Nomophobia and Alcohol, Tobacco, and Cannabis Consumption in Adolescents in Galicia.

This study aimed at exploring the association of nomophobia with alcohol, tobacco, and/or cannabis consumption among high school students. We carried out a cross-sectional study among high school and vocational training students in Galicia, Northwest Spain (N = 3,100). Collected data included nomophobia, sociodemographic variables, and alcohol, tobacco, and cannabis consumption. Nomophobia was measured using the validated Nomophobia Questionnaire. Adjusted odds ratios (ORs) and their 95 percent confidence intervals (CIs) were estimated using generalized linear mixed models. More than a quarter of the adolescents (27.7 percent) had nomophobia. We found an association between nomophobia and a high level of tobacco smoking in the last month in boys (OR = 2.16; 95 percent CI: 1.55-3.03). Nomophobia was also associated with higher odds of binge drinking in both genders (girls: OR = 1.86; 95 percent CI: 1.61-3.52; boys: OR = 2.29; 95 percent CI: 1.68-3.13) and with cannabis consumption in boys (OR = 1.74; 95 percent CI: 1.07-2.81). Our findings highlight the importance of a comprehensive investigation of the factors underlying alcohol, tobacco, and cannabis consumption in the adolescent population.

Percepción del consumo de alcohol propio y de allegados en universitarios de primer curso como predictor del consumo a 10 años. / Percepción del consumo de alcohol propio y de allegados en universitarios de primer curso como predictor del consumo a 10 años.

The alcohol use perceptions young people have of those close to them can affect their expectations regarding alcohol and, thus, their own drinking. We aim to identify the predictive ability of own and significant others' perceived drinking at age 18-19 in the alcohol use patterns at 27-28. A cohort study was carried out among university students in Spain (n=1,382). Binge Drinking (BD) and Risky Consumption (RC) were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). College students perceive their family's alcohol consumption as very low or nothing, while the perception of their own alcohol use or that of their friends is higher. Perceiving higher alcohol use among their siblings and friends increases the risk of BD for both sexes and RC for women. Living away from the parental home increases the risk of RC and BD. In conclusion, the perception of their friend's alcohol use at age 18-19 is the most influential variable in BD among both sexes and in RC among men throughout 10 years of follow-up. Parental alcohol consumption does not affect college student drinking patterns when friends and siblings are considered. Living with one's family acts as a protective factor. Preventive measures focused on young people should take a contextual approach and include those closest to them.

El consumo percibido por los jóvenes de sus allegados puede afectar a las expectativas respecto al consumo de alcohol y de este modo, a su propio consumo. El objetivo del estudio ha sido identificar la capacidad predictiva de la percepción de consumo de alcohol propio y de los allegados al inicio del periodo universitario, en los patrones de consumo observados a lo largo de 10 años de seguimiento. Se ha llevado a cabo un estudio de cohortes en universitarios en España (n=1.382). Consumo Intensivo de Alcohol (CIA) y Consumo de Riesgo de alcohol (CRA) se midieron con el Test de Identificación de los Trastornos debidos al Uso de Alcohol (AUDIT) a los 18, 20, 22, 24 y 27 años. Se calcularon las Odds Ratios (ORs) con regresión logística multinivel para medidas repetidas. Los universitarios percibían bajo o nulo consumo de alcohol de sus familiares y mayor de sus amigos. Percibir mayor consumo de sus hermanos y amigos aumentó el riesgo de CIA en ambos géneros y de CRA en mujeres. Vivir fuera del domicilio familiar aumentó el riesgo de ambos patrones. En conclusión, la percepción del consumo de alcohol de amigos a los 18-19 años resultó la variable más influyente para el CIA en ambos géneros y el CRA en mujeres a lo largo de 10 años de seguimiento. El consumo de alcohol de los padres al inicio del periodo universitario parece no afectar a los patrones de consumo practicados durante la juventud, una vez se ajusta por el consumo de amigos y hermanos. Vivir en el domicilio familiar actúa como factor protector. Las medidas preventivas en los jóvenes deben tener un enfoque contextual incluyendo a sus allegados.

Clinical Features and Long-Term Outcomes in Very Young Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries.

