Scandinavian Journal of Public Health最新文献

Aims: The existing literature lacks sufficient evidence concerning the role of personality traits in oral behaviour and their effects on oral health status (dental plaque, and dental caries) and dental visits. The aim of this study was to investigate the association between personality traits and oral health behaviour (OHB) in the adult Finnish population.

Methods: This study utilised data collected from the Northern Finland Birth Cohort 1986 individuals who participated in all the follow-ups (n = 1807). Data were collected during pregnancy and later during follow-ups conducted at 1 year, 7-8 years, 15-16 years and 33-35 years using questionnaires and clinical examinations. Oral health status and number of dental visits collected in the last follow-up were considered as dependent variables. The explanatory variables included personality traits, educational background, employment, annual income, and lifestyle choices. A recursive bivariate probit model was used to model oral health status (dental plaque, and dental caries) while considering dental care utilisation.

Results: Personality traits were associated with OHB (accumulation of dental plaque and regular dental visits). Individuals with a high degree of openness had a 13% lower probability of having teeth with dental caries. Similarly, highly neurotic individuals had a 5% lower probability of having teeth with visible dental plaque and also had a higher probability of dental visiting.

Conclusions: Personality traits are associated with OHB among young adults Finns. Policies aimed at improving dental health education and mitigating common risk factors are essential to promote oral health.

Aim: Systematic reviewing is a time-consuming process that can be aided by artificial intelligence (AI). There are several AI options to assist with title/abstract screening, however options for full text screening are limited. The objective of this study was to evaluate the performance of a custom generative pretrained transformer (cGPT) for full text screening.

Methods: A cGPT powered by OpenAI's ChatGPT4o was tested with subsets of articles assessed in duplicate by human reviewers. Outputs from the testing subset were coded to simulate cGPT as an autonomous and an assistant reviewer. Cohen's kappa was used to assess interrater agreement.

Results: For the inclusion/exclusion decision, the human-human kappa scores ranged from 0.87 to 0.96, exceeding the ranges of kappa scores for autonomous cGPT-human pairings (0.59 to 0.67) and assistant cGPT-human pairings (0.62 to 0.72). For exclusion reason classification, the human-human kappa scores ranged from 0.71 to 0.78, exceeding the ranges of kappa scores for autonomous cGPT-human pairings (0.47 to 0.53) and assistant cGPT-human pairings (0.52 to 0.63).

Conclusions: The assistant cGPT outperformed the autonomous cGPT. An assistant cGPT could speed up systematic reviewing in a sufficiently reliable manner, however, further research is needed to establish standardized thresholds for practical use. Improved speed of systematic reviewing has implications for directing timely public health policy decisions.

Aims: Overdose deaths have been increasing in parts of Europe, including Norway, where opioid analgesics have been the leading cause since 2016. This study quantifies the risk of overdose death following exposure to dispensed opioid analgesics, stratified by sex and age, and examines associated causes of death.

Methods: Nationwide data from 2010 to 2018 on overdose deaths were obtained from the Norwegian Cause of Death Registry and linked with the Norwegian Prescription Database to identify prior opioid analgesic dispensations. Aggregated prescription data and population figures from Statistics Norway were also used.

Results: From 2010 to 2018, 42% of individuals who died from an overdose had been dispensed opioid analgesics in the previous year. Among those dispensed strong opioid analgesics, the overdose death rate was low but exceeded the population death rate among men aged 20-49 and women aged 20-39 years. The rate was higher in men and remained stable over time. Opioids other than heroin or methadone were listed as the cause of death in 62% of cases with prior dispensed opioid analgesics, compared with 24% among those without.

Conclusions: The risk of overdose deaths following exposure to strong opioid analgesics was low but higher than population death rates for men under 50 and women under 40 years. Preventive strategies based on risk markers such as sex, age and opioid analgesic strengths, combined with other known risk markers, can help guide safer prescription of opioid analgesics and reduce overdose death.

Aim: To identify effective interventions designed to improve work ability and reduce early exit from the labor market of midlife and older workers.

Method: Searches were conducted in PubMed, Cochrane Library, Scopus, Web of Science, and PsycInfo up to February 17, 2025, focusing on studies aimed at improving work ability and associated conditions (work productivity, work engagement, job performance, and work capacity) and reducing early exit from the labor market among participants aged ⩾40 years. Two reviewers evaluated the quality of studies. The effectiveness of interventions was evaluated using meta-analysis and, when not feasible, qualitative synthesis.

