Medical use, nonmedical use of prescription medication and risk behaviour among Croatian adolescents.

BACKGROUND: At the drug scene some major shifts were observed, more and more reports highlighted the abuse of prescription medication. Despite the importance of controlled medication in treatment child and adolescent disorders, this increase may be a factor which influence misuse and nonmedical use of prescribed drugs among adolescents. SUBJECT AND METHODS: Croatian data from ESPAD survey in 2003, 2007 and 2011 were used, and variables selected from the international ESPAD questionnaire. Dependent variable was taking tranquilizers or sedatives prescribed by doctor in the past 12 months. Independent variables were nonmedical use of tranquilizers/sedatives, use of other psychoactive substances, school performance, truancy, delinquent behaviour, satisfaction with relationships with parents, friends, health, self-perception, financial situation and symptoms of depression. The respondents were 8849 students (4393 boys and 4456 girls) in three consecutive ESPAD surveys (2003, 2007 and 2011). RESULTS: In multivariate analysis for all three survey years the strongest predictor for prescription medication use was use of sedatives/tranquilizers without prescription (OR 6.14; CI 4.08-9.23; OR 8.16; CI4.65-14.32; OR 9.77; CI5.92-15.13). Frequent drinking and excessive drinking or drunkenness also predicted prescription medication use, (OR 1.85; CI1.10-3.10; OR 2.01: CI 1.20-3.39). Among other problem behaviours lower school performance (OR 2.92; CI 1.41-6.05; OR 2.56; CI 1.12-5.87), missed school days OR 1.59; OR1.01-2.51; OR1.72; CI 1.03-2.87), aggressive behaviour (OR 1.532; CI 1.01-2.28; OR1.65; CI 1.04-2.62), depressive symptoms (OR 2.19; CI 1.24-3.85) and poorer financial situation were connected with prescription medication use. CONCLUSION: Prescription use of tranquilizers/sedatives was predicted by nonmedical tranquilizers/sedatives use, alcohol abuse, symptoms of depression and variables indicating maladjusted behaviour. Although there is sufficient evidence that prescription medication abuse might went unobserved, the further analysis which could better explain its' role and impact is still needed.

School health services in the City of Zagreb - do we meet adolescents' needs?

BACKGROUND: School health services (SHS) have in Croatia long tradition, established organizational structure, defined program and educated staff. The program is limited to the preventive activities. The aim of the study was to investigate the satisfaction of the children, school staff and parents with existing school health services in the City of Zagreb. SUBJECT AND METHODS: The structured questionnaire was sent to the primary and secondary schools in the City of Zagreb, which were selected using random sample method. The questionnaires were anonymous and filled in supervised by class masters. In the secondary schools the structure of schooling was respected. Questionnaires were filled by 448 pupils from primary, 551 from secondary schools, by 596 parents and 595 teachers. RESULTS: In primary schools pupils rated SHS more available and accessible, staff complaisant and responsible, counselling being useful and justified, confidentiality respected higher than pupils from secondary schools (p<0.001). Teachers from primary and secondary schools perceived SHS as valuable school partners (88.9% and 82.3%). Teachers from primary and secondary schools (88.9% and 88.1%) and parents (78.3% and 67.5%) stated that SHS could not be replaced by GPs or paediatricians. Primary school pupils felt that most common problems were injuries and vocational counselling, secondary school pupils assessed behavioural and sexual related problems as mostly challenging. Satisfaction with the SHS response to the most challenging problems was rated higher by teachers from primary schools (p<0.001 for learning difficulties, chronic diseases, bullying and vocational counselling), by parents for learning difficulties and vocational counselling, but no significance was found for pupils' satisfactions. CONCLUSION: SHS in Zagreb are recognized as vital and necessary partners for schools, available and accessible for pupils, teachers and parents, especially for primary schools. Counselling is highly rated by all respondents, confidentiality considered as respected, and the problem of the most common challenges as successfully solved.

Family history and parental recognition of overweight in Croatian children.

