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Suicidal behavior in "normal" adolescents: risk and protective factors.

Risk and protective factors were examined in suicidal and nonsuicidal public high school students. With life stress and depression as independent risk factors, family cohesion was found to offset the effect of stress, and friendships to have a more indirect effect. Differential effects of ten sources of stress were analyzed from a developmental perspective, and the probability of suicidal behavior associated with clusters of factors was estimated for the general population.

Achievement↗

Factors protecting children living in disharmonious homes: maternal reports.

This study investigated factors which were protective to children living in disharmonious homes. The sample was drawn from a representative sample of children aged 9 to 12 who took part in a previous general population study. Semi-structured interviews with both parents were used to assess the quality of the parental marriage. Mothers provided information on children's emotional and behavioral problems and putative protective factors. Fifty-seven families were in the disharmonious marriage group and 62 were in the harmonious marriage group. Putative protective factors, hypothesized to be beneficial for children, were either an aspect of social support or related to children's activities. Data were analyzed using a two-way analysis of variance with parental marriage and the putative protective factor as main effects. A differentiation was made between protective factors which interacted with parental marriage and those that acted independently. Factors which interacted with the quality of parental marriage were children having a relationship with an adult outside the family, an activity for which they received much positive recognition, and good sibling relationships. The parent-child relationship was associated with children's disturbance in both harmonious and disharmonious homes.

Achievement↗

Protective factors and social risk factors for hospitalization and mortality among young men.

The association between presumed protective factors and social risk factors for hospitalization and mortality was studied during a 14-year follow-up period in a cohort of 8,168 Swedish men aged 18-20 years at baseline. Using Cox regression analysis, the authors found that five protective factors (high social class, home well-being, school well-being, good emotional control, and self-perceived good health) were associated with lower risks of hospitalization and death. Four social risk factors (contact with police or child welfare authorities, running away from home, having divorced parents, and ever using narcotics) were significantly associated with increased risk of hospitalization and mortality. The relative hazard decreased with the number of protective factors and increased with the number of social risk factors, almost linearly. The relative hazard was 0.24 for hospitalization among those with six protective factors and 0.24 for mortality for those with five or six protective factors. The relative hazard for hospitalization was 3.09 among those with five social risk factors compared with those with none, while for mortality the relative hazard among those with four or five social risk factors was 5.74 compared with those with none. While these results indicate strong cumulative effects for both the social risk factors and the protective factors, the associations of individual factors with the two outcome measures were generally reduced in models which simultaneously adjusted for all factors, which presumably indicates collinearity among the factors. There was only limited support for a buffering, or interacting, effect between the risk factors and the protective factors.

Adolescent↗

Workplace protection factors--supplied air hood.

Several organizations list assigned protection factors. For supplied air hoods, the value of the assigned protection factors varies from <10 to 2,000 depending on the organization. Workplace protection factors (WPFs) of a supplied air hood were measured during aircraft sanding and painting operations on several types of aircraft to evaluate whether the American National Standard Z88.2 (1992) assigned protection factor of 1,000 was realistic. The primary contaminant during these activities is strontium chromate. Samples collected inside the hood show that employees during sanding and painting operations were not exposed to strontium. The respirator performed adequately. This study is consistent with other simulated and WPF studies in that the ANSI Z88.2 WPF of 1,000 is supported.

Aircraft↗

Immunosuppression induced by acute solar-simulated ultraviolet exposure in humans: prevention by a sunscreen with a sun protection factor of 15 and high UVA protection.

BACKGROUND: Cutaneous exposure to UVB radiation impairs the induction of contact hypersensitivity (CHS). Variable results have been found among studies examining the use of sunscreens to prevent UV-induced immunosuppression. OBJECTIVE: Our purpose was to determine whether solar-simulated exposure of human skin resulted in an impairment of CHS responses and whether the preapplication of an intermediate sun protection factor (SPF) sunscreen could prevent this locally UV-induced immunosuppression. METHODS: Irritant and CHS responses to dinitrochlorobenzene (DNCB) were randomly assessed in 160 human volunteers with or without UV exposure and with or without prior application of an SPF 15 sunscreen with high UVA protection. DNCB sensitization was performed 3 days after acute UV irradiation corresponding to 3 minimal erythema doses. RESULTS: After solar-simulated UV exposure, the percentage of positive responses to DNCB sensitization dropped from 95% to 50% (p = 0.003). Prior application of the sunscreen formulation did not modify the percentage of positive responses (90%) and maintained the immunization rate at 85% among volunteers exposed to UV. CONCLUSION: A localized sunburn can impair the afferent arm of CHS reactions in humans. The use of intermediate SPF sunscreens with high UVA protection adequately protects from the suppression of CHS responses that occurs after acute solar-simulated UV exposure.

