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Chau K, Vilain E. Association between depressive symptoms and subsequent injuries in early adolescents: a population-based study. Nord J Psychiatry 2021; 75:406-414. [PMID: 33555969 DOI: 10.1080/08039488.2021.1877813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Depressive symptoms (DSs) may be frequent and highly increase the risk of injuries in early adolescents (10-16 years). This study assessed the association between DSs and subsequent school and out-of-school injuries in early adolescents. METHODS The study population included 1219 middle-school adolescents from north-eastern France (mean age =12.7 ± 1.3) who completed at the end of school-year a questionnaire gathering socioeconomic features (nationality, family structure, parents' occupation, parents' education, and family income), obesity, alcohol use, tobacco use, health status, DSs (Kandel scale higher than the median value, hence including moderate levels), and school and out-of-school injuries during the present school-year. Were only considered the DSs and confounders that had started before the school-year. Data was analyzed using multinomial logistic regression models. RESULTS DSs were strongly associated with one or more school-physical/sports-training injuries (sex-age-adjusted odds ratio ORsa 2.08, p < 0.001), other-school-training injuries (ORsa 2.13, p < 0.01), school-free-time injuries (ORsa 2.84, p < 0.001), out-of-school-sports injuries (ORsa 1.95, p < 0.001), and traffic injuries (ORsa 3.78, p < 0.001). The risk was higher for having two or more injury categories (ORsa 4.03, p < 0.001) than for only one injury category (ORsa 1.80, p < 0.001). These results were robust and remained after further adjustment for socioeconomic features, obesity, alcohol use, tobacco use, and health status. CONCLUSIONS DSs strongly increase the injury risk in early adolescents. Injury prevention should include DSs screening and monitoring and help adolescents and their neighborhood be aware of the risk.HighlightsInjuries and depressive symptoms (DSs) are frequent in early adolescents.DSs highly predict subsequent school and out-of-school injuries and cumulating several injury types.These results are robust after adjustment for socioeconomic features, being obese, alcohol use, tobacco use and poor health status.Injury prevention should include early DSs screening and monitoring and help adolescents and their neighborhood be aware of the risk.
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Affiliation(s)
- Kénora Chau
- Département de Médecine Générale, Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.,INSERM Centre d'Investigations Cliniques Plurithématique 1433, Vandoeuvre-lès-Nancy, France
| | - Etienne Vilain
- Département de Médecine Générale, Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
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Al Zeedi MAS, Al Waaili LH, Al Hakmani FM, Al Busaidi AM. Incidence of School-related Injuries among Students in A'Dakhiliyah Governorate Schools, Oman. Oman Med J 2020; 35:127. [PMID: 32489676 PMCID: PMC7261370 DOI: 10.5001/omj.2020.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 08/05/2019] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES Childhood injuries are among the most significant causes of mortality and morbidity as estimated by the World Health Organization. We sought to assess the incidence of school-related injuries in A'Dakhiliyah governorate schools, with the secondary aim of addressing common causes, risk factors, and how the school environment contributes to injuries. METHODS We conducted a prospective cohort study involving all students in A'Dakhiliyah governorate schools during the 2015-2016 academic year. Data were collected using a questionnaire that was filled out by the school nurses or social workers at school health units. RESULTS The incidence of school-related injuries was 2.3% per year. The majority of injured students were in grades 1-4 (63.7%) and 72.6% were boys. Improper school equipment and furniture accounted as a risk factor for 25.3% of injuries. The three most common mechanisms causing injury were falling (50.4%, n = 584), collision with an object (30.7%, n = 356), and collision with a person (18.8%, n = 218). Asphalt (59.5%, n = 295) and concrete (40.5%, n = 201) were the most common surfaces in the school environment to contribute to injuries. CONCLUSIONS School-related injuries are not uncommon and can be prevented by improving the infrastructure of school buildings and supplying appropriate school stationary equipment for age. Our results are useful in developing a national injury prevention program aimed at enhancing safety in school environments.
