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Objective To examine how physical activity and physical mobility are related to obesity in the elderly. Study design A cross-sectional study of 2558 men and women aged 65 years and older who participated in a population survey in 2012 was conducted in mid-Sweden with an overall response rate of 67%. Methods Obesity (body mass index ≥30 kg/m2) was based on self-reported weight and height, and physical activity and physical mobility on questionnaire data. Chi-squared test and multiple logistic regressions were used as statistical analyses. Results The overall prevalence of obesity was 19% in women and 15% in men and decreased after the age of 75 years. A strong association between both physical activity and obesity, and physical mobility and obesity was found. The odds for obesity were higher for impaired physical mobility (odds ratio [OR] 2.83, 95% confidence interval [CI] 2.14–3.75) than for physical inactivity (OR 1.63, 95% CI 1.28–2.08) when adjusted for gender, age, socio-economic status and fruit and vegetable intake. However, physical activity was associated with obesity only among elderly with physical mobility but not among those with impaired physical mobility. Conclusion It is important to focus on making it easier for elderly with physical mobility to become or stay physically active, whereas elderly with impaired physical mobility have a higher prevalence of obesity irrespective of physical activity.

Purpose: Psychopathic traits are associated with multiple negative outcomes. The present prospective, longitudinal study identified associations of childhood factors with adult psychopathy scores.

 Methods: 311 men, aged, on average, 33 years, were assessed using the Psychopathy Checklist-Revised (PCL-R). Predictors included neighbourhood deprivation, parents' characteristics, teacher ratings of behaviour at ages 6, 10 and 12, and academic performance at age 12. Hierarchical linear regression models were computed to identify predictors at different ages of PCL-R total and facet scores. 

Results: Age 33 PCL-R total and facet scores were significantly, and independently, associated with father's and mother's criminality and mother's age at participant's birth when teacher ratings of childhood behaviours and mathematics marks were included in the models. Anxiety was negatively associated with facet 1 scores at age 6. At age 12, 22% of the variance in facet 2 scores was predicted by father's violent convictions, mother's age and criminal charges, and reactive aggression. Facet 3 scores were associated with mother's age (marginally), inattention, and reactive aggression. Facet 4 scores were associated with father's violent criminality, mother's age, conduct probleins, inattention, and reactive aggression. 

Conclusion: Etiological research and prevention programs should focus on antecedents of psychopathic traits present in early childhood.

Background: Adolescent mental health is a growing global concern, with depressive and anxiety symptoms on the rise over recent decades. The significance of supportive social relationships, particularly within family and peer groups, is well-established in research. However, limited evidence exists on the impact of social relationships in predicting the developmental trajectories of mental health problems over time.

Methods: This study aims to fill this gap by identifying distinct trajectories of depressive and anxiety symptoms among adolescents and exploring the impact of various factors, including family relationships, peer relationships, sex, and country of origin, on predicting individuals' likelihood of belonging to specific trajectories. Based on data collected from adolescents in Sweden born in 1997 and 1999, the study utilized Group-Based Trajectory Modeling (GBTM) to analyze longitudinal data. Statistical analyses, including multinomial logistic regression, were conducted to examine the predictive effects of social relationships on depressive and anxiety symptom trajectories.

Results: Positive social relationships with family and peers emerged as robust predictors across depressive and anxiety symptom trajectories. Female participants consistently exhibited higher mean scores of depressive and anxiety symptoms than males, while participants originating from countries outside the Nordic region were at higher risk of belonging to depressive symptom trajectory groups with higher mean scores. Despite limitations such as high attrition rates, the study's methodological rigor offers valuable insights into the predictive effects of social relationships on mental health trajectories.

Conclusions: The study underscores the importance of addressing social factors in adolescent mental health prevention strategies. Despite facing limitations such as high attrition rates, the study's strengths lie in its methodological rigor, providing valuable insights into the predictive effects of social relationships on mental health trajectories and addressing crucial gaps in the literature. This pioneering approach offers implications for future intervention and prevention strategies, emphasizing the importance of social factors in understanding and addressing adolescent mental health.

Background:

Adolescent mental health problems are on the rise globally, including in Sweden. One indicator is an increase in psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the trends in PSS. However, we found limited research on such associations.

Methods:

This study is based on data collected every four years from nationally representative samples of 15-year-old boys and girls in Sweden (N = 9,196, 50.5% girls), as part of the Health Behavior in School-aged Children (HBSC) study. PSS was measured using a scale developed from the HBSC symptom checklist. We analyzed the trends in PSS from 2002 to 2018 and fitted models to investigate the associations between the trends and lifestyle factors. We included interaction terms between time and each lifestyle factor and fitted separate models for the high and low socioeconomic status (SES) groups.

