The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study.

BACKGROUND: The COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries. METHODS: Data were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption. RESULTS: A total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50-59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%). CONCLUSIONS: Smoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.

A randomized controlled trial on the effects of blue-blocking glasses compared to partial blue-blockers on sleep outcomes in the third trimester of pregnancy.

OBJECTIVE: Sleep disturbances are common in pregnancy. Blocking blue light has been shown to improve sleep and may be a suitable intervention for sleep problems during pregnancy. The present study investigated the effects of blue light blocking in the evening and during nocturnal awakenings among pregnant women on primary sleep outcomes in terms of total sleep time, sleep efficiency and mid-point of sleep. METHODS: In a double-blind randomized controlled trial, 60 healthy nulliparous pregnant women in the beginning of the third trimester were included. They were randomized, using a random number generator, either to a blue-blocking glass intervention (n = 30) or to a control glass condition constituting partial blue-blocking effect (n = 30). Baseline data were recorded for one week and outcomes were recorded in the last of two intervention/control weeks. Sleep was measured by actigraphy, sleep diaries, the Bergen Insomnia Scale, the Karolinska Sleepiness Scale and the Pre-Sleep Arousal Scale. RESULTS: The results on the primary outcomes showed no significant mean difference between the groups at posttreatment, neither when assessed with sleep diary; total sleep time (difference = .78[min], 95%CI = -19.7, 21.3), midpoint of sleep (difference = -8.9[min], 95%CI = -23.7, 5.9), sleep efficiency (difference = -.06[%], 95%CI = -1.9, 1.8) and daytime functioning (difference = -.05[score points], 95%CI = -.33, .22), nor by actigraphy; total sleep time (difference = 13.0[min], 95%CI = -9.5, 35.5), midpoint of sleep (difference = 2.1[min], 95%CI = -11.6, 15.8) and sleep efficiency (difference = 1.7[%], 95%CI = -.4, 3.7). On the secondary outcomes, the Bergen Insomnia Scale, the Karolinska Sleepiness Scale and the Pre-Sleep Arousal Scale the blue-blocking glasses no statistically significant difference between the groups were found. Transient side-effects were reported in both groups (n = 3). CONCLUSIONS: The use of blue-blocking glasses compared to partially blue-blocking glasses in a group of healthy pregnant participants did not show statistically significant effects on sleep outcomes. Research on the effects of blue-blocking glasses for pregnant women with sleep-problems or circadian disturbances is warranted. TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov (NCT03114072).

Aggression and criminality in androgen abusers.

PURPOSE OF REVIEW: To systematically review and meta-synthesize current (2019-2021) literature on aggression and criminality in androgen abusers. Results from 13 empirical human studies are discussed. RECENT FINDINGS: Some androgen abusers engage in aggressive and criminal behavior. Here, results show positive effects and associations between the administration of androgens and aggression, and descriptions of various patterns and kinds of aggression and criminality in androgen abusers. Still, this positive relationship seems to be mediated by various factors, such as cognition, neurobiology, personality, polypharmacy, and study methods. SUMMARY: The current literature on aggression and criminality in androgen abusers shows methodical diversity and underlines the need to synthesize the current evidence in order to draw overall conclusions as well as identify relevant and important knowledge gaps. On the basis of a systematic literature search, we identified 13 studies and categorized them by methodology. Of the 13 studies, 4 were meta-analyses and systematic reviews, 1 was a randomized controlled trial, 4 were cross-sectional studies, and 4 constituted case reports. Evidence on the relationship between androgen abuse and involvement in aggressive behavior seems to be mediated by cognition, neurobiology, personality, and polypharmacy as well as methodical factors, such as study design, aggression severity, type of measurement, and temporal proximity. Implications for practice and future research are presented.

Smoking and snus use among Norwegian students: Demographic, personality and substance use characteristics.

