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Biomedical subjects

Bjørn E Holstein

Publications and source records attributed to Bjørn E Holstein.

At least 19 recordsLinked to original sources

[Trends in vigorous physical activity versus physical inactivity among 11-15 year olds from 1988 to 2002].

INTRODUCTION: The increasing prevalence of overweight and obesity among children and adolescents suggests a need to study the development in main predictors of obesity, like eating habits and physical activity. The objective was to describe self-reported vigorous physical activity versus physical inactivity among children and adolescents over a period of 14 years, 1988-2002. MATERIAL AND METHODS: The study population was the Health Behaviour in School-aged Children (HBSC) study among nationally representative samples of 11, 13 and 15 year old students in 1988, 1991, 1994, 1998, and 2002. The data collection used the standardised HBSC questionnaire which included items about vigorous physical activity (VPA) outside school hours per week. We defined physically inactivity as 0 hours of VPA per week and high activity as at least 7 hours of VPA per week. RESULTS: The prevalence of high activity was higher among boys than girls and increased by age. The prevalence of physically inactive students increased from 1988 to 2002, especially among the 15 year olds. The proportion of students with high activity decreased from 1988 to 2002, especially among the 15 year olds. CONCLUSION: A large proportion of children and adolescents do not comply with the national recommendations that children should be physically active at least 60 minutes per day. The physical activity level decreased from 1988 to 2002. There is a need for extraordinary efforts to increase physical activity among children and adolescents.

Adolescent↗

School-related risk factors for drunkenness among adolescents: risk factors differ between socio-economic groups.

PURPOSE: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors to drunkenness differ between socio-economic groups. METHODS: The study population was a random sample of 1453 Danish 15-year-old students. The outcome measure was drunkenness 10 times or more, as a lifetime measure. Predictor variables comprised five aspects of well-being at school. Socio-economic position (SEP) was measured by parental occupation. RESULTS: Among girls, exposures to school-related risk factors were more prevalent in lower socio-economic groups. Poor school satisfaction was associated with drunkenness among girls from high SEP, odds ratio (OR) = 2.98 (0.73-12.16). Among boys from high SEP autonomy in decision-making was associated with drunkenness, OR = 2.74 (1.06-7.08), whereas poor school satisfaction was associated with drunkenness among boys from intermediate SEP, OR = 2.26 (0.98-5.22). Weak Parental Support in school-related matters, OR = 3.92 (1.16-13.24), and disliking school, OR = 9.12 (1.77-47.09), were associated with drunkenness among boys from low SEP. These associations were also seen among girls although not significant. CONCLUSION: We found that well-being at school had socially differential impact on drunkenness in adolescence.

Adaptation, Psychological↗

Is medicine use in adolescence risk behavior? Cross-sectional survey of school-aged children from 11 to 15.

PURPOSE: To examine the association between smoking, drunkenness, and medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness in a representative sample of 11- to 15-year-old school-aged children. METHODS DESIGN: Cross-sectional school-based survey. SETTING: A random sample of schools in Denmark in 2002. PARTICIPANTS: All students in the fifth, seventh and ninth grades in these schools, n = 4824. MEASUREMENTS: Self-reported medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness within the last month; self-reported experience of drunkenness; self-reported smoking. RESULTS: There was a strong and graded association between drunkenness and medicine use, even in models adjusted for the symptom for which the medicine was taken. There was a similar association between medicine use and smoking. CONCLUSIONS: The findings suggest that medicine use can be regarded as part of a cluster of risk behaviors among young people.

Adolescent↗

The measurement of change in functional ability: dealing with attrition and the floor/ceiling effect.

The purpose was to describe four-year change in functional ability among older persons and the relationship to sex, age, and other background factors. The baseline study, performed in 1986, is based on a random sample of older persons (n=1261). Follow-up data were collected four-years later (n=912). The analyses of change in functional ability were based on the assumption that the categories reflected an underlying latent continuous dimension. The change in functional ability, DeltaFA, was calculated by a logistic model for paired observations and applied in parallel analyses with and without inclusion of the dead to deal with the attrition problem. Fifty percent had no change in functional ability, 37% had declined and 13% improved. Models including the dead showed more functional decline with increasing age but this was not the case when the dead were excluded. Functional change was not related to sex, functional ability at baseline, relative wealth, social network, self-rated health, and life-satisfaction. Inclusion of the dead in statistical models for the study of change in functional ability reduced the attrition problem. A logistic model for paired observations of functional ability at two points in time reduced the problem related to the floor/ceiling problem.

