Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Front Psychiatry ; 12: 717955, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34616318

RESUMO

Background: Students pursuing higher education are struggling with psychological distress, which in turn may negatively affect their academic self-efficacy and study progress. Although psychotropic drug use is widespread and increasing, patterns of psychotropic drug use among students are not well-known. Aim: To describe prevalence and gender differences in psychotropic drug use among Norwegian students in higher education, and to examine associations with level of psychological distress. Methods: The study is based on data from the Norwegian Student's Health and Well-being Study (SHoT), 2018, a national survey including all fulltime students aged 18-35 years in higher education. Our sample included 49,836 students, 69% females. Use of psychotropic drugs and psychological distress (The Hopkins Symptoms Checklist [HSCL-25]) were self-reported. Generalised linear models were used to assess associations between psychological distress and psychotropic drug use. Results: Psychotropic drug use was more frequent among female than male students: 4 vs. 2% daily antidepressants usage; 5 vs. 3% last month use of anxiolytics/tranquillisers; and 8 vs. 5% last month use of hypnotics. In contrast, male students reported use of performance enhancing drugs more often than females (7 vs. 5%). Adjusted associations between high level of psychological distress (HSCL-25 ≥ 2.0) and use of psychotropics, showed an about 2-fold increased relative risk, largely consequent across drug classes and genders. Conclusion: Prevalence and gender patterns of intake of the most common psychotropic drug classes among Norwegian students are comparable to previous studies. Unexpectedly, among students with moderate to severe psychological distress, the patterns of psychotropic drug use were more or less identical between genders.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34651441

RESUMO

OBJECTIVE: This study examined the relationship between parental obesity polygenic risk and children's BMI throughout adolescence. Additionally, from a smaller subsample, the objective was to assess whether parental polygenic risk score (PRS) may act as a proxy for offspring PRS in studies lacking offspring genetic data. METHODS: A total of 8,561 parent-offspring (age 13-19 years) trios from the Trøndelag Health Study (the HUNT Study) were included, of which, 1,286 adolescents had available genetic data. Weighted parental PRSs from 900 single-nucleotide polymorphisms robustly associated with adult BMI were constructed and applied in linear mixed-effects models. RESULTS: A positive association between parental PRS and offspring sex- and age-adjusted BMI (iso-BMI) throughout adolescence was identified. The estimated marginal effects per standard deviation increase in parental PRS were 0.26 (95% CI: 0.18-0.33), 0.36 (95% CI: 0.29-0.43), and 0.62 kg/m2 (95% CI: 0.51-0.72) for maternal, paternal, and combined parental PRS, respectively. In subsample analyses, the magnitude of association of the parental PRS versus offspring PRS with iso-BMI in adolescents was similar. CONCLUSIONS: Parental PRS was consistently associated with offspring iso-BMI throughout adolescence. Results from subsample analyses support the use of parental PRS of obesity as a proxy for adolescent PRS in the absence of offspring genetic data.

3.
Brain Behav ; : e2340, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473425

RESUMO

OBJECTIVES: Psychosocial factors have been hypothesized to increase the risk of cancer. This study aims (1) to test whether psychosocial factors (depression, anxiety, recent loss events, subjective social support, relationship status, general distress, and neuroticism) are associated with the incidence of any cancer (any, breast, lung, prostate, colorectal, smoking-related, and alcohol-related); (2) to test the interaction between psychosocial factors and factors related to cancer risk (smoking, alcohol use, weight, physical activity, sedentary behavior, sleep, age, sex, education, hormone replacement therapy, and menopausal status) with regard to the incidence of cancer; and (3) to test the mediating role of health behaviors (smoking, alcohol use, weight, physical activity, sedentary behavior, and sleep) in the relationship between psychosocial factors and the incidence of cancer. METHODS: The psychosocial factors and cancer incidence (PSY-CA) consortium was established involving experts in the field of (psycho-)oncology, methodology, and epidemiology. Using data collected in 18 cohorts (N = 617,355), a preplanned two-stage individual participant data (IPD) meta-analysis is proposed. Standardized analyses will be conducted on harmonized datasets for each cohort (stage 1), and meta-analyses will be performed on the risk estimates (stage 2). CONCLUSION: PSY-CA aims to elucidate the relationship between psychosocial factors and cancer risk by addressing several shortcomings of prior meta-analyses.

