Introduction: Studies suggest bullying is associated with negative health outcomes such as depression, physical health problems, and substance use. Bullying takes two forms, at school (traditional) and through online platforms (electronic). Literature on American Indians and Alaskan Natives (AIAN) note earlier substance use initiations, yet the association of bullying and substance use has not been explored.Methods: Using pooled 2011-2019 Youth Risk Behavior Surveillance System data, this study assessed the association between bullying (traditional and electronic) and cigarette smoking, alcohol, marijuana, and heavy substances use among AIAN adolescents (N=855). Descriptive statistics were calculated for demographics, bullying, and substances measures. Gender stratified and combined multivariate logistic regression models were conducted and adjusted for sexual minority status, age, and obesity. Results: Respondents were 55.2% male and between ages 15-17 years (74.3%). Among respondents, 23.3% reported experiencing traditional bullying while electronic bullying prevalence was 17.3%. For respondent substances use, 20.5% reported cigarette smoking, 32.5% alcohol use, 34.0% marijuana use, and 10.8% heavy substance use in past 30 days. Electronic bullying exposure was statistically significantly associated with higher odds of alcohol use in the past 30 days compared to those with no electronic bullying (adjusted odds ratio (AOR)=1.65, 95% confidence interval (CI): 1.18—2.31). Among males and females, statistically significantly higher odds of alcohol use when exposed to electronic bullying were observed (AOR=1.70, 95% CI: 1.10—2.72 and AOR=1.69, 95% CI:1.08—2.63, respectively). Conclusion: AIAN adolescents tend to use alcohol when exposed to electronic bullying. This finding suggests the need for strategies to continue to address prevention for substances use and bullying for AIAN adolescents. / Epidemiology

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Given the established link between alcohol consumption and risk taking behavior, it is plausible that neighborhoods with higher density of drinking establishments will be associated with increased prevalence of HIV. We conducted an ecological study comparing neighborhoods in Luderitz, Namibia, to evaluate this relationship. We observed increased prevalence of HIV comparing high densities of registered and unregistered shebeens, bars, and total number of drinking establishments, as compared with low densities, were associated with increased prevalence of HIV (PR=3.02, 95% CI: 2.04-4.47; PR=1.71, 95% CI: 1.42-2.07; PR=1.55, 95% CI: 1.19-2.02). Our observation of increased prevalence associated with higher densities of drinking establishments merits consideration.

Includes abstract. / Includes bibliographical references. / To determine the health-related quality of life (HRQoL) in Macassar residents with persistent lower respiratory symptoms and/or asthma (PLRS and/or asthma), six years after a sulphur stockpile fire disaster.

Bibliography: leaves 53-58. / Railway fatalities are an important subset of transport-related fatalities, which account for about 60% of the fatal unintentional injuries occurring in Cape Town. The Medical Research Council reviewed three and a half years of rail injury data and found that alcohol was one of the main risk factors. Furthermore, 33% of South Africa’s national rail fatalities tested positive for alcohol in 1999. Despite the links between alcohol and all types of transport- related injury, prevention efforts have targeted motor vehicle (MV) drivers exclusively. This study aimed to clarify the relationship between alcohol and the risk of all types of transport-related injury (particularly rail injury). Post mortem reports for transport fatalities were collected retrospectively from the two cape Town mortuaries at Salt River and Tygerberg for the period 1 January 1994 to 31 December 1996. A case control study design was used with the cases comprising rail passenger and rail pedestrian fatalities, while motor vehicle drivers and passengers were the controls for the passenger group and motor vehicle pedestrians were the controls for rail pedestrians. Blood alcohol concentration was the dependent variable, the independent variables were age, sex, race, date of death, day of week, time of injury and mechanism of death and the odds ratio was used as the measure of relative risk The study showed that alcohol consumption is an important risk-factor for rail fatalities. The odds ratios imply that rail passengers are 5.23 or 2.3 times as likely to be intoxicated than motor vehicle passengers or motor vehicle drivers respectively, while rail pedestrians are 1.44 times more likely to be intoxicated than motor vehicle pedestrian fatalities. Alcohol plays as important a role, if not more so, for drunken rail passengers and pedestrians as it does for drunken drivers and road pedestrians. The role of alcohol in rail pedestrian fatalities is significant when compared to motor-vehicle pedestrians as a control group. The study has also demonstrated that data provided by the National injury Mortality Surveillance System can form the basis for analytic studies on the risk-factors of injury. The results complement a growing body of research that documents the adverse health effects of excessive alcohol consumption and provide more evidence for public health campaigners to tackle endemic alcohol abuse in South Africa.

High-income country ROP Screening guidelines are not appropriate for middle-income countries and screening requirements may vary even between units within one city. This study aimed to determine optimal ROP screening criteria, and its workload implications, for Tygerberg Children's Hospital (TCH), South Africa. Methods This cross-sectional study included premature infants screened for ROP, at TCH (1 January 2009 to 31 December 2014). Logistic regression for prediction and classification were performed. Predictors were birth weight (BW) and gestational age (GA). Endpoints were clinically significant ROP (CSROP) and Type 1 ROP (T1ROP).

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Peak bone mass is defined as the highest level of bone mass attained during life through normal growth, and small increases in peak bone mass may prevent osteoporotic fractures later in life. Non-modifiable genetic factors account for as much as 50-70% of the variation in peak bone mass, but to achieve full genetic potential an individual must work to optimize the modifiable environmental and lifestyle factors that also contribute to the variation in peak bone mass. Thus, understanding these modifiable factors affecting peak bone mass is important for osteoporosis prevention. The first paper of this dissertation examines the association between peak bone mass and body composition. Previous studies of this association are based on size-dependent bone mass measures, so the true association between body composition and peak bone mass has remained unclear. In size-adjusted analyses, we found that lean mass was positively associated peak bone mass, while fat mass measures were inversely associated with peak bone mass. This analysis clarifies that lean mass, and not fat mass, is important to peak bone mass in young premenopausal women. Women in this group should maintain a healthy body fat percentage to ensure attainment and maintenance of optimum peak bone mass. The second paper of this dissertation examines the association between overall diet quality and peak bone mass using established indices of diet quality. We found no association between these established diet quality scores and bone mass, suggesting these scores may not be appropriate for use in studies related to bone. Because scores measuring overall diet are important for epidemiologic research, a score specifically tailored to reflect bone-specific dietary components would benefit future research. The third paper of this dissertation evaluates the relative contribution of bone-related clinical and lifestyle factors to peak bone mass. We found that waist circumference explained the most variation in peak bone mass, and that physical activity measures, dietary factors, and age at menarche were also important. These findings inform osteoporosis prevention, and factors identified in this analysis are appropriate for use in a clinical setting as part of a prescreening tool for low peak bone mass.