Browsing by Subject "adolescents"

Antidepressant use among children and adolescents has become more common in many countries. The prevalence of antidepressants is higher for boys but during adolescence girls’ have a higher antidepressant prevalence. In previous studies, the prevalence of selective serotonin re-uptake inhibitors (SSRI) has increased. The aim of this study was to investigate antidepressant use among Finnish children and adolescents aged 1–17 years during 2008–2019. The differences of antidepressant use in different age groups and genders were investigated. Furthermore, the secondary objective was to examine the trends in prevalence and costs of the five most commonly used antidepressant agents. This was a nation-wide register study. The data for this study was from Kelasto which is a statistical database maintained by the Social Insurance Institution of Finland. The extracted data was from 2008–2018 and included each persons’ age, gender, dispensed drug and costs. The data extracted was for 1–17-year-olds who had been dispensed reimbursed antidepressants from community pharmacies. The data was analyzed with Microsoft Office’s Excel program. The results were transferred in to tables and reported as prevalences by age groups, genders, antidepressants and costs. The prevalence of antidepressant use among children and adolescents was 5,0 per 1000 in 2008 and it increased to 10,3 by 2018. In the youngest age group of 1–6-year-olds, antidepressant use decreased. Antidepressant use increased slightly among 7–12-year-olds. Antidepressant use increased the most among 13–17-year-olds. 13–17-year-old girls had the higher antidepressant use prevalence throughout the study. The same group had a 2,4-fold increase in prevalence during the study period which accounted for the biggest increase in the study. The most used group of antidepressants was SSRIs. The total cost for antidepressants among children and adolescents increased by 73,7 % during the study period. The most commonly used antidepressant agents were fluoxetine, sertraline, escitalopram, mirtazapine, and venlafaxine, respectively. Fluoxetine was the most used agent throughout the study. In 2014, sertraline surpassed escitalopram and became the second most used antidepressant agent. Escitalopram and venlafaxine’s cost per user decreased during the study. The cost per user stayed stable for mirtazapine. Fluoxetine and sertraline’s cost per user increased. The Kelasto database does not include data on indications for prescriptions. The prevalence of antidepressants does not necessarily correlate directly to depression among children and adolescents because antidepressants can be used to treat other diseases. More studies need to be conducted on different off-label uses for antidepressants among children and adolescents. This study only investigated the trends on cost for the five most commonly used antidepressants. Further studies on antidepressant costs among children and adolescents are needed. Additionally, it is essential to investigate the reasons for the increase in antidepressant use among children and adolescents.

Goals: Anxiety symptoms during adolescence are highly prevalent and correlate with poor academic outcomes. Despite the effects reported in prior review literature being negative on average, the results of different studies have great heterogeneity, leaving room for deeper investigation of the direction and causality of the effects between anxiety and academic achievement. This narrative review aims to synthesize the findings of recent longitudinal studies on the subject. Methods: A narrative review of seven articles on several different measures of anxiety as predictors of academic achievement during adolescence, measured in grades, education continuity and graduation. Results: Several different measures of anxiety symptoms, including social anxiety, PTSD, test anxiety, and generalized anxiety symptoms, are predictive of poor academic grades in adolescence, even when other mental health problems are controlled for. Anxiety is linked to a lower chance of college graduation but there may be no independent effect over that of depression. There appear to be cascading, long-term links between different anxiety symptoms and academic outcomes, some of them bi-directional, making longitudinal designs and repeated measures of multiple variables recommendable for future research. Most effects appear to be gender-non-specific, but effect strengths do seem to vary between groups of low and high anxiety, hinting at a possibly curvilinear relationship worth investigating.

