Elevated circulating levels of C-C chemokines in patients with congestive heart failure.

BACKGROUND: Immunologic and inflammatory responses appear to play a pathogenic role in the development of congestive heart failure (CHF). Activation and migration of leukocytes to areas of inflammation are important factors in these immunologic responses. Because the C-C chemokines are potent chemoattractants of monocytes and lymphocytes and can modulate other functions of these cells (eg, generation of reactive oxygen species), we measured circulating levels of three C-C chemokines in CHF. METHODS AND RESULTS: Levels of macrophage chemoattractant protein-1 (MCP-1), macrophage inflammatory protein- 1alpha (MIP-1alpha), and RANTES (regulated on activation normally T-cell expressed and secreted) were measured by enzyme immunoassays in 44 patients with CHF and 21 healthy control subjects. CHF patients had significantly elevated levels of all chemokines with the highest levels in New York Heart Association class IV, and MCP-1 and MIP-1alpha levels were significantly inversely correlated with left ventricular ejection fraction. Elevated C-C chemokine levels were found independent of the cause of the heart failure, but MCP-1 levels were particularly raised in patients with coronary artery disease. Studies on cells isolated from peripheral blood suggested that platelets, CD3+ lymphocytes, and in particular, monocytes, might contribute to the elevated C-C chemokine levels in CHF. The increased MCP-1 levels in CHF were correlated with increased monocyte activity reflected in an enhancing effect of serum from CHF patients on O2-generation in monocytes, which was inhibited by neutralizing antibodies against MCP-1. CONCLUSIONS: This first demonstration of increased circulating levels of C-C chemokines in CHF with particularly high levels in patients with severe disease may represent previously unrecognized pathogenic factors in CHF.

Two-year longitudinal study of alcohol expectancies and drinking among Norwegian adolescents.

AIMS: The potential importance of alcohol outcome expectancies in the initiation and maintenance of drinking has been supported by studies showing that these expectancies are present before drinking begins, and that they predict drinking both cross-sectionally and longitudinally. Although initiation of drinking behavior may be influenced by expectancy, subsequent drinking experience may modify expectations. We used structural modeling techniques to investigate the relative influence of expectancy and drinking in a three-wave longitudinal study of Norwegian adolescents. DESIGN: Survey incorporating self-administered questionnaires. SETTING: Twenty-two schools in Hordaland County on the west coast of Norway. PARTICIPANTS: Nine hundred and twenty-four seventh-grade students; 45.7% female. MEASUREMENTS: Alcohol use (frequency, quantity, drunkenness); the Norwegian version of the Alcohol Expectancy Questionnaire for adolescents. FINDINGS: Among students who were already drinkers upon entry into the study, expectations of positive social effects of alcohol predicted drinking longitudinally. Among those who began drinking during the study, these social expectancies predicted drinking initiation, but drinking also influenced subsequent expectancy in the early stages of drinking. CONCLUSIONS: These results support a reciprocal relationship of drinking to positive expectancy, highlighting the importance both of expectancies on influencing drinking, and of early drinking experiences on the development of positive expectancies.

Noncoital sexual interactions and problem behaviour among young adolescents: the Norwegian Longitudinal Health Behaviour Study.

This paper focuses on whether early onset of noncoital sexual interactions is best considered in the same paradigm as adolescent problem behaviour. Among adolescents (n = 927) followed longitudinally from age 13 to 15, the interrelationships between noncoital sexual interactions and various problem and conventional behaviours were examined. Early onset of noncoital sexual interactions was related to problem behaviour, and the higher ordered the noncoital sexual interaction was, the more strongly it correlated with measures of problem behaviour. This study provides support for the usefulness of the notion of an underlying factor of proneness to problem behaviours, which is relevant when studying developmental change in terms of accumulation of early noncoital sexual experience. It is suggested that in the construction of countermeasures to prevent the negative consequences of early sexual activities among adolescents, it may be useful to target broader correlates of behaviour.

[Perceived access to alcohol among lower secondary school students. A longitudinal study]. / Opplevd tilgang på alkohol blant ungdomsskoleelever.

