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BACKGROUND: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]

A negative relationship between mathematics anxiety (MA) and mathematics performance is well documented. One suggested explanation for this relationship is that MA interferes with the cognitive processes needed when solving mathematics problems. A demand for using more cognitive effort (e.g., when performing harder mathematics problems), can be traced as an increase in pupil dilation during the performance. However, we lack knowledge of how MA affects this relationship between the problem difficulty and cognitive effort. This study investigated, for the first time, if MA moderates the effect of arithmetic (i.e., multiplication) problem difficulty on cognitive effort. Thirty‐four university students from Norway completed multiplication tasks, including three difficulty levels of problems, while their cognitive effort was also measured by means of pupil dilation using an eye tracker. Further, the participants reported their MA using a questionnaire, and arithmetic competence, general intelligence, and working memory were measured with paper‐pencil tasks. A linear mixed model analysis showed that the difficulty level of the multiplication problems affected the cognitive effort so that the pupil dilated more with harder multiplication problems. However, we did not find a moderating effect of MA on cognitive effort, when controlling for arithmetic competence, general intelligence, and working memory. This suggests that MA does not contribute to cognitive effort when solving multiplication problems. [ABSTRACT FROM AUTHOR]

This paper explores a change process in the Central Norway Regional Health Authority that was brought about by the implementation of a new economics and logistics system. The purpose of this paper is to contribute to understanding of how employees' attitudes towards change develop over time and how attitudes differ between the five health trusts under this authority. In this paper, we argue that a process‐oriented focus through a longitudinal diary method, in addition to action research and feedback loops, will provide greater understanding of the evaluation of organizational change and interventions. This is explored through the assumption that different units will have different perspectives and attitudes towards the same intervention over time because of different contextual and time‐related factors. The diary method aims to capture the context, events, reflections and interactions when they occur and allows for a nuanced frame of reference for the different phases of the implementation process and how these phases are perceived by employees. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: This paper reports associations among socio‐demographic variables, stressor experience, self‐efficacy and life satisfaction among Norwegian adolescents aged 15–21 years and the potential moderating role of self‐efficacy on the association between stressor experience and life satisfaction. Methods: The cross‐sectional school‐based survey study involved 1816 upper‐secondary school students from Mid‐Norway. Data were analysed with independent samples t test, Pearson's product moment correlation and multiple linear regression analysis. Results: Bivariate results showed that boys scored higher than girls on life satisfaction and self‐efficacy, whereas girls scored higher than boys on all stressor domains. Multiple linear regression analysis showed that life satisfaction declined weakly with age, whereas stronger family economy and having parents who work full‐time associated with higher life satisfaction. Stress with teacher interaction, peer pressure, home life, school attendance, school–leisure conflict and school performance were all negatively associated with life satisfaction, whereas self‐efficacy associated positively and strongly with life satisfaction. Self‐efficacy moderated the association between both interpersonal and school‐related stressors and life satisfaction. Conclusion: The results provide support for the unique role of stressor experience and self‐efficacy in association with adolescents' life satisfaction as well as self‐efficacy as a stress moderator in relation to life satisfaction. [ABSTRACT FROM AUTHOR]

This paper surveys the prevalence and correlates of anabolic androgenic steroids (AAS) use among Norwegian adolescents, and examines the degree to which sports participation is a mediating or moderating factor to well-known correlations between AAS use and problem behaviour. The data come from the "Ungdata" study, a cross-national youth survey system offered to all municipalities in Norway (response rate: 74%, N= 77,572). The study demonstrates a lifetime prevalence of AAS use of 1.27% and a higher prevalence among boys (1.81%) than girls (0.76%). The analyses show that AAS use is clearly related to problem behaviour such as violence and other substance use. When controlling for problem behaviour, there are no correlations between AAS use and exercising in a sports club or on one's own, whilst there is a weak positive correlation between AAS use and exercising in a gym or engaging in other forms of physical exercise such as dancing or martial arts. These patterns are more or less the same for boys and for girls. We conclude that adolescent AAS use is a low-prevalence phenomenon that primarily takes place in smaller subgroups of individuals who engage in other forms of problem behaviour as well. [ABSTRACT FROM AUTHOR]

