Gambling involvement and problem gambling correlates among European adolescents: results from the European Network for Addictive Behavior study.

PURPOSE: Worldwide, concern has grown over the expansion of gambling among adolescents, who have an increased likelihood of developing risk-taking behaviors. This study aimed to increase knowledge of problem gambling among adolescents in seven European countries and to assess the effect of demographic and lifestyle factors recorded in the European Network for Addictive Behavior survey (https://www.eunetadb.eu). METHODS: A cross-sectional school-based study (n = 13,284) was conducted in Germany, Greece, Iceland, The Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included socio-demographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test, the South Oaks Gambling Screen-Revised for Adolescents Test and Achenbach's Youth Self-Report. RESULTS: 12.5% of the participants reported last year gambling activities either online or offline. 3.6% of the study participants and 28.1% of gamblers (either online or offline) were at risk or had a gambling problem. The study results showed that a higher proportion of adolescents was either at risk or had a gambling problem among males, in the older age group, when the parental educational level was lower/middle, and in the absence of siblings. Furthermore, being at risk or having a gambling problem was associated with lower age at first use of the internet, lower school grades, using the internet 6-7 days per week, and problematic internet use. At risk or problem gamblers had higher scores on all scales of problem behavior and lower scores (lower competence) on activities and academic performance. CONCLUSIONS: Our findings underline the need for better gambling legislation and suggest the importance of developing social responsibility tools that may help diminish adolescent gambling involvement, with special attention to males.

Cross-national aspects of cyberbullying victimization among 14-17-year-old adolescents across seven European countries.

BACKGROUND: The increasing use of the Internet and social network sites (SNS) has created a new domain of socio-emotional development for adolescents. The aim of this cross-sectional study was to explore cybervictimization across seven European countries, in relation to socio-demographic, Internet use and psychosocial variables. METHODS: A cross-sectional school-based study was conducted in the participating countries: Germany, Greece, Iceland the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control, the Internet Addiction Test and Achenbach's Youth Self-Report. RESULTS: The highest rate of cyber victimization was found in Romania (37.3%) and the lowest in Spain (13.3%). Multiple logistic regression analyses gave differing results between countries. In Romania, Poland and Germany cyberbullying victimization was associated with SNS use, whereas Internet use was associated with increased odds of cybervictimization only in Romania. Cybervictimization was associated with greater internalizing behavior problems in all countries analysed, and with externalizing problems in all except Romania. CONCLUSIONS: Cyberbullying victimization is an on-going problem, which is subject to country-specific socio-demographic factors and diverse patterns of current Internet use and its development. Preventive measures should emphasize the integration of Internet communication technology education in educational contexts, and focus on the consistent association between cybervictimization and internalizing and externalizing difficulties.

Short-term respiratory effects of e-cigarettes in healthy individuals and smokers with asthma.

BACKGROUND AND OBJECTIVE: This study investigated the duration of immediate respiratory effects of e-cigarette smoking (ECS) and tested the hypothesis that ECS has more prominent effects in asthmatics compared with healthy smokers (HS). METHODS: Fifty-four smokers, 27 healthy (HS group) and 27 with intermittent asthma (mild asthma (MA) group) underwent a control session (no liquid, no resistor coil inside e-cigarette cartridge) and an experimental session of ECS using standardized puffing settings. Impulse oscillometry impedance (Z), resistance (R), reactance (X) and fractional exhaled nitric oxide (FeNO) were measured before and 0, 15 and 30 min after control and experimental sessions. RESULTS: Control session revealed no significant changes. In the experimental session, immediately post-ECS, both groups exhibited a significant increase in respiratory system total impedance at 5 Hz (Z5) (P < 0.001), respiratory system resistance at 5 Hz (R5) (P < 0.001), respiratory system resistance at 10 Hz (R10) (P < 0.001), respiratory system resistance at 20 Hz (R20) (P < 0.05), resonant frequency (P < 0.001) and reactance area (P < 0.05). MA exhibited higher baseline values and a more prominent effect immediately after ECS compared with HS for Z5 (P = 0.022), R5 (P = 0.010) and R10 (P = 0.013). FeNO decreased significantly in both groups (P < 0.001); HS returned to baseline values in ≤15 min while the MA maintained significantly lower values for an additional 15 min (P < 0.05) and returned to baseline values at 30 min post-ECS. CONCLUSION: A single session of ECS had respiratory mechanical and inflammatory effects, which were more prominent in smokers with asthma.

