Oral health knowledge : attitudes and practice in 12-year-old schoolchildren

Objective: The objective of this study was to assess the association between knowledge, attitudes and practice of oral health in 12-year-old schoolchildren, and to analyse the findings in terms of the conventional KAP health-education model and of the critical approach. Study design: This study has a cross sectional design. The study participants were 1105 randomly selected 12-year-old children resident in the region of Galicia in Spain. For data collection, five teams of one dentist and one assistant were formed. The dentist carried out the physical examination and the assistant helped the subjects to answer the questionnaire. Knowledge, attitudes and practice were assessed, as well as oral health indicators. Multiple regression analysis was used to identify variables affecting practice (as measured by extent of plaque). Results: The results of this study show how that there is an important association between oral health knowledge, attitudes, and practice in 12-year-old schoolchildren in this region. However, the results also show that attitude is not totally explained by knowledge, so that attitude cannot be understood simply as an intermediate variable in a knowledge? practice causal chain. Specifically, the results indicate that sociocultural environment modifies the association knowledge, attitudes and practice. Conclusions: Within oral health education it is clearly important to increase public knowledge of the risk factors for dental disease. However, the efficacy of such education will be limited if health programs do not directly impinge on attitudes, and take into account factors related to the environment, education, social status and economic level of the targeted population

Quality prescription indicators in defined daily doses. Are we getting it right?

Los indicadores de la calidad de la prescripción de grado potencial de uso (IGPU) se definen como la proporción que representa el consumo de determinados principios activos frente al consumo total de su categoría anatómica terapéutica. En los últimos años, los IGPU que se han ido definiendo en nuestro país utilizan la dosis diaria definida (DDD) como unidad de medida. Y aunque la DDD no es necesariamente igual a la dosis terapéutica equivalente (DTE), se ha argumentado que es una unidad de medida estándar y, por tanto, válida. Esto podría no ser correcto, ya que las relaciones entre DTE y DDD son distintas en los diferentes fármacos, incluso dentro de la misma categoría anatómica terapéutica. Por ello, la utilización de las DDD en los IGPU puede llevar a incentivar o desincentivar la prescripción de un fármaco en función de su relación DTE/DDDQuality prescription indicators of use potential level (UPLI) are defined as the proportion that represents consumption of specific active principles as opposed to the total consumption of the anatomical therapeutic category. The UPLIs that have gradually been defined in Spain employ the defined daily dose (DDD) as the unit of measurement. Although the DDD is not necessarily the same as the therapeutic equivalent dose (TED), some authors have argued that the DDD is a standard unit of measurement and is therefore valid. However, this view may not be correct, given that the relationships between the TED and the DDD differ, depending on the drug, even within the same anatomical therapeutic category. Therefore, the use of DDDs in UPLI s may lead to prescription of a medicine being encouraged or discouraged depending on its TED/DDD ratioS

Population Attributable Fraction of Early Age of Onset of Alcohol Use in Alcohol Abuse and Dependence: A 3-Year Follow-Up Study in University Students

Background: we aimed to determine the risk factors and associated population attributable fractions (PAFs) for the age of onset of alcohol use and also to identify protective factors. Methods: we analyzed follow-up data collected between autumn 2011 and spring 2016 (n = 5170) from the first two cohorts (2011, 2012) of the Spit for ScienceTM project. The dependent variables were alcohol abuse and dependence, and the independent variables were age of drinking onset, residence, ethnicity, religiosity, sexual orientation and work status. We determined the odds ratios (OR) using multilevel logistic regression for repeated measures in SPSSv.20. Results: the early onset of alcohol use was associated with an increased risk of alcohol abuse and dependence among females (OR = 14.98; OR = 11.83) and males (OR = 7.41; OR = 6.24). The PAFs for the early onset of alcohol use in alcohol abuse and dependence were respectively 80.9% and 71.7% in females and 71.0% and 63.5% in males. Among females, being white (OR = 1.58; OR = 1.51), living off-campus (OR = 1.73; OR = 2.76) and working full-time (OR = 1.69; OR = 1.78) were also risk factors. Strong religious beliefs were found to protect males from alcohol abuse (OR = 0.58), while same-gender sexual orientation increased the risk among females (OR = 2.09). Conclusion: delaying the age of onset by one year would reduce alcohol abuse among young adultsSpit for Science: The Student Survey was supported by the Virginia Commonwealth University, the NIAAA [P20 AA107828, R37AA011408, K02AA018755, and P50 AA022537] and the National Center for Research Resources and National Institutes of Health Roadmap for Medical Research [UL1RR031990]S

