Siren Haugland

Relieving the Pressure? The Role of Physical Activity in the Relationship between School-Related Stress and Adolescent Health Complaints

Abstract The present study includes a Norwegian sample of 15-year-old students (N = 1,670) and is part of a World Health Organization cross-national survey, Health Behavior in School-Aged Children (Currie, 1998). The objective was to examine the relationship between school-related stress, leisure time physical activity, and adolescent health complaints. Physical activity was also examined as a moderating variable in the relationship between school-related stress and health complaints. The results showed that high levels of complaints were associated in a linear relationship with high levels of school-related stress and low levels of leisure time physical activity. Reports of complaints were more closely related to stress for adolescents with low levels of physical activity; thus, physical activity seems to moderate the relationship between school-related stress and health complaints.

The effect of a solution-focused approach to improve self-efficacy in socially withdrawn school children: A non-randomized controlled trial

BACKGROUND Socially withdrawn children can improve their social skills through increased self-efficacy. Previous studies have shown that socially withdrawn children are prone to low self-efficacy and problems at school. Therefore, we investigated the effects of an intervention on the self-efficacy of these school children. A solution-focused approach may be an appropriate tool in such interventions. OBJECTIVES To explore the effects of a group intervention based on a solution-focused approach on the self-efficacy of a group of socially withdrawn children and to explore possible sex-based differences. DESIGN This interventional study was a non-randomized controlled trial, with experimental and control groups. SETTING The study was performed within the school health services of 14 primary schools in eastern Norway from 2006 to 2008. PARTICIPANTS School children who were aged 12-13 years and identified as socially withdrawn participated: 156 at baseline, but 6 dropped out before the first measurement and an additional 6 did not complete the second measurement. METHODS The participants completed questionnaires assessing general self-efficacy, social self-efficacy, and assertive self-efficacy at three different times. The first time was at baseline, the second was immediately after the 6-week intervention period, and the third was 3 months after the intervention. RESULTS The general self-efficacy scores increased significantly among girls in the experimental group immediately after the intervention compared with those of the control group. The effect size was 0.60. No significant change was observed among the boys at the same time. From baseline to 3 months after the intervention, the general self-efficacy scores increased for both sexes in the experimental group and also in the control group. The assertive self-efficacy of the boys in the experimental group also increased (effect size, 0.29). CONCLUSION This study demonstrates that socially withdrawn children can benefit from a solution-focused approach group intervention and reach their goals, probably because they learn from each other and share their feelings, experiences, and support. These results indicate that a solution-focused approach may be suitable for school nurses in their work with children with special needs. Solution-focused groups are also recommended for use in school health services.

Truancy, alcohol use and alcohol-related problems in secondary school pupils in Norway

This study focuses on a vulnerable group of pupils often missed by mainstream school surveys. It explores alcohol use and alcohol-related problems for a sample of truants of secondary school age, comparing behaviours with a school-based sample from the same geographical area. Analyses are based on a survey among truants (n = 107) and a school survey (n = 3702) undertaken in Bergen, Norway. When compared with mainstream pupils, the truants reported an earlier alcohol debut and a higher frequency of drinking. They reported significantly higher levels of binge drinking (6+ units). Truants were four times more likely to report regular drunkenness and twice as likely to report problems associated with their alcohol consumption. In the truancy sample, boys were more likely to engage in regular and excessive drinking, while girls reported higher levels of problems linked to their drinking. Results suggest that higher levels of truancy were related to more frequent drinking, drunkenness and alcohol-related problems. There are strong indications for early intervention activities directed at truants, and registration of truancy in itself could be a simple and effective way of identifying pupils at risk of a wide range of social and health problems, including high levels of alcohol use.

Sleep and school attendance in adolescence: Results from a large population-based study

Background: The aim of this study was to examine the link between adolescent sleep and non-attendance in school. Methods: A large population-based study from Norway conducted in 2012, the youth@hordaland study, surveyed 8,347 adolescents aged 16–19 years (54% girls). Self-reported sleep measures included bedtime, rise time, sleep duration, sleep efficiency, sleep onset latency (SOL), wake after sleep onset (WASO), insomnia symptoms, tiredness, and sleepiness. School attendance was obtained from national administrative registries. Results: Most sleep parameters were associated with increased risk of school non-attendance. After adjusting for gender and socioeconomic status, short sleep duration and sleep deficiency were the sleep measures with the highest odds of non-attendance (OR=4.61, CI 95% 3.29–6.46) and (OR=3.26, CI 95% 2.67–3.99), respectively). Also, large bedtime discrepancies in weekend versus weekdays were associated with non-attendance (OR=2.43, CI 95% 1.93–2.02), as well as insomnia (OR=2.25, CI % 1.89–2.67) and daytime tiredness (OR=2.09, CI 95% 1.70–2.57). The associations were somewhat reduced after additional adjustment for depression, but remained significant in the fully adjusted model. Conclusion: The demonstrated relationship between sleep problems and school absence suggests that careful assessment of sleep is warranted when adolescents present with extensive school absence. Future studies on how the sleep–school absence relationship in adolescence may impact later work affiliation in adulthood are needed.