UNLABELLED: The aim of this study was to evaluate the perception of parents on the weight status of their offspring, particularly in relation to a family history of obesity and obesity-related illnesses. A cross-sectional study of 1,068 child-parent dyads sampled at school entry health examination was conducted (median age of the child 6.75 years, range 5.7-8.3 years, 50.3 % males). The parental perception of the weight status of their child was compared to the body mass index (BMI, kilogram per square meter), calculated from measured weight and height. Weight status (underweight, normal, overweight, and obese) was defined using the United States Centers for Disease Control and Prevention BMI for age reference charts. Backward multiple linear regression analysis was used to determine possible predictors of parental misclassification of overweight/obese children. Among this cohort of children, 12 % were overweight, 10.2 % obese, and 8.1 % were underweight. Only 24.8 % of obese children and 2.2 % of overweight children were considered "overweight" by their parents. A positive family history was not significantly associated with parental recognition of overweight. Parental misperception of overweight/obese children as being normal was related to the child BMI z-score (odds ratio (OR) 0.036; 0.012-0.111) and diabetes in family history (OR 3.187; 1.207-8.413). CONCLUSION: The majority of parents did not perceive their overweight/obese children as overweight. As having an obese family member or one who has suffered from an obesity-related illness does not increase the parental ability to recognize overweight in their children, strategies to increase public awareness about the importance of one's family medical history are needed.

Attitudes and beliefs related to childhood vaccinations among parents of 6 years old children in Zagreb, Croatia.

The Croatian Immunization Programme is a mandatory prevention programme in which vaccines are offered free of charge and little is known about parental vaccine-related beliefs and attitudes. We aimed to describe beliefs and attitudes towards childhood vaccination of parents in Zagreb, estimate the proportion of parents with positive attitudes towards vaccination, and to identify the possible predictors of positive attitudes. Using a self-administered questionnaire, we performed a cluster sampling survey among parents of 6-years-old children in Zagreb. In total 542 questionnaires were collected, 80% (n = 430/542) of respondents were mothers. Even though 72.6% (n = 385/531; 95%CI: 69-76) respondents feel that childhood vaccination should remain mandatory, 36.3% (n = 192/528; 95%CI: 58.3-65.3) considered that simultaneous administration of vaccines can have negative effect to their child's health. In addition, 38% (n = 202/532; 95%CI: 33.2-43.1%) feared that vaccines may harm their child. Of total, parents mostly reported positive attitude towards vaccination (61.8%; 95% CI: 34.7-42). Parents with positive attitudes were more likely to state their child experienced mild or no adverse reaction after vaccination, report not delaying vaccination and provide additional non-mandatory vaccines to their child (p < 0.05). Gender, age, education and marital status of parent were not significantly associated with the positive attitude towards vaccination. Our results suggest the need for educational interventions and communication strategies that could foster better knowledge on immunization with a focus on parental misconceptions, perceived constraints and safety issues about vaccine.

First toll free helpline for smoking cessation--analysis of results after one year of operation.

The aim of the study was to prove that there is a strong need among the smoking population for the antismoking telephone helpline, and to describe the structure and dynamics of calls to the Call-center. Basic data on socio-demographic characteristics, smoking habits, and reasons for calling the Center were collected during telephone conversations with smokers. The data were entered into previously prepared tables. Statistical analysis included 7,452 telephone calls; most calls were received from persons aged 26-45 years (34%), followed by 19-24 (24%) and 45-60 (19%) age groups. There was no statistically significant difference in the number of calls between men and women (54% vs. 46%, respectively). Most callers consumed on average 20 cigarettes per day. The most frequent reason for calling was to get on how to stop smoking, whereas seeking information on professional literature was the least frequent reason for calling among our respondents. Four-fifths of persons making a call to the Center started smoking when they were between 16 and 20 years of age. We can conclude that there was a need for this type of intervention due to its accessibility and potentially wide coverage of interested users.

Why choose Lent for a "smoke out day?" Changing smoking behavior in Croatia.

AIM: To evaluate the impact on smokers' behavior of public health activity related to a religious event such as Lent in a predominantly Roman Catholic country. METHODS: "Smoke out day" was organized on the first day of Lent, a period of self-denial for Roman Catholics, combining cultural and religious significance for Croatian people. The day was covered by a massive media campaign. Smoking behavior and attitudes to smoking were examined using a cross-sectional anonymous survey, conducted among 2,143 TV viewers and radio listeners aged 15 and older in their households. RESULTS: More than 75% of the interviewed persons knew the exact date of the "Smoke out day." Among smokers, 27% had given up smoking on that day and 16% declared they would not smoke during Lent. Significantly more women (34%) than men (23%) abstained from smoking on the "Smoke out day" and more women (24% vs 10.8%) had decided to abstain from smoking during Lent. The majority of abstainers were in the 30-44 age group. The lowest response to antismoking campaign was from smokers with university education. CONCLUSION: Antismoking mass media activity can influence smokers' behavior especially if it is connected to cultural and religious aspects. Some groups are much more sensitive to this kind of activities and may be, with a good media campaign and developed network of professional help and support, supported to transform their "Smoke out day" into a lifelong abstinence.