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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.

Purpose To determine changes to people’s social contact during COVID-19, and whether reduced social contact was associated with changes to psychosocial wellbeing. Methods 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. Results 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. Conclusion 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.

It 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. This 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. The 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. A 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. Redundancies 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.

Background Caries increment during adolescence, including enamel caries, is rarely explored in detail. This study assessed the caries increment during the period from 12 to 18 years. The specific objectives were to examine time trends, increment variability between individuals, and whether baseline caries experience at 12 years or sex had an impact on the caries increment. Methods The sample included seven birth cohorts (1996–2002; n  = 23,135) from a general adolescent population in Trøndelag County, Norway. Data was based on dental records from the Public Dental Service. Two caries increment thresholds were examined at the tooth level: the enamel caries increment (ΔD 1–2 T), and the caries increment at the dentin level, including missing and filled teeth (ΔD 3–5 MFT). Zero-inflated Poisson models were used to account for the skewed distribution with a high proportion of zero caries increment (31.1% with ΔD 1–2 T = 0 and 33.4% with ΔD 3–5 MFT=0). Results The mean caries increments for the seven cohorts were ΔD 1–2 T = 3.14 (95% CI: 3.09–3.19) and ΔD 3–5 MFT = 2.51 (95% CI: 2.47–2.55). A modest temporal trend of decreasing caries increment across cohorts was observed at both thresholds: ΔD 1–2 T = -0.31 (95% CI: ±0.13) and ΔD 3–5 MFT = -0.43 (95% CI: ±0.11). However, this decrease was small compared to the variation in caries increments between individuals. Females had slightly lower mean caries increment than males, but there was no effect of sex on the change across cohorts. Adolescents with high baseline caries experience at 12 years had higher mean caries increments compared to the intermediate or low baseline caries experience groups, and a reduction across cohorts was only seen in the two latter groups. Conclusions While there was a modest reduction in caries increment across cohorts, this reduction was small compared to the variation in caries increments between individuals. The change across cohorts was the same in females and males. Baseline caries experience at 12 years was a strong predictor of caries increment and the reduction across cohorts was only seen among those with lower baseline caries experience, incdicating an increased dental health disparity among Norwegian adolescents. Clinical Trial Registration ClinicalTrials.gov ID: NCT05935813, Release Date: 28/06/2023.

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.

Aims: Are potentially traumatic events associated with subsequent disability pension? Traumatic exposure and post-traumatic stress disorder (PTSD) may represent a disabling state with both personal and professional consequences for the affected individual. Despite this, there is a scarcity of research studying the effects of traumatic exposure on disability pension. This study examined the differences in risk for disability pension among unexposed, exposed to trauma and PTSD cases. Methods: An ambidirectional Norwegian cohort study, consisting of 1238 individuals aged 18–66 years who were at risk of disability pension, were interviewed using the Composite International Diagnostic Interview, and linked with registry data on disability pension. Registry follow-up in the Norwegian Insurance Database lasted ten years following interview in 2000–01. The risk of disability pension after traumatic exposure, divided into accidental and premeditated, was assessed by Cox proportional hazards regression analysis. Results: In 10 years, 9.5% of the cohort had been granted disability pension. Overall exposure to traumatic events did not alter the risk of disability pension. However, among women, exposure to premeditated traumas did increase the risk (HR 2.96 (95% CI 1.54–5.68)), and was an independent risk factor. Fulfilling criteria for PTSD caseness further increased the risk (HR 4.69 (95% CI 1.78–12.40)). There was no increased risk found between traumatic exposure and disability pension for men. Conclusions: Exposure to trauma, particularly premeditated trauma, seems to be an independent risk factor for disability pension in women.