Results

In general, the mean scores for PSS increased from 2.26 in 2002 to 2.49 in 2018 (p<.001). Compared to the average mean scores during preceding years, the changes in PSS mean scores at each survey year were also significant in all years except 2010. More frequent breakfast intake, daily consumption of fruits and vegetables, and higher PA were associated with lower PSS mean scores while smoking and alcohol consumption had the opposite association. The only significant interaction (B = .050; CI: .015, ¬ .085; p<.01) was observed in the high SES group, indicating that the increasing trend in PSS was stronger among those who had been drunk once or more in a lifetime, compared to those who had never been drunk.

Conclusions

The results indicate increasing trends in mental health problems among young people in Sweden. Furthermore, the study revealed that alcohol drunkenness was associated with a more substantial rise in PSS over time among those in the high SES group. Further research is needed to understand the reasons behind these findings.

Objective: Traumatic brain injuries (TBIs) are sustained by approximately 17% of males in the general population, many of whom subsequently present mental disorders, cognitive, and physical problems. Little is known about predictors of TBIs and how to prevent them. The present study aimed to determine whether inattention-hyperactivity and/or all externalizing problems presented by boys at age 10 predict subsequent TBIs to age 34 after taking account of previous TBIs and family social status (FSS). Method: 742 Canadian males were followed, prospectively, from age 6 to 34. Diagnoses of TBIs were extracted from health files, parents-reported sociodemographic and family characteristics at participants' age 6, and teachers-rated participants' behaviors at age 10. Separate logistic regression models predicted TBIs sustained from age 11 to 17 and from age 18 to 34. For each age period, two models were computed, one included previous TBIs, inattention-hyperactivity, FSS, and interaction terms, the second included previous TBIs, externalizing problems, FSS, and interaction terms. Results: In models that included inattention-hyperactivity, TBIs sustained from age 11 to 17 were predicted by age 10 inattention-hyperactivity (odds ratio [OR] = 1.46, 1.05 to 2.05) and by TBIs prior to age 11 (OR = 3.50, 1.48 to 8.24); TBIs sustained from age 18 to 34 were predicted by age 10 inattention-hyperactivity (OR = 1.31, 1.01 to 170). In models that included all externalizing problems, TBIs from age 11 to 17 were predicted by prior TBIs (OR = 3.66, 1.51 to 8.39); TBIs sustained from age 18 to 34 were predicted by age 10 externalizing problems (OR = 1.45, 1.12 to 1.86). Neither FSS nor interaction terms predicted TBIs in any of the models. Conclusions: Among males, using evidence-based treatments to reduce inattention-hyperactivity and externalizing problems among boys could, potentially, decrease the risk of TBIs to age 34. Further, boys who sustain TBIs in childhood require monitoring to prevent recurrence in adolescence.

Objective: The authors aimed to elucidate the links between traumatic brain injuries (TBIs) and criminal convictions in a sample of 724 Canadian males with and without criminal records followed up to age 24. Methods: Prospectively collected data were analyzed to determine whether prior TBIs predicted subsequent criminal convictions after taking account of family social status (FSS) and childhood disruptive behaviors. At age 24, diagnoses of TBIs were extracted from health records and convictions from official criminal records. In childhood, teachers rated disruptive behaviors and parents reported FSS. Results: Proportionately more individuals with offender status than nonoffender status sustained a TBI from age 18 to age 24 but not before age 18. Individuals with offender status who had sustained a TBI before and after their first conviction were similar in numbers, were raised in families of low social status, and presented high levels of disruptive behaviors from age 6 to age 12. When FSS and childhood disruptive behaviors were included in multivariable regression models, sustaining a prior TBI was not associated with an increased risk of juvenile convictions for any type of crime, for violent crimes, for convictions for any crime or violent crime from age 18 to age 24, or for a first crime or a first violent crime from age 18 to age 24. Conclusions: Among males, there was no evidence that prior TBIs were associated with an increased risk of subsequent criminal convictions from age 12 to age 24 when taking account of FSS and childhood disruptive behaviors, although these latter factors may be associated with an increased prevalence of TBIs among adult offenders.

