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2.
BMJ Open ; 11(4): e045872, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33827844

RESUMO

OBJECTIVES: This study aims to explore the strategies that governments and civil society organisations implemented to prevent and respond to the anticipated rise in violence against women and/or children (VAWC) during the 2019 novel coronavirus (COVID-19) pandemic. DESIGN: A scoping review and content analysis of online media reports. SETTING: WHO European region. METHODS: A scoping review of media reports and publications and a search of other grey literature (published from 1 January to 17 September 2020). Primary and secondary outcome measures included measures implemented by governments, public services and non-governmental and civil organisations to prevent or respond to VAWC during the early months of the COVID-19 pandemic. RESULTS: Our study found that in 52 of the 53 member states there was at least one measure undertaken to prevent or respond to VAWC during the pandemic. Government-led or government-sponsored measures were the most common, reported in 50 member states. Non-governmental and other civil society-led prevention and response measures were reported in 40 member states. The most common measure was the use of media and social media to raise awareness of VAWC and to provide VAWC services through online platforms, followed by measures taken to expand and/or maintain helpline services for those exposed to violence. CONCLUSION: The potential increase in VAWC during COVID-19-imposed restrictions and lockdowns resulted in adaptations and/or increases in prevention and response strategies in nearly all member states. The strength of existing public health systems influenced the requirement and choice of strategies and highlights the need for sustaining and improving violence prevention and response services. Innovative strategies employed in several member states may offer opportunities for countries to strengthen prevention and responses in the near future and during similar emergencies.


Assuntos
COVID-19 , Violência Doméstica/prevenção & controle , Meios de Comunicação de Massa , Pandemias , Criança , Controle de Doenças Transmissíveis , Europa (Continente) , Feminino , Humanos , Internet , Organização Mundial da Saúde
3.
Eur J Public Health ; 31(3): 659-664, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-33718964

RESUMO

BACKGROUND: Preventing sexual violence in nightlife environments is a pervasive issue across many countries. This study explored the associated impact of a nightlife worker sexual violence awareness raising/bystander training programme (STOP-SV) on trainees' sexual violence myth acceptance and readiness and confidence to intervene. METHODS: : Pre- and post-test (n = 118), and 3-month follow-up (n = 38) trainee surveys were implemented across three countries (Czech Republic, Portugal and Spain). Paired-sample tests examined changes across time-periods in participants' myth acceptance (e.g. unwanted sexual advances are a normal part of a night out), and readiness and confidence to intervene. Multi-nominal regression was used to examine the relationship between the change in pre-to-post-training scores and trainee characteristics. RESULTS: Compared to pre-training, post-training participants were significantly (P < 0.01) less likely to agree with sexual violence myths, and more likely to be ready and confident to intervene. In bi-variate and multi-variate analyses, we found no significant associations between the change in pre-to-post-training scores and trainee characteristics. Analyses of the small follow-up sub-sample illustrated some positive changes at the post-training and follow-up time-periods (i.e. reduction in sexual violence myth acceptance). CONCLUSION: This exploratory study suggests that the STOP-SV training programme was associated with a decrease in trainees' acceptance of sexual violence myths, and an increase in their readiness and confidence to intervene. Our findings support the case for further implementation and evaluation of awareness raising/bystander programmes for nightlife workers that aim to prevent and respond to sexual violence.


Assuntos
Delitos Sexuais , Humanos , Portugal , Espanha , Inquéritos e Questionários , Universidades
4.
BMC Med ; 18(1): 325, 2020 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-33190642

RESUMO

BACKGROUND: Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood. METHODS: Data from a nationally representative survey of household residents (adults aged 16 to 59 years; n = 21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes. RESULTS: Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16 years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA. CONCLUSIONS: Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.