Background: The main cause of acute coronary syndrome (ACS) is coronary artery obstruction due to atherosclerotic plaque growth or thrombus formation secondary to plaque rupture or erosion. However, there is a subgroup of patients with signs and symptoms suggestive of ACS but without relevant coronary artery obstruction on coronary angiography. This population is defined as myocardial infarction with non-obstructive coronary arteries (MINOCA). The present study analyzes the clinical features and outcomes of very young patients with a diagnosis of MINOCA. Method: Nested case-control study of ≤40-year-old patients referred for coronary angiography due to clinical suspicion of ACS. Patients were divided into three groups: patients with obstructive coronary artery disease (CAD), patients diagnosed with MINOCA, and controls with non-coronary artery disease. Results: Of 19,321 coronary angiographies performed in our center in a period of 10 years, 408 (2.1%) were in patients ≤40 years old, and MINOCA was identified in 32 (21%) patients. The cardiovascular risk factors for obstructive CAD and MINOCA were very similar. The incidence of major adverse cardiovascular events (MACE) at follow-up was significantly higher in the MINOCA (HR 4.13 (95%CI 1.22-13.89) and obstructive CAD (HR 4.59 (95%CI 1.90-10.99) patients compared to controls. Cocaine use HR 14.58 (95%CI 3.08-69.02), family history of CAD HR 6.20 (95%CI 1.40-27.43), and depression HR 5.16 (95%CI 1.06-25.24) were associated with a poor outcome in the MINOCA population. Conclusion: Very young patients with MINOCA had a poor prognosis at long-term follow-up, similar to patients with obstructive CAD. Focusing efforts on secondary prevention is essential in this population.

Analysis of AUDIT Domains in Freshman Students in Spain: Three Cross-Sectional Surveys (2005, 2012 and 2016).

Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify risk-associated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependence.

Coronary Artery Disease in Very Young Patients: Analysis of Risk Factors and Long-Term Follow-Up.

Coronary artery disease (CAD) is a common chronic condition in the elderly. However, the earlier CAD begins, the stronger its impact on lifestyle and costs of health and social care. The present study analyzes clinical and angiographic features and the outcome of very young patients undergoing coronary angiography due to suspected CAD, including a nested case-control study of ≤40-year-old patients referred for coronary angiography. Patients were divided into two groups: cases with significant angiographic stenosis, and controls with non-significant stenosis. Of the 19,321 coronary angiographies performed in our center in a period of 10 years, 504 (2.6%) were in patients ≤40 years. The most common cardiovascular risk factors for significant CAD were smoking (OR 2.96; 95% CI 1.65-5.37), dyslipidemia (OR 2.18; 95% CI 1.27-3.82), and family history of CAD (OR 1.95; 95% CI 1.05-3.75). The incidence of major adverse cardiovascular events (MACE) at follow-up was significantly higher in the cases compared to controls (HR 2.71; 95% CI 1.44-5.11). Three conventional coronary risk factors were directly related to the early signs of CAD. MACE in the long-term follow-up is associated to dyslipidaemia and hypertriglyceridemia. Focusing efforts for the adequate control of CAD in young patients is a priority given the high socio-medical cost that this disease entails to society.

Using Machine Learning Techniques to Predict MACE in Very Young Acute Coronary Syndrome Patients.

Coronary artery disease is a chronic disease with an increased expression in the elderly. However, different studies have shown an increased incidence in young subjects over the last decades. The prediction of major adverse cardiac events (MACE) in very young patients has a significant impact on medical decision-making following coronary angiography and the selection of treatment. Different approaches have been developed to identify patients at a higher risk of adverse outcomes after their coronary anatomy is known. This is a prognostic study of combined data from patients ≤40 years old undergoing coronary angiography (n = 492). We evaluated whether different machine learning (ML) approaches could predict MACE more effectively than traditional statistical methods using logistic regression (LR). Our most effective model for long-term follow-up (60 ± 27 months) was random forest (RF), obtaining an area under the curve (AUC) = 0.79 (95%CI 0.69-0.88), in contrast with LR, obtaining AUC = 0.66 (95%CI 0.53-0.78, p = 0.021). At 1-year follow-up, the RF test found AUC 0.80 (95%CI 0.71-0.89) vs. LR 0.50 (95%CI 0.33-0.66, p < 0.001). The results of our study support the hypothesis that ML methods can improve both the identification of MACE risk patients and the prediction vs. traditional statistical techniques even in a small sample size. The application of ML techniques to focus the efforts on the detection of MACE in very young patients after coronary angiography could help tailor upfront follow-up strategies in such young patients according to their risk of MACE and to be used for proper assignment of health resources.

