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Hobbs M, Duncan MJ, Collins P, Mckenna J, Schoeppe S, Rebar AL, Alley S, Short C, Vandelanotte C. Clusters of health behaviours in Queensland adults are associated with different socio-demographic characteristics. J Public Health (Oxf) 2018; 41:268-277. [DOI: 10.1093/pubmed/fdy043] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 12/29/2017] [Accepted: 02/13/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The co-occurrence of unhealthy lifestyles, calls for interventions that target multiple health behaviours. This study investigates the clustering of health behaviours and examines demographic differences between each cluster.
Methods
In total, 934 adults from Queensland, Australia completed a cross-sectional survey assessing multiple health behaviours. A two-step hierarchical cluster analysis using multiple iterations identified the optimal number of clusters and the subset of distinguishing health behaviour variables. Univariate analyses of variance and chi-squared tests assessed difference in health behaviours by socio-demographic factors and clusters.
Results
Three clusters were identified: the ‘lower risk’ cluster (n = 436) reported the healthiest profile and met all public health guidelines. The ‘elevated risk’ cluster (n = 105) reported a range of unhealthy behaviours such as excessive alcohol consumption, sitting time, fast-food consumption, smoking, inactivity and a lack of fruit and vegetables. The ‘moderate risk behaviour’ cluster (n = 393) demonstrated some unhealthy behaviours with low physical activity levels and poor dietary outcomes. The ‘elevated risk’ cluster were significantly younger and more socio-economically disadvantaged than both the ‘lower and moderate risk’ clusters.
Discussion
Younger people who live in more deprived areas were largely within the ‘elevated risk’ cluster and represent an important population for MHBC interventions given their wide range of unhealthy behaviours.
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Affiliation(s)
- M Hobbs
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
- Centre for Active Lifestyles, Carnegie Faculty, Research Institute of Sport, Physical Activity and Leisure, Leeds Beckett University, 227 Fairfax Hall, Headingley Campus, Leeds, UK
| | - M J Duncan
- School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, Faculty of Health and Medicine, The University of Newcastle, Newcastle, UK
| | - P Collins
- Centre for Active Lifestyles, Carnegie Faculty, Research Institute of Sport, Physical Activity and Leisure, Leeds Beckett University, 227 Fairfax Hall, Headingley Campus, Leeds, UK
| | - J Mckenna
- School of sport, Leeds Beckett University, Headingley Campus, Leeds, UK
| | - S Schoeppe
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - A L Rebar
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - S Alley
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - C Short
- Freemasons Foundation Centre for Men’s Health, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - C Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
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de Vocht F, Suderman M, Tilling K, Heron J, Howe L, Campbell R, Hickman M, Relton C. DNA methylation from birth to late adolescence and development of multiple-risk behaviours. J Affect Disord 2018; 227:588-594. [PMID: 29172051 PMCID: PMC5814676 DOI: 10.1016/j.jad.2017.11.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 10/12/2017] [Accepted: 11/12/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk behaviours in adolescence are linked to poor educational attainment and health and other outcomes in young adulthood. We explored whether there are molecular mechanisms associated with the development, or the result, of multiple risk behaviours (MRBs). METHODS MRBs (antisocial behaviour and delinquency, traffic-related risk behaviour, risky sexual behaviour, lack of exercise) and their sumscore were characterized based on self-reported questions at age 7 and 17 within the ARIES subsample of the ALSPAC birth cohort, and were linked to DNA methylation at over 485,000 CpG sites at ages 0,7 and 17. Associations were determined for participants with complete data (n = 227-575). RESULTS There was weak evidence of associations between cumulative MRBs and methylation at cg01783492 and cg16720578 at age 17. DNA methylation at age 17 was associated with risky sexual behaviour (cg22883332), lack of exercise (cg03152353, cg20056908, cg20571116) and substance use (cg02188400, cg13906377). No associations between DNA methylation and individual risk behaviours at age 7 were observed. DNA methylation at age 7 might predispose for traffic-related risk behaviour (cg24683561) and substance use (cg08761410) at age 17. LIMITATIONS Main limitations are absence of information on directly measured blood cell type proportions and tissue specificity, and a modest sample size. CONCLUSIONS Cumulative MRB in late adolescence was associated with effects on DNA methylation. More specifically, risky sexual behaviour and sedentary behaviour are associated with changes in DNA methylation, while DNA methylation in childhood may predict later traffic-related risky behaviour. For substance use effects in both temporal directions were observed.
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Affiliation(s)
- F. de Vocht
- School of Social and Community Medicine, University of Bristol, Bristol, UK,Correspondence to: Population Health Sciences, University of Bristol,Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.Population Health Sciences, University of Bristol,Canynge Hall, 39 Whatley Road,BristolBS8 2PSUK
| | - M. Suderman
- School of Social and Community Medicine, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, UK
| | - K. Tilling
- School of Social and Community Medicine, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, UK
| | - J. Heron
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - L.D. Howe
- School of Social and Community Medicine, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, UK
| | - R. Campbell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - M. Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - C. Relton
- School of Social and Community Medicine, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, UK
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Lee CH, Chang FC, Hsu SD, Chi HY, Huang LJ, Yeh MK. Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use. PLoS One 2017; 12:e0189199. [PMID: 29240799 PMCID: PMC5730183 DOI: 10.1371/journal.pone.0189199] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/21/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication. METHOD In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication. RESULTS The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%), cold or cough medicines (prevalence = 21.6%), analgesics (prevalence = 19.3%), and antacids (prevalence = 17.3%). Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%), using excessive dosages (21.6%), and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy) (30.3%). The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication. CONCLUSION Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.
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Affiliation(s)
- Chun-Hsien Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan, ROC
- Department of Pharmacy Practice, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Fong-Ching Chang
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan, ROC
| | - Sheng-Der Hsu
- Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hsueh-Yun Chi
- Department of Health Developing and Marketing, Kainan University, Taoyuan, Taiwan, ROC
| | - Li-Jung Huang
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC
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Social status strategy in early adolescent girls: Testosterone and value-based decision making. Psychoneuroendocrinology 2017; 81:14-21. [PMID: 28407517 PMCID: PMC9245628 DOI: 10.1016/j.psyneuen.2017.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/16/2017] [Accepted: 03/09/2017] [Indexed: 11/20/2022]
Abstract
There has been strong interest, spanning several disciplines, in understanding adolescence as a developmental period of increased risk-taking behavior. Our goals focus on one line of investigation within this larger developmental risk framework. Specifically, we examined levels of pubertal hormones in girls in relation to their willingness to take greater financial risks to gain social status. To this end, we tested the hypothesis that higher levels of testosterone during the ages of pubertal maturation are associated with a greater willingness to sacrifice money for social admiration. Sixty-three girls ages 10-14 (Mage=12.74) participated in laboratory measures and completed at-home saliva sample collection. The Pubertal Development Scale (PDS) and basal hormone levels (testosterone, estradiol, DHEA) measured pubertal maturation. We made use of a developmentally appropriate version of an Auction Task in which adolescents could take financial risks in order to gain socially motivated outcomes (social status). PDS and testosterone were each associated with overall levels of financial risk taking over the course of the Auction Task. In hierarchical models, PDS and testosterone were predictors of the slope of overbidding over the course of the task. Results provide evidence for the role of testosterone and pubertal maturation in girls' motivations to engage in costly decision making in order to gain social status. Findings contribute to our understanding of the developmental underpinnings of some interesting aspects of adolescent risk behavior.
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Toner P, Böhnke JR, McCambridge J. A systematic review of alcohol screening and assessment measures for young people: a study protocol. BMJ Open 2017; 7:e016406. [PMID: 28592585 PMCID: PMC5726108 DOI: 10.1136/bmjopen-2017-016406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Alcohol consumption creates a significant public health burden, and young people who drink alcohol place themselves at risk of harm. Expert guidance and reviews have highlighted the pressing need for reliable and valid, age-appropriate alcohol screening and assessment measures for young people. The proposed systematic review will evaluate existing alcohol screening and assessment measures for young people aged 24 and under. METHODS AND ANALYSIS Six electronic databases will be searched for published and grey literature. In addition, reverse and forward citation searching and consultation with experts will be performed. Three sets of search terms will be combined, including alcohol use/problems, young people and validation studies. The titles and abstracts of reports from the searches will be screened, and potentially relevant full-text reports will be retrieved and independently assessed for inclusion by two reviewers based on prespecified criteria. Discrete validation studies within included reports will then be assessed for eligibility. There will be an a priori basic quality threshold for predictive validity, internal and test-retest for studies to warrant full data extraction. Studies above the quality threshold will be assessed for quality using the modified consensus-based standards for the selection of health measurement instruments checklist and a quality assessment tool for diagnostic accuracy studies. DISSEMINATION This review will highlight the best performing measures both for screening and assessment based on their psychometric properties and the quality of the validation studies supporting their use. Providing clear guidance on which existing measures perform best to screen and assess alcohol use and problems in young people will inform policy, practice and decision-making, and clarify the need for further research. TRIAL REGISTRATION NUMBER International Prospective Register of Systematic Reviews, CRD42016053330.
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Affiliation(s)
- Paul Toner
- Department of Health Sciences, University of York, York, UK
| | - Jan R Böhnke
- Dundee Centre for Health and Related Research, School of Nursing and Health Sciences, University of Dundee, Dundee, Scotland, UK
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Wallin-Miller KG, Chesley J, Castrillon J, Wood RI. Sex differences and hormonal modulation of ethanol-enhanced risk taking in rats. Drug Alcohol Depend 2017; 174:137-144. [PMID: 28324816 PMCID: PMC5400719 DOI: 10.1016/j.drugalcdep.2017.01.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/01/2016] [Accepted: 01/09/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Ethanol (EtOH) intake correlates with increased risk-taking, and sex differences exist in both EtOH use and risk-taking in humans and rats. However, the interaction of sex and gonadal hormones to affect risk-taking under the influence of EtOH has not been determined. This was the focus of the current study. METHODS Adult Long-Evans rats (n=18 males and females) were gonadectomized and received hormone replacement at physiologic levels or blank implants (n=7-9/group). Risk-taking was assessed with probability discounting, requiring rats to choose between a small/certain reward and a large/uncertain reward delivered with decreasing probability throughout each daily session. Before testing, rats received saline or EtOH (0.5 or 1.0g/kg) ip. RESULTS In males, EtOH increased preference for the large/uncertain reward lever (F2,28=10.462, p<0.05). However, there was no effect of EtOH on lever preference in females (F1,30=0.914, p>0.05). At baseline, ORCHX+T males showed a greater preference for the large/uncertain reward lever then ORCHX males (F1,14=13.805, p<0.05). In females only, EtOH decreased choice latency relative to baseline (F1,10=7.25, p<0.05). EtOH decreased loss sensitivity in both sexes, with all rats exhibiting decreased lose-shift ratios (males: F2,18=5.10, p<0.05; females F2,10=4.37, p<0.05). CONCLUSIONS These results show that EtOH, sex, and hormones interact to influence decision making. EtOH increases risk taking in males, but not in females. However, EtOH selectively decreases choice latency in females, and decreases loss sensitivity in both sexes. These findings are relevant to understanding human behavior, particularly in adolescents who experience increased hormone levels and often drink EtOH and engage in risky behavior.