Background and aim: Smoking rates are decreasing in Norway while the use of snus has increased. We aimed to investigate the co-occurrence of, and the socio-demographics, personality and substance use characteristics associated with, student smoking and snus use. Methods: Survey data were collected among students in higher education in Bergen, Norway in 2015 (N = 11,236, response rate 39.4%). Multinomial regression analyses comparing snus users and smokers to non-users and non-smokers, respectively, on demographic, personality and substance use variables were conducted. Regression analyses comparing current dual users to current smokers and current snus users and comparing daily smokers to daily snus users, on demographic, personality and substance use variables were also conducted. Results: In total 67.9% of ever snus users identified themselves as non-smokers (past and current). Several demographic, personality and substance use characteristics associated with smoking and snus use were identified (all = p < .05), some of which were common for both (e.g., use of cannabis) and some which were exclusively associated with either smoking (e.g., neuroticism) or snus use (e.g., extroversion). Conclusion: The current study contributes with several novel findings regarding traits associated with smoking and snus use. Though limited by a cross-sectional design, the current findings may suggest that the group of students using snus consists of a combination of previous smokers, students who would have smoked if snus was not available and a new segment who may not have used nicotine if snus was not available.

The Association Between Shift Work and Immunological Biomarkers in Nurses.

Objectives: Shift work is associated with several negative health effects. The underlying pathophysiological mechanisms are unclear, but low-grade inflammation has been suggested to play a role. This project aimed to determine whether levels of immunological biomarkers differ depending on work schedule, self-reported sleep duration, self-reported sleep quality, and presence of shift work disorder (study 1). Furthermore, we aimed to determine whether these biomarkers differ after a night of sleep vs. at the end of a night or a day shift (study 2). Methods: In study 1, 390 nurses provided blood samples after a night of sleep with the dried blood spot method. In study 2, a subset of 55 nurses also provided blood samples after a day shift and after a night shift. The following biomarkers were measured: interleukin-1alpha, interleukin-1beta, interleukin-4, interleukin-6, interleukin-8, interleukin-10, interleukin-13, monocyte chemoattractant protein-1, interferon-gamma, and tumor necrosis factor-alpha. Multiple linear regressions with adjustment for age, sex and body mass index (study 1) and ANOVAs with repeated measures (study 2) were conducted. Results: In study 1, neither work schedule, number of night shifts, number of quick returns (<11 h between consecutive shifts), sleep duration, poor sleep quality, nor shift work disorder were systematically associated with most of these biomarkers. Compared with day only work, day-evening work was associated with higher levels of IL-1alpha and IL-13, quick returns were associated with higher levels of IL-1beta and MCP-1, short sleep duration (<6 h) was associated with lower levels of IL-1beta and higher levels of TNF-alpha, and long sleep duration (8+ h) was associated with higher levels of IL-13. In study 2, IL-1beta levels were higher (large effect size) both after a day shift (14% increase) and a night shift (75% increase) compared with levels after a night of sleep. Similarly, TNF-alpha levels were higher (moderate-large effect size) after a day shift (50% increase) compared to after a night of sleep. In contrast, MCP-1 levels were lower (large effect size) both after a day shift (22% decrease) and a night shift (12% decrease) compared with after a night of sleep. Conclusions: We found some indications that shift work influenced immunological biomarkers. The results should be interpreted with caution due to limitations, e.g., related to the sampling procedure and to low levels of biomarkers in the blood samples.

Shift Work and Lifestyle Factors: A 6-Year Follow-Up Study Among Nurses.

Objectives: To evaluate different work schedules, short rest time between shifts (quick returns), and night shift exposure for their possible adverse effects on different lifestyle factors in a 6-year follow-up study. Methods: Data stemmed from "The Survey of Shiftwork, Sleep and Health," a cohort study of Norwegian nurses started in 2008/9. The data analyzed in this sub-cohort of SUSSH were from 2008/9 to 2015 and consisted of 1,371 nurses. The lifestyle factors were: Exercise (≥1 h/week, <1 h/week), caffeine consumption (units/day), smoking (prevalence and cigarettes/day), and alcohol consumption (AUDIT-C score). We divided the nurses into four groups: (1) day workers, (2) night workers, (3) nurses who changed toward, and (4) nurses who changed away from a schedule containing night shifts. Furthermore, average number of yearly night shifts (NN), and average number of quick returns (QR) were calculated. Paired t-tests, McNemar tests, and logistic regression analyses were used in the analyses. Results: We found a significant increase in caffeine consumption across all work schedule groups and a decline in smoking prevalence for day workers and night workers at follow-up. Analyses did not show any significant differences between groups when analyzing (1) different work schedules, (2) different exposures to QR, (3) different exposures to NN on the respective lifestyle factor trajectories. Conclusion: We found no significant differences between the different work schedule groups or concerning different exposures to QR or NN when evaluating these lifestyle factor trajectories. This challenges the notion that shift work has an adverse impact on lifestyle factors.

