Parental reports of hospital- and community-based follow-up services, self-efficacy, and symptoms of depression a few months after discharge of a prematurely born child.

BACKGROUND: Many parents report the transition from hospital to home as challenging after the birth of a preterm-born child. This study investigates parental perceptions of community-based follow-up services after hospital discharge, alterations in parental self-efficacy during the early months at home, the prevalence of depressive symptoms among parents, and the relationship between these factors and both NICU experiences and children's regulative behaviors. METHODS: In this second phase of a descriptive study, 110 parents returned a digital questionnaire when their child was four months corrected for prematurity. Parents were recruited while hospitalized with their child, in one of eight Norwegian neonatal intensive care units (NICUs). Thus, the study provides insight into follow-up services across a broad geographical range. Parents' perception of self-efficacy was reported on the Karitane Parenting Confidence Scale, and depressive symptoms were evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Children's regulative behavior was reported on the 6-month version of the Ages and Stages Questionnaire: Social and Emotional (ASQ: SE). Using SPSS, associations between variables were investigated in multiple regression analysis in addition to descriptive analysis. Additionally, the examination of repeated measures of parental self-efficacy involved the application of linear mixed models. RESULTS: Parents reported improved perception of self-efficacy from postdischarge to the children's age of four months (F (1,167) = 1233.2, p < 0.001). On average, fathers' self-efficacy improved more than that of mothers. Parents' perception of being well informed prior to discharge from hospital predicted improved self-efficacy (F [1, 29] = 10.4, p = 0.003). Reports of depressive symptoms were at a similar level as previously reported among new parents, as 10.4% of mothers and 6.7% of fathers reported EPDS scores ≥ 10 points. Parents' reports on ASQ: SE show that 15% of the children scored above the recommended cutoff score for three- to nine-month-old children. The parent-reported benefit of follow-up services showed considerable variation. The importance of specific knowledge about prematurity among public health nurses and physicians was frequently mentioned, and public health nurses were perceived as coordinators and mediators of various services. CONCLUSIONS: Parents reported improved self-efficacy, and depressive symptoms at similar levels as new parents in general, a few months after discharge from hospital. Childrens' regulatory behavior were reported at levels comparable with term-born infants.

Cross-sectional associations between accelerometer-measured physical activity and hip bone mineral density: the Tromsø Study 2015-2016.

Positive associations between physical activity and bone health have been found in population-based studies, however, mostly based on self-reported physical activity. Therefore, we investigated the association between accelerometer-measured physical activity, measured in steps per day and minutes of moderate to vigorous physical activity (MVPA) per day, and total hip areal BMD (aBMD) measured by DXA in a general population, utilizing multiple regression models. The study participants, 1560 women and 1177 men aged 40-84 yr, were part of the seventh survey of the Tromsø Study (2015-2016). In both genders, we found a positive association between the number of daily steps and aBMD adjusted for age, BMI, and smoking status (P < .001). In women, an increase of 1000 steps per day was associated with 0.005 g/cm2 higher aBMD. For men, a polynomial curve indicated a positive association with aBMD up to 5000 steps per day, plateauing between 5000 and 14 000 steps, and then increasing again. Additionally, MVPA duration was positively associated with aBMD in both women (P < .001) and men (P = .004) when adjusted for age, BMI, and smoking status. Specifically, each 60-min increase in daily MVPA was associated with 0.028 and 0.023 g/cm2 higher aBMD in women and men, respectively. Despite positive associations, the clinical impact of physical activity on aBMD in this general population of adults and older adults was relatively small, and a large increase in daily MVPA might not be achievable for most individuals. Therefore, further longitudinal population-based studies incorporating device-based measures of physical activity could add more clarity to these relationships.

Cross-informant ratings on emotional and behavioral problems in Nepali adolescents: A comparison of adolescents' self-reports with parents' and teachers' reports.