Factors associated with health-related quality of life in adults with asthma. A cross-sectional study

Background: The measurement of health-related quality of life (HRQoL) is increasingly recognized as an important endpoint, as a reflection of the effects of the disease from a patient perspective. Our aim was to evaluate the factors determining the HRQoL in patients with asthma, according to the EQ-5D questionnaire. Methods: Patients were included using multi-stage sampling, from Primary Care clinics from all the Autonomous Communities in Spain. The patients included were: over 18 years-old, with a confirmed diagnosis of asthma for at least one year, and had visited a Health Centre in the previous 2 years. The characteristics of the asthma disease, the adherence to treatment, the socio-demographic variables, the smoking habits, and the asthma control were collected using a questionnaire. The influence of the different variables included in the study on the EQ-5D was evaluated using multivariate logistic regression analysis. Results: A total of 2,125 patients were finally included (57.7% females, mean age 48 years). The response rate was 95.4%. Some factors showed a considerable detrimental effect on the HRQoL of asthmatics. Advanced age, lower educational level and poor control of asthma are significantly associated with a worse quality of life in all the dimensions assessed by the EQ-5D scale. The baseline severity of the asthma, and having been admitted to hospital are related to a worse quality of life in 5 of the 6 dimensions analyzed. Conclusion: In our study, we could identify some factors related to quality of life in asthma patients. The most important were advanced age, lower education level, and poor control of the asthma.S

Binge drinking trajectory and decision-making during late adolescence: gender and developmental differences

Objective: Impaired affective decision-making has been consistently related to alcohol dependence. However, less is known about decision-making and binge drinking (BD) in adolescents. The main goal of this longitudinal study was to determine the association between BD and decision-making from late adolescence to early adulthood. A second aim is to assess developmental changes and performance differences in males and females. Method: An initial sample of 155 1st-year university students, (76 non-BDs, 40 females; and 79 BDs, 39 females), was followed prospectively over a 4-year period. The students were classified as stable non-BDs, stable BDs and ex-BDs according to their scores in item 3 of the AUDIT and the speed of alcohol consumption. Decision-making was assessed by the Iowa Gambling Task (IGT) three times during the study. Dependent variables were net gain and net loss. Results were analyzed using generalized linear mixed models. Results: A stable BD pattern was not associated with either disadvantageous decisionmaking or sensitivity to loss frequency. Performance improved significantly in both genders over the study period, especially in the last blocks of the task. Females showed a higher sensitivity to loss frequency than males. No gender-related differences were observed in gains. Conclusion: Performance in affective decision-making continues to improve in late adolescence, suggesting neuromaturational development in both genders. Females are more sensitive to loss frequency. Stable BD during late adolescence and emerging adulthood is not associated with deficits in decision-making. Poor performance of the IGT may be related to more severe forms of excessive alcohol consumptionThe study was supported by grants from the Spanish Ministerio de Sanidad, Servicios Sociales e Igualdad (Plan Nacional sobre Drogas), Ministerio de Ciencia e Innovacíon (PSI2011-22575) and Ministerio de Economía y Competitividad (PSI2015-70525-P) co-funded by the European Regional Development Found. Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministerio de EducacionS

Binge drinking during adolescence and young adulthood is associated with deficits in verbal episodic memory

