This scoping review provides a broad overview of the existing literature on economic evaluations of preventive, screening, and treatment programmes for peripartum depression (PPD). PPD is one of the leading causes of disease-related disability among women. However, PPD often goes undiagnosed and untreated, with as many as half of cases not being identified. We followed the PICO-P (publication type) structure. Databases were searched from inception until 30 June 2023. The intervention stage in the studies was classified as prevention, screening, treatment, screening and treatment, and prevention and treatment. The health economics methods of the studies were divided into cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis, cost-minimisation analysis, return of investment, and multiple. Ultimately, 38 studies were included for extraction and evaluation. Several interventions for PPD may be cost effective, including peer support, psychological therapies, and screening strategies using tools like the Edinburgh Postnatal Depression Scale (EPDS). However, study limitations include heterogeneity across studies, methodological limitations, and limited generalisability to diverse populations. The cost-effectiveness results of PPD interventions may differ across different health systems, partly due to differences in the amount and distribution of resources available. By implementing suggested policy recommendations, policymakers can significantly improve the identification, treatment, and prevention of PPD, ultimately improving the health and well-being of mothers, children, and families.

Gender mainstreaming was chosen as a major strategy for the promotion of gender equality in the Beijing Platform for Action in 2002. This approach has been adopted in research policy in many countries, including Norway. We ask: Has the share of published research that includes sex and/or gender perspectives increased during the last decade in Norway? And, during the same period, has the female project manager share and female author share increased? We harvested all the research publications written in English or Norwegian, having at least one author with a Norwegian affiliation and being published in 2011 or later from the Norwegian research publication database and institutional academic repositories. The publications were filtered on a predefined lexicon using a keyword-in-context-analysis followed by manual filtering to identify publications with a sex and/or gender perspective. The resulting dataset of 4,548 publications was supplemented by a second dataset containing the funding status and gender composition of all the research project proposals submitted to the Research Council of Norway during the same period. No change is identified in the share of publications with a sex and/or gender perspective over the period. During the same period, we also find that the female project manager share and the female author share, are both unaltered. The applied theory suggests that high levels of ambiguity and conflict imply symbolic policy implementation. We conclude that attempts at instituting gender mainstreaming in research policy do not seem to have impacted the share of research with a sex and/or gender perspective in Norway.

BackgroundIt is a contemporary and global challenge that the increasing number of older people requiring care will surpass the available caregivers. Solutions are needed to help older people maintain their health, prevent disability, and delay or avoid dependency on others. Technology can enable older people to age in place while maintaining their dignity and quality of life. Literature reviews on this topic have become important tools for researchers, practitioners, policy makers, and decision makers who need to navigate and access the extensive available evidence. Due to the large number and diversity of existing reviews, there is a need for a review of reviews that provides an overview of the range and characteristics of the evidence on technology for aging in place. ObjectiveThis study aimed to explore the characteristics and the range of evidence on technologies for aging in place by conducting a scoping review of reviews and presenting an evidence map that researchers, policy makers, and practitioners may use to identify gaps and reviews of interest. MethodsThe review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Literature searches were conducted in Web of Science, PubMed, and Scopus using a search string that consisted of the terms “older people” and “technology for ageing in place,” with alternate terms using Boolean operators and truncation, adapted to the rules for each database. ResultsA total of 5447 studies were screened, with 344 studies included after full-text screening. The number of reviews on this topic has increased dramatically over time, and the literature is scattered across a variety of journals. Vocabularies and approaches used to describe technology, populations, and problems are highly heterogeneous. We have identified 3 principal ways that reviews have dealt with populations, 5 strategies that the reviews draw on to conceptualize technology, and 4 principal types of problems that they have dealt with. These may be understood as methods that can inform future reviews on this topic. The relationships among populations, technologies, and problems studied in the reviews are presented in an evidence map that includes pertinent gaps. ConclusionsRedundancies and unexploited synergies between bodies of evidence on technology for aging in place are highly likely. These results can be used to decrease this risk if they are used to inform the design of future reviews on this topic. There is a need for an examination of the current state of the art in knowledge on technology for aging in place in low- and middle-income countries, especially in Africa.