BACKGROUND: Studies on cross-informant agreement on adolescents' emotional and behavioral problems (EBPs) are sparse in low- and middle-income countries. This study aimed to assess parent-adolescent and teacher-adolescent agreement on EBPs and associated factors in Nepal. METHODS: This cross-sectional survey included 1904 school-going adolescents aged 11-18, enrolled in government and private schools located in sixteen districts of Nepal. The Nepali versions of the Youth Self Report, Child Behavior Checklist, and Teacher's Report Form were administered to assess EBPs reported by adolescents, their parents, and teachers, respectively. Repeated measures analysis of variance (ANOVA) was done to assess mean differences in problem scores. Pearson's correlation was used to assess cross-informant agreement. Linear regression analysis was used to explore factors associated with cross-informant discrepancies in EBPs. RESULTS: Adolescents reported significantly more problems than their parents and teachers. Mean Total Problem scores for the 90 common items in the adolescents' self-reports, parent reports, and teacher reports were 34.5 (standard deviation [SD]: 21.4), 24.1 (SD = 19.2), and 20.2 (SD = 17.5) respectively. Parent-adolescent agreement on Total Problems was moderate, whereas teacher-adolescent agreement was low. The parent-adolescent agreement was moderate to low for the two broadband scales and all syndrome scales, whereas the teacher-adolescent agreement was low for all scales. Female gender and ethnic minority status impacted both parent-adolescent and teacher-adolescent discrepancies. Family stress/conflicts impacted parent-adolescent discrepancies, while academic performance impacted teacher-adolescent discrepancies. CONCLUSIONS: Nepali adolescents reported more EBPs than their parents and teachers. The agreement between adolescents' self-reports and reports by their parents and teachers was moderate to low. Gender, caste/ethnicity, family stress/conflicts, and academic performance were associated with cross-informant discrepancies. It is crucial to collect information from different sources, consider context-specific needs, and discern factors influencing cross-informant discrepancies to accurately assess adolescents' EBPs and develop personalized approaches to treatment planning.

Dose-Response Effects of MittEcho, a Measurement Feedback System, in an Indicated Mental Health Intervention for Children in Municipal and School Services in Norway.

Including routine client feedback can increase the effectiveness of mental health interventions for children, especially when implemented as intended. Rate of implementation, or dose, of such feedback interventions has been shown to moderate results in some studies. Variation in implementation and use of client feedback may also contribute to the mixed results observed within the feedback literature. This study evaluates dose-response associations of client feedback using a novel Measurement Feedback System (MFS) within an indicated group intervention. The primary aim was to determine whether the rate of MFS implementation predicts symptom reduction in anxiety and depression among school-aged children. The secondary aim was to assess whether the rate of MFS implementation influences children's satisfaction with the group intervention or their dropout rates. Data were collected via a randomized factorial study (clinicaltrials.gov NCT04263558) across 58 primary schools in Norway. Children aged 8 to 12 years (N = 701) participated in a group-based, transdiagnostic intervention targeting elevated symptoms of anxiety or depression. Half of the child groups also received the feedback intervention using the MittEcho MFS. Group leaders (N = 83), recruited locally, facilitated the interventions. The MFS dose was measured using the Implementation Index, which combines the use of MFS by both children and providers (group leaders) into a single dose variable. Results showed no significant additional effect of dose of MFS on change in depression or anxiety scores, on user satisfaction with the intervention or on intervention dropout. The discussion addresses potential reasons for these non-significant findings and implications for MFS implementation in preventive, group-based interventions in school settings.

Examining the psychometric properties of the Norwegian version of the Social Aptitudes Scale in two clinical samples.

BACKGROUND: Few studies have examined the psychometric properties of the Social Aptitudes Scale (SAS). The study aims of the current paper were to examine the internal consistency and the validity of the Norwegian SAS. METHODS: Parents of children from a clinical neuropediatric sample (N = 257) and from a clinical sample from child and adolescent's mental health services (N = 804) filled in the SAS. RESULTS: Internal consistency for the SAS were good in both samples and correlations between the SAS and different scales were in the expected directions. The results from the Confirmatory Factor Analyses indicated poor model fit. CONCLUSIONS: Future validity studies should investigate whether SAS is suitable as a screening instrument for detecting autism spectrum disorder.

Self-reported emotional and behavioral problems among school-going adolescents in Nepal-A cross-sectional study.

