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Causevic S, Ekström AM, Orsini N, Kagesten A, Strömdahl S, Salazar M. Prevalence and associated factors for poor mental health among young migrants in Sweden: a cross-sectional study. Glob Health Action 2024; 17:2294592. [PMID: 38180014 PMCID: PMC10773640 DOI: 10.1080/16549716.2023.2294592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Young migrants face multiple challenges that can affect their mental, sexual and reproductive health. OBJECTIVE To assess the prevalence of self-reported poor mental health and its associated demographic, post-migration and sexual risk behaviour factors among young migrants (aged 15-25) in Sweden. METHODS Data were drawn from a cross-sectional survey conducted with migrants aged 15-65 years old in Sweden between December 2018 and November 2019 (n = 6449). Among these, 990 participants aged 15-25 were eligible for the study. Mental health was measured using the Refugee Health Screener-13. Missing data indicator analysis and multivariable logistic regression models were conducted to estimate the association between mental health, sexual risk behaviour, demographic and migration-related variables. RESULTS Of the 990 participants, 59% reported poor mental health. Participants reporting poor mental health were more likely to be female (AOR:1.63, 95% CI:1.18-2.25), to have lived in Sweden more than three years (AOR:2.16, 95% CI:1.17-3.97), to engage in any sexual risk behaviour (AOR:1.99, 95% CI:1.25-3.17), and to live alone (AOR:1.95, 95% CI:1.25-3.03) or with friends they already knew (AOR:1.60, 95% CI:1.37-4.91). People arriving from the Americas (AOR:0.54, 95% CI:0.33-0.88), Asia (AOR:0.44, 95% CI:0.22-0.86), Europe (AOR:0.30, 95% CI:0.14-0.61) and Africa (AOR 0.37, 95% CI: 0.23-0.60) had lower odds of poor mental health than those arriving from Syria. CONCLUSION The prevalence of poor mental health among young migrants in Sweden was high, with specific subgroups (women, asylum seekers, people arriving from Syria, and those residing longer in Sweden) being particularly vulnerable. Our results indicate the interconnectedness between poor mental health and sexual risk behaviour in this population. Thus, policies targeting young migrants should ensure that healthcare services screen for both poor sexual and mental health at the same time.
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Affiliation(s)
- Sara Causevic
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Anna Mia Ekström
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Infectious Diseases, South Central Hospital, Stockholm, Sweden
| | - Nicola Orsini
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Anna Kagesten
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
| | - Susanne Strömdahl
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
- Department of Medical Sciences, Infectious Medicine, Uppsala University, Uppsala, Sweden
- Swedish Public Health Agency, Stockholm, Sweden
| | - Mariano Salazar
- Global and Sexual Health (GloSH) Research Group, Department of Global Public Health, Karolinska Institutet, Widerströmska huset, Stockholm, Sweden
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Ruokolainen O, Lilja E, Ollila H, Castaneda AE, Koponen P, Skogberg N. Changes in smoking due to COVID-19 pandemic among persons of migrant origin compared with the general population: a population-based study. Scand J Public Health 2024; 52:271-283. [PMID: 37726894 PMCID: PMC11067395 DOI: 10.1177/14034948231199792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/17/2023] [Accepted: 08/20/2023] [Indexed: 09/21/2023]
Abstract
AIMS Prior studies have implied that smokers may have changed their smoking behaviour during the COVID-19 pandemic. However, little is known about changes in smoking behaviour and correlates of change due to the pandemic among persons of migrant origin compared with the general population. METHODS Population-based cross-sectional studies with comparable study protocols and measures, one focusing on persons of migrant origin living in Finland (n = 3587, response rate 60%) and the other on the general Finnish population (n = 3444, response rate 56%), were utilised. The outcome measure was self-reported change in smoking behaviour due to COVID-19 among current smokers. Explanatory factors included sociodemographic-, health-, and COVID-19-related factors. Multinomial logistic regression was used in the analyses. RESULTS Most of the current smokers reported no change in their smoking behaviour. In the adjusted model, younger age was positively associated with increased smoking, while region of origin (Russia, Africa, Asia, and Latin America) and worrying about getting infected with COVID-19 were associated with decreased smoking among persons of migrant origin. In the general population, younger age, female sex, being other than employed/student, increased loneliness, and decreased contact with close ones were associated with increased smoking, while reduced working capacity and worries that someone close to the respondent will be infected with COVID-19 were associated with decreased smoking. CONCLUSIONS The findings of this study contribute to better identification of at-risk populations in future crises situations. This will allow for more efficient targeting and tailoring of health promotion services, including smoking cessation.
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Affiliation(s)
- Otto Ruokolainen
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Eero Lilja
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Hanna Ollila
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Anu E. Castaneda
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Päivikki Koponen
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
| | - Natalia Skogberg
- Finnish Institute for Health and Welfare, Department of Public Health and Welfare, Helsinki, Finland
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Hammond D. Commentary on Hall et al.: Evaluating impact of cannabis legalization in Canada-initial outcomes and current trends. Addiction 2023; 118:2073-2075. [PMID: 37635314 DOI: 10.1111/add.16322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/01/2023] [Indexed: 08/29/2023]
Affiliation(s)
- David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Petäjä UK, Terkamo-Moisio A, Häggman-Laitila A. The multifaceted nature of risk behaviour among adolescents-A document analysis of patient and aftercare service providers' records. J Adv Nurs 2023; 79:4381-4397. [PMID: 37211962 DOI: 10.1111/jan.15715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Abstract
AIM The aim of this study was to describe the forms and the prevalence of risk behaviour among adolescents in aftercare services, as well as identify the associated factors and use of services by adolescents. BACKGROUND Adolescents in aftercare services represent a vulnerable group that struggles with several aspects of life. The challenges they face are known to accumulate in certain individuals, and the problems that are relevant for this group tend to have an intergenerational nature. DESIGN The research applied retrospective document analysis, with the analysed data comprising information on 698 adolescents in aftercare services in one large Finnish city from the fall of 2020. METHODS The data were analysed using descriptive statistics and multivariate methods. RESULTS Risk behaviour was identified among 616 of the studied adolescents (88.3%), and manifested as substance abuse, reckless sexual behaviour and/or use of money, nicotine use, self-destructive behaviour, delinquency and functional dependencies. Regarding the associations between risk behaviour and background variables, an adolescents' child's clientship in child protection or the child's placement in foster care, adolescent's need for support in parenting, problems with daily rhythm and problems with studying were found to influence the prevalence of risk behaviour. Forms of risk behaviour were also found to be associated with each other. Adolescents displaying risk behaviour commonly did not use the social counsellor, psychiatric outpatient care and study counselling services, even if they would have needed them. CONCLUSIONS The interconnections between different forms of risk behaviour mean that this issue should be prioritized when developing aftercare services. IMPACT This is the first time that risk behaviour among adolescents in aftercare services has been comprehensively examined. Understanding this phenomenon is key to identifying future research topics, guiding decision-making and helping stakeholders truly understand the needs of these adolescents. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution as the study was based on a document analysis.
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Affiliation(s)
- Ulla-Kaarina Petäjä
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Anja Terkamo-Moisio
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Arja Häggman-Laitila
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- City of Helsinki, Social and Health Care, Helsinki, Finland
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Hage K, van de Kerkhof M, Boyd A, Carson JM, Newsum AM, Matser A, van der Valk M, Brinkman K, Arends JE, Lauw FN, Rijnders BJA, van Eeden A, Martinello M, Matthews GV, Schinkel J, Prins M. Screening for Hepatitis C Virus Reinfection Using a Behaviour-Based Risk Score among Men Who Have Sex with Men with HIV: Results from a Case-Control Diagnostic Validation Study. Pathogens 2023; 12:1248. [PMID: 37887764 PMCID: PMC10610046 DOI: 10.3390/pathogens12101248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
We assessed the predictive capacity of the HCV-MOSAIC risk score, originally developed for primary early HCV infection, as a screening tool for HCV reinfection in 103 men who have sex with men (MSM) with HIV using data from the MOSAIC cohort, including MSM with HIV/HCV-coinfection who became reinfected (cases, n = 27) or not (controls, n = 76) during follow-up. The overall predictive capacity of the score was assessed using the area under the receiver operating characteristic (AUROC) curve. The effects of covariates on the receiver operating characteristic (ROC) curve were assessed using parametric ROC regression. The score cut-off validated for primary early infection (≥2.0) was used, from which the sensitivity and specificity were calculated. The AUROC was 0.74 (95% confidence interval (CI) = 0.63-0.84). Group sex significantly increased the predictive capacity. Using the validated cut-off, sensitivity was 70.4% (95%CI = 49.8-86.2%) and specificity was 59.2% (95%CI: 47.3-70.4%). External validation from a cohort of 25 cases and 111 controls, all MSM with HIV, resulted in a sensitivity of 44.0% (95%CI = 24.4-65.1) and specificity of 71.2% (95%CI = 61.8-79.4). The HCV-MOSAIC risk score may be useful for identifying individuals at risk of HCV reinfection. In sexual health or HIV-care settings, this score could help guide HCV-RNA testing in MSM with a prior HCV infection.
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Affiliation(s)
- Kris Hage
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam UMC Location, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Marita van de Kerkhof
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Stichting SBOH, 3528 BB Utrecht, The Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Stichting HIV Monitoring (SHM), 1105 BD Amsterdam, The Netherlands
| | - Joanne M. Carson
- The Kirby Institute, University of New South Wales, Sydney 2052, Australia
| | - Astrid M. Newsum
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
| | - Marc van der Valk
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
- Stichting HIV Monitoring (SHM), 1105 BD Amsterdam, The Netherlands
| | - Kees Brinkman
- Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis (OLVG), 1091 AC Amsterdam, The Netherlands
| | - Joop E. Arends
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht (UMCU), 3584 CX Utrecht, The Netherlands
- Department of Health, Medicine and Life Sciences, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Fanny N. Lauw
- Department of Internal Medicine, Medical Centre Jan van Goyen, 1075 HN Amsterdam, The Netherlands
| | - Bart J. A. Rijnders
- Department of Internal Medicine and Infectious Diseases, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Arne van Eeden
- Department of Internal Medicine, DC Klinieken Oud Zuid, 1075 BG Amsterdam, The Netherlands
| | | | - Gail V. Matthews
- The Kirby Institute, University of New South Wales, Sydney 2052, Australia
| | - Janke Schinkel
- Medical Microbiology and Infection Prevention, Amsterdam UMC Location, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, 1018 WT Amsterdam, The Netherlands
- Infectious Diseases, Amsterdam Institute for Infection and Immunity, 1105 AZ Amsterdam, The Netherlands
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Maxwell KJ, Bosó Pérez R, Reid D, Freeman L, Menezes D, Sonnenberg P, Field N, Mitchell KR. Balancing risk, intimacy and (non)compliance: a qualitative study of sex across household during COVID-19 social restrictions. Cult Health Sex 2023; 25:582-598. [PMID: 35674048 PMCID: PMC10184729 DOI: 10.1080/13691058.2022.2078507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Government controls over intimate relationships, imposed to limit the spread of Sars-CoV-2, were unprecedented in modern times. This study draws on data from qualitative interviews with 18 participants in Natsal-COVID, a quasi-representative web-panel survey of the British population (n = 6,654 people), reporting that they had sex with someone from outside their household in the preceding four weeks; a period in which contact between households was restricted in the UK. Whilst only 10% of people reported sexual contact outside their household, among single people and those in non-cohabiting relationships, rates were much higher (Natsal-COVID). Our findings show that individuals did not take decisions to meet up with sexual partners lightly. Participants were motivated by needs-for connection, security, intimacy and a sense of normality. People balanced risks-of catching COVID-19, social judgement and punishment for rule-breaking-against other perceived risks, including to their mental health or relationships. We used situated rationality and social action theories of risk to demonstrate that people weighed up risk in socially situated ways and exhibited complex decision-making when deciding not to comply with restrictions. Understanding motivations for non-compliance is crucial to informing future public health messaging which accounts for the needs and circumstances of all population members.