Background Studies on Norwegian nursing homes have shown that the general care is at a relatively high level, while the level of physical and social activities is relatively low. As a response to these findings, the Norwegian government has stressed the importance of activities in various white papers and circulars and, in recent years, has launched several campaigns specifically aimed at increasing the level of activities. Aim The aim of the study was to examine the following: (i) how the government has succeeded in increasing the level of physical and social activities in Norwegian nursing homes; (ii) how the level of activities compares to the general care; and (iii) how the level of activities and the general care are influenced by the following facility characteristics: residents' mobility level, total staffing levels, ratio of RNs, ratio of unlicensed staff and ward size. Method A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Results On a scale ranging from 1 to 7, the staff members assess the activity dimension to be 4.31 and the general care dimension to be 5.66. The activity dimension was significantly negatively correlated with the ratio of unlicensed staff, the ratio of Registered Nurses and the residents' mobility level, while the general care dimension was significantly negatively correlated with the ratio of unlicensed staff. Conclusion The study shows that the level of physical and social activities offered to the residents is relatively low, while the general care level is significantly higher, in line with earlier studies. Consequently, the government has not succeeded with its current policy to increase the level of activities in nursing homes. The relationship between the two quality dimensions and the explanatory variables shows that nursing home quality is a complicated phenomenon. [ABSTRACT FROM AUTHOR]

Aims The purpose of this study was to develop and validate a survey to investigate parents' satisfaction with neonatal wards in a population of parents of children with a gestation age of ≥24 weeks to 3 months after full-term birth. Method We explored the literature and conducted three focus groups: two with expert health personnel and one with parents. We tested the survey in a parent population ( N = 105) and report the different stages in the validation process along with the full survey, the Neonatal Satisfaction Survey - 13 categories ( NSS-13). Results We found 13 subcategories in the Neonatal Satisfaction Survey. The subcategories measure parents' satisfaction with neonatal units based on staff, admission, nurses, anxiety, siblings (parents' perceptions of caring for the siblings of the newborn), information, timeout, doctors, facilities, nutrition, preparation for discharge, trust and visitors. Each subcategory showed acceptable internal consistency. The full version of the Neonatal Satisfaction Survey presents 69 items, and each subcategory contains two to eleven items. Conclusion The Neonatal Satisfaction Survey seems suitable to measure parents' satisfaction with neonatal units and can be used in full, but it can also measure subcategories. Parents' satisfaction with neonatal units can be used to improve the quality in such wards. We consider this study as the first in a series to validate the NSS-13. The full survey with subcategories is presented in this paper. [ABSTRACT FROM AUTHOR]

Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women.A 43-item FFQ was developed for the FFD study.A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations.Adding the subscales yielded a score from 0 to 10 with increasing score indicating healthier dietary behaviour.The score was divided into tertiles, grouping participants into low, medium and high adherence to the dietary recommendations. Pregnant women attending ultrasound screening at about week 19 of pregnancy were asked to complete the FFQ twice, 2 weeks apart. Of 154 pregnant women completing the first questionnaire, 106 (69%) completed the form on both occasions and was included in the study.The test-retest correlations of the score and subscales were r = 0.68 and r = 0.56-0.84, respectively (both P ⩽ 0.001). There was 68% test-retest correct classification of the score and 70-87% of the subscales. In conclusion, acceptable test-retest reliability of the FFQ and the dietary score was found. The score will be used in the FFD study to measure adherence to the dietary recommendations throughout pregnancy and in the following year post-partum. [ABSTRACT FROM AUTHOR]

The aim of this paper is to study: (1) the prevalence of flight anxiety among Norwegian airline passengers; (2) situations that may be of concern during flights and situations not related to flying; (3) whether passengers feel more afraid after the terror act of September 11, 2001; and (4) whether passengers were more afraid in 2002 than in 1986.A questionnaire was distributed during domestic flights in Norway in 1986 and 2002. To asses flight anxiety, a six point scale was used, from 0 = not afraid at all, to 5 = always very afraid, and sometimes avoid flying because of that. A 10-cm visual analogue scale ( VAS) was used to measure the degree of anxiety. There were 50.8% who were not afraid at all. There were 12 women (5.2%) and one man (0.4%) with flight phobia. However, 22 (4.5%) had cancelled flights because of anxiety during the last two years. Situations that caused most concern during flights were turbulence and fear of terrorism and highjacking. After September 11, 48% were not more afraid, 38% a little more, 10% moderately, 3% rather much and 2% very much. The passengers, however, were not more afraid of flying in 2002 than in 1986. About 3% of Norwegian airline passengers have a flight phobia. Women are significantly more concerned than men. The impact of the terror act September 11, 2001 was rather moderate. The level of flight anxiety among Norwegian airline passengers was not significantly different in 2002 and 1986. [ABSTRACT FROM AUTHOR]

