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This study investigates variation in adolescent attitudes regarding dating violence under different conditions, the association of these conditional attitudes with subsequent adolescent relationship abuse (ARA), and youth and parent-reported characteristics associated with youth attitudes. The sample consists of 607 youth, as a subset from those who responded to a nationally representative longitudinal survey of dating violence. A latent class analysis identified three profiles of attitudinal patterns: No Tolerance for Hitting Partners (NT), Some Tolerance for Hitting Partners (ST), and High Tolerance for Hitting Partners (HT). The HT profile predicted subsequent physical (compared to the NT profile), sexual ARA perpetration (compared to both the NT and the ST profiles), and physical ARA victimization (compared to the NT profile). The ST profile predicted subsequent psychological ARA perpetration and victimization (compare to the NT profile). Results inform youth dating violence prevention programs to reduce ARA and intimate partner violence by changing youth attitudes toward dating violence.
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Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Humanos , Adolescente , Comportamento do Adolescente/psicologia , Comportamento Sexual , Vítimas de Crime/psicologiaRESUMO
Technology-facilitated abuse (TFA) is of growing concern and is a form of elder abuse. There is limited TFA research in general population samples in the U.S. among older adults. Researchers conducted a survey of behavior-based forms of TFA experiences in a nationally representative sample of n = 1,011 U.S. adults ages 50 and older. Within this sample, 63.8% of respondents reported some experience of TFA during their lifetime. Latent class analyses were applied to understand the pattern of older adults' exposure to ten different forms of TFA resulting in three classes distinguished by the number of different TFA types experienced: low TFA (55%), low-mid TFA (40%) and high TFA (5%). Socio-economic characteristics associated with these TFA profiles, as well as perpetrator relationship, post-TFA behaviors, and resulting harms associated with the TFA experiences, were examined to inform research, prevention, and intervention activities. Attention across different sectors to TFA among older adults is needed.
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Abuso de Idosos , Idoso , Humanos , Análise de Classes Latentes , Abuso de Idosos/prevenção & controle , Inquéritos e Questionários , TecnologiaRESUMO
Social and emotional learning (SEL) interventions have shown promise for building resilience and protecting youth from adverse outcomes. This study reports on an experimental pilot evaluation of the Smart Brain Wise Heart SEL intervention during the 2021-2022 school year. Smart Brain Wise Heart (SBWH) uses a neurophysiological approach among ninth-grade students to evaluate the intervention's impact on youth resiliency, self-compassion, peer violence exposure, internalising disorders, and hyperactivity. Results did not indicate any significant universal changes in target outcomes. These null findings regarding universal impact may be explained by the unprecedented difficulty of implementing a school-based intervention amid ongoing COVID-19 restrictions and administrative issues. Despite these obstacles, students with lower academic achievement in the intervention condition scored significantly higher for resilience and self-compassion and lower on depressive symptoms than their peers in the comparison condition, even when controlling for baseline scores, sex, attachment (father, mother, peer), and exposure to adverse childhood experiences. Our findings suggest SBWH programming may have important implications for the trajectories of students exhibiting lower academic achievement, at a minimum, by significantly improving their emotional resilience, self-compassion, and depressive symptoms during a vital developmental stage. More research is urgently needed under optimal conditions to assess the universal implementation of the program.
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BACKGROUND: Dating abuse (DA) is prevalent and consequential, but no brief DA screening tools are available for use in pediatric or other settings. This study was designed to determine the sensitivity, specificity, and predictive values of the MARSHA-C, which is a three-item DA victimization screening tool. METHODS: The participants were 224 U.S. youth ages 11-21 years old (20% male, 77% female, 3% non-binary gender). Youth completed an online questionnaire about adolescent relationship abuse. The survey included the Measure of Adolescent Relationship Harassment and Abuse (MARSHA), which is a comprehensive DA measurement instrument normed on a nationally representative sample. Of 34 DA victimization items from the MARSHA, the three most prevalent items were hypothesized to have good predictive validity of the full scale score as a brief, screening version (MARSHA-C). The sensitivity, specificity, positive predictive value, and negative predictive value of the MARSHA-C to identify victims of DA was calculated. RESULTS: Using the MARSHA as the reference standard, the cutpoint of 1 on the MARSHA-C screening tool was identified as optimal. The MARSHA-C had a sensitivity of 84%, a specificity of 91%, and positive predictive value of 91%. Thus, for youth who endorse ≥ 1 MARSHA-C items, there is a 91% probability that they have experienced DA in the past year. Exploratory analyses by demographic subgroups suggest that the predictive validity of the MARSHA-C is approximately equivalent for females and males, younger and older adolescents, Asian, Black, Latinx, Multiracial and White youth, and heterosexual and lesbian, gay, and bisexual youth. CONCLUSIONS: The MARSHA-C can be used to detect DA among 11-21-year-old youth via online surveys for research purposes, or in clinical care settings to facilitate proactive patient counseling or parent-oriented anticipatory guidance.
