of fatal nocturnal crashes that involved single vehicles declined 5 percent in the group of States with the lowered levels for young people during the period after the law was enacted and 6 percent in the group of neighboring comparison States.(ABSTRACT TRUNCATED AT 250 WORDS)     

Substance Abuse by Youth and Young Adults in Rural America

ABSTRACT:  Purpose: Addressing substance abuse in rural America requires extending our understanding beyond urban-rural comparisons to how substance abuse varies across rural communities of different sizes. We address this gap by examining substance abuse prevalence across 4 geographic levels, focusing on youth (age 12-17 years) and young adults (age 18-25 years). Methods: The analysis is based on 3 years (2002-2004) of pooled data from the National Survey on Drug Use and Health. We measure rurality using a four-tier consolidation of the 2003 Rural-Urban Continuum Codes: urban, rural-adjacent, rural-large, and rural-small and medium. Findings: Rural youth have higher alcohol use and methamphetamine use than urban youth and the more rural the area, the higher the use. Rural young adults living in rural-large areas have higher rates of substance abuse than their urban peers; those living in the most rural areas have nearly twice the rate of methamphetamine use as urban young adults. Rural youth are more likely than urban youth to have engaged in the high-risk behavior of driving under the influence of alcohol or other illicit drugs. Conclusions: Higher prevalence rates, coupled with high-risk behavior, place rural youth and young adults at risk of continued substance use and problems associated with this use. Rural community infrastructure should be enhanced to support substance abuse prevention and intervention for these populations.     

Risky sex behavior and substance use among young adults.

Many young adults, despite widespread prevention and education efforts that target this age group, engage in behaviors that place them at risk of HIV infection. These behaviors include frequent experimentation with alcohol and other drugs before sex, sexual activity with different partners, and inconsistent safe-sex practices. The combination of these risky behaviors causes increased concern about the spread of HIV among this age group. The study discussed in this article examined the relationship between substance use during adolescence and HIV risk behavior among young adults ages 19 to 21 with and without a college education. Results indicated that increased use of alcohol and marijuana at younger ages is related to riskier sexual activity and increased use of alcohol and marijuana as young adults. Recommendations for interventions are made.     

Blood alcohol concentration at 0.06 and 0.10% causes a complex multifaceted deterioration of body movement control

Alcohol-related falls are recognized as a major contributor to the occurrence of traumatic brain injury. The control of upright standing balance is complex and composes of contributions from several partly independent mechanisms such as appropriate information from multiple sensory systems and correct feedback and feed forward movement control. Analysis of multisegmented body movement offers a rarely used option for detecting the fine motor problems associated with alcohol intoxication. The study aims were to investigate whether (1) alcohol intoxication at 0.06 and 0.10% blood alcohol concentration (BAC) affected the body movements under unperturbed and perturbed standing; and (2) alcohol affected the ability for sensorimotor adaptation. Body movements were recorded in 25 participants (13 women and 12 men, mean age 25.1 years) at five locations (ankle, knee, hip, shoulder, and head) during quiet standing and during balance perturbations from pseudorandom pulses of calf muscle vibration over 200 s with eyes closed or open. Tests were performed at 0.00, 0.06, and 0.10% BAC. The study revealed several significant findings: (1) an alcohol dose-specific effect; (2) a direction-specific stability decrease from alcohol intoxication; (3) a movement pattern change related to the level of alcohol intoxication during unperturbed standing and perturbed standing; (4) a sensorimotor adaptation deterioration with increased alcohol intoxication; and (5) that vision provided a weaker contribution to postural control during alcohol intoxication. Hence, alcohol intoxication at 0.06 and 0.10% BAC causes a complex multifaceted deterioration of human postural control.     

