Individual Differences in Learning Difficulty

Correlates of adolescent learning difficulty may include a number of issues sustained across the life course but this is little documented. This study assessed the associations of learning difficulty with socioeconomic, behavior and health-related difficulties in early adolescence. This study included 1,559 middle-school adolescents from north-eastern France, who completed a self-administered questionnaire gathering socioeconomic characteristics (gender, age, nationality, family structure, father’s occupation, and family income), measured body mass index, alcohol/tobacco/cannabis/hard drug use, health status, back pain, allergy, depressive symptoms (Kandel scale), sustained physical/verbal violence, sexual abuse, social support, learning difficulty (a 4-item scale: lesson understanding, concentration/lesson learning, follow school pace/constraints, and school interrogations, range 0-4), grade repetition, low school performance (last trimester, <10/20), and school dropout contemplation at 16 years. Data were analyzed using multiple linear and logistic regression models. Learning difficulty score was strongly related to grade repetition (gender-age-adjusted odds ratio 1.56, 95% CI 1.38-1.76), low school performance (2.39, 2.08-2.75) and school dropout contemplation (1.79, 1.50-2.13). Learning difficulty was strongly related to socioeconomic factors (gaRC reaching 0.76). It was also related to alcohol, tobacco, cannabis, and hard drug use (0.22, 0.74, 0.71 and 1.25, respectively), overweight (0.17), obesity (0.43), poor health status (0.45), back pain (0.21), allergy (0.11), depressive symptoms (0.69), sustained violence (0.41), sexual abuse (0.72), and poor social support (0.22). These associations were partly explained by socioeconomic factors (contribution reaching 54% for various factors; it was 109% for alcohol use). These findings suggest that prevention to limit learning difficulty and promote school achievement should focus on socioeconomic, behavior and health-related difficulties in early adolescence

Association between Suicide Ideation and Attempts and Being an Immigrant among Adolescents, and the Role of Socioeconomic Factors and School, Behavior, and Health-Related Difficulties

The risk of suicide behaviors in immigrant adolescents varies across countries and remains partly understood. We conducted a study in France to examine immigrant adolescents’ likelihood of experiencing suicide ideation in the last 12 months (SI) and lifetime suicide attempts (SA) compared with their native counterparts, and the contribution of socioeconomic factors and school, behavior, and health-related difficulties. Questionnaires were completed by 1559 middle-school adolescents from north-eastern France including various risk factors, SI, SA, and their first occurrence over adolescent’s life course (except SI). Data were analyzed using logistic regression models for SI and Cox regression models for SA (retaining only school, behavior, and health-related difficulties that started before SA). Immigrant adolescents had a two-time higher risk of SI and SA than their native counterparts. Using nested models, the excess SI risk was highly explained by socioeconomic factors (27%) and additional school, behavior, and health-related difficulties (24%) but remained significant. The excess SA risk was more highly explained by these issues (40% and 85%, respectively) and became non-significant. These findings demonstrate the risk patterns of SI and SA and the prominent confounding roles of socioeconomic factors and school, behavior, and health-related difficulties. They may be provided to policy makers, schools, carers, and various organizations interested in immigrant, adolescent, and suicide-behavior problems

Diastolic dysfunction, aortic stiffness and hypertension : anthropometric and metabolic risk factors and management in general population