4.
BMC Psychol ; 9(1): 130, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465377

RESUMO

BACKGROUND: Symptoms of depression and anxiety are common in adults with cardiovascular diseases (CVDs) and diabetes mellitus (DM). The literature on depression and anxiety in CVDs and DM populations is extensive; however, studies examining these relationships over time, directly compared to adults without these conditions, are still lacking. This study aimed to investigate trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population. METHODS: We used data from the population-based Trøndelag Health Study (HUNT), Norway, including adults (≥ 20 years) from three waves; the HUNT2 (1995-97; n = 65,228), HUNT3 (2006-08; n = 50,800) and HUNT4 (2017-19; n = 56,042). Depressive and anxiety symptom prevalence was measured independently by the Hospital Anxiety and Depressions scale (HADS) in sex-stratified samples. We analyzed associations of these common psychological symptoms with CVDs and DM over time using multi-level random-effects models, accounting for repeated measurements and individual variation. RESULTS: Overall, the CVDs groups reported higher levels of depression than those free of CVDs in all waves of the study. Further, depressive and anxiety symptom prevalence in adults with and without CVDs and DM declined from HUNT2 to HUNT4, whereas women reported more anxiety than men. Positive associations of depression and anxiety symptoms with CVDs and DM in HUNT2 declined over time. However, associations of CVDs with depression symptoms remained over time in men. Moreover, in women, DM was associated with increased depression symptom risk in HUNT2 and HUNT4. CONCLUSIONS: Depression and anxiety symptoms are frequent in adults with CVDs. Further, our time trend analysis indicates that anxiety and depression are differentially related to CVDs and DM and sex. This study highlights the importance of awareness and management of psychological symptoms in CVDs and DM populations.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Adulto , Ansiedade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Noruega/epidemiologia , Prevalência
5.
Front Psychol ; 12: 663161, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33935922

RESUMO

Social anxiety is highly prevalent in adolescents and is often associated with great individual suffering and functional impairment. Psychiatric comorbidity is common and further adds to this burden. The purposes of this study were: (1) to describe the occurrence of diagnosed and self-reported social anxiety among 8,199 Norwegian adolescents aged 13-19 years who participated in the population-based Young-HUNT3 study (2006-2008); (2) to examine associations between sociodemographic characteristics and different subgroups of social anxiety; and (3) to describe the psychiatric health comorbidities among adolescents diagnosed with social anxiety disorder (SAD). In total, 388 (5.9%) of the adolescents screened positive for SAD and were invited into a diagnostic interview, performed by professional nurses, using Anxiety Disorders Interview Schedule for DSM IV: child version (ADIS-C) (response rate = 54.6%). A SAD diagnosis was indicated in 106 individuals (50% of the interview subjects), and more than two-thirds of the adolescents diagnosed with SAD had one or more comorbid psychiatric disorders. Higher mean scores of self-reported social anxiety symptoms, poor self-rated health, sleep problems, poor family economic situation, low physical activity, and having sought professional help within the last year were associated with higher odds of being in the screening positive subgroup. Screening positive subjects who did not meet for a diagnostic interview did not differ notably from the rest of the screening positive group in terms of these sociodemographic characteristics. Based on our results and the fact that individuals with social anxiety often fear interview situations, the use of ADIS-C, screening questions and self-reports seem to be sufficient when aiming to identify epidemiologically representative cohorts of adolescents at risk of social anxiety.

