Scandinavian Journal of Public Health最新文献

Background: Women often reduce their working hours after childbirth, or, in some cases, exit the workforce altogether. This adjustment affects their immediate economic independence, with implications for their career trajectory and long-term financial stability. We aim to study the patterns of women's work resumption in the first year after childbirth, including the role of sick leave during pregnancy. We further aim to identify the key factors contributing to women's economic independence one year after childbirth. Methods: Drawing on data from Statistics Netherlands and the Dutch Perinatal Registry, we used descriptive analysis to examine the working hour patterns from onset of pregnancy to one year after childbirth. Additionally, multinomial logistic regression assessed how individual and work-related factors related to having employment with economic independence, having employment without economic independence, or having exited the workforce one year after childbirth. Results: Data on 114,722 Dutch employed women who delivered in 2016 showed a notable shift in employment patterns one year after birth: over half reduced their working hours, with 12.2% leaving the workforce entirely. These patterns were particularly pronounced among women with sick leave during pregnancy. Furthermore, factors such as lower education, fewer working hours, and not cohabiting with a partner were associated with being employed but not economically independent after childbirth. Conclusions: Pregnancy and delivery have a durable impact on women's workforce participation, which affects their economic independence. Strategic workplace and family policies might support retaining employment after childbirth and mitigate adverse economic effects, particularly for those with sick leave during pregnancy.

Background/aims: Municipalities in Norway are required to have a district medical officer (DMO) as chief medical advisor and leader of infection control and prevention work. There is great variation between municipalities in how the role is enacted and organized. Before the Covid-19 pandemic many DMOs felt their role to be unclear and invisible in the organization. This study aimed to explore DMOs' experiences during the Covid-19 pandemic and how organizational context mediated these experiences. Methods: We conducted a qualitative study, generating data from three focus groups involving 17 DMOs from three different regions in Norway. Data were analysed using systematic text condensation. Results: All DMOs, regardless of municipal size, position size or infection rate, reported feeling overwhelmed by the responsibility during the pandemic. Their organizational outset, number of tasks, number of enquiries and uncertain foundation for decisions contributed to this experience. Organizational characteristics that promoted DMOs' coping were resource allocation, teamwork, and professional and social support. Conclusions: Our results suggest that municipalities can enhance their crisis management of future infection control crises by establishing an organizational structure around DMOs that facilitates networking, and by developing plans for task delegation and creation of teams to support and alleviate DMOs during a crisis.

Aims: Increasing self-reported mental health problems among adolescents in many countries, accompanied by worsening results in international studies of school achievement, raises questions about how school, learning and mental health interact. The purpose of the present study is to analyse the associations between mental health, early school achievement and subsequent school failure in the final year of compulsory schooling in Sweden. Methods: This study is based on a Swedish representative sample of 9020 children born in 2004, which was drawn in 2014 by Statistics Sweden. Three logistic regression models were analysed: regressing school failure in school year 9 on psychiatric diagnoses, grades in school year 6 and sociodemographic variables. Results: Psychiatric diagnoses and grades in school year 6 are strongly associated with school failure in school year 9. These two variables interact, and their combined effects on school failure is striking. Almost every second student with a psychiatric diagnosis and not achieving passing grades in all subjects in school year 6 fails in school year 9. The corresponding figure is 2% for students with no psychiatric diagnosis and passing grades in all subjects in school year 6. Conclusions: Early identification of signs of risk factors for school failure provides opportunities to prevent mental health problems and to support school achievement. To properly estimate the magnitude of risk factors for failure in school year 9, the interactive effects of psychiatric diagnoses and grades in school year 6 on school failure need to be accounted for.

Background: Resignations among general practitioners (GPs) have been cited as a contributing factor to challenges in Norway's GP scheme. Aim: To analyse trends in GP exit rates and examine whether there is evidence of systematic changes in these rates over time. Design and setting: Registry-based observational study of all GPs in Norway since the scheme's implementation in 2001. Method: Exit rates were calculated for the entire study period and by year. Significant deviations were identified using 95% confidence intervals with Bonferroni corrections for multiple hypothesis testing. Results: GP exit rates declined until age 50 years and remained low until retirement at 67. This pattern was stable throughout the study period (2002-2022). Only two significant deviations occurred: higher-than-expected rates for 67-year-olds in 2007 and 41-year-olds in 2010. Conclusions: GP exit rates remained stable over the study period, with no evidence suggesting increased exits as a major factor in the current challenges facing Norway's GP scheme.

Collaborative initiatives like Joint Action PreventNCD are essential in addressing non-communicable diseases (NCDs), which account for over 80% of the disease burden in European Union (EU) countries. By targeting health determinants such as tobacco use, harmful use of alcohol, unhealthy diets, and physical inactivity, while leveraging technology and innovation, the European Union aims to prevent and manage NCDs efficiently. Through sustained investment and collaboration, preventive measures can significantly reduce the NCD burden, promoting healthier lives and reducing pressures on healthcare systems.

Aims: Adolescence is a critical period for mental health development, yet research exploring how contextual factors influence the development of depressive symptoms remains limited. This study explored trajectories of depressive symptoms during early to mid-adolescence and their association with various aspects of school climate.

Methods: The study sample comprised 3671, 7th-grade students (aged 12-13 years) from 101 schools across Sweden, followed longitudinally across three time points spanning grades 7, 8 and 9. Depressive symptom trajectories were identified using latent class growth modelling. The Pedagogical and Social Climate questionnaire assessed school climate, and multinomial logistic regression was employed to predict trajectory membership based on sociodemographic and school climate factors.