Validation of the Arabic and French Versions of a Knowledge, Attitudes and Practices (KAP) Questionnaire on Tranquilizer Misuse.

Tranquilizer misuse is an emerging international public health concern. The psychosocial determinants of this misuse remain understudied. Instruments to measure the Knowledge, Attitudes and Practices (KAP) of tranquilizer misuse are unavailable, except for a recently published questionnaire validated in the Spanish language. We translated the KAP questionnaire into Arabic and French, adapted it and undertook a complete validation procedure in the general adult population in Lebanon. The content validity indicators were good: item content validity index ranged between 0.89 and 1.00, the content validity index scale average was ≥0.95 and the modified Kappa statistic for each of the KAP items was equal to I-CVI. The intra-class correlation coefficient values (n = 100) were ≥0.62 for all Knowledge and Attitudes items, demonstrating the item reliability. Confirmatory factorial analysis (n = 1450) showed that the selected model of Knowledge and Attitude constructs has adequate fit indicators and encompassed three factors that showed acceptable internal reliability: Knowledge (Cronbach's alpha = 0.72), personal Attitudes towards tranquilizers (Cronbach's alpha = 0.79) and Attitudes towards healthcare providers (Cronbach's alpha = 0.65). The Arabic/French questionnaire was highly accepted, with a response rate of 95.72% and item non-response rate ≤3.6%. The availability of a cross-cultural adapted and multilingual validated questionnaire would stimulate research on tranquilizer misuse.

Heavy metal contamination in Peru: implications on children's health.

Cerro de Pasco, Peru, has been excessively contaminated with heavy metals due to high mining activities in the region. We investigated the presence of chronic exposure to heavy metals in children living in Cerro de Pasco and its effect on health. Heavy metal concentrations were determined in hair samples collected from 78 children living in a region exposed to an open-pit mine (Paragsha region) and from other 16 children unexposed to mine activities (Carhuamayo region). Children exposed to the mine showed statistically significant higher concentration of aluminum, antimony, arsenic, cadmium, chromium, iron, lead, tin and thallium (p < 0.05) than control children. Hair samples collected from the same children in two occasions (2016 and 2018) showed that the exposure is chronic with higher levels of heavy metals observed in 2018. The concentration of heavy metals was higher in hair tip than in hair root samples. Heavy metals are associated with substantial higher risk of nosebleed (odds ratio, OR = 15.40), chronic colic (OR = 7.30), dermatologic alterations (OR = 6.16), mood alterations (OR = 7.07), presence of white lines on nails (OR = 12.10), reduced visual camp (OR = 3.97) and other symptoms (OR = 5.12). Chronic heavy metal exposure implies various negative consequences on children's health. Preventive measures are crucial to protect children's health.

Contextual Determinants in Alcohol, Tobacco and Cannabis Consumption, Mood and Bullying during Adolescence.

The present study aimed to explore the differences in the consumption of alcohol, tobacco and cannabis, mood and bullying between adolescents. A cross-sectional study was carried out in five regions of Northern Spain (one in Galiza and four in central Catalonia) that share similar socioeconomic characteristics and encompass around 10,000 inhabitants each. Students living in Burela, Galiza (N = 71) were compared to those of Central Catalonia (N = 193). The independent variable was the municipality of residence. The dependent variables encompassed: weekly available pocket money, Family Affluence Scale, self-classified academic qualification, place of origin, alcohol consumption, tobacco and cannabis smoking, negative mood and bullying. The mean age and their 95% confidence intervals (95% CI) of participants were similar between the regions (Burela: 15.90 years (15.68-16.13) and Central Catalonia: 15.36 years (15.28-15.44)). More than half of the participants were females (Burela, Galiza (53.5%) and Catalonia (54.9%)). Prevalence ratios (PR) and their 95% CI were estimated using Poisson regression models. In comparison with adolescents from Burela (Galiza), those living in Central Catalonia had higher prevalence of diverse academic levels (adjusted PR = 3.92 (1.78-8.66)), tobacco consumption (adjusted PR = 2.41 (1.47-3.97)) and negative mood (adjusted PR = 5.97 (3.05-11.70)). Even when dealing with regions with similar socioeconomic characteristics and number of inhabitants, differences exist in terms of the socioeconomic level, tobacco consumption, mood and bullying, as reported by adolescents.