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Bullying , Vítimas de Crime , Adolescente , Adulto , Criança , Vítimas de Crime/psicologia , Feminino , Humanos , Masculino , Pais , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: There are burgeoning bodies of research on cyberbullying and online sexual harassment. Yet existing work often fails to distinguish between these two unique forms of online victimization, is largely cross sectional, and based on convenience or specialized samples. We examined the prevalence, predictors, and mental health and behavioral consequences of cyberbullying and online sexual harassment using a large, representative sample of adolescents. We also considered the potential compounding effects of multiple forms of victimization, as well as gender differences in the effects of online victimization. METHODS: We used nationally representative, longitudinal data from the National Survey on Teen Relationships and Intimate Violence (STRiV) (n = 1,152), a US-based sample of adolescents 10-18 years old. RESULTS: Approximately 37% of participants reported being victims of cyberbullying, and nearly 15% reported online sexual harassment experiences. Despite cyberbullying being relatively more common, the risk factors for these two forms of online victimization were similar. In addition, cyberbullying and online sexual harassment victimization were independently associated with the full range of mental health and behavioral problems examined in this investigation. Nevertheless, our findings also provided some evidence of conditional effects, such that female adolescents, and adolescents who experienced both forms of online victimization, suffered greater deleterious outcomes. CONCLUSIONS: Online sexual harassment and cyberbullying victimization have similar risk profiles, and both contribute to heightened risk of mental health and behavioral problems. Yet the prevalence and gendered nature of these experiences underscore the importance of making distinctions. We provide recommendations for future research and programmatic efforts.
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Bullying , Cyberbullying , Assédio Sexual , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , PrevalênciaRESUMO
Purpose: Investigations into rural tobacco-related disparities in the U.S. are hampered by the lack of a standardized approach for identifying the rurality-and, consequently, the urbanicity-of an area. Therefore, the purpose of this study was to compare the most common urban/rural definitions (Census Bureau, OMB, RUCA, and Isolation) and determine which is preferable for explaining the geographic distribution of several tobacco-related outcomes (behavior, receiving a doctor's advice to quit, and support for secondhand smoke policies). Methods: Data came from The Current Population Survey Tobacco Use Supplement. For each tobacco-related outcome, one logistic regression was conducted for each urban/rural measure. Models were then ranked according to their ability to explain the data using Akaike information criterion (AIC). Results: Each definition provided very different estimates for the prevalence of the U.S. population that is considered "rural" (e.g., 5.9% for the OMB, 17.0% for the Census Bureau). The OMB definition was most sensitive at detecting urban/rural differences, followed by the Isolation scale. Both these measures use strict, less-inclusive criteria for what constitutes "rural." Conclusions: Overall, results demonstrate the heterogeneity across urban/rural measures. Although findings do not provide a definitive answer for which urban/rural definition is the best for examining rural tobacco use, they do suggest that the OMB and Isolation measures may be most sensitive to detecting many types of urban/rural tobacco-related disparities. Caveats and implications of these findings for rural tobacco use disparities research are discussed. Efforts such as these to better understand which rural measure is appropriate for which situation can improve the precision of rural substance use research.
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População Rural , Produtos do Tabaco , Humanos , Prevalência , Uso de Tabaco/epidemiologia , Estados Unidos/epidemiologia , População UrbanaRESUMO
The purpose of this study was to estimate the effect of past and current rotating shift assignments on U.S. law enforcement officers' health outcomes. In a nationally representative sample of 2,867 officers, with an oversample of female officers, we estimated models of sleep quality and fatigue, physical health outcomes, and psychological health outcomes. Further, we examined individual and agency-level factors associated with officers who reported currently working a rotating shift, to investigate what patterns there may be in shift assignments. A history of rotating shift assignments was positively associated with lower sleep quality, and with hypertension, diabetes, and high cholesterol, but not with gastrointestinal disorders, perceived stress, emotional well-being, or suicidality. The associations of shiftwork with health outcomes did not vary by gender. Demographic characteristics did not predict current rotating shift assignments, but a longer history of shiftwork and more working hours did predict a current shift assignment. Attention to mitigating shift system designs as well as the effect of cumulative years of working a rotating shift for the benefit of officer health outcomes is warranted.