Assuntos
Maus-Tratos Infantis/psicologia , Vítimas de Crime/psicologia , Violência por Parceiro Íntimo/psicologia , Adolescente , Adulto , Vítimas de Crime/estatística & dados numéricos , Violência Doméstica/estatística & dados numéricos , Inglaterra , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , País de Gales , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-32824763

RESUMO

In Spain the legal age to buy alcohol is 18 years. However, official surveys show that minors perceive alcohol availability to be easy. This paper describes the impacts of a community-based intervention to increase vendors' compliance with age limits regarding alcohol sales in supermarkets. The aim of this study was to explore the association between implementation of a multicomponent intervention to reduce adolescents' alcohol use and sale of alcohol to minors in the city of Palma (Spain). Twenty trained adolescents (14-17 years old) conducted 138 alcohol test purchases in nine supermarket chains in August 2018 (baseline; n = 73) prior to the intervention, and again in January 2020 (follow-up; n = 65). Analysis was conducted according to three levels of intervention implemented across the supermarkets: (i) personnel from the supermarkets' Human Resources or Corporate Social Responsibility teams received alcohol service training as trainers (i.e., community mobilization); (ii) managers and vendors training by the capacitated trainers; and (iii) no training of managers or vendors (i.e., control group). In the supermarkets that completed the Training of Trainers and the vendors' training program, average sales decreased significantly from 76.9% in 2018 to 45.5% in 2020, asking for the age of the shopper significantly increased from 3.8% to 45.4%, and asking for proof of age significantly increased from 15.4% to 72.7%. Additionally, a statistically significant increase was observed in the visibility of prohibition to sell alcohol to minors' signs, from 61.5% to 100%. No statistically significant differences were found for the Training of Trainers intervention alone nor in the control group. In conclusion, community mobilization combined with staff training is associated with significant increases in supermarket vendors' compliance with alcohol legislation in Spain.


Assuntos
Bebidas Alcoólicas , Comércio , Adolescente , Humanos , Menores de Idade , Projetos Piloto , Espanha
6.
Artigo em Inglês | MEDLINE | ID: mdl-32486276

RESUMO

Alcohol is a common drug misused by young people worldwide. Previous studies have found that attitudes towards heavy consumption are stronger predictors than general norms concerning alcohol. This study aims to explore adolescents' alcohol use and drunkenness, to understand adolescents' attitudes towards alcohol use, drunkenness and prevention approaches, and to explore associations between attitudes and personal alcohol use and demographics. Methods: Cross-sectional face-to-face survey of 410 adolescents (61.2% women) who were socializing at night in the streets of Palma (Spain). Breath Alcohol Concentration (BrAC), self-reported measures of alcohol use and social variables were assessed. Results: 70.7% of respondents had a BrAC score higher than 0. The full sample reported having a mean of 3.9 drunk episodes in the last month, and a mean of 7.34 in Alcohol Use Disorders Identification Test (AUDIT). A total of 30.7% were under the minimum age limit for alcohol drinking in Spain and males showed higher BrAC than females. Bivariate analyses identified some differences in attitudes across participant demographics and personal alcohol use. In conclusion, we found high levels of alcohol use and drunkenness amongst adolescents, and adolescents' attitudes towards drunkenness and prevention approaches were associated with their alcohol consumption as well as with age.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Intoxicação Alcoólica/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Legislação como Assunto , Política Pública , Consumo de Álcool por Menores/estatística & dados numéricos , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas , Atitude , Estudos Transversais , Feminino , Humanos , Masculino , Espanha/epidemiologia , Consumo de Álcool por Menores/prevenção & controle , Consumo de Álcool por Menores/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-32455786

RESUMO

There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren's (aged 7-11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children's perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Conhecimentos, Atitudes e Prática em Saúde , Abandono do Hábito de Fumar , Vaping , Criança , Feminino , Humanos , Masculino , Fumar , País de Gales
8.
Br J Psychiatry ; 217(4): 583-590, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32338230

RESUMO

BACKGROUND: Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs. AIMS: To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members. METHOD: Cross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments. RESULTS: Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour. CONCLUSIONS: Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions.


