The effect of active learning on academic performance in a Norwegian primary school setting–the Health Oriented Pedagogical Project (HOPP)

Background: Numerous systematic reviews, with varying degrees of certainty, have suggested a beneficial link between physical activity and academic achievement. Methods: The Health Oriented Pedagogical Project (HOPP) in Horten, Norway, integrates active learning in seven elementary schools’ curricula (n = 1,545), aiming to merge physical activity with academic instruction. The control group consisted of two schools from Akershus County, doing standard teaching (n = 752). The data were collected from 2015 to 2019. Results: The results highlight the active learning potential to complement traditional teaching methods and foster overall academic success in elementary education. Active learning, partially replacing traditional classroom methods with physical tasks, yielded significant academic benefits. Secular trends for national tests in 5th-grade intervention school students across five years showed improvement compared to control schools in English, arithmetic, and reading. Both intervention and control schools displayed a significant change in slope across the study period. Compared to national median results, the intervention schools also revealed an improvement. Conclusion: HOPP’s findings underscore the effectiveness of active learning in enhancing academic performance, with intervention schools surpassing national medians after four years of intervention.The effect of active learning on academic performance in a Norwegian primary school setting–the Health Oriented Pedagogical Project (HOPP)publishedVersio

Gender and Digital Disconnection: Experiences in Norway

This survey-based study examines digital disconnection experiences among 1,142 respondents in Norway, focusing on self-reported behaviors and opinions regarding digital media non-use in everyday life. Specifically, it highlights gender differences, along with other sociodemographic variations, found in the responses of 552 women and 590 men. The results show that both genders reported spending ‘too much’ time on their smartphones, with women reporting this more frequently. Yet notably, there is no significant difference in self-reported screen time estimates between the two genders. Moreover, women reported imposing more frequent smartphone restrictions in various scenarios, whereas men expressed greater opposition to authorities interfering with Internet and smartphone use. Still, while these differences are significant, the quantitative description reveals them to be rather minor. This study seeks to advance the field of digital disconnection studies by integrating a gender perspective, thereby contributing to its interdisciplinary scope. Furthermore, it aims to establish a foundation for future research, potentially expanding beyond comparative analyses and the gender binary, and fostering more critical perspectives.publishedVersio

Examining criticism of WHO’s COVID-19 response: a scoping review

The COVID-19 pandemic exposed significant weaknesses in global health governance, with the World Health Organization (WHO) facing widespread criticism. This scoping review aims to systematically examine and categorize critiques of WHO’s pandemic response across multiple stakeholders. Using Arksey and O’Malley’s framework and the Joanna Briggs Institute guidelines, a systematic search of six databases (CINAHL, Embase, Web of Science, Scopus, PsycINFO, and PubMed) was conducted. Peer-reviewed research studies were screened using predefined inclusion and exclusion criteria, and thematic synthesis categorized the findings across six key themes: delays in response, communication failures, vaccine equity, global coordination, governance limitations, and trust and transparency. Included studies reported that the WHO’s effectiveness was limited by delayed emergency declarations, inconsistent public health messaging, inequitable vaccine distribution, and constrained authority over global health measures. Additionally, geopolitical tensions, donor-driven funding structures, and the exclusion of key stakeholders (e.g., Taiwan) further challenged global coordination. These issues affected public trust and highlighted structural inefficiencies in international health governance. The findings point to calls for reforms, including enhanced autonomy in crisis response, more transparent communication strategies, equitable resource distribution, and strengthened mechanisms for global collaboration. This review contributes to the understanding of how health governance, public trust, and equity are interrelated, providing a foundation to inform efforts to enhance WHO’s leadership in future health crises.publishedVersio

Waist-to-Height Ratio as a predictor of cardiovascular and metabolic health in a pediatric population

