Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories.

AIMS: To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies. PARTICIPANTS: One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993. DESIGN: Longitudinal follow-up across five waves of data collection. SETTING: Post high school in Victoria, Australia. MEASUREMENTS: Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour. FINDINGS: Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. FINDINGS: revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21. CONCLUSIONS: Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Cigarette smoking in teenage girls: exploring the role of peer reputations, self-concept and coping.

Reducing the prevalence of smoking among teenagers is an important goal for health and education professionals. In the present study, self-reported cigarette smoking status was examined among 241 adolescent females from four metropolitan, independent girls' schools in suburban Melbourne, Australia. This study was particularly concerned with the role of peer reputations, coping and self-concept as influences on teenage girls' decision making with respect to smoking. Coping strategies, levels of self-concept and reputation enhancement were assessed using the High School Student Activity Questionnaire. Three separate multivariate analyses of variance (MANOVAs) revealed that six of the 11 reputation variables, three of the four self-concept variables and two of the three coping variables contributed to the main effect of smoking status. Post hoc analyses allowed some profiling of current cigarette smokers as compared to never smokers. This study offers support to reputation enhancement theory with regard to cigarette smoking in adolescent girls, and also provides continued evidence for the importance of particular aspects of self-concept and coping skills with respect to cigarette smoking. Suggestions for further research are discussed and some possible implications of the findings for school-based health education programmes are raised.

Conceptual and methodological challenges in discourse assessment with TBI speakers: towards an understanding.

The primary objective of this paper is to review theoretical and methodological literature pertaining to the clinical evaluation of discourse abilities in speakers who have sustained traumatic brain injury (TBI). A brief history of the study of discourse impairment in this population is followed by consideration of the following issues: (1) sampling (genres selected, the physical setting in which sampling takes place, the relationship between speakers, elicitation techniques, presence of recording devices, the number of samples required, and transcription); (2) measurement; (3) the relationship between sampling and measurement; (4) other approaches to discourse assessment (self and close other report); (5) consideration of the criterion of 'normal' which clinicians should employ; (6) the relationship between discourse impairment and measures of executive function; and (7) the relationship between discourse impairment and seventy of injury. Recommendations arising from a critical review of these domains are made for both clinical practice and research.

On supplementing the selenium intake of New Zealanders. 2. Prolonged metabolic experiments with daily supplements of selenomethionine, selenite and fish.

1. The daily intake of selenium by three subjects was supplemented with 100 microgram Se as selenomethionine (Semet-Se) or sodium selenite (selenite-Se)/d for 10-11 weeks, or with 65 microgram Se as in mackerel (Scomber japonicus) (fish-Se)/d for 4 weeks. 2. Urinary and faecal excretion of Se was measured and also Se concentration in whole blood, plasma and erythrocytes. Measurements on blood were made at intervals after supplementation had ceased. 3. Selenite-Se was not as well absorbed (0.46 of the intake) during the first 4 weeks as Semet-Se (0.75 of the intake) and fish Se (0.66 of the intake). 4. Blood Se increased steadily with Semet-Se, from 0.08 to 0.18 microgram Se/ml, but more slowly with selenite-Se, reaching a plateau in 7-8 weeks at 0.11 microgram Se/ml. Plasma Se increased more rapidly with Semet-Se than with selenite-Se, so that initially with Semet-Se plasma Se was greater than erythrocyte Se. 5. Daily urinary excretion increased with all forms of supplement, with initially a greater proportion of absorbed selenite-Se being excreted than Semet-Se or fish-Se. A close relationship was found between plasma Se and 24 h urinary excretion. The findings suggested that there was a rapid initial excretion of presumably unbound Se then a slower excretion of residual unbound, loosely bound or bound Se. 6. Total retentions of 3.5 mg selenite-Se and 4.5 mg Semet-Se were large when compared with an estimate of body content of 6 mg Se, derived in another paper (Stewart, Griffiths, Thomson & Robinson, 1978). Retention of Semet-Se and fish-Se appeared to be reflected in blood Se, whereas for selenite-Se, blood Se reflected retention for only a short period after which Se appeared to be retained without altering the blood Se. This suggested that Semet-Se and selenite-Se were metabolized differently. 7. A double blind-dosing trail with 100 microgram Semet-Se was carried out for 12 weeks on twenty-four patients with muscular complaints in Tapanui, a low-Se-soil area. Blood Se increased in the experimental group (from 0.067 to 0.143 microgrm Se/ml); clinical findings were not conclusive and will be presented elsewhere. 8. Bood Se was measured in New Zealand residents before travelling to Europe or to North America. On return their blood Se was increased, and depending upon the period of time spent outside New Zealand some values reached concentrations found in visitors and new settlers to New Zealand. 9. The results from these studies and the earlier studies of single and multiple dosing have been used to look at the various criteria in use for assessing Se status of subjects. It is suggested that plasma Se be used in preference to 24 h urinary excretion, and in addition to whole blood Se and glutathione peroxidase (EC 1.11.1.9) activity.