Adult↗

Contraceptive use by Maori youth in New Zealand: associated risk and protective factors.

AIMS: To identify risk and protective factors associated with consistent contraception use by sexually active Maori youth. METHODS: Secondary analysis was undertaken utilising Youth2000, an anonymous nationally representative secondary school health and wellbeing survey, undertaken in 2001. We describe the self-reported sexual health and contraceptive use behaviours of Maori students. A multiple logistic regression model was utilised to identify risk and protective factors associated with consistent contraception use by sexually active Maori students. RESULTS: Half of the Maori students have had sexual intercourse (54% males; 48% females) and a third are currently sexually active (33% males; 34% females). Most Maori youth who have ever had sex use condoms for contraception (82%) and most sexually active Maori youth reported consistent use of contraception (71% males; 70% females). Maori youth who use contraception consistently are more likely to report getting enough time with a parent (OR 1.50; 95% CI 1.05-2.14; p=0.03) and less likely to report weekly marijuana use (OR 0.53; 95% CI 0.37-0.76; p=0.0006). CONCLUSIONS: Consistent use of condoms is a common self-reported contraceptive practice by many young Maori. However this behaviour is not universal, and in view of the significant sexual and reproductive health disparities that exist for Maori youth, sexual and reproductive health programs should examine a broader strategy of promoting protective factors such as strengthening youth-parent relationships and reducing risk factors, such as minimising substance misuse. Together with existing efforts in education, whanau (family), and community based programs, these strategies may support healthier sexual health outcomes for Maori youth.

Adolescent↗

An effective protection factor study of respirators used by primary lead smelter workers.

An industrial hygiene study was conducted at a primary lead smelter to determine the effective protection factors for negative pressure and powered air purifying half-mask respirators. The study involved 99 paired personal samples taken in six different work areas, in which randomly chosen subjects from the workforce wore dual sampling pumps connected to closed-face 37-mm cassettes. The cassettes were attached either to the workers' lapels for exposure measurements outside the respirator or to a ported respirator for exposure measurements inside the respirator. Samples were collected throughout the work shift and analyzed for lead according to National Institute of Occupational Safety and Health (NIOSH) Method 7082. Using particle size distribution data obtained for the same workplaces, the within-mask samples were corrected for sampling bias. The negative pressure half-mask respirators showed a mean effective protection factor of 6.5 and a mean corrected effective protection factor of 4.56, with a 5th percentile less than 0.5. Approximately 80 percent and 90 percent of the effective protection factors and the corrected effective protection factors, respectively, were equal to or less than the assigned protection factor of 10. For the powered air purifying half-mask respirators, the means for effective protection factor and corrected effective protection factor were 18.20 and 11.92, respectively, with a 5th percentile of 1.0 or less. Approximately 90 percent and 95 percent of the effective protection factors and the corrected effective protection factors, respectively, were equal to or less than the assigned protection factor of 50. The uncorrected and corrected within-mask lead concentrations for both types of respirators exceeded the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for lead by 19 percent to 58 percent. These results indicate that the straight application of assigned protection factors to actual workplace situations may not always be appropriate.

Adult↗

Protective factors in adolescent health behavior.

The role of psychosocial protective factors in adolescent health-enhancing behaviors--healthy diet, regular exercise, adequate sleep, good dental hygiene, and seatbelt use--was investigated among 1,493 Hispanic, White, and Black high school students in a large, urban school district. Both proximal (health-related) and distal (conventionality-related) protective factors have significant positive relations with health-enhancing behavior and with the development of health-enhancing behavior. In addition, in cross-sectional analyses, protection was shown to moderate risk. Key proximal protective factors are value on health, perceived effects of health-compromising behavior, and parents who model health behavior. Key distal protective factors are positive orientation to school, friends who model conventional behavior, involvement in prosocial activities, and church attendance. The findings suggest the importance of individual differences on a dimension of conventionality-unconventionality. Strengthening both proximal and distal protective factors may help to promote healthful behaviors in adolescence.

Adolescent↗

Sexual possibility situations and sexual behaviors among young adolescents: the moderating role of protective factors.