To determine changes to people’s social contact during COVID-19, and whether reduced social contact was associated with changes to psychosocial wellbeing. Questionnaire data were collected from a sample of adult respondents (18 years or more) in two Norwegian counties participating pre-COVID-19 (September 2019–February 2020; n = 20,196) and at two time points during COVID-19 (June [Mid] and November/December [Late] 2020; n = 11,953 and n = 10,968, respectively). The main outcome measures were participants' self-reported changes to social contact, loneliness, psychological distress, and life satisfaction. The proportion of respondents reporting less social contact due to COVID-19 decreased from 62% in Mid-2020 to 55% in Late-2020. Overall, reported psychological wellbeing remained unchanged or improved from pre-COVID-19 to Mid-2020. From Mid-2020 to Late-2020, however, a reduction in psychological wellbeing was observed. Poorer psychological wellbeing was found for those with less social contact during the pandemic compared with people reporting unchanged social contact. This effect increased over time and was observed for all age groups at Late-2020. At Mid-2020, the importance of change in social contact for change in psychological wellbeing was greatest among young adults (< 30 years), while no significant differences were found for the oldest age group. The association between COVID-19-era changes to social contact and loneliness, psychological distress, and life satisfaction is complex and appears to be age-dependent. Future studies should consider the quality of social contact and cultural contexts in which social restrictions are imposed.

Background Establishing positive oral health behaviours during adolescence should be a key priority to improve lifelong oral health. However, changing adolescent behaviours is known to be a challenge. Motivational interviewing (MI) is a method of working with patients to activate their motivation for change and has shown promising results within the dental setting. Yet, little is known about the actual experiences and perspectives of Norwegian dental health professionals in delivering motivational interviewing as part of routine care to their young patients. The overall aim of the present study was to explore the implementation of motivational interviewing by dentists and dental hygienists, employed by the Norwegian Public Dental Service, for their adolescent patients. Methods As part of the larger #Care4YoungTeeth <3 project, a Norwegian Research Council funded four-year Collaborative Project to Meet Societal and Industry-related Challenges, an online survey was developed and administered to dental personnel (n = 168) in one region of Central Norway. Data were analysed by descriptive statistics and two-sample tests of proportions at the 95% confidence level. Results A total of 98 dental personnel responded to the survey (response rate 58.3%), of which 37 were dental hygienists (response rate 72.5%) and 61 were dentists (response rate 52.1%). A greater proportion of hygienists reported implementing this intervention compared to dentists (78.4% versus 50.8%; p = 0.007). Similarly, a greater proportion of hygienists (83.8%) stated that they had received training in MI compared to dentists (65.6%; p = 0.051). About 80% of dentists and 90% of dental hygienists felt that they understood the principles of MI. However, only about 45% and 60%, respectively, felt confident in its use. Dental hygienists found MI more usable in their work (p = 0.052), to a greater extent want to use MI (p = 0.002) and found that using MI works well (p < 0.001), as compared to dentists. Conclusions A high proportion of dental professionals working within a Norwegian public dental service have received training in MI. However, barriers to implementation for adolescent patients and differences in practice between dentists and hygienists warrant further enquiry.

This study aims to investigate the associations between chronic illness in siblings and internalizing and externalizing symptoms in adolescent girls and boys. We also examined the potential mediating role of promotive factors like social competence, global self-worth, and family functioning in these associations because such relationships have not been sufficiently examined. This study used cross-sectional data from the Youth and Mental Health Study (YAMHS), a representative prospective cohort study of the Norwegian population. The sample consisted of adolescents (n = 2532) aged 13.7 to 17.0 years (mean age, 14.9 years; 50.4% female; 87.1% response rate). Data were measured by self-report questionnaires and analyzed separately for girls and boys using parallel mediation analyses (with internalizing and externalizing symptoms as dependent variables, sibling chronic illness as predictor variable, and social competence, global self-worth, and family functioning as mediators) controlling for adolescent sex, parental socioeconomic status, and divorce. The internalizing and externalizing problems of adolescents with chronically ill siblings were significantly higher than those without chronically ill siblings. For adolescent boys, but not girls, higher levels of family functioning, social competence, and global self-worth significantly mediated the associations between chronic illness in siblings and internalizing and externalizing symptoms. Adolescents with a chronically ill sibling have an increased risk of internalizing and externalizing problems. Increasing self-worth, social competence, and family functioning can improve mental health in adolescent males whose siblings are suffering from chronic illnesses. More research is needed to identify protective factors for adolescent females.