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Aplicação da Lei , Tolerância ao Trabalho Programado , Fadiga , Feminino , Humanos , Avaliação de Resultados em Cuidados de Saúde , PolíciaRESUMO
Sexual harassment is a pervasive problem predominantly perpetrated by men. Creating cultural shifts to prevent men's sexual harassment perpetration requires attention to community as well as individual factors. Study data were collected from a cohort of 768 youth and young adult males ages 10-18 at baseline (2013), with follow-up 3 years later. Multivariable regression was applied to assess the role of neighborhood characteristics, including crime rates, gender equality, and concentrated disadvantage, adjusting for individual sociodemographics and views on traditional gender stereotypes. The self-reported prevalence of sexual harassment perpetration was 8.8%. In neighborhoods characterized by greater concentrated disadvantage, the likelihood of male sexual harassment perpetration was significantly lower than in neighborhoods characterized by greater advantages. Relative neighborhood advantage was associated with sexual harassment perpetration even controlling for the significant positive association between espousing traditional gender stereotypes and perpetration of sexual harassment. The relative rates of neighborhood crime and gender equality did not predict young males' sexual harassment perpetration. In sum, young men's perpetration of sexual harassment behaviors is more common in more advantaged communities, underscoring the importance of awareness that, beyond individual attitudes, there is a collective social influence on individual behavior.
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Atitude , Homens/psicologia , Características de Residência/estatística & dados numéricos , Assédio Sexual/psicologia , Adolescente , Criança , Humanos , Masculino , Fatores de Risco , Estados UnidosRESUMO
Financial disagreements have been identified as a severe source of discord in adult relationships, yet limited work has considered whether financial considerations contribute to conflict among younger samples. Drawing on longitudinal data from a nationally representative sample of adolescents, the current investigation examined the extent to which money lending practices, feelings of financial resentment, and exposure to economic control contribute to couple-level interactions, and in turn, to conflict that escalates to the point of violence. Findings provide evidence of an association between adolescent financial behaviors and concurrent conflict due to economic considerations. Moreover, conflict due to economic considerations was an important predictor of future adolescent relationship abuse perpetration. We discuss the implications of our findings for intervention/prevention efforts.
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Comportamento do Adolescente/psicologia , Status Econômico , Violência por Parceiro Íntimo/psicologia , Adolescente , Feminino , Humanos , Modelos Logísticos , Estudos Longitudinais , Masculino , Inquéritos e QuestionáriosRESUMO
This study aims to identify homogeneous groups of individuals based on self-reported victimization and perpetration of three subtypes of adolescent relationship abuse (ARA; physical, psychological, and sexual) and sexual harassment (SH). Study sample consists of 645 current or past-year daters aged 12-21, drawn from the National Survey on Teen Relationships and Intimate Violence (STRiV). Latent class analysis was used to classify individuals, and a three-class model was selected (Low ARA-Low SH, High ARA-High SH, and Psychological ARA-Medium SH). Results provide evidence for three latent classes with varying patterns of ARA and SH. A number of exogenous variables were significantly associated with these patterns, e.g., youth who were previously exposed to any general violence were three times as likely to be in the High ARA-High SH class as those not previously exposed to violence. Adolescent relationship abuse prevention efforts should include activities to address sexual harassment, and vice versa. Results call for universal preventive intervention programs targeting adolescent relationship abuse and sexual harassment to start as early as adolescence, and the existence of the High ARA-High SH group supports the need for more targeted effort to interrupt such patterns.