Background: Understanding the relationship between central adiposity and health outcomes in children is crucial for early prevention of non-communicable diseases (NCDs). Waist-to-height ratio (WHtR) has emerged as a key anthropometric measure for predicting cardiovascular and metabolic health risks. Methods: The objective of this study was to investigate whether WHtR is associated with cardiovascular and metabolic risk markers, including HbA1c, CRP, lipid profiles, blood pressure, ferritin, and iron levels, in healthy children aged 6-12 years. The study further aimed to assess WHtR's potential as a screening tool for identification of cardiometabolic risk. Results: An association between WHtR and unfavorable lipid profiles, with elevated total cholesterol and non-HDL cholesterol levels, alongside decreased HDL levels in the highest WHtR quartile, were displayed, suggesting increased cardiovascular risk. Similarly, the combination of high erythrocyte count, low hematocrit (HCT), high ferritin, and low iron, combined with high CRP may imply chronic inflammation due to adiposities. Elevated systolic and diastolic blood pressure values further underscore this cohort's cardiovascular risks associated with central adiposity. Conclusion: WHtR's ability to predict metabolic and cardiovascular risk factors highlights its potential as a simple, non-invasive screening tool in pediatric healthcare. Implementing WHtR in routine health assessments could provide an accessible and cost-effective method for early identification of at-risk children, enabling timely interventions to improve long-term health outcomes.publishedVersio

Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: a forecasting study for the Global Burden of Disease Study 2021

Background Despite the well documented consequences of obesity during childhood and adolescence and future risks of excess body mass on non-communicable diseases in adulthood, coordinated global action on excess body mass in early life is still insufficient. Inconsistent measurement and reporting are a barrier to specific targets, resource allocation, and interventions. In this Article we report current estimates of overweight and obesity across childhood and adolescence, progress over time, and forecasts to inform specific actions. Methods Using established methodology from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021, we modelled overweight and obesity across childhood and adolescence from 1990 to 2021, and then forecasted to 2050. Primary data for our models included 1321 unique measured and self-reported anthropometric data sources from 180 countries and territories from survey microdata, reports, and published literature. These data were used to estimate age-standardised global, regional, and national overweight prevalence and obesity prevalence (separately) for children and young adolescents (aged 5–14 years, typically in school and cared for by child health services) and older adolescents (aged 15–24 years, increasingly out of school and cared for by adult services) by sex for 204 countries and territories from 1990 to 2021. Prevalence estimates from 1990 to 2021 were generated using spatiotemporal Gaussian process regression models, which leveraged temporal and spatial correlation in epidemiological trends to ensure comparability of results across time and geography. Prevalence forecasts from 2022 to 2050 were generated using a generalised ensemble modelling approach assuming continuation of current trends. For every age-sex-location population across time (1990–2050), we estimated obesity (vs overweight) predominance using the log ratio of obesity percentage to overweight percentage. Findings Between 1990 and 2021, the combined prevalence of overweight and obesity in children and adolescents doubled, and that of obesity alone tripled. By 2021, 93·1 million (95% uncertainty interval 89·6–96·6) individuals aged 5–14 years and 80·6 million (78·2–83·3) aged 15–24 years had obesity. At the super-region level in 2021, the prevalence of overweight and of obesity was highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and the greatest increase from 1990 to 2021 was seen in southeast Asia, east Asia, and Oceania (eg, Taiwan [province of China], Maldives, and China). By 2021, for females in both age groups, many countries in Australasia (eg, Australia) and in high-income North America (eg, Canada) had already transitioned to obesity predominance, as had males and females in a number of countries in north Africa and the Middle East (eg, United Arab Emirates and Qatar) and Oceania (eg, Cook Islands and American Samoa). From 2022 to 2050, global increases in overweight (not obesity) prevalence are forecasted to stabilise, yet the increase in the absolute proportion of the global population with obesity is forecasted to be greater than between 1990 and 2021, with substantial increases forecast between 2022 and 2030, which continue between 2031 and 2050. By 2050, super-region obesity prevalence is forecasted to remain highest in north Africa and the Middle East (eg, United Arab Emirates and Kuwait), and forecasted increases in obesity are still expected to be largest across southeast Asia, east Asia, and Oceania (eg, Timor-Leste and North Korea), but also in south Asia (eg, Nepal and Bangladesh). Compared with those aged 15–24 years, in most super-regions (except Latin America and the Caribbean and the high-income super-region) a greater proportion of those aged 5–14 years are forecasted to have obesity than overweight by 2050. Globally, 15·6% (12·7–17·2) of those aged 5–14 years are forecasted to have obesity by 2050 (186 million [141–221]), compared with 14·2% (11·4–15·7) of those aged 15–24 years (175 million [136–203]). We forecasted that by 2050, there will be more young males (aged 5–14 years) living with obesity (16·5% [13·3–18·3]) than overweight (12·9% [12·2–13·6]); while for females (aged 5–24 years) and older males (aged 15–24 years), overweight will remain more prevalent than obesity. At a regional level, the following populations are forecast to have transitioned to obesity (vs overweight) predominance before 2041–50: children and adolescents (males and females aged 5–24 years) in north Africa and the Middle East and Tropical Latin America; males aged 5–14 years in east Asia, central and southern sub-Saharan Africa, and central Latin America; females aged 5–14 years in Australasia; females aged 15–24 years in Australasia, high-income North America, and southern sub-Saharan Africa; and males aged 15–24 years in high-income North America. Interpretation Both overweight and obesity increased substantially in every world region between 1990 and 2021, suggesting that current approaches to curbing increases in overweight and obesity have failed a generation of children and adolescents. Beyond 2021, overweight during childhood and adolescence is forecast to stabilise due to further increases in the population who have obesity. Increases in obesity are expected to continue for all populations in all world regions. Because substantial change is forecasted to occur between 2022 and 2030, immediate actions are needed to address this public health crisis.publishedVersio