Introduction Kenya has recently acquired lower-middle income country status and is facing the triple burden of malnutrition. There is a shortage of data on food intake habits of children and adolescents especially in the rapidly changing urban environments. To be able to reliably measure food intake, one must be able to accurately estimate food portion sizes. Children’s ability to recall portion sizes consumed can vary widely. When a photographic food atlas designed for children with applicable portions is used, it can improve children’s estimation of food portions. Objectives The aim of this study was to develop a photographic food atlas to be used in assessing portion sizes among Kenyan adolescents aged 9-14 years living in urban areas, to support a quantitative 7-day food frequency questionnaire. The second aim was to assess the usability of the atlas amongst 9-14-year-olds and professionals working in the field of nutrition. Methodology A steering group of Finnish and Kenyan nutritionists was formed to oversee the development of the atlas. Literature and other official documents were reviewed to identify the most commonly consumed foods among 9-14-year-old Kenyans. To obtain weighed portion size data, participants were recruited in Nairobi sub-counties Embakasi Central and Langata to represent low- and middle-socioeconomic status respectively. Twenty-one participants aged 9-14 years participated in the weighing of portion sizes, food portions from street markets were also weighed. Three portion sizes (A, B, C) were calculated for most of the 88 food items in the photographic food atlas. Portion B was the average of all weighed portion sizes, portion A was half of B, and portion C was one and half times B. Cooking demonstrations were arranged with the families of participants and the food portions were weighed out and photographed. A photographic food atlas was compiled, and its usability was tested amongst eight adolescents and four nutrition professionals. The usability survey consisted of Likert scale and open-end questions to ascertain acceptability of the atlas. Verbal feedback and observations were also recorded. Results Based on the usability survey, the photographic food atlas received the Usability Score of “OK” and “Good” from adolescents and nutrition professionals respectively. All eight adolescents agreed that the atlas helped them recall portion sizes, but half disagreed and one was unsure whether they could use the atlas on their own. All four professionals agreed they would use the atlas in their work, but all found the quality of photographs poor. Two adolescents disagreed when asked if the portion sizes were small enough and one disagreed when asked if the portion sizes were large enough. However, all professionals agreed that portion sizes were reasonable for the age group. Professionals gave verbal suggestions on improvements, for example, which foods were missing, how to adjust layout as well as the shapes of portion sizes. Conclusion An atlas consisting of 88 most commonly consumed Kenyan foods was developed based on weighed portion sizes of 9-14-year-old Kenyans. The shapes of portion sizes as well as range of portion sizes were crucial for its usability. Poor picture quality hampered recognition of pictures. Clear instructions and explanation of the purpose of the atlas were crucial. A second version of the atlas was developed based on the feedback. The updated atlas, including 173 food items, was used in a cross-sectional study in Nairobi. Further research is recommended to validate the photographic food atlas in order to identify the possible bias it may introduce to portion size estimation.

The aim of this study was to interpret and describe the social networks of ninthgraders on school in Helsinki and analyze the possible effect of gender, language, and school class to the structure of the networks. The research questions were as follows: 1. How the social networks of the ninthgraders were formed? 1.1 How uniform and dense were the groups in the network? 1.2. Were there any central pupils in the network and what were the values of centrality of pupils? 1.3. Were there any groups that communicated with some other language than Finnish? 1.4. What was the effect of gender for the network? 1.5. Did the school class of the pupils have effect on the network? 2. How did the pupils explain their choices of friends or the formation of the group? The hypothesis, based on teachers' descriptions, was that there were groups among the network that operated separately from each other. 41 ninthgraders of one particular school participated in the study. The data was gathered with a questionnaire 14.3.2014 and also by interviewing six pupils in May 2014. The social network analysis programme UCINET-6 was used to explore the ninthgraders' social networks and the interviews were analyzed by using qualitative content analysis. The results indicated that the pupils' social networks were divided in three separate groups and the network was neither united nor dense. Gender had a clear effect on the network. The pupils communicated mainly in Finnish. The school class of the pupils also had a significant effect on with whom the pupils spent time with at school. Pupils explained their choices of friends by same hobby, similarity, knowing each other for a long period of time, same school class, trusting one another, understanding one another and sense of humor. The same explanations were given related to the formation of the group, but also gender and the language of communication had an effect on it.