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Affiliation(s)
| | | | - Fatma M. Al Hakmani
- Department of Environmental and Occupational Medicine, Director General of Disease Surveillance, Ministry of Health, Oman
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Chau K, Mayet A, Legleye S, Beck F, Hassler C, Khlat M, Choquet M, Falissard B, Chau N. Association between cumulating substances use and cumulating several school, violence and mental health difficulties in early adolescents. Psychiatry Res 2019; 280:112480. [PMID: 31377662 DOI: 10.1016/j.psychres.2019.112480] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Abstract
Multiple substances (alcohol, tobacco, cannabis and other illicit drugs (OID)) have been frequently used in early adolescents maybe due to school, violence and mental-health difficulties. We investigated the associations between substance-use patterns and related difficulties among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, school, violence and mental-health difficulties (school grade repetition, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms and suicide attempt; cumulated number noted SVMDscore) and the time of their first occurrence during the life course. Data were analyzed using logistic and negative binomial regression models. Alcohol, tobacco, cannabis and OID use affected 35.2, 11.2, 5.6 and 2.8% of the subjects respectively. The risk of using tobacco only, alcohol and tobacco, alcohol plus tobacco and cannabis, or all alcohol, tobacco, cannabis and OID strongly increased with the SVMDscore (socioeconomic features-adjusted odds ratio reaching 85). The risk began in early years in middle schools and then steadily increased, more markedly for elevated SVMDscore. Exposure to several SVMDs may be a transmission vector towards the substance use, starting mostly with alcohol/tobacco, and then shifting to cannabis/OID. These findings help to understand substance-use risk patterns and identify at-risk adolescents.
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Affiliation(s)
- Kénora Chau
- University of Lorraine, Faculty of Medicine, Department of General Medicine, Vandoeuvre-lès-Nancy F-54500, France; INSERM, Centre d'Investigations Cliniques Plurithématique, 1433, UMR 1116, Université de Lorraine, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Aurélie Mayet
- Centre d'épidémiologie et de santé publique des armées, Marseille, France; UMR 912: INSERM-IRD, Université Aix-Marseille, Marseille, France
| | - Stéphane Legleye
- Institut National de la Statistique et des Etudes Economiques (INSEE), Paris, France; CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - François Beck
- Institut National de la Statistique et des Etudes Economiques (INSEE), Paris, France
| | - Christine Hassler
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Myriam Khlat
- Institut National d'Etudes Démographiques, 133 Boulevard Davout, 75980, Paris Cedex 20, France
| | - Marie Choquet
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Bruno Falissard
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France
| | - Nearkasen Chau
- CESP, INSERM U1018, Université Paris-Saclay, Univ. Paris-Sud, UVSQ, Univ. Paris-Descartes, Paris, France.
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Chau K, Kabuth B, Chau N. Association between Suicide Ideation and Attempts and Being an Immigrant among Adolescents, and the Role of Socioeconomic Factors and School, Behavior, and Health-Related Difficulties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111070. [PMID: 27809296 PMCID: PMC5129280 DOI: 10.3390/ijerph13111070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/16/2022]
Abstract
The risk of suicide behaviors in immigrant adolescents varies across countries and remains partly understood. We conducted a study in France to examine immigrant adolescents' likelihood of experiencing suicide ideation in the last 12 months (SI) and lifetime suicide attempts (SA) compared with their native counterparts, and the contribution of socioeconomic factors and school, behavior, and health-related difficulties. Questionnaires were completed by 1559 middle-school adolescents from north-eastern France including various risk factors, SI, SA, and their first occurrence over adolescent's life course (except SI). Data were analyzed using logistic regression models for SI and Cox regression models for SA (retaining only school, behavior, and health-related difficulties that started before SA). Immigrant adolescents had a two-time higher risk of SI and SA than their native counterparts. Using nested models, the excess SI risk was highly explained by socioeconomic factors (27%) and additional school, behavior, and health-related difficulties (24%) but remained significant. The excess SA risk was more highly explained by these issues (40% and 85%, respectively) and became non-significant. These findings demonstrate the risk patterns of SI and SA and the prominent confounding roles of socioeconomic factors and school, behavior, and health-related difficulties. They may be provided to policy makers, schools, carers, and various organizations interested in immigrant, adolescent, and suicide-behavior problems.
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Affiliation(s)
- Kénora Chau
- Département de Médecine Générale, Faculté de Médecine, Université de Lorraine, 9 Avenue de la Forêt de Haye, CS50184, Vandoeuvre-lès-Nancy F-54505, France.
- INSERM Centre d'Investigations Cliniques Plurithématique 1433, UMR 1116, CHU de Nancy, Vandoeuvre-lès-Nancy F-54511, France.
| | - Bernard Kabuth
- Service de Pédopsychiatrie, Faculté de Médecine, Université de Lorraine, Hôpital d'Enfants de Nancy-Brabois, Vandoeuvre-lès-Nancy F-54500, France.
| | - Nearkasen Chau
- INSERM, U1178, Paris F-75014, France.
