Determination of depression risk factors in children and adolescents by regression tree methodology.

We used a regression tree method (RTM) to determine risks of depression in children/adolescents. The survey records of 4,143 children/adolescents in a study based in Mersin, Turkey served as data in this study, and multi-step, stratified, and cluster sampling were used. Effects of 24 variables (sex, smoking, parental problems, etc.) were evaluated on depression scores. The Child Beck Depression Inventory (CBDI) was used to determine the level of depression. Subjects were into 12 different groups based on magnitudes of mean depression scores. The interactions among 7 variables determined to be risk factors are shown on a schema. The STATISTICA (ver.6.0) package program was used for all computations. Although traditional statistical methods have often been used for analysis in this field, such approaches are associated with certain disadvantages such as missing values, ignorance of interaction effects, or restriction of the shape of the distribution. To avoid such disadvantages, we therefore suggest the use of the RTM in studies involving numerical-based outcome variables and for the investigation of a large number of variables and it may be more effective than traditional statistical methods in epidemiological studies which determine risk factors.</p

USE OF PERSONAL PROTECTIVE EQUIPMENT AND FACTORS ASSOCIATED WITH INJURIES AMONG VOCATIONAL AND TECHNICAL HIGH SCHOOL STUDENTS

WOS: 000416078300004Objective: In this study, the aim was to investigate the use of personal protective equipment (PPE) and the factors associated with injuries among vocational and industrial high schools in Adana and Mersin. Material and Method: This cross-sectional study included 1742 students who attended high schools in the Adana and Mersin provinces between April and May 2013. The questionnaire was filled out by the students. The study data were evaluated by descriptive statistics, the chi-square test, Student's t-test, the Mann-Whitney U test and binary logistic regression. Results: The study included 1742 students. Among the students, 1530 (87.8%) were male. While 1510 (86.7%) students used at least one PPE, 232 (13.3%) used none at all. In the binary logistic regression model, 10th graders (OR 3.80), 11th graders (OR 3.21), monthly income of 434 USD or less (OR 2.69), training for the use of tools/devices (OR 1.96) and the number of risks defined specifically for the department (OR 1.11) were associated with the student's PPE use. Among the participating students, 430 (24.7%) were injured within the past year. In the binary logistic regression model, 10th graders (OR 1.85), 11th graders (OR 2.26), the weekly practical training hours (OR 0.96) and household population (OR 1.10) were associated with the students' injuries. Conclusion: In vocational and technical high schools, training on the use of devices and tools, defining the risks and structured trainings on the use of PPE must be considered to protect the students

The prevalence of headache disorders in children and adolescents in Ethiopia: a schools-based study

Background The Global Burden of Disease (GBD) study establishes headache as the second-highest cause of disability worldwide. Because most headache data in GBD are from adults, leading to underestimation of headache-attributed burden, a global schools-based programme within the Global Campaign against Headache is contributing data from children (7–11 years) and adolescents (12–17 years). This national study in Ethiopia is the first in this programme reported from sub-Saharan Africa. Methods A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. Structured questionnaires were self-completed under supervision by pupils within their classes. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH). Results Of 2349 potential participants, 2344 completed the questionnaire (1011 children [43.1%], 1333 adolescents [56.9%]; 1157 males [49.4%], 1187 females [50.6%]), a participation proportion of 99.8%. Gender- and age-adjusted 1-year prevalence of headache was 72.8% (migraine: 38.6%; tension-type headache: 19.9%; UdH: 12.3%; all headache on ≥15 days/month: 1.2%; probable medication-overuse headache: 0.2%). Headache was more prevalent in females (76.2%) than males (71.0%), a finding reflected only in migraine among the headache types. Headache was more prevalent among adolescents (77.6%) than children (68.4%), reflected in all types except migraine, although prevalence of UdH fell sharply after age 14 years to 3.9%. For headache overall, findings matched those in Turkey and Austria, obtained with the same questionnaire, but the high prevalence of migraine, not increasing with age, was surprising. The study highlighted diagnostic difficulties in young people, especially when poorly educated, with migraine diagnoses driven by improbably high proportions reporting nausea (44.8%) and vomiting (28.0%) as usual symptoms accompanying their headaches. Conclusions Headache is very common in children and adolescents in Ethiopia. This has major public-health implications, since half the country’s population are aged under 18 years

The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study

Background We recently showed headache to be common in children (aged 7-11 years) and adolescents (aged 12-17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden. Methods Following the generic protocol for Lifting The Burden's global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains. Results Questionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (+/- SD) of 3.7 +/- 4.5 days/4 weeks and mean duration of 1.6 +/- 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1-3 was 1.6 +/- 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 +/- 2.8 days/4 weeks. Lost school time was 0.5 +/- 1.5 days/4 weeks (migraine 0.7 +/- 1.5, pMOH 5.0 +/- 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 +/- 2.4, migraine 1.5 +/- 2.2, pMOH 8.4 +/- 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son's or daughter's headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types. Conclusions Headache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania

Burden of headache in a HIV-positive population of sub-Saharan Africa

Background About 26 million people are living with HIV in sub-Saharan Africa. The DREAM programme in sub-Saharan Africa provides free healthcare for HIV/AIDS and a range of chronic non-communicable diseases. HIV is a risk factor for neurological non-communicable diseases including stroke and epilepsy, which themselves are associated with headache, and HIV may be a direct risk factor for headache. We investigated the prevalence and burden of headache in a HIV+ population in sub-Saharan Africa. Methods At the DREAM Centre in Blantyre, Malawi, a low-income country with a population of 19 million and 9.2% HIV prevalence, a structured questionnaire was administered by a trained lay interviewer to consecutively attending HIV+ patients aged 6-65 years. All were monitored with regular viral load detection. Results Of 513 eligible patients invited, 498 were included (mean age 34.1 +/- 12.8 years; 72% females; 15 declined). All were on antiretroviral treatment, with viral load undetectable in 83.9%. The 1-year prevalence of headache was 80.3% (females 83.6%, males 71.9%); 3.8% had >= 15 headache days/month, 1.4% had probable medication-overuse headache. Mean overall headache frequency was 4.4 +/- 5.4 days/month. Those reporting headache lost means of 2.3% of paid workdays and 3.3% of household workdays because of headache. Only one third had sought advice for their headache. Conclusions Headache is very prevalent among HIV+ patients in Malawi, imposing additional burden and costs on individuals and the community. Management of headache disorders should be implemented in HIV centres, as it is for other chronic non-communicable diseases