Aged↗

Coping with unemployment: does educational attainment make any difference?

AIMS: The aim of this study was to examine the cross-sectional association between educational attainment and coping strategies with unemployment in a random sample of 37- to 56-year-old Danish men and women in long-term unemployment. METHODS: Data were based on a survey among 575 men and 1,064 women who had been unemployed at least 70% of the time during a three-year period (October 1996 to October 1999). The outcome measures were two scales for coping with unemployment, one for problem-solving coping, and one for avoidant coping. Educational attainment was measured by years of vocational training. RESULTS: A significant association was found between low educational attainment and low use of problem-solving coping among both men, OR = 1.81 (95% CI 1.19-2.75), and women, OR = 1.57 (1.13-2.18). Adjustment for cohabitation status, self rated health, economic strain, and unemployment status did not change this association substantially. High use of avoidant coping was associated with low educational attainment among men, OR = 1.57 (0.98-2.51). For women, medium educational attainment was significantly associated with low use of avoidant coping, OR = 0.60 (0.42-0.85). This result was not affected by adjustment for the covariates. CONCLUSIONS: Coping strategies are considered a potential modifier of the impact of unemployment on health and well-being. In this study, differences in coping strategies with unemployment were associated with educational attainment.

Adaptation, Psychological↗

School connectedness and daily smoking among boys and girls: the influence of parental smoking norms.

BACKGROUND: The objective was to test whether an association between school connectedness and smoking exists among Danish school children, and if so, to examine whether parental smoking attitude and parental smoking behaviour influenced this association. METHODS: Data were collected by the Danish contribution to the cross-national study Health Behaviour in School-Aged Children (HBSC) 1998. Analyses were performed on questionnaire-based data from 1537 students at grade nine from a random sample of schools in Denmark. RESULTS: An independent inverse association was found between school connectedness and smoking among both boys and girls. Parents' attitude to their children's smoking significantly modified this association among boys. Among girls the modifying effect was less marked. Neither among boys nor girls did parental smoking behaviour significantly modify the association between school connectedness and smoking, although a modifying tendency was observed among girls. CONCLUSIONS: The smoking behaviour of Danish adolescents may be influenced by complicated interactions of varying sets of experienced smoking norms, and any research project or preventive programme focusing on the influence of school life on adolescent smoking behaviour needs to consider the family smoking norms. Additionally, the results stress the important role of gender by indicating that the smoking behaviour of girls may be more sensitive to restricting social influences than the smoking behaviour of boys.

Adolescent↗

Bullying and symptoms among school-aged children: international comparative cross sectional study in 28 countries.

BACKGROUND: There have been no large-scale international comparisons on bullying and health among adolescents. This study examined the association between bullying and physical and psychological symptoms among adolescents in 28 countries. METHODS: This international cross-sectional survey included 123,227 students 11, 13 and 15 years of age from a nationally representative sample of schools in 28 countries in Europe and North America in 1997-98. The main outcome measures were physical and psychological symptoms. RESULTS: The proportion of students being bullied varied enormously across countries. The lowest prevalence was observed among girls in Sweden (6.3%, 95% CI: 5.2-7.4), the highest among boys in Lithuania (41.4%, 95% CI 39.4-43.5). The risk of high symptom load increased with increasing exposure to bullying in all countries. In pooled analyses, with sex stratified multilevel logistic models adjusted for age, family affluence and country the odds ratios for symptoms among students who were bullied weekly ranged from 1.83 (95% CI 1.70-1.97) to 2.11 (95% CI 1.95-2.29) for physical symptoms (headache, stomach ache, backache, dizziness) and from 1.67 (95% CI 1.55-1.78) to 7.47 (95% CI 6.87-8.13) for psychological symptoms (bad temper, feeling nervous, feeling low, difficulties in getting to sleep, morning tiredness, feeling left out, loneliness, helplessness). CONCLUSION: There was a consistent, strong and graded association between bullying and each of 12 physical and psychological symptoms among adolescents in all 28 countries.

Adolescent↗

Parents' labour market participation as predictor of children's well-being: changes from 1984 to 1996 in the Nordic countries.