Assuntos
Maus-Tratos Infantis/estatística & dados numéricos , Delinquência Juvenil/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Delitos Sexuais/estatística & dados numéricos , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Transtorno da Personalidade Antissocial/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Doenças Sexualmente Transmissíveis/epidemiologia , Reino Unido/epidemiologia , Adulto Jovem
9.
J Gambl Stud ; 36(2): 527-538, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31705379

RESUMO

The current study examined the association between gambling problem severity and health risk behaviours, health and wellbeing. A cross-sectional survey (including representative population and supplementary convenience samples) was conducted with 2303 adult residents of a British Island. Gambling problem severity was assessed using the Problem Gambling Severity Index. The EQ-5D-5L, WEMWBS and AUDIT-C were used to measure general health, mental wellbeing and alcohol use, respectively. Other measures included diet, physical exercise and tobacco use. Differences between gambling severity levels for each measure were analysed using logistic regression adjusting for age, sex and income. Compared to non-problem gamblers, moderate/high severity gamblers had higher odds of a poor diet, low physical exercise and poor general health. Tobacco use was associated with both low and moderate/high severity gambling. Low severity, but not moderate/high severity gambling, was significantly associated with binge and higher risk drinking behaviours. Health risk behaviours tended to cluster, with a graded relationship between gambling problem severity and odds of reporting at least two health risk behaviours. Compared to non-problem gamblers, low severity gamblers were approximately twice as likely and moderate/high severity gamblers were three times as likely, to have low mental wellbeing. Findings suggest associations between gambling problems and a range of health risk behaviours and health issues, and crucially that such issues are not limited to gamblers with the highest severity of problems. Addressing gambling across the whole continuum of risk should be a key public health priority.


Assuntos
Comportamento Aditivo/epidemiologia , Jogo de Azar/epidemiologia , Comportamentos de Risco à Saúde , Saúde Mental/estatística & dados numéricos , Distribuição por Idade , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Feminino , Jogo de Azar/psicologia , Humanos , Modelos Logísticos , Masculino , Assunção de Riscos , Índice de Gravidade de Doença , Meio Social , Adulto Jovem
10.
Addict Behav Rep ; 9: 100163, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31193729

RESUMO

Background: Binge drinking is generally considered socially acceptable for students across Western culture. Social norms within the student population have meant that excessive drinking plays a key role in socialising and reinforcing peer group identity. Research has highlighted the United Kingdom (UK) as having elevated levels of alcohol consumption especially within the student population, and the role that drink promotions have in influencing consumption practices. This paper considers promotions of alcoholic drinks in UK nightlife venues and student perceptions of these promotions. Bourdieu's concepts of social and cultural capital are applied to the findings. Method: Content analysis of social media posts by nightlife venues (n = 12), observations of nightlife venues (n = 20) and semi-structured focus groups and paired interviews with 32 undergraduate students, from one city in the North West of England. Results: Nightlife venues target promotions of alcoholic drinks at students through social media, advertisements throughout nightlife venues, and by promoters outside of venues. These promotions will often influence the course of a night out in terms of venues visited and the drinks consumed. Alcohol holds importance within mainstream student culture; it plays a key role in achieving cultural capital and is a means for students to obtain social capital through the creation of shared experiences, which are key for those who are new to university. Conclusions: Nightlife venues will target alcoholic drink promotions at students and will use the notion of creating a shared experience as part of this targeted promotion. This contributes to the overall social and cultural capital that alcohol holds within the student population. This is an important consideration for alcohol policy - it demonstrates how prevention activities need to take into consideration the importance of shared experiences for the students; alternatives to excessive alcohol consumption need to offer a similar opportunity.