In Norway the law forbids drinking of alcohol before the age of 18 years. In spite of this, a large portion of Norwegian under-aged adolescents report drinking alcohol. A two-year prospective cohort study was conducted to investigate perceived access to alcohol in a representative sample of 7th grade students (13 years old) in the county of Hordaland, Norway (N = 861). "Getting older friends to buy alcohol", "given alcohol by friends", and "taking at home without permission" were the most frequently mentioned sources of alcohol both at baseline and at follow-up among both drinking and non-drinking students. Among 15 year old boys who reported drinking alcohol, 21% said that they would buy the alcohol themselves. Perceived access to alcohol significantly predicted the reported frequency of alcohol use two years later, even when controlled for baseline alcohol consumption and perceived social norms among parents and students of the same age. It is recommended that parents be advised to reduce their children's access to alcohol at home, and that alcohol prevention efforts targeting older adolescents should include information on the negative consequences of providing alcohol to minors. Furthermore, the current sales laws should be more stringently enforced.

[Self-reported health status among younger teenagers. A three-year follow-up study]. / Selvrapportert helse blant yngre tenåringer. En treårs oppfølgingsundersøkelse.

The purpose of this study was to investigate how school pupils perceive their own health and how this perception changes over time. A representative sample of 7th grade pupils in Hordaland county (510 boys and 414 girls) were surveyed every year from 1990 to 1993. The results indicated that boys and girls in the lower secondary school had very different conceptions of their own health. The girls reported more frequent somatic health problems than the boys did, were more often depressed, and did not perceive their own health to be as good as boys of the same age did. This gender difference seemed to increase with increasing age. A high degree of stability in reported health problems was seen overtime. To a large extent, it is the same pupils who report having poor somatic health and being depressed and who perceive their general health as less good. Health complaints among adolescents should be taken seriously, since this may indicate a need for both medical and psychological intervention.

Predicting 13-year-olds' drinking using parents' self-reported alcohol use and restrictiveness compared with offspring's perception.

This study examined whether offspring's perception of parental frequency of alcohol use and restrictiveness towards offspring's alcohol use could be used as a substitute for parental self-reports. Offspring's perception were compared with parents' self-reported alcohol use and restrictiveness in ability to predict offspring's own alcohol use. Respondents were 924 offspring, 642 fathers and 729 mothers. Correlations between fathers' and mothers' self-reported frequency of drinking alcohol and offspring's report of parental frequency of drinking alcohol ranged from 0.55 to 0.70. Fathers' and mothers' self-reported alcohol use and restrictiveness explained less than two per cent of the variance in their offspring's alcohol use in regression analyses, while offspring's perception of parental drinking frequency and restrictiveness explained about eight per cent of the variance in offspring's alcohol use. These results represent a challenge to studies of young adolescents which interpret offspring's reports of parents' alcohol use as a surrogate measure of parents' self-reported alcohol use.

Do adolescents and parents report each other's physical activity accurately?

In research concerning socialization into sports there is a need to assess children's reports of parental physical activity. Reports by young adolescents and their parents of each other's leisure-time physical activity and related issues were compared with self-reported measures. A total of 755 family units in western Norway, consisting of 755 13-year-olds, mean age 13.3 +/- 0.3 years (425 boys, 330 girls, 644 fathers and 732 mothers) completed a self-administered physical activity questionnaire. Pearson's between self-reports by parents and the reports by their children varied between 0.56 (P < 0.001) and 0.07 (nonsignificant). Pearson's r between off-springs' self-reported physical activity and reports by their parents varied between 0.41 and 0.55 (P < 0.001). The results support cautious use of young adolescents' reports of parental physical activity.

Sexual victimization in Norwegian children and adolescents: victims, offenders, assaults.

A random sample of 465 Norwegian adolescents (mean age 19.3 years) from the general population answered a questionnaire related to sexual victimization. 17.2% of the girls reported being sexually assaulted, 6.8% in childhood and 10.4% during their teens. Only 0.9% of the boys reported such experiences. Three patterns of victimization were identified: (1) Prepubertal girls abused by adult men, usually relatives or other trusted superiors. (2) Adolescent girls victimized by their boyfriends, other peers and-to a lesser degree-unknown persons. (3) A small group of girls reporting continual assaults by several offenders. By the end of their teens, it is assumed that 2.8% of the girls have experienced 'grave' and prolonged sexual abuse, which invariably started during childhood. Another 7.6% have experienced 'serious' assaults, either in childhood or in adolescence.

Predicting adolescents' intentions to drink alcohol: outcome expectancies and self-efficacy.

