Preventing Adolescent Alcohol Use: Processes and Outcomes of a Community-Based Intervention in Trelleborg

The aim of this thesis is to investigate the potential of applying a community-based intervention, implemented in the Swedish city of Trelleborg 1999-2002, to reduce adolescent alcohol use. In order to do so, we had four specific aims. First, we studied the processes, both in terms of action and institu-tionalization, within the intervention. This would improve our understanding of the quantitative analyses. Second, we investigated the effects of the intervention, based on a number of indicators related to the interven-tion objectives. Third, we investigated which risk factors were significant for adolescent alcohol use in Trelleborg. Fourth, we exam-ined whether the changes of the intervention's target indicators resulted in less alcohol-related accidents and violence among the Trelleborg youth. In the process evaluation (Paper I), we carried out a qualitative data analysis, apply-ing an iterative explanation-building process, using interviews, public records, meeting minutes and evaluation seminars. In Papers II-IV, we analyzed school survey data, apply-ing logistic regression modelling and other statistical analyses. The process evaluation showed that the community intervention did not adequately institutionalize alcohol and drug prevention within the city administration, mainly due to numerous un-planned events and that the structure was individual oriented. Neverthe-less, the community mobilization and the raise in public awareness regarding the alcohol issue are factors which could have contributed to the impact of the project. The effect evaluation (Papers II-IV) showed that the community-based interven-tion in Trelleborg is likely to have contributed to a reduction in adolescent alcohol consump-tion. When comparing the data, for a popula-tion 15 and 16 years old, from the first school survey in 1999 with the one carried out in 2003, there is a decrease in the proportion of alcohol consumers (decreased by 21.8%), monthly heavy episodic drinking (38.2%), excessive drinking (36.3%), alcohol-related accidents (38.5%), and alcohol-related vio-lence (50.0%). The data analyses show that these changes are independent of significant factors on community, group and individual level. Availability of alcohol was also reduced in the target group during the intervention, but this change was not sustained after the project completion. In addition, the analyses supported the hypothesis that the decrease in alcohol-related accidents and violence was related to the reduction in adolescent alcohol consumption. The findings in the thesis support the as-sumption that by implementing a city policy program, including a plan of action, a mu-nicipality can reduce adolescent alcohol use, and subsequently alcohol-related harm. How-ever, in order to institutionalize the interven-tions and the alcohol issue there has to be a balance of internal and external input throughout the project. It seems that the implementation process in terms of institu-tionalization and the effects of the interven-tion do not have to be correlated, i.e., a weak institutionalization does not necessarily result in weak effects

Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students.

As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience

Raman scattering in C_{60} and C_{48}N_{12} aza-fullerene: First-principles study

We carry out large scale {\sl ab initio} calculations of Raman scattering activities and Raman-active frequencies (RAFs) in ${\rm C}_{48}{\rm N}_{12}$ aza-fullerene. The results are compared with those of ${\rm C}_{60}$. Twenty-nine non-degenerate polarized and 29 doubly-degenerate unpolarized RAFs are predicted for ${\rm C}_{48}{\rm N}_{12}$. The RAF of the strongest Raman signal in the low- and high-frequency regions and the lowest and highest RAFs for ${\rm C}_{48}{\rm N}_{12}$ are almost the same as those of ${\rm C}_{60}$. The study of ${\rm C}_{60}$ reveals the importance of electron correlations and the choice of basis sets in the {\sl ab initio} calculations. Our best calculated results for ${\rm C}_{60}$ with the B3LYP hybrid density functional theory are in excellent agreement with experiment and demonstrate the desirable efficiency and accuracy of this theory for obtaining quantitative information on the vibrational properties of these molecules.Comment: submitted to Phys.Rev.