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Affiliation(s)
- Kathryn G Wallin-Miller
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA 90033, USA.
| | - Jordyn Chesley
- Department of Cell and Neurobiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
| | - Juliana Castrillon
- Department of Cell and Neurobiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
| | - Ruth I Wood
- Department of Cell and Neurobiology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA.
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Garoufi A, Grammatikos EE, Kollias A, Grammatikos E, Stergiou GS, Soldatou A. Associations between obesity, adverse behavioral patterns and cardiovascular risk factors among adolescent inhabitants of a Greek island. J Pediatr Endocrinol Metab 2017; 30:445-454. [PMID: 28315850 DOI: 10.1515/jpem-2016-0134] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 01/16/2017] [Indexed: 01/24/2023]
Abstract
BACKGROUND Excess weight, unhealthy lifestyle habits and their sequelae have become a well-recognized public health problem in most countries. The objective of the study was to examine the relationship of adolescent overweight/obesity with behavioral habits and their association with blood pressure (BP) and lipid profile. METHODS Anthropometric parameters, lifestyle, BP and lipid profile of 736 adolescents were evaluated cross-sectionally. The classifications of normal weight, overweight and obese were based on BMI z-scores. RESULTS About 42.1% of adolescents were overweight/obese, 11.3% were smokers, 33.2% consumed alcohol and 34% reported low activity. Males began smoking earlier, consumed alcohol more often, exercised less and spent more screen time than females. Alcohol consumption was more prevalent among smokers and was associated with higher BP and dyslipidemia. Smokers exercised less intensely and had lower high density lipoprotein-cholesterol (HDL-C) than non-smokers. Obesity was a risk factor for higher BP and dyslipidemia. Longer screen time was associated with higher triglycerides, while intense physical activity with lower systolic BP. CONCLUSIONS Obesity is related to an adverse lipid and BP profile during adolescence. Clustering of hazardous habits was observed, which is known to aggravate the cardiovascular risk.
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Affiliation(s)
- Anastasia Garoufi
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
| | - Evangelos E Grammatikos
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
| | - Anastasios Kollias
- Hypertension Center STRIDE-7, Third University Department of Medicine, Sotiria Hospital, Athens
| | | | - George S Stergiou
- Hypertension Center STRIDE-7, Third University Department of Medicine, Sotiria Hospital, Athens
| | - Alexandra Soldatou
- Second Department of Pediatrics, National and Kapodistrian University of Athens, "P. & A. Kyriakou" Children's Hospital, Athens
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Sumnall H, Agus A, Cole J, Doherty P, Foxcroft D, Harvey S, McKay M, Murphy L, Percy A. Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school- and community-based cluster randomised controlled trial. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BackgroundAlcohol use in young people remains a public health concern, with adverse impacts on outcomes such as health, well-being, education and relationships.ObjectivesTo assess the effectiveness and cost-effectiveness of a combined classroom curriculum and parental intervention on self-reported alcohol use [heavy episodic drinking (HED)] and alcohol-related harms (indicators such as getting into fights after drinking, poorer school performance and trouble with friends and family).DesignA two-arm, cluster randomised controlled trial with schools as the unit of randomisation.SettingA total of 105 post-primary schools in Northern Ireland (NI) and Glasgow/Inverclyde Educational Authority areas.ParticipantsA total of 12,738 male and female secondary school students (intervention delivered when students were in school year 9 in NI or S2 in Scotland in the academic year 2012–13 and aged 12–13 years) were randomised. Randomisation and baseline (T0) surveys took place when children were in school year 8 or S1. Schools were randomised (1 : 1) by an independent statistician to the Steps Towards Alcohol Misuse Prevention Programme (STAMPP) or to education as normal (EAN). All schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational).InterventionsSTAMPP combined a school-based alcohol harm reduction curriculum [an adapted version of the School Health and Alcohol Harm Reduction Project (SHAHRP)] and a brief parental intervention designed to support parents in setting family rules around drinking. The classroom component comprised two phases delivered over 2 years, and the parental component comprised a standardised presentation delivered by a trained facilitator at specially arranged parent evenings on school premises. This was followed up a few weeks later by an information leaflet mailed to all intervention pupils’ parents highlighting the main points of the evening.Main outcome measures(1) Self-reported HED (defined as self-reported consumption of ≥ 6 units in a single episode in the previous 30 days for male students and ≥ 4.5 units for female students) assessed at 33 months from baseline (T3); and (2) the number of self-reported harms (harms caused by own drinking) assessed at T3.Data sourcesSelf-completed pupil questionnaires.ResultsAt final follow-up (T3), data were available for 5160 intervention and 5073 control pupils for the HED outcome, and for 5234 intervention and 5146 control pupils for the self-reported harms outcome. The intervention reduced self-reported HED compared with EAN (p < 0.001), but did not reduce self-reported harms associated with own drinking. The odds ratio for the intervention effect on HED was 0.596 (standard error 0.0596, 95% confidence interval 0.490 to 0.725). The mean cost of delivery per school was £818 and the mean cost per individual was £15. There were no clear cost savings in terms of service utilisation associated with the intervention. The process evaluation showed that the classroom component engaged and was enjoyed by pupils, and was valued by teachers. Schools, students, intervention trainers and delivery staff (teachers) were not blind to study condition. Data collection was undertaken by a team of researchers that included the trial manager and research assistants, some of whom were not blinded to study condition. Data analysis of primary and secondary outcomes was undertaken by the trial statistician, who was blinded to the study condition.LimitationsAlthough the classroom component was largely delivered as intended, there was very low attendance at the parent/carer event; however, all intervention pupils’ parents/carers received an intervention leaflet.ConclusionsThe results of this trial provide some support for the effectiveness and cost-effectiveness of STAMPP in reducing heavy episodic (binge) drinking, but not in reducing self-reported alcohol-related harms, in young people over a 33-month follow-up period. As there was low uptake of the parental component, it is uncertain whether or not the intervention effect was accounted for by the classroom component alone.Trial registrationCurrent Controlled Trials ISRCTN47028486.FundingThis project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full inPublic Health Research; Vol. 5, No. 2. See the NIHR Journals Library website for further project information. The Public Health Agency of NI and Education Boards of Glasgow/Inverclyde provided some intervention costs. Diageo provided funds to print some workbooks. The remaining intervention costs were internally funded.
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Affiliation(s)
- Harry Sumnall
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Ashley Agus
- Northern Ireland Clinical Trials Unit, Belfast, UK
| | - Jon Cole
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Paul Doherty
- Northern Ireland Clinical Trials Unit, Belfast, UK
| | - David Foxcroft
- Social Work and Public Health, Oxford Brookes University, Oxford, UK
| | - Séamus Harvey
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Michael McKay
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Lynn Murphy
- Northern Ireland Clinical Trials Unit, Belfast, UK
| | - Andrew Percy
- School of Sociology, Social Policy and Social Work, Queen’s University Belfast, Belfast, UK
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Laxer RE, Brownson RC, Dubin JA, Cooke M, Chaurasia A, Leatherdale ST. Clustering of risk-related modifiable behaviours and their association with overweight and obesity among a large sample of youth in the COMPASS study. BMC Public Health 2017; 17:102. [PMID: 28109270 PMCID: PMC5251243 DOI: 10.1186/s12889-017-4034-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/13/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Canadian youth exhibit a number of risky behaviours, some of which are associated with overweight and obesity. The purpose of this study was to examine the prevalence of 15 modifiable risk behaviours in a large sample of Canadian youth, to identify underlying subgroups based on patterns of health behaviours, and to examine the association between identified subgroups and overweight/obesity. METHODS Data from 18,587 grades 9-12 students in Year 1 (2012-13) of the COMPASS study and latent class analysis were used to identify patterns and clustering among 15 health behaviours (e.g., physical inactivity, sedentary behaviour, unhealthy eating, substance use). A logistic regression model examined the associations between these clusters and overweight/obesity status. RESULTS Four distinct classes were identified: traditional school athletes, inactive screenagers, health conscious, and moderately active substance users. Each behavioural cluster demonstrated a distinct pattern of behaviours, some with a greater number of risk factors than others. Traditional school athletes (odds ratio (OR) 1.15, 95% CI 1.03-1.29), inactive screenagers (OR 1.33; 1.19-1.48), and moderately active substance users (OR 1.27; 1.14-1.43) were all significantly more likely to be overweight/obese compared to the health conscious group. CONCLUSIONS Four distinct subpopulations of youth were identified based on their patterns of health and risk behaviours. The three clusters demonstrating poorer health behaviour were all at an increased risk of being overweight/obese compared to their somewhat healthier peers. Obesity-related public health interventions and health promotion efforts might be more effective if consideration is given to population segments with certain behavioural patterns, targeting subgroups at greatest risk of overweight or obesity.
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Affiliation(s)
- Rachel E Laxer
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada.
| | - Ross C Brownson
- Brown School and School of Medicine, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130-4899, USA
| | - Joel A Dubin
- School of Public Health and Health Systems, Department of Statistics and Actuarial Science, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Martin Cooke
- School of Public Health and Health Systems, Department of Sociology & Legal Studies, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Ashok Chaurasia
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
| | - Scott T Leatherdale
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L3G1, Canada
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MacArthur GJ, Jacob N, Pound P, Hickman M, Campbell R. Among friends: a qualitative exploration of the role of peers in young people's alcohol use using Bourdieu's concepts of habitus, field and capital. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:30-46. [PMID: 27573161 PMCID: PMC5244664 DOI: 10.1111/1467-9566.12467] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Drinking is viewed by young people as a predominantly social activity which provides an opportunity for entertainment and bonding with friends. Using Bourdieu's concepts of habitus, field and capital, this article explores young people's attitudes and beliefs around alcohol use, influences on behaviour, and the role of peers, with a view to informing the development of preventive interventions. Semi-structured interviews were conducted with 28 young people aged 18-20 in the south west of England. We describe how friends were integral in drinking experiences, and drinking with friends was equated with fun and enjoyment. In this way, the desire for social and symbolic capital appeared to be a key motivator for adolescent drinking. Critically, however, wider cultural norms played the predominant role in shaping behaviour, via the internalisation of widely accepted practice and the subsequent externalisation of norms through the habitus. Applying Bourdieu's theory suggests that population-level interventions that regulate alcohol consumption, and thus disrupt the field, are likely to facilitate behaviour change among young people by driving a response in habitus.
