Abstainers and Drinkers–Two Sides of the Same Coin?

This commentary discusses a recently published literature review focussing on the growing trend of young people abstaining from drinking alcohol. Despite the recent increase in research on the decline in youth drinking, the review only identified 10 papers that explicitly examined abstainers. The inclusion criteria used thus excluded and overlooked the vast literature available on the decline in youth drinking. This commentary discusses the implications of this and raises the issue of how the adolescent abstainer should be viewed in research; is it a distinct social phenomenon with unique determinants or are abstainers merely the flip side of drinkers

Thyroid Hormone Signalling Genes Are Regulated by Photoperiod in the Hypothalamus of F344 Rats

Seasonal animals adapt their physiology and behaviour in anticipation of climate change to optimise survival of their offspring. Intra-hypothalamic thyroid hormone signalling plays an important role in seasonal responses in mammals and birds. In the F344 rat, photoperiod stimulates profound changes in food intake, body weight and reproductive status. Previous investigations of the F344 rat have suggested a role for thyroid hormone metabolism, but have only considered Dio2 expression, which was elevated in long day photoperiods. Microarray analysis was used to identify time-dependent changes in photoperiod responsive genes, which may underlie the photoperiod-dependent phenotypes of the juvenile F344 rat. The most significant changes are those related to thyroid hormone metabolism and transport. Using photoperiod manipulations and melatonin injections into long day photoperiod (LD) rats to mimic short day (SD), we show photoinduction and photosuppression gene expression profiles and melatonin responsiveness of genes by in situ hybridization; TSHβ, CGA, Dio2 and Oatp1c1 genes were all elevated in LD whilst in SD, Dio3 and MCT-8 mRNA were increased. NPY was elevated in SD whilst GALP increased in LD. The photoinduction and photosuppression profiles for GALP were compared to that of GHRH with GALP expression following GHRH temporally. We also reveal gene sets involved in photoperiodic responses, including retinoic acid and Wnt/ß-catenin signalling. This study extends our knowledge of hypothalamic regulation by photoperiod, by revealing large temporal changes in expression of thyroid hormone signalling genes following photoperiod switch. Surprisingly, large changes in hypothalamic thyroid hormone levels or TRH expression were not detected. Expression of NPY and GALP, two genes known to regulate GHRH, were also changed by photoperiod. Whether these genes could provide links between thyroid hormone signalling and the regulation of the growth axis remains to be investigated

Long-term adverse outcomes and resilience of individuals who misused substances as adolescents

Background: Little is known about the long-term outcomes in multiple domains of adult functioning of individuals who as adolescents misused substances. The goal of this thesis was to examine adverse and resilient outcomes through 30 years of adulthood of individuals who as adolescents had consulted a clinic for substance misuse problems and to identify risk and protective factors present in adolescence that distinguished trajectories of adult development. Method: Data were used from a longitudinal project, the Consequences of Antisocial Behaviour in Adolescence (CASBA), a follow-up study documenting adult outcomes of two cohorts of individuals who were treated for substance misuse as adolescents and a general population sample matched on age, gender, and birth place. Cohort 1 consisted of 1992 individuals who were treated from 1968 to 1971 while Cohort 2 consisted of 1576 individuals who were treated from 1980 to 1984. Information about the clinic sample in adolescence was extracted from the old clinic files while information about adult outcomes was obtained from national registers. Results: Eight main findings emerged. One, individuals who as adolescents had consulted a clinic for substance misuse problems, as compared to the general population sample, were significantly more likely to experience adverse outcomes defined as death, physical illness, mental illness, substance misuse, criminality, and poverty, during the subsequent 30 years. Two, not only did the clinic sample experience high levels of adversity in each outcome domain, they also experienced adversity in multiple domains of adult functioning. Three, among the individuals who as adolescents had engaged in substance misuse distinct developmental trajectories of resilience over 25 years of adulthood were identified. Four, factors operating in adolescence were associated with outcomes throughout three decades of adulthood. Five, substance misuse in adulthood appeared to drive criminal offending. Six, treatment received at the clinic in adolescence was not associated with resilience in adulthood. Seven, few differences in adult outcomes were found between Cohort 1 and 2. Eight, while gender differences in the risk of adverse outcomes were observed and gender independently predicted the adverse outcomes, no gender differences were observed in trajectories of resilience through adulthood, few gender differences were observed in the great majority of the associations of risk and protective factors with outcomes. Female gender was found to be protective against criminal offending. Conclusions: Adolescence is a critical life period. Both risk factors and protective factors present in adolescence impact outcomes in adulthood. Gender is associated with distinct adult outcomes but not with the accumulation of adverse outcomes or developmental trajectories of resilience in adulthood. The concept of resilience requires modification to take account of the findings that resilience is dynamic and changes over the life course and that it differs across domains of functioning. Defining distinct sub-types of adolescent substance misusers is a necessary first step to identifying causal mechanisms. Substance misuse may play a major role in promoting criminal offending in adulthood