Association of maternal smoking and alcohol consumption with young adults' cannabis use: a prospective study

This 2006 study examined 1) whether maternal use of tobacco and consumption of alcohol when a child is 5 and 14 years of age predict cannabis use in young adults, and 2) whether this association is explained by possible confounding or mediating factors. Data were taken from a prospective birth cohort study of mothers and their children in Brisbane, Australia. This study was based on a cohort of 3,176 young adults who participated at the 21-year follow-up of the study and for whom data were available on maternal smoking and alcohol consumption 5 and 14 years after their birth. After controlling for possible confounders, the authors found that maternal smoking at 14 years was associated with frequent use of cannabis in offspring at 21 years, regardless of maternal smoking at 5 years. Children of mothers who drank more than one glass of alcohol at 5 years and continued at 14 years were more likely to use cannabis in early adulthood. The association between maternal substance use and offspring cannabis use was partially mediated by adolescent externalizing behavior and smoking measured at 14 years. Prevention programs that address maternal and adolescent tobacco use and adolescent externalizing behavior should be considered as strategies to reduce cannabis use by young adults.     

The impact of early age at first childbirth on maternal and infant health

The objective of this review was to assess whether early age at first childbirth is associated with increased risk of poor pregnancy outcomes. Early age at childbirth is variously defined in studies of its effect on maternal and infant health. In this systematic review, we limit analysis to studies of at least moderate quality that examine first births among young mothers, where young maternal age is defined as low gynaecological age (≤ 2 years since menarche) or as a chronological age ≤ 16 years at conception or delivery. We conduct meta-analyses for specific maternal or infant health outcomes when there are at least three moderate quality studies that define the exposure and outcome in a similar manner and provide odds ratios or risk ratios as their effect estimates. We conclude that the overall evidence of effect for very young maternal age (<15 years or <2 years post-menarche) on infant outcomes is moderate; that is, future studies are likely to refine the estimate of effect or precision but not to change the conclusion. Evidence points to an impact of young maternal age on low birthweight and preterm birth, which may mediate other infant outcomes such as neonatal mortality. The evidence that young maternal age increases risk for maternal anaemia is also fairly strong, although information on other nutritional outcomes and maternal morbidity/mortality is less clear. Many of the differences observed among older teenagers with respect to infant outcomes may be because of socio-economic or behavioural differences, although these may vary by country/setting. Future, high quality observational studies in low income settings are recommended in order to address the question of generalisability of evidence. In particular, studies in low income countries need to consider low gynaecological age, rather than simply chronological age, as an exposure. As well, country-specific studies should measure the minimum age at which childbearing for teens has similar associations with health as childbearing for adults. This 'tipping point' may vary by the underlying physical and nutritional health of girls and young women.     

Early predictors of adult drinking: a birth cohort study

Few studies have explored early predictors of problem drinking in youth, and fewer still have simultaneously considered the role of biologic, familial, and intrapersonal factors. The present study explored early life course and later life course predictors of alcohol abuse and dependence in young adulthood. Data were taken from a cohort of 2,551 mothers and their children recruited as part of the longitudinal Mater University Study of Pregnancy and its outcomes (MUSP) carried out in Brisbane, Australia, from 1981 to 1984. Data were collected prenatally and then postnatally at 6 months and at 5, 14, and 21 years. A range of biologic, familial, and intrapersonal factors was considered. A series of logistic regression models with inverse probability weighting was used to explore pathways to problem drinking from adolescence to early adulthood. For males and females, no association was found between either birth factors or childhood factors and a lifetime diagnosis of alcohol disorders at age 21 years. Externalizing symptoms and maternal factors at age 14 years were significantly associated with alcohol problems. For youth aged 14 years, maternal moderate alcohol consumption accounted for the highest percentage of attributable risk among those exposed. Results show that exposure to maternal drinking in adolescence is a strong risk factor for the development of alcohol problems in early adulthood.     

The frequency of alcoholisation among young people injured in accidents in France.

