Alcohol consumption among university students: a Sino-German comparison demonstrates a much lower consumption of alcohol in Chinese students.

BACKGROUND: Alcohol use is reported in university students with discrepancy between countries. The study objectives were to assess prevalence and associated factors of alcohol consumption among university students in Germany and China. METHODS: Data used were from 1853 Chinese and 3306 German university students. Alcohol consumption frequency was measured by a question "How often did you drink alcohol in the last three months?" with six possible responses, which were later collapsed into three categories of "At least once a week", "Less than once a week" and "Never". Problem drinking was measured by the CAGE test and defined as a CAGE score of two or more (four as the maximum). Simple and multivariable logistic regressions were used for association analyses. RESULTS: German students reported more often "At least once a week" drinking (59.8 vs. 9.0 %). Among Germans, women drank less often "At least once a week" (OR = 0.40, 0.30-0.53). Among Chinese, a higher BMI was associated with drinking "At least once a week" (OR = 1.09, 1.02-1.18). Age revealed a positive association with "At least once a week" drinking in Chinese (1.33, 1.21-1.46) but a negative association in Germans (OR = 0.97, 0.94-0.99). Having a father with high educational level was positively related to "At least once a week" drinking in both countries (OR = 4.25, 2.67-6.78 for Chinese; OR = 1.32, 1.01-1.72 for Germans). Doing less than once a week physical exercise was negatively associated with "At least once a week" drinking in Chinese and German students (OR = 0.27, 0.15-0.48 for Chinese; OR = 0.69, 0.49-0.96 for Germans). Among the German students, 20.3 % reported problem drinking. Being a female (OR = 0.32, 0.26-0.40) and performing less than once a week physical activity (OR = 0.73, 0.56-0.95) were negatively associated with problem drinking, while having a father with high educational level (OR = 1.32, 1.09-1.60) and experiencing higher level of perceived stress (OR = 1.08, 1.04-1.13) were positively related to problem drinking. CONCLUSIONS: Country-specific strategies for reducing alcohol consumption, e.g. educational awareness programmes of alcohol use on Chinese campuses and alcohol prevention schemes among German youth before entering university, are sensible.

Sense of coherence and associated factors among university students in China: cross-sectional evidence.

BACKGROUND: Sense of Coherence (SOC) is considered as a health-promoting resource; it is mainly developed before the age of 30. The multiple demands university students face, such as study-related stress and financial difficulty, could challenge their SOC development. This study aimed to: 1) investigate the association between SOC, socio-demographic and lifestyle-related characteristics; 2) assess the effect of perceived stress on SOC controlling for other variables among the Chinese university students. Analyses were done to derive a better view on possible strategies to strengthen students' SOC and with that to promote their health. METHODS: The data used were from a Chinese university student health survey (N = 1,853). Logistic regression analyses were used to explore the effects of varied socio-demographic, lifestyle-related variables on students' level of SOC, as well as the association between perceived stress and SOC controlling for other variables in the analysis. RESULTS: Both social support (OR = 2.56 [1.87-3.50]) and better performance compared with peers (OR = 1.64 [1.15-2.34]) were associated with a stronger SOC. Not feeling isolated at university (OR = 1.60 [1.04-2.47]) and satisfaction with the political situation (OR = 2.05 [1.57-2.67]) were also associated with a stronger SOC. This counts also for high health awareness (OR = 1.40 [1.05-1.87]) and nutrition importance (OR = 1.67 [1.04-2.69]). Perceived stress (OR = 0.81 [0.79-0.83]) was negatively associated with a strong SOC when controlling for socio-demographic and lifestyle-related variables. CONCLUSION: We suggest integrating stress coping, emotion management training programmes as well as measures promoting social integration for students and teachers at campus, promoting healthy behaviours, and creating a supportive learning environment as strategies for enhancing the SOC level of university students in China.

Only-Child Status in Relation to Perceived Stress and Studying-Related Life Satisfaction among University Students in China: A Comparison with International Students.

OBJECTIVES: University students in general face multiple challenges, which may affect their levels of perceived stress and life satisfaction. Chinese students currently face specific strains due to the One-Child Policy (OCP). The aim of this study was to assess (1) whether the levels of perceived stress and studying-related life satisfaction are associated with only-child (OC) status after controlling for demographic and socio-economic characteristics and (2) whether these associations differ between Chinese and international students. MATERIALS AND METHODS: A cross-sectional health survey based on a self-administrated standardised questionnaire was conducted among 1,843 (1,543 Chinese, 300 international) students at two Chinese universities in 2010-2011. Cohen's Perceived Stress Scale (PSS-14) and Stock and Kraemer's Studying-related Life Satisfaction Scale were used to measure perceived stress and studying-related life satisfaction respectively. Multivariable logistic regression analyses were used to examine the associations of OC status with perceived stress and studying-related life satisfaction by sex for Chinese students and international students separately. RESULTS: The Chinese non-only-children (NOCs) were more likely to come from small cities. Multivariable regression models indicate that the Chinese NOCs were more stressed than OCs (OR = 1.39, 1.11-1.74) with a stronger association in men (OR = 1.48, 1.08-2.02) than women (OR = 1.26, 0.89-1.77). NOCs were also more dissatisfied than their OC fellows in the Chinese subsample (OR = 1.37, 1.09-1.73). Among international students, no associations between OC status and perceived stress or studying-related life satisfaction were found. CONCLUSIONS: To promote equality between OCs and NOCs at Chinese universities, the causes of more stress and less studying-related life satisfaction among NOCs compared to OCs need further exploration.

