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Publisher's version (útgefin grein), The co-creation of educational services that promote youth resilience and mental health is still scarce. UPRIGHT (Universal Preventive Resilience Intervention Globally implemented in schools to improve and promote mental Health for Teenagers) is a research and intervention program in the Basque Country (Spain), Trentino (Italy), Low Silesia (Poland), Denmark and Reykjavik (Iceland). UPRIGHT implemented a co-creation research process whose results, outcomes and policy implications are presented here. The co-creation had a mixed-methods participatory research design with nine specific objectives linked to paired strategies of inquiry for adolescents, families, teachers and school staff. The overarching objective was to generate a valid and feasible regional adaptation strategy for UPRIGHT intervention model. Participants answered surveys (n = 794) or attended 16 group sessions (n = 217). The results integrate quantitative and qualitative information to propose a regional adaptation strategy that prioritizes resilience skills, adolescents’ concerns, and preferred methods for implementation across countries and in each school community. In conclusion, a whole-school resilience program must innovate, include and connect different actors, services and communities, and must incorporate new technologies and activities outside the classroom. A participatory co-creation process is an indispensable step to co-design locally relevant resilience interventions with the involvement of the whole-school community., The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: UPRIGHT is a research and innovation project funded by the European Union’s Horizon 2020 Research and Innovation Programme (grant number 754919). UPRIGHT grant agreement (complete project description) has undergone peer-review by the European Commission reviewers (governmental and major funding organism) before getting approval. This paper reflects only the authors’ views, and the European Union is not liable for any use that may be made of the information contained therein. The funding body has had no role in the study design, in the writing of the manuscript or in the decision to submit the paper for publication.

In this Thesis, the relationship between Persistent Physical Symptoms (PPS), mental health, work disability and vocational rehabilitation outcome was examined in two samples. First, we looked at a sample of 324 people seeking vocational rehabilitation services and then at a subsample of 285 Non-Cardiac Chest Pain (NCCP) patients taken from a larger study on 504 chest pain patients that attended an Icelandic cardiac emergency department (CED). The participants in the vocational rehabilitation sample were between 18 and 65 years old, their mean age was 39.34 years and the majority of them were female (78.1%). Participants in NCCP study were between 18 and 66 years old, their mean age was 49.84 years and about half of them were female (54.0%) and a half of them male (46.0%). In both samples, participants filled out questionnaires measuring PPS and mental health problems. Information regarding the rehabilitation of the vocational rehabilitation service seekers and medical diagnoses of the chest pain patients was retrieved from the service providers. In the vocational rehabilitation sample, we firstly estimated the prevalence of PPS, examined how the extent of PPS related to mental health problems, and estimated how many rehabilitation seekers might benefit from psychological treatment for PPS. Secondly, we investigated whether the outcome of vocational rehabilitation and functional impairment at its beginning could be predicted by the presence of PPS, specific PPS types or symptoms of psychological distress using logistic- and hierarchical linear regression. In the CED sample, we examined the relationship between PPS, mental health and work disability from another angle by looking at patients diagnosed with NCCP. NCCP patients whose symptoms were severe enough to meet PPS criteria (n=85) were compared to other NCCP (n=200) patients in terms of work status, psychological symptoms, and total number of PPS. In our vocational rehabilitation sample, the prevalence of PPS was 80.9%, and the modal number of symptoms was three. Participants with PPS more commonly had depression, anxiety and health anxiety symptoms in the clinical range, and these symptoms were positively correlated with the number of PPS. Between 46.2% and 64.6% of our participants were identified as being likely to benefit from a specialised PPS treatment. Functional impairment at the beginning of service was predicted by depressive symptoms, PPS and social anxiety symptoms. Only persistent pain and depressive symptoms independently predicted not returning to work, and the rehabilitation duration was not related to the severity or number of psychological symptoms nor the presence or number of PPS. In the CED sample, NCCP patients whose symptoms met PPS criteria reported more symptoms of depression, anxiety and health anxiety than other NCCP patients. They also ruminated more, had a higher number of other PPS and were more likely to be inactive or unable to work. Within Icelandic vocational rehabilitation, special attention should be given to PPS and depressive symptoms as they are common, positively associated with functional impairment at the beginning of service and a specific combination of these symptoms was associated with a lower return to work rate. Overall, the results suggest a clear need for routine evaluation and specialised treatment for PPS within vocational rehabilitation and that such treatments should preferably be both transdiagnostic and work focussed. Furthermore, the results indicate that there might be value in identifying and treating PPS at earlier stages, such as through the CED., VIRK - Vocational Rehabilitation Fund RU Research Fund

