Process evaluation of the Belgian one-month-without alcohol campaign 'Tournée Minérale': a mixed method approach

BACKGROUND

The Tournée Minérale campaign [TMC] is a mass media prevention campaign challenging Belgian adults to refrain from alcohol during one month. A process evaluation may help us better understand the effect of TMC and to formulate recommendations for future editions. The current study aimed to examine reach, experiences, perceived effectiveness and maintenance of TMC.

METHODS

A mixed method design was used to assess the process, using pre- and post-questionnaires (n = 49.022, 44.5 ± 13.1 years old, 37.0% men) and focus groups (n = 31, 47.3 ± 14.3 years old, 33.3% men).

RESULTS

Most campaign materials were considered useful and/or motivating. Facilitators for taking part in TMC were connectedness with other participants, stimulus control (e.g. removing alcohol at home) and a supportive social environment. Most difficulties were encountered with abstaining during social occasions as participants had to change a habit or find alternative non-alcoholic beverages. Participants reported both beneficial (e.g. sleeping better) and adverse effects (e.g. drinking more soft drinks).

CONCLUSIONS

Future editions of TMC should try to decrease perceived adverse effects (e.g. by providing attractive non-alcoholic beverages) and can benefit from having a forum where people can share experiences.

The Relationship Between Pain Severity and Alcohol Use Among School-Aged Children and Adolescents: The Moderating Role of Drinking Motives

Objective

Evidence from adult samples suggests a co-occurrence between pain and alcohol abuse. However, studies in adolescents are scarce and results are inconsistent, with some studies observing heightened and others observing reduced alcohol consumption in adolescents suffering from pain. We hypothesized that in adolescents the association between pain and alcohol use will be moderated by drinking motives.

Methods

Data from a large representative sample of Flemish school children and adolescents (N = 10,650, 50.8% boys, age range = 10-21 years, Mage = 14.33 years) were collected as part of the World Health Organization collaborative Health Behaviour in School-Aged Children (HBSC) survey. Pain severity was graded based on a pediatric pain classification system that accounts for both pain intensity and disability. Alcohol consumption was operationalized using two variables: frequency of drinking and drunkenness. The Drinking Motives Questionnaire-Revised was used to capture drinking motives; it assesses four motive categories (enhancement, coping, social, and conformity).

Results

Findings indicated that higher pain severity was associated with greater frequency of alcohol use and drunkenness. However, drinking motives moderated this association. The positive association between pain severity and drinking frequency was stronger in case of high conformity motives. Likewise, the association between pain severity and drunkenness frequency was stronger at high levels of conformity motives and reached significance only at high levels of coping motives.

Conclusions

Our findings suggest that specific drinking motives are linked to problematic alcohol use in adolescents with pain. Future studies using a longitudinal design are needed to draw conclusions about direction of effects.

Problem drinking among Flemish students: beverage type, early drinking onset and negative personal & social consequences

Background

Although alcohol is socially accepted in most Western societies, studies are clear about its associated negative consequences, especially among university and college students. Studies on the relationship between alcohol-related consequences and both beverage type and drinking onset, however, are scarce, especially in a European context. The aim of this research was, therefore, twofold: (1) What is the relationship between beverage type and the negative consequences experienced by students? and (2) Are these consequences determined by early drinking onset? We will examine these questions within the context of a wide range of alcohol-related consequences.

Methods

The analyses are based on data collected by the inter-university project ‘Head in the clouds?’, measuring alcohol use among students in Flanders (Belgium). In total, a large dataset consisting of information from 19,253 anonymously participating students was available. Negative consequences were measured using a shortened version of the Core Alcohol and Drug Survey (CADS_D). Data were analysed using negative binomial regression.

Results

Results vary depending on the type of alcohol-related consequences: Personal negative consequences occur frequently among daily beer drinkers. However, a high rate of social negative consequences was recorded for both daily beer drinkers and daily spirits drinkers. Finally, early drinking onset was significantly associated with both personal and social negative consequences, and this association was especially strong between beer and spirits drinking onset and social negative consequences.

Conclusions

Numerous negative consequences, both personal and social, are related to frequent beer and spirits drinking. Our findings indicate a close association between drinking beer and personal negative consequences as well as between drinking beer and/or spirits and social negative consequences. Similarly, early drinking onset has a major influence on the rates of both personal and social negative consequences. The earlier students started drinking, the more negative consequences they experienced during college or university. Several (policy) interventions are discussed. This study is the first to incorporate detailed information on both beverage type and drinking onset, and its associated negative consequences, as measured by the CADS_D, in a large student population.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5120-7) contains supplementary material, which is available to authorized users.