OBJECTIVE: This article examines the relationship between intention to drink alcohol, alcohol outcome expectancies and alcohol-related self-efficacy among Norwegian adolescents. The relationship of expectancies, intention and self-efficacy was assessed for respondents of different ages and different drinking experience. METHOD: Data were collected from all seventh and ninth graders in 12 randomly selected schools in Norway. The self-administered questionnaire contained a short version of the Alcohol Expectancy Questionnaire for Adolescents and measures of intentions to drink in the next 12 months, current alcohol use and alcohol-related self-efficacy (e.g., ability to refuse alcohol). RESULTS: Results showed that both alcohol outcome expectancies and previous experience with alcohol were related to intentions to drink alcohol in the near future. Drinking experience had a larger impact than a 2-year age difference on the associations between alcohol outcome expectancies, alcohol-related self-efficacy and intention to drink. A significantly higher proportion of adolescents with drinking experience reported positive alcohol expectancies, poor alcohol-related self-efficacy and strong intention to drink alcohol than did those adolescents without drinking experience. CONCLUSIONS: Personal drinking experience was a stronger predictor of drinking intentions than was age. Still, both alcohol outcome expectancies and alcohol-related self-efficacy are significant predictors of intention to drink among both seventh and ninth graders, independent of previous drinking experience. This study indicates that postponing the onset of alcohol experimentation could be a major goal in primary alcohol prevention among adolescents, although longitudinal confirmation of these results is needed.

Adaptation of the Alcohol Expectancy Questionnaire (AEQ-A): a short version for use among 13-year-olds in Norway.

An adaptation of a Norwegian modified short version of Christiansen & Goldman's Alcohol Expectancy Questionnaire for Adolescents (AEQ-A) was examined in this survey. Subjects were 924 Norwegian seventh graders, with an average age of 13.3 years. From the original 90 items, 27 items representing all seven original scales were used in this study. Factor analysis did not create any preferred new factor solution compared to Christiansen & Goldman's original factors. Internal consistency of the seven AEQ-A scales ranged from 0.37 to 0.72 on Cronbach's alpha. All seven AEQ-A scales correlated significantly with self-reported alcohol use as was expected, and this study also replicated the relative importance of the social enhancement scale. This was the first study using AEQ-A in a non-English-speaking culture. The generalizability of alcohol outcome expectancies was strongly supported. The present study indicates that the Norwegian version of AEQ-A possesses a level of concurrent validity and internal reliability that is acceptable compared to the original scales, and can serve as a useful instrument in behavioral research on alcohol use among Norwegian adolescents in the years to come.

Adolescents' alcohol use related to perceived norms.

A questionnaire survey was carried out among 898 Norwegian adolescents age twelve to twenty. The study focused on the relation between adolescents' alcohol use on one side and estimated drinking norms (peers' drinking) together with attributed opinion norms (parents' and friends' acceptance of adolescents' alcohol use) on the other. On average, 5% of students in 7th, 8th, and 9th grade reported weekly alcohol use. They overestimated the number of fellow students using alcohol every week seven-fold. Students' estimates were significantly related to self-reported alcohol use. Even in high-school (10th, 11th and 12th grade) where 29% reported weekly alcohol use, students overestimated number of weekly drinkers among friends and fellow students by two-fold. Contrary to the results from a previous study conducted in Norway, in this study opinions attributed to both friends and parents about adolescents' alcohol use were significantly related to the students' own alcohol use. Estimated behavior norms and attributed opinion norms explained 46% of the observed variance in students' self-reported frequency of drinking. In a health promotion context, these results point to the importance of correcting student misconceptions about how often friends and fellow students drink alcohol.

Five-year results after valve replacement with the Björk-Shiley 70 degrees convexo-concave prosthesis.

In the 18 months up to July 1983, 120 Björk-Shiley convexo-concave prostheses with 70 degrees opening angle were implanted in 47 women and 61 men aged 19-78 (mean 58.6) years. The prosthetic valves were aortic in 65 cases, mitral in 23 and both aortic and mitral in 20 cases. Emergency operation was required in ten cases, and concomitant surgery was performed in 43 (39.8%). The early mortality was 5.5%. A follow-up study, comprising 498 patient years, revealed 73.1% 5-year survival. There were three mechanical failures of prosthesis, in one of which re-replacement was successful. Elective prosthesis replacement was performed in four other cases judged to be at high risk of strut fracture.

Clinical assessment of a fluoride-containing amalgam.

The aim of this study was to compare the marginal breakdown as a measure of clinical behavior of fillings made with two conventional amalgam alloys, one of which contained 1% stannous fluoride. Children requiring class II restorations in both mandibular molars received conventional amalgam (New True Dentalloy (R] in one molar and a fluoride-containing amalgam (Fluor Alloy (R)) in the other. Impressions of the filled teeth were taken just after polishing and at 1-yr intervals up to a 2-yr period. Plastic models were made and evaluated under a stereomicroscope. The results showed that the fluoride-containing amalgam presented slightly better margins than the conventional amalgam after 2 yr.