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Background: This study examined the associations of Internet and computer screen time with school difficulties and the role of sleep quality and soft and energy drinks consumption.Methods: We used data from the cross-sectional Health Behaviour in School-aged Children study collected in 2014 among Slovak adolescents (aged 11.0-15.9 years, N = 7595, 48.1% boys). We examined the inter-relations between time spent with on digital devices (time spent playing digital games or Internet use), sleeping quality (sleeping shortage, sleeping difficulties), soft/energy drinks consumption and school problems (low academic achievement, disliking school, being pressured by schoolwork and truancy), using structural equation modeling.Results: Results showed that the more time adolescents spent on digital devices during leisure time, the more school problems they had. This association was mediated by a higher consumption of soft or energy drinks and a lower quality of sleeping. The direct effect of time spent on digital devices on school problems and its indirect effect via sleeping quality were relatively small (-0.26 and -0.30, respectively, standardized solution), compared with the indirect effect of time spent on digital devices via soft/energy drinks consumption as well as sleeping quality (0.65, standardized solution).Conclusions: Time spent on digital devices is associated with school problems, with sleeping and soft/energy drinks consumption playing a substantial role in this association.

BACKGROUND: Little is known about factors associated with mental health problems (MHP) of the elderly in socioeconomically deprived neighbourhoods, and comparisons between Central European and Western European countries on this topic are lacking. We examined whether MHP occurred more frequently in deprived neighbourhoods and among deprived people. Next, we examined whether the association of MHP with area deprivation differed by country and whether this could be explained by the socioeconomic (SE) characteristics of the residents.METHODS: We obtained data on non-institutionalized residents aged 65 years and above from the EU-FP7: EURO-URHIS 2 project from Slovak (N = 665, response rate 44.0%) and Dutch cities (N = 795, response rate 50.2%). An elevated score on General Health Questionnaire-12 (≥2) indicated MHP. Education and household income with financial strain were used as measures of individual SE status. We employed multilevel logistic regression.RESULTS: Overall rates of MHP were significantly higher in Slovakia (40.6%) than in the Netherlands (30.6%). The neighbourhood unemployment rate was not associated with the mental health of elderly in either country. Rates of MHP were significantly higher among elderly with low and medium income [odds ratio (OR) = 1.75, 95% confidence interval (CI) = 1.16-2.62; OR = 1.64, 95% CI = 1.12-2.41, respectively] and financial strain (OR = 2.26, 95% CI = 1.56-3.28) when compared with those with high income and no strain, respectively. Individual-level SE characteristics explained differences between the two countries.CONCLUSION: The risk of MHP among the elderly is associated with their individual-level SE position but not with neighbourhood deprivation in both Slovakia and the Netherlands.

BACKGROUND: Ethnicity is associated with differences in clinical course and outcomes of cardiac disease, often in association with a poorer socioeconomic position. The aim of this study was to compare the mortality after coronary angiography (CAG) of Roma and non-Roma patients matched for education and adjusted for gender and age.METHODS: In total, 816 patients were included in the study (167 Roma and 649 non-Roma). Data on socio-demographic background, disease history, use of drugs, coronary findings and type of treatment were obtained from medical records. Mortality was assessed up to seven years after CAG. Kaplan-Meier curves of mortality were plotted, and differences between the Roma and non-Roma patients were assessed using log-rank tests, matched for education and adjusted for gender and age.RESULTS: Mortality after CAG was significantly higher among Roma than non-Roma (log-rank test χ(2) = 7.59, P < 0.01) and remained so after matching for education and adjustment for gender, age, history of previous myocardial infarction and abnormal CAG (hazard ratio: 2.07, 95% confidence interval: 1.13-3.82).CONCLUSION: Mortality after CAG is higher among Roma, and this is not due to differences in age, gender or education. These results warrant further reconsideration of the management of Roma cardiac patients.

BACKGROUND: Reports from schools indicate that adolescents with learning disabilities (LD) frequently show risk-taking behaviour (RTB), but evidence is lacking. The aim of the study was to assess the associations between LD status and RTBs among Slovak adolescents and to explore whether family affluence and family composition have a moderating or mediating role in these associations.METHODS: Data from the Slovak national HBSC study 2014 were analyzed. The sample comprised 1549 15-year-old adolescents (mean age: 15.4; 52.5% boys). RTBs were defined as early sexual experience, truancy, fighting, bullying, early smoking initiation and drunkenness. The associations between LD status and RTBs were assessed using binary logistic regression; the mediating as well as moderating role of family affluence and family composition was explored as well.RESULTS: Adolescents with LD are two times more likely to be engaged in early sexual experiences (OR 2.39; 95% CI 1.45-3.95), fighting (OR 1.72; 95% CI 1.01-2.95) and bullying (OR 2.08; 95% CI 1.26-3.44), but not in early smoking initiation, drunkenness or truancy. Family affluence and family composition did not moderate or mediate these associations.CONCLUSIONS: Adolescents with LD are at high risk of early sexual experiences, fighting and bullying but not of smoking initiation, drunkenness or truancy. Non-intact and poor families do not increase the risks associated with LD status of adolescents; however, in these families adolescents with LD are more prevalent.

Background: Previous studies indicate that self-esteem is lower among adolescents of low socio-economic status and is associated with a number of intrapersonal, interpersonal and socio-cultural factors. Evidence on the mechanisms by which these factors contribute to the connection between socio-economic status and developing self-esteem is incomplete, however. The purpose of this cross-sectional study is to assess whether personality, mental health and social support contribute to the relationship between socio-economic status and self-esteem. Methods: A sample of 3694 elementary-school students from Slovakia (mean age = 14.3 years, 49% boys) filled out the Rosenberg Self-esteem Scale, the Family Affluence Scale, the Ten-Item Personality Inventory, the 12-item General Health Questionnaire and the Perceived Social Support Scale. Results: Hierarchical linear regression showed family affluence, personality dimensions of extroversion, emotional stability and openness to experience, as well as mental health subscales and social support from family and significant others to be associated with self-esteem. Results indicate that personality dimensions and mental health subscales contribute to the association between family affluence and self-esteem. Conclusion: The contribution of personality and mental problems in the relation between socio-economic status and self-esteem may have important implications for the design of promotional programs aimed at enhancing self-esteem.