Jiun-Hau Huang

Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan

BackgroundAlthough studies show that maternal smoking during pregnancy increases the risks of respiratory outcomes in childhood, evidence concerning the effects of household environmental tobacco smoke (ETS) exposure remains inconsistent.MethodsWe conducted a population-based study comprised of 5,019 seventh and eighth-grade children in 14 Taiwanese communities. Questionnaire responses by parents were used to ascertain childrens exposure and disease status. Logistic regression models were fitted to estimate the effects of ETS exposures on the prevalence of asthma, wheeze, and bronchitic symptoms.ResultsThe lifetime prevalence of wheeze was 11.6% and physician-diagnosed asthma was 7.5% in our population. After adjustment for potential confounders, in utero exposure showed the strongest effect on all respiratory outcomes. Current household ETS exposure was significantly associated with increased prevalence of active asthma, ever wheeze, wheeze with nighttime awakening, and bronchitis. Maternal smoking was associated with the increased prevalence of a wide range of wheeze subcategories, serious asthma, and chronic cough, but paternal smoking had no significant effects. Although maternal smoking alone and paternal smoking alone were not independently associated with respiratory outcomes, joint exposure appeared to increase the effects. Furthermore, joint exposure to parental smoking showed a significant effect on early-onset asthma (OR, 2.01; 95% CI, 1.00-4.02), but did not show a significant effect on late-onset asthma (OR, 1.17; 95% CI, 0.36-3.87).ConclusionWe concluded that prenatal and household ETS exposure had significant adverse effects on respiratory health in Taiwanese children.

Epidemiology of Youth Gambling Problems in Canada: A National Prevalence Study

Objectives: To describe the epidemiology of gambling problems among youth aged 15 to 24 years in Canada and to examine whether these gambling prevalence patterns differ by sex and (or) by geographic region. Method: We used data from The Canadian Community Health Survey: Mental Health and Well-Being. Gambling problems were determined according to the Canadian Problem Gambling Index. All prevalence estimates used appropriate sampling weights and bootstrap variance estimation procedures developed by Statistics Canada. Multivariate logistic regression modelling was also employed to supplement the above prevalence comparisons by age, sex, and region. Results: Among Canadian youth aged 15 to 24 years (n = 5666), 61.35% gambled in the past 12 months and the national prevalence of moderate-risk or problem gambling was 2.22% (3.30% in male respondents and 1.10% in female respondents). Male respondents had significantly higher prevalence of gambling problems than female respondents. Regional prevalence estimates of youth moderate-risk or problem gambling were 1.37% in British Columbia, 2.17% in the Prairie provinces, 2.75% in Ontario, 2.12% in Quebec, and 1.71% in the Atlantic provinces. Conclusions: Youth, particularly young men, are at greater risk for gambling problems than adults. More prevention and research efforts are also needed to address the observed sex differences and interregional variability in the prevalence of gambling problems among youth. The national prevalence estimates from this study provide important baseline data against which future cohorts of Canadians can be monitored and measured.

Endorsed reasons for not drinking alcohol: a comparison of college student drinkers and abstainers

Little is known about how the reasons that college student drinkers and abstainers have for choosing not to drink might differ. The present study examined this issue among a sample of 2,500 U.S. college students from 18 colleges and universities. Abstainers endorsed significantly more reasons for not drinking than drinkers, and among drinkers, light drinkers endorsed more reasons than heavy drinkers. Abstainers’ decision not to drink appeared to be a lifestyle choice that was supported by multiple reasons, including personal values, religious beliefs, not wanting the image of a drinker, and beliefs about alcohol’s effect on behavior. Heavy drinkers were more likely to endorse situational reasons such as having to drive home later or being concerned about school work or weight gain from drinking. Implications of these findings for alcohol prevention work on college and university campuses are discussed.

