Social motives for drinking in students should not be neglected in efforts to decrease problematic drinking.

High heavy drinking prevalence persists in students. Recently, drinking motivation received a lot of attention as an important determinant. Enhancement and coping motives are mostly positively related and conformity motives are mostly negatively related with heavy drinking. Relations are less clear for social motives. This study aimed at gaining more insight in the role of drinking motives in heavy drinking students. Overall, 15 897 Belgian university and college students (mean age: 20.7, SD = 2.6) anonymously participated in an online survey. Logistic regressions tested relationships between motives and problematic drinking (>weekly drinking, ≥monthly binge drinking and being at risk for problematic drinking by the Alcohol Use Disorders Identification Test [AUDIT]). Social motives had the highest prevalence, followed by enhancement, coping and conformity motives. Men engaged more in problematic drinking and reported more motives, except for coping. Enhancement, coping and social-motivated students have higher chances for problematic drinking, while the opposite is true for conformity-motivated students. Although this study found a similar ranking of motives as in other studies, a relationship between problematic drinking and all motives, including social motives, was revealed. This might indicate the different functions of social motives in heavy drinking in different cultures/sub-populations and countries. This finding is relevant for the development of interventions.

Feasibility of percutaneous radiofrequency ablation for pulmonary malignancies in the hands of the surgeon.

AIM: To assess the feasibility of percutaneous pulmonary radiofrequency ablation (RFA) executed by a single surgeon. MATERIALS AND METHODS: Between 2007 and 2010, 15 procedures were performed in 11 patients during 13 sessions. Sex, age, pulmonary localisation and tumor diameter are discussed. Metastatic lesions as well as pulmonary primitive malignancies were treated. For metastatic lesions, the primitive tumor was considered as completely treated. Surgery was refused because of impaired pulmonary function or due to patient's refusal. All interventions were carried out by a single thoracic surgeon under CT-guidance in the department of radiology. RESULTS: RFA was completed in all patients without perprocedural complications. There was no significant perioperative morbidity. Pneumothorax was the most frequent complication but none of the patients needed thoracic drainage. Hospital stay decreased progressively since the start of this series. Follow-up was complete. Most lesions were stable or diminishing in size. CONCLUSION: These early results show that pulmonary RFA is a safe and feasible technique in the hands of the surgeon. Longer follow-up and larger series will be welcome to confirm the results and position of this procedure which might become an important tool for the surgeon and not only for radiologists.

Laparoscopic ultrasonography as a good alternative to intraoperative cholangiography (IOC) during laparoscopic cholecystectomy: results of prospective study.

Intraoperative cholangiography (IOC), used routinely or selectively, is the standard method for bile duct imaging during cholecystectomy. Laparoscopic ultrasonography (LUS) has emerged as a possible, safe and quick alternative. This study examined the evolving use and the performance of these two methods as primary technique for routine bile duct imaging, so as to detect common bile duct stones (CBDS) and to prevent common bile duct injury (CBDI). A prospective database permitted to evaluate the results of the two methods in 968 consecutive cholecystectomies. Nine hundered and twenty five were performed by laparoscopy, 18 (1.9%) by laparotomy and 25 (2.6) necessitated a conversion. The systematic use of the IOC was gradually replaced by a systematic use of the LUS. The success to delineate and evaluate the CBD, the detection of a CBDS, any type of bile duct complication, especially of CBDI, were registered. All the CBDS suspected by LUS were controlled by IOC. The patients were followed during 1 and 6 months. Six hundred and eighty five IOC and 269 LUS were performed. The procedure was technically unsuccessful in 35 IOC (5.1%) (mainly due to difficulty in catheterising the cystic duct) and in 2 LUS (1%) (due to steatosis). Concerning the detection of CBDS, 31 were detected by IOC (4.5%) and 16 by LUS (6%). Five IOC were considered as false positive, 1 as false negative (sensitivity and specificity of 96,9 and 99,2%) and 1 LUS as false positive (sensitivity and specificity of 100 and 99,6%). Five CBDI were detected in the complete seria: 2 during the dissection before the IOC, 1 thermic injury, 1 late stenosis, 1 lateral stenosis by the cystic clip detected by LUS. However none of these CBDI could have been prevented by IOC. In our experience, in this prospective study, LUS has been certainly as effective as IOC as a primary imaging technique for bile duct. It permitted to detect CBDS with a high specificity and sensitivity, and CBDS and was not followed by an increase in CBDI.