PURPOSE: To examine sexual possibility situations (SPS) and protective practices associated with involvement in intimate sexual behaviors and the initiation of sexual intercourse among young adolescents and to determine if protective factors moderate the relationship between SPS and sexual behaviors. METHODS: Data for these analyses were obtained from the baseline assessment for adolescents conducted as part of an HIV prevention study called "Keepin' it R.E.A.L.!" The study was conducted with a community-based organization (CBO) in an urban area serving a predominantly African-American population. In addition to items assessing SPS, intimate sexual behaviors, and initiation of sexual intercourse, adolescents provided information on the following protective factors: educational goals, self-concept, future time perspective, orientation to health, self-efficacy, outcome expectations, parenting, communication, values, and prosocial activities. Background personal information, including age and gender, was also collected. The analyses were conducted on data from 491 predominantly African-American adolescents, 61% of whom were boys. Variables were combined to form SPS and protective indices that were used in the first set of regression analyses. In a second set of analyses, the indices were unbundled and individual variables were entered into regression analyses. RESULTS: Both SPS and protective indices explained significant portions of variance in intimate sexual behaviors, and the SPS index explained a significant portion of variance in the initiation of sexual intercourse. The regression analysis using the unbundled SPS and protective factors revealed the following statistically significant predictors for intimate sexual behaviors: age, gender, time alone with groups of peers, time alone with a member of the opposite sex, behavior self-concept, popularity self-concept, self-efficacy for abstinence, outcome expectations for abstinence, parental control, personal values, and parental values. A similar regression analysis revealed that age, time alone with a member of the opposite sex, and personal values were significant predictors of initiation of sexual intercourse. CONCLUSIONS: These results provide evidence for the important role of protective factors in explaining early involvement in sexual behaviors and show that protective factors extend beyond personal characteristics to include both familial and peer factors.

Adolescent↗

Depressive symptomatology among Hungarian youth: a risk and protective factors approach.

Psychosocial risk and protective factors were examined to assess their influence on depressive symptomatology in a sample of Hungarian youth. Self-esteem and being happy with school were significant protective factors; older girls (ages 16-20) reported the highest depression scores, and these scores varied significantly by self-reported problem behavior. These findings are discussed in the context of their clinical and practical implications for understanding depressive symptomatology in this understudied population of Eastern European youth.

Adolescent↗

A cross-national comparison of risk and protective factors for adolescent substance use: the United States and Australia.

PURPOSE: To compare risk and protective factors that influence youth substance use in Australia and the United States. The two countries have different policy orientations toward substance use: Australia has adopted harm-reduction policies, and the United States has adopted abstinence-focused policies. METHODS: Cross-sectional survey data were collected from independent samples of adolescents in the states of Maine (N = 16,861; 53% female, 7% Non-white) and Oregon (N = 15,542; 51% female, 24% Non-white) in the United States and Victoria in Australia (N = 8442; 54% Female, 11% Non-white) in 1998 (Maine and Oregon) and 1999 (Victoria). Chi-square tests, t-tests, effect size comparisons, and logistic regression analyses that accounted for age and gender were used to investigate cross-national similarities and differences in: (a) rates of cigarette, alcohol, and marijuana use; (b) levels of risk and protective factors; and (c) magnitudes of associations between risk and protective factors and substance use. RESULTS: More adolescents in Victoria reported using cigarettes and alcohol, whereas more of the U.S. adolescents reported using marijuana. Exposure to risk and protective factors was generally similar in the cross-national samples. However, adolescents in Maine and Oregon perceived handguns to be more readily available, reported more participation in religious activities, and were higher in sensation-seeking and social skills; and adolescents in Victoria had more favorable attitudes toward drug use and reported community norms and parental attitudes more favorable to drug use. Most of the risk and protective factors were strongly associated with substance use to a similar degree in Victoria, Maine, and Oregon. However, among adolescents in Maine and Oregon peer/individual risk and protective factors associated with social detachment were more strongly related to substance use, and among adolescents in Victoria, family protective factors were less strongly related to alcohol use. CONCLUSIONS: Inter-country influences on youth substance use are generally similar despite different policy directions. Existing differences suggest that the abstinence policy context is associated with higher levels of illicit drug use and stronger relations between individual indicators of social detachment and substance use, whereas the harm reduction policy context is related to more cigarette and alcohol use, possibly from exposure to normative influences that are more tolerant of youth drug use.

Adolescent↗

Suicidality among gay, lesbian and bisexual youth: the role of protective factors.

