Scandinavian Journal of Public Health最新文献

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.

Aims: This longitudinal study investigated the prevalence of and risk factors for loneliness among older new informal caregivers, long-term informal caregivers, former informal caregivers and non-caregivers in selected regions of Finland and Sweden over 5 years.

Methods: A longitudinal sample of 5083 respondents from the Gerontological Regional Database (GERDA) survey data in 2016 and 2021 was used. Bivariate correlation tests and multivariate logistic regression analyses were performed.

Results: Loneliness prevalence rates varied between 6% and 8% in 2016 and increased in all groups, although not significantly among new informal caregivers. In 2021, the prevalence of loneliness varied between 8% and 14%. Among the baseline variables, reporting loneliness, single/unmarried/bereaved civil status, infrequent contact with friends and neighbours, poor self-rated health, depressive symptoms, living in Finland and financial strain increased the likelihood of reporting loneliness in 2021. Among the change variables, being a long-term caregiver, a negative change in civil status, a reduced number of confidants, a negative change in self-rated health and depressive symptoms increased the likelihood of reporting loneliness.

Conclusions: Loneliness increased among all four groups of comparison. Being a long-term caregiver was a significant risk factor for reporting loneliness over time (odds ratio 2.00, 95% confidence interval 1.20-3.35), when controlling for several other social and health-related variables. To develop effective support, future research could address risk factors for loneliness among distinct groups of informal caregivers based on whether the care recipients have neurological or functional health limitations and examine the availability of support measures.

Aims: Doctors have an increased risk of SARS-CoV-2 infection caused by exposure to contagious patients. We aimed to identify which clinical specialities among medical doctors had the highest occupation-related risk of testing positive for SARS-CoV-2, utilizing data for all publicly employed medical doctors in Sweden.

Methods: Data regarding positive SARS-CoV-2 test results and employment for publicly employed doctors in Sweden were divided into three observation periods: 1) 1 February to 31 December 2020, 2) 1 January to 30 June 2021 and 3) 1 July 2021 to 31 March 2022. Individuals were stratified according to occupation clinic and compared with clinical occupations with little to no patient contact. The risk of testing positive for SARS-CoV-2 was estimated using Cox proportional hazards regression, with sex, age and vaccination status as covariates.

Results: The study cohort included all publicly employed doctors in Sweden: 35,028 individuals. In the first period, Infectious Disease doctors had the highest incidence of SARS-CoV-2 positive tests, with an incidence of 20.2 %, compared with 8.7 % in the reference group, and an adjusted hazard ratio of 2.5 (95% confidence interval 2.02-3.04), which decreased during period 2-3. Doctors in Geriatric Medicine had an elevated risk throughout the whole study period.

Conclusions: Our study shows an association between working in a speciality that involves caring for contagious COVID-19 patients, which raises concerns about infection control measures and routines being insufficient to prevent occupational infection in future pandemics.

Aims: The Faroe Islands is a small homogenous archipelago located in the North Atlantic Ocean with no prior study of violence among adults. In an adult population-based sample, we studied physical, sexual and emotional violence and health and socio-economic determinants.

Methods: A population-based cross-sectional survey conducted between November 2020 and February 2021 was based on a newly initiated questionnaire that included 1068 randomly selected individuals aged 18-75.

Results: A total of 34.8% reported exposure to physical violence, 21.8% to sexual violence and 22.3% to emotional violence. A total of 12.6% of the women and 7.6% of the men reported exposure to all three types of violence. The consequences of childhood violence had a more significant effect on the subjects compared to adult-life violence. Additionally, individuals exposed to violence had significantly lower odds of achieving any educational attainment.

Conclusions: Compared to men and after adjustments, women had 50% lower odds of exposure to physical (odds ratio=0.5, p<0.001) and more than three times the odds of exposure to sexual violence (odds ratio=3.1, p<0.001). The odds of emotional violence were sex independent, both unadjusted and adjusted. Moreover, exposure to violence showed a life-long negative impact.

Aims: Cardiopulmonary disease (CPD) is a leading cause of death worldwide. Increasing evidence shows that air pollution and exposure to weather conditions have important contributory roles. Understanding the interaction of these factors is difficult due to the complexity of the relationship between CPD, air pollution, and environmental factors.

