Finnish Adolescents Research Articles

Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy.

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.

Incidence of ADHD medication use among Finnish children and adolescents in 2008-2019: a need for practice changes?

This study examined the incidence of attention-deficit/hyperactivity disorder medication among children and adolescents by sex and age group in Finland during 2008-2019. The data on children and adolescents aged 6-18 years receiving reimbursement for any attention-deficit/hyperactivity disorder medication was collected from the nationwide register on reimbursed purchases. The incidence was calculated as a ratio of the number of new users and the number of age and sex-matched population at risk. Negative binomial models were used to calculate rate ratios (RRs). In 2019, the incidence of attention-deficit/hyperactivity disorder medication was 13.4 per 1000 boys and 4.8 per 1000 girls. Among boys, the incidence became 3.7 times greater during the observed years (RR 95% confidence interval (CI) 2.0, 6.5, P<0.0001), whereas in girls it was 7.6 times greater (RR 95% CI 2.1, 27.4, P=0.0019). The boys had 2.8 times the incidence rate compared with the girls (RR 95% CI 2.2, 3.6, P<0.0001). The increase was associated with age only among boys (P=0.0001). The highest incidence rate 23.4 per 1000 individuals (95% CI 22.5, 24.4) was found in 2019 among 6-8-year-old boys. The incidence of attention-deficit/hyperactivity disorder medication use among children and adolescents increased significantly in Finland during the study period. Incidence was higher among boys, but the increase was greater among girls. The most common group to start attention-deficit/hyperactivity disorder medication was 6-8-year-old boys. These findings warrant critical evaluation of the diagnostic and treatment policies currently available in Finland for the treatment of attention-deficit/hyperactivity disorder and related symptoms.

Physical education orientation and activity among youth ice hockey coaches

Sixty-two percent of Finnish children and adolescents aged 9–15 participate in sports club activities, yet only one-third of sports participants reach the recommended 60 min of daily moderate-to-vigorous physical activity. The inadequate physical activity of participants underlines the need for physical education among those participating in sports club activities. Sports coaches have significant potential in promoting participants’ weekly overall physical activity beyond sports training, given their role of authority. However, coaches in Finland mainly work on a voluntary basis, with varying knowledge and capabilities. The aim of the study was to investigate the physical education orientation and activity of sports coaches, and the associations of these with the moderate-to-vigorous physical activity of young sports participants. Questionnaire data from coaches ( n = 26) and young sports participants aged 6–18 ( n = 201), and accelerometer data from young sports participants ( n = 293) were included in the analysis. The results indicated that even though sports coaches recognized the importance of physical education, they have not fully embraced their role as physical educators and promoters of weekly overall physical activity among young sports participants. The role of families was considered most significant in physical education. Coaches perceived their possibilities to influence the physical activity behavior of the participants as limited. Coaching education and experience had a positive relationship with the coaches’ activity in implementing physical education, highlighting the importance of coaching education. The findings suggest that there is a need to increase collaboration with coaches and families to ensure an adequate amount of weekly overall physical activity of children and adolescents.

Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13–16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.

Longitudinal Associations Between Anxiety in Physical Education and Fitness Among Finnish Adolescents

Objectives: This study aims to examine associations between changes in physical education, anxiety, cardiorespiratory fitness (CRF), and muscular fitness (MF) in adolescents. Methods: Participants were Finnish students (baseline: n = 1,147; 11.27 [0.32] years). Data were collected over 4 years (2017–2021). CRF was assessed with the 20 m shuttle run, MF using curl-up/push-up tests, and anxiety with the Physical Education State Anxiety Scale. The random intercept cross-lagged panel model, including repeated measures (within-level) and latent levels (between-level) of anxiety in PE, CRF, and MF, was used. The covariates considered were sex, body mass index, and peak height velocity. Results: CRF and anxiety increased, while MF remained stable over time. Lower fitness was associated with greater anxiety (and vice versa). Sex (female), greater body mass index, and undergoing peak height velocity were associated with greater anxiety. Conclusions: Negative experiences in PE are associated with decreased CRF and MF. Effective teaching practices are needed to optimize adolescents’ experiences in PE.

