Effectiveness of a Danish early year preschool program:A randomized trial

AbstractA significant number of studies indicate that early year preschool programs lead to positive long-term effects. Systematic quality improvement of early year preschool may enhance these outcomes. The ASP Program was built on this principle. In this program preschool staff are supported in their efforts to critically reflect on current practices and to change these. A randomized controlled study was carried out in Denmark from September 2006 to May 2008. The study encompassed 2323 children in 59 preschools in two municipalities. Children were assessed using the Strength and Difficulties Questionnaire at the start of the intervention, at mid term, and by the end. The results indicate that, in the intervention group, children developed fewer emotional symptoms, conduct problems, became less hyperactive and were more attentive. The effect sizes ranged between 0.15 and 0.2

Are there differences in birth weight between neighbourhoods in a Nordic welfare state?

<p>Abstract</p> <p>Background</p> <p>The objective of this cohort study was to examine the effect on birth weight of living in a disadvantaged neighbourhood in a Nordic welfare state. Birth weight is a health indicator known to be sensitive to political and welfare state conditions. No former studies on urban neighbourhood differences regarding mean birth weight have been carried out in a Nordic country.</p> <p>Methods</p> <p>A register based on individual data on children's birth weight and maternal risk factors was used. A neighbourhood characteristic, i.e. an aggregated measure on income was also included. Connections between individual- and neighbourhood-level determinants and the outcome were analysed using multi-level regression technique. The study covered six hundred and ninety-six neighbourhoods in the three major cities of Sweden, Stockholm, Göteborg and Malmö, during 1992–2001. The majority of neighbourhoods had a population of 4 000–10 000 inhabitants. An average of 500 births per neighbourhood were analysed in this study.</p> <p>Results</p> <p>Differences in mean birth weight in Swedish urban neighbourhoods were minor. However, gestational length, parity and maternal smoking acted as modifiers of the neighbourhood effects. Most of the observed variation in mean birth weight was explained by individual risk factors.</p> <p>Conclusion</p> <p>Welfare institutions and benefits in Sweden might buffer against negative infant outcomes due to adverse structural organisation of urban neighbourhoods.</p

Fokus på nye former for kvalitet på daginstitutionsområdet

OECD konkluderer i rapporten Starting Strong, at det kan betale sig at investere massivt i daginstitutioner. Jo tidligere man sætter ind med kvalitetsindsatser, jo højere er afkastet i form af human kapital. Men begrebet ”kvalitetsdagtilbud” er diffust, og debatten om kvalitet baseres oftere på vanetænkning og ”tro” end på viden og vision. Tiden er inde til at skifte vanetænkningen ud med en diskussion om nye former for kvalitet baseret på en vision om, hvad dagtilbudskal kunne i et videns- og velfærdssamfund som det danske. De overordnede spørgsmål, der må diskuteres, er i den sammenhæng samfundets muligheder for at styrke og skabe fornyelse af kvalitet i dagtilbud gennem uddannelses- og kompetenceudviklingsprocesser set i lyset af de nye udfordringer, de professionelle står over for. Artiklen gør det muligt for kommuner, politikere og praktikere at indkredse forhold, som er centrale og nødvendige at tænke med ind i en ny bestemmelse af kvalitet i dagtilbud. Kvalitet må således fremover måles på, om dagtilbud bliver et sted, hvor uddannelses- og dannelsesprocesser reelt finder sted for alle børn i velfærdssamfundet

Psychosocial Determinants of Attrition in a Longitudinal Study of Tobacco Use in Youth

To gain knowledge on psychosocial characteristics that predict the propensity of participation in longitudinal studies, attrition was analysed in a cohort of 3020 adolescents participating in the baseline survey of a longitudinal study with repeated followup focusing on adolescents' tobacco use. During the followup surveys, the proportion of responders was constantly at or above 90%. There were 941 adolescents (31.2%) who failed to participate in at least one of the six followup surveys. Boys had a fifty percent increased risk of nonparticipation compared with girls. Adolescents in families with experience of divorce, unemployment, and change of residence had a higher risk of nonparticipation. An increasing number of stressful life events during the previous year, uptake of tobacco use, number of friends, perceived performance at school, truancy, and alcohol use during the last term also independently associated with nonparticipation. Diverse psychosocial characteristics are independently associated with nonparticipation of youths in longitudinal studies

