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Biomedical subjects

W R Stanton

Publications and source records attributed to W R Stanton.

At least 37 records · Page 2Linked to original sources

Adolescents' experiences of smoking cessation.

Recent prevalence rates show that by Year 10 (ages 14-16 years), 15% of students are smoking each day. As the majority of young people do not smoke, schools have traditionally provided an emphasis on prevention. However, the prevalence of daily smoking increases from 15 to 31% across the last 3 years of secondary school, suggesting a need for cessation programs. Therefore, a study of smoking cessation among students was conducted with 2877 Year 10 students in Queensland, Australia. Results of the survey showed that students (i) moderately under-estimated the number of smoking peers who had tried to stop smoking (perceived as 42%, reported as 55%), and (ii) over-estimated the success their smoking peers have (perceived as 29%, reported as 13.6%). The majority of adolescents (57.5%) reported that they had done something to influence a student not to smoke in the last 12 months, including 29% of the smokers. Among those who were current smokers, 64% wanted to stop smoking and 55% had tried to stop in the past year. Withdrawal symptoms were frequently reported among adolescent smokers and more males than females reported being stressed and depressed as a result of their efforts to quit. Intention to quit in the next year was associated with high confidence in ability to quit. These issues deserve attention in prevention programs and the development of age appropriate cessation material for adolescents should have high priority.

Adolescent↗

Barriers to health promotion activities in public hospitals.

Despite the central role hospitals have in the health care system, relatively few health promotion activities are conducted in Australian public hospitals. This study investigated the types of obstacles that were perceived to inhibit health promotion activities in hospitals. A questionnaire for self-completion was sent to medical superintendents in all public hospitals in Queensland and 112 questionnaires were returned (92.6 per cent response rate). The results indicated that lack of finance, lack of interest by relevant others, and needs (for appropriate programs, training and patient receptivity) were the barriers reported by superintendents. The barriers of 'interest' and 'needs' were related to a lack of written policies in some areas, but not directly to levels of other health promotion activities being conducted in the hospitals. Success in facilitating health promotion programs in hospitals will need to include a change in the environment, in particular the views of medical superintendents. The combination of attitude change and the availability of a motivated person (such as a health promotion officer) to lead the activities may be needed in order to produce an increase in the level of health promotion in public hospitals.

Chi-Square Distribution↗

Psychiatric disorder in a birth cohort of young adults: prevalence, comorbidity, clinical significance, and new case incidence from ages 11 to 21.

Mental health data were gathered at ages 11, 13, 15, 18, and 21 in an epidemiological sample using standardized diagnostic assessments. Prevalence of Diagnostic and Statistical Manual of Mental Disorders (3rd ed. revised; American Psychiatric Association, 1987) mental disorders increased longitudinally from late childhood (18%) through mid-(22%) to late-adolescence (41%) and young adulthood (40%). Nearly half of age-21 cases had comorbid diagnoses; and comorbidity was associated with severity of impairment. The incidence of cases with adult onset was only 10.6%: 73.8% of adults diagnosed at age 21 had a developmental history of mental disorder. Relative to new cases, those with developmental histories were more severely impaired and more likely to have comorbid diagnoses. The high prevalence rate and significant impairment associated with a diagnosis of mental disorder suggests that treatment resources need to target the young adult sector of the population. The low new-case incidence in young adulthood, however, suggests that primary prevention and etiological research efforts need to target children and adolescents.

Adolescent↗

What use do people make of physicians in checking their skin for cancer?

We administered a questionnaire to 995 people selected randomly from the electoral roll in one coastal region of subtropical Australia. Three-quarters (739) indicated their skin was checked by a physician, by themselves, or both. Among the 15% who were taught to check their skin, 59% learned to do so from physicians. A family physician would be consulted immediately by 40% who found something suspicious, and by 58% after a period of delay. Several factors associated with other indicators of health-seeking behavior, including being told by a physician that there was a special risk of skin cancer, were related to an increased proportion of respondents who were checked by their physicians as well as themselves. In addition to being the main focus of help should a suspicious lesion be found, physicians may have an important role in introducing the public to the process of early detection of skin cancer as well as providing an important function in its actual conduct.

Adult↗

Prevalence, reliability and bias of adolescents' reports of smoking and quitting.