Líðan leikskólakennara og leiðbeinenda, svo og aðbúnaður á vinnustað, er meðal þess sem getur haft áhrif á leikskólabörn og þroskaferil þeirra. Því er brýnt að rannsaka líðan þessara starfshópa og hvaða þættir í vinnuumhverfinu styðja við eða draga úr góðri líðan starfsfólksins. Það er viðfangsefni þessarar greinar. Vinnufyrirkomulag um það bil helmings allra leikskólakennara og leiðbeinenda, sem starfa hjá sveitarfélögum hér á landi, er rannsakað, svo og tengsl þess við sjálfmetna andlega líðan þeirra. Meginrannsóknarspurningin er hvort tengsl séu á milli þess hvernig leikskólakennarar og leiðbeinendur upplifa vinnufyrirkomulagsþætti eins og stjórnun, stuðning, vinnuálag, skilgreiningu hlutverka og þróun í starfi annars vegar og andlegrar líðanar þeirra hins vegar. Greinin byggir á langtíma panelgögnum þar sem sömu 480 leikskólakennurum og leiðbeinendum var fylgt eftir árin 2010, 2011, 2013 og 2015. Notað var svokallað GEE-líkan (e. generalized estimating equation) til að spá fyrir um andlega líðan starfsfólksins á þessum árum. Niðurstöðurnar gerðu almennt ekki greinarmun á leikskólakennurum og leiðbeinendum. Endurteknar mælingar sýndu að sjálfmetin andleg líðan leikskólakennaranna og leiðbeinendanna versnaði á milli fyrirlagna. Þetta kom einnig fram þegar tillit hafði verið tekið til kyns, aldurs og hjúskaparstöðu. Allir þættir í vinnuumhverfinu, sem til skoðunar voru, versnuðu á milli fyrirlagna að mati starfsfólksins. Sá þáttur, sem versnaði mest, var vinnuálag. Athyglisvert er þó að tengslin voru veik á milli vinnuálags og andlegrar líðanar. Góð stjórnun og félagslegur stuðningur hafði jákvæð áhrif á líðanina. Mikilvægt er að þeir sem standa að stefnumótun á sviði leikskólanna taki þessar niðurstöður til skoðunar og að greint verði enn frekar hvað veldur því að áðurnefndir vinnufyrirkomulagsþættir og líðan starfsfólksins versna að þeirra mati á milli fyrirlagna. Með því móti er ekki einungis stuðlað að bættu vinnuumhverfi leikskólakennara og leiðbeinenda heldur einnig leikskólabarnanna og að leikskólabörnunum sé sinnt á þann hátt sem nauðsynlegt er fyrir líðan þeirra og þroska.