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Affiliation(s)
| | - Nina Jacob
- Cardiff University School of Social SciencesCardiffUK
| | - Pandora Pound
- School of Social and Community MedicineUniversity of BristolUK
| | - Matthew Hickman
- School of Social and Community MedicineUniversity of BristolUK
| | - Rona Campbell
- School of Social and Community MedicineUniversity of BristolUK
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2016; 45:181-188. [PMID: 27816465 DOI: 10.1016/j.canep.2016.09.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. As evaluated by the International Agency for Research on Cancer (IARC) Monographs, a causal relationship is established for consumption of alcoholic beverages and cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even at low and moderate alcohol intakes. The higher the amount of alcohol consumed, the higher the risk of developing cancer. In Europe, an estimated 10% (95% CI: 7%-13%) of all cancer cases in men and 3% (95% CI: 1%-5%) of all cancer cases in women are attributable to alcohol consumption. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite, acetaldehyde, play a major role. Taking all this evidence into account, a recommendation of the 4th edition of European Code against Cancer is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1 B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Taylor M, Simpkin AJ, Haycock PC, Dudbridge F, Zuccolo L. Exploration of a Polygenic Risk Score for Alcohol Consumption: A Longitudinal Analysis from the ALSPAC Cohort. PLoS One 2016; 11:e0167360. [PMID: 27902751 PMCID: PMC5130278 DOI: 10.1371/journal.pone.0167360] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 11/12/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Uncertainty remains about the true extent by which alcohol consumption causes a number of health outcomes. Genetic variants, or combinations of variants built into a polygenic risk score (PGRS), can be used in an instrumental variable framework to assess causality between a phenotype and disease outcome of interest, a method known as Mendelian randomisation (MR). We aimed to identify genetic variants involved in the aetiology of alcohol consumption, and develop a PGRS for alcohol. METHODS Repeated measures of alcohol consumption from mothers and their offspring were collected as part of the Avon Longitudinal Study of Parents and Children. We tested the association between 89 SNPs (identified from either published GWAS data or from functional literature) and repeated measures of alcohol consumption, separately in mothers (from ages 28-48) and offspring (from ages 15-21) who had ever reported drinking. We modelled log units of alcohol using a linear mixed model and calculated beta coefficients for each SNP separately. Cross-validation was used to determine an allelic score for alcohol consumption, and the AVENGEME algorithm employed to estimate variance of the trait explained. RESULTS Following correction for multiple testing, one SNP (rs1229984) showed evidence for association with alcohol consumption (β = -0.177, SE = 0.042, p = <0.0001) in the mothers. No SNPs showed evidence for association in the offspring after correcting for multiple testing. The optimal allelic score was generated using p-value cut offs of 0.5 and 0.05 for the mothers and offspring respectively. These scores explained 0.3% and 0.7% of the variance. CONCLUSION Our PGRS explains a modest amount of the variance in alcohol consumption and larger sample sizes would be required to use our PGRS in an MR framework.
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Affiliation(s)
- Michelle Taylor
- MRC Integrative Epidemiology Unit at the University of Bristol (IEU), University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, United Kingdom
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, United Kingdom
| | - Andrew J. Simpkin
- MRC Integrative Epidemiology Unit at the University of Bristol (IEU), University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, United Kingdom
| | - Philip C. Haycock
- MRC Integrative Epidemiology Unit at the University of Bristol (IEU), University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, United Kingdom
| | - Frank Dudbridge
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit at the University of Bristol (IEU), University of Bristol, Bristol, United Kingdom
- School of Social and Community Medicine, Faculty of Medicine and Dentistry, University of Bristol, Bristol, United Kingdom
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Azeredo CM, Levy RB, Peres MFT, Menezes PR, Araya R. Patterns of health-related behaviours among adolescents: a cross-sectional study based on the National Survey of School Health Brazil 2012. BMJ Open 2016; 6:e011571. [PMID: 28186927 PMCID: PMC5128904 DOI: 10.1136/bmjopen-2016-011571] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of this study was to analyse the clustering of multiple health-related behaviours among adolescents and describe which socio-demographic characteristics are associated with these patterns. DESIGN Cross-sectional study. SETTING Brazilian schools assessed by the National Survey of School Health (PeNSE, 2012). PARTICIPANTS 104 109 Brazilian ninth-grade students from public and private schools (response rate=82.7%). METHODS Exploratory and confirmatory factor analyses were performed to identify behaviour clustering and linear regression models were used to identify socio-demographic characteristics associated with each one of these behaviour patterns. RESULTS We identified a good fit model with three behaviour patterns. The first was labelled 'problem-behaviour' and included aggressive behaviour, alcohol consumption, smoking, drug use and unsafe sex; the second was labelled 'health-compromising diet and sedentary behaviours' and included unhealthy food indicators and sedentary behaviour; and the third was labelled 'health-promoting diet and physical activity' and included healthy food indicators and physical activity. No differences in behaviour patterns were found between genders. The problem-behaviour pattern was associated with male gender, older age, more developed region (socially and economically) and public schools (compared with private). The 'health-compromising diet and sedentary behaviours' pattern was associated with female gender, older age, mothers with higher education level and more developed region. The 'health-promoting diet and physical activity' pattern was associated with male gender and mothers with higher education level. CONCLUSIONS Three health-related behaviour patterns were found among Brazilian adolescents. Interventions to decrease those negative patterns should take into account how these behaviours cluster together and the individuals most at risk.
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Affiliation(s)
- Catarina Machado Azeredo
- School of Medicine—Federal University of Uberlandia (Faculdade de Medicina—Universidade Federal de Uberlândia), Uberlandia, Brazil
| | - Renata Bertazzi Levy
- School of Medicine—University of Sao Paulo (Faculdade de Medicina—Universidade de São Paulo), Sao Paulo, Brazil
| | | | - Paulo Rossi Menezes
- School of Medicine—University of Sao Paulo (Faculdade de Medicina—Universidade de São Paulo), Sao Paulo, Brazil
| | - Ricardo Araya
- Department of Population Health, London School of Hygiene and Tropical Medicine, Centre for Global Mental Health, London, UK
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Coid JW, Ullrich S, Kallis C, Freestone M, Gonzalez R, Bui L, Igoumenou A, Constantinou A, Fenton N, Marsh W, Yang M, DeStavola B, Hu J, Shaw J, Doyle M, Archer-Power L, Davoren M, Osumili B, McCrone P, Barrett K, Hindle D, Bebbington P. Improving risk management for violence in mental health services: a multimethods approach. PROGRAMME GRANTS FOR APPLIED RESEARCH 2016. [DOI: 10.3310/pgfar04160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BackgroundMental health professionals increasingly carry out risk assessments to prevent future violence by their patients. However, there are problems with accuracy and these assessments do not always translate into successful risk management.ObjectivesOur aim was to improve the accuracy of assessment and identify risk factors that are causal to be targeted by clinicians to ensure good risk management. Our objectives were to investigate key risks at the population level, construct new static and dynamic instruments, test validity and construct new models of risk management using Bayesian networks.Methods and resultsWe utilised existing data sets from two national and commissioned a survey to identify risk factors at the population level. We confirmed that certain mental health factors previously thought to convey risk were important in future assessments and excluded others from subsequent parts of the study. Using a first-episode psychosis cohort, we constructed a risk assessment instrument for men and women and showed important sex differences in pathways to violence. We included a 1-year follow-up of patients discharged from medium secure services and validated a previously developed risk assessment guide, the Medium Security Recidivism Assessment Guide (MSRAG). We found that it is essential to combine ratings from static instruments such as the MSRAG with dynamic risk factors. Static levels of risk have important modifying effects on dynamic risk factors for their effects on violence and we further demonstrated this using a sample of released prisoners to construct risk assessment instruments for violence, robbery, drugs and acquisitive convictions. We constructed a preliminary instrument including dynamic risk measures and validated this in a second large data set of released prisoners. Finally, we incorporated findings from the follow-up of psychiatric patients discharged from medium secure services and two samples of released prisoners to construct Bayesian models to guide clinicians in risk management.ConclusionsRisk factors for violence identified at the population level, including paranoid delusions and anxiety disorder, should be integrated in risk assessments together with established high-risk psychiatric morbidity such as substance misuse and antisocial personality disorder. The incorporation of dynamic factors resulted in improved accuracy, especially when combined in assessments using actuarial measures to obtain levels of risk using static factors. It is important to continue developing dynamic risk and protective measures with the aim of identifying factors that are causally related to violence. Only causal factors should be targeted in violence prevention interventions. Bayesian networks show considerable promise in developing software for clinicians to identify targets for intervention in the field. The Bayesian models developed in this programme are at the prototypical stage and require further programmer development into applications for use on tablets. These should be further tested in the field and then compared with structured professional judgement in a randomised controlled trial in terms of their effectiveness in preventing future violence.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- Jeremy W Coid
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Simone Ullrich
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Constantinos Kallis
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Mark Freestone
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Rafael Gonzalez
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Laura Bui
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Artemis Igoumenou
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Anthony Constantinou
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - Norman Fenton
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - William Marsh
- School of Electronic Engineering and Computer Science, Risk and Information Management, Queen Mary University of London, London, UK
| | - Min Yang
- West China Research Centre for Rural Health Development, Sichuan University, Chengdu, China
| | - Bianca DeStavola
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, London, UK
| | - Junmei Hu
- Basic and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jenny Shaw
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Mike Doyle
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Laura Archer-Power
- Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Mary Davoren
- Violence Prevention Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Beatrice Osumili
- Health Services and Population Research, Institute of Psychiatry, King’s College London, UK
| | - Paul McCrone
- Health Services and Population Research, Institute of Psychiatry, King’s College London, UK
| | | | | | - Paul Bebbington
- Department of Mental Health Sciences, University College London, London, UK
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Characteristics associated with risk taking behaviours predict young people's participation in organised activities. J Adolesc 2016; 53:189-194. [PMID: 27814496 PMCID: PMC5120987 DOI: 10.1016/j.adolescence.2016.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Participation in organised activities (OAs) such as sports and special groups can shape adolescent risk taking behaviours. Sensation seeking and inhibitory control play an important role in the emergence of adolescent risk taking behaviours and may explain variations in OA participation as well as inform the development of more effective interventions that use OAs. Data from the Avon Longitudinal Study of Parents and Children (England) were analysed using logistic regression to test whether inhibitory control and sensation seeking predicted participation in OAs at a mean age of 11.7 years (n = 2557) and 15.4 years (n = 2147). At 11 years of age higher sensation seeking predicted participation in any activity, sports and special groups while low inhibitory control predicted less participation in sports. At 15 years of age higher sensation seeking predicted participation in sports and activity breadth. Opportunities to develop targeted interventions aimed at increasing participation are discussed.
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Jeon KC, Goodson P. Alcohol and sex: friendship networks and co-occurring risky health behaviours of US adolescents. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2016. [DOI: 10.1080/02673843.2015.1110954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Kwon Chan Jeon
- Department of Health and Human Performance, Northwestern State University, Natchitoches, LA, USA
| | - Patricia Goodson
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
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Bertol E, Vaiano F, Boscolo-Berto R, Fioravanti A, Palumbo D, Catalani V, Mari F, Patussi V, Serpelloni G. Alcohol, caffeine, and nicotine consumption in adolescents: hair analysis versus self-report. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:341-349. [PMID: 27588338 DOI: 10.1080/00952990.2016.1216556] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Clinical reliability of self-reported data for alcohol, caffeine, and nicotine consumptions is lacking, particularly in adolescents. OBJECTIVES To compare a self-report questionnaire and hair analysis to assess the reliability and effectiveness of the self-report. METHODS A cross-sectional study on 14-15-year-old Italian students (n = 874, 38% males, 62% females) was performed comparing self-reported data to hair analysis. The latter quantified hair concentrations of caffeine, nicotine, cotinine, ethyl glucuronide (EtG), and fatty acid ethyl esters (FAEEs) using mass spectrometry. RESULTS Concordance between self-report and hair testing ranged from good to poor across substances and levels of use: poor for heavy alcohol intake (EtG: k = 0.36, 20 positive cases by hair analysis, false negative by self-report, 2.3% of total sample; FAEE k = 0.31, 25 positive cases, 2.9% of total sample); fair to poor for active smokers (k = 0.40, 125 positive cases, 14.3% of total sample); and moderate for caffeine (k = 0.57, 56 positive cases, 6.4% of total sample). CONCLUSIONS Epidemiological studies on alcohol, caffeine, and nicotine consumption in adolescents may benefit from the inclusion of toxicological analysis on hair samples to overcome the under-reporting phenomenon of questionnaires and detect more cases of problematic substance use.
