Adolescent Alcohol-use and Economic Conditions: A Multilevel Analysis of Data from a Period with Big Economic Changes

This paper examines how the unemployment rate is related to adolescent alcohol use during a time period characterized by big societal changes using repeated cross-sectional adolescent survey data from a Swedish region, collected in 1988, 1991, 1995, 1998, 2002 and 2005. Individual level alcohol use is connected to local level unemployment rate to estimate the relationship using multilevel modeling. The results show that the unemployment rate is negatively associated with adolescents alcohol use. When the unemployment rate increases, more adolescents, mainly girls, do not drink at all. Regular drinking (2/month or more) is, on the other hand, unrelated to the unemployment rate. This implies that we may se decreases in adolescent alcohol use in the now expected real economic crisis with increasing unemployment.alcohol use; unemployment rate; multilevel methods; Sweden.

ADOLESCENT ALCOHOL- AND ILLICIT DRUG-USE IN FIRST AND SECOND GENERATION IMMIGRANTS IN SWEDEN

In this paper adolescent alcohol- and illicit drug-use among 1st and 2nd generation immigrants from Nordic, non-Nordic European and non-European countries were compared with the Swedish majority population. Multilevel logistic regression analysis was performed based on survey data from three different Swedish regions including 24 municipalities sampled in 2005 including 13,070 adolescents. Immigrants from Nordic countries were more likely to use alcohol (OR: 1.10-1.37) while immigrants from non- European countries were less likely to use alcohol (OR: 0.52-0.81), mainly explained by the relatively low use by girls from non-European countries. All immigrant groups were more likely to use illicit-drugs compared to the majority population. Highest drug-use were found among first generation Nordic Immigrants (OR: 3.15-4.17) and non-European immigrants (OR: 2.92-3.13). Consumption patterns among second generation immigrants were more similar to the Swedish majority population, implying more alcohol-use and less illicit drug-use.alcohol; drug use; ethnicity; immigrants; adolescents

Child-perceived parental support and knowledge in shared physical custody and other living arrangements for children

Objective: The aim of this paper is to develop an understanding of how child-perceived parental support and knowledge among children in Sweden differ across ten forms of residential arrangement. Background: Shared physical custody has become an increasingly common arrangement for children in separated families in many European countries. In an international comparison, Sweden has a high rate of parental union dissolution but also the highest prevalence of shared physical custody arrangements following divorce or separation. Over a third of all children with divorced or separated parents spend an equal amount of time living in both parental households. Method: We used data from the Swedish HBSC survey from 2013/14, which are focused on children in grades 5, 7 and 9 in the Swedish comprehensive school system (n=7360) and used perceived parental support and perceived parental knowledge scales as dependent variables in multiple ordered logistic regressions conducted separately by the sex of the parent. Results: The results show that children in shared physical custody report higher levels of parental support and knowledge than children in sole physical custody and equally high as those who live in a two-parent family. Children living in non-symmetrical physical custody arrangements report lower levels of paternal support and knowledge than children whose parents share physical custody equally. Maternal support and knowledge does not differ between children living in symmetrical and non-symmetrical shared physical custody arrangements, whereas paternal support and knowledge is lower in families where the child lives in an unequal residential sharing arrangement with the mother as the main co-residential parent. Conclusion: Post-divorce living arrangements are clearly associated with the relationship between parents and children, with children in shared physical custody reporting stronger relationships than children in sole physical custody. The cross-sectional nature of the data prevents us from drawing conclusions on causality, however.Fragestellung: Ziel dieses Beitrags ist es, ein Verständnis dafür zu entwickeln, wie sich im schwedischen Kontext die elterliche Unterstützung und Wissen aus der Perspektive der Kinder in zehn verschiedenen Wohnformen unterscheiden. Hintergrund: Gemeinsames physisches Sorgerecht ist in vielen europäischen Ländern eine gewöhnliche Regelung für Kinder in getrennten Familien geworden. Im internationalen Vergleich hat Schweden eine hohe Scheidungs- und Trennungsrate, sowie das höchste Vorkommen an gemeinsamen Sorgerechtsregelungen nach einer Scheidung oder Trennung. Mehr als ein Drittel aller Kinder mit geschiedenen oder getrennten Eltern leben gleich viel in den Haushalten beider Elternteile. Methode: Wir verwendeten Daten aus der schwedischen HBSC-Erhebung von 2013/14, die sich auf Kinder der Klassenstufen 5, 7 und 9 im schwedischen Grundschulsystem konzentrieren (n=7360). Zudem bedienten wir uns Skalen zur wahrgenommenen elterlichen Unterstützung und zum wahrgenommenen elterlichen Wissen als abhängige Variablen in mehrfach geordneten logistischen Regressionen, die getrennt nach dem Geschlecht der Eltern durchgeführt wurden. Ergebnisse: Die Ergebnisse zeigen, dass Kinder, die das gemeinsame physische Sorgerecht haben, ein höheres Maß an elterlicher Unterstützung und elterlichem Wissen angeben als Kinder, die das alleinige physische Sorgerecht haben, und ein ebenso hohes Maß wie Kinder, die in einer Zwei-Eltern-Familie leben. Kinder, die in nicht-symmetrischen Sorgerechtsverhältnissen leben, berichten über ein geringeres Maß an väterlicher Unterstützung und Wissen als Kinder, deren Eltern sich das Sorgerecht gleichermaßen teilen. Mütterliche Unterstützung und Wissen unterscheiden sich nicht zwischen Kindern, die in symmetrischen und nicht-symmetrischen physisches Sorgerechtsvereinbarungen leben, wohingegen väterliche Unterstützung und Wissen in Familien geringer sind, in denen das Kind hauptsächlich bei der Mutter wohnt. Schlussfolgerung: Die Wohnform nach der Scheidung hängt eindeutig mit der Beziehung zwischen Eltern und Kindern zusammen, wobei Kinder, die das gemeinsame physische Sorgerecht haben, über stärkere Beziehungen berichten als Kinder, die das alleinige physische Sorgerecht haben. Aufgrund des Querschnittscharakters der Daten ist es jedoch nicht möglich, kausale Schlussfolgerungen zu ziehen