Background Readmission rates are frequently used as a quality indicator for health care, yet their validity for evaluating quality is unclear. Published research on variables affecting readmission to psychiatric hospitals have been inconsistent. The Norwegian specialist mental health care system is characterized by a multi-level structure; hospitals providing specialized -largely unplanned care and district psychiatric centers (DPCs) providing generalized -more often planned care. In certain service systems, readmission may be an integral part of individual patients' treatment plan. The aim of the present study was to describe and examine the task division in a multi-level health care system. This we did through describing differences in patient population (age, sex, diagnosis, substance abuse comorbidity and length of stay) and admissions types (unplanned vs. planned) treated at different levels (hospital, DPC or both), and by examining whether readmission risk differ according to type and place of treatment of index-admission and travel-time to nearest hospital and DPC. Methods In this population-based cohort study using administrative data we included all individuals aged 18 and older who were discharged from psychiatric inpatient care with an ICD-10 diagnosis F2-F6 ("functional mental disorders") in 2012. Selecting each individual's first discharge during 2012 as index gave N = 16,185 for analyses following exclusions. Analysis of readmission risk were done using Kaplan-Maier failure curves. Results Overall, 15.1 and 47.7% of patients were readmitted within 30 and 365 days, respectively. Unplanned admission patients were more likely to be readmitted within 30 days than planned patients. Those transferred between hospital and DPC during index admission were more likely to be readmitted within 365 days, and to experience planned readmission. Patients with short travel time were more likely to have unplanned readmission, while patients with long travel time were more likely to have planned readmission. Conclusions DPCs and hospitals fill different purposes in the Norwegian health care system, which is reflected in different patient populations. Differences in short term readmission rates between hospitals and DPCs disappeared when type of admission (unplanned/planned) was considered. The results stress the importance of addressing differences in organisation and task distribution when comparing readmission rates between mental health systems.

OBJECTIVE:There is debate regarding the use of coercion in the psychiatric services and how to minimize its use. We examine changes in the use of coercion in one Norwegian psychiatric service area during a nine-year period.METHODS:All patients receiving psychiatric services during the periods 2003-2006 and 2008-2012 in the study area were identified, subsequently also only those who had been involuntarily admitted or subjected to involuntary outpatient treatment. Yearwise rates of patients admitted to coercion and coercive treatment-episodes throughout the study period were calculated.RESULTS:The overall number and the rate of coerced patients decreased to the total patient population. Most of the reduction were initially of the observational period. However, the number of coercive episodes per coerced patient increased. The pattern of outpatient versus inpatient modes of coercion both reflected this main trend.CONCLUSION:The use of coercion seem to be reduced overall, although the increase in treatment-episodes per patient may indicate a complex pattern in use and registration of coercion. The results may be related to legislative changes, restructuring of psychiatric services, or/and modified attitudes of health-personnel to coercion following a range of efforts to reduce it.

Objectives The general practitioners' (GP) role in the care of mental health patients has received increased attention. The literature underlines the need for integration of primary and specialist services, but cross-boundary continuity for patients with severe conditions may be particularly poor. The aim of this study was to analyze the collaboration between primary care and different models of specialized psychiatric services for patients with severe conditions. Methods We compared a local and a centralized model of mental health care. Service utilization over a 5-year period was studied. Results Findings suggest that a local institution-based model of services positively affects the use of both GP and specialist outpatient care, with most inpatients utilizing both GP and specialist outpatient consultations. In the centralized model, a substantial proportion of inpatients only used GP outpatient care. Furthermore, inpatients that used both GP and specialist outpatient services received more of both services compared to those who did not enter specialist outpatient care at all. Conclusion Local inpatient units may positively affect continuity of care and collaboration between general practitioners and specialist psychiatric services compared to more traditional hospital units, probably because better functional integration of services, better facilitation of clinical alliances/relationships, or a more network-oriented treatment philosophy.