- Univ Paris-Sud, UMR-S1178, Paris F-75014, France.
- Univ Paris Descartes, UMR-S1178, Paris F-75014, France.
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Chau K, Kabuth B, Causin-Brice O, Delacour Y, Richoux-Picard C, Verdin M, Armand I, Chau N. Associations between school difficulties and health-related problems and risky behaviours in early adolescence: A cross-sectional study in middle-school adolescents in France. Psychiatry Res 2016; 244:1-9. [PMID: 27455144 DOI: 10.1016/j.psychres.2016.07.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 05/29/2016] [Accepted: 07/05/2016] [Indexed: 11/28/2022]
Abstract
Health-related problems and risky behaviours (substance use) are frequent in adolescents, may alter their physical and mental capabilities, and may thus generate school absenteeism, low academic performance, and school dropout ideation. This study assessed their associations and the contribution of socioeconomic factors among 1559 middle-school adolescents (mean age 13.5+1.3) from north-eastern France. They completed a questionnaire including socioeconomic characteristics, health-related problems (poor physical health, psychological health, social relationships, and living environment) assessed with the World Health Organization's quality of life measure (score<25th percentile), risky behaviours, school absences during the present school year, last-trimester academic performance, and school dropout ideation. Data were analysed using logistic regression models. School absenteeism was frequent (12.6% of subjects for 8-14 days, and 6.0% for ≥15 days); 8.2% of subjects had low academic performance (average school-mark <10/20) and 3.9% school dropout ideation. All school difficulties were strongly associated with all health-related problems (gender-age-school-level-adjusted odds ratios gasOR between 1.5 and 4.2), and with risky behaviours (gasOR between 1.4 and 14). Socioeconomic factors differently contributed to these associations (contribution reaching 77%). Policy makers, schools, physicians and parents should be more aware of the problems and help adolescents to reduce health-related problems and risky behaviours and to increase resilience.
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Affiliation(s)
- Kénora Chau
- Université de Lorraine, Département de Médecine Générale, Faculté de médecine, Service de Pédo-psychiatrie, Hôpital d'Enfants de Nancy-Brabois, Vandoeuvre-lès-Nancy, France.
| | - Bernard Kabuth
- Université de Lorraine, Faculté de médecine, Service de Pédo-psychiatrie, Hôpital d'Enfants de Nancy-Brabois, Vandoeuvre-lès-Nancy, France
| | - Odile Causin-Brice
- Inspection Académique, Centres médicaux, Académie Nancy-Metz, Nancy, France
| | - Yves Delacour
- Collège-Lycée la Malgrange, Jarville-la-Malgrange, France
| | | | - Monique Verdin
- Collège Montaigu, Académie Nancy-Metz, Heillecourt, France
| | - Isabelle Armand
- Inspection Académique, Service de Promotion de la Santé en Faveur des Elèves, Académie Nancy-Metz, Nancy, France
| | - Nearkasen Chau
- INSERM, U1178, University Paris-Sud, University Paris Descartes, Paris F-75014, France
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Chau K. Impact of sleep difficulty on single and repeated injuries in adolescents. ACCIDENT; ANALYSIS AND PREVENTION 2015; 81:86-95. [PMID: 25956610 DOI: 10.1016/j.aap.2015.04.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/18/2015] [Accepted: 04/26/2015] [Indexed: 05/12/2023]
Abstract
Injuries are frequent and may be caused by sleep difficulty in youth. This study assessed the impact of sleep difficulty on single and repeated school and out-of-school injuries and the confounding role of socioeconomic factors and school, behaviour and health-related difficulties among adolescents. The study population included 1559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3) who completed at the end of school year a self-administered questionnaire to gather school and out-of-school injuries during the school year, and to assess sleep difficulty and previous injury risk factors which were socioeconomic factors (family structure, parents' education, father's occupation, and family income), school performance, obesity, alcohol/tobacco/cannabis/hard drugs use, health status, psychological health, and involvement-in-violence. For sleep difficulty and behaviour and health-related difficulties their first occurring over adolescent's life course was gathered. Multinomial logistic regression models were used retaining only sleep difficulty and other risk factors which had started before the school year (thus before the injuries studied). School and out-of-school injuries and sleep difficulty were frequent. The adolescents with sleep difficulty without medical treatment had a higher risk of single school and out-of-school injuries (gender-age-adjusted odds ratio gaOR 1.86 and 1.76, respectively) and a much higher risk of repeated school and out-of-school injuries (≥2 injuries; gaOR 2.43 and 3.73, respectively). The adolescents with persistent sleep difficulty despite a medical treatment also had a higher risk of single school and out-of-school injury (gaOR 2.31 and 1.78, respectively), and a much higher risk of repeated school and out-of-school injuries (gaOR 4.92 and 4.36, respectively). Socioeconomic factors had a moderate contribution (<27%) while school, behaviour and health-related difficulties had a high contribution (reaching 71%) to the association between sleep difficulty and single/repeated injuries. The role of these factors differed between single/repeated school/out-of-school injuries. Injury prevention should focus on screening and monitoring sleep difficulty and previous difficulties, especially among adolescents with socioeconomic difficulties, via physician-parent-school-adolescent collaborations.