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Affiliation(s)
- Elisabetta Bertol
- a Department of Health Science , University of Florence , Florence , Italy
| | - Fabio Vaiano
- a Department of Health Science , University of Florence , Florence , Italy
| | - Rafael Boscolo-Berto
- b Forensic Toxicology and Antidoping , University Hospital of Padova , Padova , Italy
| | - Alessia Fioravanti
- a Department of Health Science , University of Florence , Florence , Italy
| | - Diego Palumbo
- a Department of Health Science , University of Florence , Florence , Italy
| | - Valeria Catalani
- a Department of Health Science , University of Florence , Florence , Italy
| | - Francesco Mari
- a Department of Health Science , University of Florence , Florence , Italy
| | - Valentino Patussi
- c Regional Alcoholic Center, Toscana Region, Alcohol Unit, AOU Careggi , Florence , Italy
| | - Giovanni Serpelloni
- d University of Florence, Unit of Research and Innovation in Forensic Toxicology and Neuroscience of Addiction , Florence , Italy
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Noll PRES, Silveira NDA, Noll M, Barros PDS. High School Students Residing in Educational Public Institutions: Health-Risk Behaviors. PLoS One 2016; 11:e0161652. [PMID: 27560808 PMCID: PMC4999216 DOI: 10.1371/journal.pone.0161652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 08/09/2016] [Indexed: 01/13/2023] Open
Abstract
Although several health-risk behaviors of adolescents have been described in the literature, data of high school students who reside at educational institutions in developing countries are scarce. This study aimed to describe behaviors associated with health risks among high school students who reside at an educational public institution and to associate these variables with the length of stay at the institution. This cross-sectional study was conducted during the year 2015 and included 122 students aged 14-19 years at a federal educational institution in the Midwest of Brazil; students were divided into residents of <8 months and those of >20 months. Information concerning the family socioeconomic status and anthropometric, dietary and behavioral profiles was investigated. Despite being physically active, students exhibited risk-associated behaviors such as cigarette and alcohol use and risky sexual behaviors that were exacerbated by fragile socioeconomic conditions and distance from family. A longer time in residence at the institution was associated with an older age (p ≤ 0.001), adequate body mass index (BMI; p = 0.02), nutritional knowledge (p = 0.01), and less doses of alcohol consumption (p ≤ 0.01) compared with those with shorter times in residence. In conclusion, the students exhibited different health-risk behaviors, and a longer institutional residence time, compared with a shorter time, was found to associate with the reduction of health-risk behaviors.
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Affiliation(s)
- Priscilla Rayanne e Silva Noll
- Graduate Program in Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
- Goiano Federal Institute—Ceres Campus, Ceres, Goiás, Brazil
| | | | - Matias Noll
- Goiano Federal Institute—Ceres Campus, Ceres, Goiás, Brazil
| | - Patrícia de Sá Barros
- Graduate Program in Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil
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Shek DTL, Yu L, Leung H, Wu FKY, Law MYM. Development, implementation, and evaluation of a multi-addiction prevention program for primary school students in Hong Kong: the B.E.S.T. Teen Program. ACTA ACUST UNITED AC 2016; 6:5. [PMID: 27630812 PMCID: PMC4998165 DOI: 10.1186/s40405-016-0014-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 06/27/2016] [Indexed: 11/11/2022]
Abstract
Based on the evaluation findings of the B.E.S.T. Teen Program which aimed at promoting behavioral, emotional, social, and thinking competencies in primary school students, it is argued in this paper that promotion of psychosocial competence to prevent addiction in primary school students is a promising strategy. A total of 382 Primary 5 (Grade 5) and 297 Primary 6 (Grade 6) students from five primary schools in Hong Kong participated in the program. Different evaluation strategies were adopted to evaluate the program. First, objective outcome evaluation adopting a non-equivalent group pretest–posttest experimental-control group design was conducted to examine change in the students. Second, to gauge students’ perceptions of the program, subjective outcome evaluation was conducted. The evaluation findings basically converged to tentatively suggest that young adolescents benefited from participating in the program. Implications on the development, implementation, and evaluation of addiction prevention programs for teenagers are discussed.
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Affiliation(s)
- Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, People's Republic of China ; Centre for Innovative Programmes for Adolescents and Families, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China ; Department of Social Work, East China Normal University, Shanghai, People's Republic of China ; Kiang Wu Nursing College of Macau, Macao, People's Republic of China ; University of Kentucky College of Medicine, Lexington, KY USA
| | - Lu Yu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, People's Republic of China
| | - Hildie Leung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, People's Republic of China
| | - Florence K Y Wu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, People's Republic of China
| | - Moon Y M Law
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hunghom, Hong Kong, People's Republic of China
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Hale DR, Viner RM. The correlates and course of multiple health risk behaviour in adolescence. BMC Public Health 2016; 16:458. [PMID: 27246600 PMCID: PMC4888596 DOI: 10.1186/s12889-016-3120-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 05/17/2016] [Indexed: 11/20/2022] Open
Abstract
Background Health risk behaviours often co-occur in adolescence. This may be partially explained by a set of common risk and protective factors. The current study examines the association between risk behaviours throughout adolescence and identifies common risk factors for multiple risk behaviour in late adolescence. Methods We use data from the Longitudinal Study of Young People in England. We examined the association between risk behaviours at age 14 (n = 15,588), age 16 (n = 12,416) and age 19 (n = 9,548). The associations between age 19 risk behaviour and earlier risk behaviours and risk and protective factors were assessed longitudinally. Health risk behaviours included smoking, alcohol use, illicit drug use, delinquency and unsafe sexual behaviour. Results All risk behaviours were found to be associated with other risk behaviours with associations weakening through adolescence. A number of sociodemographic, interpersonal, school and family factors at age 14 predicted risk behaviour and multiple risk behaviour at 19, though predictors for heavy alcohol use often differed from other health risk behaviours. Past risk behaviour was a strong predictor of age 19 risk behaviour though many involved in only one form of risk behaviour in mid-adolescence do not progress to multiple risk behaviour. Conclusions Our findings reaffirm the links between health risk behaviours, but these diminish throughout adolescence with multiple risk behaviour usually initiated in mid-adolescence. Multiple risk behaviour is initiated in early or mid adolescence with a number of common risk factors explaining the co-occurrence of risk behaviours.
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Affiliation(s)
- Daniel R Hale
- The Policy Research Unit in the Health of Children, Young People and Families, General and Adolescent Pediatrics, Institute of Child Health, UCL, 30 Guilford St., London, WC1N 1EH, UK.
| | - Russell M Viner
- The Policy Research Unit in the Health of Children, Young People and Families, General and Adolescent Pediatrics, Institute of Child Health, UCL, 30 Guilford St., London, WC1N 1EH, UK
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RODRIGUES PRM, PADEZ CMP, FERREIRA MG, GONÇALVES-SILVA RMV, PEREIRA RA. Multiple risk behaviors for non-communicable diseases and associated factors in adolescents. REV NUTR 2016. [DOI: 10.1590/1678-98652016000200004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: To estimate the prevalence of risk behaviors for non-communicable diseases and analyze their associated factors in adolescents. Methods: A school-based cross-sectional study was conducted in 2008 with 1,139 adolescents aged 14 to 19 years attending public and private high schools in Cuiabá, Midwestern Brazil. Data were collected using a selfadministered questionnaire, including a semiquantitative Food Frequency Questionnaire. The prevalence of tobacco smoking, alcohol experimentation, physical inactivity, unsatisfactory meal pattern, and excessive intake of saturated fat and sodium were evaluated. The associations between risk behaviors and socioeconomic variables, weight status, and self-perceived health status were evaluated. Results: The most common risk behaviors were excessive sodium intake (88%), unsatisfactory meal pattern (72%), excessive intake of saturated fat (39%), and alcohol experimentation (39%). Four of 10 adolescents were exposed to two risk behaviors simultaneously. Among male adolescents, the main factors associated with risk behaviors were: type of school, class schedule, education level of the household head, weight status, and self-perceived health status. Among female adolescents, age, type of school, class schedule, and education level of the household head were the main factors associated with risk behaviors. Conclusion: The prevalence of exposure to risk behaviors for non-communicable diseases was high, highlighting the simultaneous presence of tobacco smoking and experimentation of alcoholic beverages. Special attention should be given to educational activities to minimize the effects of the simultaneous occurrence of multiple risk behaviors.
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Sadeh N, Baskin-Sommers A. Risky, Impulsive, and Self-Destructive Behavior Questionnaire (RISQ): A Validation Study. Assessment 2016; 24:1080-1094. [PMID: 27002123 DOI: 10.1177/1073191116640356] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Risky behaviors increase the likelihood of premature death, long-term disability, and poor mental health outcomes. Most current measures of risky behavior only assess behaviors within a single domain, fail to evaluate affective triggers for engaging in these behaviors, do not index the consequences of these behaviors, and are often limited to a narrow developmental period. The present study developed and evaluated a new 38-item questionnaire-based measure, the Risky, Impulsive, and Self-Destructive Behavior Questionnaire (RISQ), designed to address each of these limitations by expanding the breadth and depth of previous questionnaires. A bifactor model with a general factor and eight domain-specific factors (measuring drug use, aggression, self-harm, gambling, risky sexual behavior, impulsive eating, heavy alcohol use, and reckless behavior) best fit the RISQ, and indicators of internal consistency, as well as, construct validity were strong. Results provide initial validation for the RISQ as a broad, yet relatively brief, measure that quantifies and qualifies risky behaviors by assessing the severity, chronicity, and triggers for a range of harmful behaviors.
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Affiliation(s)
- Naomi Sadeh
- 1 National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA.,2 Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA
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Kelly Y, Goisis A, Sacker A, Cable N, Watt RG, Britton A. What influences 11-year-olds to drink? Findings from the Millennium Cohort Study. BMC Public Health 2016; 16:169. [PMID: 26939527 PMCID: PMC4778360 DOI: 10.1186/s12889-016-2847-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 02/09/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Drinking in youth is linked to other risky behaviours, educational failure and premature death. Prior research has examined drinking in mid and late teenagers, but little is known about the factors that influence drinking at the beginning of adolescence. Objectives were: 1. to assess associations of parental and friends' drinking with reported drinking among 11 year olds; 2. to investigate the roles of perceptions of harm, expectancies towards alcohol, parental supervision and family relationships on reported drinking among 11 year olds. METHODS Analysis of data from the UK Millennium Cohort Study on 10498 11-year-olds. The outcome measure was having drank an alcoholic drink, self-reported by cohort members. RESULTS 13.6 % of 11 year olds reported having drank. Estimates reported are odds ratios and 95 % confidence intervals. Cohort members whose mothers drank were more likely to drink (light/moderate = 1.6, 1.3 to 2.0, heavy/binge = 1.8, 1.4 to 2.3). Cohort members whose fathers drank were also more likely to drink but these estimates lost statistical significance when covariates were adjusted for (light/moderate = 1.3, 0.9 to 1.9, heavy/binge = 1.3, 0.9 to 1.9). Having friends who drank was strongly associated with cohort member drinking (4.8, 3.9 to 5.9). Associated with reduced odds of cohort member drinking were: heightened perception of harm from 1-2 drinks daily (some = 0.9, 0.7 to 1.1, great = 0.6, 0.5 to 0.7); and negative expectancies towards alcohol (0.5, 0.4 to 0.7). Associated with increased odds of cohort member drinking were: positive expectancies towards alcohol (1.9, 1.4 to 2.5); not being supervised on weekends and weekdays (often = 1.2, 1.0 to 1.4); frequent battles of will (1.3, 1.1 to 1.5); and not being happy with family (1.2, 1.0 to 1.5). CONCLUSIONS Examining drinking at this point in the lifecourse has potentially important public health implications as around one in seven 11 year olds have drank, although the vast majority are yet to explore alcohol. Findings support interventions working at multiple levels that incorporate family and peer factors to help shape choices around risky behaviours including drinking.
