Adolescent Personality Risk Factors for Tobacco Smoking and Alcohol Misuse in Adult Men.

Background: Social identity theory proposes that people define themselves in terms of the social groups they belong to or aspire to belong to. Tobacco smoking and alcohol use in men have been hypothesized to be symbolic of adult male status. The current study examines whether adolescent personality characteristics linked to masculinity and nonconformity are associated with tobacco smoking and alcohol misuse in men. Methods: The analysis is based on the results of a cross-sectional study conducted in 2018 on a stratified, random sample of 703 adult male residents of Warsaw, Poland, with elementary- and secondary-school education. All survey data were collected through a paper-and-pencil questionnaire. A path model is employed to examine the direct and indirect effects of adolescent characteristics on tobacco smoking and alcohol consumption. Results: According to the path model, retrospective perceptions of self-reported character strength, rebellion against unjustified prohibitions and rules, ease in making decisions, willingness to differ from others, and interest in the opposite gender in adolescence had a significant direct effect on tobacco smoking in adolescence and a significant indirect effect on tobacco smoking in adulthood. The variables representing character strength, rebellion against unjustified prohibitions and rules, ease in making decisions, and interest in the opposite gender in adolescence also showed a significant direct effect on alcohol use in adolescence. Conclusion: Masculinity and nonconformity were related to addictive behaviors in men, which might have health policy implications. In this paper, associating traditional masculinity with health orientation in society is proposed as a possible preventive intervention.

Risk factors for homelessness: A structural equation approach.

This study aims to assess the pathway relationships between adolescent adversities, adult addictive behaviours, divorce, conviction, long-standing unemployment, disability, and homelessness. A structural equation model was estimated using data on n1 = 677 homeless men and n2 = 651 housed men of the same age and educational distribution, living in Warsaw, Poland. Retrospective adolescent adversities were found to be significantly related to the occurrence of adult homelessness (p ≤ .01). This relationship was mainly indirect and largely mediated by addictive behaviours, divorce, conviction, and unemployment. Addiction, divorce, and conviction were the three most frequent events preceding homelessness and were likely to coincide. The first job experience did not differentiate the two groups from each other. However, homeless individuals were more likely to currently prefer self-employment over wage employment. Low perceived importance of family life and preference for self-employment over wage employment were hypothesised to be related to the severity of homelessness.

Gender gap in cancer prevention and mortality. A multidimensional analysis.

BACKGROUND: During 2015 in Poland, male-to-female ratio in age-adjusted cancer mortality rate amounted to 1.83, which is close to that observed in 1990 (1.94) and considerably more than in 1965 (1.38). DATA AND METHODS: Nearest-neighbor matching and latent class model were estimated to assess gender gap in cancer prevention in 2006 and 2014. The analysis is based on nationally representative data from a two-wave survey carried out on a stratified random sample of n=7991+8079 adults. RESULTS: Even when controlling for socio-demographic characteristics, health status, and basic knowledge of cancer, three behavioral health characteristics are dramatically lower in men: uptake of preventive health care (ATE of -0.106), perceived caring for own health (-0.070), and fruit and vegetable intake (-0.034). Between 2006 and 2014 the gender gap in uptake of preventive health care and perceived caring for own health had increased, particularly in individuals aged over 40. The adjusted difference in leisure-time physical activity between men and women is near the significance threshold in individuals aged over 40. CONCLUSION: The gender differences are higher for the behavioral component of cancer prevention than cognitive domains. Without modifying behavioral risk factors, gender gap in cancer mortality is not expected to close.

Risk factors for depression. New evidence on selenium deficiency and depressive disorders. / Czynniki ryzyka depresji. O nowych przeslankach na temat znaczenia niedoborów selenu.