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Affiliation(s)
- Kénora Chau
- Lorraine University, Faculty of Medicine, Département de Médecine Générale, 9 Avenue de la Forêt de Haye, CS 50184, F-54505 Vandoeuvre-lès-Nancy Cedex, France.
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Gender and family disparities in suicide attempt and role of socioeconomic, school, and health-related difficulties in early adolescence. BIOMED RESEARCH INTERNATIONAL 2014; 2014:314521. [PMID: 25136577 PMCID: PMC4127271 DOI: 10.1155/2014/314521] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/09/2014] [Accepted: 06/13/2014] [Indexed: 11/17/2022]
Abstract
Suicide attempt (SA) is common in early adolescence and the risk may differ between boys and girls in nonintact families partly because of socioeconomic, school, and health-related difficulties. This study explored the gender and family disparities and the role of these covariates. Questionnaires were completed by 1,559 middle-school adolescents from north-eastern France including sex, age, socioeconomic factors (family structure, nationality, parents' education, father's occupation, family income, and social support), grade repetition, depressive symptoms, sustained violence, sexual abuse, unhealthy behaviors (tobacco/alcohol/cannabis/hard drug use), SA, and their first occurrence over adolescent's life course. Data were analyzed using Cox regression models. SA affected 12.5% of girls and 7.2% of boys (P < 0.001). The girls living with parents divorced/separated, in reconstructed families, and with single parents had a 3-fold higher SA risk than those living in intact families. Over 63% of the risk was explained by socioeconomic, school, and health-related difficulties. No family disparities were observed among boys. Girls had a 1.74-time higher SA risk than boys, and 45% of the risk was explained by socioeconomic, school, and mental difficulties and violence. SA prevention should be performed in early adolescence and consider gender and family differences and the role of socioeconomic, school, and health-related difficulties.
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Salminen S, Kurenniemi M, Råback M, Markkula J, Lounamaa A. School environment and school injuries. Front Public Health 2014; 1:76. [PMID: 24455667 PMCID: PMC3888947 DOI: 10.3389/fpubh.2013.00076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 12/21/2013] [Indexed: 11/13/2022] Open
Abstract
Background: Although injuries at school are an important issue in public health, environmental factors in schools and school yards have seldom been the focus of school injury research. The goal of our investigation was to examine the effect of environmental factors on school injuries. Methods: Nine comprehensive Finnish schools registered school injuries over a period of two school years. Injuries were classified as being associated with environmental factors, suspected environmental factors, and others. The consensus between two independent classifiers was 81%. Results: A total of 722 injuries were classified. In 11.6% of these injuries, the physical environment factor was evident, and in 28.1% of the injuries, physical environment was suspected of being a contributory risk factor. Thus the physical environment of the school was a contributing factor in over a third (39.7%) of injuries occurring in the school, on the school yard or during the journey to, or from school. In this study, conducted in Finland, ice on the ground was mentioned most frequently as an environmental risk factor. Conclusion: In Finland, the Nordic weather conditions are not taken into account in the school yard and playground plans as they ought to from the safety point of view. An initiative has been launched on a mandatory wintertime master plan for every school yard.