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Affiliation(s)
- Yvonne Kelly
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Alice Goisis
- Department of Social Policy, The London School of Economics and Political Science (LSE), Houghton Street, London, WC2A 2AE, UK.
| | - Amanda Sacker
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Richard G Watt
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
| | - Annie Britton
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK.
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Georgie J M, Sean H, Deborah M C, Matthew H, Rona C. Peer-led interventions to prevent tobacco, alcohol and/or drug use among young people aged 11-21 years: a systematic review and meta-analysis. Addiction 2016; 111:391-407. [PMID: 26518976 PMCID: PMC4833174 DOI: 10.1111/add.13224] [Citation(s) in RCA: 117] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 05/28/2015] [Accepted: 10/22/2015] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND AIMS Peer-led interventions may offer a beneficial approach in preventing substance use, but their impact has not yet been quantified. We conducted a systematic review to investigate and quantify the effect of peer-led interventions that sought to prevent tobacco, alcohol and/or drug use among young people aged 11-21 years. METHODS Medline, EMBASE, PsycINFO, CINAHL, ERIC and the Cochrane Library were searched from inception to July 2015 without language restriction. We included randomized controlled trials only. Screening and data extraction were conducted in duplicate and data from eligible studies were pooled in a random effects meta-analysis. RESULTS We identified 17 eligible studies, approximately half of which were school-based studies targeting tobacco use among adolescents. Ten studies targeting tobacco use could be pooled, representing 13,706 young people in 220 schools. Meta-analysis demonstrated that the odds of smoking were lower among those receiving the peer-led intervention compared with control [odds ratio (OR) = 0.78, 95% confidence interval (CI) = 0.62-0.99, P = 0.040]. There was evidence of heterogeneity (I(2) = 41%, χ(2) 15.17, P = 0.086). Pooling of six studies representing 1699 individuals in 66 schools demonstrated that peer-led interventions were also associated with benefit in relation to alcohol use (OR = 0.80, 95% CI = 0.65-0.99, P = 0.036), while three studies (n = 976 students in 38 schools) suggested an association with lower odds of cannabis use (OR = 0.70, 0.50-0.97, P = 0.034). No studies were found that targeted other illicit drug use. CONCLUSIONS Peer interventions may be effective in preventing tobacco, alcohol and possibly cannabis use among adolescents, although the evidence base is limited overall, and is characterized mainly by small studies of low quality.
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Affiliation(s)
| | - Harrison Sean
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Caldwell Deborah M
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Hickman Matthew
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Campbell Rona
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Pohl KM, Sullivan EV, Rohlfing T, Chu W, Kwon D, Nichols BN, Zhang Y, Brown SA, Tapert SF, Cummins K, Thompson WK, Brumback T, Colrain IM, Baker FC, Prouty D, De Bellis MD, Voyvodic JT, Clark DB, Schirda C, Nagel BJ, Pfefferbaum A. Harmonizing DTI measurements across scanners to examine the development of white matter microstructure in 803 adolescents of the NCANDA study. Neuroimage 2016; 130:194-213. [PMID: 26872408 DOI: 10.1016/j.neuroimage.2016.01.061] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 01/23/2016] [Accepted: 01/28/2016] [Indexed: 01/18/2023] Open
Abstract
Neurodevelopment continues through adolescence, with notable maturation of white matter tracts comprising regional fiber systems progressing at different rates. To identify factors that could contribute to regional differences in white matter microstructure development, large samples of youth spanning adolescence to young adulthood are essential to parse these factors. Recruitment of adequate samples generally relies on multi-site consortia but comes with the challenge of merging data acquired on different platforms. In the current study, diffusion tensor imaging (DTI) data were acquired on GE and Siemens systems through the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), a multi-site study designed to track the trajectories of regional brain development during a time of high risk for initiating alcohol consumption. This cross-sectional analysis reports baseline Tract-Based Spatial Statistic (TBSS) of regional fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (L1), and radial diffusivity (LT) from the five consortium sites on 671 adolescents who met no/low alcohol or drug consumption criteria and 132 adolescents with a history of exceeding consumption criteria. Harmonization of DTI metrics across manufacturers entailed the use of human-phantom data, acquired multiple times on each of three non-NCANDA participants at each site's MR system, to determine a manufacturer-specific correction factor. Application of the correction factor derived from human phantom data measured on MR systems from different manufacturers reduced the standard deviation of the DTI metrics for FA by almost a half, enabling harmonization of data that would have otherwise carried systematic error. Permutation testing supported the hypothesis of higher FA and lower diffusivity measures in older adolescents and indicated that, overall, the FA, MD, and L1 of the boys were higher than those of the girls, suggesting continued microstructural development notable in the boys. The contribution of demographic and clinical differences to DTI metrics was assessed with General Additive Models (GAM) testing for age, sex, and ethnicity differences in regional skeleton mean values. The results supported the primary study hypothesis that FA skeleton mean values in the no/low-drinking group were highest at different ages. When differences in intracranial volume were covaried, FA skeleton mean reached a maximum at younger ages in girls than boys and varied in magnitude with ethnicity. Our results, however, did not support the hypothesis that youth who exceeded exposure criteria would have lower FA or higher diffusivity measures than the no/low-drinking group; detecting the effects of excessive alcohol consumption during adolescence on DTI metrics may require longitudinal study.
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Affiliation(s)
- Kilian M Pohl
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Edith V Sullivan
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Torsten Rohlfing
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Weiwei Chu
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Dongjin Kwon
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - B Nolan Nichols
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Yong Zhang
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Sandra A Brown
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States; Veterans Affairs San Diego Healthcare System, La Jolla, CA, United States
| | - Kevin Cummins
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Wesley K Thompson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Ty Brumback
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Ian M Colrain
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Fiona C Baker
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Devin Prouty
- Center for Health Sciences, SRI International, Menlo Park, CA, United States
| | - Michael D De Bellis
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, United States
| | - James T Voyvodic
- Department of Radiology, Duke University School of Medicine, Durham, NC, United States
| | - Duncan B Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Claudiu Schirda
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bonnie J Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
| | - Adolf Pfefferbaum
- Center for Health Sciences, SRI International, Menlo Park, CA, United States; Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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Rowland B, Evans-Whipp T, Hemphill S, Leung R, Livingston M, Toumbourou J. The density of alcohol outlets and adolescent alcohol consumption: An Australian longitudinal analysis. Health Place 2016; 37:43-9. [DOI: 10.1016/j.healthplace.2015.11.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 11/02/2015] [Accepted: 11/13/2015] [Indexed: 10/22/2022]
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Barry AE, King J, Sears C, Harville C, Bondoc I, Joseph K. Prioritizing Alcohol Prevention: Establishing Alcohol as the Gateway Drug and Linking Age of First Drink With Illicit Drug Use. THE JOURNAL OF SCHOOL HEALTH 2016; 86:31-38. [PMID: 26645418 DOI: 10.1111/josh.12351] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 05/01/2015] [Accepted: 05/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Given ever-reducing budgets of community and school substance use prevention programs, there is a call for identifying the first substance in the sequence leading to polydrug use. METHODS Examining data from a nationally representative sample of 2835 United States 12th graders, we sought to determine (1) the first substance adolescents use; (2) order in which adolescents progress through alcohol, tobacco, and marijuana use; and (3) impact of age of initial substance use on lifetime and frequency of illicit substance use. RESULTS Alcohol is the most commonly used substance, and the majority of polysubstance using respondents consumed alcohol prior to tobacco or marijuana initiation. Respondents initiating alcohol use in sixth grade reported significantly greater lifetime illicit substance use (M = 1.9, standard deviation [SD] = 1.7, p < .001) and more frequent illicit substance use (M = 6.0, SD = 6.5, p < .001) than those initiating alcohol use in ninth grade or later. Overall, effect sizes for these differences were large (eta squared = 0.30 and 0.28, respectively). CONCLUSIONS Findings underscore the importance of screening for substance use, even among youth enrolled in elementary/middle school. In addition, school prevention programs should begin in elementary school (third grade) and target alcohol use.
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Affiliation(s)
- Adam E Barry
- Department of Health and Kinesiology, Texas A&M University, College Station, TX 77843-4243.
| | - Jessica King
- Department of Behavioral Science and Community Health, University of Florida, PO Box 100175 HSC, Gainesville, FL 32610-0175.
| | - Cynthia Sears
- Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL 32611-8210.
| | - Cedric Harville
- Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL 32611-8210.
| | - Irina Bondoc
- Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL 32611-8210.
| | - Kessy Joseph
- Department of Health Education and Behavior, University of Florida, PO Box 118210, Gainesville, FL 32611-8210.
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Nasui BA, Popa M, Popescu CA. Drinking Patterns and Behavioral Consequences: A Cross-Sectional Study among Romanian University Students. Zdr Varst 2015; 55:59-66. [PMID: 27647090 PMCID: PMC4820183 DOI: 10.1515/sjph-2016-0009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 10/01/2015] [Indexed: 12/04/2022] Open
Abstract
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.
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Affiliation(s)
- Bogdana Adriana Nasui
- Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Communitary Health, Louis Pasteur No. 6, 400349 Cluj-Napoca, Romania
| | - Monica Popa
- Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Communitary Health, Louis Pasteur No. 6, 400349 Cluj-Napoca, Romania
| | - Codruta Alina Popescu
- Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Department of Social Science and History of Medicine, Louis Pasteur No. 6, 400349 Cluj-Napoca, Romania
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The Drinkers Degree: Risk Taking Behaviours amongst Undergraduate Student Drinkers. JOURNAL OF ADDICTION 2015; 2015:965438. [PMID: 26713168 PMCID: PMC4680050 DOI: 10.1155/2015/965438] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022]
Abstract
Objective. To examine risk taking behaviours associated with alcohol consumption amongst UK undergraduate students. Design and Methods. A cross-sectional web survey was used to assess attitudes and health behaviours. The survey included the Alcohol Use Disorders Identification Test (AUDIT). Students were also asked about why they drank alcohol; about their preferred alcoholic beverage; and if they had experienced any consequences associated with drinking alcohol as well as questions relating to sexual risk taking, drug use, and smoking. Results. 2779 (65% female; 84% White British) students completed some part of the survey. Of these, 98% (n = 2711) completed the AUDIT. Of the 92% that drank 66% (n = 1,643) were categorised as being AUDIT positive. 8% (n = 224) were categorised as probably alcohol dependent. Higher AUDIT scores were significantly associated with negative consequences such as unplanned sexual activity, physical injuries, and arguments. Other risk taking behaviours such as drug use and smoking were also found to be positively correlated with higher AUDIT scores; drug use; and smoking. Conclusions. The results from this study provide insight into students' alcohol consumption and associated risk taking. University policies need to protect students' overall health and wellbeing to ensure academic potential is maximised.