A follow-up of smoking behaviour to age 18 in a longitudinal study of a birth cohort enabled an assessment of the prevalence of smoking and quitting among adolescents approaching adulthood. There was a dramatic increase in number of daily smokers (15% at age 15 years to 31% at age 18 years), and in a climate of expected decreases in smoking, a history of never smoking to age 15 years was not as protective against future smoking as anticipated. Among 15-year-olds who had experimented with smoking, only 11% per year stopped by age 18 years. Cessation rates for adolescent daily smokers were low (3% had not smoked in the last year at age 18 years), and previously have not been widely reported. We also examined some methodological issues related to self-reported prevalence rates, in particular reliability, validity and sources of bias, finding confirmation of the accuracy of information from prospective longitudinal studies and supporting the conclusion that adolescents' recall for information beyond a 1-year period is inconsistent.

Adolescent↗

Antecedents of vulnerability and resilience to smoking among adolescents.

PURPOSE: Studies of adolescent smoking have concentrated on factors that are associated with smoking (vulnerability), but have tended not to examine whether these factors also describe adolescents who have been at risk of becoming smokers but have not succumbed, for example, to the social pressure of having friends who smoke (resilience). METHODS: Results from a longitudinal study were used to examine the predictors of resilience to social influence from among a selected group of factors associated with adolescent smoking. RESULTS: Among these with no recent history of smoking, the predictor variables for vulnerability and resilience were different across age. However, for adolescents who had a recent history of smoking there were no predictors of continued smoking or of stopping, apart from whether or not a friend smoked. CONCLUSIONS: Resilience factors against smoking show the characteristics of those who have successfully resisted the social influence to smoke. Identification of further predictors of resilience would help in the development of intervention programs and should include a reexamination of factors not usually correlated with smoking status.

Adolescent↗

Reviewing the needs of unemployed youth in smoking intervention programmes.

In Australia, the impact of unemployment on adolescent smoking behaviour continues to present a major public health problem. Traditional prevention programmes in both primary and secondary schools appear to be achieving a delay in the onset of smoking. However, smoking rates of young people who are unemployed are unacceptably higher than those of in-school youth. This paper provides a review of the published literature, showing that there has been little effort to address smoking patterns or experiences of quitting for this target group. While the provision of employment opportunities or skill training for this group is important, these strategies will not eliminate the problem of smoking. Steps must be taken to encourage research into the development of tailored programmes for unemployed youth who smoke. These programmes must be carefully considered and evaluated and meet the needs of this diverse group of young people.

Journal Article↗

Stability in the structure of health locus of control among adolescents.

The Multidimensional Health Locus of Control (MHLC) scales have been widely used as a measure of health beliefs in adult populations. In a longitudinal study of an adolescent cohort, we examined some of the properties of the MHLC; whether there are changes in the locus of beliefs between the ages of 13 and 15 years; and the extent of gender differences at the two ages. The results provided some degree of support for the previously proposed structure of the MHLC, but showed correlations among the subscales that were higher than might be expected, and lower alpha reliability coefficients than have been reported for adult samples. There was also evidence of downward changes in scores for the 'chance' and 'powerful others' scales, as well as differences in the factor structures of females and males at age 15 years. In contrast to the structure of health beliefs found with some adult samples, 'chance' is a prominent, independent dimension of beliefs about control of health among adolescents. The independence of the 'internal control' and 'powerful others' scales seem to be a function of both age and gender. As health behaviours are multidetermined, it is concluded that the MHLC measure would be useful as part of an index of health status.

Adolescent↗

Disability in late adolescence. I: Introduction, methods, and overview.

The research sought to describe the nature and severity of disability and its impact in a large sample of 18-year-olds. It was conducted as part of a larger longitudinal study of the health and development of a cohort of approximately 1000 children. This paper presents an overview of the methods used together with the results on the prevalence of specific disabilities. The three leading disabilities were: coping with dust, pollens, or chemicals (rate: 272 per 1000), equipment dependence (186), and disability in endurance (160).

Adolescent↗

Disability in late adolescence. III: Utilization of health services.

Adolescent health service usage is a neglected research area. Data are important for planning of services and for prioritizing needs. A sample of 871 18-year-olds was surveyed about its use of health services in the preceding year. A significant proportion had made a consultation and were mostly satisfied with the service received. For a subsample of that cohort, who had a difficulty in their daily living, only a third had consulted a health professional for that difficulty over the past year. Help-seeking was related to the severity of that difficulty, particularly for the limitations that it imposed on everyday life. Some dissatisfactions with consultations were expressed in relation to expectations of the efficacy of treatment and to the communication of the health professionals.

Adolescent↗

Patient reports of health education activities in a public hospital.