Alcohol Consumption among Freshman College Students in Spain: Individual and Pooled Analyses of Three Cross-Sectional Surveys (2005, 2012 and 2016).

Objective: We aimed to evaluate changes in the prevalence of Heavy Episodic Drinking (HED) and Risky Consumption (RC) in freshman college students between 2005, 2012 and 2016; and to identify the explanatory variables of these patterns of consumption using individual and pooled analyses. Methods: A cross-sectional study involving 5260 students was carried out in Spain in 2005, 2012 and 2016. HED and RC were determined using the Alcohol Use Disorders Identification Test. Another questionnaire was used to measure parental education level and alcohol use, alcohol-related problems, age of onset of alcohol use and alcohol-related expectancies. Adjusted Odds Ratios (ORs) of RC and HED and their 95% Confidence Intervals were estimated using logistic regression. Results: An increase in the prevalence rates of HED and RC was observed among women during the three-study periods, nonetheless there was no statistically significant difference in the prevalence rates among men. High maternal educational level, living away from parental home, initiating drinking before the age of 15 and having positive expectancies about drinking are associated with higher prevalence of RC in both genders. High positive expectancies and early onset of alcohol use are associated with higher rates of HED among men and women. Students recruited in 2012 and 2016 are protected against RC in comparison to those recruited in 2005. Conclusions: The age of alcohol consumption onset is the most influencing factor on HED and RC for both genders in the three-study periods. Alcohol prevention campaigns targeting youth at early ages can reduce risky drinking behaviors.

Alcohol Use and Sexual and Physical Assault Victimization Among University Students: Three Years of Follow-Up.

The aim of this study was to determine the incidence of sexual and physical assault among university students and its association with alcohol use. The research is part of a wider cohort study (Spit for ScienceTM) at a large public university in the United States. The follow-up data include the first two cohorts (2011, 2012; n = 5,170). The dependent variables were victim of sexual assault and victim of physical assault. The independent variables were alcohol dependence and abuse according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.), cannabis use, residence, ethnicity, sexual orientation, and previous experience of sexual assault and/or physical assault. We used multilevel logistic regression for repeated measures. All data were analyzed using generalized linear mixed models. Incidence rates of sexual and physical assault (per 100 students a year) were 15.1 and 27.6 among nonabusers/dependents versus 36.4 and 56.7 among alcohol-dependent females at the first year, and 2.8 and 4.7 versus 7.7 and 23.1 at the third year; while in males, incident rates were 6.0 and 3.1 versus 18.5 and 66.6, and 2.3 and 7.4 versus 18.9 and 15.1, respectively. Our results show that alcohol abuse and dependence constitute risk factors to be victim of sexual assault in males (odds ratio [OR] = 2.21 and OR = 2.73) and alcohol dependence in females (OR = 2.16). Similarly, alcohol abuse and dependence are risk factors to physical assault among both males (OR = 1.52 and OR = 2.03) and females (OR = 1.70 and OR = 2.88). Ethnicity, sexual orientation, and whether the individual had been victimized in the past were associated with sexual assault. Regarding physical assault, cannabis use and past victimization are also risk factors. Our study has shown that assault victimization is strongly related to alcohol abuse and dependence diagnoses in both genders. Ethnicity and sexual orientation are also associated to both assaults. Our results show that incidence rates of both types of assaults were clearly higher in the first 6 months of university, probably explained by the novel and potentially risky environment.

The Use of Non-Prescribed Prescription Drugs and Substance Use Among College Students: A 9-Year Follow-Up Cohort Study.