Background Psychiatric readmissions have been studied at length. However, knowledge about how environmental and health system characteristics affect readmission rates is scarce. This paper systemically reviews and discusses the impact of health and social systems as well as environmental characteristics for readmission after discharge from inpatient care for patients with a psychiatric diagnosis. Methods Comprehensive literature searches were conducted in the electronic bibliographic databases Ovid Medline, PsycINFO, ProQuest Health Management and OpenGrey. In addition, Google Scholar was utilised. Relevant publications published between January 1990 and June 2014 were included. No restrictions regarding language or publication status were imposed. A qualitative synthesis of the included studies was performed. Variables describing system and environmental characteristics were grouped into three groups: those capturing regulation, financing system and governance; those capturing capacity, organisation and structure; and those capturing environmental variables. Results Of the 734 unique articles identified in the original search, 35 were included in the study. There is a limited number of studies on psychiatric readmissions and their association with environmental and health system characteristics. Even though the review reveals an extensive list of characteristics studied, most characteristics appear in a very limited number of articles. The most frequently studied characteristics are related to location (local area, district/region/country). In most cases area differences were found, providing strong indication that the risk of readmission not only relates to patient characteristics but also to system and/or environmental factors that vary between areas. The literature also points in the direction of a negative association of institutional length of stay and community aftercare with readmission for psychiatric patients. Conclusion This review shows that analyses of system level variables are scarce. Furthermore they differ with respect to purpose, choice of system characteristics and the way these characteristics are measured. The lack of studies looking at the relationship between readmissions and provider payment models is striking. Without the link to provider payment models and other health system characteristics related to regulation, financing system and governance structure it becomes more difficult to draw policy implications from these analyses.

Background Health literacy is fundamental to healthy behaviour, defined as seeking, processing, and evaluating health information to make informed decisions. Access to health information has historically been linked to socioeconomic status (SES), with disparities in health persisting due to unequal access to new health technologies. Digital technologies offer opportunities for spreading health information but may also increase inequalities through a digital divide. The Norwegian government established the website ung.no in 2003 to provide health information to adolescents. This study aims to investigate what oral health information adolescents seek on the ung.no Q&A service and how they use it to build oral health literacy. Methods The study analysed 1632 questions posted on the ung.no Q&A service and answered by dentists between January 1, 2020, and May 12, 2023. Data included self-reported gender and age of the individuals posting the questions. Descriptive analyses, text mining, manual coding and qualitative thematic analysis were used to assess the four elements of health literacy: finding, processing, evaluating and utilizing health information. Results The analysis revealed that most questions were posted by girls (65.8%), with the majority coming from the 13–15 age group (55%). Common themes included orthodontic treatment, caries, oral hygiene, finances and the impact of diet and substances on oral health. Adolescents used the Q&A service to seek information, confirm information from other sources, and evaluate options for oral health behaviours and treatments. Many questions reflected concerns about the appearance of teeth, fear of dental procedures and the confidentiality of dental visits. Negative emotions such as stress, fear and shame were prevalent, impacting the adolescents’ ability to process information and make informed decisions. Conclusion The ung.no Q&A service is a valuable tool for adolescents to increase their oral health literacy. The study highlights the importance of providing clear, accessible information and addressing the emotional factors that influence health behaviours. Dental professionals should focus on building trust, offering empathic communication, and providing proactive guidance to support adolescents in making informed decisions about their oral health.

Abstract Background Health literacy is fundamental to healthy behaviour, defined as seeking, processing, and evaluating health information to make informed decisions. Access to health information has historically been linked to socioeconomic status (SES), with disparities in health persisting due to unequal access to new health technologies. Digital technologies offer opportunities for spreading health information but may also increase inequalities through a digital divide. The Norwegian government established the website ung.no in 2003 to provide health information to adolescents. This study aims to investigate what oral health information adolescents seek on the ung.no Q&A service and how they use it to build oral health literacy. Methods The study analysed 1632 questions posted on the ung.no Q&A service and answered by dentists between January 1, 2020, and May 12, 2023. Data included self-reported gender and age of the individuals posting the questions. Descriptive analyses, text mining, manual coding and qualitative thematic analysis were used to assess the four elements of health literacy: finding, processing, evaluating and utilizing health information. Results The analysis revealed that most questions were posted by girls (65.8%), with the majority coming from the 13–15 age group (55%). Common themes included orthodontic treatment, caries, oral hygiene, finances and the impact of diet and substances on oral health. Adolescents used the Q&A service to seek information, confirm information from other sources, and evaluate options for oral health behaviours and treatments. Many questions reflected concerns about the appearance of teeth, fear of dental procedures and the confidentiality of dental visits. Negative emotions such as stress, fear and shame were prevalent, impacting the adolescents’ ability to process information and make informed decisions. Conclusion The ung.no Q&A service is a valuable tool for adolescents to increase their oral health literacy. The study highlights the importance of providing clear, accessible information and addressing the emotional factors that influence health behaviours. Dental professionals should focus on building trust, offering empathic communication, and providing proactive guidance to support adolescents in making informed decisions about their oral health.