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Perceptions of local HIV/AIDS prevalence and risks for HIV/AIDS and other sexually transmitted infections: preliminary study of intuitive epidemiology.

BACKGROUND: Risk perceptions are theoretically important in predicting health behavior but have only shown modest evidence in predicting sexual risk behavior. PURPOSE: Our purpose is to investigate whether perceptions of the local prevalence of disease serve as a predictor of health behavior, particularly behaviors associated with infectious diseases such as HIV/AIDS. METHODS: Four hundred eighty-seven men and 236 women receiving diagnostic and treatment services at a sexually transmitted infections (STI) clinic in a moderate-size U.S. city completed anonymous surveys of perceived prevalence of HIV/AIDS and other STI and sexual risk and protective behaviors. RESULTS: Participants who estimated a lower AIDS burden in their city relative to other U.S. cities demonstrated greater numbers of sex partners, higher rates of sexual risk practices, and higher rates of STI. They were also less likely to have been tested for HIV. CONCLUSIONS: This initial study of intuitive epidemiology suggests that STI clinic patients may have a sense for the relative burden of AIDS in their city and estimates of local disease prevalence may predict sexual risk behaviors.

Acquired Immunodeficiency Syndrome↗

Anonymous HIV surveillance with risk-factor elicitation: at Perth (for men) and Cornton Vale (for women) prisons in Scotland.

434 male and 145 female prisoners were available to participate in cross-sectional, voluntary anonymous HIV surveillance (using saliva samples) with linked self-completion questionnaire at HMP (Her Majesty's Prison) Perth on 17 May and at HMP Cornton Vale on 18 May 1995. Three hundred and four men (70%) and 136 women (94%) completed a risk-factor questionnaire and 304 and 135 samples were received for HIV antibody testing. Two hundred and eighty-two and 132 questionnaires passed logical checks. Six saliva samples from Perth (all injectors) out of 304 and none from Cornton Vale out of 134 tested were HIV antibody positive. Four were presumptively from known HIV-infected male inmates; the other 2 were local men, under 26 years, who began injecting in 1989-91, and both reported having had a recent HIV test. Overall HIV prevalence was estimated at 2% compared to a known prevalence of 1.4% (6/434), giving a 1.5 ratio of overall: disclosed HIV prevalence at HMP Perth. HIV prevalence was estimated at 7% (6/82) for injector-participants and 14% (5/35) for local injector participants. At Cornton Vale, where both known HIV-infected inmates abstained, overall and disclosed HIV prevalence, were equal at 1.4%. At Perth Prison, 29% of prisoners had injected drugs (82/278); 85% of injector-inmates reported having injected inside (some prison and 31% (25/80) had started to inject while inside, 7 during their present sentence. Of all 21 injector-inmates who first injected after 1991, 10 had started to inject inside, including one of 69 male inmates who had never been inside before. The corresponding figures for Cornton Vale, where 46% of inmates were injectors (58/132), were that 57% of injector-inmates had injected inside (32/56) but only one woman, for whom this was not her first sentence, had started to inject inside. Twenty-eight per cent of male prisoners (78/277) and 57% of male injector-inmates (47/82) had had a personal HIV test since January 1993, as had 35% of female prisoners (43/124) and 57% of female injector-inmates (30/53). A much higher proportion of Glasgow's female prisoners (64%: 38/60) were injectors than of women prisoners from the Edinburgh, Dundee and Fife area (21%: 5/26) or from elsewhere (34%: 15/45). Rape was reported by 23% of women (30/130). Women who had been raped had a more polarized distribution of male sexual partners (none to 2 plus) in the year before sentencing than other women and were more likely to report anal sex (11/30 vs 11/100, P < 0.001). Prostitution had been engaged in by 19% of female injector-inmates (11/57) and was acknowledged by one other woman. However, only 5% of women (6/130) reported ever having been treated for an STD.

Adult↗

Parietal lobe abnormalities detected with MR in patients with infantile autism.

