Measuring alcohol-related consequences in school surveys: alcohol-attributable consequences or consequences with students' alcohol attribution.

In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents' attribution of alcohol as the cause. The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF). In 2007, a total of 7,174 Swiss school students aged 13-16 years reported the numbers of 6 alcohol-related adverse consequences (e.g., fights, injuries) they had incurred in the past 12 months. Consequences were measured with and without attribution of alcohol as the cause. The alcohol-use measures were frequency and volume of drinking in the past 12 months and number of risky single-occasion (> or =5 drinks) drinking episodes in the past 30 days. Attributable fractions were derived from logistic (> or =1 incident) and Poisson (number of incidents) regression analyses. Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs). The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers.

Alcohol drinking, the metabolic syndrome and diabetes in a population with high mean alcohol consumption.

AIMS: To investigate the relationship of alcohol consumption with the metabolic syndrome and diabetes in a population-based study with high mean alcohol consumption. Few data exist on these conditions in high-risk drinkers. METHODS: In 6172 adults aged 35-75 years, alcohol consumption was categorized as 0, 1-6, 7-13, 14-20, 21-27, 28-34 and ≥ 35 drinks/week or as non-drinkers (0), low-risk (1-13), medium-to-high-risk (14-34) and very-high-risk (≥ 35) drinkers. Alcohol consumption was objectively confirmed by biochemical tests. In multivariate analysis, we assessed the relationship of alcohol consumption with adjusted prevalence of the metabolic syndrome, diabetes and insulin resistance, determined with the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS: Seventy-three per cent of participants consumed alcohol, 16% were medium-to-high-risk drinkers and 2% very-high-risk drinkers. In multivariate analysis, the prevalence of the metabolic syndrome, diabetes and mean HOMA-IR decreased with low-risk drinking and increased with high-risk drinking. Adjusted prevalence of the metabolic syndrome was 24% in non-drinkers, 19% in low-risk (P<0.001 vs. non-drinkers), 20% in medium-to-high-risk and 29% in very-high-risk drinkers (P=0.005 vs. low-risk). Adjusted prevalence of diabetes was 6.0% in non-drinkers, 3.6% in low-risk (P<0.001 vs. non-drinkers), 3.8% in medium-to-high-risk and 6.7% in very-high-risk drinkers (P=0.046 vs. low-risk). Adjusted HOMA-IR was 2.47 in non-drinkers, 2.14 in low-risk (P<0.001 vs. non-drinkers), 2.27 in medium-to-high-risk and 2.53 in very-high-risk drinkers (P=0.04 vs. low-risk). These relationships did not differ according to beverage types. CONCLUSIONS: Alcohol has a U-shaped relationship with the metabolic syndrome, diabetes and HOMA-IR, without differences between beverage types.

Iowa Maternal and Child Health Comprehensive Title V Assets and Needs Assessment, July 15, 2010

The Iowa Department of Public Health Bureau of Family Health and the Child Health Specialty Clinics embarked on a five-year needs assessment in March 2008 with a daylong strategic planning session involving key administrative and staff personnel from both agencies. As part of the strategic planning, the participants began preparation of a comprehensive assessment to identify the need in Iowa for: preventive and primary care services for pregnant women, mothers, and infants; preventive and primary care services for children; and services for children and youth with special health care needs.

Project Newsletter Iowa Public Health Tracking, July 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, August 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, September 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, October 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, October 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, November 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Cutaneous benign mixed tumor (chondroid syringoma) of the eyelid: clinical presentation and management.

PURPOSE: To describe the clinical presentation of cutaneous benign mixed tumor of the eyelid and its management options. METHODS: Periocular cases of cutaneous benign mixed tumor were gathered from members of an oculoplastics specialty Internet discussion group. A total of 9 patients are described in this retrospective, interventional case series. The clinical presentation, histopathology, and management of these lesions is reviewed. RESULTS: Patients were typically asymptomatic, presenting with a slowly enlarging, nontender nodule of 2 to 8 years' duration. The lesions ranged from 4 mm to 17 mm in greatest dimension. Four of the lesions were on the eyelid margin, three in the sub-brow area of the upper eyelid, and two in the central lids. All six cases not involving the brow were fixed to the tarsus; one brow lesion was believed to be adherent to the skin. None of the lesions was associated with significant changes of the overlying epidermis, although one lesion showed overlying pigmentation. All patients underwent excisional biopsy for diagnostic or cosmetic reasons. On histopathologic examination, the tumors were biphasic, with an epithelial component exhibiting apocrine or hair follicle differentiation and a myxoid, adipocytic, chondroid, and/or fibrous stroma. The pathologic diagnoses were all consistent with cutaneous benign mixed tumor (chondroid syringoma, pleomorphic adenoma). Follow-up ranged from 2 weeks to 12 months, although several patients failed to keep scheduled follow-up appointments. No clinical recurrences were identified. CONCLUSIONS: Cutaneous benign mixed tumor may occur in the eyelid, and, although uncommon, should be included in the differential diagnosis of firm, nodular eyelid tumors. The histopathologic features are similar to those seen in this tumor type arising in other areas of the body. Preoperative consideration of this diagnostic possibility may allow the surgeon to plan for complete excision, thereby reducing the possibility of recurrence or malignant transformation.