Binge drinking (BD), a harmful pattern of alcohol consumption, is common during adolescence. Young adults with alcohol use disorders exhibit hippocampal alterations and episodic memory deficits. However, it is not known how these difficulties progress in community BD adolescents. Our objective was to analyze the relationship between BD trajectory and verbal episodic memory during the developmental period spanning from adolescence and to early adulthood. An initial sample of 155 male and female first-year university students with no other risk factors were followed over six years. Participants were classified as stable non-BDs, stable BDs and ex-BDs according to the third AUDIT item. At baseline, participants comprised 36 ♂/ 40 ♀ non-BDs (18.58 years), 40 ♂/ 39 ♀ BDs (18.87 years), and at the third follow-up, they comprised 8 ♂/ 8 ♀ stable non-BDs (25.49 years), 2 ♂/ 2 ♀ stable BDs (25.40) and 8 ♂/ 12 ♀ ex-BDs (24.97 years). Episodic memory was assessed four times with the Logical Memory subtest (WMS-III) and the Rey Auditory Verbal Learning Test (RAVLT). Generalized linear mixed models were applied. The results showed that, relative to non-BDs, stable BDs presented difficulties in immediate and delayed recall in the Logical Memory subtest. These difficulties remained stable over time. The short-term ex-BDs continued to display difficulties in immediate and delayed recall in the Logical Memory subtest, but long-term ex-BDs did not. The effects were not influenced by age of alcohol onset, frequency of cannabis use, tobacco use or psychopathological distress. In conclusion, BD during adolescence and young adulthood is associated with episodic memory deficits. Abandoning the BD pattern may lead to partial recovery. These findings are consistent with the vulnerability of the adolescent hippocampus to the neurotoxic effects of alcoholThe study was supported by grants from the Spanish Ministerio de Ciencia e Innovación (EDU2008-03400; PSI2011-22575). Carina Carbia was supported by the FPU program (FPU13/04569) of the Spanish Ministerio de EducaciónS

Consumo temprano de alcohol y síntomas psicopatológicos en estudiantes universitarios

Background: Adolescent brain may be particularly vulnerable to alcohol. Plus, psychopathological disorders tend to emerge in this period. Consequently, early alcohol use may increase the risk of psychopathological disorders, with time and sex-dependent effects. However, few studies have analyzed the relationship between alcohol consumption and adolescent psychopathology in the general population. The objective was to determine the association between age of onset of alcohol use and psychopathological symptoms in university students, separately for both sexes. Method: A cross-sectional study involving fi rst-year university students (n = 3,696) was conducted. Symptoms were measured by the Symptom Checklist-R (SCL-90-R). The independent variable was age of fi rst alcohol use. Dependent variables were the SCL-90-R dimensions, dichotomized. Alcohol consumption was considered a mediator variable. Data were analyzed separately for males and females. Results: The fi ndings showed that a younger age of onset is a risk factor for the following global indexes: Global Severity Index, Positive Symptom Total for females, and Positive Symptom Distress Index, for males. Alcohol consumption showed a higher mediator effect for females than for males. Conclusion: Early age of alcohol use is associated with increased psychopathological symptomatology in both sexes during the college freshman year. The pattern of symptomatology is different in each sexAntecedentes: durante la adolescencia el cerebro es especialmente vulnerable a los efectos del alcohol. El consumo temprano de alcohol puede aumentar el riesgo de sintomatología psicopatológica. Pocos estudios han analizado la relación entre consumo de alcohol y sintomatología psicopatológica en adolescentes en la población general. El objetivo de este estudio es determinar la asociación entre edad de inicio del consumo de alcohol y síntomas psicopatológicos en estudiantes universitarios, separadamente para ambos sexos. Método: estudio transversal en estudiantes universitarios (n = 3.696). Los síntomas se midieron con el SCL-90-R. La variable independiente fue la edad de inicio del consumo de alcohol. Las variables dependientes fueron las dimensiones del SCL-90-R dicotomizadas. El consumo de alcohol fue una variable mediadora. Resultados: una temprana edad de inicio es un factor de riesgo para los siguientes índices globales: Índice de Severidad Global, Total de Síntomas Positivos, solo en mujeres, e Índice de Malestar, solo para hombres. El consumo de alcohol muestra un mayor efecto mediador en las mujeres. Conclusión: una temprana edad de inicio en el consumo de alcohol se asocia con un aumento de sintomatología psicopatológica en ambos sexos durante el primer año de Universidad. El patrón de sintomatología difi ere en hombres y mujeresS

The Use of Non-Prescribed Prescription Drugs and Substance Use Among College Students: A 9-Year Follow-Up Cohort Study