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Affiliation(s)
- Karen J Maxwell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - David Reid
- Institute of Global Health, UCL, London, UK
| | | | - Dee Menezes
- Institute of Health Informatics, UCL, London, UK
| | | | | | - Kirstin R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Van Minh H, Long KQ, Van Vuong D, Hung NM, Park K, Takeuchi M, Kashiwabara M, Lam NT, Nga PTQ, Anh LP, Van Tuan L, Bao TQ, Anh LDM, Hanh TTT. Tobacco and electronic cigarette smoking among in-school adolescents in Vietnam between 2013 and 2019: prevalence and associated factors. Glob Health Action 2022; 15:2114616. [PMID: 36174100 PMCID: PMC9542268 DOI: 10.1080/16549716.2022.2114616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Smoking among adolescents in schools is a major global public health concern. There is limited evidence regarding prevalence and associated factors in Vietnam. Objective To compare the prevalence of smoking and associated factors among in-school adolescents aged 13–17 years in Vietnam between 2013 and 2019. Methods Data were collected from two rounds of the national representative Vietnam Global School-based Student Health Survey (GSHS) conducted in 2013 (n = 3,331) and 2019 (n = 7,690). Logistic regression was used to identify the factors associated with tobacco and electronic cigarette smoking among in-school adolescents. Results There was a significant reduction in the prevalence of current smoking (water pipes and cigarettes) from 5.4% (95% CI: 4.0–7.2) in 2013 to 2.8% (95% CI: 2.2–3.6) in 2019. In 2019, 2.6% of the in-school adolescents reported having used electronic cigarette products 30 days prior to the survey. Factors associated with a significantly higher likelihood of current smoking status included gender, loneliness, suicidal ideation, sexual activity, truancy, and alcohol consumption. Similar patterns were observed for e-cigarettes. Conclusion Smoking among in-school adolescents in Vietnam decreased between 2013 and 2019. Follow-up studies are needed to further investigate causal factors so that future policies and communication programmes can be more effectively targeted to reduce smoking in adolescents.
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Affiliation(s)
| | | | - Do Van Vuong
- Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Kidong Park
- Data, Strategy and Innovation, World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Momoe Takeuchi
- Country Liaison Officer, World Health Organization Office for Northern Micronesia, Federated States of Micronesia, Marshall Islands and Palau
| | - Mina Kashiwabara
- Non-Communicable Diseases, World Health Organization Division of Pacific Technical Support
| | - Nguyen Tuan Lam
- Universal Health Coverage - Healthy Lifestyle and Environment, World Health Organization, Country Office for Viet Nam, Hanoi, Vietnam
| | - Pham Thi Quynh Nga
- Universal Health Coverage - Healthy Lifestyle and Environment, World Health Organization, Country Office for Viet Nam, Hanoi, Vietnam
| | - Le Phuong Anh
- Department of Epidemiology, Harvard T.H. School of Public Health, Harvard University, Massachusetts, United States of America
| | - Le Van Tuan
- Physical Education Department, Ministry of Education and Training, Hanoi, Vietnam
| | - Tran Quoc Bao
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
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Dyer ML, Sallis HM, Khouja JN, Dryhurst S, Munafò MR. Associations between COVID-19 Risk Perceptions and Mental Health, Wellbeing, and Risk Behaviours. J Risk Res 2022; 25:1372-1394. [PMID: 37872962 PMCID: PMC7615237 DOI: 10.1080/13669877.2022.2127849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/16/2022] [Accepted: 09/02/2022] [Indexed: 10/25/2023]
Abstract
Background Mental health has worsened, and substance use has increased for some people during the coronavirus (COVID-19) pandemic. Some cross-sectional studies suggest that higher COVID-19 risk perceptions are related to poorer mental health and greater risk behaviours (e.g., substance use). However, longitudinal and genetic data are needed to help to reduce the likelihood of reverse causality. Methods We used cross-sectional, longitudinal, and polygenic risk score (PRS; for anxiety, depression, wellbeing) data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined cross-sectional and prospective longitudinal associations between COVID-19 risk perceptions (i.e., cognitive, affective, self, other, and a combined 'holistic' measure) and mental health (i.e., anxiety, depression), wellbeing, and risk behaviours. Pandemic (April-July 2020) and pre-pandemic (2003-2017) data (ns = 233-5,115) were included. Results Higher COVID-19 risk perceptions (holistic) were associated with anxiety (OR 2.78, 95% confidence interval [CI] 2.20 to 3.52), depression (OR 1.65, 95% CI 1.24 to 2.18), low wellbeing (OR 1.76, 95% CI 1.45 to 2.13), and increased alcohol use (OR 1.46, 95% CI 1.24 to 1.72). Higher COVID-19 risk perceptions were also associated with self-isolating given a suspected COVID-19 infection (OR 1.74, 95% CI 1.13 to 2.68), and less face-to-face contact (OR 0.83, 95% CI 0.70 to 0.98) and physical contact (OR 0.83, 95% CI 0.68 to 1.00). Pre-pandemic anxiety (OR 1.64, 95% CI 1.29 to 2.09) and low wellbeing (OR 1.41, 95% CI 1.15 to 1.74) were associated with higher COVID-19 risk perceptions. The depression PRS (b 0.21, 95% CI 0.02 to 0.40) and wellbeing PRS (b -0.29, 95% CI -0.48 to -0.09) were associated with higher and lower COVID-19 risk perceptions, respectively. Conclusions Poorer mental health and wellbeing are associated with higher COVID-19 risk perceptions, and longitudinal and genetic data suggest that they may play a causal role in COVID-19 risk perceptions.
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Affiliation(s)
- Maddy L. Dyer
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Hannah M. Sallis
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jasmine N. Khouja
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Sarah Dryhurst
- Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, UK
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Werder O, Holland K, Kiaos T, Ferson MJ. Between the sea and the sky: A social practice investigation into health behaviours during cruise travel. Health Promot J Austr 2022; 33 Suppl 1:367-378. [PMID: 35266596 PMCID: PMC9790200 DOI: 10.1002/hpja.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED The COVID-19 pandemic has highlighted organised cruise holidays as perfect incubators for microbiological infections due to the constant socialising within closed spaces. Little is known about people's health behaviours and perceptions during cruise holidays. METHODS Narrative group interviews and respondent photo diary exercises were conducted with families (n = 25) residing in different areas across metropolitan NSW, Australia. Guided by a social practice theoretical approach we undertook a thematic analysis that identifies reasons for choosing a cruise, health considerations and behaviours in relation to cruise travel and awareness of official cruise health information. RESULTS Cruise travel included a licence to abandon cautious behaviours, reinforced by confidence in the cruise organiser's risk management ability. Health concerns were not a high priority for participants and were mainly understood in terms of eating healthy, modest exercise, managing seasickness and having adequate supplies of medications. Awareness of official cruise health and risk information was largely non-existent. CONCLUSION Understanding how travel health practices emerge and are likely to be modifiable produces health-promoting awareness and intervention efforts that recognise and link with people's ideas about cruise holidays as times of fun, leisure, relaxation, without interfering with or imposing on them. SO WHAT?: This study highlights the importance of developing health communication and promotion strategies that are responsive to the interconnected meanings, competencies and materials that have a bearing on how cruise travellers understand and enact health-related behaviours in preparation for and during a cruise holiday.
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Affiliation(s)
| | | | | | - Mark J. Ferson
- South Eastern Sydney Local Health DistrictUNSW MedicineRandwickAustralia
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10
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Fei G, Li X, Yang Y, Wei P, Stallones L, Xiang H, Zhang X. Unintentional injuries and risk behaviours of internal migrant children in southern China: A cross-sectional study. Health Soc Care Community 2022; 30:1858-1868. [PMID: 34529290 DOI: 10.1111/hsc.13565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 08/20/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to estimate the prevalence of unintentional injuries and to identify factors mediating the risk of unintentional injuries among internal migrant children in southern China using self-reported data collected between April 2016 and March 2017. Logistic regression models were used to identify significant risk factors for unintentional injuries among the internal migrant children. The prevalence of self-reported unintentional injuries among internal migrant children in this study was 19.15%. Internal migrant children exhibiting antisocial (antisocial behaviour vs. no behaviour problems, OR = 2.162, 95% CI: 1.194-3.915, p = .011) and neurotic behaviours (neurotic behaviour vs. no behaviour problems, OR = 2.064, 95% CI: 1.098-3.880, p = .024) were more likely to report unintentional injuries. There was a positive correlation between the number of risk behaviours and the prevalence of unintentional injuries among non-migrant and internal migrant children. Children's behavioural problems were closely related to unintentional injuries and may be useful as predictors of unintentional injuries in children.
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Affiliation(s)
- Gaoqiang Fei
- Department of Epidemiology and Biostatistics, Injury Prevention Research Institute, School of Public Health, Southeast University, Nanjing, China
| | - Xinyu Li
- Department of Epidemiology and Biostatistics, Injury Prevention Research Institute, School of Public Health, Southeast University, Nanjing, China
- Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Yaming Yang
- Yixing Center for Disease Control and Prevention, Yixing, China
| | - Pingmin Wei
- Department of Epidemiology and Biostatistics, Injury Prevention Research Institute, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Lorann Stallones
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Henry Xiang
- Center for Injury Research and Policy and Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Xujun Zhang
- Department of Epidemiology and Biostatistics, Injury Prevention Research Institute, School of Public Health, Southeast University, Nanjing, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Charrier L, Bersia M, Vieno A, Comoretto RI, Štelemėkas M, Nardone P, Baška T, Dalmasso P, Berchialla P. Forecasting Frequent Alcohol Use among Adolescents in HBSC Countries: A Bayesian Framework for Making Predictions. Int J Environ Res Public Health 2022; 19:ijerph19052737. [PMID: 35270429 PMCID: PMC8910627 DOI: 10.3390/ijerph19052737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 12/01/2022]
Abstract
(1) Aim: To summarize alcohol trends in the last 30 years (1985/6–2017/8) among 15-year-olds in Health Behaviour in School-aged Children (HBSC) countries (overall sample size: 413,399 adolescents; 51.55% girls) and to forecast the potential evolution in the upcoming 2021/22 HBSC survey. (2) Methods: Using 1986–2018 prevalence data on weekly alcohol consumption among 15-year-olds related to 40 HBSC countries/regions, a Bayesian semi-parametric hierarchical model was adopted to estimate trends making a clusterization of the countries, and to give estimates for the 2022 HBSC survey. (3) Results: An overall declining trend in alcohol consumption was observed over time in almost all the countries. However, compared to 2014, some countries showed a new increase in 2018 and 2021/22 estimates forecast a slight increase in the majority of countries, pointing out a potential bounce after a decreasing period in frequent drinking habits. (4) Conclusions: The clusterization suggested a homogenization of consumption habits among HBSC countries. The comparison between 2022 observed and expected data could be helpful to investigate the effect of risk behaviour determinants, including the pandemic impact, occurring between the last two waves of the survey.
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Affiliation(s)
- Lorena Charrier
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy; (L.C.); (M.B.); (P.D.)
| | - Michela Bersia
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy; (L.C.); (M.B.); (P.D.)
- Post Graduate School of Medical Statistics, University of Torino, 10126 Torino, Italy
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, 35131 Padova, Italy;
| | - Rosanna Irene Comoretto
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy; (L.C.); (M.B.); (P.D.)
- Correspondence: ; Tel.: +39-011-670-6322
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania;
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, 47181 Kaunas, Lithuania
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, 00161 Rome, Italy;
| | - Tibor Baška
- Department of Public Health, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia;
| | - Paola Dalmasso
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy; (L.C.); (M.B.); (P.D.)
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, 10043 Orbassano, Italy;
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12
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Majee W, Conteh N, Jacobs J, Jooste K, Wegner L. Rural voices: A social-ecological perspective on factors influencing youth substance use in rural South africa. Health Soc Care Community 2021; 29:1824-1832. [PMID: 33513273 DOI: 10.1111/hsc.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/21/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Youth can be a positive force for development when provided with the knowledge and opportunities they need to thrive, yet they continue to experience insurmountable challenges, such as poverty and absentee fathers, that prompt them to resort to risk behaviours such as substance use. In rural South Africa, women tend to be the breadwinners and more involved with parenting than men. OBJECTIVE The primary objective of the study was to explore perspectives of rural youth on factors influencing youth participation in substance use. The secondary objective was to obtain the perspectives of adult women on factors influencing substance use among young people. METHODS The qualitative study, informed by a social-ecological framework, utilised a semi-structured interview protocol in focus group discussions in rural South Africa. Seven focus group discussions, each with between 8 and 15 individuals were conducted with 79 youth. The eighth discussion was with nine adult women. Data were audio recorded and transcribed verbatim, manually coded and further analysed into themes using NVivo 12. FINDINGS Four themes emerged: hopelessness and lack of motivation, lack of adult role models such as father, lack of built environment for recreational activities and lack of educational opportunities. The social-ecological model provided a useful framework to understand the findings. In line with this model, rural youth in South Africa described a variety of factors that influenced youth substance use and other risk behaviours. These related to the individual, relationships with others, community and societal norms and values factors of the social-ecological model. CONCLUSIONS The broadening spectrum of substances available to an increasing youth population bulge in Africa suggests a strong threat of social and disease burden due to substance use disorders. Given this threat, this study provides awareness to a multi-systems approach needed to support the rural South African youth.