Results: Of 17,505 publications, 41 studies were included, comprising 14 randomized controlled trials (RCTs, n = 4123) and 27 non-randomized studies (n = 4,616,452). Meta-analysis of RCTs showed that aerobic or strengthening exercises modestly improved work ability (pooled standardized mean difference 0.26, 95% CI 0.08-0.44). Qualitative synthesis indicated cognitive behavioral therapy (CBT) reduced productivity loss in workers with chronic health conditions. A meta-analysis of non-randomized studies showed policy reforms raising the eligible retirement age increased employment by 12 percentage points (pps) (95% CI 7-17) and decreased retirement by 29 pps (95% CI 8-50), but increased disability benefits by 6 pps (95% CI 1-11), unemployment by 7 pps (95% CI 2-12), and economic inactivity by 6 pps (95% CI 5-8). Policy reforms tightening unemployment benefit requirements increased employment and reduced unemployment, but increased disability benefits.

Conclusions: Exercise improved work ability and CBT reduced productivity loss. Regulatory actions on retirement age and unemployment benefits were associated with higher work participation.

Aims: To explore the components that influence health and wellbeing of gender minority forced migrants residing in Sweden.

Methods: Qualitative exploratory study based on semi-structured interviews with gender minority forced migrants recruited through a combination of convenience, purposeful and snowball sampling. Guided by the levels in the social ecological model, transcripts were analysed with systematic text condensation in a collaborative process between experts by lived experience, researchers and clinical psychologist.

Results: Participants expressed resilience and hope about their future. Loneliness was a major issue contributing to health burdens and peer support was highly appreciated. Barriers hindering access to health services and judgemental behaviours among health professionals were described. Affirming support through empathy, trust, safety, confidentiality, continuity and respect was highlighted as essential in health services. While societal openness and safety for gender minority individuals was appreciated, participants faced an uncertain asylum process and unmet basic needs.

Conclusions: Gender minority forced migrants show resilience and appreciate the newfound societal safety. However, they find themselves in the margins of society and encounter various multi-layered challenges. Loneliness is a public health concern that could be addressed through peer support, which is highly desired and valued. Ensuring access to affirming health services should be a prioritized area for researchers, professionals, stakeholders and policy-makers.

Aims: Hip fracture burden is expected to increase due to the ageing population. Given that hip fracture incidence differs by educational attainment, and that a shift in the older population's educational level will manifest itself in coming decades, we investigated future hip fracture trends in Norway and their variation by attained educational level.

Methods: Estimated annual hip fracture numbers in the population aged 50+ years in 2020-2050 were based on information from the Norwegian Epidemiologic Osteoporosis Studies hip fracture database and official population projections from Statistics Norway. Projected educational attainment was obtained from the Wittgenstein Centre for Demography and Global Human Capital. We explored two scenarios: first, assuming that the observed 2019 rates remain constant until 2050, and second, assuming a continuing rate of decline corresponding to that observed during 1999-2019.

Results: The projections showed that the annual number of hip fractures will increase by 91% in women and 131% in men given constant sex- and age-specific rates, and by 27% in women and 66% in men given declining rates. The majority of hip fractures are expected in the group with secondary education, however, the numbers will increase steeply in people with tertiary education due to the temporal shift in educational attainment.

Conclusions: The annual number of hip fractures may double by 2050, placing high demands on the healthcare services. The majority of hip fractures are projected to occur in people with secondary and tertiary education. It is vital to intensify preventive efforts, not least in the high-risk populations.

Aim: To examine trends in the treatment and rehabilitation of depression prior to disability pension application due to depression.

Methods: This retrospective register-based study included 30,105 applicants for disability pension due to depression, and it is based on data from the Social Insurance Institution of Finland (Kela). The trends in antidepressant purchases and rehabilitation measures during the year preceding the application were analysed for 2010-2019 using linear regression analysis, with analysis of covariance to assess the interactions of age- and sex-based population groups with these trends.

Results: A stable proportion of approximately 1 in 10 (9.2%-12.2%) applicants had had neither antidepressant purchases nor psychotherapy in the preceding year, with no statistically significant trend (p < 0.05). The proportion of applicants with a history of antidepressant use decreased slightly from 90.3% to 87.5%. However, the proportion of applicants with a history of psychotherapy or both psychotherapy and antidepressants doubled over the same period (from 6.1% to 13.5% and from 5.6% to 11.7%, respectively). Annually, estimated average antidepressant use declined by 0.25 percentage points, psychotherapy increased by 0.90 percentage points, and combined treatment increased by 0.75 percentage points, all statistically significant. A statistically significant interaction in psychotherapy trends was observed in population groups based on sex and age. The highest proportion of applicants receiving psychotherapy was among females under the age of 40.