BACKGROUND: This study analysed the influence of parents' labour market participation on their children's well-being in the five Nordic countries, and the changes from 1984 to 1996, during which unemployment rates generally rose in the Nordic countries. METHODS: Parent-reported questionnaire data from two cross-sectional studies, 12 years apart, with 15,354 (in 1984) and 15,255 (in 1996) randomly selected children aged 2-17 years. The response rates were 67.0% (n=10290) and 67.6% (n=10317), respectively. The parents' assessment of their children's well-being was measured by six items, with three items focusing on psychological functioning and three items on social functioning. RESULTS: The association between parents' labour market participation and children's well-being changed from 1984 to 1996. In 1984, more children in families with paid work had low well-being than did children in families without paid work. In 1996, however, the share of children with low well-being was higher among children in families without paid work. This change was most notable in Finland but did not occur in Denmark. The overall level of well-being among children in the Nordic countries remained stable over this period. CONCLUSION: The relationship between parents' labour market participation and well-being among children changed from 1984 to 1996. In 1984 low well-being was most common among children in families with paid work, while in 1996 low well-being was more common in families without participation in the labour market. Social inequality in children's well-being thus increased if parents' labour market participation was used as an indicator of socioeconomic status.

Adolescent↗

Development in self-rated health among older people as determinant of social relations.

AIM: The purpose of this study was to analyse whether development in self-rated health (SRH) over four years was associated with the structure of and satisfaction with social relations, at four and eight years follow-up, among elderly women and men. METHODS: A longitudinal questionnaire-based study was undertaken of non-institutionalized Danes, aged 70-95 years, with baseline in 1986. The response rate at baseline was 69%, n= 1,231. First follow-up was carried out in 1990, with 91% of eligible individuals participating (n=911). Second follow-up took place in 1994, where 83% of eligible individuals participated (n= 542). The association was studied between development in SRH from 1986 to 1990 and social relations in 1990 and in 1994. RESULTS: A sustained poor SRH predicted low contact frequency OR= 1.7 (1.1-2.6), small contact diversity OR= 1.6 (1.0-2.6) and low contact satisfaction OR=3.4 (2.3-5.2) in the two-point analyses. Furthermore, a deterioration in SRH predicted poor contact satisfaction OR=2.8 (1.7-4.5). All analyses were adjusted for age, gender, mental health, functional ability, cohabitation status, and a measure of social relations at baseline. Results for the three-point analyses were similar to those for the two-point analyses. The associations were weaker for contact satisfaction OR=2.8 (1.7-4.7), but stronger for contact frequency OR=2.5 (1.4-4.4) and diversity OR=2.1 (1.2-3.6). CONCLUSION: Sustained poor SRH and, to some degree, deterioration in SRH were predictors of poor social relations after four and eight years.

Aged↗

Social class variation in medicine use among adolescents.

BACKGROUND: Little is known about social determinants of adolescents' medicine use. The objective was to analyse the association between the family's social class and adolescents' use of medicine for headache, stomachache, difficulties in getting to sleep, and nervousness. METHODS: Cross-sectional study of 11-, 13- and 15-year-olds, a Danish contribution to the WHO international collaborative study Health Behaviour in School-aged Children (HBSC) 1998. The study population comprised students from a national random sample of schools who answered a standardized questionnaire in the classroom, participation rate 88%, n=5,205. RESULTS: Logistic regression analyses showed that medicine use for all four symptoms increased by decreasing social class, controlled for age and prevalence of the specific symptom for which the medicine was taken. Adjusted OR (95% CI) for medicine use among students from lower social classes were: medicine for headache 1.35 (1.11-1.65), medicine for stomachache 1.41 (1.08-1.84), medicine for difficulties in getting to sleep 2.00 (1.30-3.08), and medicine for nervousness 3.22 (1.87-5.56). CONCLUSION: Symptom-adjusted medicine use in a representative sample of Danish adolescents showed a clear and graded increase with decreasing social class. Policies to reduce social inequality in health should address medicine use as well.

Abdominal Pain↗

The impact of structural and functional characteristics of social relations as determinants of functional decline.