Association between labour market trends and trends in young people's mental health in ten European countries 1983-2005

<p>Abstract</p> <p>Background</p> <p>Mental health problems have become more common among young people over the last twenty years, especially in certain countries. The reasons for this have remained unclear. The hypothesis tested in this study is that national trends in young people's mental health are associated with national trends in young people's labour market.</p> <p>Methods</p> <p>National secular changes in the proportion of young people with mental health problems and national secular labour market changes were studied from 1983 to 2005 in Austria, Belgium, Denmark, Finland, Hungary, Norway, Spain, Sweden, Switzerland and the United Kingdom.</p> <p>Results</p> <p>The correlation between the national secular changes in the proportion of young people not in the labour force and the national secular changes in proportion of young people with mental health symptoms was 0.77 for boys and 0.92 for girls.</p> <p>Conclusion</p> <p>Labour market trends may have contributed to the deteriorating trend in mental health among young people. A true relationship, should other studies confirm it, would be an important aspect to take into account when forming labour market policies or policies concerning the delivery of higher education.</p

A comparative analysis of early child health and development services and outcomes in countries with different redistributive policies

Background: The social environment is a fundamental determinant of early child development and, in turn, early child development is a determinant of health, well-being, and learning skills across the life course. Redistributive policies aimed at reducing social inequalities, such as a welfare state and labour market policies, have shown a positive association with selected health indicators. In this study, we investigated the influence of redistributive policies specifically on the social environment of early child development in five countries with different political traditions. The objective of this analysis was to highlight similarities and differences in social and health services between the countries and their associations with other health outcomes that can inform better global early child development policies and improve early child health and development. Methods: Four social determinants of early child development were selected to provide a cross-section of key time periods in a child's life from prenatal to kindergarten. They included: 1) prenatal care, 2) maternal leave, 3) child health care, and 4) child care and early childhood education. We searched international databases and reports (e.g. Organization for Economic Cooperation and Development, World Bank, and UNICEF) to obtain information about early child development policies, services and outcomes. Results: Although a comparative analysis cannot claim causation, our analysis suggests that redistributive policies aimed at reducing social inequalities are associated with a positive influence on the social determinants of early child development. Generous redistributive policies are associated with a higher maternal leave allowance and pay and more preventive child healthcare visits. A decreasing trend in infant mortality, low birth weight rate, and under five mortality rate were observed with an increase in redistributive policies. No clear influence of redistributive policies was observed on breastfeeding and immunization rates. In the analysis of child care and early education, the lack of uniform measures of early child development outcomes was apparent. Conclusions: This paper provides further support for an association between redistributive policies and early child health and development outcomes, along with the organization of early child health and development services

Minimising treatment-associated risks in systemic cancer therapy

Aim of the review To review the consequences of drug-related problems (DRP) in systemic cancer therapy and identify specific contributions of the pharmacist to minimise treatment-associated risks. Method Searches in PubMed, Embase and the Cochrane Library were conducted. Bibliographies of retrieved articles were examined for additional references. Only papers in English between 1980 and 2007 were included. Results In systemic cancer therapy there is an enormous potential for DRP due to the high toxicity and the complexity of most therapeutic regimens. The most frequently reported DRP can be classified into adverse effects, drug–drug interactions, medication errors, and non-adherence. Pharmacists have enhanced efforts to assure quality and safety in systemic cancer therapy together with other health care providers. In consequence, oncology pharmacy has evolved as a novel specialist discipline. The endeavour to merge and co-ordinate individual activities and services of the pharmacist has led to pharmaceutical care concepts which aim at offering novel solutions to the various DRP. Conclusion Pharmaceutical care for cancer patients should be developed within research projects and integrated into disease management programs in order to ensure broad implementation