Monitoring cognitive workload has the potential to improve both performance and fidelity of individuals facing safety-critical situations in their working environments. Psychophysiological signals, in particular from speech and the cardiovascular system, are an opportune choice for monitoring individuals providing minimum intrusion and disruption. For reasons perhaps mostly rooted in individual differences, current methods are limited in that moving beyond binary classification has proved challenging. The aim of the present research was to investigate the potential of speech- and cardiovascular signals both separately and in conjunction, for cognitive workload detection, using short-term variability for screen and heart rate based classification schemes. The aim was further to explore alternative methods in order to take into consideration individual differences in the cardiovascular signals that describe the extent of the reactions of the whole cardiovascular system to cognitive workload. For this purpose, new method where a single distance measure describing the hemodynamic reactions of individuals during tasks compared to their own baseline is introduced. A total of 100 university students participated in a study providing extensive information on reactions to cognitive workload that can be used for individual comparisons. The results showed that trinary classification is well achievable with the methods introduced and that the two signals do compliment each other in the cognitive workload classification task. The proposed distance measure showed obvious reactions to cognitive workload during tasks and that these reactions are highly various between individuals., Með því að fylgjast með huglægu vinnuálagi hjá einstaklingum sem starfa í ábyrgðarmiklum störfum, s.s. flugumferðarstjórn, er unnt að hafa jákvæð áhrif á bæði árangur og líðan þeirra. Lífeðlisfræðileg merki, einkum frá einkennum í tali sem og hjarta- og æðakerfi, eru einstaklega hentugar aðferðir til að fylgjast með einstaklingum og valda þar að auki lágmarks truflun á störfum þeirra. Af ástæðum sem kunna að mestu að eiga rætur að rekja til mismunar á einstaklingum, hefur hins vegar reynst erfitt að flokka þessi merki niður í meira en tvo flokka. Markmiðið með þessari rannsókn var að kanna möguleika á að draga einkenni frá tali annars vegar og hjarta- og æðakerfi hins vegar og nýta þau til að greina þrjá flokka af huglægu vinnuálagi, bæði í sitt hvoru lagi og saman. Markmiðið var einnig að kynna nýja aðferð til að greina og dýpka skilning á mismuni á milli einstaklinga á milli þeirra merkja frá hjarta- og æðakerfi. Í þessu skyni er kynnt ný aðferð þar sem ein mælieining er notuð til að lýsa viðbrögðum hjarta- og æðakerfisins sem einni heild við huglægu vinnuálagi, fyrir hvern og einn einstakling miðað við hvíldarástand hans. Alls tóku 100 háskólanemar þátt í rannsókn sem veitti víðtækar upplýsingar um viðbrögð við huglægu vinnuálagi. Niðurstöðurnar sýndu að vel væri hægt að flokka í þrjá flokka með þeim aðferðum sem kynntar eru og að þessi tvö lífeðlisfræðilegu merki bættu hvort annað upp við flokkun á huglægu vinnuálagi. Augljós einstaklingsbundin viðbrögð við huglægu vinnuálagi komu í ljós milli hvíldarástands og verkefna sem kröfðust mikils huglægs vinnuálags., This work was funded by the Icelandic aviation authority ISAVIA and Icelandair. Theexperiment design and data collection phase of this work was funded by The IcelandicCentre for Research (RANNIS) under the projectMonitoring cognitive workload inATC using speech analysis, Grant No 130749051.

Publisher's version (útgefin grein), Bullying is defined as repeated and unwanted aggressive behavior involving a power imbalance and hurt children and adolescents’ socioemotional functioning. The aim is to investigate associations between pain (headache, stomach pain, backache, and neck/shoulder pain) and bullying among school-aged children and adolescents. This cross-sectional school-based survey comes from the Icelandic data set in the international research network Health Behaviour in School-Aged Children. The study population included all Icelandic students in Grades 6, 8, and 10 (ages 11, 13, and 15 years, respectively; participation rate, 84%; n = 10,626). An anonymous standardized questionnaire was distributed and completed by students in their classrooms. About every 8 in 10 bullied students reported weekly pain (79%), compared with little over half of nonbullied students (57%). The prevalence of pain was significantly higher among bullied students compared with their nonbullied peers. Being a bullying victim was associated with an increased frequency of experiencing headaches, stomachaches, and back pain, in addition to neck or shoulder pain. It is important for mental health nurses and health professionals to ask about pain when meeting with children and adolescents as well as to inquire about their peer relationships., The author(s) received no financial support for the research, authorship, and/or publication of this article. The Health Behaviour in School-aged Children study in Iceland was directed by the University of Akureyri, Centre for Prevention Studies in Iceland. The authors thank the Centre for Prevention Studies for allowing access to the data analyzed in this study.

