Permafrost thaw poses diverse risks to Arctic environments and livelihoods. Understanding the effects of permafrost thaw is vital for informed policymaking and adaptation efforts. Here, we present the consolidated findings of a risk analysis spanning four study regions: Longyearbyen (Svalbard, Norway), the Avannaata municipality (Greenland), the Beaufort Sea region and the Mackenzie River Delta (Canada) and the Bulunskiy District of the Sakha Republic (Russia). Local stakeholders’ and scientists’ perceptions shaped our understanding of the risks as dynamic, socionatural phenomena involving physical processes, key hazards, and societal consequences. Through an inter- and transdisciplinary risk analysis based on multidirectional knowledge exchanges and thematic network analysis, we identified five key hazards of permafrost thaw. These include infrastructure failure, disruption of mobility and supplies, decreased water quality, challenges for food security, and exposure to diseases and contaminants. The study’s novelty resides in the comparative approach spanning different disciplines, environmental and societal contexts, and the transdisciplinary synthesis considering various risk perceptions. In the Arctic, the risks of the permafrost thaw are perceived differently by communities, and key hazards include infrastructure failure, mobility disruption, decreased water quality and food security, and exposure to diseases, according to a transdisciplinary analysis based on workshops and a thematic network approach.

This paper explores the challenges and key enablers of transdisciplinary research in the specific context of Svalbard, offering methodological perspectives and recommendations. The interconnected climatic and socioeconomic changes in Svalbard call for collaboration across disciplines, as well as societal stakeholders. Such integrative research collaboration is conceptualised as a transdisciplinary approach. This approach emphasises a need for continuous and holistic knowledge co-production and relevant data-sharing across sectors, ensuring a robust foundation for informed decision-making and development strategies. However, navigating transdisciplinarity can be complex, as research often aligns with traditional disciplinary structures. This paper emerged from a collaborative exchange on how to carry out transdisciplinary research in Svalbard, a process that proved productive for transdisciplinary knowledge production. It incorporates insights from two workshops where both researchers from diverse disciplines and non-academic stakeholders actively contributed to discussions and the development of this article. Acknowledging the dynamic nature of transdisciplinary research, we present the themes that emerged from our workshops, categorised as challenges, opportunities, and best practices. These themes are then discussed in light of the democratic and pragmatic principles that underpin transdisciplinary research. We conclude the study by offering recommendations aimed at fostering further co-creation across disciplines and stakeholders from a transdisciplinary perspective.

In Finland, national and local restrictions were implemented to control the COVID-19 pandemic after the increase of cases, and it changed the everyday life of people. The purpose of our study was to explore public health communication and compliance related to the COVID-19 public health instructions, recommendations, and restrictions in two municipalities in Northernmost Finland, Inari and Utsjoki. We interviewed the representatives and operators working in the municipalities to understand and learn about their experiences. Results suggested that residents complied with different COVID-19 actions, and overall, communication was found to be good. Altogether, guidelines were easy to follow but required the individual’s own activity. Guidelines were also published in Sámi language. National border restrictions were a challenging part of communication and information, and guidelines were found to be contradictory at times. National border actions required resources from the municipalities, e.g. testing, which caused more demands on municipalities operating with already low resources. In the future, it is essential to consider the local situation of the pandemic and harmonise actions and put effort on local cooperation. It is important to invest in clear communication, which reaches people of all ages, and in three Sámi languages.

This paper outlines the methodological approaches to a multi-site Circumpolar case study exploring the impacts of COVID-19 on Indigenous and remote communities in 7 of 8 Arctic countries. Researchers involved with the project implemented a three-phase multi-site case study to assess the positive and negative societal outcomes associated with the COVID-19 pandemic in Arctic communities from 2020 to 2023. The goal of the multi-site case study was to identify community-driven models and evidence-based promising practices and recommendations that can help inform cohesive and coordinated public health responses and protocols related to future public health emergencies in the Arctic. Research sites included a minimum of 1 one community each from Canada (Nunavut,) United States of America (Alaska), Greenland, Iceland, Norway, Sweden, Finland. The approaches used for our multi-site case study provide a comprehensive, evidence-based account of the complex health challenges facing Arctic communities, offering insights into the effectiveness of interventions, while also privileging Indigenous local knowledge and voices. The mixed method multi-site case study approach enriched the understanding of unique regional health disparities and strengths during the pandemic. These methodological approaches serve as a valuable resource for policymakers, researchers, and healthcare professionals, informing future strategies and interventions.