Background Strategies are needed to identify youth developing schizophrenia. The present study aimed to determine whether adolescents treated for substance misuse were at elevated risk to develop schizophrenia, whether this risk has changed since the late 1960s, and whether substance misuse in adolescence predicted poorer outcomes through adulthood. Method In a Swedish city, since the mid-1960s there has been only one clinic for adolescent substance misuse. Three samples from this clinic were studied: 1992 individuals treated from 1968 to 1971 followed to age 50 years; 1576 treated from 1980 to 1984 followed to age 35 years; and 180 treated in 2004 followed to age 22 years. Each clinical sample was matched on age, sex and place of birth to an equal, or larger, number of randomly selected individuals from the general population. Schizophrenia, substance use disorders, physical disorders related to substance misuse, criminal convictions, poverty and death were identified using national registers. Results Individuals treated for substance misuse in adolescence were at increased risk to subsequently develop schizophrenia: in males the increase was approximately four-fold and in females between five- and seven-fold. There was no difference in risk for those treated in 1968-1971 and from 1980 to 1984 when cannabis use increased from 37.6% to 49.8% of the clinical samples. Among males who developed schizophrenia, treatment for substance misuse was associated with increased risk of substance use disorders and criminal convictions through adulthood. Conclusions Treatment programmes for adolescents misusing substances include a disproportionate number developing schizophrenia. Early detection and treatment have the potential to improve long-term outcomes.

Objective: To examine associations of teacher-rated conduct problems (CP) and hurtful and uncaring behaviours (HUB) at age 6 and 10 with criminal convictions up to age 24 among 1593 males and 1423 females, and to determine whether aggressive behaviour at age 12 mediated the associations of CP and HUB with criminal convictions. Method: Teachers assessed HUB and CP at ages 6 and 10 and ratings above the 90th percentile at each age and within each sex were used to assign participants to 1 of 4 groups. Teachers assessed proactive, reactive, indirect, and verbal aggression at age 12. Juvenile and adult criminal records were obtained. Results: High CP and HUB males, aged 6, were 4 times more likely than males with lower ratings to acquire convictions for violent crimes and 5 times more likely to acquire convictions for nonviolent crimes by age 24. High HUB and CP females, aged 6, were 5 times more likely than females with lower ratings to have a conviction for a nonviolent offence by age 24. Among males, both aged 6 and 10, high HUB without CP were associated with elevations at risk of convictions for violent and nonviolent crimes, while among females the elevations at risk were limited to convictions for nonviolent crimes. Different types of aggressive behaviour mediated associations of high HUB and CP with subsequent criminal convictions, but not the association of HUB without CP and crime. Conclusions: Teachers in elementary schools rated behaviours that, from age 6 onward, significantly predicted criminal convictions into early adulthood.

Objective: To compare outcomes over 30 years experienced by individuals who as adolescents entered substance misuse treatment and a general population sample. Method: All 1992 individuals seen at the only clinic for substance misusing adolescents in Stockholm from 1968 to 1971 were compared to 1992 individuals randomly selected from the Swedish population, matched for sex, age and birthplace. Death, hospitalization for physical illness related to substance misuse, hospitalization for mental illness, substance misuse, criminal convictions and poverty were documented from national registers. Results: Relative risks of death, physical illness, mental illness, substance misuse, criminal convictions and poverty were significantly elevated in the clinic compared to the general population sample. After adjustment for substance misuse in adulthood, the risks of death, physical and mental illness, criminality and poverty remained elevated. Conclusion: Adolescents who consult for substance misuse problems are at high risk for multiple adverse outcomes over the subsequent 30 years. 

Aims: To examine trajectories of resilience over 25 years among individuals who as adolescents received treatment for substance misuse, the clinical sample (CS) and a matched general population sample (GP). Design: Comparison of the CS and GP over 25 years using Swedish national registers of health care and criminality. Setting: A substance misuse clinic for adolescents in an urban area in Sweden. Measurements: Resilience was defined as the absence of substance misuse, hospitalizations for physical illnesses related to substance misuse, hospitalization for mental illness and law-abiding behaviour from ages 21 to 45 years. Participants: The CS included 701 individuals who as adolescents had consulted a clinic for substance misuse. The GP included 731 individuals selected randomly from the Swedish population and matched for age, sex and birthplace. Findings: A total of 52.4% of the GP and 24.4% of the CS achieved resilience in all domains through 25 years. Among the CS, another one-third initially displayed moderate levels of resilience that rose to high levels over time, one-quarter displayed decreasing levels of resilience over time, while 9.3% showed little but improving resilience and 8.8% showed no resilience. Levels of resilience were associated with the severity of substance misuse and delinquency in adolescence. Conclusions: Individuals who had presented substance misuse problems in adolescence were less likely to achieve resilience over the subsequent 25 years than was a matched general population sample, and among them, four distinct trajectories of resilience were identified. The severity and type of problems presented in adolescence distinguished the four trajectories.