Sexual Risk-Taking Behaviors, Gambling, and Heavy Drinking Among U.S. College Athletes

The purpose of this study was to empirically examine the prevalence patterns of sexual risk-taking behaviors (i.e., unprotected sex and having multiple sex partners) in relation to levels of gambling problems and heavy episodic drinking (HED) status among U.S. college athletes. Data from a representative national sample of 20,739 U.S. college athletes were derived from the first National Collegiate Athletic Association national survey of problem gambling and health-risk behaviors. Among college athletes who were sexually active during the past year, males reported significantly higher prevalence of unprotected sex (10.2%) and multiple sex partners (14.6%) than females (7.9% and 9.3%, respectively). Using the DSM-IV Gambling Screen classification, as the level of gambling severity increased, the prevalence of sexual risk-taking behaviors also increased among female athletes, but decreased among male athletes. As regards the effect of heavy drinking, while both male and female HED athletes reported elevated sexual risk-taking, the effect of HED was twice as large in females as in males. It is important to note that the definitions of sexual risk behaviors in this study took into account committed sexual relationship status; hence, the results of this study need to be interpreted with the refined sexual risk measures in mind. Further investigations are warranted to help us better understand and explicate the interrelationships of sexual risk-taking behaviors, gambling, and heavy drinking among these college athletes. Findings from this exploratory study suggest new directions for future research and practice and also highlight the importance of a more inclusive multi-component approach to address these co-occurring youth risk behaviors.

Avian Influenza Risk Perception and Preventive Behavior among Traditional Market Workers and Shoppers in Taiwan: Practical Implications for Prevention

Background Avian influenza (AI) can be highly pathogenic and fatal. Preventive behavior such as handwashing and wearing face masks has been recommended. However, little is known about what psychosocial factors might influence peoples decision to adopt such preventive behavior. This study aims to explore risk perception and other factors associated with handwashing and wearing face masks to prevent AI. Methodology/Principal Findings An interviewer-administered survey was conducted among 352 traditional market workers and shoppers in Taiwan between December 2009 and January 2010. Factors associated with the recommended AI preventive behavior (i.e., when in a traditional market, wearing a face mask and also washing hands after any contact with poultry) included: having correct knowledge about the fatality rate of AI (adjusted odds ratio [AOR] = 4.18), knowing of severe cases of AI (AOR = 2.13), being informed of local AI outbreaks (AOR = 2.24), living in northeastern Taiwan (AOR = 6.01), having a senior high-school education (AOR = 3.33), and having a university or higher education (AOR = 6.86). Gender interactive effect was also found among participants with a senior high-school education, with males being less likely to engage in the recommended AI preventive behavior than their female counterparts (AOR = 0.34). Conclusions/Significance Specific information concerning AI risk perception was associated with the recommended AI preventive behavior. In particular, having correct knowledge about the fatality rate of AI and being informed of severe cases and local outbreaks of AI were linked to increased AI preventive behavior. These findings underscore the importance of transparency in dealing with epidemic information. These results also have practical implications for prevention and policy-making to more effectively promote the recommended AI preventive behavior in the public.

Precollege and In-College Bullying Experiences and Health-Related Quality of Life Among College Students

BACKGROUND AND OBJECTIVES: Bullying is a commonly occurring problem behavior in youths that could lead to long-term health effects. However, the impact of school bullying experiences on health-related quality of life (HRQOL) among college students has been relatively underexplored. This study aimed to describe school bullying experiences and to empirically examine their associations with HRQOL among college students in Taiwan. METHODS: Self-administered survey data (response rate 84.2%) were collected from 1452 college students in 2013 by using proportional stratified cluster sampling. Different types of bullying experiences (ie, physical, verbal, relational, and cyber) before and in college, for bullies and victims, were measured. HRQOL was assessed by the World Health Organization Quality of Life (WHOQOL-BREF) Taiwan version. RESULTS: College students with cyber bullying-victimization experiences before college (β 0.060) reported significantly higher HRQOL in physical health. Regarding social relationships, those with verbal (β –0.086) and relational (β –0.056) bullying-victimization experiences, both before and in college, reported significantly lower HRQOL, whereas those with verbal (β 0.130) and relational (β 0.072) bullying-perpetration experiences in both periods reported significantly higher HRQOL. Students with cyber bullying–victimization experiences in college (β 0.068) reported significantly higher HRQOL in the environment domain. Last, the effects of verbal and relational bullying-victimization experiences on psychological HRQOL could be mediated and manifested through depression. CONCLUSIONS: Various types of bullying experiences occurring before and in college were differentially associated with HRQOL in different domains. These findings underscore the importance of developing school policies and health education initiatives to prevent school bullying and ameliorate its short-term and long-term effects on HRQOL.

DSM-based problem gambling: Increasing the odds of heavy drinking in a national sample of U.S. college athletes?