Objectives. Attachment theory is a theory of social development and personality, known around the world. According to the theory, children have an innate tendency to develop a biologically based and central nervous system-regulated attachment bond to their primary caregivers in order to ensure safety, care, and survival. Early attachment experiences contribute to the way one sees oneself and others and lead to secure, insecure, or disorganized attachment styles, which affect rest of one’s life. Previous research has confirmed the universal nature of attachment, different attachment categories and styles, and early attachment’s links with future relationships and various internal and external problems. Attachment research has traditionally concentrated on early childhood and early childhood environments, whereas middle childhood, adolescence, and school context have been studied less. The objectives of the present study were to find out what kinds of links there are between attachment and the lives of school-aged children and youngsters, what kinds of attachment-related challenges teachers encounter at school, and how teachers could support their students with those attachment-related challenges. The aim is to explore attachment in the lives of school-aged children and youngsters, including at school, to gain a better understanding and to create a valuable foundation for future research. Methodology. The present study was conducted as a systematic literature review, which allowed the gathering of diverse and comprehensive, yet relevant research material, while also supporting objectivity and reproducibility aspects of the study. The material, available through electronic databases, was comprised of research articles from around the world, published in peer-reviewed international research journals. The material was analyzed thematically by research questions and topics, which were then used as a framework in the Results section. Results and conclusions. Early attachment and attachment styles were directly and indirectly linked to the lives of school-aged children and youngsters, including teacher-student relationships, peer relationships, family relationships, and academic achievement, as well as internal and external problems. Various attachment-related challenges and problems were visible at school, but teachers had many ways to buffer them. Current attachment research has not affected or changed school environments enough. Much more attention should be given to attachment within schools, teacher education, and in-service training programs in order to give students better support for their attachment-related problems and challenges.

Tutkimuksissa selvitettiin liikuntatapojen ja niiden muutosten vaikutusta painon kehittymiseen ja kehon koostumukseen nuorilla. Liikunnan ja lihavuuden väliseen kausaalisuussuhteeseen kiinnitettiin huomiota. Tutkimuksen aineistona käytettiin Kaksosten Kehitys ja Terveys tutkimuksen kaksoskohorttiaineistoa. Läpi nuoruutensa aktiivisesti liikkuneita, liikunnan lopettaneita ja täysin liikuntaa harrastamattomia nuoria vertailtiin painoindeksin suhteen 12-, 14-, 17,5- ja 22-vuotiaana ja vyötärönympäryksen suhteen 22-vuotiaana. Nuoruuden liikuntatottumukset eivät ennustaneet merkitsevästi painoindeksiä 22-vuotiaana. Sen sijaan liikunnan lopettaneilla ja täysin liikuntaa harrastamattomilla nuorilla vyötärönympärys 22-vuotiaana oli suurempi, kuin aktiiviliikkujilla, eli liikuntatottumukset vaikuttivat kehon koostumukseen. Pojilla muutos painossa tapahtui ennen muutosta liikunnassa – lihominen näytti johtavan liikkumattomuuteen.