Infinitives in transit

The study examines the use of two spoken Finnish features among Sweden Finnish adolescents in a formal education setting. The features in question are the colloquial versions of the A-infinitive lative (e.g., mä saan pelaa ‘I’m allowed to play’) and the MA-infinitive illative (e.g., mä meen pelaa ‘I’ll go and play’) forms when used with contracting verbs (e.g., pelata ‘to play’). These features are most prominent in the spoken Finnish in Helsinki, but the data shows it is also present in the speech of bilingual children in Sweden.

Relation between school education aims and Finnish adolescents’ global mindedness: The mediating role of tolerance

Global mindedness is increasingly crucial for individual, national, and global flourishing, and thus obtains great emphasis in school education. This study aimed to examine the associations between adolescents’ global mindedness and three-dimensional school education aims (aims for academic achievement, employability, and narrow-sense holistic development). We further explored the role of adolescents’ tolerance that might explain the associations. A total of 2448 15-year-old Finnish adolescents were selected and two-level hierarchical liner modeling was employed. Results showed that (1) academic achievement aim played a positive role in adolescents’ global mindedness, whereas narrow-sense holistic development aim and employability aim showed insignificant and negative effect on it, respectively; and (2) adolescents’ tolerance mediated the associations of these three school education aims and global mindedness. Findings identified the fundamental contribution of academic achievement aim to global mindedness, and imply schools to integrate global education with academic education, as well as to forbid the discouragement for tolerance and global mindedness in employability education.

Transition readiness among finnish adolescents with juvenile idiopathic arthritis

BackgroundWith chronic diseases, the responsibility for care transfers to adult clinics at some point. Juvenile idiopathic arthritis (JIA) is the most common persistent rheumatic condition in children. A successful transition requires sufficient self-management skills to manage one´s chronic condition and all the tasks involved. In this study, we evaluated transition readiness in Finnish patients with JIA. We aimed to find practical tools to support a successful transition and to study the possible consequences of an unsuccessful transition.MethodsThe usefulness of a specific questionnaire, which was administered to 83 JIA patients, was evaluated in this study. We also gathered information from their first adult clinic visit to assess the success of their transition and its relation to disease activity.ResultsIn 55 (71%) patients, the transition was estimated to be successful. We were able to determine a cut-off score in the questionnaire for a successful transition: the best estimate for a successful transition is when the score is 24 or more. At the first adult clinic visit, an unsuccessful transition was evident in its effect on disease outcome. If the transition was defined as successful, the DAS28 was better.ConclusionWe found the questionnaire to be a useful tool for evaluating transition readiness. Determination of a successful transition helped us identify those adolescents who needed more profound support to improve their self-management skills and thus enhance their transition process. An unsuccessful transition was shown to negatively impact on disease outcomes.

Have there been changes in daily smoking and cigarette consumption among adolescents? Investigation between 1999 and 2019 among Finnish adolescents.

It is postulated that due to decreased smoking rates and increased denormalisation of smoking, those who start and maintain smoking have more socially disadvantaged characteristics and are more dependent on nicotine than those who do not (the so-called 'hardening' hypothesis). The aim of this study was to measure changes in daily smoking and cigarette consumption among Finnish adolescents according to background factors. A repeated cross-sectional study using data from European School Survey Project on Alcohol and other Drugs (ESPAD) on six representative cross-sections of 15- to 16-year-old students between 1999 and 2019 in Finland. A total of 11 377 males and 12 247 females. The outcome measures included the proportion of daily smokers among current smokers, daily smoking and the estimated mean number of smoked cigarettes per day (CPD). Substance use, parental monitoring and school performance were used as independent variables. All measures were self-reported. Daily smoking decreased over time and daily smokers constituted a smaller part of current smokers in 2019 compared with 1999 (the ratio among boys 0.68 and 0.43, respectively; among girls 0.59 and 0.43). Boys using cannabis (interaction between cannabis*survey year: P = 0.020; in 2019 odds ratio [OR]: 3.68, 95% confidence interval [CI] 2.23-6.08) and girls with heavy episodic drinking (interaction between heavy episodic drinking*survey year: P = 0.006, in 2019 OR: 9.00, 95% CI 5.61-14.42) had elevated adjusted odds for daily smoking over time. The estimated mean number of CPD decreased among daily smokers from 9.0 in 1999 to 7.2 in 2019 (P = 0.0002) and the differences diminished between groups based on gender, snus/alcohol use and parental monitoring. The between-group differences remained with regard to cannabis use (P = 0.0233 in 2019) and school performance (P = 0.0111 in 2019). Among currently smoking Finnish adolescents, the proportion of daily smokers decreased between 1999 and 2019, as did the number of cigarettes smoked per day (CPD) among daily smokers, suggesting an absence of 'hardening' in this group. However, differences were observed related to the odds of daily smoking and the mean number of CPD, indicating the change has been less favorable among some adolescent groups than others.