Immediate effects of cigar smoking on respiratory mechanics and exhaled biomarkers; differences between young smokers with mild asthma and otherwise healthy young smokers.

BACKGROUND: We aimed to investigate the immediate respiratory effects of cigar smoking(CS), among young smokers with and without mild asthma. MATERIALS AND METHODS: Forty-seven young smokers (18-31years old, 29 males, average pack-years = 3.6 ± 2.8) were enrolled. Twenty-two were mild asthmatics(MA-subgroup) and the remaining 25 were otherwise healthy smokers(HS-subgroup). Exhaled carbon monoxide(eCO), multi-frequency respiratory system impedance(Z), resistance(R), reactance(X), frequency-dependence of resistance(fdr = R5Hz - R20Hz), resonant frequency(fres), reactance area(AX) and exhaled nitric oxide(FENO) were measured at the aforementioned sequence, before and immediately after 30 min of CS, or equal session in the smoking area while using a sham cigar(control group). Chi-square, student's t-tests, mixed linear models and Pearson correlation tests were used for the statistical analysis; level of significance was defined as p < 0.05. RESULTS: Immediately after CS, Z5Hz, R5Hz, R10Hz, R20Hz and eCO increased significantly in both subgroups(MA and HS). A greater increase was found for R20 in HS-subgroup. Fdr, fres and AX increased in MA, while decreased in HS. On the contrary, X10 decreased in MA and increased in HS, while X20 showed a greater decrease in MA. Changes in fdr, fres and AX were significantly correlated in both subgroups. No significant FENO alterations were detected in both subgroups. CONCLUSION: CS has immediate effects on pulmonary function. Mild asthma predisposes to higher increase of peripheral resistance(increased fdr). In otherwise healthy smokers, central resistance(R20Hz) is more affected. FENO levels are not significantly affected by CS.

Association between problematic internet use, socio-demographic variables and obesity among European adolescents.

BACKGROUND: Overweight of children and adolescents continues to be an important and alarming global public health problem. As the adolescent's time spent online has increased, problematic internet use (PIU) potentially leads to negative health consequences. This study aimed to examine the relation between PIU and overweight/obesity among adolescents in seven European countries and assess the effect of demographic and lifestyle factors recorded in the European Network for Adolescent Addictive Behaviour (EU NET ADB) survey (www.eunetadb.eu). METHODS: A cross-sectional school-based survey of 14- to 17-year-old adolescents was conducted in seven European countries: Germany, Greece, Iceland, the Netherlands, Poland, Romania and Spain. Anonymous self-completed questionnaires included sociodemographic data, internet usage characteristics, school achievement, parental control and the Internet Addiction Test. Associations between overweight/obesity and potential risk factors were investigated by logistic regression analysis, allowing for the complex sample design. RESULTS: The study sample consisted of 10 287 adolescents aged 14-17 years. 12.4% were overweight/obese, and 14.1% presented with dysfunctional internet behavior. Greece had the highest percentage of overweight/obese adolescents (19.8%) and the Netherlands the lowest (6.8%). Male sex [odds ratio (OR) = 2.89, 95%CI: 2.46-3.38], heavier use of social networking sites (OR = 1.26, 95%CI: 1.09-1.46) and residence in Greece (OR = 2.32, 95%CI: 1.79-2.99) or Germany (OR = 1.48, 95%CI: 1.12-1.96) were independently associated with higher risk of overweight/obesity. A greater number of siblings (OR = 0.79, 95%CI: 0.64-0.97), higher school grades (OR = 0.74, 95%CI: 0.63-0.88), higher parental education (OR = 0.89, 95%CI: 0.82-0.97) and residence in the Netherlands (OR = 0.49, 95%CI: 0.31-0.77) independently predicted lower risk of overweight/obesity. CONCLUSIONS: The results indicate an association of overweight/obesity with PIU and suggest the importance of formulating preventive public health policies that target physical health, education and sedentary online lifestyle early in adolescence with special attention to boys.