Asthma and wheezing symptoms in young people in six Western countries.

BACKGROUND: Asthma diagnosed in children shows wide geographical variations. Large scale surveys identify children with diagnosed asthma, but neglect the group of youngsters with multiple asthmatic complaints. METHODS: A short validated asthma questionnaire was included in six national surveys of the Health Behaviour in School-Aged Children Study. Prevalence rates are presented by country, gender and age. Gender and age differences are analysed using binary and multinomial logistic regressions controlling for age and smoking. RESULTS: Large country differences are observed in the prevalence rates of diagnosed asthma (8.6%-20.9% in boys, 6.9%-18.5% in girls) and young people with "asthma-like symptoms" (9.6%-20.2% in boys, 9.2%-23.1% in girls). When controlling for age and smoking, significant gender differences are observed (more diagnosed asthma in boys, more asthmatic symptoms in girls). Age differences were observed in adolescents with "asthma-like symptoms", but not in diagnosed asthma. CONCLUSIONS: Using a short asthma questionnaire, large differences in diagnosed asthma and wheezing symptoms are observed between the countries. A considerable group of youngsters with "asthma-like symptoms" is detected in all countries, and may be an unrecognised risk group in health promotion.

Social capital and social inequality in adolescents' health in 601 Flemish communities: a multilevel analysis.

Although it is widely acknowledged that community social capital plays an important role in young people's health, there is limited evidence on the effect of community social capital on the social gradient in child and adolescent health. Using data from the 2005-2006 Flemish (Belgium) Health Behavior among School-aged Children survey (601 communities, n = 10,915), this study investigated whether community social capital is an independent determinant of adolescents' perceived health and well-being after taking account of individual compositional characteristics (e.g. the gender composition within a certain community). Multilevel statistical procedures were used to estimate neighborhood effects while controlling for individual level effects. Results show that individual level factors (such as family affluence and individual social capital) are positively related to perceived health and well-being and that community level social capital predicted health better than individual social capital. A significant complex interaction effect was found, such that the social gradient in perceived health and well-being (i.e. the slope of family affluence on health) was flattened in communities with a high level of community social capital. Furthermore it seems that socioeconomic status differences in perceived health and well-being substantially narrow in communities where a certain (average) level of community social capital is present. This should mean that individuals living in communities with a low level of community social capital especially benefit from an increase in community social capital. The paper substantiates the need to connect individual health to their meso socioeconomic context and this being intrinsically within a multilevel framework.

Smoking in young people with asthma.

BACKGROUND: Modern guidelines for the management of asthma state that asthmatic patients should be strongly advised not to smoke. However, it remains unclear to what extend young people with asthma actually behave like this. This study compares the prevalence of daily smoking between 15-year adolescents with diagnosed asthma and without asthma, and evaluates to what extent risk factors for smoking play a comparable role in the smoking behaviour of these two groups. METHODS: The study is part of the 2001-2002 international HBSC study. Besides questions about health behaviour, individual and social resources, a set of asthma questions were included in six countries. RESULTS: Adolescents with diagnosed asthma are more likely to be daily smokers than non-asthmatic adolescents. In asthmatic and non-asthmatic adolescents, similar associations with risk factors are found for daily smoking (drunkenness, cannabis use, low life satisfaction, spending evenings with friends, having smoking parents and peers). Diagnosed asthmatics are more prone to score high on these factors than non-asthmatics. CONCLUSIONS: Smoking in adolescents with asthma is a public health problem. Smoking prevention efforts directed towards young people should pay attention to young people with asthma and the curative sector should increase their efforts to motivate asthmatic adolescents not to smoke.