The use of non-prescribed prescription drugs (NPPD) is common in post-modern societies and a significant proportion of youth consume NPPD concomitantly to other drugs. We studied the prevalence of this consumption among university students in Spain, and its relationship to different patterns of alcohol, tobacco, and cannabis use. A cohort study among university students (n=1,380) (2005-2015) was carried out. Students completed self-administered questionnaires at initial (n=1,363, 98.7%), at 2 years (n=875, 75%) and 9 years of follow-up (n=415, 30.5%). Consumption of medicines (last 15 days), risky alcohol consumption (RC), heavy episodic drinking (HED), and tobacco and cannabis use were measured. Multilevel logistic regressions for repeated measures were generated using consumption of medicines with or without medical prescription as dependent variables. Prevalence of RC, HED, tobacco and cannabis had significant reductions during the follow-up. The use of NPPD increased over time, from 35.5% and 33.3% at 18 and 22 years old, respectively, to 49.6% at 27 years old. The highest rates were found among cannabis, tobacco, RC and HED users. For females, cannabis and RC constitute signitifant risk factors for use of NPPD. Conversely, for males, tobacco and cannabis were risk factors for such use of medicines. Later onset of alcohol consumption constitutes a protective factor for females. Our results reveal high prevalence of NPDD among university students. Those who consume NPPD are -at the same time- more likely to be alcohol, tobacco, and cannabis users than those who take medication under prescription. Preventive strategies should be reinforced and focused on this target population to decrease these high levels of poly-consumption.

We Need to Delay the Age of Onset of Alcohol Consumption.

In recent years, new consumption patterns, such as binge drinking, have increased among young people and have not always been recognized as problematic either by health personnel or by society in general, as they are intensive episodes, interspersed with no consumption periods. Although the prevalence of alcohol use disorders in the adult population continues to be higher in men than in women, these gender differences in relation to alcohol consumption are barely observed in adolescents between 14 and 18. Therefore, we are witnessing a change in the pattern of consumption, from regular to episodic, and an attenuation of gender differences. New patterns of alcohol consumption have not only been associated with an increased risk of alcohol use disorders in adult life, but also with neurocognitive involvement in youth. Understanding the risk and resilience factors of alcoholism or problematic drinking patterns will not only allow us to identify the most vulnerable group, but also to guide prevention programs towards protective factors; the skills that contribute to the natural abandonment of the pattern. Knowing the variables involved in the trajectories of abandonment and dependency would contribute to personalizing the interventions and increasing their efficacy and success-a lower relapse rate-, reducing the economic and socio-sanitary costs associated with alcohol dependency, as well as improving the health and well-being, family relations, work and social status of alcohol-dependent people.

Population Attributable Fraction of Early Age of Onset of Alcohol Use in Alcohol Abuse and Dependence: A 3-Year Follow-Up Study in University Students.

BACKGROUND: we aimed to determine the risk factors and associated population attributable fractions (PAFs) for the age of onset of alcohol use and also to identify protective factors. METHODS: we analyzed follow-up data collected between autumn 2011 and spring 2016 (n = 5170) from the first two cohorts (2011, 2012) of the Spit for ScienceTM project. The dependent variables were alcohol abuse and dependence, and the independent variables were age of drinking onset, residence, ethnicity, religiosity, sexual orientation and work status. We determined the odds ratios (OR) using multilevel logistic regression for repeated measures in SPSSv.20. RESULTS: the early onset of alcohol use was associated with an increased risk of alcohol abuse and dependence among females (OR = 14.98; OR = 11.83) and males (OR = 7.41; OR = 6.24). The PAFs for the early onset of alcohol use in alcohol abuse and dependence were respectively 80.9% and 71.7% in females and 71.0% and 63.5% in males. Among females, being white (OR = 1.58; OR = 1.51), living off-campus (OR = 1.73; OR = 2.76) and working full-time (OR = 1.69; OR = 1.78) were also risk factors. Strong religious beliefs were found to protect males from alcohol abuse (OR = 0.58), while same-gender sexual orientation increased the risk among females (OR = 2.09). CONCLUSION: delaying the age of onset by one year would reduce alcohol abuse among young adults.

Association between negative mood states, psychoactive substances consumption and bullying in school-aged adolescents. / Asociación entre los estados de ánimo negativo, el consumo de sustancias psicoactivas y el bullying en adolescentes escolarizados.