11.
Addict Behav Rep ; 9: 100162, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31193765

RESUMO

Aim: To explore the nature and magnitude of alcohol's harms to others (AHTOs), and associations with mental well-being. Methods: Cross-sectional survey implemented amongst 891 randomly selected Welsh residents (aged 18+ years), via computer assisted telephone interviews. Questions established past 12-month experience of nine direct harms resulting from another person's alcohol consumption (e.g. violence) and five linked outcomes (e.g. concern for a child). The source (e.g. partner/stranger) and frequency of the AHTO were collected, and respondents' socio-demographics, drinking behaviours and mental well-being status. Results: During the past 12 months, 43.5% of respondents had experienced at least one direct harm (45.5% at least one direct harm/linked outcome). In demographically adjusted analyses, the odds of experiencing any direct harm decreased sequentially as age group increased (Adjusted Odds Ratio [AORs]: 1.9 [age 65-74 years] - 4.2 [age 18-34 years]), and was higher amongst binge drinkers (AOR, 1.5, p < 0.05). Associations between age group and suffering the direct harms anxiety, disrupted sleep, feeling threatened, property damage and emotional neglect were found. Experience of feeling threatened was lower amongst females (AOR 0.6, p < 0.05). In demographically adjusted analyses, low mental well-being was higher amongst those who had suffered alcohol-related financial issues (AOR 2.2, p < 0.001), emotional neglect (AOR 2.3, p < 0.01) and property damage (AOR 2.2, p < 0.05). Conclusion: AHTOs place a large, although unequal burden on adults in Wales. Individuals' drinking patterns are associated with experience of AHTOs. Critically, experience of some harms is associated with low mental well-being.

12.
BMC Public Health ; 19(1): 442, 2019 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-31029124

RESUMO

BACKGROUND: Drunkenness is common in nightlife environments and studies suggest it can be considered both desirable and normal by nightlife users. We aimed to compare UK nightlife users' ideal levels of drunkenness to their expected drunkenness on a night out and their perceptions of descriptive nightlife norms. METHODS: A cross-sectional survey with nightlife patrons (n = 408, aged 18-35) in three cities. Using a scale from 1 (completely sober) to 10 (very drunk), participants rated: personal drunkenness at survey; expected drunkenness on leaving nightlife; perceived descriptive drunkenness norm in the city's nightlife; and ideal personal drunkenness. Analyses were limited to those who had or were intending to consume alcohol. RESULTS: Almost half of participants (46.8%) expected to get drunker than their reported ideal level on the night of survey, rising to four fifths of those with the highest levels of expected drunkenness. 77.9% rated typical nightlife drunkenness ≥8 but only 40.9% expected to reach this level themselves and only 23.1% reported their ideal drunkenness as ≥8. Higher expected drunkenness was associated with higher ideal drunkenness, higher perceived drunkenness norm and later expected home time. CONCLUSIONS: Nightlife users' perceptions of typical drunkenness in nightlife settings may be elevated and many of the heaviest drinkers are likely to drink beyond their ideal level of drunkenness. Findings can support emerging work to address cultures of intoxication in nightlife environments and suggest that interventions to correct misperceptions of normal levels of nightlife drunkenness may be of benefit.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Intoxicação Alcoólica/psicologia , Conformidade Social , Normas Sociais , Adulto , Alcoolismo , Estudos Transversais , Feminino , Humanos , Masculino , Grupo Associado , Comportamento Social , Inquéritos e Questionários , Reino Unido , Adulto Jovem
13.
Addiction ; 113(8): 1420-1429, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29575369