Conclusions: The proportion of applicants for disability pension due to depression receiving psychotherapy has increased over time. However, most applicants, particularly older males, continue to receive only antidepressants and no rehabilitation.

Aims: To investigate the potential lead time bias of the evaluation model (extended follow-up for women diagnosed with breast cancer) used to evaluate mammography screening in a recent Danish study. This model was compared with two traditional models.

Methods: We retrieved data on women diagnosed with breast cancer in each county of Norway from 1986 to 2016. In a population-based open cohort study, the change in incidence-based mortality (IBM) was estimated by relative rate ratios comparing a screening period with a historical period for each of three age groups: women eligible for screening and younger and older ineligible women. We applied the evaluation model, and for comparison two traditional IBM models from a recent Norwegian study: one without extended follow-up and no possibility of lead time bias and one with extended follow-up irrespective of diagnosis, possibly diluting any screening effect.

Results: The evaluation model estimated an extra 11% reduction in breast cancer mortality among the screening eligible relative to ineligible women. However, this result could largely be ascribed to lead time bias inflated by overdiagnosis and a decreasing mortality from other causes among eligible women. A reduction in breast cancer mortality was observed for both eligible and younger and older ineligible women across models, and relative rate ratios close to 1 were obtained using the two traditional IBM models, indicating no effect of screening on breast cancer mortality.

Conclusions: Two models without lead time bias found no reduction in breast cancer mortality, whereas the evaluation model estimated a reduction attributable to lead time bias.

Background: The aim of this study was to investigate overall vitamin D status in the Faroese population and assess the correlation between vitamin D levels and various sociodemographic and anthropometric factors, including sex, age, exercise, alcohol and tobacco consumption, BMI, body fat percentage, and seasonal variations. To the best of our knowledge, this is the first study of vitamin D levels across all adult age groups within the Faroese population.

Methods: P25-hydroxyvitamin D concentrations, anthropometric measurements and questionnaires from 1748 individuals enrolled in the FarGen 2 cohort were collected. Statistical analyses were performed to characterise the distribution and correlates of vitamin D concentration in the population.

Results: We observed a high sufficiency of vitamin D in the FarGen cohort, with 74.3% of the cohort having P-25-hydroxyvitamin D levels exceeding the recommended concentration of 50 nmol/l, and only 3.3% having a vitamin D deficiency (<25 nmol/l). The deficiency was mostly observed in younger age groups. Our results indicated significant seasonal fluctuations in vitamin D levels, as well as significant correlations between vitamin D levels, age, sex, BMI, and physical activity.

Conclusions: Although the study suggests previous interventions have had a positive impact on vitamin D levels among the elderly, our findings emphasise the importance of enhancing awareness about vitamin D supplementation, promoting physical activity and encouraging consumption of vitamin D-rich foods. Such approaches could significantly advance public health initiatives related to vitamin D and general health within the Faroese population.

Aims: To study the importance of decreasing tobacco smoking on the occurrence of larynx cancer in men and women.

Methods: The incidence rates of larynx cancer in the Swedish population between 1970 and 2021 were retrieved from the Swedish Cancer Register for ages 50-84 years, stratified for sex, age and calendar year. Data on the population's smoking habits was retrieved from surveys and from taxation on the sale of cigarettes. The occurrence of larynx cancer was compared to smoking habits, sex and age. The time trends were compared between larynx and lung cancer.

Results: Over the years, Swedish men and women have had different smoking habits, especially older persons during the 1970s. In 1963, the prevalence of current smokers in women 50-69 years was 11%, while it was 46% in men. Around 2020, less than 10% of men and women in all age groups were current smokers. However, men had higher incidence rates of larynx cancer than women, even when their smoking habits were similar. For example, men and women 60-64 years of age in 2017-2021 had similar smoking habits during their life but the relative risk of larynx cancer in men compared to women was 3.3 (95% CI 1.7-4.8). However, pipe smoking was much more common in men.

Conclusions: The study indicates that other causes than cigarette smoking have an impact on the occurrence of larynx cancer in Sweden. Pipe smoking and occupational exposure to carcinogenic materials such as asbestos may be underlying causes of the difference in cancer risk between Swedish men and women.