This current systematic literature review aims to examine what is known about foster parents' needs, satisfaction and perceptions of foster parent training. A systematized search in relevant databases resulted in 13 publications, with mostly quantitative studies, originating from four countries. Research on foster parent training is scarce, and the satisfaction, needs and perceptions of foster parents were included as secondary outcomes in most of the reviewed studies. A synthesis of the results from the reviewed quantitative studies indicate high levels of user satisfaction, whereas qualitative findings indicate needs for more advanced training on parenting children with special needs, and more real life and flexible practice/training. In conclusion, more research is needed to increase the knowledge on prospective and current foster parents' perceptions of, and satisfaction with foster parent training, and their needs for training.

Abstract Background Ung.no is Norway’s largest information website directed at adolescents, with more than 800 000 users per month. Ung.no offers an online QA service in which 13-20-year-olds post their questions and get answers from professionals. Anonymous answers are publicly available online. Descriptive analysis of over 125 000 questions written to ung.no from 2016-2018 showed that most adolescents asked questions about body and health. Subsequent qualitative content analyses of the body-and-health-questions showed that mental health is one of the most prominent topics in the adolescents’ questions. The aim of the present study is to investigate how adolescents use the QA service to address mental issues. Methods A random selection of 360 questions - stratified by age and gender - concerning body and health were made. The questions were analysed by use of a qualitative thematic analysis with a functional textual approach, i.e. examining the questions’ linguistic functions. Results In the sample, 20 % of the questions concerned mental issues, ranging from negative feelings of sadness, fear or anger, to disorders such as psychosis and depression and grave issues such as suicidal thoughts and self-harm. Three main functions of the adolescents’ questions were identified: 1) Telling about their troubles for the first time; some of them did not ask a question in their post, they just described their feelings; 2) Asking what to do when nothing else has been of help and 3) Seeking confirmation of information they have already received from health experts, teachers, parents or friends, or read on the internet. Conclusions A low threshold service such as an anonymous QA service seems to be useful for adolescents when they need and want to tell about their mental issues or seek help, often for the first time. The outreach of the ung.no QA service is universal, and hence has great potential public health impact. Key messages Adolescents use a low threshold online QA service to address a wide range of mental problems. Adolescents use a low threshold online QA service to tell about their mental issues for the first time.

Abstract Background Adolescents prefer to collect information online. However, research has also shown than adolescents lack competency in googling information. Furthermore, boys are less likely than girls to seek help and to discuss their problems. Hence, an online information and question-answer (QA) service staffed by professionals, like ung.no, may provide what adolescents desire. The ung.no QA service is open to ages 13-20, and all questions and answers are publicly available in a searchable database. The aim of the present study is to investigate who the users of the ung.no QA-service are and what their main concerns are. Methods Data consisted of all questions posted to ung.no 2016-2018. Descriptive analyses were performed using categorization of questions established by ung.no. Results The data consisted of N = 128 289 questions. Overall 68.5% of questions were posted by girls (p < 0.01). The gender option ’other’ was chosen by 1.7%. Younger adolescents aged 13-16 posted 66.1% of the questions (p < 0.01). The age imbalance was most pronounced among girls. The age distribution suggests that users <13 and >20 present themselves as 13- and 20-year olds respectively. Three categories contained 80% of questions, these concerned: body and health (48.1%); school and education; and friends and love. While 52.4% of girls’ questions concerned body and health, boys’ questions were more evenly distributed among categories. Boys had, relatively, more questions regarding laws and rights, intoxicating substances and school, education and work. Conclusions Analyses reveal that 7 out of 10 users of the ung.no QA service are girls, and that the main area of concern is body and health. Results indicate a need for this QA service for wider age-range. The outreach of the ung.no QA service is universal, and hence has great potential public health impact. The results call for action identifying ways to reach boys and in turn efface gender inequality in help seeking behaviour and improve public health. Key messages Seven out of 10 users of a public digital QA service for adolescents ages 13-20 are girls, and seven out of 10 are in the youngest age group 13-16. The main areas of concern posted to a public digital QA service are regarding body and health, and school and education.