Глобальне опитування дорослих щодо вживання тютюну (GATS): звіт за результатами дослідження: Україна, 2010

Tobacco use is a major preventable cause of premature death and disease worldwide, presently causing over 5 million deaths each year and expected to cause over 8 million deaths yearly by 2030. Within the European Region, tobacco is responsible for approximately 1.6 million deaths a year. The World Health Organization (WHO) Tobacco Free Initiative (TFI) aims to reduce the global burden of disease and death caused by tobacco, thereby protecting present and future generations from the devastating health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. This will be accomplished by providing global policy leadership -- promoting the WHO Framework Convention on Tobacco Control (FCTC), as well as the MPOWER package of tobacco policies as a key entry point to the WHO FCTC. Within the European Region, 46 countries and the European Community have ratified the Treaty. Ukraine ratified the WHO FCTC in 2006. In August 2006, the WHO and the United States Centers for Disease Control and Prevention (CDC) convened an expert consultation to discuss adult tobacco surveillance and made recommendations for the development of a standard survey protocol. The Global Adult Tobacco Survey (GATS) enables countries to collect data on key tobacco control measures in the adult population. The aim of the GATS is to collect data on tobacco use and tobacco control measures using a standardized questionnaire, sample design, and data collection/management procedures among adults aged 15 years and older. Results from the GATS will assist countries in the formulation, tracking and implementation of effective tobacco control interventions, and countries will be able to compare results of their survey with results from other countries implementing the GATS.Вживання тютюну – основна причина передчасних смертей та хвороб в усьому світі, яким людство здатне запобігти. На сьогоднішній день від вживання тютюну щороку гине понад 5 мільйонів людей; очікується, що до 2030 року ця цифра зросте до 8 мільйонів смертей щорічно. У Європейському регіоні тютюн винен у смерті близько 1,6 мільйона людей на рік. Ініціатива "Звільнення від тютюну" (Tobacco Free Initiative (TFI)) Всесвітньої Організації Охорони Здоров’я (ВООЗ) покликана зменшити глобальний тягар хвороб і смертей, спричинених вживанням тютюну, таким чином захищаючи теперішні та майбутні покоління від шкідливих наслідків куріння для здоров’я, негативних соціальних, економічних та екологічних наслідків, пов’язаних із вживанням тютюну та впливом тютюнового диму. Цієї мети буде досягнуто через глобальне стратегічне лідерство – просування Рамкової конвенції ВООЗ із боротьби проти тютюну, так само як і через комплекс антитютюнових заходів MPOWER, що є ключовим інструментом реалізації Рамкової конвенції. У Європейському регіоні Конвенцію ратифікували 46 країн та Європейське співтовариство. Україна ратифікувала Рамкову конвенцію ВООЗ із боротьби проти тютюну 2006 року. У серпні 2006 року ВООЗ і Центри з контролю та профілактики захворювань США (ЦКПЗ) скликали експертну нараду, аби обговорити питання нагляду за вживанням тютюну серед дорослого населення й виробити рекомендації щодо розроблення стандартизованої програми опитування. "Глобальне опитування дорослого населення щодо вживання тютюну" (The Global Adult Tobacco Survey – GATS) дає країнам змогу зібрати дані щодо ключових антитютюнових заходів серед дорослого населення. Мета проекту GATS – збір даних щодо вживання тютюну і заходів контролю над тютюном із використанням стандартизованих анкети, дизайну вибірки й процедур збору та обробки даних серед населення віком 15 років і старші. Результати проекту GATS допоможуть країнам у розробленні, відстеженні і втіленні ефективних заходів контролю над тютюном, і країни матимуть змогу порівняти свої результати із результатами інших країн, які беруть участь у проекті.Bloomberg Global Initiative to reduce tobacco us

Adverse childhood experiences, childhood relationships and associated substance use and mental health in young Europeans

Background: Adverse childhood experiences (ACEs) can increase risks of health-harming behaviours and poor health throughout life. While increases in risk may be affected by resilience resources such as supportive childhood relationships, to date few studies have explored these effects. Methods: We combined data from cross-sectional ACE studies among young adults (n = 14 661) in educational institutions in 10 European countries. Nine ACE types, childhood relationships and six health outcomes (early alcohol initiation, problem alcohol use, smoking, drug use, therapy, suicide attempt) were explored. Multivariate modelling estimated relationships between ACE counts, supportive childhood relationships and health outcomes. Results: Almost half (46.2%) of participants reported >= 1 ACE and 5.6% reported >= 4 ACEs. Risks of all outcomes increased with ACE count. In individuals with >= 4 ACEs (vs. 0 ACEs), adjusted odds ratios ranged from 2.01 (95% CIs: 1.70-2.38) for smoking to 17.68 (95% CIs: 12.93-24.17) for suicide attempt. Supportive childhood relationships were independently associated with moderating risks of smoking, problem alcohol use, therapy and suicide attempt. In those with >= 4 ACEs, adjusted proportions reporting suicide attempt reduced from 23% with low supportive childhood relationships to 13% with higher support. Equivalent reductions were 25% to 20% for therapy, 23% to 17% for problem drinking and 34% to 32% for smoking. Conclusions: ACEs are strongly associated with substance use and mental illness. Harmful relationships are moderated by resilience factors such as supportive childhood relationships. Whilst ACEs continue to affect many children, better prevention measures and interventions that enhance resilience to the life-long impacts of toxic childhood stress are required