6.
Scand J Public Health ; : 14034948211011796, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33908292

RESUMO

AIM: Understanding whether increasing Life Expectancy (LE) translates to improved health and function among older adults is essential, but results are inconclusive. We aimed to estimate trends in Disability-Free Life Expectancy (DFLE) in the older Norwegian population by sex and education from 1995 to 2017. METHOD: National life table data were combined with cross-sectional data on functional ability for 70+ year-olds from the population-based Trøndelag Health Surveys 2-4 (1995-1997, 2006-2008 and 2017-2019) (n=24,733). Self-reported functional ability was assessed on a graded scale by a combination of Instrumental Activities of Daily Living (IADL) such as paying bills, going out or shopping (mild disability) and Personal Activities of Daily Living (PADL) such as washing, dressing or eating (severe disability). LE, DFLE, Mild-Disability LE and Severe-Disability LE at age 70 were estimated by the Sullivan method. RESULTS: From 1995 to 2017 DFLE at age 70 increased from 8.4 to 13.0 years in women, and from 8.0 to 12.1 years in men. DFLE increased in the basic and high educational groups, but more so in the high educational group among men. Educational inequalities in years spent with disability however, remained low. CONCLUSIONS: From the mid-1990s and over the past three decades both LE and DFLE at 70 years increased in the older Norwegian population, for both men and women, and across basic and high educational levels. Educational inequalities in DFLE increased, especially in men, but years spent with disability were similar across the three decades.

7.
PLoS One ; 16(3): e0248332, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33705441

RESUMO

Participation in cultural activities may protect against cause-specific mortality; however, there is limited knowledge regarding this association. The present study examines the association between participation in a range of receptive and creative cultural activities and risk of cardiovascular disease- and cancer-related mortality. We also examined whether participation in such activities and influence by gender have on this association. We followed 35,902 participants of the Nord-Trøndelag Health Study (HUNT3) of Cardiovascular-Disease and Cancer Mortality from 2006-08 to 2016. Cox proportional-hazards regression was used to estimate the risk of specific mortality based on baseline cultural participation. During the eight-year follow-up, there were 563 cardiovascular-disease- and 752 cancer-related deaths among the sample (292,416 person years). Risk of cardiovascular-disease mortality was higher among non-participants in associations/club meetings (22%) and outdoor activities (23%), respectively, as well as non-attendees of art exhibitions (28%). People who engaged in music, singing, and theatre had a 27% reduced risk of cancer-related mortality when compared to non-participants. Among women, participating in associations/club meetings reduced the risk of cardiovascular-disease mortality by 36%. Men who participated in music, singing, and theatre had a 33% reduced risk of cancer mortality. Overall, a reduced risk of cardiovascular-disease mortality was associated with engaging in creative activities on weekly basis to less than twice per week. For both genders, participating in creative activities less than once a week reduced cardiovascular-disease mortality risk by 40% and 33%, respectively. For the overall sample, participating > 2 times per week in combined receptive and creative activities reduced cancer-related mortality by 29%. Participating frequently in both receptive and creative activities cultural activities was associated with lower risks of CVD and cancer-related mortality. Our data suggest that, to counteract the public health burden of cardiovascular disease- and cancer mortality, policies and initiatives to increase citizens' participation in cultural activities should be considered.


Assuntos
Doenças Cardiovasculares/mortalidade , Neoplasias/mortalidade , Adulto , Idoso , Causas de Morte , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia
8.
Child Psychiatry Hum Dev ; 52(4): 628-639, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32852728

RESUMO

This study examined risk factors of physical aggression during transition from early to late adolescence using a two-wave longitudinal study. Specifically, we examined if risk factors in early adolescence predict physically aggressive behavior starting in late adolescence and why some adolescents desist physical aggressive behavior while others do not. The study sample consisted of 2289 Norwegian adolescents (1235 girls) who participated in the Young-HUNT1 study (mean age 14.5) and the follow-up study 4 years later, Young-HUNT2 study (mean age 18.4). One in six young adolescents reported engaging in physical fights. Moreover, physical aggression in early adolescence was significantly associated with male gender, attention problems, academic problems, being bullied, drinking alcohol, and smoking. Male gender and heavy drinking during early adolescence increased the risk for newly emerging aggressive behavior in late adolescence, whereas heavy drinking during early adolescence was a predictor for persistent versus desisting aggressive behavior in late adolescence.