Adolescents and the dark side of social media—Law enforcement perspectives

Adolescents are the most active user group of social media sites. Due to being in a phase of both biological and psychological development, they may be particularly vulnerable to the darker side of social media, such as its illegal aspects or coordinated information influencing. With this research, we aimed to identify threats Finnish adolescents face on social media from a law-enforcement perspective. To reach this goal, we performed semi-structured interviews with police officers from Finnish preventive measures police units. To identify and structure threats that adolescents face, we employed a twofold analysis. In the first part, we conducted inductive content analysis, which revealed three primary threats: polarization, disinformation, and social media as a pathway to illegal activities. In the second part, we employed the Honeycomb-model of social media functionality as a classificatory device for structuring these threats. Our findings provide explorative insights into the threats social media might present to adolescents from the point of view of the Finnish law-enforcement system.

Adolescent victimization and psychosocial well-being in a Finnish population-based sample

ABSTRACT Potentially traumatizing events are common in adolescence, and these experiences have an impact on psychopathology. Furthermore, these events cumulate for certain individuals. More knowledge about the relationship between well-being and victimization experiences’ amount, type, and timing in adolescents is needed to understand the phenomenon of adolescent victimization. In this cross-sectional study, we investigated in a population-based sample of Finnish adolescents, whether victimization experiences associate with psychosocial well-being. The study sample comprised 5743 adolescents aged 15–16 years who filled in a questionnaire about 12 victimization experiences and psychosocial well-being. General Linear Model regression analyses were used for statistical analysis. A greater number of victimization experiences and recent timing, as well as type of victimization such as cyberbullying, were linked to problems related to psychosocial well-being. It is important to recognize current forms of youth victimization to identify the adolescents at risk for psychosocial distress and investigate on specific types of victimization.

Associations between physical activity and digital gaming activity among Finnish adolescents

Abstract Background Physical activity (PA) for adolescents is an important health promotion habit to develop, yet other activities may be more appealing during this stage in life. According to the displacement hypothesis, time on digital games takes away the opportunity to be physically active. As there is a notable decline in PA levels between the ages of 11y- 15y in Finland, there is an urgent need to investigate potential areas that contribute to the decline. According to the 2021 Finnish Player Barometer, 65% of Finns play digital games regularly. The aims of this study were to investigate the associations between PA and digital gaming, and to examine how these associations may change by gaming genres. Methods A Finnish national representative sample (n = 1979) of 11y-15y olds, completed a self-report survey in spring 2022. Variables included PA behaviour, the frequency of digital gameplay, by sport simulation and Esports genres, and various confounders (gender, age, disability, economic status). Analyses were carried out by chi-square tests and multi-logistic regression analyses (no/low activity as reference categories). Results A third (32%) reported daily PA. Daily digital gameplay was more common among males (74%) than females (26%) and decreased from 11y (53%), 13y (30%) to 15y (17%) olds. After controlling for confounders, playing ball sport simulations (e.g. FIFA) was associated with taking part in 5 or more days/week of PA, or sport club participation (OR = 2.8, CI = 1.7-4.4), whereas playing a lot of first-person shooter games, as an Esport, was negatively associated with sport club participation (OR = 0.6, CI = 0.4-0.9) when compared to the reference categories. Conclusions The displacement hypothesis was supported partly among Esport players, but not by simulated sport gamers. Targeted interventions to promote physical activity with digital gaming, require a genre-specific approach. Key messages • Associations between physical activity and digital gaming activity among young adolescents is genre specific. • Frequent playing of digital games were more common among male 11-15y olds than females.