BACKGROUND: Studies on self-reported emotional and behavioral problems (EBPs) among adolescents are still sparse in many low- and middle-income countries. In Nepal, no such studies have been performed on a larger scale, and little is known about self-reported EBPs in the adolescent population. METHODS: This cross-sectional, school-based study on EBPs included 1904 adolescents aged 11-18 years, enrolled in government and private schools located in 16 districts in Nepal. The Nepali version of the Youth Self Report form was used to assess self-reported EBPs, and the Teacher Report Form was used to assess academic performance. Analysis of variance (ANOVA) was used for gender comparisons on adolescents' EBPs and on academic competence. Multiple regression analysis was done to explore correlates of self-reported EBPs. RESULTS: The overall prevalence of self-reported EBPs was 14.2%; 15.6% in boys and 12.9% in girls. The mean Total Problems score was 39.27 (standard deviation = 24.16); no gender differences were observed. Boys scored higher on Externalizing Problems and girls scored higher on Internalizing Problems. The effect sizes for gender comparisons were small with Hedges' g ranging from -0.29 to 0.28. Physical illness and negative/traumatic life events were positively correlated with self-reported EBPs, whereas academic performance was negatively correlated. However, the effect sizes were small (η2 < 0.02). CONCLUSION: This study helps to narrow the knowledge gap on the prevalence, magnitude, and types of self-reported EBPs in Nepali adolescents. It demonstrated an association between self-reported EBPs and academic performance and linked self-reported EBPs to other factors such as negative/traumatic life events and physical illness. The findings might assist health authorities in the planning of mental health services and may also provide valuable background information to clinicians dealing with adolescent mental health problems.

Beyond physical ability-predicting women's football performance from psychological factors.

Introduction: Even though there is a clear agreement among researchers that psychological factors are a vital part of a football player's performance, the topic has not been investigated thoroughly. The present study aimed to examine the predictive value of psychological factors on female football players' match performance. Methods: A sample of 156 players from the top two leagues in Norway completed the following questionnaires: Perceived Motivational Climate in Sport Questionnaire 2 (PMCSQ-2), Big Five Inventory (BFI-20), Self-Regulated Learning questionnaire, and Grit-S and Sport Mental Toughness Questionnaire (SMTQ). Match performance data were collected from the online database of the performance analysis company InStat. Results: Results from a linear mixed model analysis showed that perceived mastery climate and extraversion were the only significant predictors of performance. Other relevant indicators, such as mental toughness, self-regulated learning, and grit, did not predict performance. Discussion: These findings suggest that the team climate facilitated by coaches may be more important for predicting match performance than individual psychological factors.

Does Social and Economic Disadvantage Predict Lower Engagement with Parenting Interventions? An Integrative Analysis Using Individual Participant Data.

There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn affect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difficulties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for differential benefit by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1-144, 2017). However, it did not examine whether this was influenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N = 1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-effects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of five (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial effects, including tests for contextual effects. We found evidence that low SES was associated with reduced attendance at parenting programs-an 8-19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by differences in SES composition between trials or by the attendance levels of higher-SES families. The findings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

Two-year motor outcomes associated with the dose of NICU based physical therapy: The Noppi RCT.

BACKGROUND: Interventions involving both the parent and the preterm infant have demonstrated lasting effects on cognitive outcomes, but motor effects are less salient. It remains unclear when to commence early intervention and if dosages have impact on motor outcomes. AIMS: To examine the effect on motor performance at 24-months corrected age following a parent-administered intervention performed with infants born preterm in the NICU. Intervention dosing and longitudinal motor performance were also analyzed. STUDY DESIGN: Single-blinded randomized multicenter clinical trial. SUBJECTS: 153 infants born, gestational age ≤ 32 weeks at birth, were randomized into intervention or control group. OUTCOME MEASURES: Infant Motor Performance Screening Test, Test of Infant Motor Performance, Peabody Developmental Motor Scales-2. RESULTS: No significant difference was found between the intervention and the control group assessed with the PDMS-2 at 24-months CA. However, a significant positive association was found between dosing and the Gross Motor and Total Motor PDMS-2 scores. Analysis of longitudinal motor performance showed a decreasing motor performance between 6- and 24-months corrected age in both groups. CONCLUSIONS: There was no difference in motor performance between groups at 24-months corrected age. However, increased intervention dosage was positively associated with improved motor outcome.

Long-term effectiveness and trajectories of change after treatment with SMART, a transdiagnostic CBT for adolescents with emotional problems.

