The adverse effects of maternal and paternal smoking on child health have been studied. However, few studies demonstrate the interaction effects of maternal/paternal smoking, and birth outcomes other than birth weight have not been evaluated. The present study examined individual effects of maternal/paternal smoking and their interactions on birth outcomes. A follow-up hospital-based study from pregnancy to delivery was conducted from 1997 to 2010 with parents and newborn infants who delivered at a large hospital in Hamamatsu, Japan. The relationships between smoking and growth were evaluated with logistic regression. The individual effects of maternal smoking are related to low birth weight (LBW), short birth length and small head circumference. The individual effects of paternal smoking are related to short birth length and small head circumference. In the adjusted model, both parents’ smoking showed clear associations with LBW (odds ratio [OR] = 1.64, 95% confidence interval [CI] 1.18–2.27) and short birth length (−1 standard deviation [SD] OR = 1.38, 95% CI 1.07–1.79; −2 SD OR = 2.75, 95% CI 1.84–4.10). Maternal smoking was significantly associated with birth weight and length, but paternal smoking was not. However, if both parents smoked, the risk of shorter birth length increased.

People with severe mental illness (SMI) have considerable unmet physical health needs and an increased risk of early mortality. This cross-sectional survey utilized the Physical Health Attitude Scale (PHASe) to examine the attitudes, practices, and training needs of nurses towards physical health care of people with SMI in three Asian countries (Hong Kong, Japan, Qatar). Cross-country differences were explored and linear regression was used to investigate if nurses’ attitudes and confidence were associated with their level of involvement in physical health care. A total of 481 questionnaires were returned. Hong Kong nurses were less involved in physical health care than those from Japan and Qatar. Nurses’ attitudes and confidence were significant predictors of their participation in managing physical health. Compared with western countries, more nurses in this study felt that mental illness was a barrier to improving physical health. Three-quarters reported that they needed additional training in promoting cardiometabolic health. The perceived need for additional training in physical health care was held by Mental Health Nurses (MHN) irrespective of their type of nursing registration and nationality. Nurse educators and service providers should reconsider the physical health care training requirements of nurses working in mental health settings in order to improve the physical health of people with SMI.

Background: Suicide is the third leading cause of death in adolescents worldwide, self-esteem is a strong protective factor, and parents may be able to provide interventions. This cross-sectional study aimed to determine how parents can help enhance their adolescent’s self-esteem and prevent suicidal behavior among adolescents in Nepal. Methods: Self-administered questionnaires were distributed to adolescents aged 13–19 years and their parents at eight high schools in three provinces in Nepal (n = 575 pairs). The data were analyzed using descriptive and inferential statistics (bivariate and multivariate regression analyses). Results: The mean self-esteem score of adolescents according to the Rosenberg Self-Esteem Scale was 16.59, and the prevalence of suicidal behavior was 11.3%. Parent’s knowledge about the development of self-esteem in adolescents was significantly positively related to parenting practice (communication, support, positive reinforcement, etc.) (B = 1.0, 95% confidence interval, CI 0.89–1.11) and authoritative parenting style (B = 0.2, 95% CI 0.15–0.25). Parental authoritativeness was positively associated with the self-esteem of their adolescents (B = 0.1, 95% CI 0.01–0.18), while adolescents with authoritarian parents were prone to suicidal risk behavior (adjusted odds ratio, AOR = 1.1, 95% CI 1.0–1.19). Conclusion: Counseling to parents based on our findings would be helpful to enhance the self-esteem and prevent suicidal risk behavior in their adolescent children.

Adolescence is not only characterized by a period of exploration and experimentation but also by vulnerability to risk-behaviors (substance-use, suicidal behavior, and sexual behavior) that can have many negative consequences. Given the lack of studies in Nepal and the variable results from international studies on the association of self-esteem, perceived social support (PSS), and social capital (SC) with risk behaviors, this study aimed to assess the role of these factors by specifying different sources of PSS (family, friends, and others) and SC (family, school, and neighbors), and controlling for demographic, socioeconomic-status (SES), family, and school related factors. A total of 943 adolescents (grades 9-11) in 8 schools from 3 provinces in Nepal participated in the study, and were selected by multi-stage, cluster, random sampling. Data were collected through a self-administered questionnaire (response rate; 91.9%). Multivariate logistic regression analysis (<0.05 significance) revealed that family SC (OR = 0.83) and PSS from family (OR = 0.95) were negatively associated with substance-use. Self-esteem (OR = 0.90), family and school SC (OR = 0.80 and 0.91, respectively), and PSS from family and friends (OR = 0.95 and 0.96, respectively) were protective against suicidal risk. None of the independent variables showed a preventive association with sexual behavior, but self-esteem was positively associated (OR = 1.11). Therefore, to improve the likelihood of adolescents becoming healthy adults, family and school level interventions to enhance self-esteem, PSS, and SC are helpful in protecting them against substance use and suicidal behavior. On the other hand, adolescents with high self-esteem are at greater risk for inappropriate sexual behavior and should therefore be monitored.

Inoue S, et al. J Korean Med Sci. 2016 Mar;31(3):353-359. http://dx.doi.org/10.3346/jkms.2016.31.3.353