Parental supply of alcohol and alcohol consumption in adolescence: prospective cohort study.

BACKGROUND: Parents are a major supplier of alcohol to adolescents, yet there is limited research examining the impact of this on adolescent alcohol use. This study investigates associations between parental supply of alcohol, supply from other sources, and adolescent drinking, adjusting for child, parent, family and peer variables. METHOD: A cohort of 1927 adolescents was surveyed annually from 2010 to 2014. Measures include: consumption of whole drinks; binge drinking (>4 standard drinks on any occasion); parental supply of alcohol; supply from other sources; child, parent, family and peer covariates. RESULTS: After adjustment, adolescents supplied alcohol by parents had higher odds of drinking whole beverages [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.33-2.45] than those not supplied by parents. However, parental supply was not associated with bingeing, and those supplied alcohol by parents typically consumed fewer drinks per occasion (incidence rate ratio 0.86, 95% CI 0.77-0.96) than adolescents supplied only from other sources. Adolescents obtaining alcohol from non-parental sources had increased odds of drinking whole beverages (OR 2.53, 95% CI 1.86-3.45) and bingeing (OR 3.51, 95% CI 2.53-4.87). CONCLUSIONS: Parental supply of alcohol to adolescents was associated with increased risk of drinking, but not bingeing. These parentally-supplied children also consumed fewer drinks on a typical drinking occasion. Adolescents supplied alcohol from non-parental sources had greater odds of drinking and bingeing. Further follow-up is necessary to determine whether these patterns continue, and to examine alcohol-related harm trajectories. Parents should be advised that supply of alcohol may increase children's drinking.

Academic and personal problems among Australian university students who drink at hazardous levels: web-based survey.

ISSUE ADDRESSED: Australian university students consume large amounts of alcohol. There is little published information about personal and academic problems associated with this behaviour. We sought to estimate the prevalence, and identify variables associated with, alcohol-related problems among undergraduate hazardous drinkers. METHODS: The control group members (942 undergraduates, 53.3% male, mean age 19.4 years) of an internet-based intervention trial, who scored ≥8 on the Alcohol Use Disorders Identification Test, completed two validated questionnaires about their experience of alcohol-related problems in the preceding 4 weeks. Regression models were used to identify associations between individual characteristics and alcohol-related problems. RESULTS: One-quarter of participants had missed a class (25.6%) and/or had been unable to concentrate in class (25.7%), and 45% reported that their drinking had impacted negatively on their learning or grades. The most frequent non-academic problems were hangovers (74.8%), blackouts (44.8%), emotional outbursts (30.5%), vomiting (28.1%), arguments (20.2%) and drink-driving (23.2%). Male gender, lower age, being a smoker, being in the Faculty of Health (versus Humanities) and living in shared housing (versus with parents/guardians) were each associated with alcohol-related problems, whereas year of study had no association. CONCLUSIONS: There is a high prevalence of preventable alcohol-related problems among undergraduates drinking at hazardous levels and a need for restriction of the availability and promotion of alcohol as well as intervention for individuals at high risk. SO WHAT?: Universities have a duty of care to large populations of young people drinking at hazardous levels and should make greater efforts to address hazardous alcohol consumption.

Use of alcohol intoxication codes for serious non-fatal hospitalised injury.

AIM: To determine the extent to which ICD-10 alcohol intoxication codes are used for serious hospitalised injury and the distribution of these codes according to gender, age, injury mechanism and intent, severity of injury, and whether the patient was treated in an Intensive Care Unit. DESIGN: Cross-sectional study. SETTING: New Zealand. PARTICIPANTS: All injury hospital discharges in 2010 that met specified severity criteria. MEASUREMENTS: Cases which had a measurement of BAC (Y90) coded, or only a subjective assessment of alcohol intoxication (F10.0). FINDINGS: 2.5% had a blood alcohol recorded (Y90) and a further 3% were coded as being intoxicated but there was no blood alcohol code. All factors investigated were shown to be independently associated with the assignation of codes. Notable findings were the elevated odds of an alcohol code for males, assault and the more severe injuries. CONCLUSIONS: Assessment of alcohol intoxication among seriously injured persons appears to be very uncommon. The development of a standardised instrument for clinical judgement of intoxication would be highly desirable.

Missing cyclists.

OBJECTIVES: (1) For crashes on a public road, to compare serious cyclist crashes involving a motor vehicle with cyclist crashes not involving a motor vehicle, in terms of threat to life and length of stay in hospital. (2) To determine the proportion of all serious crashes involving cyclists on public roads which are recorded by the police. (3) To determine the degree to which under-reporting of serious crashes involving cyclists and motor vehicles on public roads is associated with various demographic, environmental, and injury factors. STUDY DESIGN: Records for the period 1995-99, of cyclists seriously injured on a public road and hospitalised were linked to the traffic crash report (TCR) database maintained by Land Transport Safety Authority (LTSA). RESULTS: Of the 2925 cyclist crashes on public roads, only 652 (22%) could be linked to a TCR. Of the crashes involving motor vehicles (n = 1033), only 562 (54%) could be linked to the LTSA database. Age, ethnicity, injury severity, and cumulative length of stay were the only variables that predicted whether hospitalised cycle crash cases were more likely to have a corresponding TCR. There were substantial numbers of cyclist only crashes which typically are not captured in the TCR database. Nine percent of these resulted in serious or worse injury (that is, International Classification of Diseases/abbreviated injury scale score of 3+) and 7% resulted in hospital stays greater than seven days. CONCLUSION: Greater effort and precision needs to be applied to routinely document the burden of cyclist crashes, especially cyclist only crashes.