In a nation-wide epidemiological survey carried out in France in 1982-1983, blood alcohol concentration was systematically measured in 1423 young casualties (aged 15-24 years) on their arrival in the emergency room. Traffic accidents accounted for almost half of the admissions, and they were the most severe, with over 10% requiring hospitalisation with vital risk. A quarter of the admissions was female; on average, their blood alcohol concentration was low and not statistically related to age. Conversely, among young male casualties, 1 out of 5 had a blood alcohol concentration of at least 0.50 g/l (11 mmol/l) and 1 out of 15 was classified as a chronic heavy drinker. It is of note that alcohol was implicated in 43% of the car/truck accidents of the young men and that blood alcohol concentration as well as the proportion of chronic drinkers were strongly related to age. Alcohol consumption may begin as early as 15 years; in the young men 15-24 years, only 7% were chronic drinkers whereas in men over 24, 37% were chronic drinkers. On this basis, it is appropriate to focus education about alcohol consumption on adolescents, particularly men.     

Ear damage caused by leisure noise

Noise is a health risk. Recent findings suggest that leisure noise is a substantial danger especially to children, teenagers and young adults. Epidemiological studies of teenagers with no occupational noise exposure show an increasing number with a substantial and measurable irreversible inner ear damage. This is basically due to the wide spread exposition to very loud toys (pistols and squibs), crackers and exposure to electronically amplified music, e.g. from personal cassette players (PCP), at discos or concerts etc. Protection against irreversible ear damage by leisure noise has an important impact in preventive medical care. Therefore the general public must be informed that loud leisure activities may cause damage to the ear. In order to protect children, young people and adults, the legislature ought to set limits for sound levels in discos, concert halls and for music equipment and toys by establishing the necessary standards and regulations.     

Cardiovascular risk factor profiles and their social gradient from adolescence to age 74 in a Swiss region

BACKGROUND: Few European studies have investigated how cardiovascular risk factors (CRF) in adults relate to those observed in younger generations. OBJECTIVE: To explore this issue in a Swiss region using two population health surveys of 3636 adolescents ages 9-19 years and 3299 adults ages 25-74 years. METHODS: Age patterns of continuous CRF were estimated by robust locally weighted regression and those of high-risk groups were calculated using adult criteria with appropriate adjustment for children. RESULTS: Gender differences in height, weight, blood pressure, and HDL cholesterol observed in adults were found to emerge in adolescents. Overweight, affecting 10-12% of adolescents, was increasing steeply in young adults (three times among males and twice among females) in parallel with inactivity. Median age at smoking initiation was decreasing rapidly from 18 to 20 years in young adults to 15 in adolescents. A statistically significant social gradient in disfavor of the lower education level was observed for overweight in all age groups of women above 16 (odds ratios (ORs) 2.4 to 3.3, P < 0.01), for inactivity in adult males (ORs 1.6 to 2.0, P < 0.05), and for regular smoking in older adolescents (OR 1.9 for males, 2.7 for females, P < 0.005), but not for elevated blood pressure. CONCLUSION: Discontinuities in the cross-sectional age patterns of CRF indicated the emergence of a social gradient and the need for preventive actions against the early adoption of persistent unhealthy behaviors, to which low-educated girls and women are particularly exposed.     

Children's perceptions of advertisements for cigarettes

Groups of children aged between 6 and 16 years discussed a series of advertisements, including those for cigarettes. Clear patterns emerged in their recognition of cigarette brand imagery. For example, in response to an advertisement for holidays which also presents the brand imagery of John Player Special cigarettes, 22% of primary school children and 91% of secondary school children said it advertises cigarettes. There were consistent trends in responses to the symbolism portrayed. Younger children were very much tied to what was specifically shown in the advertisements; older ones tended to perceive more complex imagery. For example, whereas 10-year-olds said people who like the advertisement for Kim cigarettes (which has symbols for drinking) would smoke and drink, some 12-year-olds and most 14- and 16-year-olds saw Kim as feminine, sociable, trendy and sporty. It seems that some 12-year-olds and most 14- and 16-year-olds perceive cigarette advertisements much in the way that young adults do; therefore advertising campaigns targeted at older teenagers and young adults are likely to present qualities which younger teenagers find attractive.