Characteristics associated with non-initiation and non-completion of human papillomavirus vaccination among Danish girls: a nationwide register-based cohort study.

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.

The Impact of the Danish National Smoking Ban From 2007 on the Incidence of Eight Smoking-related Diseases: A Nationwide Register-based Interrupted Time Series Analysis.

BACKGROUND: Previous research has documented the effect of comprehensive smoking bans on preventing various adverse health outcomes in the years post-ban. In 2007, Denmark implemented a national smoking ban that prohibited indoor smoking in workplaces and public settings, although only partial restrictions applied in specific premises such as small bars, one-person offices, and in psychiatric units. We tested the hypothesis that the implementation of the national smoking ban was associated with a decrease in incidence of smoking-related morbidity in the Danish population compared to the pre-ban period. METHODS: Interrupted time series analyses including the entire Danish population (≥30 years) was conducted. Information of hospitalizations and cause-specific mortality due to acute myocardial infarction, heart failure, hemorrhagic stroke, ischemic stroke, chronic obstructive pulmonary disease, cancer in bronchus and lung, cancer in lip, mouth, oral cavity, and pharynx, and bladder cancer were obtained from population-based registers. Poisson regression models accounting for seasonal variations and secular trends quantified immediate changes in incidence rates occurring at the time of the smoking ban as well as changes in the post-ban trend compared to pre-ban levels. RESULTS: Overall, we observed no consistent declines in incidence of cardiovascular diseases, chronic obstructive pulmonary disease, or the specific types of cancer in the post-ban period compared with the pre-ban period. CONCLUSION: No consistent reduction in incidence of smoking-related diseases was observed after the smoking ban was introduced in Denmark. This probably reflects that the Danish smoking ban included several exemptions, resulting in a less comprehensive ban compared to those introduced in other countries. IMPLICATIONS: In this study, we found that the Danish national smoking ban from 2007 did not consistently reduced the incidence of eight smoking-related outcomes in the post-ban period compared to pre-ban levels. We argue that due to the exemptions in the smoking ban, which for example allowed smoking in specific premises of the care and nursing sector, in one-person offices, and small bars, the ban was not sufficiently comprehensive to influence smoking behavior and thereof the incidence of smoking-related morbidity. Our findings highlight the importance of introducing comprehensive legislative measures to yield largest health benefits at a population level.

Time trends and geographical patterns in suicide among Greenland Inuit.

BACKGROUND: Between 1980 and 2018 Greenland has had one of the highest suicide rates in the world with an average rate of 96 suicides per 100,000 people annually. The aim of this study is to investigate suicide rates in Greenland according to age, birth cohort, period, sex, place of residence and suicide method from 1970 until 2018. METHODS: Suicide rates were examined using register and census data from 1970-2018 among Greenland Inuit. Rates were calculated by Poisson regression in Stata and by use of Excel. In analyses of the period trends, rates were standardized according to the World Standard Population 2000-2025. RESULTS: The suicide rate has been declining since a peak at 120 suicides per 100,000 people annually in the 1980s but remained high at a rate of 81.3 suicides per 100,000 people annually from 2015-2018. Descriptive analyses point to the decrease in male suicides as the primary factor for the overall decreasing rates while the rate among women has been increasing. Simultaneously, the proportion of women who used a violent suicide method increased from 60% in 1970-1979 to 90% in 2010-2018. The highest rates are seen among young people, especially young men aged 20-24 years and youth suicide rates increased with later birth cohorts. When the rates started to increase in the 1980s both the capital Nuuk and East Greenland had the highest rates. Since then, the rate in Nuuk has declined while the rate in East Greenland was three times the national rate from 2015-2018. CONCLUSIONS: From 1970 to 1989 the suicide rate increased from 28.7 to 120.5 per 100,000 people mirroring a rapid societal transition in the post-colonial period. The rate has slowly declined from the peak in the 1980s but remains at a very high level. Young people in general are at risk, but the steady increase in the rate among women is worrying and there is a need to investigate underlying causes for this development.

Alcohol Drinking Patterns and Risk of Developing Acute and Chronic Pancreatitis.