The use of non-prescribed prescription drugs (NPPD) is common in post-modern societies and a significant proportion of youth consume NPPD concomitantly to other drugs. We studied the prevalence of this consumption among university students in Spain, and its relationship to different patterns of alcohol, tobacco, and cannabis use. A cohort study among university students (n=1,380) (2005–2015) was carried out. Students completed self-administered questionnaires at initial (n=1,363, 98.7%), at 2 years (n=875, 75%) and 9 years of follow-up (n=415, 30.5%). Consumption of medicines (last 15 days), risky alcohol consumption (RC), heavy episodic drinking (HED), and tobacco and cannabis use were measured. Multilevel logistic regressions for repeated measures were generated using consumption of medicines with or without medical prescription as dependent variables. Prevalence of RC, HED, tobacco and cannabis had significant reductions during the follow-up. The use of NPPD increased over time, from 35.5% and 33.3% at 18 and 22 years old, respectively, to 49.6% at 27 years old. The highest rates were found among cannabis, tobacco, RC and HED users. For females, cannabis and RC constitute signitifant risk factors for use of NPPD. Conversely, for males, tobacco and cannabis were risk factors for such use of medicines. Later onset of alcohol consumption constitutes a protective factor for females. Our results reveal high prevalence of NPDD among university students. Those who consume NPPD are -at the same time- more likely to be alcohol, tobacco, and cannabis users than those who take medication under prescription. Preventive strategies should be reinforced and focused on this target population to decrease these high levels of poly-consumptionFunding for this study was provided by the Plan Nacional sobre Drogas (Spain) (2005/PN014) and the Fondo de Investigación Sanitaria (Spain) (PI15/00165). CC has been funded by the European Union’s Horizon 2020 research and innovation program with the Marie Sklodowska-Curie grant No. 754535S

Patterns of Alcohol Consumption in Spanish University Alumni: Nine Years of Follow-Up

The aim of this study was to empirically identify different profiles of Spanish university alumni, based on their alcohol use over 9 years, and to further characterize them. A cohort study was carried out between 2005 and 2015 among university students (Compostela Cohort-Spain; n2015 = 415). Alcohol consumption was measured using the Alcohol Use Disorder Identification Test (AUDIT). A two-stage cluster analysis, based on their AUDIT total scores was carried out separately for males and females. The further characterization of every profile was based on demographic data, age at onset of alcohol use, positive alcohol-related expectancies, tobacco and cannabis use, as well as their answers to some European Addiction Severity Index items. Five different clusters were identified: Low users (29.2%), Moderated users (37.2%), At-risk users (14.2%), Decreasing users (13.2%) and Large users (6.2%) for females, and Low users (34.4%), At-risk users (25.6%), High-risk users (15.6%), Decreasing users (14.4%) and Large users (10.0%) for males. Being a cannabis user or a smoker was positively associated to those more hazardous clusters in both genders. Regarding females, significant differences in the age of onset and high positive expectancies were found. However, there were few significant differences among the groups in relation to their employment status and social relations. The results reveal the existence of different typologies of alcohol users among university alumni, with differences among males and females. Modifying positive expectancies, limiting access to alcohol at a young age, and reducing uses of other substances uses are key to promote healthier alcohol use profiles and to prevent hazardous usesThis work was supported by a grant from the Plan Nacional sobre Drogas (Spain) (2005/PN014) and from Fondo de Investigación Sanitaria (Spain) (PI15/00165). Eduardo López-Caneda was supported by the SFRH/BPD/109750/2015 Postdoctoral Fellowship of the Portuguese Foundation for Science and Technology as well as by the Psychology Research Centre (UID/PSI/01662/2013), co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653)S

Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students

Aim: The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. Methods: We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. Results: The incidence rate of alcohol-related injuries was 0.028 year−1 for females and 0.036 year−1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR] = 2.64 and OR = 3.68), while being more than 23 is a protective factor (OR = 0.34). For males, bivariate analysis also showed HED like risk factor (OR = 4.69 and OR = 2.51). Finally, the population attributable fraction for HED among females was 37.12%. Conclusions: HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HEDThis work was supported by the Spanish National Plan on Drugs (N.P.D)(grant number 2005/PN014), and MICINN (grant number PSI2011-22575)S