9.
PLoS Med ; 17(12): e1003452, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33315864

RESUMO

BACKGROUND: Obesity has tripled worldwide since 1975 as environments are becoming more obesogenic. Our study investigates how changes in population weight and obesity over time are associated with genetic predisposition in the context of an obesogenic environment over 6 decades and examines the robustness of the findings using sibling design. METHODS AND FINDINGS: A total of 67,110 individuals aged 13-80 years in the Nord-Trøndelag region of Norway participated with repeated standardized body mass index (BMI) measurements from 1966 to 2019 and were genotyped in a longitudinal population-based health study, the Trøndelag Health Study (the HUNT Study). Genotyping required survival to and participation in the HUNT Study in the 1990s or 2000s. Linear mixed models with observations nested within individuals were used to model the association between a genome-wide polygenic score (GPS) for BMI and BMI, while generalized estimating equations were used for obesity (BMI ≥ 30 kg/m2) and severe obesity (BMI ≥ 35 kg/m2). The increase in the average BMI and prevalence of obesity was steeper among the genetically predisposed. Among 35-year-old men, the prevalence of obesity for the least predisposed tenth increased from 0.9% (95% confidence interval [CI] 0.6% to 1.2%) to 6.5% (95% CI 5.0% to 8.0%), while the most predisposed tenth increased from 14.2% (95% CI 12.6% to 15.7%) to 39.6% (95% CI 36.1% to 43.0%). Equivalently for women of the same age, the prevalence of obesity for the least predisposed tenth increased from 1.1% (95% CI 0.7% to1.5%) to 7.6% (95% CI 6.0% to 9.2%), while the most predisposed tenth increased from 15.4% (95% CI 13.7% to 17.2%) to 42.0% (95% CI 38.7% to 45.4%). Thus, for 35-year-old men and women, respectively, the absolute change in the prevalence of obesity from 1966 to 2019 was 19.8 percentage points (95% CI 16.2 to 23.5, p < 0.0001) and 20.0 percentage points (95% CI 16.4 to 23.7, p < 0.0001) greater for the most predisposed tenth compared with the least predisposed tenth, defined using the GPS for BMI. The corresponding absolute changes in the prevalence of severe obesity for men and women, respectively, were 8.5 percentage points (95% CI 6.3 to 10.7, p < 0.0001) and 12.6 percentage points (95% CI 9.6 to 15.6, p < 0.0001) greater for the most predisposed tenth. The greater increase in BMI in genetically predisposed individuals over time was apparent after adjustment for family-level confounding using a sibling design. Key limitations include a slightly lower survival to date of genetic testing for the older cohorts and that we apply a contemporary genetic score to past time periods. Future research should validate our findings using a polygenic risk score constructed from historical data. CONCLUSIONS: In the context of increasingly obesogenic changes in our environment over 6 decades, our findings reveal a growing inequality in the risk for obesity and severe obesity across GPS tenths. Our results suggest that while obesity is a partially heritable trait, it is still modifiable by environmental factors. While it may be possible to identify those most susceptible to environmental change, who thus have the most to gain from preventive measures, efforts to reverse the obesogenic environment will benefit the whole population and help resolve the obesity epidemic.


Assuntos
Epidemias , Interação Gene-Ambiente , Obesidade/epidemiologia , Obesidade/genética , Ganho de Peso/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Estudos de Associação Genética , Predisposição Genética para Doença , Inquéritos Epidemiológicos , Hereditariedade , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Obesidade/diagnóstico , Fenótipo , Prevalência , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
10.
Soc Sci Med ; 264: 113286, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32861971