RESUMO

AIMS: To estimate the association between implementation of a community-based multi-component intervention (Drink Less Enjoy More) and sales of alcohol to pseudo-intoxicated patrons and nightlife patron awareness of associated legislation. DESIGN: Cross-sectional pre-intervention and follow-up measurements, including alcohol test purchases (using pseudo-intoxicated patrons) in licensed premises (stratified random sample; 2013, 2015) and a survey with nightlife patrons (convenience sample; 2014, 2015). SETTING: One UK municipality with a large night-time economy. PARTICIPANTS: Licensed premises (pre = 73; follow-up = 100); nightlife patrons (pre = 214; follow-up = 202). INTERVENTION: The Drink Less Enjoy More intervention included three interacting components: community mobilization and awareness-raising; responsible bar server training; and active law enforcement of existing legislation prohibiting sales of alcohol to, and purchasing of alcohol for, a person who appears to be alcohol intoxicated: 'intoxicated', herein for economy. MEASUREMENTS: The primary outcomes were alcohol service refusal to pseudo-intoxicated patrons and nightlife patron knowledge of alcohol legislation (illegal to sell alcohol to, and purchase alcohol for, intoxicated people), adjusted for potential confounders including characteristics of the area, venue, test purchase and nightlife patron. FINDINGS: Pre-intervention, 16.4% of alcohol sales were refused, compared with 74.0% at follow-up (P < 0.001). In adjusted analyses, the odds of service refusal were higher at follow-up [adjusted odds ratio (aOR) = 14.63, P < 0.001]. Service refusal was also associated with server gender and patron drunkenness within the venue. Among drinkers, accurate awareness of alcohol legislation was higher at follow-up (sales: pre = 44.5%; follow-up = 66.0%; P < 0.001/purchase: pre = 32.5%; follow-up = 56.0%; P < 0.001). In adjusted analyses, knowledge of legislation was higher at follow-up (sales: aOR = 2.73, P < 0.001; purchasing: aOR = 2.73, P < 0.001). Knowledge of legislation was also associated with participant age (purchasing) and expectations of intoxication (sales). CONCLUSION: A community-based multi-component intervention concerning alcohol sales legislation in the United Kingdom (UK) was associated with a reduction in sales of alcohol to pseudo-intoxicated patrons in on-licensed premises in a UK nightlife setting and an improvement in nightlife patron awareness of associated legislation.


Assuntos
Bebidas Alcoólicas/legislação & jurisprudência , Comércio/legislação & jurisprudência , Consumo de Bebidas Alcoólicas , Intoxicação Alcoólica , Conscientização , Participação da Comunidade , Feminino , Humanos , Aplicação da Lei , Masculino , Reino Unido , Adulto Jovem
14.
Inj Prev ; 24(2): 155-156, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29353245

RESUMO

Scientific information on violence can be difficult to compile and understand. It is scattered across websites, databases, technical reports and academic journals, and rarely addresses all types of violence. In response, in October 2017 WHO released the Violence Prevention Information System or Violence Info, an online interactive collection of scientific information about the prevalence, consequences, risk factors and preventability of all forms of interpersonal violence. It covers homicide, child maltreatment, youth violence, intimate partner violence, elder abuse and sexual violence.


Assuntos
Instrução por Computador/métodos , Saúde Global , Promoção da Saúde/métodos , Violência/prevenção & controle , Organização Mundial da Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Avaliação de Programas e Projetos de Saúde , Fatores de Risco , Violência/classificação
16.
BMC Psychiatry ; 17(1): 110, 2017 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-28335746