Adolescent injury morbidity in New Zealand, 1987-96.

OBJECTIVES: Adolescents are over-represented in injury statistics. New Zealand is privileged in having a hospital discharge database allowing for analysis of non-fatal injury data at a national level. An epidemiological description of adolescent injury morbidity is provided and options for prevention are discussed. METHOD: People aged 15-19 years admitted to hospital for their injuries in the period 1 987-96 were identified from the New Zealand Health Information Service morbidity data files. The manner, causes, and nature of injury were examined. Injury prevention strategies were reviewed. RESULTS: The incidence of hospitalised injury was 1,886 per 100,000 person years. The victims were male (70%). The leading causes of injury were road traffic crashes, sports injuries, and self poisoning. The most common injury diagnoses were head injuries (29%) and limb fractures (21%). Road traffic crashes produced the highest proportion of serious injuries. CONCLUSIONS: Road traffic crashes, sports injuries, and self inflicted poisoning, stood out as areas with the greatest potential for reducing the burden of injury in late adolescence. Graduated driver licensing shows promise as an injury prevention measure but remains inadequately implemented. Policies to reduce self inflicted poisoning are of unknown efficacy, and evidence is awaited on the effectiveness of measures to reduce injury in sport.

Child injury morbidity in New Zealand, 1987-1996.

OBJECTIVES: New Zealand is one of a small number of countries that has a national hospital discharge database. The aim of this study was to use these data to provide an epidemiological description of child injury morbidity and to discuss options for prevention. METHODOLOGY: Using national data, all public hospital admissions for the fiscal year 1995/6 were identified and grouped according to cause. This allowed identification of all children (0-14 years) hospitalized for injury in the period 1987-1996. Causes of injury, diagnoses and injury severity were examined in four age groups. RESULTS: Injury was the second leading cause of public hospital admissions. Children were hospitalized with injury at the rate of 1333 per 100 000 person-years. The victims were predominantly male (61%). In all age groups, falls were the leading cause of morbidity. 'Striking events', motor vehicle traffic crashes and poisoning were also major contributors to the child injury toll. The commonest injury diagnosis was a fracture of the upper limb (25%), followed by intracranial injury (18%). CONCLUSIONS: The leading causes of injury morbidity were noted to differ from previously reported leading causes of injury mortality. Review of the data in light of research literature suggests the need for policy changes to make alternatives to motor vehicle transportation safer and to encourage increased use of child restraints in order to reduce road traffic trauma. Legislation requiring child-resistant packaging for all toxic medications and household products is necessary to reduce rates of child poisoning. Further research is required on policies concerning playground equipment heights and surfacing requirements, and on interventions for hot water scalds.

Child injury mortality in New Zealand 1986-95.

OBJECTIVES: Injury has been described as 'the last major plague of the young'. We provide an epidemiological description of injury, as a leading cause of death in New Zealand, and identify options for prevention. METHODS: We identified all deaths due to any cause for the period 1986-95 from the national data and calculated the potential years of life lost for each death. For the same period, we identified all injury deaths for children aged 0-14 years. Causes of injury were examined in four age groups. RESULTS: In the population as a whole, injury was the fourth leading cause of death and the leading cause of potential years of life lost. Injury killed children at the rate of 16.8 per 100,000 person-years. The victims were predominantly male (62%) and 52% were under 5 years of age. In infancy (<1 year of age), suffocation was the leading cause of injury mortality. From 1 to 14 years of age, motor vehicle traffic incidents were the leading cause of mortality. CONCLUSIONS: Motor vehicle traffic incidents, drowning, suffocation and suicide stood out as areas with the greatest potential for reducing child injury mortality. A number of existing prevention strategies show promise (e.g. child restraints), others are inadequately implemented (e.g. swimming pool fencing) or are of unknown efficacy (e.g. government suicide prevention policies). Strategies to reduce infant suffocation and child non-traffic pedestrian deaths remain to be developed and tested.

Intergroup bias and self-evaluation: domain-specific self-esteem, threats to identity and dimensional importance.

Recent theoretical statements argue that two predictions about self-esteem and intergroup bias may be derived from social identity theory. The first suggests that in-group bias enhances self-esteem. The second suggests that threats to self-esteem enhance in-group bias. Previous research has provided little firm evidence for either prediction. Much of this work has, however, tended to ignore realistic groups, domain-specific self-esteem, the assessment of self-esteem prior to and following the display of in-group bias and the importance attached to evaluative dimensions. The current investigation sought to redress these issues. In separate experiments, men and women presented with positive and negative feedback, evaluated in-group and out-group success and failure on dimensions important and unimportant to the in-group. Women displayed out-group bias on dimensions unimportant to their in-group (i.e. physical ability) with respect to evaluations of failure. Women subsequently manifested a decrease in physical self-esteem. Men displayed in-group bias on dimensions unimportant to their in-group (i.e. verbal ability) and, following positive feedback, on dimensions important to the in-group (i.e. physical ability). Men subsequently manifested an increase in verbal and physical self-esteem. Global self-esteem was unaffected in each study. These findings suggest that the relative display of bias can affect domain-specific self-esteem. No support was found for the postulate that low or threatened self-esteem can enhance bias on evaluative dimensions important to the in-group.