The COVID-19 pandemic challenged our lives during the years 2020-2022. Impacts could be seen in everyday life, both locally and nationally, through economic, mental and social elements. However, these effects varied depending on the life situation of individuals. This paper aims to gather information from the representatives and operators working in two Finnish municipalities, Inari and Utsjoki, to understand and learn about their experiences during the COVID-19 pandemic. The data (20 interviews) were collected between December 2021 and February 2022 and analysed following the principles of the qualitative content analysis. The results suggest that the effects of COVID-19 emerged through issues related to the national border between Finland and Norway, economic challenges, and the pressure that people experienced. However, despite challenges, people were supported by everyday life and a connection to nature, communality and close co-operation. Additionally, local needs were highlighted among participants. The results provide a deeper understanding about the public health impacts in these Northernmost municipalities and can therefore be utilised in future development work. They also provide relevant information on the experiences of Sámi people, and specific views related to Sámi people can be recognised.

Beginning January of 2020, COVID-19 cases detected in Arctic countries triggered government policy responses to stop transmission and limit caseloads beneath levels that would overwhelm existing healthcare systems. This review details the various restrictions, health mandates, and transmission mitigation strategies imposed by governments in eight Arctic countries (the United States, Canada, Greenland, Norway, Finland, Sweden, Iceland, and Russia) during the first year of the COVID-19 pandemic, through 31 January 2021s31 January 2021. We highlight formal protocols and informal initiatives adopted by local communities in each country, beyond what was mandated by regional or national governments. This review documents travel restrictions, communications, testing strategies, and use of health technology to track and monitor COVID-19 cases. We provide geographical and sociocultural background and draw on local media and communications to contextualise the impact of COVID-19 emergence and prevention measures in Indigenous communities in the Arctic. Countries saw varied case rates associated with local protocols, governance, and population. Still, almost all regions maintained low COVID-19 case rates until November of 2020. This review was produced as part of an international collaboration to identify community-driven, evidence-based promising practices and recommendations to inform pan-Arctic collaboration and decision making in public health during global emergencies.

Svalbard is facing changes related to climate change and permafrost thaw, which have impacts on the life and well-being of people. This study evaluated impacts of climate change and permafrost thaw on the life of locals living in Longyearbyen, Svalbard and focused on investigating self-rated health, well-being, quality of life, satisfaction with life, and feeling of empowerment when facing the changes and impacts. The aim was to find out which perceived environmental and adaptation factors relate to these dependent variables. The data was collected using a multidisciplinary questionnaire (n = 84); for statistical analysis cross-tabulation was used and the associations were tested either by the Pearson χ2 test or Fisher's exact test, when appropriate. Binary logistic regression analysis was used to investigate associations between the dependent variables and perceived environmental and adaptation factors. Results suggested that well-being, quality of life, satisfaction with life, and life balance (a sum variable of earlier parameters) were associated with the recognized challenges related to infrastructure or physical environment. Quality of life and life balance were supported by the opinion that not enough has been done to adapt to permafrost thaw by national and global authorities. Despite recognized challenges, participants appear to live satisfied lives. People seemed to have knowledge about the impacts of permafrost thaw, they wanted to adapt to the changes, but more actions are needed from national and global authorities. Research with a larger sample size is needed due to the complexity of the relationships between people, holistic well-being, and climate change.

Climate warming in Arctic Canada, e.g., permafrost thaw, comprehensively impacts biota and the environment, which then affects the lives of people. This study aimed to investigate which perceived environmental and adaptation factors relate to self-rated well-being, quality of life, satisfaction with life (sum variable = life balance), self-rated health, and feeling of empowerment to face the changes related to permafrost thaw. The study sample was collected from one community using a questionnaire (n = 53) and analyzed by cross-tabulation. Results indicated that most participants had at least good well-being, quality of life, satisfaction with life, and a medium level of health, and over 40% assessed being empowered to face the changes related to permafrost thaw. Problems and challenges associated with permafrost thaw, e.g., health, traditional lifeways, and infrastructure, were recognized; these had impacts on life balance, feeling of empowerment, and self-rated health. Traditional knowledge regarding adaptation to face changes was seen as important. More adaptation actions from the individual to global level seemed to be needed. This study provides an overview of the situation in one area, but more research, with a larger study sample, should be conducted to achieve a deeper understanding of climate-related impacts on life and holistic well-being.