PURPOSE: Many reports have indicated that gay, lesbian and bisexual (GLB) youth are particularly vulnerable to poor outcomes, including suicide. Certain protective factors are likely to reduce this risk. The present study examines four protective factors (family connectedness, teacher caring, other adult caring, and school safety) and their association with suicidal ideation and attempts among adolescents with same-gender experience. METHODS: Data come from the 2004 Minnesota Student Survey of 9th and 12th grade students; 21,927 sexually active youth were grouped according to the gender of their sex partner(s) into GLB and non-GLB groups. Four protective factors and suicidal ideation and attempts were compared across groups. Logistic regression was used to examine the influence of protective factors on suicide, and predicted probabilities of suicidal ideation and attempts were estimated using general linear modeling. RESULTS: There were 2,255 respondents who reported same-gender experience. Over half of GLB students had thought about suicide and 37.4% reported a suicide attempt. GLB youth reported significantly lower levels of each protective factor than their non-GLB peers. Family connectedness, adult caring, and school safety were significantly protective against suicidal ideation and attempts. Risk associated with a GLB sexual orientation is largely mediated through protective factors. CONCLUSIONS: Sexual orientation alone accounts for only a small portion of variability in suicidal ideation and attempts. If protective factors were enhanced among GLB youth, suicide in this population is expected to be considerably lower. Protective factors examined here are amenable to change and should be targeted in interventions.

Adolescent↗

High autonomic arousal and electrodermal orienting at age 15 years as protective factors against criminal behavior at age 29 years.

OBJECTIVE: Nothing is known about biological factors that protect a predisposed individual from becoming criminal. This 14-year prospective study tested the hypothesis that antisocial adolescents who desist from crime by age 29 have greater physiological arousal and orienting than antisocial adolescents who become adult criminals. METHOD: Physiological arousal and orienting were measured in 101 unselected 15-year-old male schoolchildren. Of these, 17 antisocial adolescents who desisted from adult crime (desistors) were matched on adolescent antisocial behavior and demographic variables with 17 antisocial adolescents who became criminal by age 29 (criminals), and 17 nonantisocial, noncriminal normal subjects. RESULTS: Desistors had significantly higher electrodermal and cardiovascular arousal and higher electrodermal orienting than the criminal group. CONCLUSIONS: This is the first study to report biological factors that protect against the development of criminal behavior. The findings suggest that individuals predisposed to adult crime by virtue of showing antisocial behavior in adolescence may be protected from committing crime by high levels of autonomic arousal and orienting.

Adolescent↗

A review of assigned protection factors of various types and classes of respiratory protective equipment with reference to their measured breathing resistances.

The British Standards Institution 'Guide to implementing an effective respiratory protective device programme' (BS 4275) lists assigned protection factors (APFs) for various types of respiratory protective equipment (RPE). The APFs were allocated either on the basis of available workplace studies data which met set criteria or on the basis of professional judgement that there is equivalence between its operation and that of a device for which an APF is derived from workplace data. However, in many cases no workplace study information exists to support this professional judgement. As an interim measure, pending information based on workplace measurements, the breathing resistance of a range of tight-fitting RPE from negative pressure filtering devices through to self-contained positive pressure breathing apparatus was measured at various breathing rates. The relative inhalation resistances were then compared on the assumption that similar breathing resistance performance is likely to give similar inward leakage on a facepiece and hence similar protection if all other factors, such as fit, etc., are equal. This work indicates that for most devices the allocation of APFs by analogy to other devices seems to be acceptable. However, there appears to be no justification for the allocation of an APF value of 100 to continuous flow compressed air line breathing apparatus. It is recommended that it should be lowered to 40 until there is valid workplace study data to support the current APF of 100. The work provides an informative insight into the relative performance of devices.

Humans↗

Transition into adolescent problem drinking: the role of psychosocial risk and protective factors.