Methods: This paper uses regression models and machine learning approaches to explore these relationships, and investigate whether meteorological factors and air pollution have a synergistic effect on CPD. We use daily data from 2009-2018 from four cities representing the heterogenous climate conditions in Norway: the far north, the west coast, mid-Norway, and the south-east.

Results: We demonstrate the importance of the interaction between weather and air pollution associated with higher CPD mortality, as is exposure to air pollution in the form of $\mathrm{NOx}\mathrm{and}$particulate matter. This impact is seasonal. Traffic is also positively related to CPD mortality, which may be caused indirectly through increased pollution. We demonstrate that machine learning outperforms regression models in terms of the accuracy of predicting CPD mortality.

Conclusions: The inclusion of rich lagged structures and interactions between environmental factors are both important but can lead to overfitting of traditional models; since these cities are not large cities by international standards, it is surprising that environmental factors have such obvious impacts on CPD mortality. CPD mortality shows a clear negative trend, implying an improvement in the public health situation.

Aims: This study aimed to identify subgroups of Norwegian retirees with similar trajectories of subjective well-being (SWB) across the retirement transition and to explore how various factors influence these SWB trajectories.

Methods: The study employed growth mixture modelling to analyze longitudinal data, exploring the trajectories of life satisfaction, positive affect and negative affect in retirement transition. It also examined the influence of factors such as demographic, living arrangement, pre-retirement work conditions, individual characteristics and available resources on these SWB trajectories.

Results: Contrary to the hypothesised three distinct SWB trajectories in retirement, the results more strongly support a single group solution for life satisfaction and positive affect. For negative affect, a two-group solution, consisting of one group with stable low and another with stable high negative affect, was preferred. The study identified several predictors of SWB trajectories.

Conclusions: The findings suggest that retirement is a neutral life event with stable SWB trajectories. However, several factors significantly influence whether retirees experience higher or lower SWB in retirement. The findings of this study provide updated insights into the heterogeneity of the retirement experience, as well as highlight important factors for retirement SWB.

Aim: The aim of this study was to explore young people's experiences of resources and strategies for promoting their mental health.

Methods: Individual interviews with 33 people aged 16-25 years were conducted using a method inspired by cognitive interviewing, which combines think aloud techniques with probing questions. The interviews were based on the young people's reflections of the questions in the Swedish national public health survey. Data were analysed with reflexive thematic analysis.

Results: The resources and strategies that the young people in this study described as important for promoting mental well-being are related to societal prerequisites needed to navigate life; to their immediate surroundings, including social interactions; and to the young people themselves. These resources and strategies are presented under the following three themes: prerequisites for navigating life, social interactions on one's own terms, and who I am and what I can do.

Conclusions: Young people have a variety of resources and strategies of their own available for promoting mental well-being. However, they cannot promote mental health just on their own; access to social networks and the opportunity to share thoughts and feelings are central. Further, to promote mental health, young people need good social conditions, knowledge, and support from adults so that the existence they struggle to navigate feels comprehensible, manageable and meaningful.

Aim: A worry regarding young people's physical activity engagement relates to a potentially competing development: the role of screen-based media (SBM) in their everyday lives. The present study aimed to assess time spent on different types of SBM, self-reported moderate-to-vigorous physical activity (MVPA) and physical activity in different domains and their interrelations.

Methods: The study is based on data from 3737 participants aged 11, 13 and 15 years from Norway collected in 2021/2022 as part of the Health Behaviour in School-aged Children collaborative cross-national survey.

Results: The findings revealed high amounts of total SBM time. There were age and gender differences in physical activity, especially with lower levels of active transport during leisure time among girls than among boys. A series of binary logistic regression analyses with adjustment for age, gender and socioeconomic status showed that high levels of total SBM time were negatively associated with involvement in club sports, active school transport, active travel to friends and leisure activities, and 60 min MVPA 5 days/week. Gaming and social media use were also negatively associated with most of the physical activity indicators. All SBM variables were negatively associated with involvement in club sports and 60 min MVPA 5 days/week.

Conclusions: The study demonstrates negative associations between SBM time among adolescents and physical activity in various domains. Actions to facilitate youth physical activity in the digital age seem crucial. Additional studies with nuanced data on these behaviours and longitudinal research design allowing for examining their interrelations over time are needed.