Ruth Kjærsti Raanaas

Health benefits of a view of nature through the window: a quasi-experimental study of patients in a residential rehabilitation center

Objective: To examine the health benefits of a bedroom window view to natural surroundings for patients undergoing a residential rehabilitation programme. Design: Longitudinal quasi-experiment. Setting: A residential rehabilitation centre. Subjects: Two-hundred and seventy-eight coronary and pulmonary patients provided data at all measurement points during the programme. Intervention: Blind, quasi-random allocation to a private bedroom with a panoramic view to natural surroundings or with a view either partially or entirely blocked by buildings. Main measures: Self-reported physical and mental health (SF-12), subjective well-being, emotional states, use of the private bedroom and leisure activities. Results: For women, a blocked view appeared to negatively influence change in physical health (time × view × gender interaction, F(4,504) = 2.51, P = 0.04), whereas for men, a blocked view appeared to negatively influence change in mental health (time × view × gender interaction, F(4,504) = 5.67, P < 0.01). Pulmonary patients with a panoramic view showed greater improvement in mental health than coronary patients with such a view (time × view × diagnostic group interaction, F(4,504) = 2.76, P = 0.03). Those with a panoramic view to nature more often chose to stay in their bedroom when they wanted to be alone than those with a blocked view (odds ratio (OR) = 2.32, 95% confidence interval (CI) 1.08–5.01). Conclusion: An unobstructed bedroom view to natural surroundings appears to have better supported improvement in self-reported physical and mental health during a residential rehabilitation programme, although the degree of change varied with gender and diagnostic group.

Green exercise as a workplace intervention to reduce job stress: results from a pilot study

BACKGROUND Stress and mental fatigue are major health threats to employees in office-based occupations. Physical activity is widely used as a stress-management intervention for employees. Moreover, experiences in contact with nature have been shown to provide stress-reduction and restoration from mental fatigue. OBJECTIVES In a pilot study designed as a randomized controlled trial we investigated the impact of a green-exercise intervention on psychological and physiological indicators of stress in municipality employees. METHODS Fourteen employees (7 females and 7 males, 49±8 yrs) volunteered in an exercise-based intervention in workplace either outdoors in a green/nature area or in an indoor exercise-setting. The intervention consisted of an information meeting and two exercise sessions, each including a biking bout and a circuit-strength sequence using elastic rubber bands (45-minutes, at about 55% of HR reserve, overall). Main outcomes were perceived environmental potential for restoration, affective state, blood pressure (BP) and cortisol awakening response (CAR AUC(G) and CAR AUC(I)) and cortisol levels in serum. Measurements were taken at baseline and in concomitance with the exercise sessions. Furthermore, affective state and self-reported physical activity levels were measured over a 10-weeks follow-up period. RESULTS Compared with the indoor group, the nature group reported higher environmental potential for restoration (p <  0.001) and Positive Affect (p <  0.01), along with improved CAR AUC(I) (p = 0.04) and, marginally, diastolic BP (p = 0.05). The nature group also reported higher ratings of Positive Affect at follow-up (p = 0.02). Differences at post-exercise were not found for any of the other components of affective state, systolic BP, CAR AUC(G) and cortisol levels measured in serum. CONCLUSIONS Green-exercise at the workplace could be a profitable way to manage stress and induce restoration among employees. Further studies on larger samples are needed in order to improve the generalizability of the results.

Erratum to: The relationship between negative life events, psychological distress and life satisfaction: a population-based study

Purpose Negative life events may increase psychological distress and reduce life satisfaction (LS). This study investigates associations between negative life events and both positive and negative indicators of mental health and explores the extent to which these associations are buffered by sense of mastery and perceived social support.

Nature contact and organizational support during office working hours: Benefits relating to stress reduction, subjective health complaints, and sick leave

BACKGROUND Improving social support, and providing nature contact at work are potential health promoting workplace interventions. OBJECTIVE The objective was to investigate whether nature contact at work is associated with employees health and participation, and to study whether the possible associations between nature contact and health can be explained by perceived organizational support. METHOD Data were collected through a web-based, cross-sectional survey of employees in seven public and private office workplaces in Norway (n = 707, 40% response rate). Multiple linear and logistic regression analysis were performed on 565 participants fulfilling inclusion criteria. RESULTS A greater amount of indoor nature contact at work was significantly associated with less job stress (B = -0.18, CI = -0.318 to -0.042), fewer subjective health complaints (B = -0.278, CI = -0.445 to -0.112) and less sickness absence (B = -0.061, CI = -0.009 to -0.002). Perceived organizational support mediated the associations between indoor nature contact and job stress and sickness absence, and partly mediated the association with subjective health complaints. Outdoor nature contact showed no reliable association with the outcomes in this study. CONCLUSIONS Extending nature contact in the physical work environment in offices, can add to the variety of possible health-promoting workplace interventions, primarily since it influences the social climate on the workplace.