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Affiliation(s)
- Wilson Majee
- Department of Health Sciences and Public Health, University of Missouri, Columbia, MO, USA
- Department of Occupational Therapy, Faculty of Community & Health Sciences, University of the Western Cape, South Africa
| | - Nameri Conteh
- MPH School of Health Professions, University of Missouri, Columbia, MO, USA
| | - Joachim Jacobs
- HIV and Aids Program, University of the Western Cape, South Africa
| | - Karien Jooste
- Department of Nursing, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Lisa Wegner
- Department of Occupational Therapy, Faculty of Community & Health Sciences, University of the Western Cape, South Africa
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13
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Guerras JM, Hoyos J, de la Fuente L, Román F, Ayerdi O, García-Pérez JN, García de Olalla P, Belza MJ, The Methysos Project Group. Injection of Anabolic Steroids in Men Who Had Sex with Men in Madrid and Barcelona: Prevalence Correlates and Role as a Risk Factor for Transmitted Infections. Int J Environ Res Public Health 2021; 18:8289. [PMID: 34444038 DOI: 10.3390/ijerph18168289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022]
Abstract
This study describes the prevalence of anabolic-androgenic steroid (AAS) injection, their main correlates, and the prevalence of specific AAS injection risk behaviours among men who have sex with men (MSM), an area insufficiently addressed in scientific research. Participants were HIV-negative MSM attending four HIV/STI diagnosis services: two clinics and two community programmes in Madrid and Barcelona. Participants answered an online self-administered questionnaire. Crude and adjusted lifetime prevalence and prevalence ratios (PRs) were calculated by different factors and using Poisson regression models with robust variance. Of the 3510 participants, 6.1% (95% CI: 5.3-6.9) had injected AAS before and 3.5% (95% CI: 2.9-4.2) had done so in the last 12 months. In the multivariate analysis, AAS injection was independently associated with being over 40 years old (aPR = 3.6; 95% CI: 2.0-6.5) and being born in Latin America (aPR = 2.5; 95% CI:1.9-3.4), and was less strongly associated (aPRs of around two) with having been recruited into STI clinics, having ever been paid for sex before, injected drugs, used drugs for sex, having been diagnosed with an STI before, and having been diagnosed with HIV at the recruitment consultation. Only three participants, 1.4%, of those who had injected AAS before had shared AAS or equipment for preparation or injecting before. Conclusions: In contrast to drugs, AAS injecting behaviours do not play a relevant, direct role in the transmission of blood-borne infections among MSM. However, AAS injectors have a higher prevalence of sexual risk behaviours. These findings should be confirmed using new studies that employ other sampling procedures.
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14
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Valero-Mora PM, Zacarés JJ, Sánchez-García M, Tormo-Lancero MT, Faus M. Conspiracy Beliefs Are Related to the Use of Smartphones behind the Wheel. Int J Environ Res Public Health 2021; 18:ijerph18157725. [PMID: 34360021 PMCID: PMC8345770 DOI: 10.3390/ijerph18157725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 11/24/2022]
Abstract
The belief in conspiracy theories predicts behaviors related to public health such as the willingness to receive vaccines. This study applies a similar approach to an aspect of road safety: the use of smartphones while driving. A representative sample of 1706 subjects answered a series of questions related to what can be regarded as erroneous or conspiracy beliefs against restricting or banning the use of smartphones while driving. The results show that those having such conspiracy beliefs reported a greater use of smartphones behind the wheel.
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Affiliation(s)
- Pedro M. Valero-Mora
- Departamento de Metodología de las CC del Comportamiento, Universitat de València, Blasco Ibáñez, 21, CP 46010 Valencia, Spain
- Correspondence:
| | - Juan José Zacarés
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Blasco Ibáñez, 21, CP 46010 Valencia, Spain; (J.J.Z.); (M.S.-G.)
| | - Mar Sánchez-García
- Departamento de Psicología Evolutiva y de la Educación, Universitat de València, Blasco Ibáñez, 21, CP 46010 Valencia, Spain; (J.J.Z.); (M.S.-G.)
| | | | - Mireia Faus
- Independent Researcher, CP 46010 Valencia, Spain; (M.T.T.-L.); (M.F.)
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15
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Malama K, Sagaon-Teyssier L, Gosset A, Parker R, Wall KM, Tichacek A, Sharkey T, Kilembe W, Inambao M, Price MA, Spire B, Allen S. Loss to follow-up among female sex workers in Zambia: findings from a five-year HIV-incidence cohort. Afr J AIDS Res 2021; 19:296-303. [PMID: 33337978 DOI: 10.2989/16085906.2020.1836005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
HIV-incidence studies are used to identify at-risk populations for HIV-prevention trials and interventions, but loss to follow-up (LTFU) can bias results if participants who remain differ from those who drop out. We investigated the incidence of and factors associated with LTFU among Zambian female sex workers (FSWs) in an HIV-incidence cohort from 2012 to 2017. Enrolled participants returned at month one, month three and quarterly thereafter. FSWs were considered LTFU if they missed six consecutive months, or if their last visit was six months before the study end date. Of 420 FSWs, 139 (33%) were LTFU at a rate of 15.7 per 100 person years. In multivariable analysis, LTFU was greater for FSWs who never used alcohol, began sex work above the age of consent, and had a lower volume of new clients. Our study appeared to retain FSWs in most need of HIV-prevention services offered at follow-up.
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Affiliation(s)
- Kalonde Malama
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Marseille, France
| | - Luis Sagaon-Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Marseille, France
| | - Andréa Gosset
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Rachel Parker
- Rwanda Zambia HIV Research Group, Emory University, School of Medicine, Atlanta, USA
| | - Kristin M Wall
- Rwanda Zambia HIV Research Group, Emory University, School of Medicine, Atlanta, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Amanda Tichacek
- Rwanda Zambia HIV Research Group, Emory University, School of Medicine, Atlanta, USA
| | - Tyronza Sharkey
- Zambia Emory HIV Research Project, Rwanda Zambia HIV Research Group, Emory University, Lusaka, Zambia
| | - William Kilembe
- Zambia Emory HIV Research Project, Rwanda Zambia HIV Research Group, Emory University, Lusaka, Zambia
| | - Mubiana Inambao
- Zambia Emory HIV Research Project, Rwanda Zambia HIV Research Group, Emory University, Ndola, Zambia
| | - Matt A Price
- IAVI, New York, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, USA
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France.,ORS PACA, Marseille, France
| | - Susan Allen
- Rwanda Zambia HIV Research Group, Emory University, School of Medicine, Atlanta, USA
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16
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Pengpid S, Peltzer K. Prevalence and Associated Factors of Loneliness Among National Samples of In-School Adolescents in Four Caribbean Countries. Psychol Rep 2020; 124:2669-2683. [PMID: 33084488 DOI: 10.1177/0033294120968502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The goal of the study was to estimate the prevalence and correlates of loneliness among adolescent school children in four Caribbean countries. METHODS Nationally representative cross-sectional data were analysed from 9,143 adolescents (15 years=median age) that took part in the "2016 Dominican Republic, 2016 Suriname, 2017 Jamaica and 2017 Trinidad and Tobago "Global School-Based Student Health Survey (GSHS)." RESULTS The prevalence of loneliness was 15.3% in four Caribbean countries, ranging from 12.1% in Dominican Republic to 18.6% in Jamaica. In adjusted logistic regression analysis, female sex, having no close friends, older age, anxiety induced sleep disturbance, frequent bullying victimization (≥3 days/month), having been physically attacked, parental emotional neglect, having sustained multiple serious injuries (past year) and not eating fruit and vegetables were associated with loneliness. In addition, in sex stratified adjusted logistic regression analysis, among boys, daily exposure to passive smoking, and being from Suriname, and among girls, frequent experience of hunger, low peer support, trouble from drinking alcohol and high leisure-time sedentary behaviour (≥8 hrs/day) were associated with loneliness. Moreover, in addition to above results, in unadjusted analysis, involvement in physical fight, parents never check on homework, parental disrespect of privacy, frequent school truancy (≥3 days/month), current tobacco use, having no physical education and drinking frequently soft drinks (≥3/day) were associated with loneliness. CONCLUSION Almost one in six students reported loneliness and several associated factors were identified which can aid intervention strategies.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand; Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam; Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City, Vietnam
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17
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Pengpid S, Peltzer K. Prevalence of Worry-Induced Sleep Disturbance and Associated Factors among a National Sample of In-School Adolescents in Lebanon. Behav Sci (Basel) 2020; 10:bs10100148. [PMID: 32992487 PMCID: PMC7600147 DOI: 10.3390/bs10100148] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/15/2020] [Accepted: 09/18/2020] [Indexed: 01/11/2023] Open
Abstract
Persistent worry can cause significant distress among adolescents. The goal of this study was to estimate the prevalence and correlates of worry-induced sleep disturbance (WISD) among adolescent school children in Lebanon. Cross-sectional, nationally representative data were analysed from 5849 adolescents (15 years median age) that took part in the "2017 Lebanon Global School-Based Student Health Survey (GSHS)". The results indicate that the prevalence of WISD was 14.7%, 9.6% among males and 17.2% among females. In adjusted logistic regression analysis, loneliness, older age, female sex, having no close friends, infrequent bullying victimization, parents disrespected privacy, current tobacco use, ever cannabis use, high leisure-time sedentary behaviour and having sustained multiple serious injuries (past year) were associated with WISD. In addition, in unadjusted analysis, mostly or always feeling hungry (or low economic status), school truancy, having been physically attacked, frequently being in physical fights (past year), low peer support, parental emotional neglect, parents never checking homework, ever drunk and frequent soft drink intake were positively, and infrequent fast food intake was negatively, associated with WISD. One in seven students reported WISD and several associated factors were identified, which can aid intervention strategies. Multi-level interventions are needed targeting psychosocial distress, social-environmental factors and health risk behaviours to prevent WISD in this adolescent school population.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand;
- Department of Research Administration and Development, University of Limpopo, Sovenga 0727, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein 9300, South Africa
- Correspondence:
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18
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Thapa R, Subedi RK, Regmi G, Thapaliya R, Vaidya A, Karki BB. Self-Reported Changes in Risk Behaviours of Cardiovascular Diseases among School Adolescents in Nepal: Application of an Integrated Experiential Learning Approach. Glob Heart 2020; 15:40. [PMID: 32923334 DOI: 10.5334/gh.818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cardiovascular diseases (CVDs) account for the largest proportion of all deaths in Nepal (30%). Studies report that CVDs often begin with modifiable lifestyle risk behaviours established during adolescence which manifest later. This study aimed to measure changes in the five mortality-associated CVD risk behaviours (i.e., consumption of tobacco, alcohol, and junk food, physical inactivity, and stress among school adolescents) using an integrative intervention with the experiential learning approach. The study was carried out for 24 weeks (25 credit hours) among 4,225 students from grades 8 to 10 in community schools in seven provinces in Nepal. Pre- and post-intervention in-class self-reported surveys were conducted for assessing change in the students’ aggregate risk behaviours. These percent changes were assessed through bivariate analysis. Key-informant interviews of teachers were conducted to assess their perceptions of the effectiveness of the intervention. At 24 weeks, the percentages of students reporting consumption of cigarettes and smokeless tobacco declined by 25% and 28% respectively, consumption of alcohol declined by 29%, consumption of instant noodles by 11%, and consumption of coke by 43%. The proportion of students reporting ‘going to school by foot every day’ increased by 11%, and those ‘exercising until they sweat’ increased by 29%. The percentage of students who reported feeling that their ‘life has been running as desired’ increased by 16%. Key-informant interviews of the teachers revealed that the intervention had contributed to improved motivation, knowledge, and attitude among students towards mitigating the risk behaviours. These interviews also recommended continuation of the intervention. The sample in this study has shown positive changes in school adolescents’ self-reported aggregate CVD risk behaviours using the experiential learning approach. However, further research should be conducted to explore the sustainability and scaling of these learning modules through the existing non-communicable disease (NCD) school curriculum activities in Nepal.
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19
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Maisa A, Semple S, Griffiths A, Ngui SL, Verlander NQ, McCaughey C, Doherty L, Jessop L. Risk behaviours of homeless people who inject drugs during an outbreak of hepatitis C, Northern Ireland, 2016-2017. J Viral Hepat 2019; 26:1377-1387. [PMID: 31328838 DOI: 10.1111/jvh.13184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/25/2019] [Accepted: 06/25/2019] [Indexed: 12/14/2022]
Abstract
From July to August 2016, 4 homeless people who injected drugs (PWID) with acute or recent hepatitis C virus (HCV) infection were reported in Belfast. A multidisciplinary team including public health, homeless and addiction services undertook an investigation to identify risk behaviours and interrupt transmission chains. Recent HCV cases were defined as negative test within the previous year, or reported injecting for less than 1 year; acute cases had tested negative within the previous 6 months. Contacts in the injecting networks of cases were identified for testing. We undertook a cross-sectional survey using structured questionnaires to elicit risk behaviours for PWID and compare behaviours between self-reported hepatitis C positive and negative subjects. During the outbreak investigation until December 2017, 156 PWID were tested and 45 (29%) cases identified, including 7 (16%) recent and 13 (29%) acute infections. 68 PWID, including 12 cases, were interviewed. All respondents reported using heroin, with 76% injecting once or more daily. Sharing was reported for spoons (58%) and filters (53%), but also needles (27%) and syringes (29%). Hepatitis C positive individuals had higher odds to be injecting in public toilets (AOR 17, 95% CI 0.71-400, P < .05) when compared with hepatitis C negative individuals. Hepatitis C positive individuals were more likely to inject in public spaces, but all respondents indicated concerning risk behaviours. We recommend active surveillance with ongoing testing, expanding existing harm reduction programmes and access to bespoke services.
