School wellbeing among children in grades 1 - 10

<p>Abstract</p> <p>Background</p> <p>Determinants of children's school wellbeing have not been extensively studied. In this cross-sectional study of school children we assessed how factors assumed to promote wellbeing and factors assumed to adversely influence wellbeing were associated with self-reported wellbeing in school.</p> <p>Methods</p> <p>Children from five schools, 230 boys and 189 girls in grades 1-10, responded to the same set of questions. We used proportional odds logistic regression to assess the associations of promoting and restraining factors with school wellbeing.</p> <p>Results</p> <p>In a multivariable analysis, degree of school wellbeing in boys was strongly and positively related to enjoying school work (odds ratio, 3.84, 95% CI 2.38 to 6.22) and receiving necessary help (odds ratio, 3.55, 95% CI 2.17 to 5.80) from teachers. In girls, being bothered during lessons was strongly and negatively associated with school wellbeing (odds ratio, 0.43, 95% CI 0.22 to 0.85).</p> <p>Conclusions</p> <p>Different factors may determine school wellbeing in boys and girls, but for both genders, factors relevant for lessons may be more important than factors related to recess. Especially in boys, the student-teacher relationship may be of particular importance.</p

Characteristics of the case mix, organisation and delivery in cancer palliative care: a challenge for good-quality research

Objectives: Palliative care (PC) services and patients differ across countries. Data on PC delivery paired with medical and self-reported data are seldom reported. Aims were to describe (1) PC organisation and services in participating centres and (2) characteristics of patients in PC programmes. Methods: This was an international prospective multicentre study with a single web-based survey on PC organisation, services and academics and patients' self-reported symptoms collected at baseline and monthly thereafter, with concurrent registrations of medical data by healthcare providers. Participants were patients ≥18 enrolled in a PC programme. Results: 30 centres in 12 countries participated; 24 hospitals, 4 hospices, 1 nursing home, 1 home-care service. 22 centres (73%) had PC in-house teams and inpatient and outpatient services. 20 centres (67%) had integral chemotherapy/radiotherapy services, and most (28/30) had access to general medical or oncology inpatient units. Physicians or nurses were present 24 hours/7 days in 50% and 60% of centres, respectively. 50 centres (50%) had professorships, and 12 centres (40%) had full-time/part-time research staff. Data were available on 1698 patients: 50% females; median age 66 (range 21–97); median Karnofsky score 70 (10–100); 1409 patients (83%) had metastatic/disseminated disease; tiredness and pain in the past 24 hours were most prominent. During follow-up, 1060 patients (62%) died; 450 (44%) <3 months from inclusion and 701 (68%) within 6 months. ANOVA and χ2 tests showed that hospice/nursing home patients were significantly older, had poorer performance status and had shorter survival compared with hospital-patients (p<.0.001). Conclusions: There is a wide variation in PC services and patients across Europe. Detailed characterisation is the first step in improving PC services and research. Trial registration number: ClinicalTrials.gov Identifier: NCT01362816

Factors associated with internalizing or somatic symptoms in a cross-sectional study of school children in grades 1-10

<p>Abstract</p> <p>Background</p> <p>School related factors that may contribute to children's subjective health have not been extensively studied. We assessed whether factors assumed to promote health and factors assumed to have adverse effects were associated with self-reported internalizing or somatic symptoms.</p> <p>Methods</p> <p>In a cross-sectional study, 230 boys and 189 girls in grades 1-10 from five schools responded to the same set of questions. Proportional odds logistic regression was used to assess associations of school related factors with the prevalence of sadness, anxiety, stomach ache, and headache.</p> <p>Results</p> <p>In multivariable analyses, perceived loneliness showed strong and positive associations with sadness (odds ratio, 1.94, 95% CI 1.42 to 2.64), anxiety (odds ratio, 1.78, 95% CI 1.31 to 2.42), and headache (odds ratio, 1.47, 95% CI 1.10 to 1.96), with consistently stronger associations for girls than boys. Among assumed health promoting factors, receiving necessary help from teachers was associated with lower prevalence of stomach ache in girls (odds ratio, 0.51, 95% CI 0.30 to 0.87).</p> <p>Conclusions</p> <p>These findings suggest that perceived loneliness may be strongly related to both internalizing and somatic symptoms among school children, and for girls, the associations of loneliness appear to be particularly strong.</p

Helhetlige pasientforløp – gjennomføring i primærhelsetjenesten

Et av hovedmålene i samhandlingsreformen har vært at kommuner i samarbeid med sykehus skal kunne tilby helhetlige og integrerte tjenester før og etter sykehusopphold, basert på sammenhengende pasientforløp. Kommuner og foretak er derfor i den nye helse -og omsorgsloven blitt pålagt å inngå forpliktende samarbeidsavtaler om innleggelse og utskrivning av pasienter. Vi har fulgt noen sykehus og kommuner som sammen har forsøkt å utvikle helhetlige pasientforløp for KOLS, hjertesvikt, slag og hoftebrudd som også omfattet oppfølging i kommunen. Vi finner at spesialisering av tjenester og personell i primærhelsetjenesten for oppfølging av spesifikke diagnoser hverken er bærekraftig eller funksjonelt. I tillegg vil det å forlenge diagnosespesifikke forløp fra sykehus ut i kommunen bidra til fragmentering av tjenestene til eldre og kronisk syke. I noen av kommunene ble det utviklet og tatt i bruk generisk diagnoseuavhengige forløp. Det fungerte for disse kommunene og framstår som en mer bærekraftig modell

Awareness of demands and unfairness and the importance of connectedness and security : teenage girls’ lived experiences of their everyday lives

In recent years, a number of studies have demonstrated that stress and mental health problems have increased among adolescents and especially among girls, although little is still known concerning what girls experience in their everyday lives. The aim of this study was to describe the phenomenon of teenage girls’ everyday lives, as experienced by the girls themselves. A phenomenological approach of reflective lifeworld research was used, and the findings are based on eight qualitative interviews with girls aged 13–16 years. The essence of teenage girls’ everyday lives as experienced by the girls themselves can be described as consciousness regarding demands and unfairness and regarding the importance of connectedness and security. The girls are aware of the demands of appearance and success, and they are conscious of the gender differences in school and in the media that affect them. The girls are also conscious about the meaning of connectedness with friends and family, as well as the importance of the security of their confidence in friends and feeling safe where they stay. If teenage girls feel connected and secure, protective factors in the form of manageability and meaningfulness can act as a counterweight to the demands and unfairness of everyday life. For professionals who work with teenage girls, the results from this study can be important in their work to support these girls

sj-pdf-1-pmj-10.1177_02692163231222391 – Supplemental material for PALLiative care in ONcology (PALLiON): A cluster-randomised trial investigating the effect of palliative care on the use of anticancer treatment at the end of life

Supplemental material, sj-pdf-1-pmj-10.1177_02692163231222391 for PALLiative care in ONcology (PALLiON): A cluster-randomised trial investigating the effect of palliative care on the use of anticancer treatment at the end of life by Marianne Jensen Hjermstad, Aleksandra Pirnat, Nina Aass, Sigve Andersen, Guro L Astrup, Olav Dajani, Herish Garresori, Kristin V Guldhav, Hanne Hamre, Ellinor C Haukland, Frode Jordal, Tonje Lundeby, Erik Torbjorn Løhre, Svein Mjåland, Ørnulf Paulsen, Karin A Semb, Erik S Staff, Torunn Wester and Stein Kaasa in Palliative Medicine</p