OBJECTIVE: mental health problems during adolescence lead to increased morbidity and mortality. We intend to test the hypothesis that bullying and addictive substance use is related to negative mood states. METHODS: We carried out a cross-sectional study among high school students in Burela (Northern Spain) (n=238). "Negative mood state" was defined as experiencing the following: feeling tired, sad, out of place, bored, hopeless, nervous or lacking sleep. Independent variables were binge drinking, having smoked tobacco or cannabis, and the corresponding perceived risk of using them. The variable bullying was also measured. Poisson regression models with robust variance were estimated, and Prevalence Ratios were obtained. RESULTS: 10.5% [CI 95% (7.2-15.2)] of the students reported suffering negative mood states. Students declaring low perceived risk of cannabis use [PR = 2.6 (1.2-5.5)], having tried this addictive substance at some point [PR = 3.1 (1.1-8.9)] and having suffered bullying [PR = 4.8 (2.4-9.6)] increased the risk of experiencing negative mood states. CONCLUSION: It would be advisable to design and implement interventions aimed at improving mental health during adolescence which account for the use of addictive substances and being a victim of bullying.

Antecedentes: los problemas de salud mental durante la adolescencia suponen un aumento de la morbimortalidad y la discapacidad. Se pretende testar la hipótesis de que el bullying y el consumo de sustancias psicoactivas están asociados al estado de ánimo negativo.Métodos: estudio transversal entre estudiantes de Educación Secundaria Obligatoria (ESO) (n=238) de los institutos de Burela (Lugo). El "estado de ánimo negativo" se definió a partir de los siguientes ítems: sentirse cansado/a, triste, desplazado/a, aburrido/a, desesperanzado/a, nervioso/a o insomne. Como variables independientes se consideraron: el binge drinking, el haber fumado alguna vez tabaco o cannabis, así como sus correspondientes percepciones de peligrosidad. Además, se midió la variable bullying. Se estimaron modelos de regresión de Poisson con varianza robusta y se obtuvieron Razones de Prevalencia (RP).Resultados: el 10,5% [IC95% (7,2-15,2)] de la población encuestada presentaba estado de ánimo negativo. La nula o baja percepción de peligrosidad para el cannabis [RP=2,6 (1,2-5,5)], haber probado alguna vez esta sustancia adictiva [RP=3,1 (1,1-8,9)] y haber sufrido bullying [RP=4,8 (2,4-9,6)] se asociaban al estado de ánimo negativo.Conclusiones: sería recomendable crear intervenciones para la mejora de la salud mental durante la adolescencia que tengan en cuenta el consumo de sustancias adictivas y el hecho de haber sufrido bullying.

[Alcohol outlet density and alcohol consumption in Galician youth]. / Densidad de los puntos de venta de alcohol y su consumo en jóvenes de Galicia.

OBJECTIVE: To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). METHOD: A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students' home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. RESULTS: The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). CONCLUSION: These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population.

Heavy Drinking and Non-Medical Use of Prescription Drugs among University Students: A 9-Year Follow-Up.

Purpose: Investigations suggest non-medical use of prescription drugs (NMUPD) is associated with heavy drinking and polydrug use among university students. Our aim is to determine the prevalence of NMUPD among university students and to analyze its association with alcohol, tobacco, and cannabis use, and to study the role of the age of drinking onset. Methods: Cohort study among university Spanish students (n = 1382). Heavy drinking (HED) and risky consumption (RC) were measured with the Alcohol Use Disorders Identification Test. Questions related to tobacco and cannabis consumption were also formulated. NMUPD refers to sedative, anxiety, or pain medication intake within the last 15 days without medical prescription. All variables were measured at 18, 20, and 27 years. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (odds ratios). We analyzed the results from a gender perspective. Results: Prevalence of NMUPD were higher in students who already partook in NMUPD at the beginning of the study. NMUPD in women at 27 is 3 times higher than at 18, while in men it is twice. Among females, RC (OR = 1.43) and cannabis consumption (OR = 1.33) are risk factors for NMUPD, while later onset of alcohol use (OR = 0.66) constitutes a protective factor. No significant differences were found for males. Conclusions: NMUPD is prevalent among university students. RC and early onset of alcohol use were associated with higher prevalence of NMUPD in females. The prevalence of NMUPD increased with age in both sexes. Strategies for reducing risky drinking and delaying onset of drinking should be provided for university students. Pharmacists and parents should be alerted to the risk of NMUPD.

[Public health competencies and contents of Nursing degree programs in Spanish universities]. / Competencias y contenidos de Salud Pública del Grado de Enfermería en las universidades españolas.

