Scandinavian Journal of Public Health最新文献

Aims: To determine the quality of prospectively collected data from the highly specialized Danish Cerebral Palsy Follow-up Program (CPOP), and to establish the validity of a reported cerebral palsy (CP) diagnosis in the Danish National Patient Registry (NPR), regularly used as a proxy for neurodevelopmental disorders in epidemiological research.

Methods: We compared data from the two registries on children with registered CP, born in Denmark between 2008 and 2009, with information from medical records verified by two experienced physicians specializing in pediatric neurology. Data accuracy was estimated by completeness, correctness, and reliability. Completeness was calculated as the number of cases with correctly registered CP diagnoses divided by the total number of true CP diagnoses (similar to sensitivity). Correctness was calculated as the number of cases with correct registrations divided by the total number of cases (similar to positive predictive value). Reliability was estimated using kappa statistics.

Results: Registered CP diagnoses in the CPOP had high accuracy, with 94% correctness and 91% completeness. Furthermore, most key variables in the CPOP showed excellent reliability, especially variables defining the severity of the condition. In the Danish NPR, only 225 of 348 children with a noted CP diagnosis fulfilled the diagnostic criteria for CP, resulting in 65% correctness.

Conclusions: Danish CPOP data are a valid source for epidemiological research. Conversely, a noted CP diagnosis in the Danish NPR was, at best, correct in only two out of three patients.

Aim: The aim was to identify maternal and paternal socioeconomic and demographic characteristics for non-initiation and non-completion of the human papillomavirus (HPV) vaccination among Danish girls including time-trends.

Methods: This nationwide register-based cohort study included all girls residing in Denmark who were offered free-of-charge HPV vaccination as a part of the childhood vaccination program between 2009 and 2018 (birth cohorts 1996-2005). The study samples included 296,461 daughter-mother dyads and 291,025 daughter-father dyads. Data from the Danish Vaccination Register were linked with socioeconomic and demographic data from Statistics Denmark. HPV vaccination status was classified as 'non-initiation' for girls who received no HPV vaccine and as 'non-completion' for girls who initiated the HPV vaccination program but did not receive all the scheduled HPV vaccines. Data were analyzed using logistic regression models.

Results: Non-initiation of HPV vaccination was 13.7%, and non-completion was 24.2% among girls who initiated the HPV vaccination program. Girls of parents who were descendants of immigrants (adjusted odds ratio: 1.50; 95% confidence interval: 1.35-1.68), were at least 35-years old at time of birth, had basic or no education, had a low income, were not in the labor market, and were unmarried had the highest non-initiation and non-completion odds. The associations between socioeconomic and demographic characteristics and HPV vaccination uptake were similar for mothers and fathers.

Conclusions: Despite free-of-charge availability to HPV vaccination in Denmark, we found disparities in non-initiation and non-completion of HPV vaccination among Danish girls by both mothers' and fathers' socioeconomic and demographic characteristics.

Aims: Based on selected themes from a national survey, the study aims to describe and analyse similarities and differences in community-based palliative care provided to people living at home in two different care settings - the nursing home setting and the home care setting.

Methods: Responses from four palliative care themes covered by a national survey sent to 717 managers in municipality-based care units were used. The themes were: (a) target groups in palliative care; (b) wishes for end-of-life care; (c) tools/guidelines in palliative care; and (d) palliative care provided to relatives.

Results: The response rates were 53% in the nursing home setting and 69% in the home care setting (69%). Both settings had target groups for palliative care, in which significantly more units in the home care settings cared for people with other cultural backgrounds or children. Wishes for end-of-life care were addressed by more than 90% of the units in both settings. There were significantly more nursing home units that addressed questions regarding resuscitation, decision making when you are incapable of making decisions for yourself, and the level of medication. In both settings, around half of the units did not use or did not know if they used tools/guidelines to identify palliative care needs. Half of home care and 65% of nursing home settings did not/were unaware of providing palliative care to relatives.

Conclusions: Both settings serve target populations for palliative care with few differences. Identifying palliative care needs seemed to be a low priority in both settings. A difference was found between the settings regarding end-of-life care questions and palliative care promotion to relatives.