Psychometric evaluation of the mental health continuum - short form in Swedish adolescents

The Mental Health Continuum - Short form (MHC-SF) is a self-report measure that has been increasingly used to monitor mental well-being at the population level. The aim of this study was to evaluate, for the first time, the psychometric properties of the MHC-SF in a population of Swedish adolescents. First, the evaluation was performed by examining face validity and test-retest reliability obtained in a pre-study. Then using data from the Survey of Adolescent Life in Vestmanland 2020 (n = 3880) we performed confirmatory factor analysis on different factor structures based on theory and previous research. Model-based estimates were calculated for assessing the internal reliability of the factor structure with the best fit. Convergent validity was assessed by bivariate as well as model-based correlations, and test-retest reliability was evaluated by intra-class correlation coefficients. The results show that the MHC-SF is best described with a bifactor model consisting of a dominant general well-being factor and three specific group factors of emotional, social and psychological well-being. Its overall reliability was high to very high, while the reliability of its subscales was low. A practical implication of the latter is that the subcales should not be used on their own because they are more likely to reliably measure the general well-being factor than the specific group factors. Test-retest reliability of the total scale was acceptable, and convergent validity was supported. In conclusion, we consider the Swedish MHC-SF to be a psychometrically sound instrument for monitoring overall mental well-being in Swedish adolescents

Incidence of seriously injured road users in a Swedish region, 2003-2014, from the perspective of a national road safety policy

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.

Factors related to the increasing number of seriously injured cyclists and pedestrians in a Swedish urban region 2003–17

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

What types of injuries did seriously injured pedestrians and cyclists receive in a Swedish urban region in the time period 2003–2017 when Vision Zero was implemented?

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

Children with problem drinking parents in Sweden: prevalence and risk of adverse consequences in a national cohort born in 2001.

INTRODUCTION: To estimate the prevalence of children with problem drinking parents in Sweden and the extent to which they have an elevated risk of poor health, social relationships and school situation in comparison with other children. METHODS: Survey with a nationally representative sample of Swedish youth aged 15-16 years (n = 5576) was conducted in 2017. A short version of The Children of Alcoholics Screening Test (CAST-6) was used to identify children with problem drinking parents. Health status, social relations and school situation were measured by well-established measures. Overall prevalences for girls and boys were presented as well as relative risks (RR) of harm for children with problem drinking parents compared with other children. RESULTS: A total of 13.1% of the sample had at least one problem drinking parent during adolescence according to CAST-6-a higher proportion of girls (15.4%) than boys (10.8%). This group had an elevated risk of poor general health as well psychosomatic problems compared with other children (RR 1.2-1.9). They were also more likely to use medication for depression, sleeping difficulties and anxiety (RR 2.2-2.6). Their social relations were also worse especially with their father (RR 3.1) and they had more problems at school (RR 2.6). DISCUSSION AND CONCLUSIONS: The risk of problems related to parental drinking goes beyond the most severe cases where parents have been in treatment for their alcohol problem. This is important knowledge since the majority of problem drinkers never seek treatment and the major part of parental problem drinking is found in population samples