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Busse H, Harrop T, Gunnell D, Kipping R. Prevalence and associated harm of engagement in self-asphyxial behaviours ('choking game') in young people: a systematic review. Arch Dis Child 2015; 100:1106-14. [PMID: 26111816 PMCID: PMC4680200 DOI: 10.1136/archdischild-2015-308187] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 05/21/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the prevalence of engagement in self-asphyxial (risk-taking) behaviour (SAB) ('choking game') and associated morbidity and mortality in children and young people up to age 20. DESIGN Systematic literature review. SEARCH STRATEGY Electronic database search of MEDLINE, Embase, PsycINFO, CINAHL, PubMed, Web of Science Core Collection, BIOSIS citation index and the Cochrane register with no language or date limits applied. References of key papers were reviewed, and experts were contacted to identify additional relevant papers. ELIGIBILITY CRITERIA Systematic reviews, cross-sectional, cohort and case-control studies, and case reports examining SAB with regard to individuals aged 0-20 years, without explicitly stated autoerotic, suicidal or self-harm intentions were included. RESULTS Thirty-six relevant studies were identified, and SAB was reported in 10 countries. In North America, France and Colombia, awareness of SAB ranged from 36% to 91% across studies/settings, and the median lifetime prevalence of engagement in SAB was 7.4%. Six studies identified the potential for SAB to be associated with engagement in other risk behaviours. Ninety-nine fatal cases were reported. Of the 24 cases described in detail, most occurred when individuals engaged in SAB alone and used a ligature. CONCLUSIONS The current evidence on SAB among young people is limited, and stems predominantly from North America and France. Awareness of SAB among young people is high, and engagement varies by setting. Further research is needed to understand the level of risk and harm associated with SAB, and to determine the appropriate public health response.
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Affiliation(s)
- H Busse
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - T Harrop
- Independent Public Health Doctor
| | - D Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - R Kipping
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Scoccianti C, Cecchini M, Anderson AS, Berrino F, Boutron-Ruault MC, Espina C, Key TJ, Leitzmann M, Norat T, Powers H, Wiseman M, Romieu I. European Code against Cancer 4th Edition: Alcohol drinking and cancer. Cancer Epidemiol 2015; 39 Suppl 1:S67-74. [PMID: 26115567 DOI: 10.1016/j.canep.2015.01.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/10/2014] [Accepted: 01/16/2015] [Indexed: 12/16/2022]
Abstract
Alcohol consumption is the third leading risk factor for disease and mortality in Europe. The International Agency for Research on Cancer (IARC) Monographs provide strengthened evidence that the consumption of alcoholic beverages is causally associated with cancers of the oral cavity, pharynx, larynx, oesophagus, liver, colorectum and female breast, even for low and moderate alcohol intakes. The risk of cancer increases in a dose-dependent manner, and the higher the amount of alcohol consumed, the higher the risk of developing cancer. Several biological mechanisms explain the carcinogenicity of alcohol; among them, ethanol and its genotoxic metabolite acetaldehyde play a major role. Taking all this evidence into account, a recommendation of the 4th edition of the European Code against Cancer (ECAC) is: "If you drink alcohol of any type, limit your intake. Not drinking alcohol is better for cancer prevention."
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Michele Cecchini
- Health Policy Analyst OECD, 2 rue André Pascal, 75775 Paris Cedex 16, France
| | - Annie S Anderson
- Centre for Research into Cancer Prevention & Screening, Level 7, Mailbox 7, Ninewells Hospital & Medical School, Dundee, DD1 9SY, Scotland, United Kingdom
| | - Franco Berrino
- Fondazione IRCSS Istituto Nazionale dei Tumori, 1 via Venezian, 20133 Milan, Italy
| | | | - Carolina Espina
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, 93042 Regensburg, Germany
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health Imperial College London, St Mary's Campus, London W2 1 PG, United Kingdom
| | - Hilary Powers
- Human Nutrition Unit, The Medical School, Beech Hill Road, Sheffield, S10 2RX, United Kingdom
| | - Martin Wiseman
- World Cancer Research Fund International, Second Floor, 22 Bedford Square, London WC1B 3HH, United Kingdom
| | - Isabelle Romieu
- International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Heelis R, Graham H, Jackson C. A Preliminary Test of the Interpersonal Psychological Theory of Suicidal Behavior in Young People With a First Episode of Psychosis. J Clin Psychol 2015; 72:79-87. [DOI: 10.1002/jclp.22233] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Verhagen CE, Uitenbroek DG, Schreuders EJ, El Messaoudi S, de Kroon MLA. Does a reduction in alcohol use by Dutch high school students relate to higher use of tobacco and cannabis? BMC Public Health 2015; 15:821. [PMID: 26306998 PMCID: PMC4549080 DOI: 10.1186/s12889-015-2149-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 08/12/2015] [Indexed: 11/20/2022] Open
Abstract
Background Substance use of adolescents was investigated in a region around Amsterdam, the Netherlands, in the period 2005–2009. The study was intended to find out to what extent behaviour related to different substances are interrelated and how trends develop in different subgroups. Methods Two cross-sectional surveys were conducted among Dutch students in the second and fourth year of secondary school, aged 13-16 [n = 1,854 in 2005; n = 2,088 in 2009] by making use of an online questionnaire including questions about alcohol consumption, tobacco use (smoking behaviour) and cannabis use. Two educational levels were included. Results Decreases in alcohol consumption, tobacco and cannabis use were found between 2005 and 2009. The strongest decline was seen in alcohol consumption. Last month drinking decreased from 61.8 % in 2005 to 36.5 % in 2009. Last month binge drinking decreased from 38.7 % in 2005 to 24.0 % in 2009. Reduced alcohol consumption was found among boys and girls, for all ages and in both educational levels. Changes were strongest among 13-year-olds. Weekly or daily smoking declined between 2005 and 2009 among 13-year-olds, girls and students in the lower schooling level. Last month cannabis use decreased among girls and students in the higher schooling level. In both 2005 and 2009 clustering with alcohol consumption was found for the use of other substances. Conclusions Between 2005 and 2009 alcohol consumption strongly decreased among high school students. This may be due to the national prevention campaign which in the same period highlighted the importance of not drinking before the age of 16. The decrease in smoking and cannabis use between 2005 and 2009 may be due to clustering with alcohol consumption. A reduction in the use of alcohol in adolescence did not lead to replacement by tobacco or cannabis use.
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Affiliation(s)
- Claudia E Verhagen
- Department of Epidemiology & Health Promotion, Public Health Service of Amsterdam, P.O. Box 2200, 1000 CE, Amsterdam, The Netherlands.
| | - Daan G Uitenbroek
- Department of Epidemiology & Health Promotion, Public Health Service of Amsterdam, P.O. Box 2200, 1000 CE, Amsterdam, The Netherlands.
| | - Emilie J Schreuders
- Department of Epidemiology & Health Promotion, Public Health Service of Amsterdam, P.O. Box 2200, 1000 CE, Amsterdam, The Netherlands
| | - Sabah El Messaoudi
- Department of Epidemiology & Health Promotion, Public Health Service of Amsterdam, P.O. Box 2200, 1000 CE, Amsterdam, The Netherlands
| | - Marlou L A de Kroon
- Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.
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Whitehead R, Currie D, Inchley J, Currie C. Educational expectations and adolescent health behaviour: an evolutionary approach. Int J Public Health 2015; 60:599-608. [PMID: 25994590 DOI: 10.1007/s00038-015-0692-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 05/07/2015] [Accepted: 05/14/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Previous research finds adolescents expecting to attend university are more likely to demonstrate health-promoting behaviour than those not expecting university attendance. This suggests public health improvements may be achievable by encouraging adolescents to adopt academic goals. We investigate confounders of this putative relationship, focusing on those identified by evolutionary theory. METHODS Multi-level logistic regression was used to analyse the 2010 Scottish Health Behaviour in School-aged Children survey (n = 1834). RESULTS Adolescents anticipating university attendance exhibited higher levels of engagement in health-protective behaviours (fruit and vegetable consumption, exercise and tooth brushing) and were more likely to avoid health-damaging behaviours (crisps, soft drink and alcohol consumption, tobacco and cannabis use, fighting and intercourse). These relationships persisted when controlling indicators of life history trajectory (pubertal timing, socioeconomic status and father absence). Pupil level: gender, age, perceived academic achievement and peer/family communication and school level: university expectations, affluence, leavers' destinations, exam performance and school climate were also adjusted. CONCLUSIONS Encouraging adolescents to consider an academic future may achieve public health benefits, despite social factors that might otherwise precipitate poor health via an accelerated life history trajectory.
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Affiliation(s)
- Ross Whitehead
- Child and Adolescent Health Research Unit, School of Medicine, Medical and Biological Sciences Building, University of St Andrews, St Andrews, Fife, KY16 9TF, Scotland, UK,
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Allara E, Angelini P, Gorini G, Bosi S, Carreras G, Gozzi C, Martini A, Tamelli M, Storani S, Faggiano F. A prevention program for multiple health-compromising behaviors in adolescence: baseline results from a cluster randomized controlled trial. Prev Med 2015; 71:20-6. [PMID: 25500201 DOI: 10.1016/j.ypmed.2014.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 11/12/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To describe the design and present the baseline findings of the evaluation study of 'Paesaggi di Prevenzione', a school-based prevention program tackling smoking, alcohol misuse, dietary risks, and physical inactivity in 12- to 14-year-olds. METHODS The program was implemented from January 2011 to April 2012 in Emilia-Romagna, Italy, and comprised classroom activities and school-wide policies. A two-arm cluster randomized controlled trial was designed. Schools were the units of randomization and were matched by socioeconomic status, size, and type. RESULTS Data from 4700 middle school students and 2952 high school students were collected anonymously from October to December 2010. Past-30-day smoking prevalence was 1.9% among middle school students and 20.8% among high school students. Past-30-day prevalence of alcohol intoxication was 2.2% among middle school students and 11.4% among high school students. A total of 39.7% of middle school students and 48.0% of high school students drank sugar-sweetened beverages four or more times per week; 7.5% of middle school students and 7.1% of high school students had intense physical activity every day. CONCLUSIONS This study seems adequately powered and baseline variables appear evenly distributed between study groups. Findings are in line with those of the WHO Health Behaviour in School-Aged Children study.