AIM: The aim was to analyze the effects of drinking pattern and type of alcohol on risk of acute and chronic pancreatitis. METHODS: Prospective cohort study based on data from 316,751 men and women participating in the Danish National Health Surveys 2010 and 2013. Self-reported questionnaire-based alcohol parameters and information on pancreatitis was obtained from national health registers. Cox regression models were used adjusting for baseline year, gender, age, smoking, Body Mass Index, diet and education. RESULTS: Development of acute and chronic pancreatitis increased with alcohol intake with a significant increase among abstainers and those drinking >14 drinks per week compared with individuals drinking 1-7 drinks per week. Frequent binge drinking and frequent drinking (every day) was associated with increased development of acute and chronic pancreatitis compared with those drinking 2-4 days per week. Problematic alcohol use according to the CAGE-C questionnaire was associated with increased development of acute and chronic pancreatitis.Intake of more than 14 drinks of spirits per week was associated with increased development of acute and chronic pancreatitis, and more than 14 drinks of beer per week were associated with increased development of chronic pancreatitis, whereas drinking wine was not associated with development of pancreatitis. CONCLUSION: This large prospective population study showed a J-shaped association between alcohol intake and development of pancreatitis. Drinking every day, frequent binge drinking and problematic alcohol use were associated with increased development of pancreatitis and drinking large amounts of beer and spirits might be more harmful than drinking wine.

A natural experiment: Assessment of Danish high-school students' alcohol drinking patterns from 2014 and 2019 after the introduction of a common alcohol policy.

AIM: In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy. METHODS: We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers. RESULTS: Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 (p=0.413). CONCLUSIONS: No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019.

Alcohol norms and alcohol intake among high school students.

AIMS: To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents. METHODS: This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents. RESULTS: The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents. CONCLUSIONS: Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Changes in loneliness prevalence in Denmark in the 21st century: Age-period-cohort analysis.

AIM: The aim of this study was to investigate changes in the prevalence of loneliness in Denmark from 2000 to 2021 by conducting age-period-cohort analysis. METHODS: Our study was based on a sample (N=83,437; age: ⩾16 years) of the Danish Health and Morbidity Surveys conducted in Denmark in 2000, 2005, 2010, 2013, 2017 and 2021. We used logistic regression models by gender to estimate the age-period-cohort effects, with loneliness as the dependent variable and age, survey year and birth cohort as independent variables, mutually adjusted. RESULTS: The prevalence of adult loneliness increased by each survey year over the entire period (from 13.2% in 2000 to 27.4% in 2021 among men and from 18.8% to 33.7% among women). Overall, a U-shaped curve, for the prevalence of loneliness among different age groups, was observed, which was most pronounced among women. The greatest increase in the prevalence of loneliness from 2000 to 2021 was observed among the youngest age group (16-24 years), with 28.4 and 30.7 percentage points for men and women. No significant cohort effect was observed. CONCLUSIONS: The observed increase in loneliness prevalence from 2000 to 2021 was driven by period and age effects rather than cohort effects. It should be noted that data from 2021 were collected during a national lockdown due to an outbreak of COVID-19, which could explain part of the large increase in loneliness from 2017 to 2021.

Smoking and labour market participation: a 5-year prospective cohort study of transitions between work, unemployment and sickness absence.

AIM: To examine whether smokers are at higher risk of unemployment and sickness absence and have a lower chance of getting employed compared to never smokers. METHODS: The study sample in this prospective register-based cohort study consisted of 87,830 men and women between 18 and 60 years of age from the Danish National Health Survey 2010. Assessment of smoking status was obtained at baseline and the participants were followed in the Danish register-based evaluation of marginalisation database from 2010 to 2015. Data were analysed by Cox proportional hazards. RESULTS: The median age was 44.5 years and 47.3% were men. At baseline, 88.8% were categorised as working, 7.7% as unemployed and 3.5% as being on sickness absence. At the 5-year follow-up, hazard ratios for transitions from work to unemployment were 1.31 (95% confidence interval (CI) 1.22-1.40; P<0.001) for current smokers (<15/day) and 1.52 (95% CI 1.43-1.62; P<0.001) for current heavy smokers (⩾15/day), compared to never smokers. Hazard ratios for transitions from work to sickness absence were 1.31 (95% CI 1.24-1.38; P<0.001) for current smokers (<15/day) and 1.64 (95% CI 1.56-1.71; P<0.001) for current heavy smokers (⩾15/day). Current heavy smokers (⩾15/day) also had a lower chance of becoming re-employed with a hazard ratio of 0.81 (95% CI 0.75-0.88; P<0.001) compared to never smokers.Smoking was associated with a higher risk of unemployment and sickness absence, and a lower chance of becoming employed. More focus on smoking prevention and smoking cessation could therefore be implemented in relation to job seeking and sickness absence.