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Comportamento do Adolescente/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Assédio Sexual/prevenção & controle , Adolescente , Bullying , Criança , Vítimas de Crime/psicologia , Feminino , Humanos , Análise de Classes Latentes , Masculino , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários , Adulto JovemRESUMO
Research has shown that neighborhoods play a role in the etiology of violence. However, few adolescent relationship aggression (ARA) studies have objective measures of violent neighborhoods. Drawing on a nationally representative sample of youth, this study examines the association between ARA and local levels of violent crime (measured using geocoded Uniform Crime Report data from each of the youths' residential neighborhoods). Study analyses are based on survey data from 723 youth (ages 10-18) in current or recent dating relationships (351 males and 372 females) in the Survey on Teen Relationships and Intimate Violence (STRiV), a national representative household panel survey exploring interpersonal violence and related aggression among adolescents. About 19% of the sample reported ARA victimization in their most recent dating relationship (ARA perpetration was 17%). Neighborhood violent crime in the study (males living in 86.9 and females 99.8) was slightly lower than the national average of 100. With a broad national sample, 40% non-Whites, hypotheses guided by theories of neighborhood influence were tested. The study did not find an association between neighborhood violent crime and ARA victimization and perpetration, controlling for key demographic factors. The results, for a broad range of high- and low-crime neighborhoods, suggest that neighborhood violence does not seem to affect individual rates of ARA. The results suggest the ARA victimization and perpetration are perhaps ubiquitous and found both in low and high violent crime neighborhoods, suggesting that addressing local violent crime rates alone does not seem to be a path to also reducing ARA.
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Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Comportamento do Adolescente/psicologia , Agressão , Criança , Feminino , Humanos , Masculino , Características de ResidênciaRESUMO
Hypokalaemia with alkalosis can suggest excess aldosterone. Aldosterone stimulates the collecting duct mineralocorticoid receptor (MR) to upregulate the epithelial sodium channel (ENaC) and stimulate electrogenic sodium reabsorption, with secretion of potassium and protons. Gitelman, Bartter and Liddle syndrome, and liquorice ingestion all cause hypokalaemic alkalosis. This mini-review outlines the pathophysiology of these conditions as well as how to differentiate them.
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Alcalose/diagnóstico , Síndrome de Bartter/diagnóstico , Biomarcadores/metabolismo , Glycyrrhiza/efeitos adversos , Hipopotassemia/diagnóstico , Aldosterona/metabolismo , Alcalose/etiologia , Alcalose/metabolismo , Síndrome de Bartter/complicações , Síndrome de Bartter/metabolismo , Diagnóstico Diferencial , Canais Epiteliais de Sódio/metabolismo , Humanos , Hipopotassemia/etiologia , Hipopotassemia/metabolismo , Túbulos Renais/metabolismo , Potássio/metabolismo , Sódio/metabolismoRESUMO
The purpose of this study was to assess the longitudinal association between adolescent dating relationship dynamics (measures of intimacy and problem dynamics), mental health, and physical and/or sexual victimization by a dating partner. Gender-stratified analyses were conducted in a sample of 261 adolescents, ages 10-18 at baseline, interviewed in three annual waves (2013-2015) of the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV). Among male daters, better mental health at baseline was negatively associated with problem dynamics at follow-up, and aspects of problem dynamics at baseline predicted worse mental health at follow-up. However, unexpectedly, aspects of relationship intimacy at baseline were also negatively associated with mental health at follow-up. Male daters' victimization did not mediate longitudinal measures of mental health or of relationship dynamics, but did predict worse mental health at follow-up. Among female daters, we found no longitudinal associations between mental health and intimacy or problem relationship dynamics, in either direction. However, victimization mediated aspects of female daters' reported relationship dynamics. Dating violence prevention efforts should reflect that adolescent females reporting controlling behaviors and feelings of passionate love may be at increased risk for victimization. Positive youth development efforts should attend to the bidirectional associations of mental health and dating relationship dynamics over time, particularly for male adolescents.
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Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Saúde Mental/tendências , Comportamento Sexual/psicologia , Adolescente , Bullying/psicologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/tendências , Estudos Longitudinais , Masculino , Fatores de Risco , Parceiros Sexuais/psicologiaRESUMO
Despite extensive research regarding patterns and outcomes of victimization in dating relationships, there has been limited investigation of the developmental profiles of the perpetration of adolescent dating abuse (ADA). We estimated longitudinal latent growth models of ADA perpetration in a sample of 2,269 U.S. adolescents/young adults ages 12-18 at baseline, drawing on four waves (2013-2017) of data from the nationally representative Survey of Teen Relationships and Intimate Violence. Model results revealed three classes representing "nondaters," respondents showing "increasing dating/ADA," and respondents with "high/stable dating/ADA." Results support prior research finding heightened patterns of ADA perpetration by older youth, and distinguish individual and family characteristics associated with adolescent/young adults' ADA perpetration for the purpose of informing individual and programmatic prevention efforts.