Challenges of Reliability and Validity in the Identification and Monitoring of Emerging Drug Trends

There is increasing pressure on drug monitoring systems to achieve earlier detection and greater precision in reporting of emerging drug use trends. Such systems typically operate in settings where government interest and the drug use trends themselves can be fluid. To achieve the goal of informing timely policy and practice responses in this environment, drug use monitoring systems must be flexible and responsive, as well as reliable and valid. This paper explores three interrelated areas relevant to trend monitoring that can benefit from a clearer focus in terms of increasing validity and reliability: the research paradigm to which systems adhere; the selection of sources or drug use indicators utilized by systems; and the process of analysis used by systems to ensure valid results. The reliability and validity of currently utilized drug use related indicators is discussed, with a focus on the validity of data sources as measures of emerging drug use trends. The relevance and utility of current descriptives such as “lagged” and “leading edge” indicators are assessed. Five dimensions, against which the validity of drug use indicators may be assessed in a trend-monitoring context are proposed as an alternative. Faced with a lack of clear conceptual frameworks underpinning and driving monitoring systems, it is argued that a pragmatic research paradigm can be adopted as a basis for guiding selection of indicators and helping to make explicit the concurrent or supplementary triangulation and analysis procedures on which valid results are necessarily founded. The current trend of using triangulation as the primary means of ensuring the validity of systems is critically reviewed and a challenge is issued to the field to make the analysis process more overt. No external funding was received for this article.

Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review

ABSTRACT This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims’ age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3–23% for boys and 11–36% for girls. The prevalence rates for contact abuse were 1–12% for boys and 6–30% for girls, while 0.3–6.8% of the boys and 1.1–13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology.

Comparing urine samples and cervical swabs for Chlamydia testing in a female population by means of Strand Displacement Assay (SDA)

BackgroundThere has been an increasing number of diagnosed cases of Chlamydia trachomatis in many countries, in particular among young people. The present study was based on a growing request to examine urine as a supplementary or primary specimen in screening for Chlamydia trachomatis in women, with the Becton Dickinson ProbeTec (BDPT) Strand Displacement Assay (SDA). Urine samples may be particularly important in screening young people who are asymptomatic.MethodsA total of 603 women aged 15 and older were enrolled from the Sexually Transmitted Infection (STI) clinic at Haukeland University Hospital, Norway, in 2007. Only 31 women were older than 35 years. Cervical swabs and urine samples were tested with BDPT for all participants. In cases of discrepant test results from a given patient, both samples were retested by Cobas TaqManCT and a Polymerase Chain Reaction (PCR)-method (in-house). Prevalence of C. trachomatis, sensitivity, and specificity were estimated by latent class analysis using all test results available. Bootstrap BC confidence intervals (10 000 computations) were estimated for sensitivity and specificity, and their differences in cervix vs. urine tests.ResultsA total of 1809 specimens were collected from 603 patients. 80 women (13.4%) were positive for C. trachomatis. Among these, BDPT identified 72 and 73 as positive in cervix and urine samples, respectively. Of the 523 C. trachomatis negative women, BDPT identified 519 as negative based on cervical swabs, and 514 based on urine samples. Sensitivity for cervical swabs and urine samples with the BDPT were 89.0% (95% CI 78.8, 98.6) and 90.2% (95% CI 78.1, 95.5), respectively. The corresponding values for specificity were 99.2% (95% CI 98.3, 100) and 98.3% (95% CI 96.4, 100).ConclusionsThis study indicates that urine specimens are adequate for screening high-risk groups for C. trachomatis by the SDA method (BDPT). Such an approach may facilitate early detection and treatment of the target groups for screening, and be cost-effective for patients and the health services.

Pain in childhood and adolescence: diagnosis, smokescreen or everyday complaints?

A large number of adolescents complain of headaches, backache, abdominal pain and pain in the limbs.

Breastfeeding surveyed using routine data

BACKGROUND The purpose of this study was to investigate breastfeeding as a health indicator through routine data registered at public child health centres. The prevalence and course of breastfeeding were surveyed, as well as factors that affect breastfeeding. MATERIAL AND METHOD Breastfeeding status at six weeks and six months of age and other routine data were systematically recorded in a newly developed electronic medical records system (Health Profile 0-20 years) for infants attending public child health centres in Bergen in the period 2010-11. This information was linked to data from the Medical Birth Registry. RESULTS Of 6,093 infants, 73.6% were exclusively breastfed at six weeks of age and 18.9% at six months. In adjusted analyses, there was an association between breastfeeding cessation before six months and the factors smoking, low maternal age, marital status as single, unsatisfactory family situation and social network, and birth weight under 2,500 g. Attendance at a specialist breastfeeding centre and uncertain/abnormal sleep patterns in infants were associated with continued breastfeeding after six months. INTERPRETATION The medical records system «Health Profile 0-20 years», linked to the Medical Birth Registry, was well suited to studying factors that can affect breastfeeding. Mothers and infants with increased need for follow-up were identified.

Abuse of gamma-hydroxybutyrate

BACKGROUND Gamma-hydroxybutyrate (GHB) is naturally present in the human body, but may also be used as an intoxicating drug. Information from several sources has suggested its increased availability and use in Norway. There have also been reports of an increasing use of the chemical precursor gamma-butyrolactone (GBL).There is currently a need for knowledge on symptoms, addictiveness and overdoses, as well as targeted preventive measures. MATERIAL AND METHODS The article is based on a discretionary selection of articles resulting from a literature search in PubMed, as well as reports from Norwegian and European authorities and research institutions. RESULTS An intake of small amounts of GHB produces an intoxicating effect, whereas higher doses can result in poisoning. Deaths have been reported. The effect may be variable, due to a steep dose-response curve and interaction with alcohol and other intoxicants. Treatment of poisoning is symptomatic and supportive. Treatment of abstinence is also supportive, while delirium may be treated as delirium tremens. INTERPRETATION Preventive measures should be tailored specifically to potential user-groups.