RESUMO

Recent decades have shown an international trend of decline in small-scale fishing; a longstanding and vital industry for numerous coastal populations. The decline has resulted in a loss of livelihoods in many coastal communities, potentially afflicting public health. Still, knowledge about the health situation of these areas is limited. Former studies on coastal health have primarily defined coastal areas based solely on their proximity to the coast, therefore not targeting the traditional coastal communities with longstanding coastal involvement through small-scale fishing. In this paper, we aim to illuminate the health situation in these areas by introducing a more fine-grained classification of the coastal study population; considering both geographical proximity to the coast, population density and employment in fishing. Using data from the Norwegian population-based HUNT Study, we perform individual and simultaneous adjustments for employment, behavioural and psychosocial factors to assess the contributions of these factors to the association between geographical affiliation and self-rated general health. The rural coastal areas with a history of small-scale fishing show a poorer health situation compared to urban coastal, rural inland and rural fjord populations, and behavioural factors contribute the most to the observed health disparities. Our findings encourage greater focus on societal differences between coastal communities when studying coastal health.


Assuntos
Emprego , Saúde Pública , Geografia , Humanos , Noruega/epidemiologia , População Rural , Fatores Socioeconômicos
11.
J Clin Med ; 9(9)2020 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-32858852

RESUMO

Multimorbidity and socioeconomic position are independently associated with mortality. We investigated the association of occupational position and several multimorbidity measures with all-cause mortality. A cohort of people aged 35 to 75 years who participated in the Trøndelag Health Study in 2006-2008 and had occupational data was linked to the Norwegian National Population Registry for all-cause mortality from study entry until 1 February 2019. Logistic regression models for each occupational group were used to analyze associations between the number of conditions and 10-year risk of death. Cox regression models were used to examine associations between combinations of multimorbidity, occupational position, and mortality. Analyses were conducted for men and women. Included were 31,132 adults (16,950 women (54.4%)); occupational groups: high, 7501 (24.1%); low, 15,261 (49.0%)). Increased mortality was associated with lower occupational group, more chronic conditions, and all multimorbidity measures. The joint impact of occupational group and multimorbidity on mortality was greater in men than women. All multimorbidity measures are strongly associated with mortality, with varying occupational gradients. Social differences in multimorbidity are a public health challenge and necessitate consideration in health care. Men in lower occupational groups seem to be a particularly vulnerable group.

12.
Front Psychol ; 11: 1472, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32733331

RESUMO

Background: Adolescents' mental health, and its consistent relationship with their socioeconomic background, is a concern that should drive education, health, and employment policies. However, information about this relationship on a national scale is limited. We explore national overall trends and investigate possible socioeconomic disparities in adolescents' mental health, including psychological distress and symptoms of depression, anxiety, and loneliness in Norway during the period 2014-2018. Methods: The present study builds on data retrieved from five waves of the national cross-sectional Ungdata survey (2014-2018). In total 136,525 upper secondary school students (52% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results: The prevalence of students with moderate to high symptoms score and mean symptoms scores of psychological distress (in terms of symptoms of depression, anxiety, and loneliness) increased among girls and boys during 2014-2018, with girls showing higher rates. Our results suggest distinct, but stable, inequalities between socioeconomic groups, both in absolute and relative terms, among girls and boys during the study period. Conclusion: Rising rates of adolescents' psychological distress, particularly among girls, may have long-term consequences for individuals involved and the society as a whole. Future studies should investigate the causes of these results. We did not find evidence of any change in inequalities in adolescents' mental health between socioeconomic groups, suggesting current strategies are not sufficiently addressing mental health inequalities in the adolescent population and therefore a significant need for research and public health efforts.

13.
BMC Public Health ; 20(1): 900, 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32522193

RESUMO

BACKGROUND: Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort. METHODS: Participants were 55-64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995-97) who also participated in HUNT3 (2006-08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later. RESULTS: Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR's = 1.39-1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12-1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes. CONCLUSIONS: Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.