OBJECTIVE: Infantile autism is a neurologic disorder that severely disrupts the development of many higher cognitive functions. The most consistent abnormal neuroanatomic findings in autism are loss of Purkinje neurons in the posterior cerebellum as detected by autopsy studies and hypoplasia of the posterior cerebellar vermis and hemispheres as detected by in vivo neuroimaging. Evidence of developmental arrest has also been detected in limbic structures in autopsy studies of autistic patients with mental retardation. Neither in vivo neuroimaging nor autopsy studies of autistic persons have reported abnormalities in the cerebrum. Because the cerebrum mediates many higher cognitive functions, such as social communication, language, abstract reasoning, planning, and organization, that are known to be deficient in patients with autism, a closer examination of the neuroanatomy of the cerebrum in infantile autism is warranted. MATERIALS AND METHODS: MR images of 21 healthy autistic patients (6-32 years old) were mixed with MR images of control subjects and reviewed on four separate occasions by a neuroradiologist for any neuroanatomic abnormalities. Autism was diagnosed on the basis of criteria for autism as defined by the Diagnostic and Statistical Manual of Mental Disorders, and the autistic patients did not have any other concurrent neurologic disorders. To control for systematic bias in judging the type and location of abnormalities in the autistic population, three control groups were used: a normal control group of 12 subjects, a control group of 23 nonautistic patients with a variety of brain abnormalities for the first review, and another control group of 17 nonautistic patients for the second review. Control patients with brain abnormalities were selected from patients' files on the basis of MR findings of a variety of brain abnormalities. All MR images were coded for anonymity, randomly mixed, and examined by a neuroradiologist blinded to the purpose of the study and to the group membership of each subject. All normal and abnormal findings seen on the MR images of each subject were described on a standard form listing all major brain structures to ensure an examination of each structure in turn. To test for reliability, three subsequent reviews were performed by the same neuroradiologist. RESULTS: Parietal lobes were abnormal in appearance in 43% (9/21) of autistic patients. Cortical volume loss in the parietal lobes was seen in seven autistic patients; in four of these cases, cortical volume loss extended either into the adjacent superior frontal or occipital lobe. Additional abnormalities detected with MR in these nine patients included white matter volume loss in the parietal lobes (three patients) and thinning of the corpus callosum, especially along the posterior body (two patients). Abnormalities were bilateral. The mesial, lateral, and orbital regions of the frontal lobes; temporal lobes; limbic structures; basal ganglia; diencephalon; and brainstem were normal in all autistic patients. No abnormalities were found in the 12 normal control subjects. The control subjects with neurologic abnormalities had various abnormal findings consistent with their medical conditions. CONCLUSION: Our results indicate that the parietal lobes are reduced in volume in a portion of the autistic population. Possible origins for this localized cerebral abnormality include early-onset altered development and late-onset progressive atrophy.

Adolescent↗

[The evaluation of smoking and alcohol consumption by university students in Gdańsk].

Anonymous questionnaire examination were performed among 1585 students from eight universities in Gdańsk, including 664 men and 921 women from 17 to 48 (mean 21.4 +/- 2.26) years old. Alcohol was consumed by 1452 (91.61%) students, including 91.53% women and 91.72% men. Both men and women preferred beer, respectively, 73.7% and 50.6%. In three-stage AUDIT-test (alcohol drinking dangerous to health) including 716 (45.2%) students, most of them in stage A (81.6%); in stage B about 8.2% comprised while there were about 10.2% in stage C students. Alcohol consumption carried the lowest risk (stage A) among students of Medical University while corresponding risk was the highest among students of Maritime High School. Among respondents drinking alcohol dangerously to health there were significantly more persons who did drugs (73.7%). Students qualified to the AUDIT test smoked cigarettes significantly more often than the rest of the examined population. Smokers amounted to 399 (25.2%) students, including 224 (26.3%) women and 157 (23.6%) men. The difference in figures was statistically non-significant. Among smoking respondents the students of Fine Arts Academy constituted the majority, while those of Medical University and of University School of Physical Education were in minority. Catholic Priest Seminary respondents did not have the relevant experiences.

Adolescent↗

What are additives?

Historical development of the concern exercised by the public institutions of a country for the food taken by their citizens, through care for its safety and proper testing by authorized governmental institutions, is presented. In the USA, FDA was established for this purpose, whereas European Union agencies are in charge in Europe. Additives are listed and classified according to E-number groups introduced in the European Union in 1990. Difference between the additives and supplements is explained. Special reference is given to an anonymous leaflet that appeared in Zagreb in the autumn 2000, in which some additives were described as harmful, detrimental, carcinogenic and highly hazardous, providing no valid arguments for such a statement. The author considers it merely an unargumented propaganda attack on particular European food manufactures.