Alzheimer's disease is the most commonly known neurocognitive disorder characterized by deterioration in areas such as memory, attention, and activities of daily living. From a behavioral perspective, memory and attentional deficits may be described as deterioration of stimulus control. This paper provides a case study of discrimination behavior in a patient with neurocognitive disorder. The purpose of the current study was twofold: (i) to study the effect of using presumed familiar pictures in arbitrary matching-to-sample tasks and (ii) to study variables that affect stimulus control in a patient diagnosed with vascular dementia. There were 12 conditional discrimination experimental conditions with various types of stimuli, from familiar pictures to identity matching. The results showed that the participant's responses were not in accord with experimenter-defined stimulus classes when using familiar pictures. However, intact stimulus control by sample stimulus was established following systematic procedural changes in the conditional discrimination tasks. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In three experimental studies, with managers and students as participants, we explore in this paper the relation between two kinds of responsibility judgments, called Responsibility 1 (R1) and Responsibility 2 (R2). Decision makers can be viewed as being more or less responsible for their choice and its consequences (R1). Their actions can also be evaluated, from a normative point of view, as instances of more or less responsible behavior (R2). Experiment 1 showed that managers who depart from the default or 'normal' course of action, by choosing a new (versus familiar) alternative, changing (versus sticking to) an initial decision, or going against (versus following) the advice of a management team, are rated as more responsible (R1) for the outcomes of their decision. At the same time, they are perceived to act in a less responsible way (R2). Experiment 2 compared decision makers choosing between more or less risky options. High risk takers were held more responsible (R1) for their choice and for its consequences, but were again viewed as behaving in a less responsible way (R2) than low risk takers. In Experiment 3, participants judged decision makers who followed or opposed others' advice by choosing either a high or a low risk option. Opposing others' advice led to higher R1 and lower R2 scores, especially when choosing the high risk option, moderated by outcome (successful decisions appearing more responsible than those that went wrong). Thus R1 and R2 judgments should be distinguished as having different and sometimes even opposite determinants. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate whether psychosocial functioning in adulthood (e.g., friends support, cohabitation, community connectedness and work satisfaction) could be predicted by mental health, subjective well-being, social relations and behavior problems in adolescence, and whether gender was a moderator in these associations. Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study ( HUNT), in which 517 men and 819 women completed an extensive self-report questionnaires at baseline (mean age 14.4 years) and at follow-up (mean age 26.9 years). Community connectedness as well as work satisfaction were predicted by subjective well-being. Cohabitation was predicted by male gender and frequency of meeting friends in adolescence, and friends support was predicted by frequency of meeting friends. Gender had a minor effect as a moderator. Frequency of meeting friends and subjective well-being seemed to be the strongest adolescent predictors of psychosocial functioning in young adulthood. These findings may have implications both for prevention and intervention in adolescence, as well as for future research. [ABSTRACT FROM AUTHOR]

Moksnes, U. K. & Espnes, G. A. (2012). Self-esteem and emotional health in adolescents - gender and age as a potential moderators. Scandinavian Journal of Psychology 53, 483-489. The present paper investigates possible gender and age differences on emotional states (depression and anxiety) and self-esteem as well as the association between self-esteem and emotional states. The cross-sectional sectional sample consists of 1,209 adolescents 13-18 years from public elementary and secondary schools in mid-Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on self-esteem in all age groups. Self-esteem was strongly and inversely associated with both state depression and state anxiety. An interaction effect of gender by self-esteem was found on state depression, where the association was stronger for girls than for boys. The associations found give support for the positive role of self-esteem in relation to adolescents' emotional health and well-being. [ABSTRACT FROM AUTHOR]