BACKGROUND: There is a need for long-term effectiveness trials of transdiagnostic treatments. This study investigates the effectiveness and diagnosis-specific trajectories of change in adolescent patients attending SMART, a 6-week transdiagnostic CBT for anxiety and depression, with 6-month follow-up. METHODS: A randomized controlled trial with waiting list control (WLC) was performed at three child and adolescent mental health outpatient services (CAMHS) in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% females) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to treatment or to WLC. Long-term follow-up (N = 83, baseline age = 15.57, 94% females) was performed 6 months after treatment completion (Mean = 7.1 months, SD = 2.5). Linear mixed model analysis was used to assess time by group effects in patients with no diagnosis, probable anxiety, depressive disorder, and combined anxiety and depressive disorder. RESULTS: Almost one third (31%) obtained full recovery according to the inclusion criterium (SDQ emotional). There was highly significant change in all outcome variables. Effect sizes (ES) were largest for general functioning, measured with CGAS (ES: d = 2.19), and on emotional problems measured with SDQ (ES: d = 2.10), while CORE-17, BDI-II and CGAS all obtained ES's close to 1. There were no significant time by diagnostic group interactions for any outcomes, indicating similar trajectories of change, regardless of diagnostic group. Waiting 6 weeks for treatment had no significant impact on long-term treatment effects. LIMITATIONS: Possible regression to the mean. Attrition from baseline to follow-up. CONCLUSIONS: Six weeks of transdiagnostic treatment for adolescents with emotional problems showed highly significant change in emotional symptoms and functioning at 6-month follow-up. Patients with anxiety, depression, combined anxiety and depression, and emotional problems with no specific diagnoses, all had similar trajectories of change. Hence this transdiagnostic SMART treatment can be recommended for adolescent patients with symptoms within the broad spectrum of emotional problems. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02150265. First registered May 29, 2014.

Concerns of Parental Substance Abuse and Mental Health Problems Reported to Child Welfare Services-Testing a Moderated Mediation Model for Paths From Reports to Substantiated Concern and Service Provision.

Background: Parental mental health and substance abuse problems are found in reports of concern to child protection and welfare services. The aim of this study was first to investigate what characterized these reports and how they differed from reports with other types of concerns. Two hypotheses were tested. The first hypothesis was (i) if a report contains concerns about mental health and substance abuse problems, the likelihood of service provision was mediated by substantiation status. The second hypothesis was (ii) that the threshold for substantiation of such problems differed depending on child age, single parent status, and the presence of other child and parent related problems. Method: The study was designed as a case file study which was carried out retrospectively (N = 883). A conceptual model was tested in two steps. First a mediation model with direct and indirect paths from reports of concerns through substantiation decision to service provision was tested. Then a second model was expanded to also include moderators for the indirect effects of reported concerns on substantiation decisions. Results: A total of 33.1% of reports about substance abuse and 41.7% of reports about parental mental illness concerns were provided services. The first hypothesis was confirmed. There is a negative direct effect and a positive mediated effect of reported concern on service provision. The second hypothesis was not confirmed. We failed to identify any significant moderating effect of child age, single caregiver status, or number of child problems, upon the threshold for substantiation of mental health and drug abuse problems. Conclusions: The total effect of reports about mental illness and substance abuse upon service provision was low. Service provision in cases with suspected substance abuse and/or mental illness is highly dependent upon substantiation of that specific problem. Substantiation threshold is not impacted by other case characteristics. This is surprising because there are good theoretical reasons to assume that parental drug abuse and or mental illness are potentially more detrimental to child health, development and safety if the child is younger, if the parent is a single caregiver, and there are many other parallel concerns.

A 15-year follow-up study of hip bone mineral density and associations with leisure time physical activity. The Tromsø Study 2001-2016.