L’augmentation de l’obésité durant les dernières décennies expose la population à un risque accru de problèmes métaboliques et des maladies cardiovasculaires. Ce travail étudiait, d’une part, l’association de l’obésité avec la dysfonction diastolique et la rigidité artérielle aortique vingt ans plus tard chez des adultes initialement en bonne santé. Cette étude montrait que l’obésité générale mesurée par l’indice de masse corporelle et l’adiposité abdominale mesurée par le tour de taille étaient associées positivement à la dysfonction diastolique. Mais elles semblaient jouer un rôle protecteur sur la rigidité artérielle. Le ratio “tour de taille/indice de masse corporelle” semblait mieux isoler l’adiposité abdominale/viscérale de l’obésité générale, et était associé positivement à la rigidité artérielle. Il permettrait de montrer un rôle néfaste à long terme de l’adiposité abdominale/viscérale sur la rigidité artérielle même quand le poids est normal. La présence combinée de l’obésité abdominale (mesurée par le tour de taille) et d’un taux plus élevé de triglycérides était associée à un risque élevé de dysfonction diastolique. Dans la deuxième partie, nous nous sommes intéressés aux individus ayant déjà une hypertension artérielle. Ce travail montrait que, parmi les sujets ayant une hypertension, ceux ayant une hypertension non-diagnostiquée avaient un profil spécifique (plus souvent de sexe masculin, un tour de taille moins élevé, et moins souvent de maladies cardiovasculaires/diabète, antécédents familiaux d’hypertension et consultations de soins primaires moins fréquents). La présence concomitante d’un nombre élevé de ces critères renforçait fortement l’absence de primo-diagnostic. Nos résultats peuvent aider dans l’identification précoce des sujets à risque, la prévention et le management thérapeutiqueWorldwide increasing obesity over the last decades expose the population to an increased risk of metabolic perturbations and cardiovascular diseases. This research investigated first the association of obesity with diastolic dysfunction and aortic stiffness observed 20 years later in initially healthy adults. General obesity measured with body mass index and abdominal adiposity measured with waist circumference were positively associated with diastolic dysfunction. But, these anthropometric parameters played a protective role in aortic stiffness. The ratio “waist circumference / body mass index” appeared to better isolate abdominal adiposity from general obesity and was then positively associated with aortic stiffness. It allowed to evidence a harmful role of abdominal adiposity in aortic stiffness, even in subjects with normal body weight. The presence of abdominal adiposity (measured with waist circumference) combined with an elevated level of triglycerides was associated with a higher risk of diastolic dysfunction. In the second part, our research focused on hypertensive individuals. It showed that among hypertensive subjects, those having undiagnosed-hypertension had specific features (being more often male, having less elevated waist circumference, and having fewer cardiovascular diseases/diabetes, familial hypertension history, and primary care uses). The concomitant presence of a higher number of these criteria appeared to strongly reinforce the absence of diagnosis. Our findings may help to early identify subjects at risk, and to establish prevention and therapeutic managemen

Dysfonction diastolique, rigidité artérielle aortique et hypertension : facteurs anthropométriques et métaboliques associés et prise en charge en population générale

Worldwide increasing obesity over the last decades expose the population to an increased risk of metabolic perturbations and cardiovascular diseases. This research investigated first the association of obesity with diastolic dysfunction and aortic stiffness observed 20 years later in initially healthy adults. General obesity measured with body mass index and abdominal adiposity measured with waist circumference were positively associated with diastolic dysfunction. But, these anthropometric parameters played a protective role in aortic stiffness. The ratio “waist circumference / body mass index” appeared to better isolate abdominal adiposity from general obesity and was then positively associated with aortic stiffness. It allowed to evidence a harmful role of abdominal adiposity in aortic stiffness, even in subjects with normal body weight. The presence of abdominal adiposity (measured with waist circumference) combined with an elevated level of triglycerides was associated with a higher risk of diastolic dysfunction. In the second part, our research focused on hypertensive individuals. It showed that among hypertensive subjects, those having undiagnosed-hypertension had specific features (being more often male, having less elevated waist circumference, and having fewer cardiovascular diseases/diabetes, familial hypertension history, and primary care uses). The concomitant presence of a higher number of these criteria appeared to strongly reinforce the absence of diagnosis. Our findings may help to early identify subjects at risk, and to establish prevention and therapeutic management.L’augmentation de l’obésité durant les dernières décennies expose la population à un risque accru de problèmes métaboliques et des maladies cardiovasculaires. Ce travail étudiait, d’une part, l’association de l’obésité avec la dysfonction diastolique et la rigidité artérielle aortique vingt ans plus tard chez des adultes initialement en bonne santé. Cette étude montrait que l’obésité générale mesurée par l’indice de masse corporelle et l’adiposité abdominale mesurée par le tour de taille étaient associées positivement à la dysfonction diastolique. Mais elles semblaient jouer un rôle protecteur sur la rigidité artérielle. Le ratio “tour de taille/indice de masse corporelle” semblait mieux isoler l’adiposité abdominale/viscérale de l’obésité générale, et était associé positivement à la rigidité artérielle. Il permettrait de montrer un rôle néfaste à long terme de l’adiposité abdominale/viscérale sur la rigidité artérielle même quand le poids est normal. La présence combinée de l’obésité abdominale (mesurée par le tour de taille) et d’un taux plus élevé de triglycérides était associée à un risque élevé de dysfonction diastolique. Dans la deuxième partie, nous nous sommes intéressés aux individus ayant déjà une hypertension artérielle. Ce travail montrait que, parmi les sujets ayant une hypertension, ceux ayant une hypertension non-diagnostiquée avaient un profil spécifique (plus souvent de sexe masculin, un tour de taille moins élevé, et moins souvent de maladies cardiovasculaires/diabète, antécédents familiaux d’hypertension et consultations de soins primaires moins fréquents). La présence concomitante d’un nombre élevé de ces critères renforçait fortement l’absence de primo-diagnostic. Nos résultats peuvent aider dans l’identification précoce des sujets à risque, la prévention et le management thérapeutique