A healthy and balanced diet is essential for healthy growth and nutrition during childhood and youth has permanent and long-term effects for an individual’s health status. However, in contrast to other Nordic countries and most other European countries, there is no national data on adolescents’ food consumption and nutrient intake available in Finland. The Finnish Institute for Health and Welfare conducted a pilot study on nutrition monitoring in adolescents during Autumn 2021. The study was conducted altogether in six schools in Helsinki and Tampere and the study group consisted of 110 ninth graders. The data on the adolescents’ food consumption and nutrient intake was collected with two 24-h dietary recalls. The first recall was conducted face to face and the second by phone. Based on this pilot study, the goal is to develop a national study protocol for examining the food consumption and nutrient intake of 12-18-year-old adolescents. The aim of this master’s thesis is to find out if the study protocol of the pilot study is suitable for a larger national study. In addition, the aim is to find out how was the food consumption and nutrient intake of the ninth graders from Helsinki and Tampere who participated in the study. The statistical tests and graphs were made using IBM SPSS Statistics 29 -software and Microsoft Excel - program. Non-parametric Mann-Whitney U -test was used to compare groups. The participation rate of the study was good. 73% of the invited adolescents participated in the first recall, from which 98% participated also in the second recall. Based on the results of this pilot study, 24-h dietary recalls conducted face to face and by phone are a practical and reliable study method when examining adolescents’ food consumption and nutrient intake. Adolescents’ mean intake of vegetables, fruits, berries, and dietary fibre was below the recommended amount, while the mean intake of salt and saturated fatty acids exceeded the recommended level. Based on the results, the study protocol is suitable for a larger national study. A national study is needed to better understand adolescents’ food consumption and nutrient intake from the point of view of health and environmental sustainability, and to see if there are differences by region, age, or sociodemographic factors. In addition, the national study would help to improve adolescents’ health and to prevent, for example, overweight, obesity and chronic diseases.

The Nordic countries are united by shared values and similar social systems. Traditionally, the cultures in the Nordic countries have been mostly homogeneous, but due to globalization and increased immigration, the Nordic countries have become increasingly culturally diverse. Does this affect how people perceive and identify with the Nordic countries? The purpose of the thesis is to describe Finnish adolescents' perceptions of the Nordic countries and how they identify with the Nordics. Furthermore, I would like to explore how a different ethnic background from Finnish influences Nordic identification. Background and contextual research consisted of theories on identity and identification and previous studies of Nordic, social and cultural identities. The thesis is a part of the research project NordId, which is part of a research network, whose aim is to explore the challenges facing the Nordic education systems. The thesis was conducted as a qualitative research project with a phenomenographic approach. The data collection was done in April 2019, and the sample consisted of 25 adolescents from an upper secondary school in Finland with broad ethnic diversity. The data, consisting of photographs and interviews, was collected through participatory photography and semi-structured group interviews. It was analysed thematically. From the results three themes emerged regarding what the adolescents considered to be Nordic: nature, welfare state, and culture and traditions. Adolescents identified with the Nordics through belonging, similarities and common traditions, and values within the three themes. Family, nationality, geography, ethnicity and language were relationships and categories that they identified through. The results showed that the adolescents with a different ethnic background from Finnish identified with the Nordic countries the same way as the Finnish do. A slight difference in what the adolescents perceived as Nordic was revealed. The most notable difference was that the adolescents with a different ethnic background emphasized the welfare society, freedom of speech and freedom of religion more explicitly and to a greater extent in the photographs and interviews. The results can promote future Nordic cooperation, by showing what the Nordic region means to young people. In addition, the results can inform the educational system of whether Nordic countries, cultures, and history are adequately taught in the curricula, based on what Finnish adolescents know about the Nordic countries.