Aims: This study examined whether social capital and a sense of coherence are associated with hazardous alcohol use in a large population-based Swedish sample. In particular, the objectives were (a) to examine which of five subdimensions of social capital is associated with hazardous alcohol use, (b) to investigate the moderating role of sense of coherence and (c) to examine possible sex differences. Methods: A postal survey was distributed to a sample of respondents (aged 18-84 years) from five Swedish counties that was stratified by sex, age and city; 40,674 (59.2%) participants responded, of which 45.5% were men and 54.5% were women with a mean±SD age of 53.8±17.9 years. Results: Structural dimensions of social capital were associated with an increased probability of hazardous alcohol use among both men and women, whereas the increased probability associated with cognitive dimensions occurred mostly among women. Sense of coherence was robustly associated with a decreased probability of hazardous alcohol use among both men and women. There were few moderating effects of sense of coherence and sex differences emerged mainly for the cognitive dimension of social capital. Conclusions: Associations between social capital dimensions and hazardous alcohol use were partly sex-specific, whereas the benefits of a sense of coherence accrued to both sexes. Social capital dimensions and sense of coherence were generally unrelated to each other. Only associations between the cognitive dimensions of social capital and hazardous alcohol use differed by sex.

Conduct disorder (CD) and anxiety disorders (ADs) are often comorbid and both are characterized by hyper-sensitivity to threat, and reduced structural and functional connectivity between the amygdala and orbitofrontal cortex (OFC). Previous studies of CD have not taken account of ADs nor directly compared connectivity in the two disorders. We examined three groups of young women: 23 presenting CD and lifetime AD; 30 presenting lifetime AD and not CD; and 17 with neither disorder (ND). Participants completed clinical assessments and diffusion-weighted and resting-state functional MRI scans. The uncinate fasciculus was reconstructed using tractography and manual dissection, and structural measures extracted. Correlations of resting-state activity between amygdala and OFC seeds were computed. The CD + AD and AD groups showed similarly reduced structural integrity of the left uncinate compared to ND, even after adjusting for IQ, psychiatric comorbidity, and childhood maltreatment. Uncinate integrity was associated with harm avoidance traits among AD-only women, and with the interaction of poor anger control and anxiety symptoms among CD + AD women. Groups did not differ in functional connectivity. Reduced uncinate integrity observed in CD + AD and AD-only women may reflect deficient emotion regulation in response to threat, common to both disorders, while other neural mechanisms determine the behavioral response.

The study examined associations between antisocial behavior (ASB) before age 15 and eight adverse outcomes from age 21 to 50 among 1,623 men and 324 women who as adolescents consulted a clinic for substance misuse problems. Outcomes were documented using Swedish national registers and included death, hospitalization for physical illnesses related to substance misuse, mental illness, self-inflicted harm, substance misuse, convictions for violent and nonviolent crimes, and poverty. ASB before age 15 was associated with increased odds of all outcomes in adulthood except hospitalization for mental illness after adjusting for low family socioeconomic status, sex, Sex × ASB, and substance misuse in adulthood and with an increased number of adverse outcomes up to age 50. No gender differences were detected.

Most studies on adolescent offending heterogeneity are based on general population samples, and few include individuals with substance misuse or look specifically at substance-related offending. It is also unclear how offender subtypes develop after young adulthood or how offending heterogeneity varies between genders. This study aimed to identify subgroups of offending among adolescents with misuse problems and to examine associations with offending in adulthood. The study included 1,992 females and males that consulted a clinic for adolescents with misuse problems between 1968 and 1971. Latent Class Analyses were conducted to identify subgroups based on violent and nonviolent offending before age 20. Participants were then followed until age 50 and reexamined regardingviolent, nonviolent, and substance-related crimes. Associations between subgroups before age 20 and subgroups age 21-50 were examined. Before age 20, three subgroups were identified among the females and six among the males. Males were more specialized in their offending and demonstrated higher levels ofoffending. Results pointed to both stability and decrease of violent and nonviolent offending, and to the emergence of substance-related offending in adulthood in both genders. The connection between substance-related crimes and general delinquency in adulthood among individuals treated for substance misuse suggests that interventions should also address substance misuse for reducing the overall volume of crime. This study also highlights the importance of including females in research on offending heterogeneity.

BACKGROUND: Inequality in health and health care is increasing in Sweden. Contributing to widening gaps are various factors that can be assessed by determinants, such as age, educational level, occupation, living area and country of birth. A health care service that can be used as an indicator of health inequality in Sweden is mammographic screening. The non-attendance rate is between 13 and 31 %, while the average is about 20 %. This study aims to shed light on three associations: between municipality and non-attendance, between age and non-attendance, and the interaction of municipality of residence and age in relation to non-attendance.