Distribution of causes of maternal mortality among different socio-demographic groups in Ghana; a descriptive study

BACKGROUND: Ghana's maternal mortality ratio remains high despite efforts made to meet Millennium Development Goal 5. A number of studies have been conducted on maternal mortality in Ghana; however, little is known about how the causes of maternal mortality are distributed in different socio-demographic subgroups. Therefore the aim of this study was to assess and analyse the causes of maternal mortality according to socio-demographic factors in Ghana.METHODS: The causes of maternal deaths were assessed with respect to age, educational level, rural/urban residence status and marital status. Data from a five year retrospective survey was used. The data was obtained from Ghana Maternal Health Survey 2007 acquired from the database of Ghana Statistical Service. A total of 605 maternal deaths within the age group 12-49 years were analysed using frequency tables, cross-tabulations and logistic regression.RESULTS: Haemorrhage was the highest cause of maternal mortality (22.8%). Married women had a significantly higher risk of dying from haemorrhage, compared with single women (adjusted OR = 2.7, 95%CI = 1.2-5.7). On the contrary, married women showed a significantly reduced risk of dying from abortion compared to single women (adjusted OR = 0.2, 95%CI = 0.1-0.4). Women aged 35-39 years had a significantly higher risk of dying from haemorrhage (aOR 2.6, 95%CI = 1.4-4.9), whereas they were at a lower risk of dying from abortion (aOR 0.3, 95% CI = 0.1-0.7) compared to their younger counterparts. The risk of maternal death from infectious diseases decreased with increasing maternal age, whereas the risk of dying from miscellaneous causes increased with increasing age.CONCLUSIONS: The study shows evidence of variations in the causes of maternal mortality among different socio-demographic subgroups in Ghana that should not be overlooked. It is therefore recommended that interventions aimed at combating the high maternal mortality in Ghana should be both cause-specific as well as target-specific

The impact of relaxed traveller allowances: Fixed-effects analyses of the associations between consumer behaviour and alcohol use

Aim: To analyse to what extent the gradual relaxation of traveller allowances for alcoholic beverages 2001–2004 changed consumer behaviours and subsequent alcohol consumption patterns within a longitudinal panel data population study in Southern Sweden. Methods: General population random sample panel data study with repeated measurements were collected in 1999, in 2005, and in 2010 in the county of Scania. The study analyses answers from 9770 individuals, who in 1999 were 18–80 years old. A fixed-effects modelling was applied to assess the association between consumer behaviour and change in alcohol use across the study period. Results: Cross-border shopping for alcoholic beverages was associated, on average, with a 3.1% (p < 0.001) increase in alcohol use. Buying imported alcohol from a private person was associated with a mean increase of 2.6% (p < 0.001), with a total additive effect of 5.7%. Furthermore, when stratified for gender, age, and location, significant fixed effects were found. The magnitude was greater among women, younger and older ages, and in particular in the Northeast and Central regions. Both consumer behaviours – cross-border trading (OR 1.6, CI 95% 1.28–1.92) and buying alcohol from a private person (OR 1.4, CI 95% 1.12–1.73) – were significantly associated with heavy alcohol use. Conclusion: The fixed-effects analyses identified significant associations between consumer behaviours and alcohol consumption. The uptake of behaviours that developed because of a relaxation of the Swedish alcohol policy has contributed to an overall long-term increase in alcohol use and higher prevalence of heavy alcohol use within this general population study sample

Influence of Parental Alcohol-Related Attitudes, Behavior and Parenting Styles on Alcohol Use in Late and Very Late Adolescence.