BACKGROUND:Climate change is a major global challenge, especially for Indigenous communities. It can have extensive impacts on peoples' lives that may occur through the living environment, health and mental well-being, and which are requiring constant adaptation.OBJECTIVES:The overall purpose of this research was to evaluate the impacts of climate change and permafrost thaw on mental wellness in Disko Bay, Greenland. It contained two parts: multidisciplinary fieldwork and a questionnaire survey. The aim of the fieldwork was to learn about life and living conditions and to understand what it is like to live in a community that faces impacts of climate change and permafrost thaw. For the questionnaire the aim was to find out which perceived environmental and adaptation factors relate to very good self-rated well-being, quality of life and satisfaction with life.ANALYSIS:Fieldwork data was analyzed by following a thematic analysis, and questionnaire data statistically by cross-tabulation. First, the associations between perceived environmental and adaptation factors were studied either by the Pearson χ2 test or by Fisher's exact test. Second, binary logistic regression analysis was applied to examine more in depth the associations between perceived environmental/adaptation variables and self-rated very good well-being, satisfaction with life and quality of life. The binary logistic regression analysis was conducted in two phases: as univariate and multivariate analyses.RESULTS:Nature and different activities in nature were found to be important to local people, and results suggest that they increase mental wellness, specifically well-being and satisfaction with life. Challenges associated with permafrost thaw, such as changes in the physical environment, infrastructure and impacts on culture were recognized in everyday life.CONCLUSIONS:The results offer relevant information for further plans and actions in this field of research and at the policy level. Our study shows the importance of multidisciplinary research which includes the voice of local communities.

Thawing permafrost creates risks to the environment, economy and culture in Arctic coastal communities. Identification of these risks and the inclusion of the societal context and the relevant stakeholder involvement is crucial in risk management and for future sustainability, yet the dual dimensions of risk and risk perception is often ignored in conceptual risk frameworks. In this paper we present a risk framework for Arctic coastal communities. Our framework builds on the notion of the dual dimensions of risk, as both physically and socially constructed, and it places risk perception and the coproduction of risk management with local stakeholders as central components into the model. Central to our framework is the importance of multidisciplinary collaboration. A conceptual model and processual framework with a description of successive steps is developed to facilitate the identification of risks of thawing permafrost in a collaboration between local communities and scientists. Our conceptual framework motivates coproduction of risk management with locals in the identification of these risks from permafrost thaw and the development of adaptation and mitigation strategies.

Climate change is a global challenge which has direct and indirect health impacts on the lives of people and communities in the Arctic. The aim of our study was to evaluate the perception of permafrost thaw and health challenges and to determine which perceived environmental and adaptation factors relate to self-rated health and, more specifically, to feeling of empowerment when facing the changes and impacts of climate change and permafrost thawing. Questionnaire data (n = 100) were collected from one community located in Greenland, Disko Bay. Data were analyzed by cross-tabulation and the significances were tested either by Pearson’s χ2 test, Fisher’s exact test or by the t-test, when applicable. Based on these analyses, logistic and linear regression analyses were used to evaluate the associations between demographic variables, challenges posed by permafrost thaw and self-rated health, and associations between feeling of empowerment and perceived environmental/adaptation factors. The results indicated that climate change was not assessed as being a direct risk for the health of local people or their feeling of empowerment. Nature seemed to play an important role for local people, and not being in the natural environment for recreational activities seemed to decrease feeling of empowerment (OR 0.42, p = 0.042, 95% CI 0.17–0.97). This paper provides new, multidisciplinary research information about the perception of health challenges, health, and feeling of empowerment among people living in an environment impacted by permafrost thaw and climate change.

Clinical studies investigating adolescents’ adherence to medicinal and non-pharmacological treatment in hospitalized psychiatric populations are few. In our study of 13–17 year old adolescents admitted to psychiatric inpatient care, the patients’ adherence to treatment in general, and to medicinal and non-pharmacological treatment individually, was examined, with special focus on family and clinical factors. Data on adherence was collected from patients’ hospital records. A step-wise logistic regression analysis was used to find the significant predictors of adherence to treatment. Good family or social network relational functioning and use of special services at school were positively related to adherence in adolescents. Involuntary treatment and self-mutilative behavior were related to non-adherence to treatment. The results indicate the importance of addressing adherence to treatment in adolescent psychiatric inpatients. More studies with larger samples are needed to investigate this area further.

