The first genome-wide association study for BMI identified a polymorphism, rs7566605, 10 kb upstream of the insulin-induced gene 2 (INSIG2) transcription start site, as the most significantly associated variant in children and adults. Subsequent studies, however, showed inconsistent association of this polymorphism with obesity traits. This polymorphism has been hypothesized to alter INSIG2 expression leading to inhibition of fatty acid and cholesterol synthesis. Hence, we investigated the association of the INSIG2 rs7566605 polymorphism with obesity- and lipid-related traits in Danish and Estonian children (930 boys and 1,073 girls) from the European Youth Heart Study (EYHS), a school-based, cross-sectional study of pre- and early pubertal children. The association between the polymorphism and obesity traits was tested using additive and recessive models adjusted for age, age-group, gender, maturity and country. Interactions were tested by including the interaction terms in the model. Despite having sufficient power (98%) to detect the previously reported effect size for association with BMI, we did not find significant effects of rs7566605 on BMI (additive, P = 0.68; recessive, P = 0.24). Accordingly, the polymorphism was not associated with overweight (P = 0.87) or obesity (P = 0.34). We also did not find association with waist circumference (WC), sum of four skinfolds, or with total cholesterol, triglycerides, low-density lipoprotein, or high-density lipoprotein. There were no gender-specific (P = 0.55), age-group-specific (P = 0.63) or country-specific (P = 0.56) effects. There was also no evidence of interaction between genotype and physical activity (P = 0.95). Despite an adequately powered study, our findings suggest that rs7566605 is not associated with obesity-related traits and lipids in the EYHS.
OBJECTIVE: To investigate determinants of the acceptability of isoflavone products among postmenopausal women with regard to social and lifestyle factors, dietary habits, health concerns, food beliefs, menopausal symptoms and therapies, and to elucidate preferences for specific products. METHODS: A consumer survey was conducted among postmenopausal women in four European countries (Germany, Denmark, Italy and the UK), including a total of 465 respondents. RESULTS: The declared acceptability of isoflavones was highest in Germany (80%), followed by Italy (75%), the UK (59%) and Denmark (55%; p
Little is known about whether the accuracy of tools for assessment of sexual offender recidivism risk holds across ethnic minority offenders. I investigated the predictive validity across ethnicity for the RRASOR and the Static-99 actuarial risk assessment procedures in a national cohort of all adult male sex offenders released from prison in Sweden 1993-1997. Subjects ordered out of Sweden upon release from prison were excluded and remaining subjects (N = 1303) divided into three subgroups based on citizenship. Eighty-three percent of the subjects were of Nordic ethnicity, and non-Nordic citizens were either of non-Nordic European (n = 49, hereafter called European) or African Asian descent (n = 128). The two tools were equally accurate among Nordic and European sexual offenders for the prediction of any sexual and any violent nonsexual recidivism. In contrast, neither measure could differentiate African Asian sexual or violent recidivists from nonrecidivists. Compared to European offenders, AfricanAsian offenders had more often sexually victimized a nonrelative or stranger, had higher Static-99 scores, were younger, more often single, and more often homeless. The results require replication, but suggest that the promising predictive validity seen with some risk assessment tools may not generalize across offender ethnicity or migration status. More speculatively, different risk factors or causal chains might be involved in the development or persistence of offending among minority or immigrant sexual abusers.
A total of 1,729 children (2nd-9th grades) in South Africa, Iceland, Poland, Australia, the U.K., and the U.S.A. rated 20 events in terms of how upsetting they are. Save in Poland, the ratings were in close agreement (r, .85-.97), placing the loss of parent at the top and a new baby sibling at the bottom. In Poland, the baby's arrival led the list. Even so, what was seen as quite upsetting fell everywhere in the same two categories--experiences that threaten one's sense of security and those that occasion personal denigration and embarrassment.
A comparative study of adolescent reproductive behavior in the 1980s examined difference in pregnancy, birth, and abortion levels among teenagers in developed countries especially in the US, Canada, the UK, France, the Netherlands, and Sweden. Only 6 of 37 countries with total fertility rates 3.5 and per capita income US$2000/year, and at least 1 million people had adolescent birth rates higher than the US (Bulgaria, Cuba, Puerto Rico, Romania, Hungary, and Chile). The US had the highest abortion rate (42/1000) followed by Hungary (27/1000). Thus the US had the highest adolescent pregnancy rate (96/1000) as well as Hungary (96/1000). The 6 country analysis showed that reducing the level of sexual activity among teenagers is not necessarily needed to achieve lower pregnancy rates. For example, Sweden had the highest levels of sexual activity but its pregnancy rate were 33% as high as those of the US. The rates of sexual activity among teenagers in the Netherlands equaled those of the US, but its pregnancy rates were 14% as high as those of the US. All countries had earlier, more extensive, and better contraceptive use among sexually active teenagers than the US which accounted for their lower pregnancy rates. The more realistic acceptance of sexual activity among teenagers and provision of contraceptives in all the countries except the US differed from the societal ambivalence in the US. Thus ambivalence about sexuality and the appropriateness of contraceptive use results in lower contraceptive use and greater adolescent pregnancy rates. US adolescents constantly receive conflicting messages that sex is romantic, thrilling, and arousing but it is also immoral to have premarital sex. Thus adults need to be more candid about sexuality so they can clearly convey to adolescents their expectations for responsible behavior and to provide the information and services needed to make effective use of contraceptives when sexually active.