Association between untreated low back pain and injury proneness and confounding role of behavioral-health difficulties among younger adolescents: a population-based study

International audiencePurpose: Low back pain (LPB) is mostly left untreated (LBPuntreated) and may increase the injury risk due to associated behavioral-health difficulties (BHDs) among adolescents. This study assessed the association between LBPuntreated (vs. treated LBP (LBPtreated)) and injuries and the mediating role of BHDs among younger adolescents (10–16 years). Methods: This population-based study compared 328 adolescents with LBPuntreated (mean age = 13.7 ± 1.3) with 291 with LBPtreated (mean age = 13.3 ± 1.2) from north-eastern France. They completed a questionnaire collecting, at school-year end, socioeconomic features, LBPtreated/LBPuntreated, BHDs (alcohol/tobacco use, excessive screen-time, poor social support, poor physical health, depressive symptoms, and pain limiting activities), and injuries during the current school-year. Data were analyzed using multinomial logistic regression models and Kaplan–Meier estimates. Results: The proportion of subjects without alcohol/tobacco use or depressive symptoms decreased with time more quickly since age 10 among the adolescents with LBPuntreated than among those with LBPtreated. Hence, most LBP early started and the subjects with LBPuntreated had a higher risk of single injury (sex-age-class-level-socioeconomic-features-adjusted relative risk ratio RR = 1.63, p < 0.05, vs. LBPtreated) and a much higher risk of ≥ 2 injuries (RR = 2.60, p < 0.001). BHDs played a strong mediating role in the association between LBPuntreated and ≥ 2 injuries (contribution = 48%) but a modest mediating role in that between LBPuntreated and single injury (contribution = 10%) (pseudo R 2 = 7.6%). Conclusion: LBPuntreated is common and associated with injuries partly due to BHDs (which may alter physical/mental capabilities, risk perception/awareness, and vigilance) among younger adolescents. Our results may inform healthcare providers that they can detect/treat LBP and BHDs to prevent their aggravation and injuries

Gender and Family Disparities in Suicide Attempt and Role of Socioeconomic, School, and Health-Related Difficulties in Early Adolescence

Suicide attempt (SA) is common in early adolescence and the risk may differ between boys and girls in nonintact families partly because of socioeconomic, school, and health-related difficulties. This study explored the gender and family disparities and the role of these covariates. Questionnaires were completed by 1,559 middle-school adolescents from north-eastern France including sex, age, socioeconomic factors (family structure, nationality, parents’ education, father’s occupation, family income, and social support), grade repetition, depressive symptoms, sustained violence, sexual abuse, unhealthy behaviors (tobacco/alcohol/cannabis/hard drug use), SA, and their first occurrence over adolescent’s life course. Data were analyzed using Cox regression models. SA affected 12.5% of girls and 7.2% of boys (P<0.001). The girls living with parents divorced/separated, in reconstructed families, and with single parents had a 3-fold higher SA risk than those living in intact families. Over 63% of the risk was explained by socioeconomic, school, and health-related difficulties. No family disparities were observed among boys. Girls had a 1.74-time higher SA risk than boys, and 45% of the risk was explained by socioeconomic, school, and mental difficulties and violence. SA prevention should be performed in early adolescence and consider gender and family differences and the role of socioeconomic, school, and health-related difficulties

Associations of unhealthy Behaviors and Depressive Symptoms with School Difficulties and Role of Socioeconomics Factors in Early Adolescence

