Research CMAJ OPENT he consumption of energy drinks, beverages that contain moderate to high concentrations of caffeine as well as taurine, herbal supplements, and sugar or sweeteners, has risen steadily in the last decade, 1 with sales surpassing those of many other nonalcoholic beverages in North America.2,3 These beverages have become particularly popular among youth and young adults owing to their purported stimulant effects and ability to increase alertness and enhance mental and physical energy. 1,[4][5][6][7] Clinical studies have shown that the consumption of energy drinks increases stimulation, attention and memory; decreases reaction times and mental fatigue; and improves performance on some physical activities. [8][9][10] At the same time, these beverages have been associated with negative health effects, including those typically associated with excess caffeine consumption, such as irritability, arrhythmia, nervousness, nausea and seizures. 7,[11][12][13][14][15][16] Despite warnings to the contrary, a popular practice among consumers of energy drinks is to mix them with alcohol. 17,18The combined effects of alcohol mixed with caffeine produce varied results on cognitive and motor performance. Because of increased feelings of alertness produced by caffeine, subjective estimates of alcohol impairment are typically underestimated, and the perceived rewarding aspects of drinking are enhanced. 5,17,[19][20][21] As such, consumption of alcohol mixed with energy drinks has been associated with greater risk-taking, impaired driving, higher volumes of alcohol consumption per sitting, increased injury susceptibility and higher rates of alcohol dependence. 1,16,[22][23][24][25][26][27][28][29] Other health consequences associatedBackground: An emerging body of research has reported high consumption of alcohol mixed with energy drinks among young adults, particularly college students. However, little is known about adolescents' consumption of these drinks. The purpose of this study was to determine the prevalence of consumption of alcohol mixed with energy drinks and to examine its correlates among Canadian high school students. Methods:We used a nationally representative sample of 36 155 Canadian students in grades 7 to 12 who participated in the 2010/2011 Youth Smoking Survey.Results: About 20% of Canadian high school students reported consuming alcohol mixed with energy drinks in the last year, with considerable variation across provinces. Multivariate logistic regression analyses showed that the odds of consumption of these drinks were higher among students in lower grades (grades 7 and 8) and among students who identified their ethnicity as black or "other." Consumption of alcohol mixed with energy drinks was positively associated with substance use (current smoking [adjusted odds ratio (OR) 1.52, 95% confidence interval (CI) 1. , absence from school, participation in school team sports and having more weekly spending money. Students who felt more connected to school and had an academic average of 70% or h...

Objective: Several interrelated factors, including depression, influence adolescents' chances of risky sexual behaviour. We examined the relation between depression and sexual risk-taking behaviours in adolescents after accounting for the effects of other variables. Method:We surveyed male (n = 1120) and female (n = 1177) adolescents at 4 high schools in central Nova Scotia, measuring factors known to be associated with sexual risk taking. Risk of depression was assessed using the Center for Epidemiologic Studies Depression Scale. Outcomes were self-reported sexual behaviours. We used logistic regression to assess associations of multiple factors with sexual risk taking. Results:In univariate analyses, risk of depression was associated with 3 risk-taking behaviours for females (being sexually active, having unplanned sex when using substances, and not using effective contraception at last intercourse) and 2 for males (having unplanned sex when using substances and having more than 1 partner in the previous year). In full multivariate models, risk of depression in females remained significantly associated with unplanned sex and nonuse of effective contraception at last intercourse, but was no longer associated with being sexually active. For males, both associations remained significant. Conclusions:Risk of depression is consistently and independently associated with adolescent sexual risk behaviours after adjusting for other variables. Health care providers working with teenagers should screen for risky sexual behaviours and sexually transmitted infections if depression is apparent in their patients.Can J Psychiatry. 2010;55(9):577-585.Clinical Implications · Risk of depression is independently associated with risky sexual activity in male and female adolescents after adjusting for sociodemographic and behavioural characteristics. · The association between risky sexual activity and risk of depression is not explained by comorbid drug or alcohol use. · Clinicians should assess sexual activity in depressed adolescents. Limitations · We relied on a self-report survey and we cannot establish causality given the cross-sectional design. · The results are from central Nova Scotia, which is essentially rural, and may not be generalizable to major urban centres. · We cannot exclude the effect of other confounders such as conduct disorder, given we have no information on behavioural issues, discipline problems at school or home, or contact with the police.

Objective:To determine whether school connectedness demonstrated an independent protective association with risk of depression in students in grades 10 to 12 attending a high school in a rural community in southwestern Nova Scotia.Methods: Students at a high school in rural Nova Scotia participated in a self-completion survey in May 2009. Students were asked about a wide range of health-related factors to determine their needs for health services and promotion. Examining girls and boys separately, we used logistic regression to examine associations of an established measure of school connectedness with risk of depression as measured by the 12-item Center for Epidemiologic Studies Depression (CES-D) Scale, while including numerous potential confounding variables in our models. Results:The response rate was 95.2% among registered students present in class during the survey. Four hundred eight students (216 girls and 192 boys) completed both the CES-D12 and the School Connectedness Scale. Higher school connectedness was independently protective of risk of depression in girls (OR 0.85; 95% CI 0.78 to 0.93, P < 0.01) and in boys (OR 0.81; 95% CI 0.71 to 0.91, P < 0.01).Conclusions: Among adolescents in rural Nova Scotia, higher school connectedness has protective associations with risk of depression in both girls and boys, independent of a wide range of factors known to be associated with depression in adolescents. School may be a key place for helping adolescents to develop positive mental health. W W WObjectif : Déterminer si le sentiment d'appartenance à l'école a démontré une association protectrice indépendante avec le risque de dépression chez les élèves de la 10e à la 12e année fréquentant une école secondaire dans une communauté rurale du sud-ouest de la Nouvelle-Écosse. Méthodes :Les élèves d'une école secondaire d'un secteur rural de la Nouvelle-Écosse ont participé à un sondage auto-déclaré en mai 2009. Les élèves ont répondu à des questions sur une vaste série de facteurs liés à la santé afin de déterminer leurs besoins en matière de services de santé et de promotion de la santé. Examinant séparément les réponses des filles et des garçons, nous avons utilisé la régression logistique pour examiner les associations d'une mesure établie du sentiment d'appartenance à l'école avec le risque de dépression tel qu'il est mesuré par l'échelle de dépression en 12 items du centre d'études épidémiologiques (CES-D), en incluant dans nos modèles de nombreuses variables potentielles de confusion.

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The presence of a diseased SA artery is significantly associated with AF post-CABG. Such association may be used to identify a subset of patients who might be targeted with prophylaxis.