Short rest between shifts (quick returns) and night work is associated with work-related accidents.

PURPOSE: The aim of this study was to examine whether less than 11 h between shifts (i.e., quick returns, QRs) and night shifts is associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses. METHODS: The study was based on cross-sectional data from 1784 nurses (response rate = 60%; mean age = 40.1 years, SD = 8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different self-reported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors. RESULTS: The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009; 95% CI = 1.005-1.013), causing harm to patients/others (IRR = 1.006; 95% CI = 1.002-1.010) and causing harm to equipment (IRR = 1.004; 95% CI = 1.001-1.007); while night shifts were associated with nurses involuntarily dozing off at work (IRR = 1.015; 95% CI = 1.013-1.018), dozing off while driving to/from work (IRR = 1.009; 95% CI = 1.006-1.011), and harming patients/others (IRR = 1.005; 95% CI = 1.001-1.009). CONCLUSION: QRs and night shifts were both associated with the self-reported work-related accidents, near-accidents and dozing off at work. Studies that can establish the causal relationship between QRs and accidents are called for.

Prevalence of Parasomnias in Patients With Obstructive Sleep Apnea. A Registry-Based Cross-Sectional Study.

Objective: To assess the prevalence of parasomnias in relation to presence and severity of obstructive sleep apnea (OSA). We hypothesized higher parasomnia prevalence with higher OSA severity. Methods: The sample comprised 4,372 patients referred to a Norwegian university hospital with suspicion of OSA (mean age 49.1 years, 69.8% males). OSA was diagnosed and categorized by standard respiratory polygraphy (type 3 portable monitor). The patients completed a comprehensive questionnaire prior to the sleep study, including questions about different parasomnias during the last 3 months. Pearson chi-square tests explored differences according to the presence and severity of OSA. Furthermore, logistic regression analyses with the parasomnias as dependent variables and OSA severity as predictor were conducted (adjusted for sex, age, marital status, smoking, and alcohol consumption). Results: In all, 34.7% had apnea-hypopnea index (AHI) <5 (no OSA), 32.5% had AHI 5-14.9 (mild OSA), 17.4% had AHI 15-29.9 (moderate OSA), and 15.3% had AHI ≥30 (severe OSA). The overall prevalence of parasomnias was 3.3% (sleepwalking), 2.5% (sleep-related violence), 3.1% (sexual acts during sleep), 1.7% (sleep-related eating), and 43.8% (nightmares). The overall parasomnia prevalence was highest in the no OSA group. In the chi-square analyses, including all OSA groups, the prevalence of sleep-related violence and nightmares were inversely associated with OSA severity, whereas none of the other parasomnias were significantly associated with OSA severity. In adjusted logistic regression analyses the odds of sleepwalking was significantly higher in severe compared to mild OSA (OR = 2.0, 95% CI = 1.12-3.55). The other parasomnias, including sleep-related violence and nightmares, were not associated with OSA presence or severity when adjusting for sex and age. Conclusions: We found no increase in parasomnias in patients with OSA compared to those not having OSA. With the exception of sleepwalking, the parasomnias were not associated with OSA severity.

A Pilot Study of Impulse Radio Ultra Wideband Radar Technology as a New Tool for Sleep Assessment.

STUDY OBJECTIVES: To validate Impulse radio ultra wideband pulse-doppler radar technology against polysomnography (PSG) for sleep assessment. METHODS: In all, 12 participants were recruited and their overnight sleep was assessed both by a Novelda XeThru radar and PSG. Two subjects had two nightly recordings, whereas 10 had one recording. Epoch by epoch (30 seconds) comparisons from bedtime to rise time were conducted. Concordance was estimated in terms of the mean difference between the radar and the PSG estimates regarding sleep onset latency, wake time after sleep onset and total sleep time. In addition, accuracy, sensitivity, specificity and Cohen kappa were calculated. RESULTS: The mean difference (minutes) between the radar and the PSG registrations was -5.7 minutes (standard deviation [SD] = 22.1 minutes) for sleep onset latency, 6.4 minutes (SD = 32.5 minutes) for wake after sleep onset, and 1.5 minutes (SD = 24.6 minutes) for total sleep time. The mean values obtained for accuracy, sensitivity, specificity and Cohen kappa were 0.931, 0.961, 0.695 and 0.670, respectively. CONCLUSION: Impulse radio ultra wideband radar technology is a promising tool in terms of affordable and practical objective sleep assessment. Further technical development and more validation studies are needed in order to conclude about the utility potential of this device.