Parental education, ADHD in family and ADHD diagnosis incidence in Finnish children and adolescents

Abstract Background Lower parental education is linked to higher incidence of attention-deficit hyperactivity disorder (ADHD) diagnosis in offspring, as is having ADHD in family, but these associations are rarely studied together. We examined whether parental education predicts offspring ADHD diagnosis differently for children and adolescents with or without ADHD family members. Methods We used Finnish total population register-based data on individuals born between 1994-2003 with non-migrant background. We followed 228,247 boys and 217,866 girls for first ADHD diagnosis, measured from health care or medication registers, in childhood (4-12) and adolescence (13-17), and identified ADHD for biological parents or full siblings. We used Poisson regression to examine differences in diagnoses separately by offspring sex and age group. Results Preliminary results show that boys are more often diagnosed for ADHD in childhood and girls in adolescence, but incidence is higher for boys in both age groups. Among boys and girls without ADHD family members, lower parental education is associated with higher incidence in both childhood and adolescence. Among those with ADHD family members, lower parental education predicts higher incidence in childhood, but in adolescence the differences by parental education even out for boys, and for girls, higher parental education predicts higher incidence. Conclusions While lower parental education predicts higher ADHD diagnosis incidence in general, for adolescents in ADHD families, higher parental education seems to increase the likelihood of getting diagnosed -particularly for girls. This suggests that adolescents in ADHD families with lower parental education may remain without ADHD diagnosis if they are not diagnosed as children. Support measures should be developed to ensure equal access to diagnosis and care irrespective of age, gender and family background. Key messages • Lower parental education predicts higher ADHD diagnosis incidence in general. Yet, adolescents in ADHD families with lower educated parents may remain underdiagnosed. • Support measures should be developed to guarantee equal access to ADHD diagnosis and care regardless of family background.

O.5.1-2 Associations of active school transport and leisure-time physical activity with educational and school-related mental health outcomes among Finnish adolescents: a nationwide cross-sectional study

Abstract Purpose Physically active pupils may be better and more resilient learners. However, it is unknown whether active school transport (walking or cycling to school) could affect educational and school-related mental health outcomes. We examined the associations of active school transport and leisure-time moderate-to-vigorous physical activity with perceived academic performance, self-reported competency in academic skills (concentration in classroom, writing, reading, and calculation), school burnout, and school enjoyment among Finnish adolescents. Methods We included 34103 eighth and ninth graders (mean age 15.4 years; 53% girls) from the nationwide School Health Promotion study cohort of 2015. We used logistic regression, adjusting for major sociodemographic, lifestyle, and physical activity covariates, to estimate the associations. Results We observed small but positive associations between active school transport and educational outcomes. For example, compared with non-active transport, 10-30 minutes of active school transport a day was associated with 30% higher odds of high perceived academic performance (OR 1.30, 95% CI 1.21-1.40) and 16% higher odds of high competency in reading (OR 1.16, 95% CI 1.07-1.26). Any dose of active school transport was also associated with higher school enjoyment, but no relationship with school burnout was observed. Compared with inactivity, higher doses of leisure-time physical activity were robustly associated with better educational outcomes. For example, the most physically active adolescents had 85% higher odds of high perceived academic performance (OR 1.85, 95% CI 1.65-2.08). Regarding competency in academic skills, the strongest association was observed for calculation (OR 1.57, 95% CI 1.39-1.77). Engaging in leisure-time physical activity, at any dose, was also associated with lower odds of school burnout, and higher odds of school enjoyment. Conclusions Compared with active school transport, engaging in leisure-time moderate-to-vigorous physical activity seems to be more strongly associated with high perceived academic performance, high competency in academic skills, and less school burnout among youth. Despite this, walking and cycling to school might lead to minor improvements in classroom performance and school enjoyment. Funding Source Juuso J. Jussila was supported by the Academy of Finland, Strategic Research Council (#336003).

O.4.6-10 Move! – A national monitoring system for health-related fitness and motor competence of Finnish school-aged children and adolescents