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Affiliation(s)
- Anna Maisa
- Public Health Agency, Health Protection Service Northern Ireland, Belfast, Northern Ireland.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Susan Semple
- Homeless Public Health Nursing Service, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Alison Griffiths
- Public Health Agency, Health Protection Service Northern Ireland, Belfast, Northern Ireland
| | - Siew Lin Ngui
- Virus Reference Department, National Infection Service, Public Health England, Colindale, London, UK
| | - Neville Q Verlander
- Statistics, Modelling and Economics Department, National Infection Service, Public Health England, London, UK
| | - Conall McCaughey
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland
| | - Lorraine Doherty
- Public Health Agency, Health Protection Service Northern Ireland, Belfast, Northern Ireland
| | - Lucy Jessop
- Public Health Agency, Health Protection Service Northern Ireland, Belfast, Northern Ireland
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20
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Regmi PR, Teijlingen EV, Mahato P, Aryal N, Jadhav N, Simkhada P, Zahiruddin QS, Gaidhane A. The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks. Int J Environ Res Public Health 2019; 16:E3655. [PMID: 31569445 DOI: 10.3390/ijerph16193655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/26/2019] [Accepted: 09/26/2019] [Indexed: 11/16/2022]
Abstract
Background: Most health research on Nepali migrant workers in India is on sexual health, whilst work, lifestyle and health care access issues are under-researched. Methods: The qualitative study was carried out in two cities of Maharashtra State in 2017. Twelve focus group discussions (FGDs) and five in-depth interviews were conducted with Nepali male and female migrant workers. Similarly, eight interviews were conducted with stakeholders, mostly representatives of organisations working for Nepali migrants in India using social capital as a theoretical foundation. Results: Five main themes emerged from the analysis: (i) accommodation; (ii) lifestyle, networking and risk-taking behaviours; (iii) work environment; (iv) support from local organisations; and (v) health service utilisation. Lack of basic amenities in accommodation, work-related hazards such as lack of safety measures at work or safety training, reluctance of employers to organise treatment for work-related accidents, occupational health issues such as long working hours, high workload, no/limited free time, discrimination by co-workers were identified as key problems. Nepali migrants have limited access to health care facilities due to their inability to prove their identity. Health system of India also discriminates as some treatment is restricted to Indian nationals. The strength of this study is the depth it offers, its limitations includes a lack of generalizability, the latter is a generic issue in such qualitative research. Conclusion: This study suggests risks to Nepali migrant workers’ health in India range from accommodation to workplace and from their own precarious lifestyle habit to limited access to health care facilities. We must conduct a quantitative study on a larger population to establish the prevalence of the above mentioned issues and risks. Furthermore, the effectiveness of Nepali migrant support organisations in mitigating these risks needs to be researched.
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21
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Negesa LB, Magarey J, Rasmussen P, Hendriks JM. Cardiovascular risk behaviour is an emerging health issue in developing countries: a cross-sectional study. Eur J Cardiovasc Nurs 2019; 18:679-690. [PMID: 31269808 DOI: 10.1177/1474515119861772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Low and middle-income countries are facing a high burden of cardiovascular disease while there is limited availability of resources and evidence to educate and modify lifestyle behaviours in the population as well as to guide policy making. AIM The goal of the present study was to quantify the prevalence of different cardiovascular risk behaviours among patients with known cardiovascular conditions in a developing country. METHODS A hospital-based cross-sectional survey was conducted in two referral hospitals in eastern Ethiopia. Outpatients who had a confirmed diagnosis of cardiovascular disease were recruited for the study. Data were collected through face-to-face interviews with patients using validated tools. RESULTS A total of 287 cardiovascular disease patients was recruited, of which 56.4% were women and 90.2% were urban residents. Most patients had inadequate consumption of fruit and vegetables, 51.6% were physically inactive, 20% were current khat chewers, 19% were current alcohol drinkers and only 1% were current smokers. Approximately one-third (30%) of the patients had one of these risk behaviours, more than half (51.9%) had two, 15% had three and 3.1% had four risk behaviours. The majority (70%) of the patients had multiple (more than two) risk behaviours. The prevalence of multiple risk behaviours did not significantly vary with sex, residence and educational level differences (P>0.05). CONCLUSION Cardiovascular disease patients continue to follow unhealthy lifestyles although they attend follow-up care with a specific focus on risk management. The findings of this study provide evidence for policy makers that health services reform is required to promote healthy lifestyle behaviours for the patients.
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Affiliation(s)
- Lemma B Negesa
- Adelaide Nursing School, The University of Adelaide, Australia.,College of Health and Medical Sciences, Haramaya University, Ethiopia
| | - Judy Magarey
- Adelaide Nursing School, The University of Adelaide, Australia
| | | | - Jeroen Ml Hendriks
- Centre for Heart Rhythm Disorders, Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Australia.,Department of Medical and Health Sciences, Linköping University, Sweden
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22
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Baudel H, De Nys H, Mpoudi Ngole E, Peeters M, Desclaux A. Understanding Ebola virus and other zoonotic transmission risks through human-bat contacts: Exploratory study on knowledge, attitudes and practices in Southern Cameroon. Zoonoses Public Health 2019; 66:288-295. [PMID: 30677236 PMCID: PMC7165775 DOI: 10.1111/zph.12563] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/12/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
The ecology of Ebola virus (EBV) remains largely unknown, but the previous detection of viral RNA and anti-EBV antibodies in African bats suggests that they might play a role in the EBV reservoir. Moreover, African bats also carry other potentially zoonotic agents such as Henipah-like viruses, coronaviruses and lyssaviruses. Today only little information is available on interactions between humans and bats. The objective of our exploratory study was to describe the extent and modes of contacts between humans and bats in southern Cameroon, considered as an area at risk for future EBV outbreaks. The survey was conducted in 11 villages of four distinct rural areas in southern Cameroon. A total of 135 respondents were interviewed using semi-structured questionnaires, between February and May 2017. The study showed that direct contacts between bats and humans are relatively common. Bat bushmeat appeared to be an occasional meat resource; 40% of respondents consume bats with a median annual consumption of three, and 28% of respondents hunt them. About 22% of the respondents reported children catching bats. Indirect contact also appeared to be common; 55% of hunters use caves as shelters and 67% of interviewees eat fruits previously chewed by bats. Bat consumption varied significantly between regions (from 0% to 87%) and between pygmies and bantus in the extreme south-east of Cameroon. The study revealed considerable diversity in practices among interviewees, most of them being subsistence cultivators and relying on self-hunted bushmeat. Geographical diversity of contacts and perceptions regarding bats in Cameroon emphasizes the need to adjust zoonotic pathogen surveillance and education campaigns to the specificities of the communities and their context of interaction with wildlife.
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Affiliation(s)
- Helene Baudel
- TransVIHMI, Institut de Recherche pour le Développement (IRD), University of Montpellier, INSERM, Montpellier, France
| | - Helene De Nys
- TransVIHMI, Institut de Recherche pour le Développement (IRD), University of Montpellier, INSERM, Montpellier, France
| | - Eitel Mpoudi Ngole
- Laboratoire de Virologie, CREMER, Institut de Recherches Médicales et d'Etudes des Plantes Médicinales (IMPM), Yaoundé, Cameroon
| | - Martine Peeters
- TransVIHMI, Institut de Recherche pour le Développement (IRD), University of Montpellier, INSERM, Montpellier, France
| | - Alice Desclaux
- TransVIHMI, Institut de Recherche pour le Développement (IRD), University of Montpellier, INSERM, Montpellier, France
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Odukoya OO, Sobande OO, Adeniran A, Adesokan A. Parental monitoring and substance use among youths: A survey of high school adolescents in Lagos State, Nigeria. Niger J Clin Pract 2018; 21:1468-1475. [PMID: 30417846 DOI: 10.4103/njcp.njcp_15_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Risk behaviours including marijuana use, alcohol consumption and cigarette smoking have a significant impact on the present and future health of adolescents. There are limited studies in sub-Saharan Africa to show evidence, if it exists, of the relationship between parental monitoring practices and the prevalence of substance use among adolescents. The aim of this study is to assess the relationship between parental monitoring practices and alcohol consumption, cigarette smoking and marijuana use among in-school adolescents in Mushin Local Government Area of Lagos State, South-Western Nigeria. Methods This was a cross-sectional survey of 437 in-school adolescents randomly selected from two schools in Mushin Local Government Area of Lagos State, Nigeria. Information on socio-demographic characteristics, the three domains of parental monitoring practices (Parental monitoring; negotiated unsupervised time and parental trust) and substance use were elicited using a modified version of parental monitoring practice scale and the Youth Risk Behaviour Surveillance System (YRBSS) questionnaire. Independent T tests and logistic regression models were used to assess relationship between parental monitoring practices and substance use. Results The overall prevalence of use of any of the substance was 21.7%. Negotiated unsupervised time was significantly associated with use of alcohol (P < 0.05), marijuana (P < 0.05) and cigarette smoking (P < 0.05). After controlling for age and gender, one unit increase in parental monitoring reduced the odds of engaging in any substance use by 10% (AOR = 0.90, 95% CI = 0.81-0.99) while a similar increase in negotiated unsupervised time significantly increases the odds of any substance use by 7% (AOR = 1.07, 95% CI = 1.01-1.14). Conclusion Of the three domains assessed, negotiated unsupervised time was consistently associated with substance use among these youth. Efforts to educate parents on the need to restrict unsupervised time of their wards may be warranted.
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Affiliation(s)
- O O Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos; Department of Community Health, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - O O Sobande
- Department of Community Health, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria
| | - A Adeniran
- Department of Community Health, College of Medicine, Lagos State University Teaching Hospital, Lagos State, Nigeria
| | - A Adesokan
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi Araba, Lagos State, Nigeria
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Newman PA, Guta A, Lacombe‐Duncan A, Tepjan S. Clinical exigencies, psychosocial realities: negotiating HIV pre-exposure prophylaxis beyond the cascade among gay, bisexual and other men who have sex with men in Canada. J Int AIDS Soc 2018; 21:e25211. [PMID: 30474351 PMCID: PMC6253066 DOI: 10.1002/jia2.25211] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Notwithstanding the efficacy of oral pre-exposure prophylaxis (PrEP) in clinical trials, a number of obstacles exist to achieving population-level impact among gay, bisexual and other men who have sex with men (GBM). However, few studies have explored the subjective experiences of GBM PrEP users and non-users in the community, outside of clinical trials. The objectives of this study were to explore GBM's experiences of considering, accessing and using (or not using) PrEP, and to understand emerging sexual health, social and community issues among GBM in the PrEP era. METHODS From October 2015 to March 2016, we purposively sampled PrEP-naïve and PrEP-experienced GBM from community organizations and health centres in Toronto, Canada. In-depth, 45- to 90-minute semi-structured interviews explored PrEP perspectives and decision-making, access, initiation, use over time, sexual practices and psychosocial considerations. Interviews were recorded, transcribed verbatim, uploaded into NVIVO, reviewed using thematic analysis and then contrasted with the PrEP cascade. RESULTS Participants included PrEP users (n = 15) and non-users (n = 14) (mean age = 36.7 years; SD = 8.2), largely gay-identified (86.2%), cisgender male (89.7%) and white (79.3%). Themes indicate not only correspondences, but also limitations of the PrEP cascade by complicating a user/non-user binary and challenging the unilateral presupposition that HIV risk perception leads to PrEP acceptance. Findings further call into question assumptions of a linear stage progression and retention in care as a universal endpoint, instead revealing alternate trajectories of seasonal or intermittent PrEP use and, for some, an end goal of terminating PrEP. GBM's narratives also revealed potent psychological/affective experiences of untethering sex from HIV anxiety; multifaceted PrEP stigma; and challenges to sexual norms and practices that complicate existing behavioural prevention strategies and sexual and social relationships. CONCLUSIONS An expanded PrEP cascade should consider alternate trajectories of use based on dynamic relationships and behavioural risks that may call for seasonal or intermittent use; systemic barriers in access to and sustaining PrEP; and multiple end goals including PrEP maintenance and discontinuation. Incorporating GBM's lived experiences, evolving preferences, and psychosocial and community-level challenges into PrEP implementation models, rather than a circumscribed biomedical approach, may more effectively support HIV prevention and GBM's broader sexual and psychological health.