Determinants of participation in a longitudinal two-stage study of the health consequences of the Chornobyl nuclear power plant accident

<p>Abstract</p> <p>Background</p> <p>The determinants of participation in long-term follow-up studies of disasters have rarely been delineated. Even less is known from studies of events that occurred in eastern Europe. We examined the factors associated with participation in a longitudinal two-stage study conducted in Kyiv following the 1986 Chornobyl nuclear power plant accident.</p> <p>Methods</p> <p>Six hundred child-mother dyads (300 evacuees and 300 classmate controls) were initially assessed in 1997 when the children were 11 years old, and followed up in 2005–6 when they were 19 years old. A population control group (304 mothers and 327 children) was added in 2005–6. Each assessment point involved home interviews with the children and mothers (stage 1), followed by medical examinations of the children at a clinic (stage 2). Background characteristics, health status, and Chornobyl risk perceptions were examined.</p> <p>Results</p> <p>The participation rates in the follow-up home interviews were 87.8% for the children (88.6% for evacuees; 87.0% for classmates) and 83.7% for their mothers (86.4% for evacuees and 81.0% for classmates). Children's and mothers' participation was predicted by one another's study participation and attendance at the medical examination at time 1. Mother's participation was also predicted by initial concerns about her child's health, greater psychological distress, and Chornobyl risk perceptions. In 1997, 91.2% of the children had a medical examination (91.7% of evacuees and 90.7% of classmates); in 2005–6, 85.2% were examined (83.0% of evacuees, 87.7% of classmates, 85.0% of population controls). At both times, poor health perceptions were associated with receiving a medical examination. In 2005–6, clinic attendance was also associated with the young adults' risk perceptions, depression or generalized anxiety disorder, lower standard of living, and female gender.</p> <p>Conclusion</p> <p>Despite our low attrition rates, we identified several determinants of selective participation consistent with previous research. Although evacuee status was not associated with participation, Chornobyl risk perceptions were strong predictors of mothers' follow-up participation and attendance at the medical examinations. Understanding selective participation offers valuable insight for future longitudinal disaster studies that integrate psychiatric and medical epidemiologic research.</p

Participation at time 1 (1997) and time 2 (2005–6) by mothers and children in Kyiv

<p><b>Copyright information:</b></p><p>Taken from "Determinants of participation in a longitudinal two-stage study of the health consequences of the Chornobyl nuclear power plant accident"</p><p>http://www.biomedcentral.com/1471-2288/8/27</p><p>BMC Medical Research Methodology 2008;8():27-27.</p><p>Published online 8 May 2008</p><p>PMCID:PMC2396662.</p><p></p

Associations between subjective social status and DSM-IV mental disorders results from theworld mental health surveys

The inverse social gradient in mental disorders is a well-established research finding with important implications for causal models and policy. This research has used traditional objective social status (OSS) measures, such as educational level, income, and occupation. Recently, subjective social status (SSS) measurement has been advocated to capture the perception of relative social status, but to our knowledge, there have been no studies of associations between SSS and mental disorders. OBJECTIVES To estimate associations of SSS with DSM-IV mental disorders in multiple countries and to investigate whether the associations persist after comprehensive adjustment of OSS. DESIGN, SETTING, AND PARTICIPANTS Face-to-face cross-sectional household surveys of community-dwelling adults in 18 countries in Asia, South Pacific, the Americas, Europe, and the Middle East (N = 56 085). Subjective social status was assessed with a self-anchoring scale reflecting respondent evaluations of their place in the social hierarchies of their countries in terms of income, educational level, and occupation. Scores on the 1 to 10 SSS scale were categorized into 4 categories: low (scores 1-3), low-mid (scores 4-5), high-mid (scores 6-7), and high (scores 8-10). Objective social status was assessed with a wide range of fine-grained objective indicators of income, educational level, and occupation. MAIN OUTCOMES AND MEASURES The Composite International Diagnostic Interview assessed the 12-month prevalence of 16 DSM-IV mood, anxiety, and impulse control disorders. RESULTS The weighted mean survey response rate was 75.2%(range, 55.1%-97.2%). Graded inverse associations were found between SSS and all 16 mental disorders. Gross odds ratios (lowest vs highest SSS categories) in the range of 1.8 to 9.0 were attenuated but remained significant for all 16 disorders (odds ratio, 1.4-4.9) after adjusting for OSS indicators. This pattern of inverse association between SSS and mental disorders was significant in 14 of 18 individual countries, and in low-, middle-, and high-income country groups but was significantly stronger in high- vs lower-income countries. CONCLUSIONS AND RELEVANCE Significant inverse associations between SSS and numerous DSM-IV mental disorders exist across a wide range of countries even after comprehensive adjustment for OSS. Although it is unclear whether these associations are the result of social selection, social causation, or both, these results document clearly that research relying exclusively on standard OSS measures underestimates the steepness of the social gradient in mental disorders