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Affiliation(s)
- Simo Salminen
- Finnish Institute of Occupational Health , Helsinki , Finland
| | - Marja Kurenniemi
- National Research and Development Centre for Welfare and Health (STAKES) , Helsinki , Finland
| | - Mirka Råback
- National Institute for Health and Welfare , Helsinki , Finland
| | - Jaana Markkula
- National Institute for Health and Welfare , Helsinki , Finland
| | - Anne Lounamaa
- National Institute for Health and Welfare , Helsinki , Finland
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Chau K, Baumann M, Kabuth B, Chau N. School difficulties in immigrant adolescent students and roles of socioeconomic factors, unhealthy behaviours, and physical and mental health. BMC Public Health 2012; 12:453. [PMID: 22712754 PMCID: PMC3515352 DOI: 10.1186/1471-2458-12-453] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 06/06/2012] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND School is a multi-cultural setting where students need social, material, physical, and mental resources to attain school achievement. But they are often lacking, especially for immigrant students. In an early adolescence context, this study assessed risk for school difficulties among European and non-European immigrants and the roles of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours. METHODS This cross-sectional study included 1,559 middle-school adolescents from north-eastern France, who completed a self-administered questionnaire including socioeconomic characteristics (gender, age, family structure, father's occupation, and family income), WHO-Quality of life (measuring the four dimensions physical health, psychological health, social relationships, and living environment), unhealthy behaviours (last-30-day uses of tobacco, alcohol, cannabis, and other illicit drugs and no regular sports/physical activities), grade repetition, low school performance (<10/20), and school dropout ideation at 16 years. Data were analyzed using logistic models. RESULTS Grade repetition affected 14.8% of students, low school performance 8.2%, and school dropout ideation 3.9%. European immigrants had a higher risk for grade repetition only with a gender-age-adjusted odds ratio (OR) of 2.44, vs. French students. This odds ratio decreased to 1.76 (contribution 47%) with further adjustment for all confounders (family structure, father's occupation, family income, physical health, psychological health, social relationships, living environment, and unhealthy behaviours). Non-European immigrants had a statistically higher risk for all grade repetition, low school performance, and school dropout ideation with ORs of 3.29, 3.02, and 3.42, respectively vs. French students. These odds ratios decreased to 1.76, 1.54, and 1.54, respectively (contributions 66%, 73%, and 78%) with further adjustment for all confounders. CONCLUSIONS Compared with French students, European immigrant students were more affected only by grade repetition while non-European immigrant students by all grade repetition, low school performance, and school dropout ideation. The contribution of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours was very high and much higher for non-European than for European immigrant students. Public policy should focus on these factors and services to reduce school difficulties.
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Affiliation(s)
- Kénora Chau
- Service of Pedopsychiatry, Hôpital d'Enfants de Nancy-Brabois, Université de Lorraine, Faculté de médecine, Vandoeuvre-lès-Nancy, France
- University of Luxembourg, INtegrative research unit on Social and Individual DEvelopment (INSIDE), Walferdange, Luxembourg
| | - Michèle Baumann
- University of Luxembourg, INtegrative research unit on Social and Individual DEvelopment (INSIDE), Walferdange, Luxembourg
| | - Bernard Kabuth
- Service of Pedopsychiatry, Hôpital d'Enfants de Nancy-Brabois, Université de Lorraine, Faculté de médecine, Vandoeuvre-lès-Nancy, France
| | - Nearkasen Chau
- INSERM, U669, Paris, F-75014, France
- Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France
- Inserm, U669, 8 rue du Breuil, F-54180, Heillecourt, France
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Warsh J, Janssen I, Pickett W. Do overweight and obese youth take longer to recover from injury? Int J Inj Contr Saf Promot 2011; 18:143-9. [DOI: 10.1080/17457300.2010.540329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ramirez M, Fillmore E, Chen A, Peek-Asa C. A comparison of school injuries between children with and without disabilities. Acad Pediatr 2010; 10:317-22. [PMID: 20674529 DOI: 10.1016/j.acap.2010.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Revised: 06/01/2010] [Accepted: 06/04/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to compare rates, nature, and mechanisms of school injuries in children with and without disabilities. METHODS We conducted a retrospective cohort study with repeated measures of 269 919 children with and without disabilities who were enrolled in 35 adapted schools from a large urban school district. Reports of injuries sustained from 1994 to 1998 were collected by the district's insurance division, and disability was assessed using special education guidelines determined by the California Department of Education. A generalized estimating equations model was used to estimate rate ratios, accounting for the repeated, nested nature of the data. RESULTS Children with disabilities had more than double the rate of injury reported than children without disabilities (incidence density ratio [IDR] 2.3, 95% CI, 2.2-2.5). Almost one third of these injuries were due to fights, roughhousing, and assaults. Among all disabled children, those with orthopedic disabilities had the highest risk, with rates over 5 times that of children without disabilities (IDR 5.4, 95% CI, 4.4-6.6). Children with cognitive disabilities had comparatively lower rates of injury than children with physical disabilities. CONCLUSIONS For children with disabilities, physical impairment may play a greater role than cognitive impairment in managing risk for injury at school. Individual education programs (IEP), developed for children in special education, could be tailored to include injury prevention strategies.