The psychometric properties of a shortened Dutch version of the consequences scale used in the Core Alcohol and Drug Survey

BACKGROUND

Alcohol and drug misuse among college students has been studied extensively and has been clearly identified as a public health problem. Within more general populations alcohol misuse remains one of the leading causes of disease, disability and death worldwide. Conducting research on alcohol misuse requires valid and reliable instruments to measure its consequences. One scale that is often used is the consequences scale in the Core Alcohol and Drug Survey (CADS). However, psychometric studies on the CADS are rare and the ones that do exist report varying results. This article aims to address this imbalance by examining the psychometric properties of a Dutch version of the CADS in a large sample of Flemish university and college students.

METHODS

The analyses are based on data collected by the inter-university project 'Head in the clouds', measuring alcohol use among students. In total, 19,253 students participated (22.1% response rate). The CADS scale was measured using 19 consequences, and participants were asked how often they had experienced these on a 6-point scale. Firstly, the factor structure of the CADS was examined. Two models from literature were compared by performing confirmatory factor analyses (CFA) and were adapted if necessary. Secondly, we assessed the composite reliability as well as the convergent, discriminant and concurrent validity.

RESULTS

The two-factor model, identifying personal consequences (had a hangover; got nauseated or vomited; missed a class) and social consequences (got into an argument or fight; been criticized by someone I know; done something I later regretted; been hurt or injured) was indicated to be the best model, having both a good model fit and an acceptable composite reliability. In addition, construct validity was evaluated to be acceptable, with good discriminant validity, although the convergent validity of the factor measuring 'social consequences' could be improved. Concurrent validity was evaluated as good.

CONCLUSIONS

In deciding which model best represents the data, it is crucial that not only the model fit is evaluated, but the importance of factor reliability and validity issues is also taken into account. The two-factor model, identifying personal consequences and social consequences, was concluded to be the best model. This shortened Dutch version of the CADS (CADS_D) is a useful tool to screen alcohol-related consequences among college students.

Who does not cut down? Comparing characteristics and drinking motives of drinkers and abstainers during the exam periods

OBJECTIVE

Drinking alcohol during the exams can affect academic performance and future career options, but is rarely investigated. Drinking motives, sociodemographics and personality characteristics are investigated in nonabstainers and weekly drinkers during the exams.

PARTICIPANTS

7,181 Belgian university students who anonymously responded to an email invitation to an online survey.

METHODS

Logistic regressions and mixed design analysis of variance on cross-sectional data.

RESULTS

One-third of the students continued drinking during the exams, with 40% drinking weekly. Nonabstainers were mainly men, elder, internally motivated when drinking, and housed with parents or independently. Weekly drinkers were similar, except mainly housed in student apartments or independently. Personality characteristics were nonsignificant. All drinking motives were less pronounced during the exams, with smaller differences for internal motives.

CONCLUSIONS

Mainly linked to internal drinking motives, drinking during the exams in higher education is underestimated. The characteristics and motives of students doing so can be used in future interventions.

The role of community social capital in the relationship between socioeconomic status and adolescent life satisfaction: mediating or moderating? Evidence from Czech data

BACKGROUND

The concept of social capital has been extensively used to explain the relationship between socioeconomic status (SES) and adolescent health and well-being. Much less is known about the specific mechanism through which social capital impacts the relationship. This paper investigates whether an individual's perception of community social capital moderates or mediates the association between SES and life satisfaction.

METHODS

This study employs cross-sectional data from the 2009-2010 Czech Health Behaviour in School-Aged Children survey: a WHO Collaborative Cross-National Study (HBSC). A sample of 4425 adolescents from the 5^th, 7^th and 9^th grade (94.5% school response rate, 87% student response) was used to perform multilevel analysis.

RESULTS

We found that pupils' life satisfaction was positively related to both family affluence and perceived wealth. Moreover, we found the cognitive component of social capital to be positively associated with life satisfaction. Additionally, a significant interaction was found, such that the social gradient in life satisfaction was flattened when pupils reported high levels of perceived community social capital.

CONCLUSIONS

The present findings suggest that community social capital acts as an unequal health resource for adolescents, but could potentially represent opportunities for public health policy to close the gap in socioeconomic disparities.

A comparative study of screening instruments and biomarkers for the detection of cannabis use

BACKGROUND

The aim of this study was to compare the usefulness of 3 different screening instruments (questionnaires) for the detection of cannabis use (CU) with biological markers in blood and hair.