METHODS: The study is based on data from the register that identifies attenders and non-attenders of mammographic screening in a Swedish county, namely the Radiological Information System (RIS). Further, in order to provide a socio-demographic profile of the county's municipalities, aggregated data for women in the age range 40-74 in 2012 were retrieved from Statistics Sweden (SCB), the Public Health Agency of Sweden, the National Board of Health and Welfare, and the Swedish Social Insurance Agency. The sample consisted of 52,541 women. Analysis conducted of the individual data were multivariate logistic regressions, and pairwise chi-square tests.

RESULTS: The results show that age and municipality of residence associated with non-attendance of mammographic screening. Municipality of residence has a greater impact on non-attendance among women in the age group 70 to 74. For most of the age categories there were differences between the municipalities in regard to non-attendance to mammographic screening.

CONCLUSIONS: Age and municipality of residence affect attendance of mammographic screening. Since there is one sole and pre-selected mammographic screening facility in the county, distance to the screening facility may serve as one explanation to non-attendance which is a determinant of inequity. From an equity perspective, lack of equal access to health and health care influences facility utilization.

Introduction and AimsTraditionally, non-drinking adults or young adults have been associated with health deficits rather than health benefits. However, as the proportion of Swedish non-drinking adolescents has doubled since 2000, their health profiles are of interest. The aim of the present study is to examine whether social relations, school characteristics, lifestyle factors or health behaviours distinguish adolescent non-drinkers from adolescent drinkers, and if their health profiles have changed from 2004 to 2012. Design and MethodsData from the Survey of Adolescent Life in Vestmanland, a health survey biennially distributed to all 9th graders (15-16years) in a medium-sized Swedish county, was used. In total, 2872 students in 2004 and 2045 students in 2012 were included. ResultsNon-drinkers were distinguished from drinkers in both 2004 and 2012 by elevated parental supervision, a lower rate of school truancy and lower rates of cannabis use, use of other illicit drugs, daily smoking and lower scores on antisocial behaviour, but more problems of getting new friends. No differences between 2004 and 2012 were found. Discussion and ConclusionsNon-drinkers presented more adaptive and healthier behaviours than their drinking peers, but it is difficult to determine whether their health benefits were related to their improved alcohol status or to the more general trend towards adaptation that occurred from 2004 to 2012 among adolescents.

Introduction: Little is known about the long-term outcome of substance misuse by teenagers, this is especially true for gender specific consequences. Objectives: To examine the prevalence of death, physical illnesses related to substance misuse, mental illness, substance misuse, criminality, and poverty in adulthood among two cohorts of individuals who as adolescents had consulted for substance misuse problems, to estimate the effect of sex on adverse outcomes, and to compare cohort effects. Methods: Individuals who had consulted a substance misuse clinic as adolescents during 1968-1971 and 1980-1984 were followed until 2002. Adverse outcomes were documented using information from Swedish national registers. Results: In the older cohort followed to age 50, only one-in-five escaped all six adverse outcomes, while over half of subjects experienced at least two or more. Sex and the severity of adolescent substance misuse and delinquency were predictors of adverse outcomes. More women than men experienced physical illness and poverty in the older cohort while more men than women were convicted of criminal offences in both cohorts and presented continued substance misuse in the younger cohort. Men in the younger as compared to the older cohort had higher rates of substance misuse and criminal convictions. Conclusions: Adolescents seeking help for substance misuse problems are at elevated risk for multiple adverse outcomes later in life. Outcomes differ for women and men and by severity of adolescent misuse and delinquency. Few cohort differences in adult outcomes exist.

Introductions and AimsThe proportion of adolescents who do not drink alcohol has increased during the last decade in many European countries, the USA and Australia. Few studies have addressed why this positive trend has occurred. The aim of the present study is to examine associations between parenting factors, peers' alcohol use and non-drinking among 15- to 16-year-old adolescents over time, from 2003 to 2015, and to evaluate potential gender differences. Design and MethodsData from the Swedish subsample of European School Survey Project on Alcohol and Other Drugs were used. Data were available for 2003, 2007, 2011 and 2015 in nation-based samples with responses from 11531 adolescents in total. ResultsThe proportion of non-drinkers increased from 23.2% in 2003 to 48.7% in 2015. For each year, indicators of especially restrictive attitudes toward offspring drinking were robustly associated with an increased probability of non-drinking. However, neither indicators of parental monitoring nor parental attitudes toward offspring drinking were associated with the increase in the proportion of non-drinkers that occurred from 2003 to 2015. Two indicators of parental monitoring were more strongly associated with non-drinking among girls than among boys, while paternal restrictive attitudes toward offspring drinking were more strongly associated with non-drinking among boys than girls. Discussion and ConclusionsParenting characteristics are important for adolescents who do not use alcohol, which has implications for prevention strategies. However, the increased trend of non-drinkers could not be attributed to parental factors.