Global burden of vision impairment due to age-related macular degeneration, 1990–2021, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Age-related macular degeneration (AMD) is a growing public health concern worldwide, as one of the leading causes of vision impairment. We aimed to estimate global, national, and region-specific prevalence and disability-adjusted life-years (DALYs) along with tobacco as a modifiable risk factor to aid public policy addressing AMD. Methods Data on AMD were extracted from the Global Burden of Disease, Injuries, and Risk Factor Study 2021 database in 204 countries and territories, 1990–2021. Vision impairment was defined and categorised by severity as follows: moderate to severe vision loss (visual acuity from <6/18 to 3/60) and blindness (visual acuity <3/60 or a visual field <10 degrees around central fixation). The burden of vision impairment attributable to AMD was subsequently estimated. These estimates were further stratified by geographical region, age, year, sex, Healthcare Access and Quality (HAQ) Index, and Socio-demographic Index (SDI) levels. Additionally, the effect of tobacco use, a modifiable risk factor, on the burden of AMD was analysed, and projections of AMD burden were estimated through to 2050. These projections also included scenario modelling to assess the potential effects of tobacco elimination. Findings Globally, the number of individuals with vision impairment due to AMD more than doubled, rising from 3·64 million (95% uncertainty inverval [UI] 3·04–4·35) in 1990 to 8·06 million (6·71–9·82) in 2021. Similarly, DALYs increased by 91% over the same period, from 0·30 million (95% UI 0·21–0·42) to 0·58 million (0·40–0·80). By contrast, age-standardised prevalence and DALY rates declined, with prevalence rates decreasing by 5·53% (99·50 per 100 000 of the population [95% UI 83·16–118·04] in 1990 to 94·00 [78·32–114·42] in 2021) and DALY rates dropping by 19·09% (8·38 [5·70–11·53] to 6·78 [4·70–9·32]). These rates showed a consistent decrease in higher SDI quintiles, reflecting the negative correlation between HAQ Index and AMD burden. A general downward trend was observed from 1990 to 2021, with the largest age-standardised reduction occurring in the low-middle SDI quintile. The global contribution of tobacco to age-standardised DALYs decreased by 20%, declining from 12·45% (95% UI 7·73–17·37) in 1990 to 9·96% (6·12–14·06) in 2021. By 2050, the number of individuals affected by AMD is projected to increase from 3·40 million males (95% UI 2·81–4·17) in 2021 to 9·02 million (5·72–14·20) and from 4·66 million females (3·88–5·65) to 12·32 million (8·88–17·08). Eliminating tobacco use could reduce these numbers to 8·17 million males (5·59–11·92) and 11·15 million females (8·58–14·48) in 2050. Interpretation While the total prevalence and DALYs due to AMD have steadily increased from 1990 to 2021, age-standardised prevalence and DALY rates have declined, probably reflecting the effect of population ageing and growth. The consistent decrease in age-standardised rates with higher SDI levels highlights the crucial role of health-care resources and public policies in mitigating AMD-related vision impairment. The downward trend observed from 1990 to 2021 might also be partially attributed to the reduced effect of tobacco as a modifiable risk factor, with declines in tobacco use seen globally and across all SDI quintiles. The burden of vision impairment due to AMD is projected to increase to about 21·34 million in 2050. However, effective tobacco regulation has the potential to substantially reduce AMD-related vision impairment, particularly in lower SDI quintiles where health-care resources are limited.Gates FoundationpublishedVersio

Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021

Background The WHO Global Oral Health Action Plan has set an overarching global target of achieving a 10% reduction in the prevalence of oral conditions by 2030. Robust and up-to-date information on the global burden of oral conditions is paramount to monitor progress towards this target. The aim of this systematic data analysis was to produce global, WHO region, and country-level estimates of the prevalence of, and disability-adjusted life-years (DALYs) attributed to, untreated caries, severe periodontitis, edentulism, other oral disorders, lip and oral cavity cancer, and orofacial clefts from 1990 to 2021. Methods This report is based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Input data were extracted from epidemiological surveys, population-based registries, and vital statistics. Data were modelled with DisMod-MR 2.1, a Bayesian meta-regression modelling tool, to ensure consistency between prevalence, incidence, remission, and mortality estimates for oral conditions. DALYs were estimated as the aggregation of the years of life lost (YLLs) due to premature mortality and years lived with disability (YLDs). YLDs were calculated by multiplying prevalence estimates, the severity of the oral condition's sequelae (disability weight) and duration of the sequelae. Although all oral conditions lead to YLDs, only lip and oral cavity cancer and orofacial clefts lead to YLLs as well. 95% uncertainty intervals (UIs) were generated for every metric with the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings The combined global age-standardised prevalence of the main oral conditions (untreated caries, severe periodontitis, edentulism, and other oral disorders) was 45 900 (95% UI 42 300 to 49 800) per 100 000 population in 2021, with 3·69 billion (3·40 to 4·00) people affected globally. Untreated dental caries of permanent teeth and severe periodontitis were the most common oral conditions, with a global age-standardised prevalence of 27 500 (24 000 to 32 000) per 100 000 population and 12 500 (10 500 to 14 500) per 100 000 population, respectively. Edentulism, severe periodontitis, and lip and oral cavity cancer caused the highest burden as demonstrated by their counts of DALYs and age-standardised DALY rates. Existing trends for 1990–2021 reveal relatively small changes (upward or downward) in prevalence and burden. Increasing counts of prevalent cases and DALYs were noted for all oral conditions but untreated caries of deciduous teeth (no percentage change in prevalence or DALYs) and orofacial clefts (–68·3% [–79·3 to –46·5] decrease in DALYs). There were decreases in both age-standardised prevalence and DALY rate for untreated caries of permanent teeth and edentulism, no change in both for untreated caries of deciduous teeth and severe periodontitis, an increase in the prevalence but no change in the DALY rate for lip and oral cavity cancer, and no change in the prevalence but a decrease in the DALY rate for orofacial clefts. By WHO region, the African and Eastern Mediterranean regions showed the largest increases in prevalent cases and DALYs for most oral conditions, while the European region showed the smallest increases or no change. The European region was the only region with decreasing age-standardised prevalence of untreated caries in both deciduous (–9·88%; –12·6 to –6·71) and permanent teeth (–5·94% (–8·38 to –3·62). The prevalence and DALY rate of severe periodontitis decreased in the African region, while the prevalence and DALY rate of edentulism decreased in the African region, South-East Asia region, and Western Pacific region. Furthermore, DALY rates of lip and oral cavity cancer decreased in the European region and the region of the Americas, while DALY rates of orofacial clefts decreased in all regions. Interpretation The minor changes in the burden of oral conditions over the past 30 years demonstrate that past and current efforts to control oral conditions have not been successful and that different approaches are needed. Many countries now face the double challenge of controlling the occurrence of new cases of oral conditions and addressing the huge unmet need for oral health care.publishedVersio