Alcohol use among adolescents during the first pandemic lockdown in Denmark, May 2020.

OBJECTIVE: As alcohol is often consumed for social purposes, we aimed to explore how restrictions during the first Danish COVID-19 lockdown affected the alcohol use among adolescents aged 15-20. METHOD: In May 2020, 11,596 15- to 20-year-olds from two subpopulations answered a survey regarding their alcohol use and social life, as well as changes to these, during the Danish lockdown. Using survey data from all participants, we performed a multinomial logistic regression to assess the association between determinants of alcohol use and perceived change in alcohol use during the Danish lockdown. We used longitudinal data from one subpopulation (n=1869) to perform negative binomial regressions exploring changes in frequency of alcohol use from 2019 to 2020. RESULTS: Of all participants, 59% drank less, 75% had fewer in-person social interactions and 56% met more frequently online during lockdown. Girls were more likely than boys to have a perceived decrease in alcohol use during lockdown (odds ratio (OR)=1.41; 95% confidence interval (CI) 1.27-1.56). A perceived decrease in in-person social interaction during lockdown was associated with less drinking (OR=2.27; 95% CI 1.98-2.61), while a perceived increase in in-person social interaction during lockdown was associated with more drinking (OR=1.42; 95% CI 1.11-1.82) compared to unchanged drinking behaviour and social interaction. CONCLUSIONS: Adolescents in Denmark drank less during the Danish lockdown than before. Findings indicate that there is a close relationship between in-person social interactions and frequency of drinking. Drinking episodes when meeting online were rare and were not unambiguously associated with changes in drinking during lockdown.

Trends in smoking-related diseases by socioeconomic position following a national smoking ban in 2007: a nationwide study in the Danish population.

BACKGROUND: National comprehensive smoke-free legislation has been found to decrease the incidence of several smoking-related diseases. In 2007, Denmark introduced a national smoking ban, which banned smoking indoor in workplaces and public places, although only partial restrictions were applied in certain settings. We examined the impact of the smoking ban on smoking-related diseases and whether this differed across socioeconomic groups. METHODS: Interrupted time series analyses of nationwide register data were performed using Poisson regression models to examine the differential impact of the smoking ban on monthly incidence rates of acute myocardial infarction, chronic obstructive pulmonary disease, and smoking-related cancers from 2002 to 2015. Immediate changes in incidence rates after the smoking ban and long-term changes in disease trends were estimated by comparing data from the pre- and post-ban period. Models were stratified by socioeconomic position. RESULTS: Overall, we found neither immediate changes in rates of acute myocardial infarction, chronic obstructive pulmonary disease, and smoking-related cancers following the smoking ban nor long-term post-ban changes in disease trends as compared to before the ban. Results did not differ across socioeconomic groups. A pronounced socioeconomic gradient in incidence rates was observed for all outcomes both before and after the smoking ban. CONCLUSION: The national smoking ban was not associated with a lower incidence of smoking-related diseases in the post-ban period compared to pre-ban levels and no differences between socioeconomic groups were observed. Future tobacco control in Denmark should consider which measures most effectively target the low socioeconomic groups to decrease the current strong socioeconomic inequality in health.

Prevention of hazardous use of alcohol among high school students: a study protocol for the randomized controlled trial 'Our choice'.