Abstract Purpose The Move! system was launched in 2016 and it aims to provide systematic feedback to students on their physical performance, and to collect annual nationwide data on physical performance from 5th and 8th grade students (11–15 years old). The physical performance in the Move! system has been operationalized to include components of health-related fitness and motor competence, which are ideally needed during adolescence and later in life. Project description The Move! is included in the national core curriculum for physical education (PE) and is therefore targeted for all students. Move! measurements include 20m shuttle run (endurance), 5-leaps (strength of the lower body, locomotor skills, stability skills), throwing-catching combination (object control skills), curl-up (endurance of abdominal muscles), push-up (endurance of upper body muscles), and flexibility tests. The Move! results are used extensively. In schools, PE teachers give immediate feedback to students during and after test sessions. In addition, teachers can utilize Move! data when designing PE programs and lessons. Students’ results are sent home, and parents are encouraged to discuss the results and their implications with their children. Students and their parents are directed to the Move! web pages, where they are provided with more information about the tests along with guidance on how to develop different elements of physical performance. The results are also utilized in healthcare as school nurses and doctors consider students’ physical performance information along with other health data. Through a database, it is possible to follow students’ physical performance development. The data can also be used in informed decision-making at national and local levels. Conclusions The Move! system annually reaches a vast majority of Finnish grade 5 and 8 students (&amp;gt;100 000), schools (&amp;gt;2000), and municipalities (&amp;gt;95 %). The system ties together school PE, health care, and data-informed decision-making, and can be seen as a pedagogical innovation enhancing Finnish students’ health-related fitness, physical activity, and overall well-being.

O.4.3-1 Girls with low motor competence may be particularly at risk of insufficient skeletal loading; latent profiles analysis of a four-year follow-up of Finnish adolescents

Abstract Purpose Adequate skeletal loads during the adolescent growth spurt are elemental in building a robust skeleton. Adolescents with poorer motor competence are less active and develop a less robust skeleton compared to their peers with better develop motor competence. However, few longitudinal examinations of motor competence and skeletal loading through adolescence have been reported. Therefore, the purpose of the present study was to explore the association between motor competence and free-living bone-generating (osteogenic) skeletal load trajectories among adolescents. Methods A total of N = 562 5th graders (11 to 13 years-of-age) were initially included in the sample and were followed up annually for four years from 2017 to 2020 (N = 239 in 2020). The children were asked to wear a waist-worn accelerometer for 7 days and motor competence was assessed with 5-leap and side-to-side jumping tests once a year. Latent profiles were identified based on motor competence, and skeletal loading was estimated using an osteogenic index, which combines the number of loading peaks in particular intensity categories akin to counting steps but with accounting for the magnitude of the impact. Results Three motor competence groups arose from the data for both boys and girls and all groups exhibited persistent low, mid or high motor competence throughout the follow-up. The latent group with the low motor competence consistently exhibited the lowest skeletal loads (10 to 20% below the highest motor competence), and the highest motor competence group the highest with the mid-group in between. All latent groups declined in skeletal loads over the follow-up (from osteogenic index 420 SD[80] to 300[90]) with no difference in the steepness of the decline among boys. However, the lowest motor competence group among girls had a slightly steeper decline in skeletal loads than the other groups. Conclusions the finding that motor competence is associated with skeletal loading among adolescents was confirmed in this longitudinal study. Notably, girls with the lowest motor competence had the steepest decline in skeletal loading over the follow-up. Policies aiming to improve fundamental movement skills could be expected to improve skeletal development particularly among less motor competent girls.

Protective factors against school burnout symptoms in Finnish adolescents

Burnout rates among adolescents have risen dramatically over the last decades. It is recognised by ICD-11 but is not categorized as a diagnosis. Most of the studies concerning burnout have focused on adults and work life, neglecting the fact that adolescents can also experience burnout at school. Therefore, it is important to investigate which internal and contextual factors are potentially relevant for protecting against the development of burnout during adolescence. This study examined coping, resilience, and school atmosphere as predictors for burnout symptoms in adolescents. Upper secondary school students around Finland, aged 15–19 (N = 284, M = 16.92) participated in the study by filling out a questionnaire. Results showed that coping strategies focusing on problem solving and seeking social support were associated with less burnout symptoms. A positive school atmosphere, especially instilling meaning in students, showed a similar relationship to burnout. Resilience was unexpectedly associated with more symptoms of burnout. Furthermore, females showed higher rates of burnout symptoms than males. These findings suggest that teaching suitable coping strategies and focusing on creating a meaningful school atmosphere could provide means for preventing burnout and school-related stress in adolescents. However, longitudinal or intervention studies are needed to confirm the causal relationships between these factors.

Are active school transport and leisure-time physical activity associated with performance and wellbeing at secondary school? A population-based study.

