No abstract

ObjectiveOur knowledge on the adverse correlates of traumatic brain injuries (TBI), including non-hospitalized cases, among adolescents is limited to case studies. We report lifetime TBI and adverse mental health and conduct behaviours associated with TBI among adolescents from a population-based sample in Ontario.Method and FindingsData were derived from 4,685 surveys administered to adolescents in grades 7 through 12 as part of the 2011 population-based cross-sectional Ontario Student Drug Use and Health Survey (OSDUHS). Lifetime TBI was defined as head injury that resulted in being unconscious for at least 5 minutes or being retained in the hospital for at least one night, and was reported by 19.5% (95%CI:17.3,21.9) of students. When holding constant sex, grade, and complex sample design, students with TBI had significantly greater odds of reporting elevated psychological distress (AOR = 1.52), attempting suicide (AOR = 3.39), seeking counselling through a crisis help-line (AOR = 2.10), and being prescribed medication for anxiety, depression, or both (AOR = 2.45). Moreover, students with TBI had higher odds of being victimized through bullying at school (AOR = 1.70), being cyber-bullied (AOR = 2.05), and being threatened with a weapon at school (AOR = 2.90), compared with students who did not report TBI. Students with TBI also had higher odds of victimizing others and engaging in numerous violent as well as nonviolent conduct behaviours.ConclusionsSignificant associations between TBI and adverse internalizing and externalizing behaviours were found in this large population-based study of adolescents. Those who reported lifetime TBI were at a high risk for experiencing mental and physical health harms in the past year than peers who never had a head injury. Primary physicians should be vigilant and screen for potential mental heath and behavioural harms in adolescent patients with TBI. Efforts to prevent TBI during adolescence and intervene at an early stage may reduce injuries and comorbid problems in this age group.

BackgroundTraumatic brain injury (TBI) survivors often report difficulties with understanding and producing paralinguistic cues, as well as understanding and producing basic communication tasks. However, a large range of communicative deficits in this population cannot be adequately explained by linguistic impairment. The review examines prosodic processing performance post-TBI, its relationship with injury severity, brain injury localization, recovery and co-occurring psychiatric or mental health issues post-TBIMethodsA systematic review using several databases including MEDLINE, EMBASE, Cochrane, LLBA (Linguistics and Language Behaviour Abstract) and Web of Science (January 1980 to May 2015), as well as a manual search of the cited references of the selected articles and the search cited features of PubMed was performed. The search was limited to comparative analyses between individuals who had a TBI and non-injured individuals (control). The review included studies assessing prosodic processing outcomes after TBI has been formally diagnosed. Articles that measured communication disorders, prosodic impairments, aphasia, and recognition of various aspects of prosody were included. Methods of summary included study characteristics, sample characteristics, demographics, auditory processing task, age at injury, brain localization of the injury, time elapsed since TBI, reports between TBI and mental health, socialization and employment difficulties. There were no limitations to the population size, age or gender. Results were reported according to the PRISMA guidelines. Two raters evaluated the quality of the articles in the search, extracted data using data abstraction forms and assessed the external and internal validity of the studies included using STROBE criteria. Agreement between the two raters was very high (Cohen’s kappa = .89, P < 0.001). Results are reported according to the PRISMA guidelines.ResultsA systematic review of 5212 records between 1980 and 2015 revealed 206 potentially eligible studies and 8 case-control studies (3 perspective and 5 retrospective) met inclusion and exclusion criteria for content and quality. Performance on prosodic processing tasks was found to be impaired among all participants with a history of TBI (ages ranged from 8 to 70 years old), compared to those with no history of TBI, in all eight studies examined. Compared with controls, individuals with a history of TBI had statistically significantly slower reaction time in identifying emotions from prosody and impaired processing of prosodic information that is muffled, non-sense, competing, or in conflict (prosody versus semantics). Heterogeneous findings on correlations between specific brain locations and prosodic processing impairment were reported. Psychiatric issues, employment status or social integration post-TBI were scarcely reported but, when reported, they co-occurred with a history of TBI and prosodic impairments.ConclusionsThe current review confirms the relationship between impaired prosodic processing and history...