OBJECTIVES: This study examines whether aspects of social relations at baseline are related to functional decline at 5-year follow-up among nondisabled old men and women. METHODS: The investigation is based on baseline and follow-up data on 651 nondisabled 75-year-old persons in Jyväskylä (Finland) and Glostrup (Denmark). The analyses are performed separately for men and women. Possible selection problems were considered by using three outcome measures: first, functional decline among the survivors (n = 425); second, functional decline, including death, assuming that death is part of a general decline pattern (n = 565); and third, mortality (n = 651). Social relations were measured at baseline by several items focusing on the structure and function of the social network. RESULTS: In men, no weekly telephone contact was related to functional decline and mortality. Among women, less than weekly telephone contact, no membership in a retirement club, and not sewing for others were significantly related to functional decline and mortality. The associations were stronger when the dead were included in the outcome measure. DISCUSSION: The results point to the importance of social relations in the prevention of functional decline in older adults.

Activities of Daily Living↗

Revitalising the Metropolit 1953 Danish male birth cohort: background, aims and design.

Recent research indicates that factors operating during childhood are related to adult health. Thus, longitudinal studies with information on subsequent phases may be key to understanding later health outcomes. The main objective of this paper is to describe the history and design of a Danish birth cohort, and its revitalisation. In 1965, information from birth certificates for 11 591 of a total of 12 270 males born in 1953 in the Metropolitan area of Copenhagen, Denmark were traced. These boys were the study population of a sociological investigation conducted with the aim of describing social mobility. At age 12 years, 9537 of these cohort members completed a questionnaire in school, which included cognitive measures and information on social aspirations and leisure time activities. In 1966 educational performance tests were administered for these boys and, in 1968, mothers of 2890 cohort members were interviewed regarding family social backgrounds. With the establishment of the Civil Registration System (CRS) in 1968, it was possible to identify 11 532 cohort members. In 2002 we began the process of revitalising this study with the aim of investigating the influence of early life factors on later health. We succeeded in ascertaining the vital status of all subjects in the CRS. This showed that 863 subjects had died between 1968 and 2002. Linkages to the Register of Causes of Death, the National Hospital Register, Psychiatric Central Register and Danish Cancer Registry have been completed. In total, 7969 cohort members had been hospitalised for any somatic illness and, according to the Psychiatric Central Register, 1382 men had been admitted to a psychiatric hospital or ward. In the Cancer Registry we found 363 of our study participants. Analyses exploring the influence of social conditions in early life, birth dimensions, and childhood cognition on adult health experience are at various stages of completion. A questionnaire-based postal follow-up survey is planned. Thus, the Metropolit study provides an important opportunity to examine the processes by which factors that operate over the life course influence adult health.

Birth Weight↗

Tracking drinking behaviour from age 15-19 years.

AIMS: The aim of this paper was to assess (1) changes in drinking behaviour over time among Danish adolescents and (2) use of which alcoholic beverages and what drinking patterns would have the strongest predictive effect on later alcohol consumption. DESIGN, SETTING, PARTICIPANTS: The population was a random sample of 15-year-olds (baseline 1990, response rate 86%, n= 847) with a first follow-up 4 years later (response rate 85%, n= 729). MEASUREMENTS: Alcohol intake was assessed by experience of drunkenness, quantity and frequency of consumption. Thresholds recommended by the Danish National Board of Health were used to discriminate high from low intake. FINDINGS: At 19 years of age at least 80% drank alcohol monthly, and 24% of the men and 11% of the women had an alcohol intake above the recommended national limits, i.e. 21 weekly units of alcohol for men and 14 for women. Consumption of alcoholic beverages at age 15 increased the risk of drinking alcohol weekly at the age of 19 [odds ratio (OR)-values from 1.11 to 3.53]. Drunkenness among the 15-year-old boys and the use of spirits of the 15-year-old girls showed the strongest predictive relationship with excessive consumption at age 19 [OR = 2.44, confidence interval (CI): 1.38-4.29, respectively, OR = 1.97, CI: 1.15-3.38]. CONCLUSIONS: Alcohol consumption as early as the age of 15 predicted weekly alcohol consumption and alcohol intake exceeding the recommended amount 4 years later. Young teenagers' high alcohol consumption was not just a passing phenomenon. It was a behaviour that tracked into young adulthood, leaving the adolescents at increased risk of being long-term, large-scale consumers.

Adolescent↗

Social position and health in old age: the relevance of different indicators of social position.