Parents influence adolescent drinking behavior, but to what extent does this association diminish with age, however? The cross-sectional data was drawn from the Scania drug use survey 2007, consisting of 4,828 secondary education students in the 9th and 11th grade. The age- and gender-adjusted findings indicate that having parents who are consenting to alcohol use (OR 1.4), having been provided with alcohol by one's parents (OR 1.8), having parents with an authoritarian (OR 1.5) or neglectful (OR 2.1) parenting style, and having parents who both have a university degree (OR 1.3) were factors significantly associated with monthly heavy episodic drinking. These findings lead to the conclusion that parenting styles as well as parental attitudes and behaviors are important throughout the high school years. Thus, prevention targeting parents should emphasize both these domains. © 2014 S. Karger AG, Basel

Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence

AIM: To assess how drinking patterns and delinquency are associated with self-reported experiences of alcohol-related violence in an adolescent population. POPULATION AND RESEARCH DESIGN: Cross-sectional data were acquired from the Scania drug use survey 2005, consisting of 3847 students in 9th grade. Abstainers were omitted and 1873 responses analyzed, with binary and multi-variable logistic regression modeling. RESULTS: All drinking pattern indicators were statistically significantly associated with alcohol-related violence, high usual volume of distilled spirits consumed (OR 2.2, CI 95 % 1.7-2.9) being the strongest. Delinquency had, when included in the analysis, a significant effect (OR 2.5, CI 95 % 1.8-3.6); however, the drinking pattern indicators also remained statistically significant. An analysis of the effect moderation between usual volume of distilled spirits consumed and delinquency showed that there was a synergetic effect between them (SI 1.6, CI 95 % 1.1-2.4). A separate analysis for non-delinquent students, those with little experience of delinquency, and those who engaged regularly in delinquent activities, showed that the effects of different drinking patterns, especially use of distilled spirits, were significant in both groups, however, differently distributed. CONCLUSION: The results show that alcohol consumption pattern, with usual volume of distilled spirits being the most prominent one, had an effect on alcohol-related violence, and that this effect was amplified by delinquent behavior. The analyses also showed that there are similarities, regarding risk factors for alcohol-related violence, between delinquent and non-delinquent youth. This, indicating that consumption pattern cannot be discarded as a key factor in alcohol-related violence in adolescence. POLICY IMPLICATIONS: The study shows that alcohol-related violence in adolescence is related to both alcohol consumption patterns, e.g. usual volume of distilled spirits consumed, and delinquency. In order to prevent the harm outcome, both phenomenons have to be targeted, either by alcohol or broader social policy initiatives

A schematic model of the associations of socioeconomic and socio-psychological determinants and drinking patterns on alcohol-related violence in adolescence

<p><b>Copyright information:</b></p><p>Taken from "Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence"</p><p>http://www.substanceabusepolicy.com/content/2/1/18</p><p>Substance Abuse Treatment, Prevention, and Policy 2007;2():18-18.</p><p>Published online 2 Jul 2007</p><p>PMCID:PMC1936421.</p><p></p

Socio-economic determinants for alcohol consumption and heavy episodic drinking in a Ugandan student population

Aims: To examine whether the socio-economic determinants of alcohol use found in high-income university student settings are also true of Uganda. Design: Two cross-sectional surveys, conducted in 2005 and 2010, combined into a single dataset. Setting: Mbarara University of Science and Technology (MUST) in southwestern Uganda. Participants: 2,934 students (N in 2005 = 980; N in 2010 = 1,954). Total response rate = 76.8%. Results: Multivariate logistic regression showed the following socio-economic determinants to be positively associated with alcohol consumption: having attended boarding school (for males only); being Catholic; religion not playing a big role while growing up; head of household having had secondary education or higher (for females only); being a student of development studies, tropical forest conservation or computer science (the latter two for males only). Being Muslim or, for males, being a non-Anglican Protestant were negatively related to alcohol use. Different patterns were found for heavy episodic drinking. Being a male Muslim or a male student of development studies was positively related to heavy episodic drinking; while among females, being of a non-classified faith, having had a head of the household with a secondary education, not being raised by both parents, or being a student of development studies or science were positively related to heavy episodic drinking. Conclusion: Alcohol consumption and heavy episodic drinking on a monthly basis among the students at MUST seem linked to a student’s socio-economic background, with varying patterns for male and female students