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Affiliation(s)
- Marizen Ramirez
- University of Iowa Injury Prevention Research Center, Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa 52242-5000, USA.
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Abstract
OBJECTIVE To determine whether relationships between physical activity and physical activity injuries are modified by BMI status in youth. METHOD Data were obtained from the 2006 Canadian Health Behaviour in School-Aged Children survey; a representative study of 7,714 grade 6-10 youth. A sub-sample of 1,814 were re-administered the survey in 2007. Analyses considered relationships among the major variables in theory-driven cross-sectional and longitudinal analyses. RESULT Among normal weight youth, cross-sectional analyses indicated that those who reported high levels of physical activity outside of school experienced 2.28 (95% confidence interval 1.95-2.68) the relative odds for physical activity injury in comparison to those with low levels of physical activity outside of school. Analogous odds ratios for overweight and obese youth were 1.89 (1.31-2.72) and 3.72 (1.89-7.33), respectively. BMI status was not an effect modifier of the relationship between physical activity and physical activity injury. Similar observations were made in the confirmatory longitudinal analyses. CONCLUSION Concerns surrounding the design of physical activity programmes include side-effects such as injury risk. This study provides some re-assurance that physical activity participation relates to injury in a consistent manner across BMI groups.
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Affiliation(s)
- Joel Warsh
- Department of Community Health and Epidemiology, Kingston, ON, Canada
| | - William Pickett
- Department of Community Health and Epidemiology, Kingston, ON, Canada
- Department of Emergency Medicine, Kingston, ON, Canada
| | - Ian Janssen
- Department of Community Health and Epidemiology, Kingston, ON, Canada
- School of Kinesiology and Health Studies, Queen’s University, Kingston, ON, Canada
- *Ian Janssen, PhD School of Kinesiology and Health Studies Queen’s University Kingston, ON, Canada, K7L 3N6 Tel. +1 613 533-6000, Fax -2009
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Chau N, Baumann M, Falissard B, Choquet M. Social inequalities and correlates of psychotropic drug use among young adults: a population-based questionnaire study. Int J Equity Health 2008; 7:3. [PMID: 18205942 PMCID: PMC2262083 DOI: 10.1186/1475-9276-7-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 01/19/2008] [Indexed: 11/28/2022] Open
Abstract
Background Use of psychotropic drugs is widespread in Europe, and is markedly more common in France than elsewhere. Young adults often fare less well than adolescents on health indicators (injury, homicide, and substance use). This population-based study assessed disparities in psychotropic drug use among people aged 18–29 from different socio-occupational groups and determined whether they were mediated by educational level, health status, income, health-related behaviours, family support, personality traits, or disability. Methods A total of 1,257 people aged 18–29, randomly selected in north-eastern France completed a post-mailed questionnaire covering sex, date of birth, height, weight, educational level, occupation, smoking habit, alcohol abuse, income, health-status, diseases, reported disabilities, self-reported personality traits, family support, and frequent psychotropic medication for tiredness, nervousness/anxiety or insomnia. The data were analyzed using the adjusted odds ratios (ORa) computed with logistic models. Results Use of psychotropic drugs was common (33.2%). Compared with upper/intermediate professionals, markedly high odds ratios adjusted for sex were found for manual workers (2.57, 95% CI 1.02–6.44), employees (2.58, 1.11–5.98), farmers/craftsmen/tradesmen (4.97, 1.13–21.8), students (2.40, 1.06–5.40), and housewives (3.82, 1.39–10.5). Adjusting for all the confounders considered reduced the estimates to a pronounced degree for manual workers (adjusted OR 1.49, non-significant) but only slightly for the other socio-occupational groups. The odds ratio for unemployed people did not reach statistical significance. The significant confounders were: sex, not-good health status, musculoskeletal disorders and other diseases, being worried, nervous or sad, and lack of family support (adjusted odds ratios between 1.60 and 2.50). Conclusion There were marked disparities among young adults from different socio-occupational groups. Sex, health status, musculoskeletal diseases, family support, and personality traits were related to use of psychotropic drugs. These factors mediated the higher risk strongly among manual workers and slightly among the other groups.
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