Unhealthy behaviors such as alcohol, tobacco, cannabis and hard drugs uses and depressive symptoms are common in early adolescence and they are well known to affect physical, mental and cognitive functions. These factors can thus favor persistent school difficulties. Socioeconomic factors are known to favor unhealthy behaviors and depressive symptoms as well as school difficulties. This study assessed the associations of unhealthy and depressive symptoms with learning difficulty, low school performance, and school dropout ideation, and the confounding roles of socioeconomic factors in early adolescence. Design: Cross-sectional study. Methods: The sample included 1,559 middle-school adolescents from north-eastern France (mean age 13.5, SD 1.3), who completed a self-administered questionnaire including gender, birth date, socioeconomic factors (father’s socioeconomic category, family structure, parents’ education, parent death, nationality, family income, and social supports), last-30-day alcohol, tobacco, cannabis and hard drugs uses, depressive symptoms (Kandel scale, score>90th percentile), learning difficulty, low school performance (last-trimester mark 90th percentile). The school difficulties were chosen to measure various difficulty levels. Data were analyzed using logistic models to compute gender-age-grade-adjusted odds ratios (OR1) and the contributions of socioeconomic factors. Findings: Learning difficulty, low school performance, and school dropout ideation affected respectively 14.1%, 8.2%, and 3.8% of students. These school difficulties were linked with alcohol use: OR1 1.72 (95%CI 1.26-2.33), 1.51 (1.03-2.21), and 3.43 (1.96-6.01), respectively. Higher OR1 were found for tobacco use: 3.82 (2.64-5.52), 5.81 (3.83-8.82), and 6.31 (3.53-11.28), respectively; cannabis use: OR1 3.61 (2.23-5.86), 4.12 (2.41-7.04), and 6.89 (3.45-13.76), respectively; hard drugs uses: OR1 6.37 (3.41-11.89), 5.05 (2.53-10.08), and 10.85 (4.99-23.55), respectively; and depressive symptoms: OR1 7.21 (5.06-10.27), 1.84 (1.16-2.93), 3.14 (1.64-6.03), respectively. The socioeconomic factors considered explained respectively <4%, 15-37%, 10%-31%, 20%-43%, and 20%-68% of the associations of school difficulties with alcohol, tobacco, cannabis, and hard drugs uses and depressive symptoms. Conclusions: Unhealthy behaviors and depressive symptoms were strongly associated with school difficulties. Socioeconomic factors highly confounded their associations. Public policy to improve school achievement, and thus community participation in adulthood, should focus on unhealthy behaviors and mental disorders, especially among students with socioeconomic difficulties. Causal relationships could not be advanced (study cross-sectional nature)

School difficulties and role of social, material, behavioural, physical and mental resources among multi-cultural students.

Background: School is a multi-cultural setting where students need social, material, physical, and mental resources to attain school achievement. But they are often lacking, especially for immigrant students. In an early adolescence context, this study assessed risk for school difficulties among European and non-European immigrants and the roles of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours. Methods: This cross-sectional study included 1,559 middle-school adolescents from north-eastern France, who completed a self-administered questionnaire including socioeconomic characteristics (gender, age, family structure, father’s occupation, and family income), WHO-Quality of life (measuring the four dimensions physical health, psychological health, social relationships, and living environment), unhealthy behaviours (last-30-day uses of tobacco, alcohol, cannabis, and other illicit drugs and no regular ports/physical activities), grade repetition, low school performance (<10/20), and school dropout ideation at 16 years. Data were analyzed using logistic models. Results: Grade repetition affected 14.8% of students, low school performance 8.2%, and school dropout ideation 3.9%. European immigrants had a higher risk for grade repetition only with a gender-age-adjusted odds ratio (OR) of 2.44, vs. French students. This odds ratio decreased to 1.76 (contribution 47%) with further adjustment for all confounders (family structure, father’s occupation, family income, physical health, psychological health, social relationships, living environment, and unhealthy behaviours). Non-European immigrants had a statistically higher risk for all grade repetition, low school performance, and school dropout ideation with ORs of 3.29, 3.02, and 3.42, respectively vs. French students. These odds ratios decreased to 1.76, 1.54, and 1.54, respectively (contributions 66%, 73%, and 78%) with further adjustment for all confounders. Conclusions: Compared with French students, European immigrant students were more affected only by grade repetition while non-European immigrant students by all grade repetition, low school performance, and school dropout ideation. The contribution of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours was very high and much higher for non-European than for European immigrant students. Public policy should focus on these factors and services to reduce school difficulties