Despite previously found co-occurrence of youth gambling and alcohol use, their relationship has not been systematically explored in a national sample using DSM-based gambling measures and multivariate modeling, adjusted for potential confounders. This study aimed to empirically examine the prevalence patterns and odds of at-least-weekly alcohol use and heavy episodic drinking (HED) in relation to various levels of gambling severity in college athletes. Multivariate logistic regression analyses were performed on data from a national sample of 20,739 U.S. college athletes from the first National Collegiate Athletic Association national survey of gambling and health-risk behaviors. Prevalence of at-least-weekly alcohol use significantly increased as DSM-IV-based gambling severity increased, from non-gambling (24.5%) to non-problem gambling (43.7%) to sub-clinical gambling (58.5%) to problem gambling (67.6%). Multivariate results indicated that all levels of gambling were associated with significantly elevated risk of at-least-weekly HED, from non-problem (OR = 1.25) to sub-clinical (OR = 1.75) to problem gambling (OR = 3.22); the steep increase in the relative risk also suggested a possible quadratic relationship between gambling level and HED risk. Notably, adjusted odds ratios showed problem gambling had the strongest association with at-least-weekly HED, followed by marijuana (OR = 3.08) and cigarette use (OR = 2.64). Gender interactions and differences were also identified and assessed. In conclusion, attention should be paid to college athletes exhibiting gambling problems, especially considering their empirical multivariate associations with high-risk drinking; accordingly, screening for problem gambling is recommended. More research is warranted to elucidate the etiologic mechanisms of these associations.

Measuring College Student Drinking: Illustrating the Feasibility of a Composite Drinking Scale.

Abstract This study explored the feasibility of a Composite Drinking Scale (CDS) designed to capture fully the phenomenon of problem drinking among college students while allowing easy public understanding. A survey conducted at 32 four-year U.S. colleges included four consumption measures: 30-day frequency; average number of drinks per week; number of drinks usually consumed when partying; and greatest number of drinks in one sitting in the past two weeks. Responses were normalized and added to create a continuous distribution, which was then subdivided into quartiles (CDS/Q1-Q4). The CDS is an easily understood scoring system, but compared to the simplistic “binge drinking” measure, it captures a broader range of relative risks and more clearly establishes the quadratic relationship between consumption and alcohol-related problems. Development of the CDS will require further exploring the best set of questions to include, establishing U.S. norms for the general population, and then transforming those scores to a simple measurement yardstick whose meaning can be easily communicated to the public.

Pandemic influenza H1N1 vaccination intention: psychosocial determinants and implications from a national survey, Taiwan.

BACKGROUND Vaccination has been recommended as an effective way to protect people from severe illness during influenza pandemics; however, little is known about the acceptability and psychosocial determinants of intention to receive vaccination against pandemic influenza A/H1N1 (pH1N1). METHODS A national computer-assisted telephone interview survey using random digit dialing was conducted during 28-30 October 2009 among residents of Taiwan aged ≥15 years. RESULTS Of the 1079 participants interviewed, 70.1% reported intention to receive pH1N1 vaccination. Multivariate logistic regression analysis showed that participants who perceived pH1N1 in Taiwan to be much more severe than that in other countries [adjusted odds ratio (AOR) = 1.94; 95% confidence interval (CI) = 1.05-3.60], who agreed (AOR = 2.44; 95% CI = 1.30-4.58) or strongly agreed (AOR = 2.53; 95% CI = 1.38-4.65) that contracting pH1N1 would have a great impact on their daily life, who perceived pH1N1 vaccination to be very effective in preventing pH1N1 (AOR = 2.64; 95% CI = 1.61-4.33) and who considered receiving vaccination not very difficult (AOR = 8.97; 95% CI = 6.05-13.29) or not at all difficult (AOR = 30.72; 95% CI = 19.24-49.04) were more inclined towards getting vaccinated against pH1N1. CONCLUSION These specific and modifiable health beliefs have practical implications for prevention and policy making, and highlight the importance of minimizing perceived barriers while convincing the public of the seriousness of the disease and effectiveness of vaccination when promoting vaccination programmes.

Prevalence and associated psychosocial factors of increased hand hygiene practice during the influenza A/H1N1 pandemic: findings and prevention implications from a national survey in Taiwan

Objective  To investigate increased hand hygiene practice in response to the pandemic influenza A/H1N1 (pH1N1) and its associated psychosocial factors in the Taiwanese general population.