Parents who supply sips of alcohol in early adolescence: A prospective study of risk factors

BACKGROUND: Parents are a major supplier of alcohol to adolescents, often initiating use with sips. Despite harms of adolescent alcohol use, research has not addressed the antecedents of such parental supply. This study investigated the prospective associations between familial, parental, peer, and adolescent characteristics on parental supply of sips. METHODS: Participants were 1729 parent-child dyads recruited from Grade 7 classes, as part of the Australian Parental Supply of Alcohol Longitudinal Study. Data are from baseline surveys (Time 1) and 1-year follow-up (Time 2). Unadjusted and adjusted logistic regressions tested prospective associations between Time 1 familial, parental, peer, and adolescent characteristics and Time 2 parental supply. RESULTS: In the fully adjusted model, parental supply was associated with increased parentreport of peer substance use (odds ratio [OR] = 1.20, 95% confidence ratio [CI], 1.08-1.34), increased home alcohol access (OR = 1.07, 95% CI, 1.03-1.11), and lenient alcohol-specific rules (OR=0.88, 95% CI, 0.78-0.99). CONCLUSIONS: Parents who perceived that their child engaged with substance-using peers were more likely to subsequently supply sips of alcohol. Parents may believe supply of a small quantity of alcohol will protect their child from unsupervised alcohol use with peers. It is also possible that parental perception of peer substance use may result in parents believing that this is a normative behavior for their child's age group, and in turn that supply is also normative. Further research is required to understand the impacts of such supply, even in small quantities, on adolescent alcohol use trajectories

Gender differences in the supply of alcohol to adolescent daughters and sons

Background: Parents are the main supplier of alcohol to children but it is not known whether mothers and fathers equally contribute to the supply of alcohol to their female and male children as these children transition to adulthood. Objectives: i) to determine whether the gender of the parent is associated with the gender of the adolescent offspring when alcohol is supplied and ii) whether the gender of the parent supplying is associated with gender differences in adolescent binge drinking and alcohol related harms. Methods: Longitudinal cohort of 1,927 (males = 1052) Australian adolescents (mean age 12.9 years), recruited in 2010/11 from schools in Australia and surveyed annually for six years. We assessed the association between adolescent and parent gender related to subsequent adolescent drinking, binge drinking (>4 standard drinks), and alcohol-related harms. Results: At mean age of 12.9 years about one in ten children report parental supply of alcohol which increases to about four in ten children by 17.8 years. Mothers consistently more often supply their daughters with alcohol than their sons, [Wave 5 OR 1.77 (1.53,2.05)], while mothers less often supply sons than their daughters, [Wave 5 OR 0.82 (0.71,0.95)]. Mothers’ supply of alcohol to daughters predicts substantially increased odds of daughters binge drinking, [OR 1.67 (1.10,2.53)] and experiencing alcohol related harms, [OR 1.65 (1.10,2.48)]. Conclusion: There is a need to involve both mothers and fathers and to equally target female and male children in programs to reduce the harmful consequences of parental supply of alcohol to their children

Behavioural and Cognitive Associations of Short Stature at 5 Years

Objectives To determine the extent to which childhood short stature is associated with cognitive, behavioural and chronic health problems, and whether these problems could be attributed to recognized adverse biological, psychosocial or psychological factors. Methodology At their first antenatal session, 8556 women were enrolled in a prospective study of pregnancy. When their children were 4 and 6 years of age, mothers completed a detailed questionnaire concerning their child's health and behaviour. A Peabody Picture Vocabulary Test-Revised (PPVT-R) was completed by the child at 5 years of age. Z scores were used to categorize height measurements in 3986 children. The relationship of these height categories with the child's health, and behavioural and cognitive problems was then examined. Results No association was found between height and symptoms of chronic disease or behaviour problems in boys or girls. On the unadjusted analysis, mean PPVT-R scores were significantly lower in boys with heights < 3 percentile and 3-10 percentile compared with study children between 10 to 90 percentile (P < 0.01). Scores were similarly significantly lower in girls with heights < 3 percentile and 3-10 percentile (P = 0.01). Even after adjusting for psychosocial and biological confounders, short stature remained a significant predictor for lower PPVT-R scores in both boys and girls, although height only accounted for 1.1% of the variance in scores in boys and 0.5% of the variance in PPVT-R scores in girls. Psychosocial factors had a greater role than height in determining PPVT-R scores at 5 years of age. Conclusions These findings suggest a significant, though small, association between height and PPVT-R scores at 5 years of age, independent of psychosocial disadvantage and known biological risk factors

Quality of life in Type 1 (insulin-dependent) diabetic patients prior to and after pancreas and kidney transplantation in relation to organ function