Aims: The study aimed to investigate the association between parental unemployment and grade point average and school completion in adolescence, and the importance of family cohesion, parental education, and family income in explaining these associations.

Methods: Data stem from the Norwegian cross-sectional 2012 youth@hordaland-survey including 8437 adolescents (53.4% girls). Information on grade point average, school completion, parental education, and family income were retrieved from the National Education Database. Parental work status and family cohesion were assessed by adolescent self-report.

Results: Adolescents with at least one unemployed parent had lower grade point averages (3.49 compared with 3.92, P<0.001) and rates of school completion (71.9% compared with 86.6%, P<0.001) compared with adolescents with two working parents. The associations between parental unemployment and both grade point average (b = -0.22, 95% confidence interval -0.32, -0.12) and school completion (odds ratio 0.59, 95% confidence interval 0.46, 0.76) partly attenuated but remained significant when taking family cohesion, parental education, and family income into account. There was a significant interaction between parental unemployment and family cohesion on grade point average, in which the positive association between family cohesion and grade point average was weaker for adolescents with unemployed parents.

Conclusions: Adolescents with parents outside of the workforce are at higher risk of poorer educational outcomes than peers with working parents. Combined with the positive associations between parental education, family cohesion, family income, and educational outcomes, this underscores the importance of parents for adolescent educational outcomes, and suggests that parents and the family situation should be considered when providing academic support for adolescents who struggle in upper secondary school.

Aim: The Danish Health Survey among Marginalized People is a nationwide health survey targeting people in marginalized life situations in Denmark. The aim of this paper is to present the study design, data collection methods and respondent characteristics of the survey, which was conducted in 2007, 2012, 2017 and 2022.

Methods: The survey applies an outreach data collection approach which entails reaching out to social services (public and private) asking for their help with distributing self-administered paper questionnaires among their users. Themes include self-rated health, mental health, morbidity, pain, oral health, health behaviours, gambling problems, social relations, violence, sexual harassment and assault, suicide, and source of income.

Results: The overall number of respondents has decreased slightly from 2007 (1290) to 2022 (1134). In all survey waves, men were overrepresented among the respondents. In 2007, women represented only 28%, which increased to 37% in 2022. There have been remarkable changes in the age distribution among respondents between 2007 and 2022. For example, the oldest age group (55-80 years) accounted for 15% of the respondents in 2007 and 40% in 2022.

Conclusions: Conducting surveys among marginalized people entails methodological challenges and ethical considerations. However, continually attempting to reach marginalized people in surveys by tailoring data collection strategies to their specific life situation is essential to gain insight into their health and well-being.

Background: Smoking and poor mental health in youth represent important public health priorities. This study aimed to (i) compare tobacco-related behaviors and mental health in two educational settings with high smoking rates: vocational education and training (VET) schools and preparatory basic education (PBE) schools, and (ii) examine associations between smoking at school start and mental health 5 months later.

Methods: Data were obtained from baseline (N = 1843) and follow-up (N = 1039) assessments conducted as part of a school-based trial in two rounds (baseline in August 2018 and August 2019). Students' characteristics were presented by adjusted prevalences. Logistic regression analyses assessed associations between smoking and measures of mental health: school-related well-being, overall loneliness, and stress.

Results: More PBE students than VET students reported daily smoking (40% vs. 27%), nicotine dependence, perceived benefits of smoking (e.g., stress reduction: 41% vs. 33%), low smoking-related self-efficacy (e.g., ability to resist smoking if offered by a friend: 20% vs. 32%), school-related loneliness, and low school connectedness (25% vs. 11%). Daily smokers at VET and PBE schools had lower odds of school-related loneliness (AOR = 0.51, 95% CI: 0.35-0.74) and higher odds of stress (AOR = 2.75, 95% CI: 2.00-3.80). Smoking was associated with better classmate relations in VET schools but not in PBE schools.

Conclusions: Our study suggested that students in PBE schools constitute a more vulnerable group in terms of smoking and mental health compared with students in VET schools. Smoking seemed to prevent loneliness in school but was associated with heightened stress levels.