Kapittel 7: Fra flaggskip til forbruker: Betydningen av den fysiske butikken og DTC-salg

The phenomenon of “retail apocalypse” and declining physical store usage has prompted brand suppliers globally and in Norway to rethink their marketing and sales strategies. This shift has led suppliers to explore Direct-to-Consumer (DTC) approaches and establish experiential retail environments. This chapter examines how brands change their sales and marketing channels by opening physical flagship stores, adapting these spaces to counteract the decline in customer visits, and leveraging experiences to boost product and service sales. The role of physical stores is examined within the context of the Norwegian market, mainly focusing on the sports industry. Empirical data were gathered through interviews with marketing and store managers of the branded stores. Findings suggest that physical flagship stores have transformed into venues for engaging sensory experiences, detailed product education, and robust brand-building efforts. The DTC strategy allows brands to directly influence customer perceptions and create lasting emotional connections with consumers. Additionally, the chapter discusses the integration of sustainability practices within these strategies, highlighting the importance of repair services and circular economy efforts in Norwegian retail.Kapittel 7: Fra flaggskip til forbruker: Betydningen av den fysiske butikken og DTC-salgpublishedVersio

SOCIAL MEDIA ENGAGEMENT AND IDENTITY: THE LONELINESS AND FOMO EXPERIENCE OF YOUNG PEOPLE

Social media platforms, designed to facilitate connectivity, have a complex impact on psychological well-being. This study investigates the relationship between social media usage, loneliness, and the fear of missing out among young people in Slovakia, focusing on gender differences. Using a quantitative cross-sectional design, data was collected from 225 university students (70.2% female, 29.8% male) through the UCLA Loneliness Scale, the Social Media Engagement Questionnaire (SMEQ), and the Fear of Missing Out (FOMO) Scale. Statistical analyses conducted included linear regression and correlation analyses; the results showed no significant correlation between social media use and loneliness (r = 0.08, p = 0.11), although a weak to moderately strong positive correlation was found between loneliness in women and FOMO (r = 0.24, p = 0.001). Additionally, a significant positive correlation was identified between FOMO and social media use (r = 0.27, p < 0.001), with FOMO predicting increased social media engagement. The study concludes that while social media use does not directly predict loneliness, FOMO significantly influences social media engagement among young people. These findings underscore the importance of considering psychological factors like FOMO in understanding students’ social media behaviour and point to the need for genderspecific approaches to digital wellness.acceptedVersio

Employee Emotions During Organizational Change Among Nordic Academics: Health-Promoting Self-Leadership as a Coping Strategy

Abstract The purpose of this conceptual and explorative study is to investigate whether health-promoting self-leadership could be used as a coping strategy enabling employees to deal with negative emotions in an organizational change process, providing a conceptual framework. A total of 18 faculty members from a Nordic university college were interviewed about their experiences, perceptions, and emotional reactions. The study reveals that new IT-systems; heavier workloads; and a lack of involvement, trust, and information, in particular, were stated to be the main reasons for negative emotions, detachment from the university-status aim, and the disruption of employee work–life balance. A few faculty members practiced fragments of what, in theory, is defined as health-promoting self-leadership to successfully manage the organizational change processes. Some were unconscious of their self-leadership practices, while others had no tools to enable them to cope with changes, leading to negative emotions. I discuss the findings regarding health-promoting self-leadership practice based on self-leadership, change management, and emotion theory. Based on both the findings in this study and relevant theories regarding self-leadership and coping strategies, I propose a health-promoting self-leadership-based coping model that could provide both individual and organizational health and performance benefits.publishedVersio