BACKGROUND: Adolescent hazardous alcohol use is prevalent and has serious short- and long-term consequences. The trial 'Our Choice' examines efficacy, feasibility and acceptability of prevention interventions targeting school, parent, and student levels at Danish high schools. We hypothesize that students in a structural intervention (school and parent levels) reduce hazardous alcohol use and related health behaviors compared to students in an assessment only control group 12 months post baseline; and that adding group-based Motivational Interviewing (group MI) yields further improvements. The study examines the efficacy of interventions targeting multiple levels with the aim of providing novel insights into prevention of adolescent hazardous alcohol use and related health outcomes. METHOD: The study employs a parallel group cluster randomized controlled trial design with three conditions: (1) structural condition targeting school and parent levels, (2) structural condition combined with group MI which also targets the student level, and (3) assessment-only control condition. A participatory approach is used to adapt and develop interventions. Sixteen high schools in Denmark and about N = 3100 first-year students (15-18 years) enrolled in high school in August 2023 will be recruited. Data will be collected via online questionnaires pre-interventions (baseline), 2, 6, 9 and 12 month post baseline and analyzed with generalized linear mixed models. The primary outcome is past month high intensity drinking; secondary outcomes are alcohol use, alcohol-related consequences, well-being, tobacco, and illegal substance use. Feasibility and acceptability will be assessed via surveys (students) and interviews (high school staff) to inform future implementation. DISCUSSION: 'Our Choice' is the first trial to compare the efficacy of a structural intervention targeting school- and parent levels to an intervention targeting these levels and the student level via group MI - on hazardous drinking and related health outcomes among students. Preventing and reducing hazardous alcohol use during adolescence is crucial due to the short- and long-term negative consequences. The tested interventions can be implemented at low cost. The study has significant implications for adolescent health and well-being and has potential to inform evidence-based decisions on alcohol prevention policy, education, and health professions. TRIAL REGISTRATION NUMBER: The trial was retrospectively registered at ClinicalTrials.gov on August 24th, 2023. TRIAL REGISTRATION NUMBER: ID NCT06018389.

Changes in adult obesity prevalence in Denmark, 1987-2021: age-period-cohort analysis of nationally representative data.

BACKGROUND: During the last decades, the prevalence of obesity [body mass index (BMI): weight/height2), ≥30.00 kg/m2] among adults has increased considerably. We examined whether this increase in a high-income, welfare state, like Denmark was driven by age, period or cohort effects, which would inform preventive strategies aiming at reducing the prevalence. METHODS: We used data from the National Representative Health and Morbidity Studies, which are representative surveys of the Danish adult population (age 16 years and above), conducted in 1987, 1994, 2000, 2005, 2010, 2013, 2017 and 2021 (N = 91 684). Participants reported height and weight, from which BMI was calculated after correction for systematic bias in self-reported data and non-response. Age, survey year and birth cohorts were mutually adjusted and adjusted for sex in generalized linear models. RESULTS: The obesity prevalence increased from 6.1% in 1987 to 18.4% in 2021, similarly in men (18.8%) and women (18.0%) and in all age groups. Age had an inverted u-shaped effect on the prevalence. Compared with individuals aged 16-24 years, the highest rate of obesity was seen for the age group 55-64 years [rate ratio 3.27, 95% confidence interval (CI): 2.58; 4.14]. The increasing rate for each recent survey year over time was compatible with a period effect without any birth cohort effects. The rate for obesity in 2021 was 4.16 in 1987 vs. 1987 (95% CI: 3.10; 5.59). CONCLUSIONS: Obesity prevalence in Denmark increased steadily during the period 1987 through 2021, primarily driven by secular changes over time across all ages and birth cohorts.

Symptoms of distress among young Danes during the national lockdown in May 2020.

Objectives of this study were to assess (1) prevalence of worries and symptoms of distress, and (2) perceived change in symptoms of distress by sociodemographic factors and preexisting vulnerabilities, among young Danes under the first COVID-19 related lockdown. Data were derived from online surveys, collected 7th-18th of May 2020. The study population included 11,245 young people (15-20 years of age), of which 1807 had participated in The Danish National Youth Study 2019 (DNYS19). Descriptive statistics and linear regressions analyses, including robust standard errors, were performed. All analyses were based on cross-sectional data, except analyses of preexisting vulnerabilities among responders from DNYS19. Few young people were very worried to get infected with coronavirus. Females reported a higher frequency of symptoms of distress than males. Perceived change in symptoms of distress, did not vary systematically based on age, cohabitation, nor physical health conditions. Individuals working, perceived a lower increase in symptoms of distress, than those studying etc. Females with symptoms of anxiety pre-pandemic, mental health disorders, and in families with economic hardship had a marginal higher perceived increase in symptoms of distress, than females without these difficulties. The tendencies were similar but nonsignificant among males, and for symptoms of depression pre-pandemic. In conclusion, during the lockdown, young females reported a higher frequency of symptoms of distress than males, and individuals with symptoms of anxiety pre-pandemic, mental health disorders, and in families with economic hardship were more likely to perceive the lockdown to be associated with an increase in symptoms of distress, than individuals without these difficulties.

The Danish National Youth Study 2019: study design and participant characteristics.