Background: Although adherence to somatic treatment has been studied extensively, adherence to mental health treatment has not. In this study, the term treatment adherence is used to refer to adherence to medication regimes and other non-pharmacological recommended treatments as part of mental health and psychiatric care. Knowledge of factors connected to adolescents' adherence to such treatment is fairly fragmented. Although treatment staff members are broadly aware of the factors that influence adherence, it would be desirable to develop formalized treatment assessment and planning approaches that specifically take these factors into account.Objective: The purpose of this article is to review the available data related to factors that affect adolescents' adherence to both medication and non-pharmacological treatments in mental health and psychiatric care. Methods: A systematic literature search that involved four databases was undertaken. A thematic analysis was conducted on 17 studies to extract relevant information.Results: It appears that an adolescent's own positive beliefs toward his or her treatment are the main factor that improves his or her adherence to that treatment. Good cohesion with close supportive people appears to be positively related to adherence, whereas sociodemographic characteristics (e.g., race, gender) were not related.Conclusions: By identifying the factors related to the treatment adherence of adolescents, this review article can provide guidance to help improve the quality of care and thus further increase adolescents' satisfaction with their mental health and psychiatric treatment.

AIMS AND OBJECTIVES:To review current research into the adherence to mental health treatment by adolescents. BACKGROUND:Nonadherence to medication among adolescents has been studied much more extensively than nonadherence to other forms of treatment. Monitoring adherence to all recommended services is essential when assessing the long-term effectiveness of different treatment programmes. Healthcare professionals who treat patients with mental illness must be able to accurately determine which of their patients are adhering to all prescribed treatments. DESIGN:This is a systematic narrative literature review of the current literature. METHODS:Using a narrative synthesis, the data from 15 relevant articles concerning adolescents in inpatient or outpatient mental health care were extracted and synthesised. RESULTS:The reviewed papers are discussed in terms of the methods used to study treatment adherence, the working definition of adherence used in each case and the results obtained concerning adherence in adolescents. Thirty-four to sixty-seven per cent of adolescents treated are fully adherent to their medication and exhibit reasonably good follow-through for the recommended treatments. However, rates of noncompliance with medication are quite high, and significant numbers of adolescents choose to discontinue their medication. CONCLUSIONS:This review synthesises current published data on adherence to mental health treatment among adolescents in order to provide practitioners and researchers with a better understanding of this important area. It is recommended that future investigations should focus on adherence in inpatient care, adherence to nonpharmacological treatments and the identification of factors that influence adherence. RELEVANCE TO CLINICAL PRACTICE:The monitoring and understanding of adherence to recommended services is important. Therefore, these findings can be used by healthcare professionals who treat patients with mental illness to help them assess which of their patients are adhering to the prescribed treatments.

AIMS AND OBJECTIVES:To examine the adolescent's adherence in psychiatric inpatient care that includes both medication and non-pharmacological treatment.BACKGROUND:Adolescents can deny having a problem or being in need of treatment and are therefore prone to defying attempts to engage them in a collaborative treatment process. There is still little information in the literature concerning adherence to psychiatric inpatient treatment among mentally ill adolescents, especially focusing on the entire treatment period and all forms of treatment.DESIGN:This is a retrospective, mixed-method study.METHODS:Data were collected from discharge reports written by doctors (n = 72) and were subjected to inductive content analysis. Adherence to all forms of treatment was considered, over the entirety of the treatment period rather than focusing on a single specific time point.RESULTS:Three main adherence-related content categories were identified: non-adherence to treatment, adherence to treatment and challenges of adherence. The last of these categories contains information on factors that affect adolescent treatment adherence.CONCLUSIONS:We found that adherent adolescents are cooperative, willing to receive treatment and participate actively in therapies aimed at relieving their mental symptoms or illness.RELEVANCE TO CLINICAL PRACTICE:The findings presented herein are likely to be informative in the context of inpatient treatment, and it is expected that the results presented herein will help to improve adolescents' quality of treatment.