Mental health problems are increasing, and adolescents are particularly sensitive to the development of psychological complaints. The aim of this thesis was to find out if the experience of psychological complaints among Finnish-Swedish adolescents can be explained by their experience of family support, peer support, classmate support and loneliness. It was also examined whether associations between social support and psychological complaints can be explained by loneliness. In addition, it was investigated if there are differences in experiences of psychological complaints, social support and loneliness between Finnish-Swedish youth living in the city and in the countryside. A sample of 599 Finnish-Swedish youth from grades 5, 7 and 9 completed the Health Survey of School-aged Children (HBSC) in 2018. As statistical analysis methods of this thesis, Spearman's rank correlation analysis, multiple linear regression analysis, mediation analysis, independent t-test and chi2 test were used. The results showed that family support and classmate support significantly and negatively predicted psychological complaints, that is, lower levels of family and classmate support was associated with higher levels of psychological complaints. Loneliness predicted psychological complaints significantly and positively, which means that higher levels of loneliness was associated with higher levels of psychological complaints. Peer support was not directly related to psychological complaints. Girls experienced psychological complaints to a significantly greater extent than boys according to several analyzes, and one of the analyzes also indicated that pupils in grade 9 experienced significantly higher levels of nervousness than pupils in grade 5. Among pupils in grades 7 and 9, those who lived in rural areas experienced more irritability or bad mood than those living in urban areas. Perceived socioeconomic status predicted psychological complaints significantly and negatively among pupils in grades 7 and 9. According to the results, the relationship between social support from family, peers and classmates, and psychological complaints could partly be explained by loneliness. There were no significant differences between Finnish-Swedish youth living in cities and those living in rural areas in terms of psychological complaints, social support or loneliness when pupils from all three grades were included in the analyzes. This thesis contributes to new knowledge about the well-being of Finnish-Swedish youth and could encourage development of health-promoting activities. Longitudinal research is needed in order to gain a deeper understanding of whether lower levels of social support and experiences of loneliness may be risk factors for the development of mental health problems.

Johdanto: Suomalaisten nuorten terveyskäyttäytymisessä on viime vuosien aikana tapahtunut positiivisia muutoksia, erityisesti päihteiden käyttö on vähentynyt. Etelä-Pohjanmaalla väestön merkittävimpiä terveyshaasteita ovat nuorten vähäinen fyysisen aktiivisuuden määrä ja lisääntyvä ylipaino. Seinäjokelaisista nuorista 20 % harrastaa liikuntaa vähintään 60 minuuttia päivässä, nuoret viettävät yhä enemmän aikaa internetissä ja sosiaalisessa mediassa sekä kärsivät uniongelmista aiempaa enemmän. Ylipainon yleistyessä myös välipalojen kulutus ja välipaloista saadun energian määrä on kasvanut. Vaikka välipalojen käyttö on lisääntynyt merkittävästi viime vuosien aikana, on kasvisten, hedelmien ja marjojen sekä täysjyväviljan kulutus suositukseen nähden vähäistä. Keskeisimmät lasten ja nuorten ravitsemushaasteet liittyvät suolan ja sokerin liialliseen saantiin, joka näkyy etenkin makeisten ja juomien runsaana kulutuksena. Tavoitteet: Pro gradu -tutkimuksen tavoitteena oli tutkia, täyttyvätkö välipalojen ravitsemuslaadulle asetetut ravitsemussuositusten mukaiset tavoitteet seinäjokelaisilla 8.