Workaholism and negative work-related incidents among nurses.

The present study comprised 1,781 nurses who participated in an investigation about working conditions, sleep, and health. They answered a questionnaire about age, sex, marital status, children living at home, work hours per week, number of night shifts last year, and total sleep duration and that also included a validated instrument assessing workaholism. In addition, they were asked to report on eight items concerning negative work-related incidents (dozed off at work, dozed while driving, harmed or nearly harmed self, harmed or nearly harmed patients/others, and harmed or nearly harmed equipment). Logistic regression analyses identified several predictors of these specific incidents: Low age (dozed at work, harmed and nearly harmed self, harmed and nearly harmed equipment), male sex (harmed and nearly harmed self, nearly harmed equipment), not living with children (harmed patients/others), low percentage of full-time equivalent (nearly harmed self and harmed patients/others), number of night shifts last year (dozed off at work and while driving, nearly harmed patients/others) and sleep duration (inversely related to dozed off at work and while driving, nearly harmed self). However, the most consistent predictor of negative work-related incidents was workaholism which was positively and significantly associated with all the eight incidents.

Restless Legs Syndrome/Willis-Ekbom Disease Is Prevalent in Working Nurses, but Seems Not to Be Associated with Shift Work Schedules.

Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis-Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25-67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference (p < 0.001) in the prevalence of RLS/WED between nurses having SWD (33.5%) compared to nurses not having SWD (23.8%). SWD remained significantly associated with RLS/WED in the adjusted logistic regression analysis (1.56, CI: 1.24-1.97). This study did not support the hypothesis. RLS/WED was associated with SWD, which might indicate that nurses vulnerable to shift work also are sensitive to other complaints related to a misalignment of the biological clock.

Androgen abuse epidemiology.

PURPOSE OF REVIEW: To systematically review current epidemiological literature on androgen abuse. Estimates from 32 empirical epidemiological articles were reviewed. RECENT FINDINGS: Generally, androgen abuse epidemiology and prevalence is higher in Europe, the Middle East, North America (the USA), Oceania (Australia and New Zealand), and South America (Brazil) and lower in Africa and Asia. In contrast to the general population, androgen abuse epidemiology and prevalence is higher among athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. SUMMARY: From the 1970s, androgen abuse spread from athletes into the general population. Consistent with previous evidence, reviewed studies suggest that androgen abuse epidemiology and prevalence is higher in Western cultural contexts, the Middle East, and South America (Brazil) and lower in Africa and Asia. Evidence also corroborates indications that androgen abuse is less prevalent among women (vs. men), and in the general population in contrast to particular subpopulations consisting of athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. Adolescents' androgen abuse should be of special concern. Androgen abuse in some nonsports occupations (e.g. security workers) requires further exploration. Polypharmacy and the Internet proliferation of androgens and other PIEDs require surveillance for prevention and harm reduction.

Increased severity of obstructive sleep apnea is associated with less anxiety and depression.

The objective was to investigate symptoms of depression and anxiety in relation to the presence and severity of obstructive sleep apnea (OSA) among patients referred with suspicion of OSA. The sample comprised 3770 consecutive patients with a mean age of 49.1 years; 69.7% were male. OSA was diagnosed and categorized based on a standard respiratory polygraphic sleep study using a type 3 portable monitor. Patients completed the validated Hospital Anxiety and Depression Scale (HADS) prior to the sleep study. In addition, they answered questions about whether they were currently in treatment for mental disorders and whether they had been diagnosed previously with depression. We adjusted for sex, age, smoking, alcohol consumption and obesity in the logistic regression analyses. In total, 35.1% had apnea-hypopnea index (AHI) < 5 (no OSA), 31.9% had AHI: 5-14.9 (mild OSA), 17.3% had AHI: 15-29.9 (moderate OSA) and 15.7% had AHI ≥ 30 (severe OSA). The prevalence of anxiety and depressive symptoms were significantly lower with increased OSA severity, and also when adjusting for sex, age, smoking, alcohol consumption and obesity (AHI ≥ 15 as dependent variable). Similarly, currently being in treatment for mental disorders and being diagnosed previously with depression were both associated negatively with OSA severity, with only the latter remaining significant in the fully adjusted model. Furthermore, multiple linear regressions showed that HADS anxiety and depression total scores were associated negatively with AHI. In conclusion, symptoms of anxiety and depression were associated negatively with OSA severity in these referred patients. The findings remained significant also after adjusting for several relevant confounders.