OBJECTIVE: The Forum of Public Health University Teachers aims to update the Public Health training in the degree studies. The aim was to determine the competences and basic contents of Public Health of Nursing Degree in Spain according to the criterion of the university academic staff. METHODS: Qualitative study, based on the nominal group technique. The snowball sampling was used to recruit Public Health professors of the Nursing degree, with full time dedication and preferably of the area of Preventive Medicine and Public Health. Finally, 17 professors from 11 public universities participated, who formed the Forum of University Professors of Public Health of the Nursing Degree, which was held at the University of Barcelona. RESULTS: Nursing professors selected 43 of the 80 competences which are recognized for Public Health professionals. The majority corresponded to the functions 'Assessing population health needs' and 'Developing health policies'. Professors also got to agree about 47 issues organized in 7 blocks, with contents on introduction of Public Health, demography, health determinants, epidemiology of communicable and non-communicable diseases, health systems and health management, and health promotion and education for health. CONCLUSIONS: The university teachers agreed on Public Health competencies and contents suitable for the Nursing Degree. This consensus constitutes a reference to elaborate educational guides of Public Health for Nursing Degree.

OBJECTIVO: El Foro de Profesorado Universitario de Salud Pública pretende actualizar la formación de Salud Pública en los estudios de grado.El objetivo fue determinar las competencias y contenidos básicos de Salud Pública del Grado de Enfermería en España según el criterio del profesorado universitario. METODOS: Estudio cualitativo, basado en la técnica de grupo nominal. Se consultaron las guías docentes de las asignaturas de Salud Pública y se empleó la técnica bola de nieve para reclutar a profesorado de Salud Pública del Grado de Enfermería, con dedicación a tiempo completo y preferentemente del área de Medicina Preventiva y Salud Pública. Participaron 17 docentes de 11 universidades públicas, que constituyeron el Foro de Profesorado Universitario de Salud Pública del Grado de Enfermería, celebrado en la Universitat de Barcelona en enero de 2017. RESULTADOS: Se seleccionaron 43 de las 80 competencias profesionales reconocidas para el ámbito de la Salud Pública. La mayoría, se correspondieron con las funciones de 'Valorar las necesidades de salud de la población' y 'Desarrollar las políticas de salud'. También se consensuaron 47 unidades temáticas organizadas en 7 bloques, con contenidos sobre introducción a la salud pública, demografía, determinantes de salud, epidemiología de enfermedades trasmisibles y no trasmisibles, sistemas sanitarios y gestión, y promoción y educación para la salud. CONCLUSIONES: El profesorado universitario consensuó competencias y contenidos de Salud Pública adecuados para el Grado de Enfermería. Dicho consenso constituye una referencia para elaborar guías docentes de Salud Pública en el Grado de Enfermería.

Trends in alcohol use among young people according to the pattern of consumption on starting university: A 9-year follow-up study.

AIM: To identify differences in Risky Consumption (RC) and Binge drinking (BD) trends in students who already followed these patterns of alcohol consumption on starting university and those who did not, and also to try to understand what leads students to engage in these types of behaviour at university. MATERIAL AND METHODS: Cohort study among university students in Spain (n = 1382). BD and RC were measured with the Alcohol Use Disorders Identification Test at ages 18, 20, 22, 24 and 27 years. Multilevel logistic regression for repeated measures was used to calculate the adjusted Odds Ratios (ORs). RESULTS: The prevalence rates of RC and BD were lower throughout the study in students who did not follow these patterns of consumption at age 18. For RC and BD, the differences at age 27 years, expressed as percentage points (pp), were respectively 24 pp and 15 pp in women and 29 pp and 25 pp in men. Early age of onset of alcohol use increased the risk of engaging in RC and BD patterns at university, for men (OR = 2.91 & 2.80) and women (OR = 8.14 & 5.53). The same was observed in students living away from the parental home for BD (OR = 3.43 for men & 1.77 for women). Only women were influenced by having positive expectancies for engaging in RC (OR = 1.82) and BD (OR = 1.96). CONCLUSIONS: The prevalence rates of both RC and BD at age 27 years were much higher among university students who already followed these patterns of consumption at age 18 years, with the differences being proportionally higher among women. Focusing on the age of onset of alcohol consumption and hindering access to alcohol by minors should be priority objectives aimed at preventing students from engaging in these patterns of alcohol consumption at university.