Assuntos
Nível de Saúde , Estilo de Vida , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Coortes , Exercício Físico , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Noruega/epidemiologia , Prevalência , Estudos Prospectivos , Análise de Regressão , Aposentadoria , Fatores de Risco , Assunção de Riscos , Comportamento Sedentário , Transtornos do Sono-Vigília/epidemiologia , Fumar/epidemiologia , Participação Social
14.
BMJ Open ; 10(6): e035070, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32546489

RESUMO

OBJECTIVES: To explore prevalences and occupational group inequalities of two measures of multimorbidity with frailty. DESIGN: Cross-sectional study. SETTING: The Nord-Trøndelag Health Study (HUNT), Norway, a total county population health survey, 2006-2008. PARTICIPANTS: Participants older than 25 years, with complete questionnaires, measurements and occupation data were included. OUTCOMES: ≥2 of 51 multimorbid conditions with ≥1 of 4 frailty measures (poor health, mental illness, physical impairment or social impairment) and ≥3 of 51 multimorbid conditions with ≥2 of 4 frailty measures. ANALYSIS: Logistic regression models with age and occupational group were specified for each sex separately. RESULTS: Of 41 193 adults, 38 027 (55% female; 25-100 years old) were included. Of them, 39% had ≥2 multimorbid conditions with ≥1 frailty measure, and 17% had ≥3 multimorbid conditions with ≥2 frailty measures. Prevalence differences in percentage points (pp) with 95% confidence intervals of those in high versus low occupational group with ≥2 multimorbid conditions and ≥1 frailty measure were largest in women age 30 years, 17 (14 to 20) pp and 55 years, 15 (13 to 17) pp and in men age 55 years, 15 (13 to 17) pp and 80 years, 14 (9 to 18) pp. In those with ≥3 multimorbid conditions and ≥2 frailty measures, prevalence differences were largest in women age 30 years, 8 (6 to 10) pp and 55 years, 10 (8 to 11) ppand in men age 55 years, 9 (8 to 11) pp and 80 years, 6 (95% CI 1 to 10) pp. CONCLUSION: Multimorbidity with frailty is common, and social inequalities persist until age 80 years in women and throughout the lifespan in men. To manage complex multimorbidity, strategies for proportionate universalism in medical education, healthcare, public health prevention and promotion seem necessary.


Assuntos
Fragilidade/epidemiologia , Multimorbidade , Ocupações , Classe Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Prevalência
15.
BMJ Open ; 10(6): e036851, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32546494

RESUMO

OBJECTIVES: Multimorbidity, the co-occurrence of multiple long-term conditions, is common and increasing. Definitions and assessment methods vary, yielding differences in estimates of prevalence and multimorbidity severity. Sociodemographic characteristics are associated with complicating factors of multimorbidity. We aimed to investigate the prevalence of complex multimorbidity by sex and occupational groups throughout adulthood. DESIGN: Cross-sectional study. SETTING: The third total county survey of The Nord-Trøndelag Health Study (HUNT), 2006-2008, Norway. PARTICIPANTS: Individuals aged 25-100 years with classifiable occupational data and complete questionnaires and measurements. OUTCOME MEASURE: Complex multimorbidity defined as 'the co-occurrence of three or more chronic conditions affecting three or more different body (organ) systems within one person without defining an index chronic condition'. ANALYSIS: Logistic regression models with age and occupational group were specified for each sex separately. RESULTS: 38 027 of 41 193 adults (55% women) were included in our analyses. 54% of the participants were identified as having complex multimorbidity. Prevalence differences in percentage points (pp) of those in the low occupational group (vs the high occupational group (reference)) were 19 (95% CI, 16 to 21) pp in women and 10 (8 to 13) pp in men at 30 years; 12 (10 to 14) pp in women and 13 (11 to 15) pp in men at 55 years; and 2 (-1 to 4) pp in women and 7 (4 to 10) pp in men at 75 years. CONCLUSION: Complex multimorbidity is common from early adulthood, and social inequalities persist until 75 years in women and 90 years in men in the general population. These findings have policy implications for public health as well as healthcare, organisation, treatment, education and research, as complex multimorbidity breaks with the specialised, fragmented paradigm dominating medicine today.