Results: Four distinct developmental patterns of depressive symptoms emerged: 'Sustained low symptoms' (76.7%), 'Low-increasing' (10.9%), 'Sustained high symptoms' (7.9%), and 'High-decreasing' (4.5%). Gender, parental education and six specific school climate factors, out of the total 19 examined, significantly distinguished these trajectory classes. Positive teacher expectations and strong principal involvement were associated with more favourable trajectories, whereas teaching activities, teacher support and communication between school and home were associated with less favourable trajectories, suggesting a nuanced understanding of their relationship with depressive symptom trajectories.

Conclusions: Few school factors were found to be relevant to depressive symptoms, highlighting the importance of considering external factors beyond the school environment in supporting adolescents during this developmental stage. Although the findings are multifaceted, it is primarily positive interpersonal relationships, especially through teacher expectations, that stand out as significant factors in promoting youth mental health.

Aims: Psychosomatic complaints are common in youth and are often assumed to indicate stress. Although several studies have confirmed that a cross-sectional association exists, few have empirically investigated whether or not perceived stress influences psychosomatic complaints. The objective of the present study was to build upon previous research by exploring whether changes in perceived stress over time are associated with corresponding changes in psychosomatic complaints. This analytical approach takes unmeasured time-invariant confounding into account, thereby offering more robust evidence for a causal association between the variables under study.

Methods: Data was derived from the Swedish national cohort study Futura01, with information from 2,708 participants aged 17-18 in 2019 and 20-21 in 2022. Perceived stress was measured by Cohen's Perceived Stress Scale. Psychosomatic complaints were measured by questions on the frequency of stomach aches, headaches and difficulties falling asleep, which were added to an index. Information on gender, parental education, and parental country of birth was derived from registries. Linear regression analyses were conducted and the first difference (FD) approach was used.

Results: Perceived stress and psychosomatic complaints exhibited cross-sectional associations at both time points. The FD analyses showed that increases in perceived stress were associated with increases in psychosomatic complaints, and this was the case irrespective of sociodemographic characteristics.

Conclusions: This study provides further empirical support for the assumption that psychosomatic complaints can be partially attributed to stress. Societal efforts aimed at reducing stressors and strengthening coping resources and strategies among young people may help mitigate perceived stress and, consequently, the likelihood of developing psychosomatic complaints.

Aims: This study examined the incidence of attention-deficit/hyperactivity disorder medication among children and adolescents by sex and age group in Finland during 2008-2019.

Methods: The data on children and adolescents aged 6-18 years receiving reimbursement for any attention-deficit/hyperactivity disorder medication was collected from the nationwide register on reimbursed purchases. The incidence was calculated as a ratio of the number of new users and the number of age and sex-matched population at risk. Negative binomial models were used to calculate rate ratios (RRs).

Results: In 2019, the incidence of attention-deficit/hyperactivity disorder medication was 13.4 per 1000 boys and 4.8 per 1000 girls. Among boys, the incidence became 3.7 times greater during the observed years (RR 95% confidence interval (CI) 2.0, 6.5, P<0.0001), whereas in girls it was 7.6 times greater (RR 95% CI 2.1, 27.4, P=0.0019). The boys had 2.8 times the incidence rate compared with the girls (RR 95% CI 2.2, 3.6, P<0.0001). The increase was associated with age only among boys (P=0.0001). The highest incidence rate 23.4 per 1000 individuals (95% CI 22.5, 24.4) was found in 2019 among 6-8-year-old boys.

Conclusions: The incidence of attention-deficit/hyperactivity disorder medication use among children and adolescents increased significantly in Finland during the study period. Incidence was higher among boys, but the increase was greater among girls. The most common group to start attention-deficit/hyperactivity disorder medication was 6-8-year-old boys. These findings warrant critical evaluation of the diagnostic and treatment policies currently available in Finland for the treatment of attention-deficit/hyperactivity disorder and related symptoms.

Aims: The Joint Action project on Cancer and other Non-communicable Diseases (NCDs) prevention, Action on Health Determinants, includes a dedicated workstream on structural and population-level interventions. The overarching objective of this workstream is to strengthen the compliance, coherence, implementation and enforcement of evidence-based regulatory measures that support governmental efforts to reduce the burden of NCDs.

Methods: The workstream adopts a multi-method approach, informed by existing academic literature and previous European studies. Key methodologies include policy mapping, evidence reviews, behavioural assessments, policy impact modelling, and pilot testing. Governmental alcohol and tobacco policies will be evaluated using comparative policy scales, while the health and economic impacts of health taxation policies will be projected through and microsimulation modelling. Nutrient profile modelling and food composition databases will be developed to inform strategies for food reformulation. The effectiveness of labelling interventions will be examined. Tools for monitoring digital marketing exposure will be developed, and the impact of environmental policy impact will be assessed.

Expected results: The workstream is expected to deliver comprehensive policy analyses, demonstrate the potential impact of health taxation, propose harmonized nutrient profiling frameworks, assess the effectiveness of food and alcohol labelling practices and contribute to the development of cross-national structures for public food procurement. Additionally, it will provide guidance on the implementation of effective measures and evaluate divergences in national policy approaches across Europe.

Conclusions: The workstream will generate actionable evidence and documentation to inform and support public policy processes, thereby contributing to reductions in the burden of preventable disease across the region.