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Comportamento do Adolescente/fisiologia , Vítimas de Crime/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Parceiros Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
INTRODUCTION: In order to prevent youth and young adult partner abuse, it is necessary to have a better understanding of dating relationship dynamics as the context for potential abusive interactions. METHODS: Youth and young adults (ages 10-18â¯at baseline) were surveyed along with a matched parent/caregiver. Data, including parent and youth responses (nâ¯=â¯437 youth/parent dyads), are drawn from the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV). RESULTS: Applying latent class analytic techniques with seven different positive and problematic descriptors of dating relationships, this study found four classes of relationship dynamics representing healthy, unhealthy, intense, and disengaged relationships. The intense relationship dynamic class exhibits the strongest associations with reports of any youth and young adult partner abuse, as well as distinctly with the subtypes of psychological, physical, and sexual victimization and perpetration. CONCLUSIONS: Results demonstrate the importance of clinicians, parents and other responsible adults attending to an array of youth and young adult dating relationship dynamics rather than single indicators, to assess youth and young adult risk for involvement in abusive relationships.
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Vítimas de Crime/estatística & dados numéricos , Relações Interpessoais , Violência por Parceiro Íntimo/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adolescente , Adulto , Criança , Vítimas de Crime/psicologia , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Análise de Classes Latentes , Estudos Longitudinais , Masculino , Pais/psicologia , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
Depression is a particularly prevalent form of psychopathology affecting millions of individuals worldwide. It is associated with a variety of adverse social and behavioral outcomes. Numerous observational studies have found that depressed individuals have significantly elevated rates of interpersonal violence. As of now, the social mechanisms that explain the association between depression and violence remain understudied and not well understood. Drawing on the aggression and social psychology literatures, we argue that depressed actors suffer skills deficits and exhibit hostile communication styles that provoke grievances and disputes. We suggest that, because of these interpersonal tendencies, depression increases involvement in verbal disputes, and that frequent participation in verbal disputes foments social contexts where interpersonal violence is more common. Findings from a series of regression models based on a nationally representative sample of 2171 respondents offer support for our assumptions. The study suggests a consideration of interpersonal dynamics, particularly verbal disputes, might unlock clues about the association between depression and violence involvement.
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Agressão/psicologia , Depressão/psicologia , Relações Interpessoais , Violência/psicologia , Adulto , Feminino , Humanos , Masculino , Grupo Associado , Fatores de Risco , Estresse Psicológico/psicologiaRESUMO
Significant disparities exist between rural-urban U.S. POPULATIONS: Besides higher smoking rates, rural Americans are less likely to be protected from SHS. Few studies focus across all regions, obscuring regional-level differences. This study compares support for SHS restrictions across all HHS regions. DATA: 2014/15 TUS-CPS; respondents (nâ¯=â¯228,967): 47,805 were rural residents and 181,162 urban. We examined bi-variates across regions and urban-rural adjusted odds ratios within each. Smoking inside the home was assessed along with attitudes toward smoking in bars, casinos, playgrounds, cars, and cars with kids. Urban respondents were significantly more supportive of all SHS policies: (e.g. smoking in bars [57.9% vs. 51.4%]; support for kids in cars [94.8% vs. 92.5%]. Greatest difference between urban-rural residents was in Mid-Atlantic (bar restrictions) and Southeast (home bans): almost 10% less supportive. Logistic regression confirmed rural residents least likely, overall, to support SHS in homes (ORâ¯=â¯0.78, 95% CI 0.74, 0.81); in cars (ORâ¯=â¯0.87, 95% CI 0.79, 0.95), on playgrounds (ORâ¯=â¯0.88, 95% CI.83, 0.94) and in bars ORâ¯=â¯0.88, 95% CI 0.85, 0.92), when controlling for demographics and smoking status. South Central rural residents were significantly less likely to support SHS policies-home bans, smoking in cars with kids, on playgrounds, in bars and casinos; while Heartland rural residents were significantly more supportive of policies restricting smoking in cars, cars with kids and on playgrounds. Southeast and South Central had lowest policy score with no comprehensive state-level SHS policies. Understanding differences is important to target interventions to reduce exposure to SHS and related health disparities.