Assuntos
Multimorbidade/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
16.
Sociol Health Illn ; 42(7): 1548-1565, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32539185

RESUMO

This study investigates patterns of adoption and diffusion of innovative health technologies by socioeconomic status (SES) in order to assess the extent to which these technologies may be a fundamental cause of health-related inequalities. Quantitative analyses examined SES-based inequalities in the adoption and diffusion of diabetes technologies. Diabetes data from three panels of the Nord-Trøndelag Health Study (HUNT), Norway, were combined with income and education data. Cross-sectional and longitudinal regression analyses were used to examine relevant inequalities. Cross-sectional analyses suggest often present SES-based gradients in the adoption of diabetes technologies, favouring high-SES groups. Statistically significant differences (p ≤ 0.05) were most often present when technologies were new. In a cohort followed from 1984 to 1997, high SES individuals were more likely to adopt insulin injection technologies but, due to modest sample sizes, these inequalities were not statistically significant after adjusting for age, gender, and duration of illness. Moreover, compared to low SES individuals, high SES individuals are more active users of diabetes technologies. Results suggest that SES-based variations in access and use of innovative health technologies could act as a mechanism through which inequalities are reproduced. This study provides a discussion of mechanisms and a methodological foundation for further investigation.

17.
BMC Geriatr ; 20(1): 21, 2020 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-31964341

RESUMO

BACKGROUND: With increasing age, having multiple chronic conditions is the norm. It is of importance to study how co-existence of diseases affects functioning and mortality among older persons. Complex multimorbidity may be defined as three or more conditions affecting at least three different organ systems. The aim of this study was to investigate how complex multimorbidity affects activities of daily living and mortality amongst older Norwegians. METHODS: Participants were 60-69-year-olds at baseline in the Nord-Trøndelag Health Study 1995-1997 (HUNT2) n = 9058. Multinomial logistic regression models were used to investigate the association between complex multimorbidity in HUNT2, basic and instrumental activities of daily living in HUNT3 (2006-2008) and mortality during follow-up (n = 5819/5836). Risk ratios (RR) and risk differences (RD) in percentage points (pp) with 95% confidence intervals (CI) were reported. RESULTS: 47.8% of 60-69-year-olds met the criteria of complex multimorbidity at baseline (HUNT2). Having complex multimorbidity was strongly associated with the need for assistance in IADL in HUNT3 11 years later (RR = 1.80 (1.58-2.04) and RD = 8.7 (6.8-10.5) pp) and moderately associated with mortality during the follow-up time (RR = 1.22 (1.12-1.33) and RD = 5.1 (2.9-7.3) pp). Complex multimorbidity was to a lesser extent associated with basic activities of daily living 11 years later (RR = 1.24 (0.85-1.83) and RD = 0.4 (- 0.3-1.1) pp). CONCLUSIONS: This is the first study to show an association between complex multimorbidity and activities of daily living. Complex multimorbidity should receive more attention in order to prevent future disability amongst older persons.


Assuntos
Atividades Cotidianas , Multimorbidade , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Estudos Prospectivos
18.
BMJ ; 366: l4067, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31270083

RESUMO

OBJECTIVES: To study the trajectories of body mass index (BMI) in Norway over five decades and to assess the differential influence of the obesogenic environment on BMI according to genetic predisposition. DESIGN: Longitudinal study. SETTING: General population of Nord-Trøndelag County, Norway. PARTICIPANTS: 118 959 people aged 13-80 years who participated in a longitudinal population based health study (Nord-Trøndelag Health Study, HUNT), of whom 67 305 were included in analyses of association between genetic predisposition and BMI. MAIN OUTCOME MEASURE: BMI. RESULTS: Obesity increased in Norway starting between the mid-1980s and mid-1990s and, compared with older birth cohorts, those born after 1970 had a substantially higher BMI already in young adulthood. BMI differed substantially between the highest and lowest fifths of genetic susceptibility for all ages at each decade, and the difference increased gradually from the 1960s to the 2000s. For 35 year old men, the most genetically predisposed had 1.20 kg/m2 (95% confidence interval 1.03 to 1.37 kg/m2) higher BMI than those who were least genetically predisposed in the 1960s compared with 2.09 kg/m2 (1.90 to 2.27 kg/m2) in the 2000s. For women of the same age, the corresponding differences in BMI were 1.77 kg/m2 (1.56 to 1.97 kg/m2) and 2.58 kg/m2 (2.36 to 2.80 kg/m2). CONCLUSIONS: This study provides evidence that genetically predisposed people are at greater risk for higher BMI and that genetic predisposition interacts with the obesogenic environment resulting in higher BMI, as observed between the mid-1980s and mid-2000s. Regardless, BMI has increased for both genetically predisposed and non-predisposed people, implying that the environment remains the main contributor.