Risk factors for young-onset colorectal cancer.

PURPOSE: We investigated risk factors for colorectal cancer in early-onset cancers, to provide quantitative estimates for major selected risk factors. METHODS: We analyzed data from three Italian and Swiss case-control studies conducted between 1985 and 2009, including 329 colorectal cancer cases and 1,361 controls aged ≤45 years. We computed odds ratios (ORs) from unconditional logistic regression models, adjusted for major confounding factors. RESULTS: The OR of young-onset colorectal cancer was 4.50 for family history of colorectal cancer in first-degree relatives, the association being higher in subjects with affected siblings (OR 11.68) than parents (OR 3.75). The ORs of young-onset colorectal cancer were 1.56 for ≥14 drinks/week of alcohol, 1.56 for the highest tertile of processed meat, 0.40 for vegetables, 0.75 for fruit, and 0.78 for fish intake. Among micronutrients, the ORs were 0.52 for β-carotene, 0.68 for vitamin C, 0.38 for vitamin E, and 0.59 for folate. No significant associations emerged for physical activity, overweight, and diabetes. CONCLUSIONS: This study-the largest on young-onset colorectal cancer-confirms that several recognized risk factors for colorectal cancer are also relevant determinants of young-onset colorectal cancer. Family history of colorectal cancer in particular is a stronger risk factor in young subjects, as compared to middle age and elderly ones.

Project Newsletter Iowa Public Health Tracking, December 2013

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, January 2014

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Project Newsletter Iowa Public Health Tracking, February 2014

The IDPH Public Health Tracking Program is an excellent way to collect data related to various indicators for Iowans, but those looking for national statistics or data from other states may want to check out the Health Indicators Warehouse (healthindicators.gov). Run and maintained by the CDC’s National Center for Health Statistics, this site is a centralized source for national, state, and county data for a wide variety of indicators. The data is available to the public, and can be accessed either through the tables and charts directly on the website, or indicators can be downloaded to use in a spreadsheet. Once on the site, users are able to search for their desired data either by topic or geographic region. Filters can then be applied to the chosen field to narrow down the user’s search and obtain the preferred statistics. In addition, users are also able to search for indicators derived from state and federal health indicator initiatives: County Health Rankings, Community Health Status Indicators, Healthy People 2020, and CMS Community Indicators. The warehouse provides an overview of each indicator after the user has made their selection. This overview includes information on how the data was calculated and what characteristics are being represented. For example, percent of binge drinking adults is prefaced in the overview that data was based on the question: “Considering all types of alcoholic beverages, how many times during the past 30 days did you have [5 for men, 4 for women] or more drinks on an occasion?" Data is viewable either in the basic table format, chart format, or for some indicators it is possible to view it in terms of a national map. The Health Indicators Warehouse updates indicators as data becomes available, but the collection of years varies amongst the indicators. Nonetheless, this site is a useful resource to anyone looking for comparative indicators throughout the nation or is interested in one of the hundreds of indicators housed by the site. For more information or to check out what the warehouse has to offer visit: http://healthindicators.gov/

Which change talk dimensions are associated with subsequent drinking among young men receiving a brief motivational intervention in a non-clinical setting?

Background: Patient change talk (CT) during brief motivational interventions (BMI) has been linked with subsequent changes in drinking in clinical settings but this link has not been clearly established among young people in non-clinical populations. Objective: To determine which of several CT dimensions assessed during an effective BMI delivered in a non-clinical setting to 20-year old men are associated with drinking 6 months later. Methods: Of 125 individuals receiving a face-to-face BMI session (15.8 ± 5.4 minutes), we recorded and coded a subsample of 42 sessions using the Motivational Interviewing Skill Code 2.1. Each patient change talk utterance was categorized as `Reason´, `Ability´, `Desire´, `Need´, `Commitment´, `Taking steps´, or `Other´. Each utterance was graded according to its strength (absolute value from 1 to 3) and direction (i.e. towards (positive sign) or away (negative sign) from change/in favor of status quo). `Ability´, `Desire´, and `Need´ to change (`ADN´) were grouped together since these codes were too scarce to conduct analyses. Mean strength scores over the entire session were computed for each dimension and later dichotomized in towards change (i.e. mean core > 0) and away from change/in favor of status quo. Negative binomial regression models were used to assess the relationship between CT dimensions and drinking 6 months later, adjusting for drinking at baseline. Results: Compared to subjects with a `Taking steps´ score away from change/in favor of status quo, subjects with a positive `Taking steps´ score reported significantly less drinking 6 months later (Incidence Rate Ration [IRR] for drinks per week: 0.56, 95% Confidence Interval [CI] 0.31, 1.00). IRR (95%CI) for subjects with a positive `ADN´ score was 0.58, (0.32, 1.03). For subjects with a positive `Reason´, `Commitment´, and `Other´ scores, IRR (95%CI) were 1.28 (0.77; 2.12) 1.63 (0.85; 3.14) and 1.03 (0.61; 1.72), respectively. Conclusion: A change talk dimension reflecting steps taken towards change (`Taking steps´) is associated with less drinking 6 months later among young men receiving a BMI in a non-clinical setting. Encouraging patients to take steps towa change may be a worthy objective for clinicians and may explain BMI efficacy.