AIM: To present the study design, study population and questionnaire content of the Danish National Youth Study 2019, and to describe the differences between participants and non-participants regarding demographic and socioeconomic characteristics. METHOD: The Danish National Youth Study 2019 is a nationwide web-survey among high school students in Denmark. Data was collected from January to April 2019 through a self-administered questionnaire in the classroom. The questionnaire included 120 questions on, for example, physical and mental health, health behaviour and well-being. Data collection took place at 50 general high schools, 32 preparatory high schools, 15 commercial high school and 19 technical high schools. RESULTS: A total of 29,086 students participated (20,287 general high school students, 2,113 preparatory higher school students, 4027 commercial high school students and 2659 technical high school students) corresponding to 66% of the students in the 88 participating schools (31% of invited schools). Among students, 55% were female and the mean age was 17.8 years. Participants were more likely to be female, to be younger, to be of Danish origin, and have family disposable income in the highest quartile compared to non-participants. CONCLUSIONS: The Danish National Youth Study 2019 contributes to knowledge on high school students' health, health behaviour and well-being that can support health planning and prioritizing, through identification of specific risk groups at both local and national level. The study also offers great opportunities for future research as it provides possibility of linkage to various Danish national registers.

The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings.

BACKGROUND: Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. METHODS: We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. DISCUSSION: The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. TRIAL REGISTRATION: www.ClinicalTrials.gov ; ID NCT04601779 ; Protocol ID 95-110-21307. Registered 25 June 2021.

Are emotional symptoms and depression among young people with parental alcohol problems modified by socioeconomic position?

The aim was to test the hypothesis that parental alcohol problems and low socioeconomic position would be associated with higher odds ratio of emotional symptoms and depression as compared to high socioeconomic position and parental alcohol problems. Data came from Danish National Youth Study 2014, a web-based national survey with 75,853 high school and vocational school students participating, merged with register-data on family socioeconomic position. Multi-level logistic regression models (nesting participants within schools) were used to assess the association between perceived parental alcohol problems and frequent emotional symptoms and depression and effect modification by financial strains in the family, family income, or parental educational level. All analyses were adjusted for age, sex, education, immigration status, and cohabitation with parents. Young people with parental alcohol problems had higher odds ratio of experiencing frequent emotional symptoms (OR = 1.56 [1.46-1.66]) and depression (OR = 2.07 [1.88-2.28]), compared to young people without parental alcohol problems. There was no effect modification between severity of parental alcohol problems and the measures of socioeconomic position on the odds ratio of frequent emotional symptoms and depression. This study found that young people with parental alcohol problems in all social strata had higher odds ratios of frequent emotional symptoms and depression compared to young people without parental alcohol problems; the more severely they had been affected by parent's alcohol problems, the higher the odds ratios of frequent emotional symptoms and depression.

Associations between health-risk behaviours and non-condom use among 28,620 Danish students: a cross-sectional study.

PURPOSE: Investigations into the associations between health-risk behaviours and non-condom use are important for planning effective preventive interventions targeted sexually transmitted infections. To date, there are no such studies on the Danish general population. The aim of this study was to examine associations between health-risk behaviours (including daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) and non-condom use among Danish students. MATERIAL AND METHOD: Cross-sectional data from 28,620 sexually active students aged 15-25 years from the Danish National Youth Study 2014 were analysed using multilevel logistic regression. RESULTS: Health-risk behaviours (daily smoking, frequent binge-drinking, cannabis use within the last month and illicit drug use) were significantly associated with higher odds for non-condom use among Danish students, even after adjustment for age, gender, education, religion, and geographical region. The associations remained significant after adjusting for the remaining health-risk behaviours. CONCLUSION: Overall, the study showed a clear association between health-risk behaviours and non-condom use among Danish students. The findings of this study have important implications for future planning of more targeted health promotion intervention programmes aimed to increase condom use among young people as a means to reduce sexually transmitted infections.

Changes in relationship status following bariatric surgery.