European Union↗

Health status and risk behavior of adolescents in the north of Madrid, Spain.

PURPOSE: To study the health status and risk behavior in an adolescent population of Madrid, Spain. METHODS: An anonymous self-administered questionnaire was completed by 2831 pupils aged 14-20 years from urban, suburban, and rural populations in the north of Madrid. A large number of questions were from the Minnesota Adolescent Health Survey questionnaire, which included sociodemographics, health status, drug use, sexual practices, suicidal thoughts, emotional problems, and injury risk. Student's t-test, analysis of variance, and Chi-square statistics are used for analyzing associations between the different variables. RESULTS: A majority (80%) of students thought they are in good or very good health (better for males than females); 18.3% had had intercourse, the average age of the first intercourse was 15.4 years +/- 1.68 SD for males and 16.1 years +/- 1.46 SD for females. Most (73%) had used some kind of contraception. Eighty-five percent had tried alcohol, and regular use (frequently or every day) was as high as 24%. Males drank more than females (28% vs. 20%); 58.2% of the population drink only during weekends, the percentage increasing with age. Seventy percent of the sample had smoked at least once; 34. 5% reported regular tobacco use and this increased with age. Males smoked less than females (27% vs. 42%); 3.2% smoked more than 20 cigarettes/day. The consumption of illegal drugs was very low (20% had tasted cannabis and use by males was higher). Cocaine, heroin, etc. were used by less than 5%. CONCLUSION: In general, our adolescents are in good health with most problems being preventable. Sexual activity was lower than in other European and American countries. The consumption of tobacco and alcohol started early and in general was high. Our study confirms the relationship among different health-compromising behaviors. There is a need to implement health promotion and preventive programs for adolescents.

Adolescent↗

Characterization of the major susceptibility region for psoriasis at chromosome 6p21.3.

Psoriasis is a common inflammatory skin condition caused by genetic and environmental factors. Recent genome-wide linkage analyses have identified a locus encoding susceptibility to psoriasis and placed this gene in the 12 cM interval between markers D6S426 and D6S276 on chromosome 6p21.3. This is a broad region and encompasses the human major histocompatibility complex. We have sought to localize the susceptibility gene more precisely by exploiting the linkage, haplotype, and linkage disequilibrium information available through genotyping 118 affected sib pairs, their parents and other affected family members. A total of 14 highly polymorphic markers were genotyped, combining anonymous loci with the class I genes HLA-B and -C distributed across a genetic interval of approximately 14 cM including the entire major histocompatibility complex. Through the application of higher density mapping within the major histocompatibility complex, we identified those regions most commonly shared identical by descent in patients with psoriasis. Using the transmission-disequilibrium test, we found significant evidence of linkage and allelic association across an interval defined by the markers tn62 (p = 1.0 x 10(-7)), HLA-B (p = 4.0 x 10(-7)), and HLA-C (p = 2.7 x 10(-9)), a region encompassed within a 285 kb genomic DNA fragment. Hence these studies contribute to the refinement of the localization of a major psoriasis susceptibility gene and place the critical region near to HLA-C.

Adolescent↗

Audit of the management of early syphilis at North Manchester General Hospital.

The city of Manchester has seen a sustained increase in reported cases of early (infectious) syphilis since the late 1990s. We audited the management of patients presenting with early syphilis to North Manchester General Hospital, with reference to the UK national guidelines. Between January 1999 and December 2001 72 cases of early syphilis were identified. Most (90%) occurred in men who have sex with men, 50% of whom were HIV-positive. Serology and polymerase chain reaction testing of lesions were useful diagnostic tests. Treatment regimens followed the national guidelines in 63% of cases, with adherence to the guidelines improving as the outbreak continued. The majority of patients were treated with intramuscular penicillin (78%), with only three discontinuing this treatment due to side effects. Only 4% of sexual contacts identified were traced and screened, an indication of high levels of both anonymous sex and partner change in this group.

Administration, Oral↗

Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders.