Improvement of the quality of life in Type 1 (insulin-dependent) diabetic patients with severe late complications is one of the main goals of pancreas and/or kidney grafting. To assess the influences of these treatment modalities on the different aspects of the quality of life a cross-sectional study in 157 patients was conducted. They were categorized into patients pre-transplant without dialysis (n=29; Group A), pre-transplant under dialysis (n=44; Group B), post-transplant with pancreas and kidney functioning (n=31; Group C), post-transplant with functioning kidney, but insulin therapy (n=29; Group D), post-transplant under dialysis and insulin therapy again (n=15; Group E) and patients after single pancreas transplantation and rejection, with good renal function, but insulin therapy (n=9; Group F). All patients answered a mailed, self-administered questionnaire (217 questions) consisting of a broad spectrum of rehabilitation criteria. The results indicate a better quality of life in Groups C and D as compared to the other groups. In general the scores are highest in C, but without any significant difference to D. Impressive significant differences between C or D and the other groups were found especially in their satisfaction with physical capacity, leisure-time activities or the overall quality of life. The satisfaction with the latter is highest in C (mean±SEM: 4.0±0.2 on a 1 to 5-rating scale; significantly different from A: 3.1±0.1, B: 2.7±0.2 and E: 2.6±0.3; p<0.01), followed by D (3.8±0.2; significantly different from B and E; p<0.01). Group F shows a mean of 3.1±0.4, which is not significantly different from C. The percentages of patients in each group, who are not working: A: 38 %, B: 64 %, C: 74 %, D: 66 %, E: 87 % and F: 78 % indicate that there is no marked improvement in the vocational situation after successful grafting

The overall effect of parental supply of alcohol across adolescence on alcohol-related harms in early adulthood—a prospective cohort study

Background and Aims: Recent research suggests that parental supply of alcohol is associated with more risky drinking and alcohol-related harm among adolescents. However, the overall effect of parental supply throughout adolescence remains unclear, because parental supply of alcohol varies during adolescence. Due to the complexity of longitudinal data, standard analytical methods can be biased. This study examined the effect of parental supply of alcohol on alcohol-related outcomes in early adulthood using robust methods to minimize risk of bias. Design: Prospective longitudinal cohort study. Setting: Australia. Participants: A cohort of school students (n = 1906) recruited in the first year of secondary school (average age 12.9 years) from Australian schools in 2010–11, interviewed annually for 7 years. Measurements: The exposure variable was self-reported parental supply of alcohol (including sips/whole drinks) during 5 years of adolescence (waves 1–5). Outcome variables were self-reported binge drinking, alcohol-related harm and symptoms of alcohol use disorder, measured in the two waves after the exposure period (waves 6–7). To reduce risk of bias, we used targeted maximum likelihood estimation to assess the (counterfactual) effect of parental supply of alcohol in all five waves versus no supply on alcohol-related outcomes. Findings: Parental supply of alcohol throughout adolescence saw greater risk of binge drinking [risk ratios (RR) = 1.53; 95% confidence interval (CI) = 1.27–1.84] and alcohol-related harms (RR = 1.44; 95% CI = 1.22–1.69) in the year following the exposure period compared with no supply in adolescence. Earlier initiation of parental supply also increased risk of binge drinking (RR = 1.10; 95% CI = 1.05–1.14), and any alcohol-related harm (RR = 1.09; 95% CI = 1.05–1.13) for each year earlier parental supply began compared with later (or no) initiation. Conclusions: Adolescents whose parents supply them with alcohol appear to have an increased risk of alcohol-related harm compared with adolescents whose parents do not supply them with alcohol. The risk appears to increase with earlier initiation of supply

Income differences in food consumption in the 1995 Australian national nutrition survey

Objective: To assess the relationships between an index of per capita income and the intake of a variety of individual foods as well as groups of food for men and women in different age groups. Design: Cross-sectional national survey of free-living men and women. Subjects: A sample of 5053 males and 5701 females aged 18 y and over who completed the Australian National Nutrition Survey 1995. Methods: Information about the frequency of consumption of 88 food items was obtained. On the basis of scores on the Food Frequency Questionnaire, regular and irregular consumers of single foods were identified. The relationships between regularity of consumption of individual foods and per capita income were analysed via contingency tables. Food variety scores were derived by assigning individual foods to conventional food group taxonomies, and then summing up the dichotomised intake scores for individual foods within each food group. Two-way ANOVA (income age group) were performed on the food variety scores for males and females, respectively. Results: Per capita income was extensively related to the reported consumption of individual foods and to total and food group variety indices. Generally, both men and women in low income households had less varied diets than those in higher-income households. However, several traditional foods were consumed less often by young high-income respondents, especially young women. Conclusions: Major income differentials in food variety occur in Australia but they are moderated by age and gender. Younger high-income women, in particular, appear to have rejected a number of traditional foods, possibly on the basis of health beliefs. The findings also suggest that data aggregation has marked effects on income and food consumption relationships.<br /