Recently, an increased trend toward non-drinking among adolescents has been observed in several countries. The aim of the present study is to evaluate a common suggestion in literature, that adolescents do not drink alcohol because they spend more time on the internet, monitored at home, by examining associations between internet activities (social media/chatting and computer gaming) and non-drinking. A health questionnaire was distributed to all 9th graders (1516 years) in a mid-sized Swedish county in 2008, 2010 and 2012. In total, 7089 students returned the questionnaire. In contrast to the suggestion, no association was found between total time spent on computers and non-drinking. Social media/chatting was robustly associated with a decreased probability of non-drinking across the three survey years. On the other hand, computer gaming during weekends only (OR = 1.74, CI = 1.132.69) or both on weekdays and weekends increased the probability of non-drinking (OR = 1.82, CI = 1.312.54) in 2012 only. However, neither social media/chatting nor computer gaming was associated with the increased trend of non-drinking from 2008 to 2012. Internet activities were in general not associated with non-drinking among adolescents aged 1516 years in Sweden. Although, a weak positive association between computer gaming and non-drinking was found in 2012, this effect benefited the vast majority of the boys. The larger alcohol use among those with extensive social media use/chatting may indicate that these online platforms are arenas where adolescents are exposed for positive alcohol preferences and alcohol advertising without parental supervision.

The aim of the study was to examine whether online social network chatting (OSNC) is related to any of three peer-related pathways to alcohol use among adolescents including a stress-exposure pathway, a peer status pathway and a social context pathway. A survey was distributed to a Swedish population-based sample of 2439 boys and girls 15–16 years old enrolled in the 9th grade of primary school. Indirect effects, moderating effects, and gender differences were analysed. The results exposed a robust positive association between OSNC and alcohol use, but also that OSNC accounted for one-fifth of the association between the peer status pathway and alcohol use. A positive association between the stress-exposure pathway and alcohol use was found that was weaker among adolescents who scored high on OSNC whereas a positive association between the social context pathway and alcohol use also was found that was stronger among adolescents who scored high on OSNC. Consequently, OSNC may contribute differently to alcohol use depending on which peer-related pathway that the adolescent follows. The robust positive association between OSNC and alcohol use that remained when the three peer-related pathways were accounted for also indicates that this association is accounted for by other factors. 

Introduction and Aims: Researchers in a number of countries have recently identified major changes in adolescent alcohol consumption since the early 2000s, with the prevalence of teenage drinking more than halving in some countries. The major aims of the current study are to examine if there are sub-groups among non-drinking Swedish ninth graders and to describe how the prevalence of these groups has changed during the period 1999 to 2015. Design and Methods: Data from five waves of the Swedish European School Survey Project on Alcohol and other Drugs study was used. The data covered 16 years and the total sample comprised 14 976 students. Latent class analysis was used to identify sub-groups of non-drinkers (n = 4267) based on parental approval towards drinking, parental monitoring, leisure time activities, school performance and use of other substances. Results: Five latent classes were found: computer gamers (8.3%), strict parents (36.5%), liberal parents (27.0%), controlling but liberal parents (16.6%) and sports (11.6%). In the non-drinking sub-group the strict parents group increased most between 1999 and 2015. Discussion and Conclusions: The results imply that there is notable within-group diversity in non-drinking youth. Several mechanisms and explanations are thus likely to be behind the decline in drinking participation among Swedish adolescents.

While many studies have observed a positive association between maltreatment in childhood and criminality in adolescence and adulthood, others have failed to detect such an association. Most studies, however, have not examined different types of maltreatment, nor taken account of other family and childhood factors that are predictive of criminality. Using data from a prospective, longitudinal investigation of a community sample of 1,037 males, we calculated hierarchical logistic regression models to estimate the associations of boys' self-reports of neglect, emotional abuse, and physical abuse at ages 10 and 12, with convictions for criminal offenses from age 12 to 24, after taking account of conduct problems, hurtful and uncaring behaviours (HUB), and parent's criminality. At ages 10 and 12, boys' reports of neglect, emotional abuse, and physical abuse, were not associated with criminal convictions for non-violent or for violent crimes from age 12 to 24. Among boys who did not engage in HUB towards others reports of emotional abuse were associated with subsequent criminality, while this association disappeared among the boys engaging in such behaviours. In this community sample of males, levels of each type of maltreatment were low and there were no direct associations with subsequent criminal convictions. The findings add to emerging evidence that the characteristics of the child and parents, as well as the type of maltreatment modify the association with future criminal offending.

