Adolescent alcohol and cannabis use in Iceland 1995-2015

Introduction. Over the past two decades, alcohol consumption of Icelandic adolescents has decreased dramatically. The aim of this study was to quantify the extent of this reduction and compare it with the trend in cannabis use over a 20 year period and to identify possible explanations. Methods. We used data from the Icelandic participants to the European School Survey Project on Alcohol and Other Drugs study (collected via paper-and-pencil questionnaires in classrooms). The sample included all students in the 10th grade (54–89% response rate). Results. The percentage of participants who had never used alcohol during their lifetime rose from 20.8% in 1995 to 65.5% in 2015. Similarly, there was a decline in the proportion of students who had consumed alcohol 40 times or more, from 13.7% to 2.8%. During the same period, the number of students who had never used cannabis rose from 90.2% to 92.0%. In contrast, we found a small, but statistically significant, increase in the prevalence of those who had used cannabis 40 times or more, from 0.7% in 1995 to 2.3% in 2015. Parental monitoring increased markedly between 1995 and 2015,but availability of alcohol decreased. Perceived access to cannabis and youth attitudes towards substance use remained unchanged. Discussion. Although Iceland has enjoyed success in lowering alcohol use among adolescents over the past decades, and somewhat fewer claim to have ever tried cannabis, there has been a threefold increase among heavy users of cannabis. Increased parental monitoring and decreased availability of alcohol explain some of the changes seen.Embætti landlæknis (Icelandic Directorate of Health) KEA Háskólinn á Akureyri (University of Akureyri)Peer Reviewe

Self-rated health and socio-economic status among older adults in Northern Iceland

Publisher's version (útgefin grein)Little is known about self-rated health (SRH) of older people living in more remote and Arctic areas. Iceland is a high-income country with one of the lowest rates of income inequality in the world, which may influence SRH. The research aim was to study factors affecting SRH, in such a population living in Northern Iceland. Stratified random sample according to the place of residency, age and gender was used and data collected via face-to-face interviews. Inclusion criteria included community-dwelling adults ≥65 years of age. Response rate was 57.9% (N = 175), average age 74.2 (sd 6.3) years, range 65–92 years and 57% were men. The average number of diagnosed diseases was 1.5 (sd 1.3) and prescribed medications 3.0 (sd 1.7). SRH ranged from 5 (excellent) to 1 (bad), with an average of 3.26 (sd 1.0) and no difference between the place of residency. Lower SRH was independently explained by depressed mood (OR = 0.88, 95% CI = 0.80–0.96), higher body mass index (OR = 0.93, 95% CI = 0.87–0.99), number of prescribed medications (OR = 0.88, 95% CI = 0.78–1.00) and perception of inadequate income (OR = 0.45, 95% CI = 0.21–0.98). The results highlight the importance of physical and mental health promotion for general health and for ageing in place and significance of economic factors as predictors of SRH.This work was supported by the Háskólinn á Akureyri [R-1803]; Icelandic Regional Development Institute (Byggðastofnun) [102022].Peer Reviewe

Therapeutic alliance

In today’s mental health care, the field of practice for advanced practice mental health nurses (APMHNs) is extensive and exacting. While there are many important required skills and competencies, there is something that remains as a core of all mental health nursing, the therapeutic alliance. APMHNs are in a key position to support, enhance and enable the therapeutic alliance in mental health practice. APMHNs work with service users, families, groups, networks and communities, with the therapeutic alliance as the core of their practice. This chapter provides APMHNs and interested readers different viewpoints of the therapeutic alliance while at the same time acknowledging the difficulty of capturing the unique essence of the therapeutic encounter. The aim of the chapter is to encourage APMHNs to grow and cultivate their competence in the therapeutic alliance and to develop further their professional competence to ensure high-quality mental health care