The Effect Of Breastfeeding On Child Development At 5 Years: A Cohort Study

Objective It is uncertain to what degree the relationship between breastfeeding and later cognitive development is a true biological effect, or is confounded by psychosocial factors. The study aim was to further investigate this relationship and the effect of duration of breast feeding on cognitive development. Methods A total of 3880 children were followed from birth. Breastfeeding duration was measured by questionnaire at 6 months of age and a Peabody Picture Vocabulary Test Revised (PPVT-R) was administered at 5 years. PPVT-R scores were adjusted for the effects of a large array of biological and psychosocial confounders. The relationship between breastfeeding and the mean PPVT-R scores were examined using analysis of variance and multiple linear regression. Results A strong positive relationship was demonstrated between breastfeeding and the PPVT-R scores with increasing scores with increased duration of breastfeeding. After adjusting for a wide range of biological and social factors, the adjusted mean for those breastfed for 6 months or more was 8.2 points higher for females and 5.8 points for males when compared to those never breastfed. Conclusion These findings suggest a significant benefit to child development is conferred by breastfeeding and is related independently to longer periods of breastfeeding

Change in maternal body mass index is associated with offspring body mass index: a 21-year prospective study

High body-mass index (BMI; defined as 25 kg/m(2) or greater) is associated with increased risk of cancer. To inform public health policy and future research, we estimated the global burden of cancer attributable to high BMI in 2012

How Mistimed and Unwanted Pregnancies Affect Timing of Antenatal Care Initiation in three Districts in Tanzania

Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation. Data originate from a cross-sectional household survey on health behaviour and service utilization patterns. The survey was conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania on 910 women of reproductive age who had given birth in the past two years. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy gestation. A recently completed pregnancy was defined as mistimed if a woman wanted it later, and if she did not want it at all the pregnancy was termed as unwanted. Chisquare was used to test for associations and multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies affect timing of ANC initiation. Although 49.3% of the women intended to become pregnant, 50.7% (34.9% mistimed and 15.8% unwanted) became pregnant unintentionally. While ANC initiation in the 1st trimester was 18.5%, so was 71.7% and 9.9% in the 2nd and 3rd trimesters respectively. Multivariate analysis revealed that ANC initiation in the 2nd trimester was 1.68 (95% CI 1.10‒2.58) and 2.00 (95% CI 1.05‒3.82) times more likely for mistimed and unwanted pregnancies respectively compared to intended pregnancies. These estimates rose to 2.81 (95% CI 1.41‒5.59) and 4.10 (95% CI 1.68‒10.00) respectively in the 3rd trimester. We controlled for gravidity, age, education, household wealth, marital status, religion, district of residence and travel time to a health facility. Late ANC initiation is a significant maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania. Women should be empowered to delay or avoid pregnancies whenever they need to do so. Appropriate counseling to women, especially those who happen to conceive unintentionally is needed to minimize the possibility of delaying ANC initiation.\u

Increasing body mass index from age 5 to 14 years predicts asthma among adolescents: evidence from a birth cohort study

Background:Obesity and asthma are common disorders, and the prevalence of both has increased in recent decades. It has been suggested that increases in the prevalence of obesity might in part explain the increase in asthma prevalence. This study aims to examine the prospective association between change in body mass index (BMI) z-score between ages 5 and 14 years and asthma symptoms at 14 years. Methods:Data was taken from the Mater University Study of Pregnancy and its outcomes (MUSP), a birth cohort of 7223 mothers and children started in Brisbane (Australia) in 1981. BMI was measured at age 5 and 14 years. Asthma was assessed from maternal reports of symptoms at age 5 and 14 years. In this study analyses were conducted on 2911 participants who had information on BMI and asthma at both ages. Results: BMI z-score at age 14 and the change in BMI z-score from age 5 to 14–years were positively associated with asthma symptoms at age 14 years, whereas BMI z-score at age 5 was not associated with asthma at age 14. Adjustment for a range of early-life exposures did not substantially alter these findings. The association between change in BMI z-score with asthma symptoms at 14 years appeared stronger for male subjects compared with female subjects but there was no statistical evidence for a sex difference (P=0.36). Conclusions: Increase in BMI z-score between age 5 and 14 years is associated with increased risk of asthma symptoms in adolescence