There are strong and demographically stable associations between TBI and substance use. These associations may not only increase the odds of injury but impair the quality of postinjury recovery.

This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8% of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. The association between these problems suggests that these problems could be addressed in a unified manner.

, a 16% increase over the previous year. 2 Caffeine is the primary active ingredient in energy drinks, but the level of caffeine content varies widely across the many brands sold. 1,3 The caffeine content per 250 mL of an energy drink is usually 80-140 mg or the equivalent of two cans of cola or a 6-oz to 8-oz cup of coffee. [3][4][5] There are, however, energy drinks with caffeine content of up to 500 mg per can. 3,4 Additional ingredients include amino acid, vitamins, herbs, and other supplements purported to boost energy, alertness, and mental performance. 6 The short-and long-term health effects of many of these ingredients, and energy drink consumption in general, are for the most part unknown. 1,[7][8][9] Energy drinks are often aggressively marketed to adolescents through carefully crafted campaigns, including sponsorship of events that appeal to this age group (e.g., snowboarding), and product placement in video games and social media. 4,10,11 Easy access from a convenience store, appealing names (e.g., Red Bull®, Rockstar®, Full Throttle®), product claims of greater stamina, alertness and energy, 12 and perceptions of energy drinks as a "legal drug", 13 make these drinks particularly appealing to adolescents. Reports indicate that the main consumers of energy drinks are adolescents and young adults, 6,7 with between 30% and 50% of adolescents and young adults consuming energy drinks. 7,11 Yet, there is relatively little empirical data on the health and behavioural effects of energy drinks. There is research indicating that energy drink consumption helps to improve attention, maintain or improve performance on some difficult activities, and decrease reaction times. 14,15 There is also evidence of adverse consequences such as seizures, difficulty sleeping, cardiac arrhythmia, and even death. 1,6,7 In the US, there was a twofold increase in the number of visits to emergency departments between 2007 (10,068 visits) and 2011 (20,783 visits) that involved energy drinks, with 12-17 year olds accounting for 11.4% and 7.2% of those visits in 2007 and 2011, respectively. 16 In addition to questions about the health effects of energy drinks, there are questions about the demographic, social, and behavioural correlates of energy drink consumption among adolescents. The sparse research that has been conducted suggests that the consumption of energy drinks is correlated with heavy alcohol use, licit and illicit drug use, impulsivity, and risk-taking behaviours, including fighting and risky sexual behaviours. 7,10,[17][18][19] ABSTRACT OBJECTIVE: To examine energy drink consumption and its association with demographic characteristics, drug use, and injury among adolescents. METHODS:Data on 4,342 adolescents were derived from the 2011 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12. The survey was based on a two-stage cluster design and analyses include appropriate adjustments for the complex sample design. RESULTS:Overall, 49.6% of adolescents had ...

Objective: Prostate cancer (PCa) is the most prevalent form of cancer among men and has one of the most favorable survival rates among all cancers. Here we examine the association between depression and anxiety symptoms in a population-based sample of men.

This study describes the prevalence of reported history of traumatic brain injury (TBI) and its association with reports of current substance use, cigarette smoking, and psychological distress among Canadian adults in a population sample. A cross-sectional sample of 1999 Ontario adults 18-93 years of age were surveyed by telephone in 2011 as part of the Center for Addiction and Mental Health's ongoing representative survey of adult mental health and substance use in Ontario, Canada. Loss of consciousness for at least 5 min or at least one overnight hospitalization resulting from symptoms associated with the TBI injury represented minimum criteria for TBI. An estimated 16.8% (95% confidence interval, 14.8, 19.0) of adults reported a TBI in their lifetime. Men had higher prevalence of TBI than women. Adults who reported a history of TBI had higher odds of reported past-year daily smoking (adjusted odds ratio [AOR] = 2.15), using cannabis (AOR = 2.80) and nonmedical opioids (AOR = 2.90), as well as screened significantly for recent elevated psychological distress (AOR = 1.97) in the past few weeks, compared to adults without a history of TBI. Co-occurrence of a history of TBI with current elevated psychological distress and substance use warrants vigilance among medical practitioners to assess the possibility of a history of TBI during reviews of the history leading to the occurrence of these conditions.