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Affiliation(s)
- Peter A Newman
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoONCanada
| | - Adrian Guta
- School of Social WorkUniversity of WindsorWindsorONCanada
| | - Ashley Lacombe‐Duncan
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoONCanada
- School of Social WorkUniversity of MichiganAnn ArborMIUSA
| | - Suchon Tepjan
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoTorontoONCanada
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Demissie M, Johnston LG, Muleta M, Desyebelew D, Belete W, G/Egxiabehre A, Gezahegn N, Kassa D, Aseffa Y. Prevalence of HIV and other infections and injection behaviours among people who inject drugs in Addis Ababa, Ethiopia. Afr J AIDS Res 2018; 17:259-264. [PMID: 30319040 DOI: 10.2989/16085906.2018.1511604] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ethiopia is one of the sub-Saharan African countries most affected by HIV/AIDS. However, the country lacks data describing the extent of the epidemic among people who inject drugs (PWID). Thus, a bio-behavioural study was conducted in 2015 to generate strategic information on the magnitude of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), syphilis and related risk behaviours among PWID in Addis Ababa. METHODS A cross-sectional study using respondent-driven sampling was conducted among people reported to have injected illicit drugs within 6 months before the study. Males and females aged 15 years or above and who were resident in Addis Ababa were included in the study between 26 March and 22 May 2015. Data was analysed using respondent-driven (RDS) Analyst software. RESULTS A total of 237 participants, including 6 seeds, enrolled in the study; most of the PWID were males (96%) with a mean age of 26 years. Most (79%) of the PWID reported injecting heroin but also reported using non-injecting drugs, including marijuana or ganja (47%) and/or khat (31%). Forty per cent of PWID reported ever sharing needles and 56% reported sharing other injecting equipment. However, only 14% reported injecting daily, and 49% reported injecting only 1 to 3 times a month. HIV prevalence was 6%, HBV was 5.1%, HCV was 2.9% and syphilis 5.1% among PWID. Among HIV-positive PWID, 60% reported sharing a needle the last time they injected. CONCLUSION Even though the prevalence of HIV among drug users is not much higher than in the general population in Addis Ababa, the needle sharing prevalence was high. Thus, this baseline study shows the need to establish harm reduction programmes and prevention strategies for the PWID in Addis Ababa.
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Affiliation(s)
| | - Lisa G Johnston
- b United Nations Office on Drug and Crime , Washington , DC , USA
| | - Mekonnen Muleta
- b United Nations Office on Drug and Crime , Washington , DC , USA
| | - Dires Desyebelew
- b United Nations Office on Drug and Crime , Washington , DC , USA
| | - Wudinesh Belete
- a Ethiopian Public Health Institute , Addis Ababa , Ethiopia
| | | | | | - Desta Kassa
- a Ethiopian Public Health Institute , Addis Ababa , Ethiopia
| | - Yibeltal Aseffa
- a Ethiopian Public Health Institute , Addis Ababa , Ethiopia
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McKetin R, Lubman DI, Baker A, Dawe S, Ross J, Mattick RP, Degenhardt L. The relationship between methamphetamine use and heterosexual behaviour: evidence from a prospective longitudinal study. Addiction 2018; 113:1276-1285. [PMID: 29397001 DOI: 10.1111/add.14181] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/15/2017] [Accepted: 01/26/2018] [Indexed: 11/26/2022]
Abstract
AIMS To estimate the extent to which specific sexual behaviours (being sexually active, having multiple sex partners, casual sex, condomless casual sex, anal sex and condomless anal sex) change during periods of methamphetamine use. DESIGN Within-person estimates for the relationship between methamphetamine use and sexual behaviour were derived from longitudinal panel data from the Methamphetamine Treatment Evaluation Study (MATES) cohort (2006-10). SETTING Sydney and Brisbane, Australia. PARTICIPANTS Participants (n = 319) were recruited through treatment and other health services, self-identified as heterosexual, were aged 17-51 years, 74% were male and all were dependent on methamphetamine on study entry. MEASUREMENTS Days of methamphetamine use in the past month and sexual behaviour in the past month were both assessed using the Opiate Treatment Index. FINDINGS When using methamphetamine, participants had double the odds of being sexually active compared with when they were not using, after adjustment for demographics and other substance use [adjusted odds ratio (aOR) = 1.9, P = 0.010]. When participants were sexually active, they were more likely to have multiple sex partners (aOR = 3.3, P = 0.001), casual sex partners (aOR = 3.9, P < 0.001) and condomless casual sex (aOR = 2.6, P = 0.012) when using methamphetamine than when they were not using. During months when participants had a casual sex partner, there was no significant reduction in their likelihood of condom use when they were using methamphetamine. There was no significant change in the likelihood of having anal sex or condomless anal sex during months of methamphetamine use. CONCLUSIONS Methamphetamine use is associated with an increase in being sexually active, having multiple sex partners and casual sex partners and having condomless sex with casual partners, but it is not associated with a change in condom use per se.
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Affiliation(s)
- Rebecca McKetin
- National Drug Research institute, Curtin University, Perth, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Dan I Lubman
- Turning Point, Eastern Health and Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Amanda Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Sharon Dawe
- School of Psychology, Griffith University, Brisbane, Australia
| | - Joanne Ross
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Nguyen HH, Bui DD, Dinh TTT, Pham LQ, Nguyen VTT, Tran TH, Pham TH, Nguyen SM, Suthar AB, Do NT, Ford N, Lo Y, Nguyen LH, Giang LM, Kato M. A prospective "test-and-treat" demonstration project among people who inject drugs in Vietnam. J Int AIDS Soc 2018; 21:e25151. [PMID: 29984473 PMCID: PMC6036396 DOI: 10.1002/jia2.25151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/15/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Modelling suggests that early diagnosis and immediate antiretroviral therapy (ART) among key populations would have a substantial impact in reducing HIV transmission and mortality in Vietnam. An implementation research project of "test-and-treat" among people who inject drugs (PWID) was developed to inform effective roll-out of such interventions. METHODS "Test-and-treat" was offered to PWID in two high burden provinces, Thai Nguyen and Thanh Hoa. The interventions comprised the offer of biannual HIV testing and immediate ART, irrespective of CD4 count. PWID were enrolled between April 2014 and July 2015 and followed up for 12 months, and retention, HIV viral load (VL) and risk behaviours were assessed. Retention in care of this prospective cohort was compared with the retention among men enrolled in care in the preceding period (April 2012 to March 2013) at the same clinics when ART was initiated at CD4 cell count ≤350 cells/mm3 . RESULTS In total, 287 HIV positive PWID started immediate ART. The majority (98%) were men; median age was 34; and median (interquartile range) CD4 count was 199 (50 to 402) cells/mm3 . After 12 months, 238 participants (83%) were retained on ART, and 205 achieved viral suppression (<1000 copies/mL) (92% among those in whom VL was measured, 71% overall). Baseline CD4 count ≤100 cells/mm3 and history of imprisonment were associated with lower retention and viral suppression, while engagement in methadone maintenance was associated with higher retention. Retention in care was higher in the "test-and-treat" cohort (83%) compared with men enrolled in care in the preceding period (78%), primarily because lost-to-follow-up during pre-ART care was eliminated. No decline in consistent condom use and clean needle use was observed. CONCLUSIONS Early ART initiation resulted in successful treatment outcomes among PWID, with no observed increase in self-reported risk behaviours, suggesting feasibility and potential effectiveness of "test-and-treat" approach. The results also call for differentiated care for PWID, including promoting early diagnosis and engagement in methadone maintenance therapy while enhancing care for those with advanced HIV disease and history of imprisonment.
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Affiliation(s)
- Hai H Nguyen
- Viet Nam Authority of HIV/AIDS ControlMinistry of HealthHanoiVietnam
| | - Duong D Bui
- Viet Nam Authority of HIV/AIDS ControlMinistry of HealthHanoiVietnam
| | | | | | - Van TT Nguyen
- Vietnam Country OfficeWorld Health OrganizationHanoiVietnam
| | - Tram H Tran
- National Institute of Hygiene and EpidemiologyHanoiVietnam
| | - Thang H Pham
- National Institute of Hygiene and EpidemiologyHanoiVietnam
| | | | | | - Nhan T Do
- Viet Nam Authority of HIV/AIDS ControlMinistry of HealthHanoiVietnam
| | - Nathan Ford
- HIV DepartmentWorld Health OrganizationGenevaSwitzerland
| | - Ying‐Ru Lo
- Regional Office for the Western PacificWorld Health OrganizationManilaPhilippines
| | - Long Hoang Nguyen
- Viet Nam Authority of HIV/AIDS ControlMinistry of HealthHanoiVietnam
| | | | - Masaya Kato
- Vietnam Country OfficeWorld Health OrganizationHanoiVietnam
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McIntosh C, Trenholme A, Stewart J, Vogel A. Evaluation of a sudden unexpected death in infancy intervention programme aimed at improving parental awareness of risk factors and protective infant care practices. J Paediatr Child Health 2018; 54:377-382. [PMID: 29125216 DOI: 10.1111/jpc.13772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 08/23/2017] [Accepted: 09/03/2017] [Indexed: 11/29/2022]
Abstract
AIM Sudden unexpected death in infancy (SUDI) rates for Māori and Pacific infants remain higher than for other ethnic groups in New Zealand and bed-sharing is a major risk factor when there is smoking exposure in pregnancy. Sleep space programmes of education and Pēpi-Pod baby beds require evaluation. METHODS Two hundred and forty Māori and Pacific women and infants were randomised 1:1, to the Pēpi-Pod sleep space programme, or to a control group with 'usual care'. When infants were under 2 weeks of age, baseline interviews occurred, followed up by interviews at 2 and 4 months of age to assess safe sleep knowledge, infant care practices and Pēpi-Pod use and acceptability. All participants were offered a New Zealand Standard approved portable cot. RESULTS At baseline, 25% of babies did not have a baby bed. Knowledge of smoking and bed-sharing as SUDI risks improved at follow-up in both groups. One quarter regularly bed-shared at follow-up in both groups. Intention to bed-share was a strong predictor of subsequent behaviour. Pēpi-Pods were regularly used by 46% at 2 months and 16% at 4 months follow-up. CONCLUSIONS Bed-sharing and knowledge improvement were similar irrespective of group. It is likely that the impact of the intervention was reduced because the control group received better support than 'usual care' and all participants had a baby bed. New Zealand SUDI rates have declined since sleep space programmes have been available. Sleep space programmes should be prioritised for those with modifiable SUDI risk.
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Affiliation(s)
- Christine McIntosh
- Primary Health and Community Services, Counties Manukau Health, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand
| | - Adrian Trenholme
- Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.,Department of Paediatrics, Counites Manukau Health, Auckland, New Zealand
| | | | - Alison Vogel
- Department of Paediatrics, Counites Manukau Health, Auckland, New Zealand
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Rotermann M, Macdonald R. Analysis of trends in the prevalence of cannabis use in Canada, 1985 to 2015. Health Rep 2018; 29:10-20. [PMID: 29465739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Canadian federal government has committed to legalize, regulate, and restrict non-medical cannabis use by adults in 2018. To prepare for monitoring the health, social and economic impacts of this policy change, a greater understanding of the long-term trends in the prevalence of cannabis use in Canada is needed. DATA AND METHODS Nine national surveys of the household population collected information about cannabis use during the period from 1985 through 2015. These surveys are examined for comparability. The data are used to estimate past-year (current) cannabis use (total, and by sex and age). Based on the most comparable data, trends in use from 2004 through 2015 are estimated. RESULTS From 1985 through 2015, past-year cannabis use increased overall. Analysis of comparable data from the Canadian Tobacco Use Monitoring Survey and the Canadian Tobacco, Alcohol and Drugs Survey for the 2004-to-2015 period suggests that use was stable among 15- to 17-year-old males, decreased among 15- to 17-year-old females and among 18- to 24-year-olds (both sexes), and increased among people aged 25 or older. DISCUSSION According to data from national population surveys, since 2004, cannabis use was stable or decreased among youth, and rose among adults. Results highlight the importance of consistent monitoring of use in the pre-and post-legalization periods.
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Affiliation(s)
| | - Ryan Macdonald
- Economic Analysis Division, Statistics Canada, Ottawa, Ontario
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Tchernev G, Pidakev I, Chokoeva AA, Wollina U, Lotti T, Maximov GK, Lozev I. Advanced Pretibial Melanoma (APM): Clinicians Behaviour As Triggering Factor? Open Access Maced J Med Sci 2017; 6:64-66. [PMID: 29483985 PMCID: PMC5816319 DOI: 10.3889/oamjms.2018.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/02/2017] [Accepted: 08/21/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND: Pigmented lesions represent a broad spectrum of clinical conditions, both benign and malignant. The precise diagnosis is often a challenge, while the clinical diagnostic criteria could be misleading, as a result of the frequently atypical presentation of otherwise completely benign in nature lesions. The variety of therapeutic options for benign pigmented lesions including shave curettage, local laser destruction, electrocoagulation removal could sound enticingly both for the physician and patient, but they destroy the possibility for histological examination and provide a deceptively feeling of calm, that the problem is solved. If there is even a minimum chance for misdiagnosis, the risk could be a human life. Furthermore, a simple surgical excision could provide total resolution of the problem, with correct histological verification and further therapeutic measurements, if needed. CASE REPORT: We present a case of a patient, with advanced pretibial melanoma with multiple lung metastases, misdiagnosed as a seborrheic keratosis, treated with shave-curettage 6 months earlier, as we want to emphasize the importance of the correct therapeutic method in all cases with pigmented lesions with unknown origin, in order to minimize the risk of dramatic consequences of misdiagnosis of melanoma. So, we want to ask you- is this risk justified? CONCLUSION: So, we want to ask you - is this risk justified?
