Health and health risk behaviour of adolescents—Differences according to family structure. Results of the German KiGGS cohort study

<div><p>Objective</p><p>This study’s aim was to investigate the association between family structure and different health-related outcomes in adolescence (self-rated health, emotional and behavioural problems, health-related quality of life, regular smoking, and heavy episodic drinking). Furthermore, we analysed the extent to which socio-economic status, family cohesion and the pre-transition health status explain family structure-related health disparities.</p><p>Methods</p><p>We used longitudinal data from the first two waves of the German KiGGS cohort study carried out by the Robert Koch Institute (baseline: 2003–2006, follow-up: 2009–2012). The sample comprised 4,692 respondents aged 11 to 17 years. Using data from both waves, effects of family structure on health status at follow-up were calculated applying linear and logistic regression models.</p><p>Results</p><p>We found that adolescents continuously living with both birth parents were in good health. Adolescents whose parents separated after the baseline survey, reported poorer health and were more likely to smoke. The transition from stepfamily to single parent family was also associated with a higher risk of regular smoking. Lower health-related quality of life as well as higher scores for emotional and behavioural problems occurred in almost all non-nuclear family structures, although not all effects were statistically significant. No significant effects of family structure on heavy episodic drinking were found. While family cohesion mediated the effects of family structure on adolescents’ health, the mediating effect of socio-economic status was small. After controlling for pre-transition health, the effects were even lower.</p><p>Conclusions</p><p>Because the direct effects of family structure on adolescents’ health were small and family cohesion was found to be an important mediator in the association between family structure and adolescents’ health, prevention programmes and interventions should be directed towards the parent–adolescent relationship rather than just the family structure, in order to minimize the psychosocial stress of adolescents during the period of family transition.</p></div

Sample characteristics.

<p>Sample characteristics.</p

Results from the linear regression models on self-rated health.

<p>Adolescents aged 11 to 17 years.</p

Results from the linear regression models on health-related quality of life.

<p>Adolescents aged 11 to 17 years.</p

Results from the logistic regression models on regular smoking.

<p>Adolescents aged 14 to 17 years.</p

Results from the logistic regression models on heavy episodic drinking.

<p>Adolescents aged 14 to 17 years.</p

Mean values / proportions of the health outcomes according to family status.

<p>Mean values / proportions of the health outcomes according to family status.</p

The Impact of Different Levels of Adaptive Iterative Dose Reduction 3D on Image Quality of 320-Row Coronary CT Angiography: A Clinical Trial

<div><p>Purpose</p><p>The aim of this study was the systematic image quality evaluation of coronary CT angiography (CTA), reconstructed with the 3 different levels of adaptive iterative dose reduction (AIDR 3D) and compared to filtered back projection (FBP) with quantum denoising software (QDS).</p><p>Methods</p><p>Standard-dose CTA raw data of 30 patients with mean radiation dose of 3.2 ± 2.6 mSv were reconstructed using AIDR 3D mild, standard, strong and compared to FBP/QDS. Objective image quality comparison (signal, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), contour sharpness) was performed using 21 measurement points per patient, including measurements in each coronary artery from proximal to distal.</p><p>Results</p><p>Objective image quality parameters improved with increasing levels of AIDR 3D. Noise was lowest in AIDR 3D strong (p≤0.001 at 20/21 measurement points; compared with FBP/QDS). Signal and contour sharpness analysis showed no significant difference between the reconstruction algorithms for most measurement points. Best coronary SNR and CNR were achieved with AIDR 3D strong. No loss of SNR or CNR in distal segments was seen with AIDR 3D as compared to FBP.</p><p>Conclusions</p><p>On standard-dose coronary CTA images, AIDR 3D strong showed higher objective image quality than FBP/QDS without reducing contour sharpness.</p><p>Trial Registration</p><p>Clinicaltrials.gov <a href="https://www.clinicaltrials.gov/ct2/show/NCT00967876?term=NCT00967876&rank=1" target="_blank">NCT00967876</a></p></div

Analysis of signal and noise.

<p>Measurement in the vessel and the surrounding tissue at the example of right coronary artery (RCA) being reconstructed by using filtered back projection/ quantum denoising filtering software; axial slices; <b>a/d</b>: proximal RCA measurement point 5 mm distal of the beginning of the vessel; <b>b/e</b>: medial RCA measurement point 5 mm distal of the first branch; <b>c/f</b>: distal RCA measurement point 5 mm distal of the second branch; <b>a-c:</b> field of view of 180 mm; <b>d-f:</b> zooming of <b>a-c;</b> The ROIs in the vessel lumen were placed as large as possible without integrating calcified and non-calcified plaques, stents and also the vessel wall into the analysis (approximately 50% of the vessel lumen).</p

Comparison of contour sharpness.

<p>No significant difference was found for the contour sharpness based on the difference between 25% and 75% of the maximal gray value (<b>a</b>) and the maximal slope of gray values between two pixels in percent of the difference between minimal and maximal density (<b>b</b>); comparison between FBP/QDS, AIDR 3D mild, AIDR 3D standard (STD) and AIDR 3D strong (STR).</p