AIMS: The aim was to investigate the long-term association between leisure time physical activity and hip areal bone mineral density (aBMD), in addition to change in hip aBMD over time, in 32-86 years old women and men. METHODS: Data were retrieved from the 2001, 2007-2008, and 2015-2016 surveys of the Tromsø Study, a longitudinal population study in Norway. Leisure time physical activity was assessed by the four-level Saltin-Grimby Physical Activity Level Scale which refers to physical exertion in the past twelve months. Hip aBMD was assessed by Dual-Energy X-ray Absorptiometry. Linear Mixed Model analysis was used to examine long-term associations between physical activity and hip aBMD (n = 6324). In addition, the annual change in hip aBMD was analyzed in a subsample of 3199 participants. RESULTS: Physical activity was significantly and positively associated with total hip aBMD in the overall cohort (p<0.005). Participants who reported vigorous activity had 28.20 mg/cm2 higher aBMD than those who were inactive (95% CI 14.71; 41.69, controlled for confounders), and even light physical activity was associated with higher aBMD than inactivity (8.32 mg/cm2, 95% CI 4.89; 11.76). Associations between physical activity and femoral neck aBMD yielded similar results. Hip aBMD decreased with age in both sexes, although more prominently in women. From 2001 to 2007-2008, aBMD changed by -5.76 mg/cm2 per year (95% CI -6.08; -5.44) in women, and -2.31 mg/cm2 (95% CI -2.69; -1.93), in men. From 2007-2008 to 2015-2016, the change was -4.45 mg/cm2 per year (95% CI -4.84; -4.06) in women, and -1.45 mg/cm2 (95% CI -1.92; -0.98) in men. CONCLUSIONS: In this cohort of adult men and women, physical activity levels were positively associated with hip aBMD in a dose-response relationship. Hip aBMD decreased with age, although more pronounced in women than men.

Home, school, and community violence exposure and emotional and conduct problems among low-income adolescents: the moderating role of age and sex.

PURPOSE: The purpose of this study is to assess whether violence exposure is associated with emotional/conduct problems, when adjusting for confounders/covariates and controlling for comorbidity, and to investigate interactions between violence exposure and sex and/or age. METHODS: This cross-sectional study evaluated a community-based sample of 669 in-school 11-15-year-olds. A three-stage probabilistic sampling plan included a random selection of census units, eligible households, and target child. Multivariable logistic regression investigated the effect of severe physical punishment by parents, peer victimization at school, and community violence on the study outcomes (adolescent-reported emotional/conduct problems identified by the Strengths and Difficulties Questionnaire/SDQ) when controlling for confounders (resilience, parental emotional warmth, maternal education/unemployment/anxiety/depression) and covariates (age, sex, stressful life events, parental rejection). RESULTS: Considering interactions, emotional problems were associated with community violence victimization among girls, while conduct problems were associated with severe physical punishment among the younger, suffering peer aggression among the oldest, bullying victimization among girls, and witnessing community violence among boys. Desensitization (less emotional problems with greater violence exposure) was noted among the youngest exposed to severe physical punishment and the oldest who witnessed community violence. CONCLUSION: Age and sex are moderators of the association between violence exposure and emotional/conduct problems. Interventions at local health units, schools, and communities could reduce the use of harsh physical punishment as a parental educational method, help adolescents deal with peer aggression at school and keep them out of the streets by increasing the usual five hours in school per day and making free sports and cultural/leisure activities available near their homes.

Evaluating Delivery of a CBT-Based Group Intervention for Schoolchildren With Emotional Problems: Examining the Reliability and Applicability of a Video-Based Adherence and Competence Measure.

Adherence and competence are essential parts of program fidelity and having adequate measures to assess these constructs is important. The Competence and Adherence Scale for Cognitive Behavioral Therapy (CAS CBT) was developed to evaluate the delivery of cognitive therapies for children with clinical anxiety. The present study is an assessment of the slightly adapted version of the CAS CBT evaluating the delivery of a Cognitive Behavioral Therapy (CBT)-based preventive group intervention: EMOTION: Kids Coping with Anxiety and Depression. This study was part of a Norwegian cluster randomized controlled trial (cRCT) investigating the effectiveness of a transdiagnostic intervention, the EMOTION program-an indicated prevention program targeting anxious and depressive symptoms. The applicability and psychometric properties of the CAS CBT were explored. Results are based on six raters evaluating 239 video-recorded sessions of the EMOTION program being delivered by 68 trained group leaders from different municipal services. Interrater reliability (intraclass correlation coefficients, ICC [3, 1]) indicated fair to good agreement between raters. Internal consistency of the instrument's key domains was calculated using the Omega coefficient which ranged between 0.70 to 0.94. There was a strong association between the two scales Adherence and Competence, and inter-item correlations were high across the items, except for the items rating the adherence to the session goals. Competence and Adherence Scale for Cognitive Behavioral Therapy is a brief measure for use in first-line services, with some promising features for easily assessing program fidelity, but some of the results indicated that the instrument should be improved. Future attention should also be made to adapt the instrument to fit better within a group setting, especially regarding evaluation of session goals. More research on how to adequately evaluate fidelity measures are also warranted. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT02340637.