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Affiliation(s)
- Elias Allara
- Department of Translational Medicine, Avogadro University, Novara, Italy; School of Public Health, University of Torino, Torino, Italy.
| | - Paola Angelini
- Public Health Unit, Emilia-Romagna Regional Authority, Bologna, Italy
| | - Giuseppe Gorini
- Environmental and Occupational Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Sandra Bosi
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Giulia Carreras
- Environmental and Occupational Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Cristina Gozzi
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Andrea Martini
- Environmental and Occupational Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | - Marco Tamelli
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Simone Storani
- Italian League against Cancer (LILT), Reggio Emilia, Italy
| | - Fabrizio Faggiano
- Department of Translational Medicine, Avogadro University, Novara, Italy
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Individual-, family-, and school-level interventions for preventing multiple risk behaviours relating to alcohol, tobacco and drug use in individuals aged 8 to 25 years. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011374] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Hu H, Scheidell J, Xu X, Coatsworth AM, Khan MR. Associations between blood lead level and substance use and sexually transmitted infection risk among adults in the United States. ENVIRONMENTAL RESEARCH 2014; 135:21-30. [PMID: 25261860 DOI: 10.1016/j.envres.2014.05.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 05/08/2014] [Accepted: 05/15/2014] [Indexed: 05/03/2023]
Abstract
The effects of low-level lead exposure on neuropsychological status in the United States (US) general adult population have been reported, and the relationship between neuropsychiatric dysfunction and health risk behaviors including substance use and sexual risk taking is well established. However, the potential influence of lead exposure on risk-taking behavior has received little attention. Using the National Health and Nutrition Examination Survey (NHANES) 2005-2010, we estimated multivariable logistic regression models to measure odds ratios (ORs) and 95% confidence intervals (CIs) for the cross-sectional associations between blood lead level and risk behaviors including binge drinking, drug use, and indicator of sexually transmitted infection (STI) risk. STI indicators included past 12 month sexual risk behaviors (age mixing with partners who were at least five years younger or older and multiple partnerships), self-reported STI, and biologically-confirmed herpes simplex virus type 2 (HSV-2) infection. Dose-response like relationships were observed between blood lead and substance use, age mixing with younger and older partners, self-reported STI, and HSV-2. In addition, participants with lead levels in highest quartile versus those with levels in the lowest quartile had over three times the odds of binge drinking and over twice the odds of injection drug or cocaine use in the past 12 months, while being in one of the top two quartiles was significantly associated with 30-70% increased odds of multiple partnerships, sex with older partners, and self-reported and biologically confirmed STI. Results from this study suggested that lead exposure may contribute to substance use, sexual risk-taking, and STI. However, given limitations inherent in the cross-sectional nature of the study, additional studies that use longitudinal data and measure detailed temporal information are warranted.
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Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Joy Scheidell
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Ashley M Coatsworth
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Maria R Khan
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States.
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Newbury-Birch D, Scott S, O’Donnell A, Coulton S, Howel D, McColl E, Stamp E, Graybill E, Gilvarry E, Laing K, McGovern R, Deluca P, Drummond C, Harle C, McArdle P, Tate L, Kaner E. A pilot feasibility cluster randomised controlled trial of screening and brief alcohol intervention to prevent hazardous drinking in young people aged 14–15 years in a high school setting (SIPS JR-HIGH). PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BackgroundApproximately 33% of 15- to 16-year-olds in England report alcohol intoxication in the past month. This present work builds on the evidence base by focusing on Alcohol Screening and Brief Intervention (ASBI) to reduce hazardous drinking in younger adolescents.ObjectivesTo explore the feasibility and acceptability of a future definitive cluster randomised controlled trial (cRCT) of ASBI in a school setting to staff, young people and parents; to explore the fidelity of the interventions as delivered by school learning mentors; to estimate the parameters for the design of a definitive cRCT of brief alcohol intervention, including rates of eligibility, consent, participation and retention at 12 months; and to pilot the collection of cost and resource-use data to inform the cost-effectiveness/utility analysis in a definitive trial.SettingSeven schools across one geographical area in North East England.MethodsFeasibility of trial processes, recruitment and retention and a qualitative evaluation examined facilitators and barriers to the use of ASBI approaches in the school setting in this age group. A three-arm pilot cRCT (with randomisation at the school level) with qualitative evaluation to assess the feasibility of a future definitive cRCT of the effectiveness and cost-effectiveness of ASBI in a school setting, with an integrated qualitative component. The trial ran in parallel with a repeated cross-sectional survey, which facilitated screening for the trial.ParticipantsYear 10 school pupils (aged 14–15 years).InterventionsYoung people who screened positive on a single alcohol screening question, and consented to take part, were randomised to one of three groups: (1) feedback that their drinking habits may be risky and provision of an advice leaflet (control condition,n = two schools); (2) feedback as for the control condition plus a 30-minute brief interactive session, which combined structured advice and motivational interviewing techniques, delivered by the school learning mentor (intervention 1,n = two schools); or (3) feedback as for the control condition plus a 30-minute brief interactive session as for intervention 1 plus a 60-minute session involving family members delivered by the school learning mentor (intervention 2,n = three schools). Young people were followed up at 12 months.Main outcome measuresFeasibility and acceptability.RandomisationRandomisation was carried out at the school level. Randomisation achieved balance on two school-level variables (numbers of pupils in school year and proportion receiving free school meals).BlindingSchool staff, young people and researchers were not blind to the intervention allocated.ResultsA total of 229 young people were eligible for the trial; 182 (79.5%) were randomised (control,n = 53; intervention 1,n = 54; intervention 2,n = 75). Of the 75 randomised to intervention 2, 67 received intervention 1 (89%). Eight received both intervention 1 and intervention 2 (11%). In total, 160 out of 182 were successfully followed up at 12 months (88%). Interviews were carried out with six school lead liaisons, 13 learning mentors, 27 young people and seven parents (n = 53). Analysis shows that the school setting is a feasible and acceptable place to carry out ASBI, with learning mentors seen as suitable people to do this. Intervention 2 was not seen as feasible or acceptable by school staff, parents or young people.Outcomes/conclusionsIt is feasible and acceptable to carry out a trial of the effectiveness and cost-effectiveness of single-session ASBI with young people in the school setting, with learning mentors delivering the intervention. Future work should include a definitive study that does not include a parental arm.Trial registrationCurrent Controlled Trials ISRCTN07073105.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Dorothy Newbury-Birch
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Stephanie Scott
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Amy O’Donnell
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Coulton
- Centre for Health Services Research, University of Kent, Canterbury, UK
| | - Denise Howel
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Newcastle Clinical Trials Unit, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine Stamp
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Erin Graybill
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Eilish Gilvarry
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Kirsty Laing
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
| | - Paolo Deluca
- Institute of Psychiatry, King’s College London, London, UK
| | - Colin Drummond
- Institute of Psychiatry, King’s College London, London, UK
| | - Christine Harle
- Newcastle Clinical Trials Unit, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Paul McArdle
- Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Les Tate
- Young People’s Drug and Alcohol Department, North Tyneside Council, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, UK
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Chauchard E, Goutaudier N, Valls M, Melioli T, van Leeuwen N, Chabrol H. Consommation de cannabis et comportements antisociaux dans un échantillon d’adolescents scolarisés. Encephale 2014; 40:387-91. [DOI: 10.1016/j.encep.2013.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 11/27/2013] [Indexed: 11/29/2022]
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Sidebotham P, Fraser J, Covington T, Freemantle J, Petrou S, Pulikottil-Jacob R, Cutler T, Ellis C. Understanding why children die in high-income countries. Lancet 2014; 384:915-27. [PMID: 25209491 DOI: 10.1016/s0140-6736(14)60581-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Many factors affect child and adolescent mortality in high-income countries. These factors can be conceptualised within four domains-intrinsic (biological and psychological) factors, the physical environment, the social environment, and service delivery. The most prominent factors are socioeconomic gradients, although the mechanisms through which they exert their effects are complex, affect all four domains, and are often poorly understood. Although some contributing factors are relatively fixed--including a child's sex, age, ethnic origin, and genetics, some parental characteristics, and environmental conditions--others might be amenable to interventions that could lessen risks and help to prevent future child deaths. We give several examples of health service features that could affect child survival, along with interventions, such as changes to the physical or social environment, which could affect upstream (distal) factors.
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Affiliation(s)
- Peter Sidebotham
- Division of Mental Health and Well Being, University of Warwick, Coventry, UK.
| | - James Fraser
- Bristol Royal Hospital for Children, Bristol, UK
| | - Teresa Covington
- National Center for the Review and Prevention of Child Deaths, Michigan Public Health Institute, Okemos, MI, USA
| | - Jane Freemantle
- Centre for Health and Society, The Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Stavros Petrou
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | | | - Tessa Cutler
- Centre for Epidemiology and Biostatistics, The Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Ellis
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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Age at first use of alcohol predicts the risk of heavy alcohol use in early adulthood: a longitudinal study in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 26:131-4. [PMID: 25107830 DOI: 10.1016/j.drugpo.2014.07.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 06/27/2014] [Accepted: 07/02/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Two ecological cross-sectional studies which relied on national survey data (U.S. and Australia) have shown that starting drinking at a younger age increases the frequency of heavy drinking in the general population, including those with good mental and physical health status. This study further investigates the hypothesis that age at first use of alcohol increases the risk of heavy alcohol use by applying data from a longitudinal study. METHOD This study used public-use data collected from Wave I, Wave III and Wave IV of the National Longitudinal Study of Adolescent Health in the United States. The association between age at first use of alcohol and heavy alcohol use (5+ drinks per occasion) was examined with two different multivariate analysis approaches with data from 2316 participants: ordered logistic regression models and Poisson regression models with longitudinal data settings. In addition, the newly developed proxy outcome approach was further used to estimate and adjust for unmeasured/unobserved confounding factors. RESULTS Age at first use of alcohol before 18 years was associated significantly higher risk of heavy alcohol use at follow-up. CONCLUSION After adjusting for known and residual confounders, younger age at first use of alcohol was associated with significantly higher risk of heavy alcohol use, moreover, we posit that the association observed from this longitudinal study is probably causal. Abstinence from alcohol until the age of 18 years will likely reduce individual risk of alcohol-related problems in adulthood. In the longer term, delayed onset of exposure with widespread abstinence among this age group is also likely to reduce the overall prevalence of alcohol-related problems in the general population.
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92
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Vaht M, Merenäkk L, Mäestu J, Veidebaum T, Harro J. Serotonin transporter gene promoter polymorphism (5-HTTLPR) and alcohol use in general population: interaction effect with birth cohort. Psychopharmacology (Berl) 2014; 231:2587-94. [PMID: 24408213 DOI: 10.1007/s00213-013-3427-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 12/20/2013] [Indexed: 12/16/2022]
Abstract
RATIONALE AND OBJECTIVE Prevalence of alcohol use is markedly influenced by socioeconomic conditions and is therefore subject to cohort effects. The common genetic variation 5-HTTLPR (serotonin transporter gene-linked polymorphic region) has been related to several aspects of alcohol use and addiction but with mixed results, probably due to different environmental interaction effects. We aimed at assessing whether the association between alcohol use and 5-HTTLPR genotype is subject to cohort effects as birth cohorts may be raised in significantly different environments. METHODS We used the database of the Estonian Children Personality Behaviour and Health Study (beginning in 1998). Cohorts of initially 9-year-old (recalled at ages 15 and 18) and 15-year-old (recalled at ages 18 and 25) children provided self-reports on their alcohol use in all data collection waves (complete data available n = 1,075). RESULTS A significant genotype × gender × cohort interaction effect on the age of consuming the first alcoholic drink was found [F(2, 1,063) = 7.2, p < 0.001]. Females with the s/s genotype in the older cohort were the latest experimenters with alcohol, while the s/s females of younger cohort had tried alcohol earlier than any other group. In males, there was no significant cohort × genotype interaction, but the 5-HTTLPR genotype was associated with alcohol use, the s/s subjects reporting the highest consumption. CONCLUSION Expression of genetic vulnerability to alcohol use is influenced by birth cohort effects. The 5-HTTLPR genotype is associated with alcohol consumption in general population, but the effect depends on gender and birth cohort.