Child and Adolescent Health Research Unit (CAHRU), Department of PE, Sport and Leisure Studies, University of Edinburgh, St. Leonard's Land, Holyrood Road, EH8 8AQ, Edinburgh, UK. firstname.lastname@example.org
This paper examines the relationship between family structure and smoking among 15-year-old adolescents in seven European countries. It also investigates the association between family structure and a number of known smoking risk factors including family socio-economic status, the adolescent's disposable income, parental smoking and the presence of other smokers in the adolescent's home. Findings are based on 1998 survey data from a cross-national study of health behaviours among children and adolescents. Family structure was found to be significantly associated with smoking among 15-year-olds in all countries, with smoking prevalence lowest among adolescents in intact families and highest among adolescents in stepfamilies. Multivariate analysis showed that several risk factors were associated with higher smoking prevalences in all countries, but that even after these other factors were taken into account, there was an increased likelihood of smoking among adolescents in stepfamilies. Further research is needed to determine the possible reasons for this association.
The exercise of compulsory powers for the protection of society against the spread of infectious diseases may impose severe restrictions on individual liberty. The law should therefore enable public health officials to strike the proper balance between public health and individual rights. An overview of the infectious diseases control legislation of five European countries (Germany, Switzerland, England, Sweden and the Netherlands) shows outdated medical approaches to infectious diseases, deficiencies in substantive statutory criteria and a lack of suitable procedural protection. The law has to be modified not only to fit current epidemiological insights, but also to give full weight to evolving individual rights.
This paper examines the effect of banning broadcast advertising of alcoholic beverages. The data used in this study are a pooled time series from 17 countries for the period 1970 to 1983. The empirical results show that countries with bans on spirits advertising have about 16% lower alcohol consumption than countries with no bans and that countries with bans on beer and wine advertising have about 11% lower alcohol consumption than countries with bans only on spirits advertising.
Comment In: J Health Econ. 1993 Jul;12(2):213-2810127781
AIMS: To test if there is relationship between alcohol consumption and pancreatitis mortality at the population level. DATA AND METHODS: Annual pancreatitis death rates for 1950-95 were converted into age-adjusted mortality rates per 100,000 inhabitants. Per capita alcohol consumption was measured by alcohol sales. The relationship was estimated with time-series analysis on data from 14 western countries. Several models were tested with different assumptions about risk function and lag structure. RESULTS: According to the assumed most appropriate model, a positive relationship was found in each country, and statistical significance was reached in all countries except from Finland, Italy and Canada. The magnitude of the association was fairly consistent across countries, with the alcohol effect parameters ranging between 0.05 and 0.14. However, Sweden and Norway deviated from this pattern with estimates between 0.30 and 0.40. CONCLUSIONS: Pancreatitis joins a wide range of causes of death where the mortality rate is influenced by per capita alcohol consumption, and more so in northern Europe. It is suggested that pancreatitis mortality is an important indicator of alcohol-related harm, not least because a large amount of morbidity is likely to be connected to the mortality rate.
OBJECTIVES: The European Commission's new health strategy for improving health at the European Union (EU) level includes tackling alcohol consumption. This study aimed to assess the prevalence of alcohol consumption and problem drinking, as well as students' attitudes towards banning the sale of alcohol on campus. STUDY DESIGN: In total, 5826 students from universities in seven European countries (Denmark, Germany, Spain, Lithuania, Poland, Bulgaria and Turkey) took part in this cross-sectional study. METHODS: A self-administered questionnaire assessed sociodemographic information, frequency of alcohol consumption, problem drinking and attitudes towards banning the sale of alcohol on campus. RESULTS: The highest prevalence of drinking alcohol more than once per week was reported in Bulgarian (males 46%, females 64%) and Spanish students (males 59%, females 64%). Among those students who drank alcohol (n=3170), problem drinking (CAGE score >1) was found in 24% of males and 13% of females. Male gender, depressive moods and a low importance of good grades at university were risk factors for drinking alcohol more than once per week as well as for problem drinking. There were substantial country differences in the proportion of students who would support a ban of alcohol sales on campus (23% in Denmark, 88% in Poland). Support for a ban was higher among female students and among students who drank alcohol once or less per week. CONCLUSIONS: Problem drinking is a concern among students in many European countries, especially among males. Students' support for banning the sale of alcohol on campus varies between countries and should be considered in developing EU policy.