Solidarity in the neighbourhood, social support at work and psychosomatic health problems

Aims: The aim of this study was to analyse the link between psychosocial factors in the neighbourhood and work environments, and psychosomatic health problems. Methods: The data were collected in the survey 'Life and Health', which was conducted in 2000 in six Swedish county councils. A total of 71,580 questionnaires were distributed to randomly selected individuals aged 18-79. A total of 46,636 respondents completed the questionnaire. This gives a response rate of around 65%. For the purpose of this study only gainfully employed individuals aged 18-64 are included, which gives a total of 22,164 individuals: 11,247 (50.7%) women and 10,917 (49.3%) men. Two scales were used to measure the psychosocial environments in the neighbourhood and at work. The link between these scales and psychosomatic health problems was analysed by using multinomial logistic regression. Results: The results show that both 'Psychosocial Neighbourhood Environment' (PNE) and 'Psychosocial Working Environment' (PWE), independently, are related to psychosomatic health problems. Hence, the health effects of social relations in the neighbourhood were not modified by the quality of social relations at work, or vice versa. The levels of psychosomatic health problems are highest for people experiencing a low degree of social solidarity in the neighbourhood and for those experiencing low degrees of supportive work relationships. Conclusion: The strong, but independent, effects of social factors related to the neighbourhood and to the workplace on psychosomatic health problems point to the importance of simultaneously considering social relations in different arenas in order to increase the knowledge of the connection between social relations and health

Electronic media use and symptoms of depression among adolescents in Norway

Background The purpose of this study was to examine the association between electronic media use, including use of social media and gaming, and symptoms of depression, and whether gender or having friends moderated these associations. Methods This study was based on self-reported cross-sectional data from the Ungdata survey, conducted in 2018 by the Norwegian Social Research (NOVA) Institute in cooperation with seven regional drug and alcohol competence centres. The target group comprised 12,353 15–16 years old adolescents. Binominal logistic regression was used to analyse the association between electronic media use and symptoms of depression. Results The odds of having symptoms of depression were higher for those who used social media more than 3 hours per day (OR: 1.60, 95% CI: 1.43–1.80), compared to those who used social media 3 hours or less per day. Additionally, the odds of having symptoms of depression was higher for those who used more than 3 hours on gaming per day (OR: 1.57, 95% CI: 1.36–1.80), compared to those who used 3 hours and less on gaming per day after adjustment for potential confounders. There were no interaction effects between social media and gaming use with symptoms of depression. Neither were the associations between social media use and gaming with symptoms of depression moderated by gender or having friends. Conclusions The odds of having symptoms of depression were significantly higher for adolescents with a more frequent use of electronic media.publishedVersionpublishedVersio

