Food environments in and around post-primary schools in Ireland: Associations with youth dietary habits.

BACKGROUND: The food environment within and surrounding schools may influence children's diets. This study explored if the internal and external school food environments were associated with intake of specific food groups among adolescents. METHODS: Participants were a subset of 5344 post-primary school students that took part in the Health Behaviour in School-aged Children (HBSC) survey. Four school-level variables were created: urban/rural, disadvantaged status, percentage fast food premises within one kilometer of the school and food sold in the school. Logistic regression models were used to examine school-level influences on daily food consumption controlling for individual and family food environmental factors. RESULTS: For students in disadvantaged schools, the odds of having soft drinks (OR 1.79, 95% CI 1.30-2.47) or chips (OR 1.82, 95% CI 1.17-2.83) daily were larger and the odds of consuming fruits (OR 0.79, 95% CI 0.62-0.99) or vegetables (OR 0.73, 95% CI 0.60-0.88) daily were smaller than for students at other schools. Girls and those from higher socioeconomic classes also had healthier eating habits. Attending a school where more than 10% of the food premises within one kilometer of the school were fast food outlets was associated with a 0.78 (95% CI 0.64 to 0.94) and a 0.79 (95% CI 0.66 to 0.93) decreased odds of daily fruit and vegetable intake, respectively. CONCLUSIONS: Fast food environments around post-primary schools are associated with less fruit and vegetable intake. Children in disadvantaged schools and from lower social classes are more likely to report poorer dietary habits than children in other schools or from higher social classes, respectively. Multiple contexts influence diet, and children at an economic or social disadvantage are at most risk of poor dietary habits.

Evaluation of a theory-based concussion education program for secondary school student-athletes in Ireland.

Concussion education is an important aspect of concussion prevention. The purpose of this study was to investigate the effect of a novel, theory of planned behavior (TPB)-driven concussion education program on secondary school athletes' concussion-reporting relevant cognitions immediately post-intervention and at 3 months follow-up. Data were collected from 428 secondary school athletes during the 2016-2017 academic year: 229 were assigned to an intervention group of which 59 (25.76%) completed assessments at all timepoints; 199 were assigned to a control group of which 153 (76.88%) completed assessments at all timepoints. Using repeated measures ANOVAs, we examined differences in athletes' concussion-reporting cognitions, by group and gender. The program had a significant positive effect on athletes' knowledge (P < 0.01), perceived behavioral control over concussion recognition and reporting (P < 0.01), and reporting intention (P < 0.01). These results were maintained at 3 months follow-up, with the exception of perceived behavioral control. The program did not have a significant effect on athletes' attitudes toward concussion reporting and subjective reporting norms. Results suggest that the TPB may be a useful framework to inform the development of more effective educational programs. There is a need for multi-layered interventions that aim to create sporting environments that encourage positive concussion care seeking behaviors.

The mean age at menarche of Irish girls in 2006.

Strong evidence exists of a downward secular trend in the age at menarche; which appears to be associated with improved health and nutritional circumstances over the past two centuries. The aim of this study was to determine the mean age at menarche of Irish girls in 2006, as this has not been verified since 1986. A nationally representative sample of Irish girls (n = 4720, age 10-18 years) was obtained from the 2006 Irish Health Behaviour in School Aged Children survey and mean menarcheal age was calculated using the recall method. Mean age at menarche decreased from 13.52 years in 1986 to 12.53 years in 2006 and was lowest in cities and among manual groups. No significant differences were found between Irish-born and immigrant girls. Ongoing observation of this biological milestone is warranted to identify whether this secular trend will stabilise in Ireland and at what age. Consequences of earlier biological maturation on adolescent health behaviours and outcomes should also be monitored.

Interpersonal relationships as predictors of positive health among Irish youth: the more the merrier?