Comparison of Subjective Health Complaints between Chinese and German University Students: A Cross-Sectional Study.

High rates of health complaints (HCs) with substantial variation are reported in different university populations, which can be linked to socio-demographic, lifestyle-related factors, and cultural differences. HCs can be categorized into distinct components. This study aimed to identify and compare underlying dimensions of HCs (HC components); to access and compare HC prevalence, and the associations between HC components, socio-demographic, lifestyle-related factors, and perceived stress in German and Chinese university students. Two health surveys were conducted among 5159 university students (1853 Chinese, 3306 German). Factor analysis and logistic regression were applied. The prevalence of HC ranged from 4.6% to 40.2% over the two countries. Germans reported at least three HCs more often (47.2% vs. 35.8%). Chinese students more often reported gastrointestinal complaints. Perceived stress was positively associated with all three HC components in both countries (OR = 1.03-1.50) with stronger associations among Germans. Women more often reported HCs (OR = 1.32-2.43) with stronger associations among the Germans. Having a father with a low educational level was associated with high psychological symptoms among the Chinese (OR = 1.51), but with low gastrointestinal complaints among the Germans (OR = 0.79). The high prevalence of HCs in students requires country-specific interventions.

A cross-country comparison of tobacco consumption among youths from selected South-Asian countries.

BACKGROUND: Tobacco consumption (TC) among youths poses significant public health problem in developing countries. This study utilized the data of Global Youth Tobacco Survey (GYTS), 2007 to examine and compare youth TC behavior in Bangladesh, Nepal and Sri Lanka. METHODS: The GYTS covered a total of 2,242 Bangladeshi, 1,444 Nepalese and 1,377 Sri-Lankan youths aged 13-15 years. They represented response rates of 88.9%, 94.6%, and 85.0% for the three countries, respectively. Socioeconomic, environmental, motivating, and programmatic predictors of TC were examined using cross tabulations and logistic regressions. RESULTS: Prevalence of TC was 6.9% (9.1% in males, 5.1% in females) in Bangladesh, 9.4% (13.2% in males, 5.3% in females) in Nepal and 9.1% (12.4% in males, 5.8% in females) in Sri Lanka. The average tobacco initiation age was 9.6, 10.24 and 8.61 years, respectively. Cross tabulations showed that gender, smoking among parents and friends, exposure to smoking at home and public places, availability of free tobacco were significantly (P < 0.001) associated with TC in all three countries. The multivariable analysis [odds ratio (95% confidence interval)] indicated that the common significant predictors for TC in the three countries were TC among friends [1.9 (1.30-2.89) for Bangladesh, 4.10 (2.64-6.38) for Nepal, 2.34 (1.36-4.02) for Sri Lanka], exposure to smoking at home [1.7 (1.02-2.81) for Bangladesh, 1.81 (1.08-2.79) for Nepal, 3.96 (1.82-8.62) for Sri Lanka], exposure to smoking at other places [2.67 (1.59-4.47) for Bangladesh, 5.22 (2.76-9.85) for Nepal, 1.76 (1.05-2.88) for Sri Lanka], and the teaching of smoking hazards in schools [0.56 (0.38-0.84) for Bangladesh, 0.60 (0.41-0.89) for Nepal, 0.58 (0.35-0.94) for Sri Lanka]. CONCLUSIONS: An understanding of the influencing factors of youth TC provides helpful insights for the formulation of tobacco control policies in the South-Asian region.

The effect of atmospheric thermal conditions and urban thermal pollution on all-cause and cardiovascular mortality in Bangladesh.

This study assessed the effect of temperature and thermal atmospheric conditions on all-cause and cardiovascular mortality in Bangladesh. In particular, differences in the response to elevated temperatures between urban and rural areas were investigated. Generalized additive models (GAMs) for daily death counts, adjusted for trend, season, day of the month and age were separately fitted for urban and rural areas. Breakpoint models were applied for determining the increase in mortality above and below a threshold (equivalent) temperature. Generally, a 'V'-shaped (equivalent) temperature-mortality curve with increasing mortality at low and high temperatures was observed. Particularly, urban areas suffered from heat-related mortality with a steep increase above a specific threshold. This adverse heat effect may well increase with ongoing urbanization and the intensification of the urban heat island due to the densification of building structures. Moreover, rising temperatures due to climate change could aggravate thermal stress.

Validating neonatal mortality and use of NGO reproductive health outreach services in rural Bangladesh.

Although the neonatal mortality rate (NMR) in Bangladesh remained steady between 1995-99 and 1999-2003 (41-42 deaths per 1,000 live births), evidence from the management information system (MIS) of a large nongovernmental organization (NGO) program indicates that the NMR declined by about 50 percent between 1996 and 2002 in the area served. This study aims to validate the recording of neonatal deaths among the cohort of children registered as born in 2003 and to assess the evidence of a decline in the NMR. It also measures the coverage of reproductive health outreach services, focusing on 12 of the 27 NGOs that have provided services in the same areas since 1996. Field-workers' registers, verbal autopsy reports, and immunization records were checked to confirm infants' survival. Interviews were conducted with 142 mothers of children who died within 28 days postpartum and with a random sample of 109 women with registered stillbirths. Out of 11,253 registered live births in 2003, 210 neonatal deaths were found, compared with 194 deaths that were reported in the MIS for 2003. The corrected NMR was 19 deaths per 1,000 live births, and it was in the range of 15-29 deaths per 1,000 live births in 11 of the NGO areas. Because underreporting of neonatal deaths was probably higher in 1996 when the MIS-reported NMR was 39 deaths per 1,000 live births, the decline in the NMR is likely to have been genuine.

Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.