Assuntos
Índice de Massa Corporal , Predisposição Genética para Doença , Obesidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Lineares , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Obesidade/epidemiologia , Obesidade/genética , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Adulto Jovem
19.
BMJ Open ; 9(7): e029809, 2019 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-31352423

RESUMO

OBJECTIVE: We conducted a population-based study on a sample of more than 7000 adolescents where we examined the associations between suicidal ideation (SI) and disordered eating (DE) and its related traits. DESIGN: Cross-sectional. SETTINGS: Data were derived from two Norwegian population-based cohorts, the Young-HUNT1 (1995-1997) and Young-HUNT3 (2006-2008) from the county of Nord-Trøndelag, Norway. PARTICIPANTS: A total of 7268 adolescents (15-19 years) who had completed self-reported questionnaires including items on SI, DE, body size and weight perception were included. PRIMARY OUTCOME MEASURES: ORs for SI given DE, body size or weight perception. Analyses were performed in multivariate logistic regression models. RESULTS: The prevalence of SI was 23.1% in total population. Both girls and boys who reported DE, evaluated their body size as not 'about the same as others' or were 'unhappy about their weight' had between twofold to fivefold increase in odds for SI; these incremental risks were observed independent of sex, age, body mass index and socioeconomic status. We observed higher odds for SI among boys. CONCLUSIONS: Our findings suggest a clear association between SI and DE and its associated traits, in both genders but especially in males. Special attention should be paid on early detection of DE traits among adolescents.


Assuntos
Comportamento do Adolescente , Imagem Corporal/psicologia , Tamanho Corporal , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Ideação Suicida , Adolescente , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Noruega/epidemiologia , Prevalência , Autorrelato , Fatores Sexuais , Classe Social , Adulto Jovem
20.
Front Psychol ; 10: 45, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30733694

RESUMO

Student life can be stressful and for some students it may cause mental distress. Besides being a major public health challenge, mental distress can influence academic achievement. The main objectives of the current study were to examine associations of mental distress with academic self-efficacy and study progress. A secondary aim was to examine mental health help seeking for students with mental distress. Data was derived from the Norwegian Students' health and welfare survey 2014 (SHOT 2014) which is the first major survey comprising questions of both mental health, academic self-efficacy and psychosocial factors amongst students. Utilizing these data for a Norwegian region, we found that 749 (31%) of the 2430 Norwegian full-time students under the age of 35 responded to the survey. Symptoms of mental distress were measured using the Hopkins Symptom Checklist (HSCL-25) and academic self-efficacy was measured using a Norwegian version of the General Self-Efficacy Scale (GSE) tailored to the academic setting. Demographic-, social, lifestyle, and study-related variables were included in the analyses. Logistic regression analyses were performed to assess the relationship between mental distress, academic self-efficacy, and academic performance. Seventeen percent reported severe symptoms of psychological distress which is similar to the overall prevalence among students in Norway. Students reporting severe mental distress were four times as likely to report low academic self-efficacy and twice as likely to report delayed study progress compared to students reporting few or moderate symptoms of mental distress. 27% of those reporting severe mental distress had sought professional help whereas 31% had considered seeking help. The study showed that there was a strong association between symptoms of mental distress, academic self-efficacy and study progress. Prospective studies should evaluate whether improved help-seeking and psychological treatment can promote students mental health and ultimately improve academic self-efficacy and study progress.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...