Dating and relationship violence victimization and perpetration among 11-16 year olds in Wales: a cross-sectional analysis of the School Health Research Network (SHRN) survey.

BACKGROUND: This study examines the prevalence of dating and relationship violence (DRV) victimization, perpetration and joint victimization and perpetration, and associations between DRV and socio-demographic characteristics. METHODS: Cross-sectional self-report data from 74 908 students aged 11-16 from 193 schools across Wales were collected and analysed using generalized estimating equations to examine prevalence and predictors of emotional and physical DRV victimization, perpetration and joint victimization and perpetration. RESULTS: More girls reported emotional victimization (28%) and perpetration (18%) than boys (20% and 16%, respectively). More girls (8%) than boys (7%) reported physical perpetration. However, boys (17%) reported more physical victimization than girls (12%). Age-related trajectories of DRV victimization and perpetration were stronger in girls than in boys. Students from single or step parent homes, those in care, and certain ethnic minority groups had increased odds of DRV. No association was found between socioeconomic status and DRV. CONCLUSIONS: Age-related trajectories and the lack of social patterning by socioeconomic status point to the value of early, universal interventions, while some evidence of ethnic patterning and family structure-related risk factors suggest areas for further research and targeted interventions. DRV continues to be a major public health problem for which little UK-specific intervention evidence exists.

Risk of emergency hospital admission in children associated with mental disorders and alcohol misuse in the household: an electronic birth cohort study.

BACKGROUND: Mental disorders and alcohol misuse are common in families but their effects on the physical health of children are not known. We investigated the risk of emergency hospital admissions during childhood associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. METHODS: We did this cohort study in a total population electronic child cohort in Wales, UK, which includes all children who live in Wales or with a mother who is resident in Wales. We used Cox regression to model time to first emergency hospital admission during the first 14 years of life associated with living with an adult who has a mental health disorder, or who had an alcohol-related hospital admission. We adjusted our results for social deprivation and perinatal risk factors. FINDINGS: We included data for 253 717 children with 1 015 614 child-years of follow-up. Living with an adult with a mental disorder was associated with an increased risk of emergency admission for all causes (adjusted hazard ratio [aHR] 1·17, 95% CI 1·16-1·19), for injuries and external causes (1·14, 1·11-1·18), and childhood victimisation (1·55, 1·44-1·67). Children living with a household member who had an alcohol-related hospital admission had a significantly higher risk of emergency admissions for injuries and external causes (aHR 1·13, 95% CI 1·01-1 ·26) and victimisation (1·39, 1·00-1·94), but not for all-cause emergency admissions (1·01, 0·93-1·09). INTERPRETATION: The increased risk of emergency admissions in children associated with mental disorders and alcohol misuse in the household supports the need for policy measures to provide support to families that are affected. FUNDING: Economic and Social Research Council, Medical Research Council, Alcohol Research UK, Public Health Wales.

School practices important for students' sexual health: analysis of the school health research network survey in Wales.

Background: This study investigates how the sexual health outcomes of a representative sample of students aged 15-16 in Wales vary according to the person delivering Sex and Relationships Education (SRE) in schools, students' access to on-site sexual health services and access to free condoms. Methods: Cross-sectional, self-report survey data were collected from students who participated in the 2015/16 School Health Research Network questionnaire in Wales. Data were analyzed from 59 schools, totalling 3781 students aged 15-16 (M = 15.7; SD = 0.3) who responded to questions about ever having had sex; age of sexual initiation and condom use at last intercourse. School level data were also collected, examining who delivers school SRE, provision of on-site, school 'drop-in' sexual health services and provision of free condoms for students. Binary and linear multi-level analyses explored the relationship between school level predictors and sexual health outcomes. Results: Compared to teachers, other modes of SRE delivery were associated with better sexual health outcomes, including remaining sexually inactive, later age of first intercourse and condom use. Providing on-site sexual health services did not significantly reduce the odds of having ever had sex or delaying first intercourse; but was associated with increased condom use. On-site condom provision was associated with lower condom use. Conclusions: SRE delivery by educators other than teachers is optimum to young people's sexual health outcomes. Further funding and coordination of on-site sexual health advice services are required. Longitudinal research is needed to identify the temporal sequence of sexual health practices and outcomes.

Comparison of substance use, subjective well-being and interpersonal relationships among young people in foster care and private households: a cross sectional analysis of the School Health Research Network survey in Wales.

OBJECTIVE: To investigate the association of living in foster care (FC) with substance use and subjective well-being in a sample of secondary school students (11-16 years) in Wales in 2015/16, and to examine whether these associations are attenuated by the perceived quality of interpersonal relationships. DESIGN: Cross-sectional, population-based health behaviour and lifestyle questionnaire. SETTING AND PARTICIPANTS: Wales, UK; young people who took part in the 2015/16 School Health Research Network (SHRN) questionnaire (n=32 479). PRIMARY OUTCOME: Health behaviours among young people in FC were compared with those from private households. RESULTS: The prevalence of all adverse outcomes was higher among young people in FC. Those in FC were significantly more likely to report mephedrone use (OR=9.24, 95% CI 5.60 to 15.34), multiple substance misuse behaviours (OR=3.72, 95% CI 2.30 to 6.00), poorer relationships with peers (RR=1.88, 95% CI 1.23 to 2.88) and teachers (RR=1.83, 95% CI 1.31 to 2.56), having experienced bullying (OR=1.80, 95% CI 1.38 to 2.35), dating violence (OR=1.66, 95% CI 1.13 to 2.43) and poor well-being (RR=1.72, 95% CI 1.20 to 2.46). The association between FC and substance use remained significant, though was attenuated after accounting for relationship variables. The association between FC and subjective well-being became non-significant after adjustment for relationship variables. CONCLUSIONS: Young people living in FC experience significantly worse outcomes than young people not in care, likely due to a range of care and precare factors, which impact adversely on subsequent social relationships. The analyses are consistent with the hypothesis that the associations of FC with substance use and life satisfaction are partially explained by poorer quality social relationships. Large scale, longitudinal studies are required to investigate the relationship between being in care and health, educational and social outcomes. Mental health interventions and interventions to reduce substance use and improve well-being in FC should include a focus on supporting healthy social relationships.

Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales.

OBJECTIVES: To investigate the risk of emergency hospital admissions for violence (EHAV) associated with demographic and socioeconomic factors in Wales between 2007/2008 and 2013/2014, and to describe the site of injury causing admission. DESIGN: Database analysis of 7 years' hospital admissions using the Patient Episode Database for Wales (PEDW). SETTING AND PARTICIPANTS: Wales, UK, successive annual populations ∼2.8 million aged 0-74 years. PRIMARY OUTCOME: The first emergency admission for violence in each year of the study, defined by the International Classification of Diseases V.10 (ICD-10) codes for assaults (X85-X99, Y00-Y09) in any coding position. RESULTS: A total of 11 033 admissions for assault. The majority of admissions resulted from head injuries. The overall crude admission rate declined over the study period, from 69.9 per 100 000 to 43.2 per 100 000, with the largest decrease in the most deprived quintile of deprivation. A generalised linear count model with a negative binomial log link, adjusted for year, age group, gender, deprivation quintile and settlement type, showed the relative risk was highest in age group 18-19 years (RR=6.75, 95% CI 5.88 to 7.75) compared with the reference category aged 10-14 years. The risk decreased with age after 25 years. Risk of admission was substantially higher in males (RR=4.55, 95% CI 4.31 to 4.81), for residents of the most deprived areas of Wales (RR=3.60, 95% CI 3.32 to 3.90) compared with the least deprived, and higher in cities (RR=1.37, 95% CI 1.27 to 1.49) and towns (RR=1.32, 95% CI 1.21 to 1.45) compared with villages. CONCLUSIONS: Despite identifying a narrowing in the gap between prevalence of violence in richer and poorer communities, violence remains strongly associated with young men living in areas of socioeconomic deprivation. There is potential for a greater reduction, given that violence is mostly preventable. Recommendations for reducing inequalities in the risk of admission for violence are discussed.

A double-blind trial of the effect of docosahexaenoic acid and vitamin and mineral supplementation on aggression, impulsivity, and stress.

OBJECTIVES: Although a series of well-designed studies have reported that supplementation with vitamins/minerals and omega-3 fatty acids reduces the incidence of aggressive behavior, to date, the relative contribution and interaction between these nutrients has not been examined. The aim was therefore to consider the relative contribution of supplementation with multivitamins/minerals and/or docosahexaenoic acid (DHA) on laboratory-based measures of aggression, impulsivity, and stress. METHODS: In a double-blind randomized trial, four groups of young adult men without a history of aggressive or impulsive behavior received a placebo (n = 42), multivitamins/minerals (n = 43), DHA (n = 47) or both (n = 41) for 3 months. RESULTS: With the Picture-Frustration Task, DHA decreased the display of aggressive behavior. DHA also decreased impulsivity as measured using the GoStop Impulsivity Paradigm that examines the ability to inhibit already initiated behavior. Although a multivitamin and mineral supplement did not influence these measures, it did decrease perceived stress. CONCLUSIONS: The influence of supplementation on aggression and impulsivity can be conveniently studied in a sample without a history of antisocial behavior, using laboratory-based measures. No evidence was found of a synergistic interaction between vitamins/minerals and DHA.

Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis.

OBJECTIVE: Biochemical processes in the brain affect mood. Minor dietary inadequacies, which are responsible for a small decline in an enzyme's efficiency, could cumulatively influence mood states. When diet does not provide an optimal intake of micronutrients, supplementation is expected to benefit mood. This meta-analysis evaluated the influence of diet supplementation on mood in nonclinical samples. METHODS: Databases were evaluated and studies were included if they considered aspects of stress, mild psychiatric symptoms, or mood in the general population; were randomized and placebo-controlled; evaluated the influence of multivitamin/mineral supplements for at least 28 days. Eight studies that met the inclusion criteria were integrated using meta-analysis. RESULTS: Supplementation reduced the levels of perceived stress (standard mean difference [SMD]=0.35; 95% confidence interval [CI]=0.47-0.22; p=.001), mild psychiatric symptoms (SMD=0.30; 95% CI=0.43-0.18; p=.001), and anxiety (SMD=0.32; 95% CI=0.48-0.16; p<.001), but not depression (SMD=0.20; 95% CI=0.42-0.030; p<.089). Fatigue (SMD=0.27; 95% CI=0.40-0.146; p<.001) and confusion (SMD=0.225; 95% CI=0.38-0.07; p<.003) were also reduced. CONCLUSIONS: Micronutrient supplementation has a beneficial effect on perceived stress, mild psychiatric symptoms, and aspects of everyday mood in apparently healthy individuals. Supplements containing high doses of B vitamins may be more effective in improving mood states. Questions about optimal levels of micronutrient intake, optimal doses, and active ingredients arise.