ADHD With Co-Occurring Depression/Anxiety in Children: The Relationship With Somatic Complaints and Parental Socio-Economic Position

Attention-Deficit/Hyperactivity Disorder (ADHD) and depression/anxiety are often comorbid in children, and consequences of ADHD are more detrimental in lower socioeconomic levels. The aim of this study was to compare co-occurrence of ADHD and depression/anxiety with ADHD alone and depression/anxiety alone when the outcome measure is somatic complaints. Additionally, we examined whether low parental Socio- Economic Position (SEP) were related to occurrence of ADHD alone, depression/anxiety alone, and co-occurrence. The sample consisted of 12,900 parents who participated in a cross-sectional health survey that included Strengths and Difficulties Questionnaire (SDQ) and impact supplement. Socio-economic factors were dichotomized into low versus average/high parental socio-economic position (SEP), abdominal pain, neck pain and headache were categorized as somatic complaints. Parents described 58 % of the children with ADHD as comorbid with depression/anxiety. Children with ADHD only report somatic complaints when thedisorder is co-occurring with depression/anxiety. The prevalence of ADHD, depression/ anxiety, or a combination of the two disorders in children, is higher when parents have a low socio-economic position. Increased awareness of the heterotypic nature of ADHD is needed, especially when interpreting somatic complaints. There is a pattern of an inverse relationship between mental health and socio-economic position in children when measured by ADHD and depression/anxiety.

Restorative Elements at the Computer Workstation: A Comparison of Live Plants and Inanimate Objects With and Without Window View

The objective of the study was to test whether live plants on computer workstations with and without window view had restorative effects. Guided by Stress Recovery Theory and Attention Restoration Theory a mixed randomized experiment was conducted exploring restorative effects of plants, including mediating effects of perceived fascination. Eighty-five participants carried out a 1-hr work session with repeated tasks demanding directed attention in an office with one of three interior conditions: live plants, inanimate objects and control, all with and without a window view. Plant presence led to greater perceived fascination, but perceived fascination was not related to either self-reported restoration or directed attention capacity. The presence of plants during work did not have superior restorative effects compared with inanimate objects, neither with nor without access to a window view. However, environmental enrichment with either plants or inanimate objects at the computer workstation seemed to provide a restorative potential, which should be investigated further.

Shaping Occupational Possibilities for Norwegian Immigrant Children: A Critical Discourse Analysis

Elementary school education is a key occupational arena for the integration of immigrant children. In this study conducted in Norway, questions about how best to support the education of immigrant children arose partly due to their poorer performance in primary school testing. A critical discourse analysis of the construction of the problem of the educational gap between Norwegian and immigrant children was conducted drawing on a sample of 20 newspaper articles published in 2012 about educational matters in Oslo. The analysis deconstructed how issues related to immigrant childrens performance were problematized, with particular foci on how occupation was drawn into solution frames and the occupational possibilities promoted for immigrant children and their families. Three problematizations of the educational gap were identified, with each locating the problem in a different rationale, specifically, linguistic deficiency, parental deficiency and spatial segregation. Within each problematization, although contrasting political rationalities emphasized individual or social solutions, occupations forwarded as means to address the gap and promote integration were narrowly defined in ways that focused on assimilation into Norwegian ways of doing and de-valued difference. Concerns are raised regarding the implications of this narrow framing of occupational possibilities for identity, well-being, and occupational marginalization of immigrant children and families.

Unifying and diversifying workplace-based efforts for promoting health and preventing disability.