OBJECTIVES: This study aims to evaluate the effect of selenium deficiency on depressive disorders with adjustment for possible confounders. Its importance among non-dietary and dietary risk factors for depression is discussed using empirical evidence. METHODS: A structural equation model was fitted using diagonally weighted least squares estimation with adjusted chi-square test statistics (WLSMV). The average daily intake of selenium and other nutrients was calculated to verify their possible association with self-reported depressive disorders. The effect of dietary patterns was adjusted for possible confounders, including the presence of chronic diseases, life problems, pain levels, physical activity, and income. The study was performed on a sample of 9,354 men and women aged 45-65 of the Polish-Norwegian Study (PONS) cohort. RESULTS: The model shows a significant effect of low selenium intake (standardized total effect of 0.133), high lipids intake (0.102) and low iron intake (0.065) on depressive disorders. Other dietary factors fail to make a significant contribution to depressive disorders, according to the model (p > 0.05). Among the considered non-dietary risk factors, home stress (0.181), pain (0.179) and low income (0.178) show a strong correlation with depression. Pain mediates a small part of the effect of morbidity (0.140). Depressive disorders are also associated with work problems (0.123) and low physical activity (0.024). CONCLUSIONS: Selenium intake is most strongly related to depression among all the dietary factors considered. In the model, the effect of dietary risk factors on depressive disorders is moderate when compared to non-dietary variables. Chronic pain, low income and morbidity are the main correlatives of depressive disorders.

Increasing deaths from colorectal cancer in Poland - Insights for optimising colorectal cancer screening in society and space.

INTRODUCTION AND OBJECTIVE: With respect to the increasing numbers of deaths due to colorectal cancer in Poland, the aim of the study was to investigate socio-demographic characteristics which influence colorectal cancer screening acceptance and to assess spatial variation of colorectal cancer mortality. MATERIAL AND METHODS: An age-period-cohort model was estimated to assess mortality trends in colorectal cancer in Poland. A geographical analysis was performed by spatial regression. Factors influencing participation in colorectal cancer screening were identified using structural equation modelling. RESULTS: In 2014 in Poland, 6.4 thousand men and 5.0 thousand women died due to colorectal cancer. In total, by 2030 this number is expected to rise to nearly 14.4 thousand. Observed spatial clustering of age-adjusted colorectal cancer mortality is associated with spatial variation in tobacco use, employment in industry, and consumption of red meat. Patient-physician communication, advanced age, and healthy diet are the most important predictors of colorectal cancer screening acceptance. Tobacco and alcohol users are not more likely to participate in colorectal cancer screening, adjusting for other variables. CONCLUSIONS: Self-selection of patients who follow healthy diet means that individuals at higher risk of colorectal cancer are less likely to participate in colorectal cancer screening. Therefore, screening should be more targeted. According to the structural equation modelling results, the phenomenon of 'no-show' for screening can be mitigated by patient-physician communication. The inhabitants of the Greater Poland region are at the highest risk of dying due to colorectal cancer, which may have public health policy implications.

High prostate cancer mortality in Poland. A spatial, temporal and structural analysis

INTRODUCTION: This study investigates spatial distribution and future trends in prostate cancer mortality in Poland. Since detection of prostate cancer is based on patients' requests (not an invitation system), hypothesis of self-selection of patients was also verified MATERIAL AND METHODS: Age-period-cohort model was estimated to assess mortality trends. A spatial analysis was performed by Kulldorff's and Moran's tests. Structural equation model was fitted to identify factors influencing decision on participation in prostate cancer screening. Statistical analysis is based on data from the National Cancer Registry for 1980-2014 and a 2014 questionnaire survey of 1,700 men aged 45+. RESULTS: The annual number of registered deaths due to prostate cancer is expected to increase from 4,440 in 2014 to 6,550 in 2030. Prostate cancer mortality in Poland is to a large extent spatially uniform (global Moran's Ig=0.066) and was not found to be related to spatial patterns in oral contraceptive use in women which was recently hypothesised. Nevertheless, a Kulldorff's cluster can be identified over the Lubusz and Greater Poland areas for both the 1980-1984 and the 2010-2014 periods (p<0.001). The structural equation model showed that the early detection of prostate cancer is influenced mainly by physician's activeness and local availability of healthcare (p<0.050). The direct effect of socio-economic status on early detection of prostate cancer is insignificant. CONCLUSIONS: When considering prediction results, one should request more actions aimed at facing the upward trend of deaths, including making research funding in prostate cancer a priority, improving understanding of prostate cancer among males, and offering to patients individualised risk-adapted strategy modelled on the guidelines of the European Association of Urology. Currently, uptake of prostate cancer screening is largely affected by external factors.