Parental mental health screening in a neuropaediatric sample: Psychometric properties of the Everyday Feeling Questionnaire and variables associated with parental mental health.

BACKGROUND: Many previous studies have highlighted distress in parents of children with neurodevelopmental disorders. Further knowledge about the relationship between parental mental health and children's characteristics could help neuropaediatric services improve treatment. The current study examined the applicability of the Everyday Feeling Questionnaire (EFQ) as a screening tool for parental mental health in a neuropaediatric sample. METHODS: Children and adolescents (N = 299) referred to neurodevelopmental/neurological assessment at neuropaediatric outpatient clinics in Northern Norway were assessed for concurrent mental health problems; one of their parents completed the EFQ. RESULTS: The EFQ items loaded highly on a general mental health factor. Parental mental health was more strongly associated with child functional impairment than child emotional/conduct difficulties; it was not associated with child neurodevelopmental disorders. CONCLUSIONS: The EFQ is a suitable screening tool for parental mental health in a neuropaediatric population. Child functional impairment seems an important predictor of parental mental health.

Effect of Sex, Body Mass Index and Physical Activity Level on Peak Oxygen Uptake Among 14-19 Years Old Adolescents.

The aim was to describe longitudinal trends in peak oxygen uptake (VO2peak) among 14- to 19-year-old adolescents in Norway, and to examine effects of sex, body mass index (BMI), and physical activity (PA) level on VO2peak during adolescence. Of 124 invited students from two lower secondary schools in Norway, 116 eighth-grade students (61 boys and 55 girls; 14 years old at baseline) volunteered to participate. The study has a longitudinal design with 6 yearly repeated measures of body height and mass, VO2peak and PA level. VO2peak allometrically scaled to body mass raised to the power of 0.67 was measured using a walking or running incremental test on a treadmill, whereas PA level was self-reported. Among 696 possible observations, 555 (79.7%) were valid. Multiple linear regression and linear mixed model analyses were used to examine the associations between age, sex, BMI, PA level and VO2peak. VO2peak showed a non-linear pattern from age 14 to 19, with a distinct increase for boys peaking at age 17, while the results provide a flatter and more stable curve for girls. Sex, BMI and PA level together explained 43-71% of the variance in VO2peak at the different age levels. Sex and PA level contributed independently to explain a significant proportion of the variance in VO2peak at all measurement occasions, while BMI did not. Adjusted sex differences in VO2peak increased over time, from 26.5 ml·kg-0.67·min-1 at age 14 to 55.5 ml·kg-0.67·min-1 at age 19. The independent contribution from PA level to the variance in VO2peak increased from age 14 to 16 and then decreased. While PA level explained 32.5% of the total variance in VO2peak for 16-year-olds, this number was 14% in 19-year-olds. In conclusion, aerobic power showed a non-linear pattern during adolescence, peaking at age 17. Sex and PA level explained a large proportion of the variance in VO2peak, each of them being an independent contributor to VO2peak. Aerobic power is linked to improved health and seems to depend largely on sex and PA level in adolescents, emphasizing the importance of maintaining a sufficient PA level during adolescence.

Mediating Mechanisms of the Incredible Years Teacher Classroom Management Program.

This study examined whether, and the extent to which, the Incredible Years Teacher Classroom Management program predicted positive development of children's emotional, behavioral, and social adjustment through changes in the child-teacher relationship. Using data from a longitudinal quasi-experimental intervention trial with a matched control condition, including 1,085 children (49.7% girls, meanage = 4.22 years; SDage = 0.88 years), the potential associations were tested by means of multilevel path modeling. The mediation model demonstrated that (1) children in the intervention condition achieved more favorable changes in the child-teacher relationship than the control condition; (2) changes in the child-teacher relationship were associated with changes in the target outcomes; and (3) the intervention effects were mediated via changes in the child-teacher relationship.