“Psykisk ohälsa” bland unga i Sverige – olika aktörers perspektiv på orsaker och åtgärder

Abstrakt - svenskaTrots omfattande åtgärder mot psykisk ohälsa bland unga har inga framsteg har skett. För att förstå situation har aktörerna, beskrivningar av orsaker och föreslagna/genomförda åtgärder i den politiska diskussionen identifierats med hjälp av Google sökningar. De mest framträdande aktörerna är statliga institutioner, regioner och kommuner som alla producerar olika former av vård. De främsta förklaringarna till de ungas psykiska ohälsa, som de framträder vid sökningarna, är brister i skolan, ungas svårigheter att få arbete samt medikalisering av vardagsproblem. Brister i vården framstår ej som väsentlig orsak. I programmen för de politiska riksdagspartierna, och de betänkanden som bifallits i riksdagen, dominerar däremot utökad vård som främsta åtgärd. En förklaring till diskrepansen mellan uppfattning om orsaker och genomförda/föreslagna åtgärder kan vara specialiseringen inom politiken där psykisk ohälsa främst uppfattas som en fråga om vård.Abstract - EnglishA large number of measures to combat mental illness among young people have been implemented - but no progress has been made. To understand the political discussion , actors, causes and measures have been identified by means of Google searches. The most prominent actors are state institutions, regions and municipalities. The main explanations for the young people's mental ill-health are shortcomings in school, young people's difficulties finding work and the medicalization of everyday problems. However, in the programs for the political parliament parties, and the reports approved in the parliament, extended care dominates as a measure. An explanation for the discrepancy between the perception of causes and implemented and proposed measures may be the specialization in politics where mental illness is primarily perceived as a matter of care.Nyckelordmental hälsa, adolescens, statsvetenskap, riksdag, politiska partie

Att minska ojämlikhet i hälsa – några dilemman

Mottot för den WHO-kommission som lämnade en rapport år 2008 var att ”eliminera de sociala skillnaderna inom en generation”. Syftet med denna artikel är att diskutera ett antal dilemman inom området. De nordiska länderna präglas av väl utvecklad välfärdspolitik. Trots detta har de relativa skillnaderna i dödlighet ökat snabbare i dessa länder, jämfört med övriga Västeuropa och Sydeuropa. Det finns ingen given förklaring till denna utveckling. Utvecklingen i Storbritannien under perioden 1997–2010 är tänkvärd. Regeringen lanserade ett omfattande program som syftade till att reducera hälsoskillnader. Trots detta ökade både de relativa och absoluta hälsoskillnaderna under perioden. En förklaring kan vara att den sociala skiktningen av hälsa hänger samman med individens totala tillgång till resurser, det som ibland kallas den ”fundamentala orsaken”. Genomgången visar att kunskaperna om effektiva åtgärder ofta är ofullständiga. Detta kan dock inte utgöra hinder för politiska initiativ. Uppenbart behövs ytterligare forskning inom området

Unga mäns hälsa i de nordiska länderna

Den socialt betingade ojämlikheten i hälsa har tilltagit under de senaste decennierna. Den här utvecklingen har särskilt drabbat unga män i form av ökad förekomst av drogrelaterad sjuklighet och död, värk i nacke och rygg, självmord och skador betingade av våld. Utvecklingen har sannolikt en grund i ökade krav för inträde på arbetsmarknaden, vilket i sin tur hänger samman med ökad global konkurrens. Den här rapporten tar upp fyra frågor: först beskrivs hälsoutvecklingen bland unga män, sedan utvecklingen av sociala skillnader bland unga, följt av en diskussion om några tänkbara förklaringar till att hälsan är sämre bland män än bland kvinnor. Rapporten avslutas med ett avsnitt som diskuterar förklaringar till varför hälsan bland unga utvecklats sämre än hälsan i andra åldersgrupper