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Exposição Ambiental/efeitos adversos , Disparidades nos Níveis de Saúde , População Rural , Política Antifumo , Poluição por Fumaça de Tabaco/prevenção & controle , Adulto , Idoso , Atitude , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , População UrbanaRESUMO
Witnessing inter-parental intimate partner violence has been found to be associated with adolescents' own relationship abuse. This study investigates the relationship between patterns of inter-parental intimate partner verbal and physical violence victimization reported by parents and their children's reports of dating abuse experiences and behavior. Latent class analysis was performed on a sample of 610 parents (42% male and 67% white) and their dating adolescent children (ages 12-21 years; 52% male). Parents reported five types of victimization by their partners in the past year, while youth concurrently reported their own victimization and perpetration within their dating relationships. Three profiles of parents' intimate partner victimization were related to youth relationship abuse experiences and behaviors. Children of parents who experienced verbal abuse were more likely to experience similar patterns in their own relationships, whereas children of parents who report physical and verbal abuse were more likely to report psychological, physical and sexual abusive encounters in their partnerships. Findings indicate that parents' relationship quality and abusive behaviors may have a long lasting effect on their children as they enter mid and late adolescence. Parents should pay attention to their own relationship quality and behavior even as their teen-age children gain independence.
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Comportamento do Adolescente , Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Pais/psicologia , Psicologia do Adolescente , Adolescente , Adulto , Agressão/psicologia , Bullying , Criança , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Masculino , Adulto JovemRESUMO
The purpose of this longitudinal study was to investigate whether there are distinct etiological processes explaining dual usage of alcohol and conventional cigarettes by mothers from preconception through the early parenting years. Data on 8800 biological mothers were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), representative of US births in 2001. A general growth mixture model (GGMM) was used to empirically identify developmental trajectories of maternal smoking and drinking over the 5-6-year study period. Six classes defined by alcohol consumption and cigarette smoking were identified. These included a nonsmoking, low probability of drinking class (41%), and two drinking classes displaying no smoking with either moderate (26%) or escalating high (8%) probability drinking. Additionally, two predominantly smoking classes were identified, one displaying temporary reduction in smoking during pregnancy and low probability of drinking (11%) and one following a trajectory of persistent heavy smoking with a declining probability of drinking (9%). The sixth class was described by temporary reduction in smoking during pregnancy with high probability of drinking (6%). Covariates differentially predicted class membership, e.g., having a high school degree but not further education predicted concurrent drinking and smoking, and breastfeeding for more than 6 months is protective against concurrent use. Prior to conception, during prenatal care, and in post-natal clinical visits, whether for personal or pediatric care, screening women of reproductive age via characteristics that predict heterogeneity in smoking and drinking trajectories may help guide prevention and treatment options.
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Consumo de Bebidas Alcoólicas , Pais , Fumar , Feminino , Humanos , Gravidez , ProbabilidadeRESUMO
BACKGROUND: Highly pathogenic avian influenza A (H5N1) virus has been of public health concern since 2003. Probable risk factors for A(H5N1) transmission to human have been demonstrated in several studies or epidemiological reports. However, transmission patterns may differ according to demographic characteristics of the population and local practices. This article aggregates these data from three studies with data collected in the previous surveys in 2006 and 2007 to further examine the risks factors associated with presence of anti-A(H5) antibodies among villagers residing within outbreak areas. METHODS: We aggregated 5-year data (2006-2010) from serology survey and matched case-control studies in Cambodia to further examine the risks factors associated with A(H5N1) infection among villagers in the outbreak areas. RESULTS: Serotesting among villagers detected 35 (1.5 % [0-2.6]) positive cases suggesting recent exposure to A(H5N1) virus. Practices associated with A(H5N1) infection among all ages were: having poultry cage or nesting area under or adjacent to the house (OR: 6.7 [1.6-28.3]; p = 0.010) and transporting poultry to market (OR: 17.6 [1.6-193.7]; p = 0.019). Practices found as risk factors for the infection among age under 20 years were swimming/bathing in ponds also accessed by domestic poultry (OR: 4.6 [1.1-19.1]; p = 0.038). Association with consuming wild birds reached borderline significance (p = 0.066). CONCLUSION: Our results suggest that swimming/bathing in contaminated pond water and close contact with poultry may present a risk of A(H5N1) transmission to human.