RESUMO

BACKGROUND: Adverse childhood experiences (ACEs) including child abuse and household problems (e.g. domestic violence) increase risks of poor health and mental well-being in adulthood. Factors such as having access to a trusted adult as a child may impart resilience against developing such negative outcomes. How much childhood adversity is mitigated by such resilience is poorly quantified. Here we test if access to a trusted adult in childhood is associated with reduced impacts of ACEs on adoption of health-harming behaviours and lower mental well-being in adults. METHODS: Cross-sectional, face-to-face household surveys (aged 18-69 years, February-September 2015) examining ACEs suffered, always available adult (AAA) support from someone you trust in childhood and current diet, smoking, alcohol consumption and mental well-being were undertaken in four UK regions. Sampling used stratified random probability methods (n = 7,047). Analyses used chi squared, binary and multinomial logistic regression. RESULTS: Adult prevalence of poor diet, daily smoking and heavier alcohol consumption increased with ACE count and decreased with AAA support in childhood. Prevalence of having any two such behaviours increased from 1.8% (0 ACEs, AAA support, most affluent quintile of residence) to 21.5% (≥4 ACEs, lacking AAA support, most deprived quintile). However, the increase was reduced to 7.1% with AAA support (≥4 ACEs, most deprived quintile). Lower mental well-being was 3.27 (95% CIs, 2.16-4.96) times more likely with ≥4 ACEs and AAA support from someone you trust in childhood (vs. 0 ACE, with AAA support) increasing to 8.32 (95% CIs, 6.53-10.61) times more likely with ≥4 ACEs but without AAA support in childhood. Multiple health-harming behaviours combined with lower mental well-being rose dramatically with ACE count and lack of AAA support in childhood (adjusted odds ratio 32.01, 95% CIs 18.31-55.98, ≥4 ACEs, without AAA support vs. 0 ACEs, with AAA support). CONCLUSIONS: Adverse childhood experiences negatively impact mental and physical health across the life-course. Such impacts may be substantively mitigated by always having support from an adult you trust in childhood. Developing resilience in children as well as reducing childhood adversity are critical if low mental well-being, health-harming behaviours and their combined contribution to non-communicable disease are to be reduced.


Assuntos
Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/psicologia , Violência Doméstica/prevenção & controle , Violência Doméstica/psicologia , Comportamentos Relacionados com a Saúde , Transtornos Mentais/prevenção & controle , Transtornos Mentais/psicologia , Poder Familiar/psicologia , Qualidade de Vida/psicologia , Resiliência Psicológica , Assunção de Riscos , Apoio Social , Confiança , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
Emerg Med J ; 34(6): 364-369, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28228473

RESUMO

OBJECTIVE: The aim of this study was to explore the potential of ambulance call-out data in understanding violence to inform about prevention activity. METHOD: This cross-sectional (2013-2015) study examined the nature, extent and characteristics of violence-related ambulance call-outs (n=15 687) across North West England and relationships with temporal, celebratory and sporting events. RESULTS: The majority of call-outs were for men, with a mean age of 33 years. Most call-outs were to deprived (64.4%) and urban (65.4%) areas and occurred at night (18:00-5:59; 75.2%). Three-quarters (77.3%) were recorded as assault/sexual assault and 22.7% stab/gunshot/penetrating trauma. Significant differences in call-out characteristics were identified between the two violence types. Generalised linear modelling found that call-outs significantly increased on weekends, New Year's Eve and weekday bank holiday eves (except for stab/gunshot/penetrating trauma). No significant associations between all violence call-outs, the two violence categories and sporting or celebration events were identified. Two-thirds (66.1%) of the call-outs were transferred to another health service for further assessment and/or treatment. The odds of being transferred were significantly higher among men (adjusted OR (AOR) 1.5, 95%CI 1.4 to 1.6), those aged 13-24 years (AOR 1.2, 95%CI 1.0 to 1.4), call-outs for stab/gunshot/penetrating trauma (AOR 1.4, 95%CI 1.3 to 1.5) and call-outs on Fridays/Saturdays (AOR 1.1, 95%CI 1.0 to 1.2) and lower for call-outs on New Year's Eve (AOR 0.6, 95%CI 0.4 to 0.9). CONCLUSION: Ambulance call-out data can provide a wealth of information to understand violence and subsequently inform about violence prevention and response activity. Ambulance services and staff could play a key role in preventing violence through sharing data and identifying and supporting victims.