To investigate positive health and its associations with supportive relationships with friends and family members, we conducted an analysis of data from the 2002 Irish Health Behaviour in School-Aged Children Study (HBSC); a cross-sectional survey of 8,424 Irish schoolchildren aged 10-18. 36.0% and 63.4% of the students reported lack of emotional and physical symptoms respectively, 56.1% reported high life satisfaction, 46.9% scored highly on positive life index and 44.2% reported that they are very happy with their life. Parent, sibling and friend relationships were independent predictors of positive health, with higher odds ratios for parents than those for siblings or friends. A greater number of supportive relationships was strongly associated with positive health. Gender and age variations are also reported. The data suggest that there are gains to be made in terms of adolescent health from assisting adolescents to build and maintain their interpersonal relationships, and independently to support parents in their relationships with their children.

Assessing the use of the Family Affluence Scale (FAS) among Irish schoolchildren.

The objective of this analysis was to examine the answering rates, internal reliability and external validity of the Family Affluence Scale (FAS) employing data from the 2002 Irish Health Behaviour in School-aged Children study HBSC; a cross-sectional survey of 8,424 Irish schoolchildren aged 10-18. Father's occupation was reported by 80.6% of the schoolchildren and 60.6% reported on mother's occupation, while over 96% reported on the FAS items. Lower answering rates on parental occupation were found among younger schoolchildren and among those with poorer material circumstances. Analysis of the FAS revealed a moderate internal reliability and FAS scores were significantly associated with reported parental occupation. The traditional SES measures suffer from poor answering rates that pose a serious methodological threat. The FAS has moderate internal reliability and does not capture the SES status in full, but it has high completion rates, and can be used as an additional measure of SES in late childhood and adolescence.

The epidemiology of non-fatal injuries among 11-, 13- and 15-year old youth in 11 countries: findings from the 1998 WHO-HBSC cross national survey.

The primary objective was to present a cross-country comparison of injury rates, contexts and consequences. The research design was the analysis of data from the 1998 cross-national Health Behaviour in School-aged Children survey and 52955 schoolchildren from 11 countries, aged 11, 13 and 15 years, completed a self-administrated questionnaire. A total of 41.3% of all children were injured and needed medical treatment in the past 12 months. Injury rates among boys were higher than among girls, 13.3% reported activity loss due to injury and 6.9% reported severe injury consequences. Most injuries occurred at home and at a sport facility, mainly during sport activity. Fighting accounted for 4.1% of injuries. This paper presents the first cross-national comparison of injury rates and patterns by external cause and context. Findings present cross-country similarities in injury distribution by setting and activity. These findings emphasize the importance of the development of global prevention programmes designed to address injuries among youth.

Cross national study of injury and social determinants in adolescents.

OBJECTIVES: To compare estimates of the prevalence of injury among adolescents in 35 countries, and to examine the consistency of associations cross nationally between socioeconomic status then drunkenness and the occurrence of adolescent injury. DESIGN: Cross sectional surveys were obtained from national samples of students in 35 countries. Eight countries asked supplemental questions about injury. SETTING: Surveys administered in classrooms. SUBJECTS: Consenting students (n = 146 440; average ages 11-15 years) in sampled classrooms. 37 878 students (eight countries) provided supplemental injury data.Exposure measures: Socioeconomic status (material wealth, poverty) and social risk taking (drunkenness). OUTCOME MEASURES: Specific types and locations of medically treated injury. RESULTS: By country, reports of medically treated injuries ranged from 33% (1060/3173) to 64% (1811/2833) of boys and 23% (740/3172) to 51% (1485/2929) of girls, annually. Sports and recreation were the most common activities associated with injury. High material wealth was positively (OR>1.0; p<0.05) and consistently (6/8 countries) associated with medically treated and sports related injuries. Poverty was positively associated with fighting injuries (6/8 countries). Drunkenness (social risk taking) was positively (p<0.01) and consistently (8/8 countries) associated with medically treated, street, and fighting injuries, but not school and sports related injuries. CONCLUSION: The high prevalence of adolescent injury confirms its importance as a health problem. Social gradients in risk for adolescent injury were illustrated cross nationally for some but not all types of adolescent injury. These gradients were most evident when the etiologies of specific types of adolescent injury were examined. Prevention initiatives should focus upon the etiologies of specific injury types, as well as risk oriented social contexts.

Home care therapy for respirator-dependent patients.