AIMS: An analysis was undertaken to investigate social inequalities in health among old men and women in relation to five indicators of social position. METHODS: The study is based on a population-based cross-sectional survey among 748 75-year-old men and women, which was performed as clinical examinations and interviews in 1989 in Glostrup, a suburban area west of Copenhagen. Social position was measured by vocational education, occupation, social class, income, and housing tenure. Health was measured by number of chronic diseases, tiredness in relation to mobility, need of help in relation to mobility, oral health (number of teeth), and well-being (the CES-D Scale). The statistical analysis included bivariate contingency tables and logistic regression analyses. RESULTS: Two material wealth variables (income and tenure) were consistently related to nearly all health measures while the relationships between the other social position variables and health showed no consistent patterns. Multiple logistic regression analyses with tenure and income as independent variables and each of the health variables as dependent variables and control for education and occupation showed different patterns for men and women. In men the odds ratios of housing tenure on four health variables were strong and unaffected by education and occupation while in women the odds ratios of income on three health variables were strong and unaffected by education and occupation. CONCLUSION: This study demonstrates strong, consistent associations between variables of material wealth indicators and various measures of health among 75-year-old men and women.

Aged↗

Self-reported medicine use among 11- to 15-year-old girls and boys in Denmark 1988-1998.

AIMS: To describe the self-reported medicine use for common health complaints among 11-15-year-olds in Denmark during a ten year period, 1988-1998. The paper focuses on medicine for headache, stomach ache, cough, cold, nervousness, and difficulties in getting to sleep. METHODS: Four cross-sectional surveys of 11-15-year-old students in random samples of schools in Denmark, conducted in 1988 (n=1671), 1991 (n=1860), 1994 (n=4046) and 1998 (n=5205). The surveys were similar with regard to sampling and data collection. Data were collected by self-administered questionnaires in the classroom. RESULTS: A large proportion of 11-15-year-olds reported medicine use during the past month. It was most common to take medicines for headache (used by 55% of 15-year-old girls and 36% of 15-year-old boys in 1998) and stomach ache (33% among 15-year-old girls in 1998). Pain reliever use was higher among girls than boys and this sex difference increased with age. There was an upward trend in reported medicine use from 1988 to 1998, in particular regarding medicine for stomach-ache among 13- and 15-year-old girls. A large proportion of girls were frequent users of medicine for headache, stomach-ache, and sleeping difficulties. CONCLUSION: A high proportion of 11-15-year-old girls and boys reported medicine use in relation to common health complaints. The proportion of users increased during the past decade. It is suggested that more information about medicine be built into health education programs in the future.

Adolescent↗

International survey of self-reported medicine use among adolescents.

OBJECTIVE: To examine gender, age, and country variations in adolescents' self-reported medicine use. DESIGN: Cross-sectional school surveys of representative samples of 11- to 15-year-old girls and boys were used. The 1997/1998 Health Behaviour in School-aged Children study was referenced. A standardized questionnaire was completed during school hours. SETTING: Canada, US, Greenland, Israel, and 24 European countries. PARTICIPANTS: 123 227 participants equally distributed by gender and by 3 age groups (mean 11.7, 13.6, 15.6 y). MAIN OUTCOME MEASURES: Self-reported medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness during the past month. RESULTS: The magnitude of the adolescents' medicine use for headache, stomachache, difficulties in getting to sleep, and nervousness varied substantially across countries. In each of the 28 countries, more girls than boys used medicine for pain. Use of medicine for headache increased by age; use of medicine for stomachache increased by age among girls, but decreased among boys; and use of medicine for difficulties in getting to sleep and nervousness decreased from the age of 11 to 15 years. There was an increase in the crude girl versus boy ratios for medicine use by age for all 4 symptoms. Multivariate logistic regression analyses, adjusting for age group and country, revealed the following odds ratios (95% CI) for girls' versus boys' medicine use: headache 1.56 (1.53 to 1.60), stomachache 2.16 (2.10 to 2.22), difficulties in getting to sleep 0.96 (0.91 to 1.00), and nervousness 1.04 (0.99 to 1.08). CONCLUSIONS: Substantial proportions of adolescents used medicine for common health problems. The prevalence of use differed between type of symptom for which the medicine was used, between countries, and between gender and age groups. We suggest that young people's medicine use should be addressed in public health policy.

Adolescent↗