Background/aim: The Cognitive Emotion Regulation Questionnaire (CERQ) is among the most popular and widely used measures of emotion regulation across age groups. This study aimed to validate the CERQ short version (CERQ-short) for use on adolescents in the Norwegian population.

Method: A sample of 3461 adolescents (47.3% girls) aged 12-16 years was recruited through the UEVO population-based study of child maltreatment in Norway. Factor structure, reliability, measurement invariance and criterion validity were investigated.

Results: Confirmatory factor analysis supported the original nine-factor model including 18 items; however, not a two-factor structure nor a higher order two-factor solution. Internal consistency was adequate for all subscales, with alpha levels ranging from .73 to .84 between subscales across genders. Relationships with internalizing problems measured with the 10-item Hopkins Symptom Checklist and health-related quality of life according to KIDSCREEN-10 supported the criterion-related validity of the Norwegian CERQ-short.

Conclusions: Results suggest that the CERQ-short can be used to measure cognitive emotion regulation strategies in the Norwegian adolescent population. The validation of the CERQ-short in Norway could significantly improve mental health care by facilitating better diagnosis, treatment planning, and evaluation, as well as informing public health policy and cross-cultural research.

Aims: Lack of consensus on wellness has led to a vast number of different conceptualisations, which hinder international efforts to monitor individual-level wellness and social progress comparably. This study aimed to aid in the harmonisation of the concept by contributing to the scarce research on laypeople's views on wellness. The study investigates whether the importance of different areas of wellness varies depending on age, gender, education or socio-economic position. Furthermore, considering that wellness models are often constructed by expert panels, this study aimed to shed light on how experts' and laypeople's views on wellness vary.

Methods: Altogether, 1152 laypeople and 23 Finnish experts rated the importance of 61 systematic review-based wellness domains. Each domain received an ordinal number, which, together with the Mann-Whitney U-test or Kruskal-Wallis test, was used to examine the differences between the groups.

Results: Thirteen wellness domains were found at the top of the lists, regardless of whether the results were analysed based on gender, age, education or socio-economic position. When looking at the priority order of different domains, we were able to identify several differences between the expert panel and laypeople.

Conclusions: To ensure the relevance of wellness models, it is vital to understand the areas that laypeople consider to be important for their comprehensive wellness. This study offers 13 domains that could be combined with an expert view on wellness and used as a starting point for creating a more comprehensive, inclusive and better-suited wellness instrument.

Aim: This editorial presents state of the art developments in research and policy in the newly emerging field of climate and health and examines the gaps in research, the relevance of Nordic research in a global context, and the need to place the climate-health agenda in the policy space.

Methods: We use a set of articles from the Special Issue on 'Climate change and health in the Nordic countries' in this journal to understand current research in climate and health. We identify three emerging areas that characterize the current focus of research: modelling climate change-induced exposures; health cross-linkages of the climate health agenda and targeted communication. On linking the ongoing research with several recent policies and projects within the EU and Nordic countries, we identify vital questions where future research needs to concentrate and discuss the challenges associated with this.

Results: We identify three key questions related to interaction, vulnerable groups and equitable adaptation that will be crucial to future risk. We highlight a need for integrated study designs and innovative data analysis tools to help answer these questions.

Conclusion: We conclude with proposing a path forward for the 'Climate and Health' research and policy agenda in the years to come.

Socioeconomic conditions remain an important factor in determining health outcomes in Northern Europe. In this commentary, we argue for evidence-based temperature-related climate adaptation policies in Northern Europe that account for disparities in socioeconomic conditions and aim at universal health coverage. We highlight the role of spatial and occupational disparities in urban areas that can be important factors in increased physical and mental health impacts related to heat and cold. We further highlight how these factors interplay with exposure to air pollution and access to green areas and worsen health conditions. Adaptation to changing climatic conditions requires both physiological acclimatization and behavioral adaptation, both of which are difficult to assess for socioeconomically deprived communities. We argue for more equitable climate adaptation strategies that include i) better integration of health in climate change adaptation plans; ii) building climate resilient communities, and iii) integrated surveillance and health systems. These actions could be vital in spearheading research in new cross-cutting areas like climate change, migration, and health.