Publisher's version (útgefin grein), Háskólar þurfa að bregðast við aukinni fjölbreytni í hópi nemenda með því að mæta ólíkum þörfum þeirra. Í greininni eru kynntar niðurstöður rannsóknar á upplifun og reynslu nemenda sem stunda nám við Félagsvísindasvið Háskóla Íslands. Markmið rannsóknarinnar var að varpa ljósi á reynslu nemenda sem glíma við námsvanda. Leitað var svara við eftirfarandi rannsóknarspurningu: Hvað styður og hvað hindrar nemendur í HÍ sem glíma við námsvanda í að takast á við nám sitt? Tekin voru þrjú einstaklingsviðtöl og rýnihópsviðtal við sex nemendur í BA-námi við félagsráðgjafardeild. Niðurstöður sýna að viðmælendur voru ánægðir með ýmsa þætti í skipulagi námsins og fannst skilningur kennara á stöðu þeirra vera góður en töldu þó að í kennsluháttum væru ýmsar hindranir sem gerðu þeim erfitt fyrir. Þær hindranir felist meðal annars í erfiðleikum við aðlögun að háskólasamfélaginu, álagi í námi sem veldur streitu og kvíða og því að of lítið tillit sé tekið til námsvanda þeirra. Slík innsýn í viðhorf nemenda sem glíma við námsvanda getur gagnast kennurum við að taka tillit til fjölbreytileikans í nemendahópnum og stuðlað þannig að bættri sálfélagslegri líðan nemenda, sem aftur hjálpar þeim við námið. Auk þess sýna niðurstöður að aukin áhersla á kennslu í fræðilegum vinnubrögðum ásamt virkri endurgjöf í námi getur hjálpað nemendum með námsvanda.

Publisher's version (útgefin grein), Background: More than 500 million people worldwide live within exposure range of an active volcano and children are a vulnerable subgroup of such exposed populations. However, studies on the effects of volcanic eruptions on children’s health beyond the first year are sparse. Objective: To examine the effect of the 2010 Eyjafjallajökull eruption on physical and mental health symptoms among exposed children in 2010 and 2013 and to identify potential predictive factors for symptoms. Method: In a population-based prospective cohort study, data was collected on the adult population (N = 1615) exposed to the 2010 Eyjafjallajökull eruption and a non-exposed group (N = 697). The exposed group was further divided according to exposure level. All participants answered questionnaires assessing their children´s and their own perceived health status in 2010 and 2013. Results: In 2010, exposed children were more likely than non-exposed children to experience respiratory symptoms (medium exposed OR 1.47; 95% CI 1.07–2.03; high exposed OR 1.52; 95% CI 1.03–2.24) and anxiety/worries (medium exposed OR 2.39; 95% CI 1.67–3.45; high exposed OR 2.77; 95% CI 1.81–4.27). Both genders had an increased risk of symptoms of anxiety/worries but only exposed boys were at increased risk of experiencing headaches and sleep disturbances compared to non-exposed boys. Within the exposed group, children whose homes were damaged were at increased risk of experiencing anxiety/worries (OR 1.62; 95% CI 1.13–2.32) and depressed mood (OR 1.55; 95% CI 1.07–2.24) than children whose homes were not damaged. Among exposed children, no significant decrease of symptoms was detected between 2010 and 2013. Conclusions: Adverse physical and mental health problems experienced by the children exposed to the eruption seem to persist for up to a three-year period post-disaster. These results underline the importance of appropriate follow-up for children after a natural disaster., The data collections were funded by a grant from the Icelandic government in 2010. The preparation of this paper was also supported by the Nordic Centre of Excellence for Resilience and Societal Security (NORDRESS) which is funded by the NordForsk (grant number 68825)