Background: Since 1997 Sweden has a policy for road safety called Vision Zero. Given that Vision Zero is mainly used to reduce fatalities among car occupants, the question has been raised by the research community whether a Vision Zero approach promotes health for all road traffic users. The objective is to measure target fulfilment of the national road safety policy for a Swedish region by examining incidence of serious injury during 2003-2014 in rural and urban road spaces with or without implemented measures. Methods: Data on seriously injured road users, defined as ISS > 8 (Injury Severity Score), were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) together with data from NVDB (National Road Database). These data are used to describe where road users are seriously injured in relation to implemented national policy and using a conceptual model of a road space comprising roads, pavements and tracks for walking and cycling. Seriously injured road users in single and multiple crashes with and without vehicles are included. The development of the incidence is analysed for different road users and places in the road space. Results: Despite implemented road safety measures in the region, the incidence of seriously injured road users per 100,000 inhabitants in rural areas increased from 7.8 in 2003 to 9.3 in 2014 but doubled in urban areas from 8.0 in to 16.3 respectively. In areas not transformed by Vision Zero, only 36% were injured in rural areas while 64% were injured in urban areas. In contrast, in transformed areas 61% of injuries occurred in rural areas, whereas 39% occurred in urban areas. While the incidence decreased for car occupants on transformed national roads in rural areas, the incidence of serious injuries increased among unprotected road users in urban areas, in particular on pavements and tracks for cycling and walking than on the roads where Vision Zero had been implemented. Conclusion: The reduction in the incidence for car occupants in the region may not be adequate to contribute to fulfilling the national target. More needs to be done, especially in the urban areas, where more active mobility is desired. 

The authors regret < Published PDF is correct including the corrections we did because of the comments from the reviewers. But the abstract including keywords is missing in the published version of the article. > The authors would like to apologise for any inconvenience caused. Abstract Introduction: In the EU, the number of seriously injured road users has fallen more slowly than that of fatalities, and fatalities have fallen more slowly for single motor-vehicle crashes than multi-crashes. Instead, the number of injured vulnerable road users such as cyclists and pedestrians has increased and there are calls to promote walking and cycling. The study aims to increase the knowledge about serious injuries in single crashes/falls and to study the differences within and between pedestrians, cyclists, car occupants and motorcyclists. Methods: Data was retrieved from national registries (Strada; National Road Database) for all seriously injured road users on roads, tracks and pavements in Sweden 2016–2019 together with speed limits for crash locations. Statistical analysis used descriptive statistics, multiple logistic regression and multiple linear regression. Results: More road users sustained serious injuries in single crashes than in multi-crashes. Nearly four out of five were injured where the speed limit was 30–50 km/h, or in areas without any speed limit. The mean Injury Severity Scores (ISS) for pedestrians and cyclists were slightly higher than the definition of a seriously injured road user, while car occupants and motorcyclists had mean scores three to four points higher. The most frequently injured body region for cyclists and pedestrians was the lower extremities, and for car occupants and motorcyclists it was the thorax. Higher age increased the probability of these injuries. Male pedestrians and cyclists had higher ISS scores than their female counterparts. Conclusions: Pedestrians and cyclists are the largest groups of road users who are seriously injured in single crashes. Pedestrian falls on pavements, tracks and roads need to be included in road-safety efforts for all road users. The road space will define the pedestrian fall as a crash. Keywords single crash, fall, walking, cycling, ISS.

Background

The number of seriously injured unprotected road users has increased during implementation of a road safety policy Vision Zero. The aim of the study is to identify factors associated with the increase in serious injuries among cyclists and pedestrians (even single pedestrian accidents) that occurred in an urban road space in a Swedish region 2003–17. The urban road space includes roads, pavements and tracks for walking and cycling.

Methods

Data were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) and NVDB (National Road Database). Descriptive statistics and logistic regression with odds ratios for sex, age and part of road space were assessed.

Results

The number of seriously injured cyclists and pedestrians more than doubled from 2003 to 2017, with the greatest increase for pedestrians. Older age increased the probability of serious injury since 2012 for the group ≥ 80 years and since 2015 for the group 65–79 years. No significant effect of sex. Most injuries occur in areas not transformed by Vision Zero.

Conclusions

An increasing number of elderly persons in the generation born in the 1940s and increased life expectancy are important factors. There is a need to increase road safety measures that also promote active mobility.