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Affiliation(s)
- Mariliis Vaht
- Department of Psychology, Estonian Centre of Behavioural and Health Sciences, University of Tartu, Tartu, Estonia
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93
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Salameh P, Salamé J, Waked M, Barbour B, Zeidan N, Baldi I. Risk perception, motives and behaviours in university students. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2014; 19:279-292. [PMID: 25431509 PMCID: PMC4235506 DOI: 10.1080/02673843.2014.919599] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 04/27/2014] [Indexed: 11/12/2022] Open
Abstract
Risky behaviours among young people are relatively frequent, with several motives and attitudes lying behind. Our objective was to evaluate the role of risk perception, attractiveness and motives for risk behaviour taking among university students in Lebanon. A cross-sectional study was carried out using a proportionate cluster sample of Lebanese students in public and private universities. Items of risk intake and perception scale, attractiveness of risky behaviours, and motives for risky behaviours were assessed, in addition to cigarette and waterpipe smoking and dependence, alcohol problematic consumption and mental distress scale. After verifying the validity of scales and reliability in the university students' population, we found that risk perception was associated with lower risk intake, while risk attractiveness was a driver for it. Moreover, motives differed in their driving of risky behaviour, a particular point was that women indicated more goal achievement objectives, the latter concept was associated with lower risk taking. University students in Lebanon, women in particular, demonstrated wiser behaviour and may benefit from heath education programme to increase their awareness about risky behaviours. Identifying other personal, environmental, social and psychological predictors may also be important to improve effectiveness of these programmes.
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Affiliation(s)
- P Salameh
- Clinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University , Hadath , Lebanon
| | - J Salamé
- Charité, Universitätsmedizin University Hospital , Berlin , Germany
| | - M Waked
- Pulmonology Department, Faculty of Medicine, Saint Georges Hospital, Balamand University , Beirut , Lebanon
| | - B Barbour
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - N Zeidan
- Faculty of Public Health, Lebanese University , Fanar , Lebanon
| | - I Baldi
- Laboratoire Santé Travail Environnement, Université Bordeaux Segalen , Bordeaux , France
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de la Haye K, D'Amico EJ, Miles JNV, Ewing B, Tucker JS. Covariance among multiple health risk behaviors in adolescents. PLoS One 2014; 9:e98141. [PMID: 24858838 PMCID: PMC4032285 DOI: 10.1371/journal.pone.0098141] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 04/28/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE In a diverse group of early adolescents, this study explores the co-occurrence of a broad range of health risk behaviors: alcohol, cigarette, and marijuana use; physical inactivity; sedentary computing/gaming; and the consumption of low-nutrient energy-dense food. We tested differences in the associations of unhealthy behaviors over time, and by gender, race/ethnicity, and socioeconomic status. METHODS Participants were 8360 students from 16 middle schools in California (50% female; 52% Hispanic, 17% Asian, 16% White, and 15% Black/multiethnic/other). Behaviors were measured with surveys in Spring 2010 and Spring 2011. Confirmatory factor analysis was used to assess if an underlying factor accounted for the covariance of multiple behaviors, and composite reliability methods were used to determine the degree to which behaviors were related. RESULTS The measured behaviors were explained by two moderately correlated factors: a 'substance use risk factor' and an 'unhealthy eating and sedentary factor'. Physical inactivity did not reflect the latent factors as expected. There were few differences in the associations among these behaviors over time or by demographic characteristics. CONCLUSIONS Two distinct, yet related groups of health compromising behaviors were identified that could be jointly targeted in multiple health behavior change interventions among early adolescents of diverse backgrounds.
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Affiliation(s)
- Kayla de la Haye
- RAND Corporation, Santa Monica, California, United States of America
| | | | | | - Brett Ewing
- RAND Corporation, Santa Monica, California, United States of America
| | - Joan S. Tucker
- RAND Corporation, Santa Monica, California, United States of America
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Scoccianti C, Straif K, Romieu I. Recent evidence on alcohol and cancer epidemiology. Future Oncol 2014; 9:1315-22. [PMID: 23980679 DOI: 10.2217/fon.13.94] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This review presents an overview of the impact of alcohol consumption on cancer risk. Results from the 2009 International Agency for Research on Cancer monograph as well as the most recent meta-analyses and epidemiological studies are considered. Alcohol consumption is one of the most important known risk factors for human cancer and potentially one of the most avoidable factors, but it is increasing worldwide. Ethanol in alcoholic beverages is carcinogenic to humans and causes several cancers (oral cavity, pharynx, larynx, esophagus, colorectum, liver and female breast). Cumulative lifetime consumption, frequency and drinking pattern appear to play a role in risk characterization. While the role of heavy drinking has been long recognized, new evidence suggests that light consumption (up to one drink/day) is also associated with adverse effects. In addition, some genetic polymorphisms interact with alcohol metabolism and may modify its impact.
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Affiliation(s)
- Chiara Scoccianti
- International Agency for Research on Cancer, Nutrition & Metabolism Section, 150 Cours Albert Thomas, Lyon Cedex 08, France
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96
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Scoccianti C, Lauby-Secretan B, Bello PY, Chajes V, Romieu I. Female breast cancer and alcohol consumption: a review of the literature. Am J Prev Med 2014; 46:S16-25. [PMID: 24512927 DOI: 10.1016/j.amepre.2013.10.031] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 10/29/2013] [Accepted: 10/29/2013] [Indexed: 10/25/2022]
Abstract
CONTEXT Consumption of alcoholic beverages is one of the single most important known and modifiable risk factor for human cancer. Among women, breast cancer is the most common cancer worldwide and the leading cause of cancer-related mortality. Consumption of alcoholic beverages is causally associated with female breast cancer and the association shows a linear dose-response relationship. The role of heavy drinking has been long recognized and even a moderate intake is associated with an increased risk for breast cancer. The present review is an update of the current evidence on the association between alcohol consumption and breast cancer risk. The aim is to gain further insight into this association and to improve our current understanding of the effects of the major modifying factors. EVIDENCE ACQUISITION Epidemiologic and experimental studies published since the most recent International Agency for Research on Cancer (IARC) Monograph on alcoholic beverages were identified in PubMed using a combination of keywords such as alcohol, breast cancer, polymorphisms, menopausal status. EVIDENCE SYNTHESIS Cumulative lifetime consumption, drinking frequency, drinking patterns and timing of exposure each modulate the association between alcohol consumption and breast cancer. Hormonal status, genetic polymorphisms, and nutritional factors may interact with ethanol metabolism and further influence breast cancer risk. CONCLUSIONS Better standardization among experimental and epidemiologic designs in assessing alcohol intake and timing of exposure may improve our understanding of the heterogeneity observed across studies, possibly allowing the quantification of the effects of occasional heavy drinking and the identification of a window of higher susceptibility to breast cancer development.
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Affiliation(s)
- Chiara Scoccianti
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon
| | | | | | - Véronique Chajes
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon
| | - Isabelle Romieu
- Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon.
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James A, James C, Thwaites T. The brain effects of cannabis in healthy adolescents and in adolescents with schizophrenia: a systematic review. Psychiatry Res 2013; 214:181-9. [PMID: 24139960 DOI: 10.1016/j.pscychresns.2013.07.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2013] [Revised: 05/31/2013] [Accepted: 07/26/2013] [Indexed: 12/24/2022]
Abstract
Cannabis is widely used in adolescence; however, the effects of cannabis on the developing brain remain unclear. Cannabis might be expected to have increased effects upon brain development and cognition during adolescence. There is extensive re-organisation of grey (GM) and white matter (WM) at this time, while the endocannabinoid (eCB) system, which is involved in the normal physiological regulation of neural transmission, is still developing. In healthy adolescent cannabis users there is a suggestion of greater memory loss and hippocampal volume changes. Functional studies point to recruitment of greater brain areas under cognitive load. Structural and DTI studies are few, and limited by comorbid drug and alcohol use. The studies of cannabis use in adolescent-onset schizophrenia (AOS) differ, with one study pointing to extensive GM and WM changes. There is an intriguing suggestion that the left parietal lobe may be more vulnerable to the effects of cannabis in AOS. As in adult schizophrenia cognition does not appear to be adversely affected in AOS following cannabis use. Given the limited number of studies it is not possible to draw firm conclusions. There is a need for adequately powered, longitudinal studies.
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Affiliation(s)
- Anthony James
- Highfield Unit, Warneford Hospital, Oxford OX3 7JX. UK.
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Age at first use of alcohol and risk of heavy alcohol use: a population-based study. BIOMED RESEARCH INTERNATIONAL 2013; 2013:721761. [PMID: 24471139 PMCID: PMC3891545 DOI: 10.1155/2013/721761] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/12/2013] [Indexed: 11/17/2022]
Abstract
AIM To examine the association between age at first alcohol use and risk of heavy alcohol use among the adult US general drinking population. METHODS This population-based study used the 2010 National Survey on Drug Use and Health (NSDUH) from United States. Multivariate Poisson regression was employed to predict the frequency of heavy alcohol use (five or more drinks per occasion) in the last 30 days with age at first use of alcohol controlling for potential confounding factors. RESULTS Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use in the last 30 days in this population-based sample. This association remained significant when analysis was reperformed for the subgroup of participants who were with desired good health status and Kessler score lower than 12. CONCLUSION Younger age at first use of alcohol was associated with increased likelihood of heavy alcohol use.
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Donovan JE, Molina BSG. Types of alcohol use experience from childhood through adolescence. J Adolesc Health 2013; 53:453-9. [PMID: 23763961 PMCID: PMC3783556 DOI: 10.1016/j.jadohealth.2013.03.024] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 03/23/2013] [Accepted: 03/25/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE There have been few reports of the development of alcohol involvement from childhood through adolescence. We examined the ages at which children first sipped or tasted alcohol, drank, had three or more drinks in a row, had five or more drinks in a row, were drunk, or had alcohol problems, to describe the types of drinking experience exhibited at each age from 8.5 through 18.0 years. Sipping and three or more drinks per occasion have been understudied to date. METHODS We collected 14 waves of longitudinal data from 452 children aged 8 or 10 years, randomly sampled from Allegheny County, Pennsylvania. Ages of initiating each alcohol use behavior were determined, and the data were coded to reflect the child's status on each behavior at each age. We determined types of alcohol use experience using latent class analyses. RESULTS From age 8.5 to 12.5 years, there were two latent classes: abstainers and sippers. The percentage of sippers increased to 67% by age 12.5 years. From ages 13.0 to 18.0, we identified three latent classes: abstainers, sippers/light drinkers, and drinkers with drunkenness. At ages 13.5-15.5 years, drinkers in the latter class reported drunkenness with just three to four drinks per occasion. By age 18 years, sippers/light drinkers comprised 55% of the sample and drinkers with drunkenness comprised 38%. CONCLUSIONS Childhood experience with alcohol was surprisingly widespread. Sipping or tasting alcohol was common by age 12 years. A quarter of the sample drank before age 15 years. Experience of intoxication increased throughout adolescence, even among those who had ever consumed just three to four drinks on an occasion.
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Affiliation(s)
- John E. Donovan
- Departments of Psychiatry and Epidemiology, University of Pittsburgh
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