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Affiliation(s)
- Georgi Tchernev
- "Onkoderma"- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.,Medical Institute of Ministry of Interior (MVR-Sofia), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606 Sofia, Bulgaria
| | - Ivan Pidakev
- Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia, Bulgaria
| | | | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
| | | | | | - Ilia Lozev
- Medical Institute of Ministry of Interior, Department of General, Vascular and Abdominal Surgery, General Skobelev 79, 1606 Sofia, Bulgaria
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Ramji R, Arnetz BB, Nilsson M, Wiklund Y, Jamil H, Maziak W, Arnetz J. Waterpipe use in adolescents in Northern Sweden: Association with mental well-being and risk and health behaviours. Scand J Public Health 2017; 46:867-876. [PMID: 29226800 DOI: 10.1177/1403494817746534] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS There is a lack of studies examining the association between waterpipe smoking and mental well-being among adolescents. This study sought to determine whether waterpipe smoking is associated with mental well-being and other risk and health behaviours in adolescents. METHODS A questionnaire was distributed to 1006 adolescents in grades 9-12 (with a response rate of >95%), containing questions on measures of stress, mental energy and sleep. In addition, the questionnaire assessed risk and health behaviours, including use of a waterpipe, cigarettes, e-cigarettes, snus, alcohol, narcotics, gambling and exercise. Logistic regression was used to assess factors associated with waterpipe use. RESULTS Thirty-seven per cent ( n=371) of the participants had used a waterpipe at some point. Waterpipe use was associated with lower mental energy (odds ratio [OR] = 0.90, 95% confidence interval [CI] 0.81-0.99), higher stress (OR = 1.10, 95% CI 1.02-1.20) and use of cigarettes (OR = 3.82, 95% CI 2.33-6.03), e-cigarettes (OR = 3.26, 95% CI 2.12-4.99), snus (OR = 2.29, 95% CI 2.12-4.99), alcohol (OR = 1.92, 95% CI 1.07-3.44) and narcotics (OR = 3.64, 95% CI 1.75-7.58). Waterpipe use was not significantly associated with gambling, exercise or sleep quality. CONCLUSIONS Waterpipe use in adolescents is associated with worse mental well-being, as well as use of other nicotine products, alcohol and narcotics. Prospective studies are needed to delineate causal and temporal relationships further between waterpipe use and mental well-being and its relationship to other risky behaviours in order to design effective prevention programs.
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Affiliation(s)
- Rathi Ramji
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Bengt B Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Maria Nilsson
- 2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,4 Västerbotten County Council, Sweden
| | | | - Hikmet Jamil
- 3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
| | - Wasim Maziak
- 5 Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Judy Arnetz
- 1 Department of Public Health and Caring Sciences, Uppsala University, Sweden.,2 Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health, Umeå University, Sweden.,3 Department of Family Medicine, College of Human Medicine, Michigan State University, USA
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Abstract
OBJECTIVES Adolescent risk behaviours are a key health concern. The purpose of this research is to gaina deeper understanding of how, why, for whom, and inwhat circumstances complex adolescent risk behaviourprevention programmes are most successful. METHODS AND ANALYSIS To understand how adolescent risk behaviour prevention programmes work in a reallife context, a realist synthesis will be undertaken, operationalised in four phases. Phase one Developing a framework to map the theoretical and conceptual landscape of adolescent risk behaviour prevention. Guided by stakeholder consultation. Phase two Formulating initial programme theories through exploration of the literature, along with primary data from professional stakeholder interviews. Phase three Refining programme theories through more purposeful, in depth screening of the literature, along with primary qualitative data, from young people and professionals. Data will be collected through semi structured focus groups, to explore specific elements of the emerging programme theories. Phase four Testing programme theories through interviews with youth workers, following consultation with young people, using vignettes to explore the relationship between specific programme theories. This relatively novel method of primary and secondary data integration within a realist synthesis will provide deeper insight in to young peoples lived experience of risk behaviour prevention programmes, while maintaining transparency in the process of programme theory development. DATA ANALYSIS A realist logic of analysis will be used to align data from each phase with context mechanism outcome configurations or specific elements thereof. Substantive theory will then be sought to understand and explain the findings. ETHICS AND DISSEMINATION This study has been approved by the Ethics committee at Northumbria University, UK. Findings will be disseminated through knowledge exchange with stakeholders, publications in peer-reviewed journals, conference presentations, and formal and informal reports.
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Affiliation(s)
- Christina Cooper
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Monique Lhussier
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Janet Shucksmith
- Institute of Health and Social Care, University of Teesside, Middlesbrough, UK
| | - Susan Mary Carr
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Tjagur S, Mändar R, Punab M. Prevalence of Mycoplasma genitalium and other sexually transmitted infections causing urethritis among high-risk heterosexual male patients in Estonia. Infect Dis (Lond) 2017; 50:133-139. [PMID: 28868962 DOI: 10.1080/23744235.2017.1366044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND We aimed to evaluate the prevalence of sexually transmitted infections (STI, including Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis) among high-risk heterosexual male patients and to clarify their potency to cause complaints and inflammation. METHODS The study group included 825 men (18.0-49.5 y) consulting andrologist at Tartu University Hospital (Estonia) due to subjectively perceived risk of STI. Patients completed STI risk behaviour questionnaire. First voided urine was analysed for white blood cells and STIs. RESULTS In total 193 (23.4%) patients were positive for one or multiple STI. The prevalence of C. trachomatis, M. genitalium, N. gonorrhoeae, T. vaginalis and combined STI was 14.3%, 4.4%, 2.7%, 0.7% and 1.3%, respectively. N. gonorrhoeae had the highest potency to generate inflammatory reaction in first voided urine (100%) followed by C. trachomatis (72.0%), M. genitalium (63.9%) and T. vaginalis (33.3%). N. gonorrhoeae and T. vaginalis caused the highest mean number of complaints while half of T. vaginalis cases and nearly fifth of M. genitalium and C. trachomatis cases were asymptomatic. CONCLUSIONS C. trachomatis has the highest prevalence among Estonian high-risk men but M. genitalium holds an important second place. Prevalence of combined STIs is low. N. gonorrhoeae has the highest potency to generate urethral inflammation followed by C. trachomatis and M. genitalium. The highest number of complaints is also associated with N. gonorrhoeae while half of T. vaginalis cases and nearly a fifth of M. genitalium and C. trachomatis cases are asymptomatic.
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Affiliation(s)
- Stanislav Tjagur
- a Tartu University Hospital, Centre of Andrology , Tartu , Estonia.,b Faculty of Medicine , University of Tartu , Tartu , Estonia
| | - Reet Mändar
- c Department of Microbiology, Faculty of Medicine , University of Tartu, Institute of Biomedicine and Translational Medicine , Tartu , Estonia.,d Competence Centre on Health Technologies , Tartu , Estonia
| | - Margus Punab
- a Tartu University Hospital, Centre of Andrology , Tartu , Estonia.,e Department of Surgery, Faculty of Medicine , University of Tartu, Institute of Clinical Medicine , Tartu , Estonia
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Abstract
AIMS Previous studies indicate that young people who have positive attitudes towards illicit drugs are more inclined to experiment with them. The first aim of our study was to identify the sociodemographic and risk behaviour characteristics of young people (16-24 years) with positive attitudes towards illicit drug use. The second aim was to identify the characteristics of young people with positive attitudes towards illicit drugs among those who had never tried drugs, those who had tried cannabis but no other illicit drugs, and those who regularly used cannabis and/or had tried other illicit drugs. METHODS The analysis was based on a population-based survey from 2013 ( N = 3812). Multiple logistic regression was used to analyse the association between sociodemographic and risk behaviour characteristics and positive attitudes towards illicit drugs. RESULTS Young men had twice the odds of having positive attitudes towards illicit drug use compared with young women (AOR = 2.1). Also, young age, being single, being employed, smoking tobacco, practising unprotected sex, and experimental cannabis use were associated with positive attitudes towards illicit drug use. Finally, use of cannabis at least 10 times during the previous year and/or use of other illicit drugs had the strongest association with positive attitudes to illicit drug use (AOR = 6.0). CONCLUSIONS Young people who have positive attitudes towards illicit drug use are characterized by a broad range of risky behaviours. These findings may help to identify young people at risk of initiating illicit drug use and thereby support the development and implementation of prevention programmes.
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Affiliation(s)
- Karina Friis
- 1 DEFACTUM, Public Health & Health Services Research, Central Denmark Region, Denmark
| | | | - Sidsel Reese
- 1 DEFACTUM, Public Health & Health Services Research, Central Denmark Region, Denmark.,3 Department of Political Science, Aarhus University, Denmark
| | - Mathias Lasgaard
- 1 DEFACTUM, Public Health & Health Services Research, Central Denmark Region, Denmark.,4 Department of Psychology, University of Southern Denmark, Denmark
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Parker RD, Rüütel K. Sexually Transmitted Infections - Prevalence, Knowledge and Behaviours among Professional Defence Forces in Estonia: a Pilot Study. Cent Eur J Public Health 2017; 25:11-14. [PMID: 28399349 DOI: 10.21101/cejph.a4498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/26/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Our study assessed sexually transmitted infections (STI) occurrence and risk behaviours from a sample of the defence forces of Estonia. Previous research on military personnel yields various results on the prevalence of STIs and high risk behaviours. The increasing recognition of high risk behaviours among military personnel is evident given increased programmes that focus on education of drug use and risky sexual behaviours. Many militaries conduct routine, periodic screening for diseases such as HIV and viral hepatitis at entry and pre-foreign deployment. Protecting deployed forces from secondary infections is important as persons with chronic viral infections are living longer, healthier lives and are more frequently serving in military forces. METHODS A cross sectional study used convenient sampling among professional defence forces. Participation was both voluntary and anonymous. RESULTS Of 186 participants accounting for 7.3% of all forces (86.6% male, mean age 30 years) at selected bases, there were four cases of chlamydia. No cases of gonorrhea, trichomoniasis, hepatitis C, hepatitis B, or HIV were found. One person reported ever injecting drugs. CONCLUSIONS These findings indicate a lower STI occurrence among professional defence forces in Estonia compared with the non-military population. While these rates were lower than expected, as a voluntary study, people suspicious of having an STI might opt not to participate, limiting generalizability to the remainder of the military. Militaries without regular screening programmes could consider regular scheduled testing for STIs, HIV and blood borne pathogens, even if voluntary, especially prior to foreign deployment. Consistent testing would align across many militaries who deploy international peace keepers.
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Affiliation(s)
- R. David Parker
- School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Kristi Rüütel
- Infectious Diseases and Drug Abuse Prevention Department, Estonian National Institute for Health Development, Tallinn, Estonia
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Gould GS, Bovill M, Chiu S, Bonevski B, Oldmeadow C. Exploring an adapted Risk Behaviour Diagnosis Scale among Indigenous Australian women who had experiences of smoking during pregnancy: a cross-sectional survey in regional New South Wales, Australia. BMJ Open 2017; 7:e015054. [PMID: 28566365 PMCID: PMC5729996 DOI: 10.1136/bmjopen-2016-015054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Explore Aboriginal women's responses to an adapted Risk Behaviour Diagnosis (RBD) Scale about smoking in pregnancy. METHODS AND DESIGN An Aboriginal researcher interviewed women and completed a cross-sectional survey including 20 Likert scales. SETTING Aboriginal Community Controlled Health Services, community groups and playgroups and Aboriginal Maternity Services in regional New South Wales, Australia. PARTICIPANTS Aboriginal women (n=20) who were pregnant or gave birth in the preceding 18 months; included if they had experiences of smoking or quitting during pregnancy. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes: RBD constructs of perceived threat and perceived efficacy, dichotomised into high versus low. Women who had quit smoking, answered retrospectively. SECONDARY OUTCOME MEASURES smoking status, intentions to quit smoking (danger control), protection responses (to babies/others) and fear control responses (denial/refutation). Scales were assessed for internal consistency. A chart plotted responses from low to high efficacy and low to high threat. RESULTS RBD Scales had moderate-to-good consistency (0.67-0.89 Cronbach's alpha). Nine women had quit and 11 were smoking; 6 currently pregnant and 14 recently pregnant. Mean efficacy level 3.9 (SD=0.7); mean threat 4.3 (SD=0.7). On inspection, a scatter plot revealed a cluster of 12 women in the high efficacy-high threat quadrant-of these 11 had quit or had a high intention of quitting. Conversely, a group with low threat-low efficacy (5 women) were all smokers and had high fear control responses: of these, 4 had low protection responses. Pregnant women had a non-significant trend for higher threat and lower efficacy, than those previously pregnant. CONCLUSION Findings were consistent with a previously validated RBD Scale showing Aboriginal smokers with high efficacy-high threat had greater intentions to quit smoking. The RBD Scale could have diagnostic potential to tailor health messages. Longitudinal research required with a larger sample to explore associations with the RBD Scale and quitting.