Physically active pupils may be better and more resilient learners. However, it is unclear whether walking or cycling to school yields similar educational and school-related mental health benefits as leisure-time physical activity. We examined the associations of active school transport and leisure-time moderate-to-vigorous physical activity with perceived academic performance, competency in academic skills, school burnout and school enjoyment. We included 34 103 Finnish adolescents (mean age 15.4 years; 53% girls) from the 2015 School Health Promotion study cohort. For the analyses, we used logistic regression, adjusting for major sociodemographic, environmental, lifestyle and physical activity covariates. Active school transport was positively associated with educational outcomes and school enjoyment, but not with school burnout. For example, compared with non-active transport, 10-30 min of daily active school transport was linked to 30% [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.21-1.40] and 17% (OR 1.17, 95% CI 1.08-1.27) higher odds of high perceived academic performance and high reading competency, respectively. Leisure-time physical activity was robustly associated with all outcomes. For example, compared with the inactive, the most physically active adolescents had 86% higher odds of high perceived academic performance (OR 1.86, 95% CI 1.66-2.08), 57% higher odds of high competency in mathematics (OR 1.57, 95% CI 1.39-1.77) and 40% lower odds of school burnout (OR 0.60, 95% CI 0.52-0.69). Compared with active school transport, leisure-time physical activity was more strongly associated with educational and school-related mental health outcomes. Nevertheless, walking or cycling to school might lead to improvements in classroom performance and school enjoyment.

Prevalence and associated factors of metabolic-associated fatty liver disease in overweight Finnish children and adolescents.

Data on the prevalence of pediatric fatty liver disease remain limited, partly due to challenges in diagnosis. A novel concept of metabolic-associated fatty liver disease (MAFLD) makes it possible to establish the diagnosis in overweight children with sufficiently elevated alanine aminotransferase (ALT). We investigated the prevalence, risk factors, and metabolic co-morbidities of MAFLD in a large group of overweight children. Data on 703 patients aged 2-16 years examined due to overweight in different levels of healthcare in 2002-2020 were collected retrospectively from patient records. MAFLD was here defined as ALT >2x reference (>44 U/l in girls and >50 U/l in boys) in overweight children according to recently updated definition. Patients with MAFLD and without it were compared, and subgroup analyses were conducted among boys and girls. Median age was 11.5 years, and 43% were girls. Altogether 11% were overweight, 42% obese and 47% severely obese. Abnormal glucose metabolism was present in 44%, dyslipidemia in 51%, hypertension in 48% and type 2 diabetes (T2D) in 2%. MAFLD prevalence varied between 14-20% in examined years without significant change (p=0.878). The pooled prevalence over the years was 15% (boys 18%, girls 11%; p=0.018), peaking in girls at early puberty and increasing in boys with age and puberty. Associated factors in boys were T2D (OR 7.55, 95% CI 1.23-46.2), postpubertal stage (5.39, 2.26-12.8), increased fasting insulin (3.20, 1.44-7.10), hypertriglyceridemia (2.97, 1.67-5.30), hyperglycemia (2.88, 1.64-5.07), decreased high-density lipoprotein (HDL) cholesterol (2.16, 1.18-3.99), older age (1.28, 1.15-1.42) and higher body-mass-index (1.01, 1.05-1.15), and in girls T2D (18.1, 3.16-103), hypertriglyceridemia (4.28, 1.99-9.21), and decreased HDL (4.06, 1.87-8.79). Prevalence of MAFLD was 15%, with no statistically significant increase in the 2000s. The condition was associated in general with male gender, puberty stage and disturbances in glucose and lipid metabolism, and higher age and BMI in boys.

Adolescents’ experiences in nature: Sources of everyday well-being

Recently, adolescents’ decreasing contact with nature has raised concerns in many urbanized societies. In this study, we analyze Finnish adolescents’ leisure time experiences in natural environments. The material consists of 39 thematic writings written by 15–16-year-old adolescents living in the city of Lahti, Finland. The analysis of the written accounts was informed by hermeneutic phenomenology. While visiting nature was a spontaneous everyday activity for young participants, it meant a possibility to escape daily life filled with routines, demands, and social norms. Nature was experienced as multisensory via sight, hearing, touch, smell, and taste. Natural environments enabled not only shared experiences with friends and family but also positive experiences in solitude. The experiences were typically described by their psychological well-being benefits, especially increasing calmness, and improving mood or positive feelings. The findings highlight the importance of acknowledging the role of nature in adolescents’ leisure time experiences.