-9.-luokkalaisilla nuorilla välipalojen valinnassa. Välipalojen ravitsemuslaatua tarkasteltiin erityisesti kasvisten, hedelmien ja marjojen kulutuksen sekä välipalojen sisältämän rasvan määrän ja laadun, kuidun, sakkaroosin ja suolan osalta. Lisäksi tarkasteltiin välipalojen ravitsemuksellista laatua ja niiden käyttöön yhteydessä olevia terveyskäyttäytymiseen liittyviä tekijöitä. Terveyskäyttäytymiseen liittyvistä tekijöistä huomioitiin ateriarytmi, koululounaalle osallistuminen, fyysisen aktiivisuuden ja ruutuajan määrät, yöunen kesto ja riittävyys, tupakointi sekä alkoholin käyttö. Tutkimuksessa selvitettiin myös, eroaako välipalojen ravitsemuslaatu ylipainoisten ja normaalipainoisten nuorten välillä. Aineisto ja menetelmät: Tutkimusaineisto kerättiin sähköisellä kyselylomakkeella, johon vastasi 152 Seinäjoen lyseon 8.-9.-luokkalaista helmikuussa 2018. Tutkittavat kutsuttiin tutkimukseen satunnaisotannalla luokka-asteen mukaan. Välipalojen ravitsemuslaatua ja käyttötiheyttä tarkasteltiin ruoankäytönfrekvenssikyselyllä, jossa mukana oli yhteensä 52 välipaloiksi luokiteltavaa elintarviketta. Kyselyssä oli mukana osioita, joiden avulla selvitettiin nuorten terveyskäyttäytymistä. Tilastollisina menetelminä käytettiin ristiintaulukointia, Mann-Whitney U –testiä, Kruskal-Wallsin -testiä, yksisuuntaista varianssianalyysiä sekä logistista regressioanalyysiä. Tulokset: Nuorista suurin osa söi 1 – 2 välipalaa päivässä. Tytöt kuluttivat välipaloina poikia useammin kasviksia, hedelmiä, marjoja sekä täysjyvätuotteita. Terveyskäyttäytymiseen liittyvistä tekijöistä ruutuajan määrä sekä välipalojen runsaampi kulutus olivat yhteydessä etenkin runsaampaan energian saantiin sakkaroosia sisältävistä makeista välipaloista kuten kekseistä, muroista, makeisista ja jäätelöstä. Suurin osa nuorista kulutti välipaloja etenkin ruutuajan käytön yhteydessä. Fyysisen aktiivisuuden määrän lisääntyessä myös kasvisten (p=0,006), hedelmien (p=0,045) ja marjojen (p=0,000) käyttö lisääntyi. Kuitenkin fyysisesti aktiivisemmat nuoret söivät lähes yhtä paljon tai useammin sokeroituja ja happamia juomia verrattuna vähän liikkuviin. Nuoret, jotka nukkuivat riittävästi, söivät todennäköisemmin tuoreita kasviksia, hedelmiä ja marjoja välipaloinaan (p=0,000). Nuoret, jotka tupakoivat (OR=0,12; [95 % CI=0,02-0,64]) ja joiden yöuni oli riittämätöntä (OR=0,11; [95 % CI=0,04-0,28]) söivät myös ravitsemuksellisesti vähemmän laadukkaampia välipalakokonaisuuksia. Energiatiheiden välipalojen käyttö on yhteydessä epäsäännölliseen ateriarytmiin (p=0,001), koululounaan syömättä jättämiseen (p=0,040), runsaampaan ruutuajan viettoon (p=0,002), riittämättömään yöuneen (p=0,003) sekä päihteiden käyttöön (p=0,001). Välipalojen ravitsemuslaatu ei tässä tutkimuksessa pääosin eronnut normaalipainoisten ja ylipainoisten nuorten välillä. Johtopäätökset: Tässä työssä saatujen tulosten perusteella seinäjokelaisten nuorten välipalojen ravitsemuslaatua ja käyttöfrekvenssejä koskevat ravitsemussuositukset toteutuvat vain osittain. Nuoret syövät liian vähän kasviksia, hedelmiä ja marjoja välipaloillaan. Myös täysjyvätuotteiden ja rasvattomien maitovalmisteiden kulutus on suositusta pienempää. Tämä saattaa johtaa ylipainoon ja lihavuuteen liittyvien terveysriskien ilmenemiseen ja yleistymiseen nuoruudessa. Tutkimuksessa havaittiin useita terveyskäyttäytymiseen liittyviä tekijöitä, jotka olivat yhteydessä välipalojen ravitsemuslaatuun. Tulevaisuuden ravitsemusohjauksessa, hankkeissa ja interventiossa olisi tärkeää kiinnittää huomiota nuorten välipalatottumuksiin ja kannustaa nuoria terveellisten välipalojen valintaan. Myös välipalojen ravitsemukselliseen täysipainoisuuteen tulee kiinnittää huomiota. Lasten ja nuorten ylipaino on kasvava kansanterveyshaaste, jonka puitteissa tarvitaan lisätutkimusta painon nousua hillitsevistä ruokavaliotekijöistä.