Publisher's version (útgefin grein), Objective Few studies have explored the potential interrelated associations of screen time and physical activity with mental health in youth, particularly using objective methods. We examined cross-sectional associations of these variables among Icelandic adolescents, using objective and subjective measurements of physical activity. Methods Data were collected in the spring of 2015 from 315 tenth grade students (mean age 15.8 years) in six elementary schools in metropolitan Reykjavík, Iceland. Participants reported, via questionnaire, on demographics, weekly frequency of vigorous physical activity, daily hours of screen time and mental health status (symptoms of depression, anxiety and somatic complaints, self-esteem and life satisfaction). Total physical activity was measured over one week with wrist-worn accelerometers. Body composition was determined by DXA-scanning. Poisson regression analysis was used to explore independent and interactive associations of screen time and physical activity with mental health variables, adjusting for gender, body fat percentage and maternal education. Results Less screen time (below the group median of 5.3 h/day) and more frequent vigorous physical activity (≥4x/week) were each associated with reporting fewer symptoms of depression, anxiety, low self-esteem, and life dissatisfaction. No significant associations were observed between objectively measured physical activity and mental health outcomes. Interactive regression analysis showed that the group reporting both less screen time and more frequent vigorous physical activity had the lowest risk of reporting symptoms of depression, anxiety, low self-esteem, and life dissatisfaction. Conclusions Reports of less screen time and more frequent vigorous physical activity were associated with lower risk of reporting mental health problems among Icelandic adolescents. Those who reported a combination of engaging in less screen time and more frequent vigorous physical activity had the lowest risk, suggesting a synergistic relationship between the two behaviors on mental health outcomes. Our results support guiding youth towards more active and less sedentary/screen-based lifestyle., The study was funded by The University of Iceland Research Fund (grant number HI16120043, http://sjodir.hi.is/node/16129; authors receiving grant: smh, saa) and the Icelandic Centre for research (RANNIS) (grant number 152509-051, https://en.rannis.is/funding/research/icelandic-research-fund/, all authors).

Objective: The antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are multisystem diseases of the small blood vessels. Patients experience irreversible damage and psychological effects from AAV and its treatment. An international collaboration was created to investigate the impact of AAV on health-related quality of life (HRQoL), and develop a disease-specific patient-reported outcome measure to assess outcomes of importance to patients. Methods: Patients with AAV from the UK, USA, and Canada were interviewed to identify salient aspects of HRQoL affected by AAV. The study was overseen by a steering committee including four patient research partners. Purposive sampling of interviewees ensured representation of a range of disease manifestations and demographics. Inductive analysis was used to identify themes of importance to patients; these were further confirmed by a free-listing exercise in the US. Individual themes were recast into candidate items, which were scrutinized by patients, piloted through cognitive interviews and received a linguistic and translatability evaluation. Results: Fifty interviews, conducted to saturation, with patients from the UK, USA, and Canada, identified 55 individual themes of interest within seven broad domains: general health perceptions, impact on function, psychological perceptions, social perceptions, social contact, social role, and symptoms. Individual themes were constructed into >100 candidate questionnaire items, which were then reduced and refined to 35 candidate items. Conclusion: This is the largest international qualitative analysis of HRQoL in AAV to date, and the results have underpinned the development of 35 candidate items for a disease-specific, patient-reported outcome questionnaire., Sponsored by the University of Oxford, the Vasculitis Clinical Research Consortium and the University of Ottawa. With support from the Medical Research Fund, Oxford, the Oxfordshire Health Services Research Committee (Ref 1098), the US National Institute of Arthritis and Musculoskeletal and Skin Diseases (U54 AR057319 and U01 AR51874), the National Center for Research Resources (U54 RR019497), and the Office of Rare Diseases Research. Oxford University Innovation funded the translatability exercise. Additional support received by a Patient-Centred Outcomes Research Institute Pilot Project Grant.