OBJECTIVE: To establish the role of psychosocial risk and protective factors in cross-sectional variation in adolescent problem drinking, and in the transition into problem drinking over time. METHOD: The data were from a four-wave (1989-1992) longitudinal study of 1,591 adolescents in a large, urban school district. School district officials selected schools for the study with an aim toward maximizing representation of minority students from inner-city areas. At Wave 1, all students in Grades 7, 8, and 9 were asked to participate. RESULTS: Both psychosocial risk factors (such as low expectations for success, peer models for substance use, and poor school performance) and psychosocial protective factors (such as intolerance of deviance, peer models for conventional behavior, and involvement in prosocial activities) account for significant cross-sectional variation in adolescents' involvement in problem drinking, as indicated by more frequent drunkenness and more numerous instances of alcohol-related problems. They also account for significant variation in the timing of transition into problem drinking during adolescence. Higher risk and lower protection are each associated with greater problem use of alcohol. Among adolescents who are not problem drinkers, higher risk and lower protection accelerate the likelihood of becoming a problem drinker in subsequent years. Protection also moderates the impact of risk in the cross-sectional account of involvement in problem drinking, but protective factors appear not to play a moderating role in the longitudinal account of the transition into problem drinking. Findings were similar for males and females and among white, black and Hispanic adolescents. CONCLUSIONS: Protective factors play an independent role in accounting for adolescent involvement in problem drinking and in the transition into problem drinking in adolescence. Intervention efforts to enhance protection, especially for adolescents who are exposed to risk, should supplement efforts to reduce risk.

Achievement↗

Rel/NF-kappaB transcription factors protect against tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)-induced apoptosis by up-regulating the TRAIL decoy receptor DcR1.

Rel/nuclear factor (NF)-kappaB transcription factors play a major role in the regulation of programmed cell death. A few anti-apoptotic Rel/NF-kappaB target genes have been characterized; they act either downstream in the apoptotic pathway or upstream, for example at the tumor necrosis factor (TNF) receptor level. We found using DNA arrays, reverse transcription-polymerase chain reaction, and immunofluorescence that Rel/NF-kappaB factors up-regulate DcR1, a receptor for TNF-related apoptosis-inducing ligand (TRAIL), a cytokine of the TNF family that induces apoptosis in tumor cells. Four related receptors bind TRAIL, two death receptors (DR4 and DR5) that signal apoptosis and two decoy receptors (DcR1 and DcR2) that act as dominant negative inhibitors of TRAIL-mediated apoptosis. DcR1 is devoid of an intracellular domain and is anchored at the cell surface membrane by a glycophospholipid. Our results indicate that overexpression of cRel or activation of endogenous Rel/NF-kappaB factors by TNFalpha in HeLa cells up-regulates DcR1 without changing the expression of DcR2, DR4, and DR5 and makes cells resistant against TRAIL-induced apoptosis. This resistance is a consequence of DcR1 up-regulation, because it was abolished when DcR1 was removed from the cell surface by a phosphatidylinositol phospholipase C. Therefore, Rel/NF-kappaB transcription factors could regulate the sensitivity of cells to TRAIL, by controlling the ratio of TRAIL-decoy to -death receptors.

Apoptosis↗

Platelet-activating factor-acetylhydrolase and other novel risk and protective factors for cardiovascular disease in systemic lupus erythematosus.

OBJECTIVE: There is an important inflammatory component to atherosclerosis and cardiovascular disease (CVD). It is therefore interesting that the risk of CVD is high in inflammatory diseases such as systemic lupus erythematosus (SLE). In this study, we investigated nontraditional risk factors for the development of CVD in patients with SLE. METHODS: Twenty-six women (mean age 52 years) with SLE and a history of CVD were compared with 26 age-matched women with SLE and no clinical manifestations of CVD (SLE controls) and 26 age-matched healthy women (population controls). Serum levels of several novel nontraditional risk and protective factors were determined: heat-shock protein (HSP)-related factors (Hsp60, Hsp70, anti-human Hsp60, anti-human Hsp70, and anti-mycobacterial Hsp65), platelet-activating factor-acetylhydrolase (PAF-AH) activity, secretory phospholipase A(2) GIIA (sPLA(2)), and anti-endothelial cell antibody (AECA). The intima-media thickness and the presence of plaques in the common carotid arteries were determined by B-mode ultrasound as a surrogate measure of atherosclerosis. RESULTS: Levels of PAF-AH, but not HSP-related factors, AECA, or sPLA(2), were significantly increased in SLE cases. Only PAF-AH discriminated between SLE cases and SLE controls (P = 0.005). PAF-AH was significantly associated with low-density lipoprotein (LDL) cholesterol and total cholesterol in the SLE cases (r = 0.50, P = 0.0093 and r = 0.54, P = 0.0045), but not in either control group. CONCLUSION: The increased levels of PAF-AH in SLE cases and the association between PAF-AH and LDL cholesterol adds support to the notion that PAF-AH may promote atherothrombosis in SLE. The role of HSPs in CVD is complex, since anti-Hsp65 appears to be associated with the presence of CVD, whereas Hsp70 might protect against it. In this cross-sectional study, levels of HSP-related factors, AECA, and sPLA(2) were not associated with CVD in SLE.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