Sozial- und Praventivmedizin最新文献

Objectives: To investigate the relationship between subjective health complaints (SHCs), health-related quality of life and physician visits.

Method: 3'773 participants of the Study of Health in Pomerania (SHIP) filled questionnaires and were interviewed. Data consisted of 1) 38 statements concerning SHCs, 2) the SF12, and 3) statements concerning visits to 11 different groups of physicians. Factor analysis was done on the SHC data, with a subsequent varimax rotation. Relationships between resulting factors and remaining variables were analysed using 1) the cumulative logit model for the first SF12 item (overall health evaluation), 2) linear regression for the physical and mental sum scores of the SF12, and 3) logistic regression for physician visits.

Results: Eight factors have eigenvalues greater than one and together explain 54.2% of total variance. Varimax rotated factors can be interpreted easily. Altogether, these factors, sex and age significantly affect the first SF12 item (Nagelkerke's R2 = 0.27), both sum scores (physical: R2adj. = 0.40; mental: R2adj. = 0.36), and all physician visits (Nagelkerke's R2 between 0.03 and 0.23).

Conclusions: Subjective health complaints are important. Total sum scores of typical SHC questionnaires do not reflect all relevant aspects of SHCs.

Objectives: To provide nationally representative data on smoking prevalence of Turkish adolescents; to examine their knowledge, attitude and exposure to tobacco.

Methods: A school-based representative survey of adolescents (13-15 years) was conducted within the frame of Global Youth Tobacco Survey (GYTS). 15957 students were selected using a two-stage cluster sampling method and completed an internationally standardized questionnaire on tobacco use and related factors.

Results: About one-third of students had already experienced smoking and 10% were current smokers. Rate of exposure to passive smoking was high both in current smokers (89.0%) and never smokers (79.2%). More than one-third of current smokers had intended to quit. Susceptibility to initiate smoking was fairly high among never smokers, especially in boys (9.1% versus 5.8%). Considerable proportions of both never, and current smokers had positive attitude toward tobacco use. Half of the students had no school curriculum about the effects of tobacco use.

Conclusions: Smoking prevalence among Turkish adolescents is alarmingly high and the gender gap is closing. A relevant legislation is a must for success in tobacco control but should be combined by other effective prevention and cessation programs.

Objective: To examine cancer mortality trends in Central Serbia (1985-2002).

Methods: Cancer mortality rates were based on the official death certificates (n=192849). They were standardized for age and sex.

Results: In the observed period, mortality rates showed a tendency to increase in both males (y = 118.54 + 2.27x, p = 0.0001) and females (y = 83.32 + 1.02x, p = 0.0001). Mortality of lung cancer increased in both sexes (y = 32.38 + 0.86x, p < 0.001 for males, y = 6.25 + 0.25y, p < 0.001 for females), as did colorectal cancer (y = 10.87 + 033x, p < 0.001 for males, y = 8.51 + 0.09x, p < 0.05 for females). Breast cancer mortality rates increased (y = 14.48 + 0.35x, p = 0.0001), and so did cervical cancer (y = 5.14 + 0.14x, p < 0.01). Mortality of gastric cancer in males has been moderately decreasing after 1990s (y(19902002) = 13.67-0.20x, p < 0.01), while prostate cancer mortality remained relatively stable.

Conclusions: Increasing cancer mortality trends in the last 18 years in Central Serbia indicate the extremely urgent needs for health authorities to adopt measures of cancer prevention that proved effective in other countries.

Objective: To test the effects of the volume of alcohol consumption and drinking patterns on alcohol-related aggression and victimization, both at the individual and class levels.

Methods: Representative sample drawn from the European School Survey Project on Alcohol and Other Drugs (ESPAD) of 6496 Swiss adolescents (13 to 16 years). Hierarchical multi-level models were used to simultaneously estimate individual and environmental influences. In addition to indicators of consumption of alcohol and other substances, age, sex, socioeconomic indicators and satisfaction with the relationship to parents were used as covariates.

Results: After controlling for confounding, both volume of alcohol consumption and the frequency of binge drinking occasions were associated independently with alcohol-related problems (aggression/victimization) on the individual level. On the aggregate level, there was colinearity between volume of drinking and frequency of heavy drinking occasions. When entered in the same model, however, only the effect of volume effect stayed in the same direction.

Conclusions: Not only individual volume of drinking, but also the way alcohol is consumed influences individual problem levels. This includes individual patterns of drinking as well as environmental influences at school. These results open up important considerations for theory, research and prevention.