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Affiliation(s)
- Gillian Sandra Gould
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Michelle Bovill
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Simon Chiu
- Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, 1/1 Kookaburra Circuit, New South Wales, Australia
| | - Billie Bonevski
- Centre for Brain and Mental Health Research, School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Christopher Oldmeadow
- Clinical Research Design, Information Technology and Statistical Support, Hunter Medical Research Institute, 1/1 Kookaburra Circuit, New South Wales, Australia
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Kohli A, Remy MM, Binkurhorhwa AK, Mitima CM, Mirindi AB, Mwinja NB, Banyewesize JH, Ntakwinja GM, Perrin NA, Glass N. Preventing risky behaviours among young adolescents in eastern Democratic Republic of Congo: A qualitative study. Glob Public Health 2017; 13:1241-1253. [PMID: 28443367 DOI: 10.1080/17441692.2017.1317009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This qualitative study explores and describes adolescent risk behaviours, specifically consumption of alcohol and use of violence; the perceived consequences of these behaviours on future well-being and relationships; and collaboratively identifies the essential components of a prevention intervention for risk behaviours (alcohol use, violence) among young adolescents while strengthening the protective individual and relationship factors in post-conflict Democratic Republic of Congo. One-on-one in-depth interviews were conducted with 28 male and female youth, 20 parents/guardians and 20 stakeholders in three rural villages of South Kivu Province. Trained interviewers conducted interviews and participated in daily debriefing. Descriptive qualitative analysis was used to analyse the data. Youth use of violence and alcohol was associated with a range of factors including peer influence, parent behaviours, school enrolment and poverty. The consequences of risk behaviour include damaged family and social bonds, reduced economic and educational productivity and promise. Community-based, multilevel prevention interventions that promote protective factors and reduce youth exposure and vulnerability to risk factors may have immediate and long-term impact on youth health and behaviour. Such a programme could engage youth, adults and local stakeholders in a range of social, educational and economic activities.
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Affiliation(s)
- Anjalee Kohli
- a Johns Hopkins University School of Nursing , Baltimore , MD , USA
| | - Mitima Mpanano Remy
- b Programme d'Appui aux Initiatives Economiques (PAIDEK) , Bukavu , Democratic Republic of Congo
| | | | | | | | | | | | | | | | - Nancy Glass
- a Johns Hopkins University School of Nursing , Baltimore , MD , USA
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Zedini C, Sahli J, El Ghardallou M, Mellouli M, Limam M, Bouhlel S, Mtiraoui A, Nabli Ajmi T. [Prevalence and associated factors of alcohol consumption among students of the Sousse region of Tunisia]. Sante Publique 2017; 29:255-262. [PMID: 28737344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Aim: This study was designed to assess the prevalence of alcohol consumption and factors associated with alcohol consumption among students of the Sousse region of Tunisia. Methods: This was a cross-sectional study conducted among 556 students of Sousse universities during the 2012-2013 academic year, using an anonymous self-report questionnaire. Data capture and statistical analysis were performed with SPSS software 18.0. Results: Our study population was composed of 268 males (48.2%) with a mean age of 21.8 ± 2.1 years. Eighty-four students (15.1%) had consumed alcohol at least once. On multivariate analysis, male gender (OR = 6.94; 95%CI = [2.32-20.72]), smoking (OR = 13.21; 95%CI = [6.20-27.78]), drug use (OR = 32.22; 95%CI = [6.73-154.26]) and parental alcohol consumption (OR = 4.31; 95%CI = [1.70-10.91]) were the factors significantly associated with alcohol consumption among students. Conclusion: This study was designed to determine the characteristics of alcohol consumption among Tunisian students. Alcohol consumption levels were comparable to those reported in the general population and were significantly related to smoking and drug use. The next step of this study will consist of developing strategies to prevent risk behaviours in the student population.
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Harakeh Z. Experimental study designs examining social context and smoking: scientific challenges and considerations. Addiction 2017; 112:398-399. [PMID: 27915464 DOI: 10.1111/add.13666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/12/2016] [Accepted: 10/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Zeena Harakeh
- Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
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Trick S, Jantzer V, Haffner J, Parzer P, Resch F. [Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample]. Prax Kinderpsychol Kinderpsychiatr 2016; 65:592-608. [PMID: 27686987 DOI: 10.13109/prkk.2016.65.8.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Parental Monitoring and its Relation to Behaviour Problems and Risk Behaviour in an Adolescent School Sample Numerous research studies emphasize parental monitoring as a protective factor for adolescent problem behaviour. The purpose of the study presented was to use Stattin and Kerr's (2000) monitoring subscales for the first time in a German-speaking area and to explore the relations to behaviour problems in an adolescent school sample. The two active monitoring strategies "parental control" and "parental solicitation" as well as "parental knowledge" and "child disclosure" relating to behaviour problems and risk behaviour were examined. A sample of 494 pupils, grades 5, 7 and 9, of German secondary schools and their parents answered questions on "parental knowledge", "control", "solicitation" and "child disclosure". Adolescents also answered the German version of the Strengths and Difficulties Questionnaire (SDQ) and items about risk behaviour like frequency of violence, delinquency, substance abuse, self-injuring behaviour and school absenteeism. Behaviour problems in terms of the SDQ could be predicted sufficiently by "parental knowledge", but for the prediction of risk behaviour, the active parental monitoring strategies were of importance, too. More "parental knowledge", more "control" and less "solicitation" could predict less risk behaviour. Results confirm "parental knowledge" as a general protective factor for problem behaviour. However, they show the importance of "parental control" for adolescent risk behaviour.
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Abstract
The aim of the research on which this article is based was to understand the behavioural changes of the target student population over time to ensure that future prevention programmes are more effective in changing behaviour. This study reports on quantitative data collected at the University of the Western Cape over a six-year period between 2007 and 2012. All the students attending the orientation sessions and who were willing to complete the anonymous questionnaire during each of the six years were included in the study. Data were collected on the following aspects and subjects: sexual activity, age at first sexual encounter, number of sexual partners, condom usage, knowledge of how to use a condom, perceived ability to discuss condoms usage with a sexual partner, perception of HIV risk and HIV testing as well as the intention to be tested. Reported alcohol and drug usage, as well as depressive symptoms, was also recorded. The percentage of students reporting having had vaginal sex prior to entering university increased from 44% in 2007 to 51% in 2012 but, alarmingly, the consistent use of condoms decreased from 60% in 2007 to 51% in 2012. The average onset age of about 15.6 years for males and 16.7 years for females for vaginal sex did not change over the six-year period. No difference in smoking patterns or drug use was seen over the period of the study, but the number of entering students who indicated that they consumed alcohol increased significantly from 48% in 2007 to 58% in 2012. HIV testing increased from 19% in 2007 to 47% in 2012, whereas the intention to be tested showed no significant change over the period. Although students increasingly reported that they knew enough about HIV/AIDS (63% in 2007 and 69% in 2012), about a third reported suffering from AIDS fatigue. Prevention efforts targeted at those incoming first-year students who are not yet sexually active (about 45% in this study) should be developed and should take into account the multiplicity of factors that appear to influence their sexual debut.
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Affiliation(s)
- Rénette J Blignaut
- a PhD, is a Professor at the Department of Statistics and Population Studies , UWC , Bellville , South Africa
| | - Joachim Jacobs
- b MA, is a Director of HIV & AIDS Programme, UWC , Bellville , South Africa
| | - Tania Vergnani
- c PhD, is a Retired Director of HIV and AIDS Programme, c/o HIV & AIDS Programme, UWC , Private Bag X17, Bellville , South Africa
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Lund I, Scheffels J. Adolescent tobacco use practices and user profiles in a mature Swedish moist snuff (snus) market: Results from a school-based cross-sectional study. Scand J Public Health 2016; 44:646-653. [PMID: 27340188 DOI: 10.1177/1403494816656093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The aim of this work was to study the diversity of tobacco use among Norwegian adolescent tobacco users and to investigate how different user groups compared with each other in terms of lifestyle and risk correlates. Swedish moist snuff (snus) use has increased dramatically in Norway over the last few years and is now more prevalent than smoking in younger age groups. METHODS The participants were 736 15-year-old tobacco users obtained from a large school-based cross-sectional survey (response rate 73%). Leisure time activity and risk behaviour factors were extracted by principal components analysis. Associations between tobacco use, leisure activities, risk behaviours, alcohol use and sex were studied bivariately and by logistic regression. RESULTS In total, 41.5% of the tobacco users were dual users (smokers and snus users). Problem behaviour and risk-taking lifestyles were associated with tobacco use frequency and high-frequency dual use, with a low risk profile for all types of occasional users (snus, cigarettes or dual users), a medium risk profile for all types of daily single-product users, including those who occasionally used the other product (i.e. dual users) and a high-risk profile for those who used both products daily (daily dual users). CONCLUSIONS Fragmented use patterns in adolescence undermine the dichotomy often applied between smokers and snus users. For associations with lifestyle and risk correlates, use frequency and high-frequency dual use seem to be more important than the choice of product.
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Affiliation(s)
- Ingeborg Lund
- Department of Drug Policy, Norwegian Institute of Public Health, Norway
| | - Janne Scheffels
- Department of Drug Policy, Norwegian Institute of Public Health, Norway
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Ip P, Chan KL, Chow CB, Lam TH, Ho SY, Wong WHS, Wong MFY. An Internet-Based Intervention to Promote Alcohol-Related Attitudinal and Behavioral Change Among Adolescents: Protocol of a Cluster Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e103. [PMID: 27252072 PMCID: PMC4909980 DOI: 10.2196/resprot.5001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/14/2015] [Accepted: 01/03/2016] [Indexed: 11/29/2022] Open
Abstract
Background Underage drinking is a prevalent risk behavior and common public health problem. Research shows that alcohol abuse not only affects the quality of life of drinkers themselves. The problems resulting from underage drinking pose substantial costs to society as well. The proposed study will address underage drinking with the use of an Internet campaign, which is a cost-effective way of tackling the problem. Objective The aims of this study are to test the effectiveness of an online quiz competition in changing adolescents’ alcohol-related attitudes and behavior and to explore the feasibility of using Internet viral marketing to reach a significant number of adolescents. Methods The study will constitute a cluster randomized controlled trial for 20 secondary schools (6720 Grade 7-9 students). Schools will be randomized to intervention or control arm with equal likelihood. Students in intervention schools will be invited to take part in the Internet campaign, whereas those in control schools will receive relevant promotional leaflets. Results Alcohol-related attitude and behavior will be the primary outcome measures. The results of the proposed study will provide evidence on the efficacy of an Internet intervention in modifying adolescents’ attitudes and behavior and guide further investigation into the prevention of and intervention in such risk behaviors as underage drinking. The project was funded July 2015, enrollment started September 2015, and results are expected July 2017. Conclusions With the Internet increasingly being recognized as a practical and cost-effective platform for health information delivery, the proposed Internet-based intervention is expected to be more effective in altering adolescents’ alcohol-related attitudes and behaviors than traditional health promotion. ClinicalTrial ClinicalTrials.gov NCT02450344; https://clinicaltrials.gov/ct2/show/NCT02450344 (Archived by WebCite at http://www.webcitation.org/6heB2zMBD)
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Affiliation(s)
- Patrick Ip
- The University of Hong Kong, Department of Paediatrics and Adolescent Medicine, Hong Kong, China (Hong Kong).
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Karoly HC, Callahan T, Schmiege SJ, Ewing SWF. Evaluating the Hispanic Paradox in the Context of Adolescent Risky Sexual Behavior: The Role of Parent Monitoring. J Pediatr Psychol 2016; 41:429-40. [PMID: 25972373 PMCID: PMC4829736 DOI: 10.1093/jpepsy/jsv039] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 04/09/2015] [Accepted: 04/14/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In the United States, Hispanic adolescents are at elevated risk for negative outcomes related to risky sexual behavior. To evaluate potential protective factors for this group, we examined the fit of the Hispanic Paradox for sexual behavior among high-risk youth and the moderating role of parent monitoring. METHOD We enrolled 323 justice-involved Hispanic youth (73% male; mean age 16 years), and measured generational status, parent monitoring (monitoring location, who children spend time with outside of school, family dinner frequency), and sexual risk behavior. RESULTS There were no main effects for generational status on sexual behavior. Parent monitoring of location moderated the relationship between generational status and sexual behavior, such that greater monitoring of location was associated with less risky sexual behavior, but only for youth second generation and above. CONCLUSIONS Rather than direct evidence supporting the Hispanic Paradox, we found a more nuanced relationship for generational status in this sample.