Santé, comportements de santé et violence parmi les immigrants. Rôle des facteurs socioéconomiques chez les adolescents

Etudier les problèmes relatifs à la santé (usage de substances, état de santé, symptômes dépressifs, violence physique/verbale et abus sexuel subis, et implication dans la violence) des immigrés européens et non-européens et le rôle des difficultés socioéconomiques, relationnelles et scolaires. Les problèmes relatifs à la santé sont plus fréquents chez les immigrés européens et non-européens que les français. Ils sont fortement expliqués par les difficultés socioéconomiques, relationnelles et scolaires. Contexte. Cette enquête transversale a été réalisée sur 1559 adolescents des collèges dans le nord-est de la France. Elle est basée sur un auto-questionnaire, rempli en classe sous la surveillance de l’équipe de recherche, concernant le sexe, l’âge, la nationalité, les caractéristiques socioéconomiques (structure familiale, faible éducation parentale (90ème percentile), violence physique/verbales subie, agression sexuelle subie, et implication dans la violence. Les données sont analysées par les modèles de régression logistiques. Résultats. Les problèmes sont fréquents : usage d’alcool (35,2%), tabac (11,2%), cannabis (5,6)%, drogues dures (2,8%), mauvais état de santé (25,8%), symptômes dépressifs (13,3%), être victime de violence physique/verbale (16,2%) ou d’abus sexuel (3,7%) et implication dans la violence (14,6%). Comparés aux français, les immigrés ont un risque accru pour : usage de tabac (odds ratio ajusté sur le sexe et l’âge 2,04), cannabis (2,33), drogues dures (4,18), mauvais état de santé (1,89), violence subie (1,84) et implication dans la violence (1,77). Les situations socioéconomiques expliquaient respectivement 25%, 9%, 13%, 30%, 12% et 39% de ces risques. L’ajout de relations sociales et de la performance scolaire expliquait respectivement 43%, 20%, 29%, 53%, 24% et 61% des risques. Ces problèmes et les contributions des cofacteurs diffèrent beaucoup entre les immigrés européens et non-européens. Conclusions. Les problèmes relatifs à la santé sont plus fréquents chez les immigrés européens et non-européens que les français. Ils sont fortement expliqués par les difficultés socioéconomiques, relationnelles et scolaires. La prévention pour leur intégration sociale devrait traiter ces problèmes

Suicide behaviors and role of family characteristics, school difficulties, unhealthy behaviors, and mental health among multi-cultural students.

Background: School is a multi-cultural setting where students are trained for community participation, especially at adulthood. But some students experience suicidal behaviors and the risk may be exacerbated among immigrant students because of their living conditions. In an early adolescence context, this study assessed of risk for suicide behaviors among European and non-European immigrants and the roles of family characteristics, school difficulties, unhealthy behaviors, and mental health. Methods: Questionnaires were completed by 1559 middle-school adolescents from north-eastern France (mean age 13.5 (SD 1.3) years) including: sex, age, family structure, nationality, father’s occupation, unhealthy behaviors (last-30-day consumption of tobacco/alcohol/cannabis/hard drug, no regular sports/physical activities), repeating a school year, low-school-performance (<10/20), and quittingschool- thinking, depressive symptoms, victim of violence or sexual abuse, implication in violence, and suicide behaviors. Data were analyzed using logistic models. Results: Last-12-month suicidal ideation (SI) and lifetime suicide attempts (SA) affected 11.7% and 9.9% of students. The risk for SI was higher for European immigrants (gender-age-adjusted odds ratio ORa 2.06) and non-European immigrants (2.60) compared with French. Further adjustment for father’s occupation and family structure reduced the ORs to 1.76 (28%) and 2.43 (11%) respectively. Further adjustment for unhealthy behaviors, school difficulties, depressive symptoms, victim of violence or sexual abuse, and implication in violence reduced the ORs to 1.50 (53%) and 2.23 (23%) respectively. The risk for SA was higher for European immigrants only (ORa 2.21). Further adjustment for father’s occupation and family structure reduced the OR to 2.03 (15%), and further adjustment for other covariates reduced it to 1.59 (51%). Conclusion: Immigrant students have a higher risk for suicidal ideation or suicide attempts depending on their origin. The risk is strongly mediated by family characteristics, school difficulties, unhealthy behaviors, and mental heath. Public policy may focus on these issues. This should promote school achievement and community participation