Plasma brain natriuretic peptide: a biochemical marker of effective blood pressure management?

OBJECTIVE: To investigate plasma brain natriuretic peptide (BNP) concentrations in association with blood pressure (BP) at baseline and after antihypertensive drug treatment. PATIENTS AND METHODS: We prospectively examined 186 individuals with newly diagnosed essential hypertension without target organ damage, whose mean age was 48.7 +/- 10.9 years. Treatment initiation began with irbesartan 150 mg/day and was doubled at 4 weeks in cases of inadequate BP control. If indicated, at 8-week-follow-up hydrochlorothiazide 12.5 mg alone or with amlodipine 5-10 mg was added. BNP levels were measured at baseline and after 3 months of antihypertensive treatment. RESULTS: At baseline plasma BNP levels were found to be related to systolic BP (r = 0.27, P < 0.001), independent of age, sex, smoking status, BMI and left ventricular mass index estimated by echocardiography (beta = 11.81, SE = 3.82, P = 0.002). Additionally, higher BNP concentrations were observed in patients with stage 2 hypertension compared with those with stage 1 (median 38.9 vs. 29.9 pg/ml, P = 0.022). Multivariate analysis showed a positive association between BNP and systolic BP variability (beta = 0.03, SE = 0.01, P = 0.034). At follow-up, 64.7% of the participants who had achieved BP control showed decreased BNP levels in contrast to those with poor BP control (median change -14.5 vs. -1.3 and median range from -34.4 to -4.4 vs. -9.6 to 10.9, respectively, P < 0.001). CONCLUSION: In this hypertensive population, increased BNP concentrations are associated with higher BP levels and systolic BP variability. The fall of BNP observed in those who achieved BP control indicates that BNP could be used as a biochemical marker of effective BP control and target organ protection.

Metabolic syndrome and incident cardiovascular morbidity and mortality in a Mediterranean hypertensive population.

BACKGROUND: Although the metabolic syndrome (MetS) is associated with adverse cardiovascular disease (CVD) risk in the general population, it is not clear whether its existence is independently associated with CVD in hypertensives. We investigated the presence of MetS in subjects with hypertension and its impact on the incidence of CVD. METHODS: We prospectively investigated 1007 hypertensive individuals. The MetS was assessed using the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. The incidence of fatal and nonfatal cardiovascular events was ascertained during a median follow-up period of 2.1 years. RESULTS: The prevalence of MetS was 42.1% (39.0% in men and 44.7% in women). In addition to hypertension, four MetS components were present in 3.6% of the individuals, three in 13.7%, two in 24.8%, and only one in 33.7%. The incidence of cardiac, cerebrovascular, and total cardiovascular events/1000 person-years was higher among MetS subjects than among those without (31.0% v 21.3%, P = .050, 25.5% v 13.7%, P = .045, and 55.4% v 35.8% P = .009, respectively). After adjustment, MetS subjects had higher risk for cardiac, cerebrovascular, and total cardiovascular events (by 72%, 90%, and 75%, respectively). Hypertensive subjects with three or more components of MetS had threefold higher risk for cardiac events, 2.59 for cerebrovascular, and 2.26 for total cardiovascular events compared with those with no other component. CONCLUSIONS: The MetS is a significant predictor of cardiovascular morbidity and mortality. The clustering of three or more components of the syndrome in addition to hypertension recognizes a population of even higher cardiovascular risk independently of other traditional risk factors.