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Affiliation(s)
- Hollis C Karoly
- Department of Psychology and Neuroscience, University of Colorado,
| | - Tiffany Callahan
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, and
| | - Sarah J Schmiege
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, and
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Diesterheft R, Brady JP, Shattell M. Risk behaviours of an interrelated syphilis-infected sexual network of men who have sex with men. J Clin Nurs 2016; 25:3597-3604. [PMID: 27104302 DOI: 10.1111/jocn.13209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 12/17/2022]
Abstract
AIMS AND OBJECTIVES We examined the risk behaviours in an interrelated sexual network of 33 syphilis-infected men who have sex with men on the use of condoms, substances and websites to meet sexual partners. Our study used a descriptive exploratory design to investigate co-occurring high-risk behaviours in this interrelated sexual network to inform future health interventions and research directions. BACKGROUND Although the risk behaviours for human immunodeficiency virus transmission in men who have sex with men have been studied, few have studied the high-risk population of men who already have syphilis, and even fewer have studied the risk behaviours in sexual networks of syphilis-infected men who have sex with men who were identified using contact tracing. DESIGN/METHODS The data were collected from semi-structured, individual interviews at a not-for-profit lesbian, gay, bisexual and transgender health centre in a large city in the Midwestern USA. RESULTS Inconsistent condom use was substantial during both insertive (92%) and receptive (88%) anal intercourse. Most participants (97%) reported using one or more substances prior to or during anal intercourse, and Internet websites were the most common place to meet sexual partners (88%). CONCLUSIONS High-risk behaviours were significant within this syphilis-infected sexual network of men who have sex with men. The majority of our 33 participants were non-Hispanic Whites (n = 27, 82%), possessed a baccalaureate degree or higher (n = 23, 70%), and actively sought out unprotected anal intercourse [21 participants (64%) used BareBackRT.com, a website to seek out unprotected anal intercourse]. RELEVANCE TO CLINICAL PRACTICE Nurses should be more informed about the risk factors of a high-risk sexual network of syphilis-infected men who have sex with men. Interrelated sexual networks have high levels of similarity among participants' high-risk behaviours; contact tracing may be used to identify individual participants for relevant risk-reduction interventions.
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Affiliation(s)
| | - John P Brady
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Mona Shattell
- School of Nursing, DePaul University, Chicago, IL, USA.,Department of Community, Systems, and Mental Health Nursing, Rush University, DePaul University, Chicago, IL, USA
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Rasmussen DN, Wejse C, Larsen O, Da Silva Z, Aaby P, Sodemann M. The when and how of male circumcision and the risk of HIV: a retrospective cross-sectional analysis of two HIV surveys from Guinea-Bissau. Pan Afr Med J 2016; 23:21. [PMID: 27200126 PMCID: PMC4856489 DOI: 10.11604/pamj.2016.23.21.7797] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 01/20/2016] [Indexed: 11/19/2022] Open
Abstract
Introduction Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV is crucial and can increase insight into the HIV epidemic in Africa. Methods We used data from two retrospective HIV surveys conducted in Guinea-Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV risk and circumcision status, timing, method of circumcision, and socio-demographic factors. Results MC was protective against HIV infection in both cohorts, with adjusted odds ratios (AORs) of 0.28 (95% CI 0.12-0.66) and 0.30 (95% CI 0.09-0.93), respectively. We observed that post-pubertal (≥13 years) circumcision provided the highest level of HIV risk reduction in both cohorts compared to non-circumcised. However, the difference between pre-pubertal (≤12 years) and post-pubertal (≥13 years) circumcision was not significant in the multivariate analysis. Seventy-six percent (678/888) of circumcised males in the 2006 cohort were circumcised traditionally, and 7.7% of those males were HIV-infected compared to 1.9% of males circumcised medically, with AOR of 2.7 (95% CI 0.91-8.12). Conclusion MC is highly prevalent in Guinea-Bissau, but ethnic variations in method and timing may affect its protection against HIV. Our findings suggest that sexual risk behaviour and traditional circumcision may increases HIV risk. The relationship between circumcision age, sexual behaviour and HIV status remains unclear and warrants further research.
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Affiliation(s)
- Dlama Nggida Rasmussen
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau; Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense, Denmark; Center for Global Health, Institute of Clinical Research, University of Southern Denmark, DK-5000 Odense, Denmark
| | - Christian Wejse
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, DK-8200 Aarhus, Denmark; Center for Global Health, Department of Public Health, Aarhus University, DK-8000 Aarhus, Denmark
| | - Olav Larsen
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau; Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense, Denmark
| | - Zacarias Da Silva
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau
| | - Peter Aaby
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau; Statens Serums Institute, DK-2300 Copenhagen, Denmark
| | - Morten Sodemann
- Bandim Health Project, Indepth Network, Apartado 861, 1004 Bissau Codex, Bissau, Guinea-Bissau; Department of Infectious Diseases, Odense University Hospital, DK-5000 Odense, Denmark; Center for Global Health, Institute of Clinical Research, University of Southern Denmark, DK-5000 Odense, Denmark
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Lehmann S, Akré C, Berchtold A, Flatz A, Suris JC. The winner takes it all? Characteristics of adolescent at-risk/problem gamblers in Switzerland. Int J Adolesc Med Health 2016; 29:/j/ijamh.ahead-of-print/ijamh-2015-0100/ijamh-2015-0100.xml. [PMID: 26812769 DOI: 10.1515/ijamh-2015-0100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/19/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gambling has and still entertains people in almost all societies throughout the world. Western societies have faced considerable changes in the amount and accessibility of gambling possibilities during the last decades, and the rates of both adolescent gamblers and problem gamblers have increased significantly. OBJECTIVE To determine the characteristics of at-risk and problem adolescent gamblers in Switzerland. SUBJECTS The study population consisted of 3134 students (1669 females) attending post-mandatory education in 15 randomly chosen centres. Participants were divided into non- (n=2207), non-problematic (n=754) and at-risk/ problematic gamblers (n=176). METHODS Both gambling groups were compared to non-gamblers on socio-demographic measures, substance use and Internet use. Overall, 29.6% had gambled during the past year and 5.6% had gambled in a risky or problematic way. Compared to non-gamblers and after controlling for potential confounders, non-problem gamblers were significantly more likely to be male, apprentices and to misuse alcohol. At-risk/problematic gamblers were additionally more likely to smoke cannabis, to be problematic Internet users and to be non-Swiss than non-gamblers. CONCLUSION At-risk and problematic adolescent gambling is associated with other health risk behaviours. Health practitioners should include gambling in the psycho-social screening and preventive counselling of adolescents.
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Abstract
PRIMARY OBJECTIVE To analyse patterns of departure from a popular hiking trail in Yosemite National Park, at sites where fatal drownings have occurred in the past. METHODS This study employed direct observation. For 32 days throughout the summer of 2013, study team members observed hikers who entered areas that brought them in close proximity to hazardous sections of the Merced River. Subject and environmental data were recorded for 1417 such approaches. RESULTS In 81% of our observation hours, subjects entered 'risk zones.' The median number of hikers seen near/in the river was eight per hour at the Vernal Fall footbridge, and three at the top of the waterfall. A regression analysis found that air temperature and later hike starts were positively associated, and water level was negatively associated, with the rate of river approach. Means of river access were also identified. Males, teens and people who were alone were significantly more likely to be observed entering particularly dangerous areas. CONCLUSIONS It is common for hikers to approach water sources during summer months, particularly as air temperatures rise. By analysing how behaviour and environmental factors co-vary, safety advocates can tailor risk reduction measures to specific settings and visitor populations.
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Affiliation(s)
- Deborah C Girasek
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA and
| | - Joy S Marschall
- Division of Visitor and Resource Protection, Yosemite National Park, Yosemite, CA, USA
| | - Dov Pope
- Division of Visitor and Resource Protection, Yosemite National Park, Yosemite, CA, USA
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Mubyazi GM, Exavery A, Tenu F, Massaga JJ, Rugemalila J, Malebo HM, Wiketye V, Makundi EA, Ikingura JK, Mushi AK, Malekia SE, Mziray A, Ogondiek JW, Kahwa A, Kafuye MM, Malecela MN. Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania. BMC Res Notes 2015; 8:630. [PMID: 26526184 PMCID: PMC4630838 DOI: 10.1186/s13104-015-1621-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 10/26/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Condoms are scientifically recommended as potential products for preventing infections attributable to human immuno-deficiency viruses (HIV). However, evidence on factors leading to their inadequate use in developing countries is still scanty. This paper reports an exploratory study of factors constraining condoms use in Tanzania from the perspectives of barmaids, guest-house workers and retailers. METHODS Data were collected in two districts-Mpwapwa in Dodoma Region and Mbeya Rural in Mbeya Region-between October and December 2011, using structured interviews with 238 individuals including barmaids, guesthouse workers and 145 retailers. Data analysis was performed using STATA 11 software. RESULTS Awareness about condoms was high among all study groups. Male condoms were more popular and available than female ones. A considerable proportion of the barmaids and guesthouses were disappointed with condoms being promoted and distributed to young children and disliked condom use during sexual intercourse. Accessibility of condoms was reported as being lowered by condom prices, shortage of information concerning their availability; short supply of condoms; some people shying away to be watched by children or adult people while purchasing condoms; retailers' using bad languages to condom customers; occasionally condom shops/kiosks found closed when they are urgently needed; and prevailing social perception of condoms to have low/no protective efficacy. Regression analysis of data from barmaids and guesthouse-workers indicated variations in the degree of condom acceptability and methods used to promote condoms among respondents with different demographic characteristics. CONCLUSION A combination of psychosocial and economic factors was found contributing to lower the demand for and actual use of condoms in study communities. Concerted measures for promoting condom use need to address the demand challenges and making operational research an integral element of monitoring and evaluation of the launched interventions, hence widening the evidence for informed policy decisions.
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Affiliation(s)
- Godfrey M Mubyazi
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Amon Exavery
- Ifakara Health Institute (IHI), P.O Box 78373, Dar es Salaam, Tanzania.
| | - Filemoni Tenu
- Amani Medical Research Centre (MRC), P.O Box 81, Muheza, Tanzania.
| | - Julius J Massaga
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Jovitha Rugemalila
- National Bureau of Statistics (NBS), P.O Box 796, Dar es Salaam, Tanzania.
| | - Hamisi M Malebo
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Victor Wiketye
- NIMR Ngongongare Research Station, Usa River, P.O Box 514, Arusha, Tanzania.
| | - Emmanuel A Makundi
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Joyce K Ikingura
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Adiel K Mushi
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Sia E Malekia
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Abubakary Mziray
- Amani Medical Research Centre (MRC), P.O Box 81, Muheza, Tanzania.
| | - John W Ogondiek
- NIMR Ngongongare Research Station, Usa River, P.O Box 514, Arusha, Tanzania.
| | - Amos Kahwa
- Muhimbili Medical Research Centre, P.O Box 5004, Dar es Salaam, Tanzania.
| | - Mwanaidi M Kafuye
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
| | - Mwelecele N Malecela
- National Institute for Medical Research (NIMR), P.O Box 9653, Dar es Salaam, Tanzania.
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Gradvohl E, Vida K, Rácz J. [Fill it up...! Combined consumption of alcohol with energy drinks and its correlation with risk taking behaviour among young adults]. Orv Hetil 2015; 156:1100-8. [PMID: 26122905 DOI: 10.1556/650.2015.30170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In Hungary and all around the world the incidence of consumption of energy drinks together with alcohol has increased among adolescents and young adults. AIM The foremost aim of this survey was to find out whether alcohol mixed with energy drinks can enhance the appearance of other forms of risky behaviour among young adults. METHOD In spring 2013 the authors carried out a quantitative sociological survey at three faculties of two major universities in Budapest, Hungary. RESULTS The survey showed that 1) consumers, who mixed alcohol with energy drinks, were likely to drink more alcohol both at parties and on ordinary days, and they took part in binge drinking more frequently than those consuming only alcohol; 2) students drank significantly less alcohol when they mixed it with energy drink. CONCLUSIONS The conflicts of the results showed that even at the starting point there was a clear distinction between the two groups, moreover, it is not yet clear what interactions the combined effect of caffeine and alcohol can trigger in the behaviour of the individual.
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Affiliation(s)
- Edina Gradvohl
- Társadalomtudományi Tanszék, Semmelweis Egyetem, Egészségtudományi Kar, Alapozó Egészségtudományi Intézet Budapest, Vas utca 17., 1088
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