BACKGROUND AND OBJECTIVE: Bariatric surgery is a major event associated with psychological changes such as improvements in self-esteem, increased autonomy, and better self-value. Such changes could affect the patient's interpersonal relationships; however, little is known about the impact of bariatric surgery on changes in relationship status. In this paper, we aim to test the hypothesis that bariatric surgery is associated with changes in interpersonal relationships such as becoming single for those who were in a relationship or entering a relationship among those who were single before surgery. METHODS: This register-based cohort study consisted of 12,493 patients undergoing bariatric surgery (95% gastric bypass) from 2005 to 2013 and a reference group of 15,101 individuals with obesity between the age of 18-63 with a body mass index between 32 and 60 kg/m2. Transitions between married, divorced, widowed, never-married single, and living with a partner without being married were analyzed by Poisson regression. Additionally, the outcome was dichotomized, and transitions between being single and being in a relationship were also analyzed. All analyses were weighted using inverse probability of treatment weighting based on propensity scores. RESULTS: The overall incidence rate ratio (IRR) of changing status from being single to in a relationship was 2.03 (95% CI: 1.18-2.28), and the overall IRR of changing status from being in a relationship to single was 1.66 (95% CI: 1.50-1.83). CONCLUSION: Bariatric surgery is associated with a higher chance of finding a partner among single individuals, and a higher risk of separating from a partner among individuals in a relationship.

Plasma Concentrations of Magnesium and Risk of Dementia: A General Population Study of 102 648 Individuals.

BACKGROUND: Low and high concentrations of plasma magnesium are associated with increased risk of future all-cause dementia; however, the underlying reasons remain elusive. The magnesium ion is an important electrolyte serving as a cofactor in many enzymatic processes in the human organism. Magnesium affects both neuronal and vascular functions. We investigated the associations of plasma concentrations of magnesium associate with common subtypes of dementia as Alzheimer dementia and non-Alzheimer dementia, and potential pathways by which magnesium may affect risk of dementia. METHODS: Plasma concentrations of magnesium were measured in 102 648 individuals from the Copenhagen General Population Study. Cox regression and natural effects mediation analyses evaluated associations with either Alzheimer dementia or non-Alzheimer dementia. RESULTS: Multifactorially adjusted hazard ratios for non-Alzheimer dementia were 1.50(95% confidence interval (CI):1.21-1.87) for the lowest and 1.34(1.07-1.69) for the highest vs the fourth quintile (reference) of plasma magnesium concentrations. Diabetes, cumulated smoking, stroke, and systolic blood pressure mediated 10.4%(3.1-22.8%), 6.8%(1.2-14.0%), 1.3%(0.1-3.6%), and 1.0%(0.2-2.6%), respectively, in the lowest quintile, whereas stroke mediated 3.2%(0.4-11.9%) in the highest quintile. No associations were observed for Alzheimer dementia. CONCLUSIONS: Low and high plasma magnesium concentrations were associated with high risk of vascular-related non-Alzheimer dementia, with the lowest risk observed at a concentration of 2.07 mg/dL (0.85 mmol/L). No association was observed for Alzheimer dementia. Mediation analysis suggested that diabetes may be in the causal pathway between low plasma magnesium concentrations and high risk of non-Alzheimer dementia, while cumulated smoking, stroke, and systolic blood pressure played minor mediating roles.

Does Class Proportion of Students with Non-Western Origin in High Schools Affect Drinking Habits Among Ethnic Danish Students?

AIM: the objective was to test the hypothesis that a higher proportion of students with non-Western origin in high school classes is associated with lower and less frequent alcohol consumption among ethnic Danish students. METHOD: data on country of origin was obtained from the Danish Civil Registration System, while information on drinking habits were derived from the Danish National Youth Study 2014. Multilevel zero-inflated binominal regression was used to assess the association between class proportion of students with non-Western origin and odds of non-drinking and mean weekly alcohol consumption, while multilevel logistic regression was used to assess the association with frequent binge drinking. RESULTS: a higher proportion of students with non-Western origin in class was associated with higher odds of non-drinking among ethnic Danish student in the same class. For example, ethnic Danish boys in classes with more than 15% of the students of non-Western origin had 77% higher odds of being non-drinkers, compared to ethnic Danish boys in classes where 0-5% had non-Western origin (OR: 1.77, 95% CI; 1.42-2.20). Among ethnic Danish students that did consume alcohol, class proportion of students with non-Western origin was not associated with weekly alcohol consumption, while a higher proportion of students with non-Western origin in class was associated with lower odds of frequent binge drinking. CONCLUSION: the downward drinking trend among adolescents in Western countries may be partly explained by the higher proportion of youth with non-Western origin, influencing the prevalence of drinking and frequency of binge drinking among adolescents in the ethnic majority population.