BACKGROUND: Changing immigration trends pose new challenges for the UK's open access health service and there is considerable speculation that migrants from resource-poor countries place a disproportionate burden on services. Data are needed to inform provision of services to migrant groups and to ensure their access to appropriate health care. We compared sociodemographic characteristics and impact of migrant groups and UK-born patients presenting to a hospital A&E/Walk-In Centre and prior use of community-based General Practitioner (GP) services. METHODS: We administered an anonymous questionnaire survey of all presenting patients at an A&E/Walk-In Centre at an inner-city London hospital during a 1 month period. Questions related to nationality, immigration status, time in the UK, registration and use of GP services. We compared differences between groups using two-way tables by Chi-Square and Fisher's exact test. We used logistic regression modelling to quantify associations of explanatory variables and outcomes. RESULTS: 1611 of 3262 patients completed the survey (response rate 49.4%). 720 (44.7%) were overseas born, representing 87 nationalities, of whom 532 (73.9%) were new migrants to the UK (< or =10 years). Overseas born were over-represented in comparison to local estimates (44.7% vs 33.6%; p < 0.001; proportional difference 0.111 [95% CI 0.087-0.136]). Dominant immigration status' were: work permit (24.4%), EU citizens (21.5%), with only 21 (1.3%) political asylum seekers/refugees. 178 (11%) reported nationalities from refugee-generating countries (RGCs), eg, Somalia, who were less likely to speak English. Compared with RGCs, and after adjusting for age and sex, the Australians, New Zealanders, and South Africans (ANS group; OR 0.28 [95% CI 0.11 to 0.71]; p = 0.008) and the Other Migrant (OM) group comprising mainly Europeans (0.13 [0.06 to 0.30]; p = 0.000) were less likely to have GP registration and to have made prior contact with GPs, yet this did not affect mode of access to hospital services across groups nor delay access to care. CONCLUSION: Recently arrived migrants are a diverse and substantial group, of whom migrants from refugee-generating countries and asylum seekers comprise only a minority group. Service reorganisation to ensure improved access to community-based GPs and delivery of more appropriate care may lessen their impact on acute services.

Adolescent↗

Reliable test for prenatal prediction of fetal RhD type using maternal plasma from RhD negative women.

OBJECTIVES: The objective of this study was to establish a reliable test for prenatal prediction of fetal RhD type using maternal plasma from RhD negative women. This test is needed for future prenatal Rh prophylaxis. METHODS: A novel real-time PCR-based assay targeting RHD exon 7 combined with a published assay for RHD exon 10 were used to determine the fetal RHD status in DNA extracted from plasma, sampled from 56 pregnant RhD negative women in 15th-36th week of gestation. Thirty-eight samples were from ongoing pregnancies of Danish women and 21 samples from 18 pregnant women were stored anonymized samples from the International Blood Group Reference Laboratory, Bristol, United Kingdom. Prediction of fetal RhD type was compared with the serological result obtained after birth. RESULTS: The prediction of the fetal RhD type was in 100% concordance with the serological RhD type from the 16th week of gestation. One sample from the 15th week of gestation was inconclusive. The number of copies of fetal RHD DNA was found to increase with gestational age. Low levels of DNA were found to follow the Poisson distribution (p = 1.0000). CONCLUSION: Our set-up was very reliable for determination of fetal RhD genotype, and thus will be of value in prenatal Rh prophylaxis and in the management of immunized women.

DNA↗

The simulated tutorial. Method for assessing medical school applicants.

The simulated tutorial is a method for selecting medical students by their performance in a small problem-solving group, currently being tested at McMaster University. Four hundred and thirty-two applicants were randomly allocated to groups consisting of 5 or 6 members, assigned a group leader, and asked to work through two unstructured problem situations in a 50-minute session. Assessors, seated behind a one-way mirror, evaluated applicants according to their abilities to relate to their peers, to function in the group, and to define issues in the problem situations. Feedback from the assessors and applicants suggests that the simulated tutorial is potentially useful as a selection tool. All assessors thought they were able to evaluate the 5 or 6 applicants in the group in the time provided. Nearly 80% of the applicants who anonymously returned questionnaires felt they were able to express themselves during their simulated tutorial. The data also suggest that applicants with experience in small groups and applicants previously rated as having outstanding 'personal qualities' are given higher ratings than other applicants. A validation study of the simulated tutorial, comparing individual's scores with evaluations of performance in tutorial groups in the undergraduate M.D. programme, is currently in progress.

Age Factors↗

gm: a practical tool for automating DNA sequence analysis.