Objective This paper aims to study long-term bone mineral development in former patients with an onset of anorexia nervosa during childhood and adolescence. Methods Bone mineral density (BMD) in lumbar spine and total hip was measured in 39 female participants (mean age = 23.1 years, SD 3.5) an average of 8.1 (±3.3) years after treatment start. Results At follow-up, seven participants (17.9%) still suffered from an eating disorder. Mean BMD in the former patients was within the normal range in the hip but significantly reduced in the spine. Fourteen (36%) of the participants had osteopenia, and three (8%) had osteoporosis in the spine and/or hip. Amenorrhea for more than two years was associated with reduced BMD in the spine, whereas low weight at follow-up was associated with low BMD in both the spine and the hip. Conclusion A large minority of these former patients had low bone mass in young adulthood. In accordance with other studies, our findings support the importance of weight restoration for future bone health in young patients with anorexia nervosa. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Depression is a major problem for mental health. Empirical studies and clinical observations have shown that the symptoms of depression occur across four main domains-emotional, cognitive, somatic and interpersonal. However, commonly used depression assessment scales fail to address the evaluation of interpersonal symptoms, as summarized in this paper. Therefore, a new depression assessment scale, which aimed to evaluate all four domains of depressive symptomatology, was developed. In an initial analysis, a pilot 85-item questionnaire containing possible depressive symptoms was distributed for evaluation to experts from different mental health professions, from which 52 items were subsequently selected for the new multidimensional depression assessment scale. One hundred community participants completed the questionnaire along with the Beck Depression Inventory-II. The results indicated that the new depression scale had good psychometric properties. It was found to be reliable and valid for the assessment of depression severity and symptomatology, though it is emphasized that these data are only preliminary and based on a relatively healthy sample. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message [ABSTRACT FROM AUTHOR]

This longitudinal study examined the dynamic relationship between work engagement (vigour and dedication) and symptoms of anxiety and depression. A sample of 3475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, people working in advertising and people working in information technology) in Norway supplied data at two points in time with a 2-year time interval. The advantages of longitudinal design were utilized, including testing of reversed causation and controlling for unmeasured third variables. In general, the results showed that the hypothesized normal causal relationship was superior to a reversed causation model. In other words, this study supported the assumption that work engagement is more likely to be the antecedent for symptoms of depression and anxiety than the outcome. In particular, the vigour facet of work engagement provides lower levels of depression and anxiety 2 years later. However, additional analyses modelling unmeasured third variables indicate that unknown third variables may have created some spurious effects on the pattern of the observed relationship. Implications of the findings are discussed in the paper. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Although some attempts are being made to increase children's participation in Norwegian child protection cases, much needs to be done in order to comply with the participation principle in the United Nations Convention on the Rights of the Child. This paper reports on a study of factors that are likely to predict if social workers will attempt to give children an effective voice in decision making processes. 53 child protection case managers and 33 social work students participated in a questionnaire survey in which they were asked to agree or disagree with 20 statements about child participation. Statistical factor analysis was used in order to identify underlying factors in the dataset. The results suggest three main reasons for children not being allowed to participate: communication difficulties (communication factor); because child participation was not deemed necessary (participation advocacy factor); or that participation was considered inappropriate because it might be harmful (protectionism factor). This research suggests that, if we are to improve participation within the child protection system, formal regulations and guidelines need to be accompanied by a greater attention to development of social work skills in working with children through participatory processes. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The ability to measure pain across diverse cultures is important for understanding the universal aspects of pain and expediting nursing intervention. The McGill Pain Questionnaire (MPQ) is the most valid and reliable single multidimensional pain instrument available for measuring pain. Although it has been translated in several languages, most efforts, including two Norwegian translations, have resulted in a variety of new versions, all lacking sufficient faithfulness to the original MPQ to allow qualitative or quantitative cross-cultural comparisons. There is a need for direct translations that maintain the original denotation, connotation and numerical value of the MPQ and thus provide a base for future cross-cultural studies of pain. This paper reports on the development and initial testing of a direct translation of the McGill Pain Questionnaire into Norwegian (NMPQ). The translation process involved three phases: translation, back-translation and consensual. In order to evaluate its performance and validity, the NMPQ was administered to a group of adult surgical patients at two different points in time during the postoperative period. The NMPQ was examined for its feasibility, its sensitivity in detecting decreases in intensity of pain postoperatively and for construct validity. A visual analogue scale was used to check for converging validity, and Spielberger's state anxiety scale was used to assess discriminate validity. The initial testing of the NMPQ with adult surgical patients suggests that the NMPQ is culturally acceptable, relevant, sensitive to fluctuations in pain and numerically consistent with the original MPQ. The moderate levels of validity attained lend considerable assurance to the instrument's readiness for use in cross-cultural studies of pain. [ABSTRACT FROM AUTHOR]