Aggression Is Associated With Increased Anabolic-Androgenic Steroid Use Contemplation Among Adolescents.

We investigated the relationship between aggression and anabolic-androgenic steroid (AAS) use intent among adolescents. A nationally representative sample of Norwegian 18-year-olds (N = 1,334, females = 58.7%) took part in a survey in 2013 (response rate = 64.9%). Participants completed the physical and verbal subscales of the Short-Form Buss-Perry Aggression Questionnaire, the Intent to use AAS Scale, the Alcohol Use Disorders Identification Test-Consumption, and the Hospital Anxiety and Depression Scale. They also provided demographic information and answered questions about AAS use, gambling participation, as well as cigarette and snus use. Descriptive statistics and multinomial logistic regression were used to analyze the data. Lifetime and past year prevalence of AAS use was 0.1%. Between 0.4% and 1.7% of participants disclosed intent to use while between 1.1% and 2.5% expressed neutral intent to initiate AAS use. Compared to persons low on aggression, individuals high on aggression were more likely to report intent and curiosity towards initiating AAS use. Our findings indicate that aggression is a risk factor for AAS use contemplation among adolescents.

Prescription trajectories and effect of total hip arthroplasty on the use of analgesics, hypnotics, antidepressants, and anxiolytics: results from a population of total hip arthroplasty patients.

Total hip arthroplasty (THA) has been shown to reduce pain and improve function. In addition, it is suggested that THA improves sleep and alleviates symptoms of anxiety and depression. Patients with chronic pain are frequent users of analgesic and psychotropic drugs and thereby risk adverse drug events. The impact of THA on such drug use has not been thoroughly investigated. Based on merged data from the Norwegian Prescription Database and the Norwegian Arthroplasty Register, this study sought to investigate redeemed medications in a complete population (N = 39,688) undergoing THA in 2005 to 2011. User rates and redeemed drug volume of analgesics (nonsteroid anti-inflammatory drugs (NSAIDs), opioids, and nonopioids) and psychotropics (hypnotics, anxiolytics, and antidepressants) were calculated for 4 quarters before and 4 quarters after surgery. We analysed preoperative prescription trends (Q1 vs Q4), postoperative prescription (Q4 vs Q5), and long-term effect of surgery (Q4 vs Q8). Before surgery, use of all drug groups increased from Q1 to Q4. Use of opioids, nonopioids, and hypnotics dramatically increased from Q4 to Q5. Long-term (Q4 vs Q8) surgery reduced prescriptions of analgesics, hypnotics, and anxiolytics, but not antidepressants. Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms.

Associations between night work and BMI, alcohol, smoking, caffeine and exercise--a cross-sectional study.

BACKGROUND: Shift work is associated with negative health effects. Increased prevalence of several cardiovascular risk factors among shift workers/night workers compared with day workers have been shown resulting in increased risk of cardiovascular events among shift workers and night workers. Previous studies have taken a dichotomous approach to the comparison between day and night workers. The present study uses a continuous approach and provides such a new perspective to the negative effects of night work load as a possible risk factor for undesirable health effects. METHODS: This cross sectional study (The SUrvey of Shift work, Sleep and Health (SUSSH)) uses data collected from December 2008 to March 2009. The study population consists of Norwegian nurses. The study collected information about demographic and lifestyle factors: Body Mass Index (BMI), smoking habits, alcohol consumption, caffeine consumption and exercise habits. The lifestyle parameters were evaluated using multiple hierarchical regression and binary logistic regression. Number of night shifts worked last year (NNL) was used as operationalization of night work load. Adjustment for possible confounders were made. Obesity was defined as BMI > 30. Alcohol Consumption was evaluated using the short form of the Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Data were analyzed using SPSS version 22. RESULTS: We had data from 2059 nurses. NNL was significantly and positively associated with BMI, both when evaluated against BMI as a continuous parameter (Beta = .055, p < .05), and against obesity (OR = 1.01, 95 % CI = 1.00-1.01). The AUDIT-C score was significantly and positively associated with hours worked per week (OR = 1.03, 95 % CI = 1.01-1.05). CONCLUSIONS: We found a positive significant association between night work load and BMI. This suggests that workers with a heavy night work load might need special attention and frequent health checks due to higher risk of undesirable health effects.

Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis.

BACKGROUND: As far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published. METHOD: We systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users' polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council's qualitative research synthesis manual and the PRISMA guidelines. RESULTS: A total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n=22), followed by Sweden (n=7), England only (n=5), and the United Kingdom (n=4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement. CONCLUSIONS: Our findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy.

Prevalence and Correlates of Problem Gambling in a Representative Sample of Norwegian 17-Year-Olds.

We report data collected in a representative sample of 17-year-old Norwegians to investigate prevalence rates of non-problem, risk, and problem gambling, as measured by the Problem Gambling Severity Index (PGSI). In addition, we explored the importance of demographic, personality, motivational, social, and health variables explaining variance in adolescent gambling. Prevalence rates of risk and problem gambling were low but similar to those found in previous studies outside of Norway using the PGSI in adolescent samples. With regard to the relative importance of the various covariates, we found that motivational variables (future gambling intentions, attitudes toward gambling, and gambling-related knowledge) distinguished best between those who did not gamble, non-problem gamblers, and risk and problem gamblers. Furthermore, social variables were important covariates of adolescent gambling; significant associations were found for family and friends' approval of gambling, parental monitoring, father's level of education, and having relatives or friends with a history of a gambling disorder. We discuss possible reasons for differences between the covariates with regard to their importance for explaining adolescent gambling and address implications for future research.

Prevalence and correlates of anabolic-androgenic steroid use in a nationally representative sample of 17-year-old Norwegian adolescents.

BACKGROUND: Anabolic-androgenic steroid (AAS) use has been identified as a serious public health problem. OBJECTIVES: This study investigates the prevalence and correlates of AAS use among Norwegian adolescents. METHODS: In 2012, a nationally representative sample of 2,055 17-year-old adolescents (963 males and 1,088 females) participated in a survey. The response rate was 70.4%. In addition to questions about AAS use, participants completed the Parental Monitoring Scale, the Family Relations/Cohesion Scale, the Alcohol Use Disorders Identification Test C, the Mini-International Personality Item Pool-Five-Factor Model, the Eysenck Narrow Impulsiveness Subscale, the Arnett Inventory of Sensation Seeking, the Short-Form Buss-Perry Aggression Questionnaire, the Hospital Anxiety and Depression Scale, and the UCLA Loneliness Scale. They also answered questions about demography, gambling, smoking, snus, and narcotic use. Descriptive statistics and logistic regression were used to analyze the data. RESULTS: The lifetime prevalence of AAS use was 0.30% (0.52% in males and 0.09% in females), while current prevalence was 0.25%. Moreover, 19.39% of the sample reported having an acquaintance who used or had used AAS. Having an acquaintance who used or had used AAS was significantly related to snus use, depression, aggression, extraversion, and conscientiousness in both univariate and multivariate logistic regression analyses. Conclusions/Importance: Our findings suggest a high prevalence of AAS use among Norwegian adolescents and denote the significance of social, personality, and health factors in adolescents' exposure to AAS milieu.

Attentional bias in snus users: an experimental study.

The use of nicotine in the form of "snus" is substantial and increasing in some geographic areas, in particular among young people. It has previously been suggested that addictions may operate through a mechanism of attentional bias, in which stimuli representative of the dependent substance increase in salience, thus increasing the addictive behavior. However, this hypothesis has not been tested for the case of snus. The current experiment used a modified Stroop task and a dot-probe task to investigate whether 40 snus users show an attentional bias towards snus-relevant stimuli, compared to 40 non-snus users. There were no significant differences between the two groups on reaction times or accuracy on either Stroop or dot-probe task, thus failing to show an attentional bias towards snus-relevant stimuli for snus users. This could imply that other mechanisms may contribute to maintenance of snus use than for other addictions. However, this is the first experimental study investigating attentional bias in snus users, and more research is warranted.