The gm (gene modeler) program automates the identification of candidate genes in anonymous, genomic DNA sequence data. gm accepts sequence data, organism-specific consensus matrices and codon asymmetry tables, and a set of parameters as input; it returns a set of models describing the structures of candidate genes in the sequence and a corresponding set of predicted amino acid sequences as output, gm is implemented in C, and has been tested on Sun, VAX, Sequent, MIPS and Cray computers. It is capable of analyzing sequences of several kilobases containing multi-exon genes in less than 1 min execution time on a Sun 4/60.

Algorithms↗

Symptoms and findings related to HIV in women in rural Gutu District, Zimbabwe, 1992 to 1993.

OBJECTIVE: To relate self-reported morbidity and clinical findings to HIV-status in rural women in Zimbabwe. DESIGN: A cross sectional study. SETTING: 12 randomly selected villages in rural Gutu District, Zimbabwe. SUBJECTS: In 1992 to 1993 all women of fertile age (15 to 44 years) in the selected villages were interviewed and examined (n = 1,213). Retrospectively, HIV status was assessed anonymously from frozen blood samples. MAIN OUTCOME MEASURES: Self-reported morbidity, body mass index (BMI), arm circumference, palpable lymphnodes, prevalence of syphilis, haemoglobin, HIV status. RESULTS: Overall HIV prevalence was 22%. Mean haemoglobin (Hb) was significantly lower (p < 0.005) and anaemia was significantly more common (p < 0.001) among HIV positive women. Syphilis prevalence was 2.2%, a positive syphilis test increased the risk of being HIV positive three-fold. Persistent cough was significantly more common in HIV positives (OR = 3.0, 95% CI 1.4-6.2). Palpable lymphnodes was the most common clinical finding and generalised lymph adenopathy had a positive predictive value of 67% for HIV. Self-reported morbidity was low and no increased pregnancy loss was reported related to HIV. CONCLUSION: The low morbidity found in 1992 to 1993, in spite of the high prevalence, indicates a fairly short duration of the HIV infection and would also have contributed to the late awareness of the problem.

Adolescent↗

Psychosocial predictors of "safer sex" behaviors in young adults.

This study tested a model of safer sex behavior using variables from social learning theory, the health belief model, the theory of reasoned action, and theories of cognitive coping style. Two types of safer sex behavior were measured: frequency of condom use and the discussion of AIDS and past partners with a sexual partner. The participants--275 undergraduate students--completed an anonymous written questionnaire. The variables (behavioral intention, perceived susceptibility, barriers, self-efficacy, monitoring, blunting, and social support) predicted 35% of the variance in condom use and 13% of the variance in discussion (adjusted R2s). Intention was the strongest predictor of both types of safer sex behavior. Perceived susceptibility and perceived barriers were associated with intention to use a condom; perceived barriers was inversely related to condom use. Self-efficacy was associated with the intention to discuss and reported discussion of AIDS and past partners with a sexual partner; social support was related to the intention to discuss. An information-avoiding coping style was negatively associated with condom use. Implications for future research and intervention efforts in the area of AIDS prevention are discussed.

Adaptation, Psychological↗

HIV seroprevalence surveys of childbearing women--objectives, methods, and uses of the data.

A seroprevalence survey of human immunodeficiency virus (HIV) among childbearing women is being conducted in 43 States and Territories as one of the family of HIV seroprevalence surveys. This blinded survey, in which serologic test results are not linked to identifiable persons, uses neonatal dried blood specimens on filter paper to test for maternal antibodies to HIV. This survey provides relatively unbiased estimates of prevalence of HIV infection in the population of women delivering live children during given survey periods, by month or quarter of delivery, geographic area, and demographic subgroup. This objective will be met while protecting the integrity and efficient conduct of neonatal screening programs and ensuring patient anonymity. Information from this survey will be used to (a) assess the levels and trends of HIV infection in women and infants, (b) help develop and evaluate prevention programs, and (c) project the number of women and children who will develop HIV infection and the acquired immunodeficiency syndrome (AIDS) and will require health care and social services in the future.

Acquired Immunodeficiency Syndrome↗

[Acquired immune deficiency syndrome in the region of Zurich. Report on 12 cases].