Assuntos
Ambulâncias/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Aniversários e Eventos Especiais , Criança , Pré-Escolar , Estudos Transversais , Serviços Médicos de Emergência/estatística & dados numéricos , Inglaterra/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Áreas de Pobreza , Prevalência , Delitos Sexuais/estatística & dados numéricos , Esportes/estatística & dados numéricos
18.
BMC Public Health ; 16: 222, 2016 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-26940088

RESUMO

BACKGROUND: Individuals' childhood experiences can strongly influence their future health and well-being. Adverse childhood experiences (ACEs) such as abuse and dysfunctional home environments show strong cumulative relationships with physical and mental illness yet less is known about their effects on mental well-being in the general population. METHODS: A nationally representative household survey of English adults (n = 3,885) measuring current mental well-being (Short Edinburgh-Warwick Mental Well-being Scale SWEMWBS) and life satisfaction and retrospective exposure to nine ACEs. RESULTS: Almost half of participants (46.4 %) had suffered at least one ACE and 8.3 % had suffered four or more. Adjusted odds ratios (AORs) for low life satisfaction and low mental well-being increased with the number of ACEs. AORs for low ratings of all individual SWEMWBS components also increased with ACE count, particularly never or rarely feeling close to others. Of individual ACEs, growing up in a household affected by mental illness and suffering sexual abuse had the most relationships with markers of mental well-being. CONCLUSIONS: Childhood adversity has a strong cumulative relationship with adult mental well-being. Comprehensive mental health strategies should incorporate interventions to prevent ACEs and moderate their impacts from the very earliest stages of life.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Transtornos Mentais/epidemiologia , Adolescente , Adulto , Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Idoso , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
19.
BMJ Open ; 5(12): e010112, 2015 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-26700293

RESUMO

OBJECTIVE: To examine factors associated with suffering harm from another person's alcohol consumption and explore how suffering such harms relate to feelings of safety in nightlife. DESIGN: Cross-sectional opportunistic survey (Global Drug Survey) using an online anonymous questionnaire in 11 languages promoted through newspapers, magazines and social media. SUBJECTS: Individuals (participating November 2014-January 2015) aged 18-34 years, reporting alcohol consumption in the past 12 months and resident in a country providing ≥ 250 respondents (n=21 countries; 63,725 respondents). MAIN OUTCOME MEASURES: Harms suffered due to others' drinking in the past 12 months, feelings of safety on nights out (on the way out, in bars/pubs, in nightclubs and when travelling home) and knowledge of over-serving laws and their implementation. RESULTS: In the past 12 months, >40% of respondents suffered at least one aggressive (physical, verbal or sexual assault) harm and 59.5% any harm caused by someone drunk. Suffering each category of harm was higher in younger respondents and those with more harmful alcohol consumption patterns. Men were more likely than women to have suffered physical assault (9.2% vs 4.7; p<0.001), with women much more likely to suffer sexual assault or harassment (15.3% vs 2.5%; p<0.001). Women were more likely to feel unsafe in all nightlife settings, with 40.8% typically feeling unsafe on the way home. In all settings, feeling unsafe increased with experiencing more categories of aggressive harm by a drunk person. Only 25.7% of respondents resident in countries with restrictions on selling alcohol to drunks knew about such laws and 75.8% believed that drunks usually get served alcohol. CONCLUSIONS: Harms from others' drinking are a threat to people's health and well-being. Public health bodies must ensure that such harms are reflected in measures of the societal costs of alcohol, and must advocate for the enforcement of legislation designed to reduce such harms.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Intoxicação Alcoólica/psicologia , Emoções , Segurança , Violência/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/psicologia , Intoxicação Alcoólica/epidemiologia , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Saúde Global , Inquéritos Epidemiológicos , Humanos , Masculino , Violência/legislação & jurisprudência , Violência/psicologia , Adulto Jovem
20.
J Epidemiol Community Health ; 68(5): 453-6, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24430583

RESUMO

BACKGROUND: By measuring alcohol retailers' propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol. METHODS: 73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars. RESULTS: 83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas. CONCLUSIONS: UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.


Assuntos
Consumo de Bebidas Alcoólicas/legislação & jurisprudência , Bebidas Alcoólicas/economia , Bebidas Alcoólicas/provisão & distribuição , Intoxicação Alcoólica/prevenção & controle , Comércio/legislação & jurisprudência , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Intoxicação Alcoólica/epidemiologia , Inglaterra , Feminino , Humanos , Masculino
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