METHODS

Ninety-four students were recruited in October 2013. Participants filled out the Severity of Dependence Scale (SDS), the CAGE-AID ("Cut down Annoyed Guilty Eye-opener"-Adapted to Include Drugs), and ProbCannabis-DT questionnaires concerning their possible CU. Blood and hair samples were taken and analyzed by gas chromatography-mass spectrometry. Logistic regression (Nagelkerke R(2)) and receiver operating characteristic (ROC) curve analyses were performed. THCCOOH (Δ(9)-tetrahydrocannabinoic acid) plasma of ≥5 ng/mL and THC (Δ(9)-tetrahydrocannabinol) hair concentrations of ≥0.1 and ≥0.02 ng/mg were used as the gold standard for CU. The questionnaire results were compared with different concentration ranges for THCCOOH in plasma (<5, 5-75, and >75 ng/mL, indicating the intensity of use) and THC in hair (≥0.02 ng/mg, ≥0.1 ng/mg).

RESULTS

The Nagelkerke R(2) for comparing the SDS, CAGE-AID, and ProbCannabis-DT with THCCOOH in plasma was 0.350, 0.489, and 0.335, respectively. The area under the ROC curve (95% confidence interval) was 0.772 (0.662-0.882), 0.797 (0.710-0.884), and 0.769 (0.669-0.870), respectively. Corresponding sensitivity/specificity were 70%/84%, 100%/59%, and 87%/67%, respectively. These values were similar to those compared to a 0.02 ng/mg THC cutoff in hair.

CONCLUSIONS

Moderate agreement was found between all questionnaires and biomarkers of CU. The CAGE-AID and probCannabis-DT questionnaires were very sensitive, but less specific. SDS was less sensitive, but more specific.

Tracking and predictors of screen time from early adolescence to early adulthood: a 10-year follow-up study

PURPOSE

To examine tracking of weekday and weekend screen time (ST; i.e., television [TV] and computer [PC] time) from early adolescence to early adulthood and to identify social ecological predictors of weekday and weekend ST among boys and girls separately.

METHODS

Data were retrieved from elementary schools (n = 59) in Flanders (Belgium). At baseline, 1,957 children (age, 9.9 ± .43 years) and one of the parents filled out a questionnaire on sedentary behavior and individual, social, and environmental variables. After a 10-year follow-up period, six hundred fifty-five 20-year-olds (age, 19.9 ± .43 years) filled out an adapted questionnaire on sedentary behavior, of which 593 contained full data at baseline and follow-up. Multiple regressions were performed to examine predictors (baseline) of ST (follow-up), and logistic regressions were used to analyze tracking of ST.

RESULTS

For boys, a consistent positive predictor of weekday and weekend TV and PC time at follow-up was ST at baseline (p < .01). For girls, drinking more soda at baseline predicted more weekday and weekend TV and PC time at follow-up (p ≤ .02). Some other individual variables also predicted ST in both boys and girls. Tracking was only found among boys; those exceeding the ST guideline at baseline were three to five times more likely to exceed this guideline at follow-up (p ≤ .001). Tracking was not present among girls.

CONCLUSIONS

To minimize TV and PC time during early adulthood, interventions for adolescent boys should focus on minimizing ST. For girls, focus should be on healthy eating. However, more research is warranted to confirm these conclusions.

The influence of parental drinking on offspring's drinking motives and drinking: a mediation analysis on 9 year follow-up data

BACKGROUND AND AIMS

The influence of parental drinking on offspring's drinking is well-documented. However, longitudinal evidence on the mediating role of drinking motives in this relationship is lacking. This study longitudinally investigates the mediating role of drinking motives in the relationship between parental and offspring's drinking.

METHODS

Using a prospective design, 587 Flemish children (response 30.0%) were followed for 9 years. Parental drinking was documented during the offspring's late childhood (10 and 11 years old) through paper-and-pencil questionnaires distributed by schools. The offspring's drinking habits and -motives were documented in early adulthood (18 and 19 year old) through a web-based questionnaire; invitations were sent by letter. Motives were measured using the Drinking Motives Questionnaire Revised Short-form, and mediation analyses were conducted with the product of coefficient test using bootstrapping.

RESULTS

Half the offspring were female (53.8%) and the mean age was 19.35 (SD = 0.52) years. A significant direct effect of maternal drinking during childhood on offspring drinking nine years later was found (β = 0.091, t = 2.071, p = 0.039). However, the association turned non-significant after stratifying the model for boys and girls. No direct effect was found for paternal drinking on offspring's drinking. Nevertheless, paternal drinking indirectly affected offspring's drinking through offspring's enhancement motives (β = 0.041, 95%CI[0.004, 0.082]) and maternal drinking indirectly affected male offspring's drinking through offspring's social motives (β = 0.067, 95%CI[0.007, 0.148]).