Hospitals have been greatly underutilised as settings for health promotion activities in Australia. Most research on this subject has been derived from hospital administrators or clinicians. An exit survey of inpatients (n = 460) of a large regional public hospital in Queensland was conducted to examine reported levels of health education in relation to cancer prevention and control. Patients indicated considerable receptivity to a range of secondary prevention activities in the hospital setting, indicating the potential for an increased contribution to the national health agenda by many hospitals.

Age Distribution↗

Smoking in pregnancy and child development to age 9 years.

This study examined the association between women's retrospective reports of smoking during pregnancy and subsequent language, cognitive, behavioural and physical development in their children up to age 9 years. While there was a strong association between maternal smoking and an index of disadvantageous child rearing, maternal smoking was not associated with more general family disadvantage. After controlling for levels of background disadvantage, no relationship was found between reports of smoking and language, cognitive or physical development. However, smoking was related to maternal reports of behaviour problems at age of school entry. Possible explanations for this relationship are discussed.

Adolescent↗

Skin cancer prevention: a link between primary prevention and early detection?

The aim of this paper was to determine if there is any link between primary prevention and early detection for skin cancer. Results from a study of a large random sample of Gold Coast residents (N = 995) identified an association (P < 0.01) between individual primary prevention and early detection activities. People were also more likely to use both prevention methods if they had personal experience with skin cancer (P = 0.01) or if they were male (P = 0.05). Future primary prevention and early detection skin cancer programs might be most effective if they are combined.

Adolescent↗

Enhancing the early detection of melanoma within current guidelines.

Queensland has the highest reported incidence of malignant melanoma in the world, and early detection offers the possibility of reducing the burden of this cancer in the short term. We report on a survey of 995 residents of the Gold Coast, Queensland, regarding behavioural aspects of the early detection of skin cancer. Survey results suggest that although many people report some form of skin examination behaviour, by either checking their own skin, having another nonmedical person check their skin, or by going to their general practitioner for a skin check, much of this activity may be inadequate. They indicate that current early detection could be enhanced by encouraging individuals and general practitioners to extend the coverage of the examinations they already conduct.

Adolescent↗

Sociodemographic characteristics of adolescent smokers.

In this study we examined the interdependence of a broad range of sociodemographic characteristics in a large sample of 15-year-old smokers and nonsmokers. The most prominent risk factors for smoking included the father figure not being the natural father, low family SES, and the young person having a recent part-time job. In particular, the number of adverse sociodemographic conditions present was associated with an increased likelihood of daily smoking at ages 15 and 18. It is estimated that over a 1-year period the cost of cigarettes consumed by 15-year-olds alone is NZ$4.6 million. Use of sociodemographic characteristics to target adolescents at risk of becoming smokers is discussed.

Adolescent↗

Allergic disorders and attention deficit disorder in children.

It has been suggested that children with attention deficit disorder-hyperactivity (ADDH) are likely to show allergic disorders, and that both ADDH and allergic disorders may share a common biological background. In a large sample of children from the general population we found no association between parent, teacher, and self-reports of ADDH behaviors and a history of allergic disorders (asthma, eczema, rhinitis, and urticaria) at ages 9 or 13 years. Similarly, reports of ADDH behaviors at age 13 years were not related to level of atopic responsiveness by skin test or serum IgE levels. Our findings call into question the hypothesis that there is a relationship between ADDH and allergic disorder.

Adolescent↗

Helping agency contact for emotional problems in childhood and early adolescence and the risk of later disorder.

Despite waning enthusiasm for labelling theories in the development of psychopathology, it has been claimed that contact with professional agencies in childhood can be associated with increased levels of later problem behaviour. In this study, help-seeking by parents for children with behaviour problems was examined using a birth cohort followed longitudinally to age 15 years. No evidence was found to support the hypothesis that agency contact increased the risk of later mental health disorder, either in childhood or adolescence. Rather, the results suggested that help-seeking was associated with a reduction in both the risk of DSM-III disorder and problem behaviour scores, up to five years after agency contact.

Adolescent↗

Consistency in children's recall of age of initiating smoking.

Studies of the accuracy of long-term recall for information about smoking status have tended to conclude that this information is consistent and reliable. Estimation of consumption levels have been found to be less reliable and can be influenced by current consumption levels. Results of this longitudinal study indicated that children's and adolescents' 2-year recall of smoking status was inconsistent and that children's reports of age of initiating smoking showed an unacceptably high level of misclassification, particularly if they had not smoked in the last 2 years. Children's and adolescents' 2-year recall for the age at which they first smoked were imprecise and suggested that those who had smoked in the last 2 years retained a perspective as they grew older of having started in the last few years. It is recommended that the period of recall for children and adolescents be restricted to no more than 1 year.

Adolescent↗