Objectives

The aim of the study is to examine what types of injuries that seriously injured pedestrians and cyclists received in urban road spaces from 2003 to 2017 in the Swedish region of Västmanland, when the road safety policy Vision Zero was implemented.

Study design

This is a cross-sectional data annually collected over a period of fifteen years.

Methods

Data from health care for 403 seriously injured pedestrians and cyclists were retrieved from the registry STRADA (Swedish Traffic Accident Data Acquisition) and cross-referenced with the National Road Database to see if any Vision Zero measures had previously been implemented at the crash location. The study includes injuries from both single and multiple crashes on roads, pavements, and tracks for walking and cycling (road space). Statistical analysis was performed by descriptive statistics, chi-square tests, and multiple logistic regression analyses.

Results

Pedestrians were seriously injured in lower extremities more than cyclists, whereas more cyclists were seriously injured in the head. During the period, pedestriansꞌ head injuries decreased significantly, but injuries in lower extremities increased significantly. In addition, for cyclists, there was a shift from decreased probability of head injuries to increased probability of injuries in lower extremities related to increased age. For pedestrians, pavements/tracks were associated with a decreased probability of a majority of injury outcomes but for cyclists only for severe injury outcomes.

Conclusions

From 2003 to 2017, there was a shift among seriously injured pedestrians, with head injuries decreasing and injuries in lower extremities increasing. This shift was probably related to an ageing population in the region, given that increased age among both pedestrians and cyclists was associated with a decreased probability of head injuries but increased probability of injuries in lower extremities. On Vision Zero roads, there was a decreased probability of pedestrians receiving serious injury to more than one bodily region. An increased number of older people combined with policies for more active mobility such as walking and cycling are a challenge for road authorities in urban areas.

Background: School nurses in the school health services are assigned to promote health and participation among children when conducting health visits. Still, for children of foreign origin this promotion of participation might be hampered by challenges related to cultural diversity and language barriers. Therefore, knowledge needs to be developed regarding how these children’s participation can be promoted, to support them in sharing and describing matters important for their health. The aim was to investigate school nurses’ descriptions of promoting participation for children of foreign origin in health visits. Methods: A content analysis of 673 Swedish school nurses’ answers to eight open-ended questions regarding promotion of participation for children of foreign origin was conducted. The open-ended questions were part of a larger web-based cross-sectional survey distributed to school nurses in Sweden. Results: The results show that school nurses use three main approaches during the health visit: adjusting according to the child’s proficiency in Swedish and/or cultural or national background, adjusting according to the child’s individual needs, and doing the same for all children regardless of their origin. Yet, adjustments according to the child’s proficiency in Swedish and/or cultural or national background were the most common. Conclusions: By combining the approaches of adjusting, a child-centered care that contributes to children’s participation in health visits and equity in health could be provided. 

The purpose of this study was to investigate associations between school nurses' self-assessed cultural competence in health visits with children of foreign origin and demographic variables, by using a cross-sectional design. A Web-based questionnaire assessing cultural competence and demographic variables was distributed to a nationally representative sample (n = 816) of school nurses in Sweden. Data were analyzed using regression analysis. School nurses assessed themselves as culturally aware and moderately culturally competent, but not as culturally knowledgeable, culturally skilled, or comfortable in cultural encounters. Cultural competence was related to education in cultural diversity, how often nurses encounter children of foreign origin, and nurses' country of origin. In total, these variables explained 23.6% of the variation in school nurses' cultural competence. Because school nurses regard themselves as moderately culturally competent, a foundation for promoting children's health on equal terms in school health care exists. However, education in cultural diversity combined with other additional strategies is needed to further strengthen school nurses' cultural knowledge, skills, and comfort level in encounters with children of foreign origin.

Conclusions: Social support had its strongest effect at high levels of financial stress. The question whether the altering of our social networks may improve physical health is important for the prevention of ill health in people experiencing financial stress. Strengthening social networks may have the potential to influence health-care costs and improve quality of life. Introduction. Financial stress is an important source of distress and is related to poor mental and physical health outcomes. The present study investigated whether tangible social support could buffer the effect of financial stress on psychological and psychosomatic health. Results: Individuals with high financial stress and low tangible social support had six to seven times increased odds ratios for low psychological well-being and many psychosomatic symptoms. By contrast, individuals with high financial stress and high tangible social support had only two to three times increased odds ratios for low psychological well-being and three to four times increased odds ratios for many psychosomatic symptoms, suggesting a buffering effect of tangible social support. Consistent with the buffering hypothesis, there were significant interactions between financial stress and social support, particularly in relation to low psychological well-being.