CONCLUSION

These results show that parental drinking during late childhood relates to a high level of those drinking motives among young adults that are known risk factors for heavy drinking in early adulthood.

Complete crystal structure of monocyte chemotactic protein-2, a CC chemokine that interacts with multiple receptors

Monocyte chemotactic protein 2 (MCP-2) is a CC chemokine that utilizes multiple cellular receptors to attract and activate human leukocytes. MCP-2 is a potent inhibitor of HIV-1 by virtue of its high-affinity binding to the receptor CCR5, one of the major coreceptors for HIV-1. Although a few structures of CC chemokines have been reported, none of these was determined with the N-terminal pyroglutamic acid residue (pGlu1) and a complete C-terminus. pGlu1 is essential for the chemotactic activity of MCP-2. Recombinant MCP-2 has Gln1 at the N terminus, 12-15% of which cyclizes automatically and forms pGlu1. The chemotactic activity of such MCP-2 mixture, which contains 12-15% pGlu1-form and 85-88% Gln1-form protein, is approximately 10 times lower when compared with that of fully cyclized MCP-2 preparation. Therefore, this chemokine is practically inactive without pGlu1. We have determined the complete crystal structure of MCP-2 that contains both pGlu1 and an intact C-terminus. With the existence of pGlu1, the conformation of the N-terminus allows two additional interactions between the two subunits of MCP-2 dimer: a hydrogen bond between pGlu1 and Asn17 and a salt bridge between Asp3 and Arg18. Consequently, both pGlu1 are anchored and buried, and thereby, both N-terminal regions are protected against protease degradation. We have also observed not previously reported extended helical nature of the C terminal region, which covers residues 58-74.

Protein-chemical characterization of NF-H, the largest mammalian neurofilament component; intermediate filament-type sequences followed by a unique carboxy-terminal extension

NF-H has the highest mol. wt. of the three mammalian neurofilament components (NF-L, NF-M, NF-H). In spite of its unusually large mol. wt., estimated to be 200 K by gel electrophoresis, NF-H contains sequences which identify it as an integral intermediate filament (IF) protein in its amino-terminal region. We have isolated and partially characterized a basic, non-alpha-helical segment located at the amino-terminal end with properties similar to headpieces of other non-epithelial IF proteins. The highly alpha-helical 40-K fragment excised by chymotrypsin is now identified by the amino acid sequence of a 17-K fragment. This sequence can be unambiguously aligned with the rod region of other IF proteins and covers about half of the presumptive coiled-coil arrays. NF-H and NF-M show 45% sequence identity in this region. The extra mass of NF-H in comparison with most other IF proteins arises from a carboxy-terminal extension thought to be responsible for inter-neurofilament cross-bridges in axons. This autonomous domain has a unique amino acid composition characterized by a high content of proline, alanine and particularly of lysine and glutamic acid. The NF-H tailpiece extension also carries a large number of serine phosphates, which are not evenly distributed, but are restricted to the amino-terminal part. Having now delineated the intermediate filament-type sequences for all three neurofilament proteins it seems very likely that the three components interact via coiled-coil interactions. They all carry unique carboxy-terminal extensions which increase in length from NF-L to NF-H and seem to extend from the filament wall.

Human fibroblast interferon for clinical trials: production, partial purification, and characterization

The production and partial purification of human fibroblast interferon for performing clinical trials is described. The interferon was produced by superinduction (exposure to riboinosinic-ribocytidylic acid, cycloheximide, and actinomycin D) of large numbers of human diploid fibroblast cultures. The yield averaged 750 units per cm(2) of culture area. The interferon was concentrated and purified by a two-step procedure involving acid desorption from controlled-pore glass beads and dialysis against polyethylene glycol. Human plasma protein was added as a stabilizer. The lyophilized end product had a specific activity of 0.5 x 10(6) to 1 x 10(6) units/mg of protein; it could be reconstituted for injection at a concentration of 2 x 10(6) units/ml. The composition of this interferon was characterized by crossed immunoelectrophoresis with polyspecific antibodies prepared against the principal sources of potential contaminants: human serum, calf serum, and normal human fibroblasts. Several components of each source were detected. Although the major component of calf serum, bovine serum albumin, was absent, other minor components were retained by the production and purification sequence. One of the main contaminants of fibroblast origin was found to be fibronectin.