Our experience with 13 patients suffering from various ventilatory disorders who received mechanical ventilation at home for periods between 1 and 12 years is presented. Seven of the 13 patients were ventilated by positive pressure via tracheostomy, 3 by negative body ventilators and 3 by exufflation belt and positive pressure. Only a few hospitalizations were required due to pulmonary complications, and there was no case of sudden death occurring at home. Costs of home care for respirator-dependent patients, including the initial investment of home equipment, are much lower than the costs of long-term hospital care. A comprehensive home care program should be the preferred choice for medically stable ventilator-dependent patients.

The effect of pyridostigmine on respiratory function in healthy and asthmatic volunteers.

Respiratory function was evaluated in 12 healthy and 13 asthmatic volunteers following a single oral dose of pyridostigmine in a double-blind, placebo-controlled cross-over study. Respiratory function tests were performed at rest and after submaximal exercise at the time corresponding to the expected peak cholinesterase inhibition by pyridostigmine. A single dose of 60 mg pyridostigmine given to nonasthmatic subjects led to a decrease of 28.4% in cholinesterase activity when compared to the baseline and a statistically (but not physiologically) significant decrease in FEV1 (forced expiratory volume in 1 sec) both at rest (P less than 0.015) and after exercise (P less than 0.05). This effect showed a strong correlation to the degree of cholinesterase inhibition (r = -0.936, P less than 0.0001). According to these findings, a smaller dose of pyridostigmine (30 mg) was given to subjects with mild bronchial asthma. At that dose, pyridostigmine resulted in a similar inhibition of cholinesterase activity to a mean of 76.7% of the baseline. A significant decrease in the pulse rate was also found (P less than 0.005). However, no changes in respiratory function were observed when compared with the effects of placebo. The effect of post-exertion atropine inhalation on respiratory function was also unchanged with pyridostigmine at that dose. We conclude that, in general, at this dose pyridostigmine is a safe drug for asthmatics; however, the distribution of individual results in this group cannot preclude the existence of a subpopulation of asthmatic patients who are more vulnerable to the effects of pyridostigmine.

Motivation, vocational interests and job satisfaction of mentally retarded adults.

The relationship between vocational interests of 83 mildly to moderately retarded adults in a residential facility in Israel, their actual work and the factors which they perceived as the most important motivators for them at work and job satisfaction were investigated. Two questionnaires were used: the Illustrated Vocational Inventory (Whelan & Reiter, 1980) and a specially designed questionnaire on motivation to work based on Herzberg, Mausner, and Snyderman's (1959). The results demonstrate the importance of taking into consideration mentally retarded persons' vocational interests when assignig them to different jobs. It further demonstrates the importance of the environment in influencing mentally retarded individuals to seek instrinsic or extrinsic rewards and satisfaction from work.

Attitudes of superintendents of institutions for the mentally retarded towards deinstitutionalization: a cross-cultural perspective.

A cross-cultural study was conducted on the attitudes of superintendents of institutions regarding deinstitutionalization in the United States and in Israel. The attitudes of 29 superintendents from Israel were compared with the attitudes of 181 American superintendents. The most general finding was that in spite of important legislative and demographic differences, in both countries the attitudes were neither highly in favor nor strongly against deinstitutionalization. Most respondents in both countries believed that the parents of the mentally retarded do not generally support deinstitutionalization.

Beclomethasone dipropionate aerosol in the treatment of steroid-dependent chronic bronchial asthma in adults.

15 adult chronic asthmatic patients who were on daily maintenance dose of oral steroid for at least 6 months were studied. Following an investigation period of 2 weeks, the patients were started on BDA, 100 microgram four times daily. The daily oral steroid dose, which averaged 12 mg of prednisone or its equivalent, was gradually reduced by about 1 mg per day. The trial lasted 8 weeks, at the end of which, ten patients were as good or better on BDA than on oral steroids. Two patients had to return to oral corticosteroid therapy before the trial ended and three patients were unable to discontinue their oral steroid treatment. The lack of systemic effects of BDA was demonstrated by the appearance of symptoms which were apparently previously suppressed by the oral steroids and the excretion of normal amounts of 17-OHCS in the urine in some to the patients who had evidence of adrenal suppression while on oral steroids.