A critique of Rasch analysis using the Dyspnoea‐12 as an illustrative example

Aim. This paper is a report of a study of the application and critique of Rasch analysis to the development of the Dyspnoea‐12 questionnaire; an instrument that measures breathlessness severity. Background. The development of questionnaires has traditionally involved application of classical test theory. Rasch analysis has gained international momentum as a robust application of ‘modern’ psychometric testing for the development of new instruments and the refinement of existing ones. Method. A total of 358 patients [mean age 62 (sd = 8); chronic obstructive pulmonary disease = 123, interstitial lung disease = 129, heart failure = 106], responded to an initial list of 81 items (between May 2006 and February 2008). Hierarchical modelling reduced the list to 34 items. Rasch analysis was used to inform decisions about further item removal and fit to the unidimensional model. Rasch analysis included tests of item response appropriateness, item residual, differential item functioning (including gender and diagnosis) and unidimensionality. Results. Twenty‐two items failed to reach the requirements of the Rasch model and were removed. Reasons included high residuals and item bias associated with gender and diagnosis. The 12‐items conformed to the Rasch unidimensional parameters (number of statistically significant t‐tests 6·7%; confidence interval: 4·4–9·0%). Conclusion. We have presented the steps involved in reducing and refining a large item‐set by identifying those items which possessed the most reliable measurement properties. The Dyspnoea‐12 is reliable and simple to use and should find utility in both practice and research settings. We recommend that nurses consider Rasch analysis in the development of health‐related questionnaires

Spanish adaptation of the pedagogical leadership scale Vanderbilt Assessment of Leadership in Education (VAL-ED)

Educational leadership has become a key factor in the improvement of educational quality. The aim of the work was to describe the adaptation of the Pedagogical Leadership Scale VAL-ED (Vanderbilt Assessment of Leadership in Education) to the Spanish population (cross-cultural adaptation process and validation) and obtain their psychometric characteristics through Rasch analysis. The obtained results confirm that the unidimensionality of each of the six subscales that compose it has been demonstrated, it is guaranteed its usefulness to diagnose the educational leadership, to decide ways of improvement and to measure the effectiveness of its implementation. The conclusion is that the adaptation of the VAL-ED questionnaire to the Spanish population is a valid and reliable tool for the measurement of educational leadership.El liderazgo educativo ha llegado a ser un factor clave en la mejora de la calidad educativa. El objetivo del estudio fue adaptar la escala de liderazgo pedagógico VAL-ED (Vanderbilt Assessment of Leadership in Education) a población española (adaptación cross-cultural y validación) y obtener sus características psicométricas mediante análisis de Rasch. Los resultados obtenidos confirman que la unidimensionalidad de cada una de las seis subescalas que la componen ha sido demostrada, garantizando su utilidad para diagnosticar el liderazgo educativo, decidir vías de mejora y llevar a cabo mediciones de la eficacia de las medidas implementadas. La conclusión es que la adaptación del cuestionario VAL-ED a población española es una herramienta válida y fiable para la medición del liderazgo educativo.Este trabajo se ha hecho en el marco del proyecto I+D Liderazgo pedagógico y desarrollo del centro como comunidad profesional: prácticas de éxito en educación obligatoria , financiado por el Ministerio Economía y Competitividad dentro del Programa Estatal de Investigación Científica y Técnica y de Innovación (Referencia EDU2013-48432-P)

Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

BACKGROUND: As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ) has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. METHODS: We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. RESULTS: Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. CONCLUSION: Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards

Acceptability, reliability, referential distributions and sensitivity to change in the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE) outcome measure: Replication and refinement

Background: Many outcome measures for young people exist, but the choices for services are limited when seeking measures that (a) are free to use in both paper and electronic format, and (b) have evidence of good psychometric properties. Method: Data on the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE), completed by young people aged 11-16, are reported for a clinical sample (N = 1269) drawn from seven services and a nonclinical sample (N = 380). Analyses report item omission, reliability, referential distributions and sensitivity to change. Results: The YP-CORE had a very low rate of missing items, with 95.6% of forms at preintervention fully completed. The overall alpha was .80, with the values for all four subsamples (11-13 and 14-16 by gender) exceeding .70. There were significant differences in mean YP-CORE scores by gender and age band, as well as distinct reliable change indices and clinically significant change cut-off points. Conclusions: These findings suggest that the YP-CORE satisfies standard psychometric requirements for use as a routine outcome measure for young people. Its status as a free to use measure and the availability of an increasing number of translations makes the YP-CORE a candidate outcome measure to be considered for routine services