Observations of 12 patients with AIDS at this institution from March 1981 to April 1984 are reported. Ten patients were homosexuals and two were bisexual. The majority had travelled abroad (USA, Haiti) and reported multiple anonymous sexual contracts. Eleven patients reported symptoms and signs, of 2-12 months' duration, frequently seen in pre-AIDS: fatigue (10), weight loss (10), diarrhea (7), night sweats (5), fever (4), and generalized lymphadenopathy (1). Laboratory studies showed anemia (10), lymphopenia (9), leukopenia (7), decreased T-helper/T-suppressor ratio (10) and cutaneous anergy to multiple skin-test antigens (9). P. carinii pneumonia was diagnosed in three patients, P. carinii pneumonia and Kaposi's sarcoma in one patient and Kaposi's sarcoma in six patients. Another patient had a chronic mucocutaneous infection with herpes simplex and another an intestinal cryptosporidiosis and Kaposi's sarcoma. Alpha-A-interferon was used to treat patients with Kaposi's sarcoma and three patients with limited disease showed a favorable response. Six patients with advanced disease died.

Acquired Immunodeficiency Syndrome↗

A high-resolution whole genome radiation hybrid map of human chromosome 17q22-q25.3 across the genes for GH and TK.

We have constructed a whole genome radiation hybrid (WG-RH) map across a region of human chromosome 17q, from growth hormone (GH) to thymidine kinase (TK). A panel of 128 WG-RH hybrid cell lines generated by X-irradiation and fusion has been tested for the retention of 39 sequence-tagged site (STS) markers by the polymerase chain reaction. This genome mapping technique has allowed the integration of existing VNTR and microsatellite markers with additional new markers and existing STS markers previously mapped to this region by other means. The WG-RH map includes eight expressed sequence tag (EST) and three anonymous markers developed for this study, together with 23 anonymous microsatellites and five existing ESTs. Analysis of these data resulted in a high-density comprehensive map across this region of the genome. A subset of these markers has been used to produce a framework map consisting of 20 loci ordered with odds greater than 1000:1. The markers are of sufficient density to build a YAC contig across this region based on marker content. We have developed sequence tags for both ends of a 2.1-Mb YAC and mapped these using the WG-RH panel, allowing a direct comparison of cRay6000 to physical distance.

Animals↗

[Alcohol consumption among students of a health area. Habits and beliefs].

OBJECTIVES: 1. To describe the habits and conduct of school students (13-17 years old) around alcohol in the Cartagena Health Area. 2. To discover the factors underlying consumption. 3. To analyse beliefs and behaviour about consumption. DESIGN: Cross-sectional descriptive study. SETTING: Health area. PARTICIPANTS: 16,657 school students. Sample population (n = 1004). Large-group sampling (sampling unit: class-room), accuracy = 3%, CI = 95%, p = q = 50%, stratified by school and geographical area. MEASUREMENTS AND MAIN RESULTS: Anonymous, self-filled questionnaire (33 open and closed questions). SELECTION CRITERIA: attendance at class on the day of the questionnaire. VARIABLES: social, economic and cultural data on parents and students, course, type of family, alcohol consumption (starting age, access, individual habits, friends and family), beliefs about consumption, study profile of consumer. STATISTICAL ANALYSIS: description of variables, chi-squared test, t test, logistical regression. 99.2% filled in the questionnaire. Students' average age was 15.84 (SD, 1.21). 89.96% lived with their parents. 83.4% had consumed alcohol on some occasion, with no relationship to current consumption (p > 0.05). Starting age was 13.77 (SD, 1.78), 48.5% in discos/bars and 19% at home (p > 0.05). 47.5% had got drunk on some occasion (p > 0.05). 88.2% customarily drank alcohol mixed with other drinks (p > 0.05). 51.8% drank at week-ends (2.4% every day) (p > 0.05). 63.3% thought it easy to acquire drinks: 48.9% in supermarkets, 26.4% at petrol stations (p = 0.038). 71% of consumers agreed that "alcohol is a drug" (p = 0.005). 13% believed "it does not cause dependency" (p = 0.00001). 23.3% thought that it is not true to say "the person who does sport is healthier and does not take alcohol". CONCLUSIONS: The pattern of consumption is similar to that found in other autonomous communities, although in greater quantity and without differences in kind. Mean age of consumer: 15 years old. They usually drink alcohol mixed with other soft drinks, normally at week-ends. They are very ignorant of the effects of consumption.

Adolescent↗