Background Economic crises and unemployment have profound impact on mental health and well-being. Main goal of the Healthy Employment (HE) project is to enhance intersectoral actions promoting mental health among unemployed, namely through the implementation and effectiveness-evaluation of short-term and sustainable group interventions. Methods The project follows a RE-AIM-based (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework for assessing a cognitive-behavioural and psychoeducational intervention that has been developed for promoting mental health among unemployed people. It is a short-term group intervention (five sessions, four hours each, 20 unemployed persons per group) focused on mental health literacy, interpersonal communication and of emotional regulation. Implementation of the intervention will be carried out by clinical psychologists, following a standardized procedure manual. Effectiveness will be assessed through a randomized field study with two arms (intervention and control). Participants are unemployed people (18–65 years old, both genders, having at least nine years of formal education) registered at public employment centres from different geographical regions for less than 12 months (including first-job seekers). Allocation to arms of the study will follow a random match-to-case process, considering gender, age groups and educational level. Three moments of evaluation will occur: before intervention (baseline), immediately after its ending and three months later. Main outcomes are mental health literacy, mental health related personal and perceived stigma, psychological well-being, satisfaction with life and resilience. Intention-to-treat and per-protocol analyses will be conducted. Cohen’s d coefficient and odds ratio will be used for assessing the size of the intervention effect, when significant. Discussion Scientific and clinical knowledge will be applied to promote/protect psychological well-being of unemployed people. While the first phases of the project are funded by the European Economic Area Grants, long-term assessments of the intervention require a larger timeframe. Further funding and institutional support will be sought for this purpose. Already established intersectoral collaborations are key-assets to reach long-term sustainability of this project. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry; Prospectively registered number: ACTRN12616001432404; date of registration: 13 October 2016., Public Health Initiatives Programme - EEA Grants Financial Mechanism PT06

Markmið þessarar greinar er að skoða starfsöryggi og líðan grunn- og leikskólakennara hér á landi í kjölfar efnahagshrunsins 2008. Blönduðum aðferðum var beitt við gagnaöflun og greiningu. Rafrænn spurningalisti var sendur í tvígang til alls starfsfólks 20 sveitarfélaga, fyrst árið 2010 og svo aftur ári síðar. Jafnframt voru tekin rýnihópaviðtöl við grunn- og leikskólakennara í tveimur sveitarfélaganna, samtals við 30 einstaklinga. Niðurstöður rannsóknarinnar leiddu m.a. í ljós að í mörgum grunn- og leikskólum hefur starfsfólki verið sagt upp og starfsöryggi minnkað milli áranna 2010 og 2011. Tengsl eru á milli óöryggis og neikvæðrar heilsu og líðanar starfsfólks. Skert starfsöryggi hafði sterkust tengsl við löngun til að hætta í starfi og sterkari tengsl við sjálfmetna andlega heilsu en sjálfmetna líkamlega heilsu.

Publisher's version (útgefin grein), Background. A positive association between time spent on sedentary screen-based activities and physical complaints has been reported, but the cumulative association between different types of screen-based activities and physical complaints has not been examined thoroughly. Methods. The cross-sectional association between screen-based activity and physical complaints (backache and headache) among students was examined in a sample of 31022 adolescents from Denmark, Sweden, Norway, Finland, Iceland and Greenland, as part of the Health behaviour in school-aged children 2005/06 (HBSC) study. Daily hours spent on screen-based activities and levels of physical complaints were assessed using self-reports. Results. Logistic regression analysis indicated that computer use, computer gaming and TV viewing contributed uniquely to prediction of weekly backache and headache. The magnitude of associations was consistent across types of screen based activities, and across gender. Conclusion. The observed associations indicate that time spent on screen-based activity is a contributing factor to physical complaints among young people, and that effects accumulate across different types of screen-based activities.