CORE-OM as a routine outcome measure for adolescents with emotional disorders: factor structure and psychometric properties.

BACKGROUND: Instruments for monitoring the clinical status of adolescents with emotional problems are needed. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) according to theory measures problems/symptoms, well-being, functioning and risk. Documentation of whether the theoretical factor structure for CORE-OM is applicable for adolescents is lacking. METHODS: This study examined the factor structure and psychometric properties of the CORE-OM based on two samples of adolescents (age 14-18): youths seeking treatment for emotional problems (N = 140) and high school students (N = 531). A split half approach was chosen. An exploratory factor analysis (EFA) was performed on the first half of the stratified samples to establish the suitability of the model. A Confirmatory Factor Analysis (CFA) with the chosen model from the EFA was performed on the second half. Internal consistency and clinical cut-off scores of the CORE-OM were investigated. RESULTS: The best fitting model only partially confirmed the theoretical model for the CORE-OM. The model consisted of five factors: 1) General problems, 2) risk to self, 3) positive resources 4) risk to others and 5) problems with others. The clinical cut-off score based on the all-item total was higher than in an adult sample. Both the all-item total and general problems cut-off scores showed gender differences. CONCLUSION: The factor analysis on CORE-OM for adolescents resulted in a five-factor solution, and opens up for new subscales concerning positive resources and problems with others. A 17-item solution for the general problems/symptoms scale is suggested. We advise developers of self-report instruments not to reverse items, if they do not intend to measure a separate factor, since these seem to affect the dimensionality of the scales. Comparing means for gender in non-clinical samples should not be done without modification of the general emotional problem and the positive resources scales. Slightly elevated CORE-OM scores (up to 1.3) in adolescents may be normal fluctuations.

Temperamental Development among Preterm Born Children. An RCT Follow-Up Study.

A randomized controlled trial study recruited 146 preterm born children, either to participate in a modified version of the Mother-Infant Transaction Program (MITP-m) or to receive the usual follow-up services, before and after discharge from a neonatal intensive care unit. This follow-up study investigates whether MITP participation is associated with parental perceptions of child temperament from two to seven years. Children's temperament was reported by mothers and fathers separately at children's ages of 2, 3, 5, and 7 years. Parents in the MITP-m group reported lower levels of negative emotionality in their children compared to the control group. In maternal reports, a group effect (F(1, 121) = 9.7, p = 0.002) revealed a stable difference in children's negative emotionality from two to seven years, while a group-by-time interaction related to an increasing difference was detected in reports from fathers (F(1, 94) = 4.8, p = 0.03). Another group difference appeared in fathers' reports of children's soothability (F(1, 100) = 14.2, p < 0.0005). MITP-m fathers seemed to perceive their children as easier to soothe at all ages as no interaction with time appeared. Parental reports on children's sociality, shyness, and activity did not differ between the groups.

A randomized controlled trial of a six-session cognitive behavioral treatment of emotional disorders in adolescents 14-17 years old in child and adolescent mental health services (CAMHS).

BACKGROUND: This study aims to investigate effectiveness of a 6-week, transdiagnostic cognitive behavioral therapy (CBT) for anxiety and depression in adolescents, the Structured Material for Therapy (SMART), in naturalistic settings of child and adolescent mental health outpatient services (CAMHS). METHODS: A randomized controlled trial with waiting list control (WLC) was performed at three community CAMHS in Norway. Referred adolescents (N = 163, age = 15.72, 90.3% girls) scoring 6 or more on the emotional disorders subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomly assigned to SMART or to WLC. RESULTS: In the treatment group (CBT), 32.9% improved in the main outcome measure (SDQ), compared to 11.6% in the WLC. Clinically significant and reliable change was experienced by 17.7% in the CBT condition, compared to 5.8% in the WLC. No patients deteriorated. Statistically significant treatment effects were achieved for internalization symptoms, anxiety symptoms and general functioning. CONCLUSIONS: These promising findings indicate that SMART may be considered as a first step in a stepped care model for anxiety and/or depression treatment in CAMHS. The recovery rates imply that further investigations into the effectiveness of brief treatments should be made. Furthermore, there is a need for more comprehensive second-stage treatments for some of these patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02150265. First registered May 292,014.