In the last decades, the workplace has gradually been more acknowledged as a core arena for interventions aiming at promoting health and preventing disability [1–3]. A first example of this acknowledgement is the frequent use of Workplace or Worksite Health Promotion Programs (WHPP), built on a Public Health tradition, aiming at improving employees’ health and lifestyle (i.e., physical activity, healthy eating, weight loss, relaxation, smoking, and drug/alcohol use). The body of knowledge assessing WHPP’s effectiveness is increasing [4–6]. A systematic review found more than 300 trials of WHPP published between 2000 and 2012 [5]. Still, the effectiveness of such interventions is for several of the targeted lifestyle changes inconclusive or non-consistent [5–8]. One review even found that high-quality trials tended to report smaller effects than low-quality trials [8]. A second example is Individual Placement Support (IPS), aiming at increasing participation in work, among groups with larger work disability challenges [9]. Inspired by the recovery ideology, the paradigm ∗Address for correspondence: Randi W. Aas, Presenter, Stavanger Innovation Park, Prof. Olav Hanssens v. 7a, Stavanger 4021, Norway. Tel.: +4791182266; E-mail: randi.aas@presenter.no. shift in the 80’s in psychiatric vocational rehabilitation from “train then place” to “place then train” changed the field, and IPS became the new paradigm [9, 10]. Competitive employment became the goal, and lengthy pre-employment training was replaced with rapid job search. This made us design “placement interventions” at real workplaces, where the efficient Supported Employment [11, 12] is a great example. To train first and most at workplaces, not in clinics is therefore common today in psychiatric rehabilitation. A third example is treatment of musculoskeletal disorders (MSD). “Disease prevention” in the mid-1990’s suggested to be replaced with “disability prevention”, by which workplace foci were strengthened [13–15]. Ten years ago, we were still asking if workplace interventions were an effective means for secondary prevention of low back pain [16]. Today, we know more and judge workplace-based efforts as main solutions for reducing sick leave and return to work for sick-listed employees with MSD and common mental disorders [17–21]. The Workplace Disability Prevention and Integration (WDPI) community of researchers is these days building a strong body of knowledge about workplacebased efforts worldwide, as still much is unknown. For example, we do not know why workplace interventions seem to reduce sick leave and promote return to work, but not affect health outcomes [3, 19].

The association between adolescent and parental use of non-prescription analgesics for headache and other somatic pain – A cross-sectional study

Graphical Abstract Abstract Background and purpose Over the last years, concern has been expressed about adolescents’ possible liberal attitude towards – and use of – non-prescription analgesics. A high consumption of analgesics is unfortunate as it may lead to various harmful effects and worsening of headache. In order to address this challenge, it is necessary to achieve a more extensive knowledge about adolescent consumption. The main aim of this study was to examine the association between adolescent and parental use of nonprescription analgesics, taking into account headache as well as other somatic pain. The effects of parental prescription analgesics use was a secondary aim. Methods The study is based on data from two cross-sectional health studies conducted in 2005 and 2012 in Norway, including 646 adolescents and an accompanying parent. By using sample weights, the final weighted sample used in the analysis was 1326. Data was collected through postal questionnaires to parents and adolescents as well as parental telephone interviews. Questionnaires included questions on different pain locations and the pain for each location was graded according to how troubling the pain was. Medication data on prescription and non-prescription analgesics was from telephone interviews and was quantified based on the pattern over the past 4 weeks. Multivariate logistic regression models and complex samples analyses were used. Results 20% of adolescents were reported as using non-prescription analgesics during the previous 4 weeks. Girls were more often reported to use non-prescription analgesics than boys. Headache and all other somatic pain locations except back pain were reported more frequently among girls while boys more frequently reported back pain. There was a clear association between the use of non-prescription analgesics and headache with 34% of adolescents with headache using non-prescription analgesics versus 19% of adolescents with other somatic pain and 14% of adolescents not reporting pain. Among adolescents reporting headache, 9% were reported to use non-prescription analgesics daily or almost daily versus 3% and 2% among those reporting other somatic pain and reporting no pain respectively. In addition, parental use of non-prescription analgesics was a strong independent predictor of adolescent use (adjusted OR 1.69 for boys, 1.54 for girls). This relationship increased when the adolescents were less bothered by headache themselves. Conclusion Headache is the dominant medication-driving pain for non-prescription analgesics among adolescents but parental medication use of non-prescription analgesics also strongly influences adolescent use. Implications There is a need for health services to improve information to parents and adolescents about risks associated with use of analgesics and also to work on prophylactic strategies focusing on adolescents. Parents should be made aware that their medicine use strongly influences that of their children.

Peer Victimization and Related Mental Health Problems in Early Adolescence The Mediating Role of Parental and Peer Support

Peer victimization is a widespread phenomenon especially prevalent in early adolescence. This study investigates the prevalence of peer victimization and its association with mental health problems and impact on everyday life, and the possible mediating effect of parental and peer support. Data are based on a cross-sectional health survey (N = 9,707) among adolescents (10-13 years) and their parents (N = 8,210). The Strengths and Difficulties Questionnaire was used to measure mental health problems, as well as impact on everyday life. Approximately, 17.6% of boys and 15.3% of girls reported being peer victimized. Both genders had higher symptoms of emotional problems, conduct problems, and hyperactivity than non-peer victimized adolescents. Boys had higher symptoms of emotional problems than girls. All symptom scales were strongly associated with perceived impact on everyday life. Peer and parental support buffer mental health problems among the victimized. Study indicates the importance of interventions strengthening peer support among victimized early adolescents.