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Background: Sleep and Colic problems in infancy have been linked to adverse health outcome, but there is limited knowledge of the association between sleep and colic problems in infancy and subsequent development, emotional and behavior problems in young children. The aim of the present study was to examine whether there is an associations between infants’ crying and sleep problems at 6 months and behavioral and development problems at 18 months, 3 and 5 years Methods: A population-based longitudinal study, using data from the Norwegian Mother and Child Cohort Study conducted at the Norwegian Institute of Public Health from June 1999, to December 2008. A total of 86,724 children were included. Colic and sleep (sleep duration, nocturnal awakenings and easy to put to bed) was assessed by mother-reports. Z-scores were used to assess differences between groups of children (e.g. having colic or not, having a sleep problem or not). Emotional and behavioral problems were measured with items from the Child Behavior Checklist. Development problems were measured with items from The Ages and Stages Questionnaire. Results: Infants with colic scored significantly lower on development at 5 years (B=-0.10, CI [-0.14-; - 0.06]) and higher on internalizing problems both at 18 months (B=-0.06 .CI [-0.09-; - 0.03]) and 3 years (B=-0.05 .CI [0.08-; - 0.01]) than the reference population. Children who awoke frequently (≥ 3 times) and were more difficult to put to bed at 6 months scored significantly lower on development at 18 months and 3 and 5 years, and higher on internalizing behavior problems at 18 months and 3 years (B=0.18 and B=0.16), and children with shorter sleep duration (≤ 10 hours) at 6 months had more internalizing behavior problems at 18 months (B=-0.14. CI [0.07; - 0.02]) and 3 years (B=-0.15 .CI [0.05-; - 0.25]) than the reference population.Conclusions: Colic and disruptive sleep early in life are risk factors for development, emotional and behavioral problems within the first five years of a child’s life. It is important to be aware that disruptive sleep and colic in infancy may have long-term negative consequences.

Background Impaired sleep is common in menopausal women. The aim was to examine associations between uses of systemic menopausal hormone therapy (MHT) and sleep disturbance in a large population sample. Methods Female participants aged 45 to 75 years were selected from the Norwegian Health Study in Nord-Trøndelag (HUNT3, 2006–2008) (N = 13,060). Data were linked to the Norwegian Prescription Database, identifying use of prescribed MHT and use of sleep medication. Data were analyzed using multiple linear regression. Results In total, 996 women used systemic MHT (7.6%), with the highest prevalence of 10.3% among women 55 to 64 years of age. Despite high reports of frequent nocturnal awakening (24.7%) and high reports of hot flashes, use of MHT was low in this large population based survey. Although MHT use was associated with more sleep disturbance in unadjusted analyses, the association was not significant after adjusting for relevant covariates. Using sleep medication, reporting poor health, tobacco and alcohol use, doing daily exercise, having higher levels of anxiety, and being less satisfied with life were factors showing the strongest associations with sleep disturbance. Conclusion The lack of association between MHT and sleep disturbance suggests that other factors, such as self-perceived good health, a healthy lifestyle and anxiety/depression, are more relevant to sleep than MHT.

Adolescence is a sensitive period in life and a time to redefine and learn new skills. In Norway, school health services provide individual health-promoting consultations with all eighth-grade students. As an aid to support these consultations, a dialogue tool called SchoolHealth was developed using a co-creation approach. SchoolHealth consists of a web-based health information form designed to be completed by the students and generates individual feedback reports to help the school nurses to prepare for the consultation and tailor it to the individual student’s need. Our aims were to evaluate the feasibility and user experiences of SchoolHealth among students and school nurses using a mixed methods approach. A total of 79 eighth-grade students (69% of those invited) and four school nurses from three schools participated. Analyses indicated that SchoolHealth was feasible, promoted reflection among students, and helped prepare students and school nurses for the consultation.

Background: Having good Quality of Life (QoL) is essential, particularly for women after childbirth. However, little is known about the factors associated with maternal QoL after giving birth. We aimed to investigate the relationship between characteristics of the mother (socio-demographic variables), selected symptoms (depression and joy/anger), health perception (perception of birth) and possible characteristics of the environment (infant temperament, colic, sleep, parental relationship), with mothers’ overall quality of life when the child is six months of age.Methods: This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa), conducted at the Norwegian Institute of Public Health from June 1999 to December 2008, which included a total of 86,724 children. Maternal QoL was assessed by the Satisfaction With Life Scale. Joy and anger were measured using the Differential Emotional Scale, mothers’ mental health was assessed using the Edinburgh Postnatal Depression Scale and satisfaction with relationship was measured using the Relationship Satisfaction Scale. Child temperament was measured using the Infant Characteristics Questionnaire and colic, sleep duration and feelings related to childbirth were assessed by mothers’ reports. The associations between life satisfaction and selected variables were analysed using stepwise multiple linear regression models.Results: Maternal feelings of joy of having a baby (B=0.35, CI [0.79 to 0.83]), high relationship satisfaction (B= 0.02, CI [0.28 to 0.60]), as well as having a baby with normal sleep (B=0.32, CI [0.21 to 0.22]), are factors associated with higher maternal overall QoL. Postnatal depression was negatively associated with mothers’ QoL, and infant colic or child’s temperament (fussiness) showed no such association with mothers’ QoL.Conclusions: Health professionals and clinicians should focus on these issues when they develop health interventions or provide counselling to new mothers and their families.

Higher education students are considered to belong to a population susceptible to poor sleep health; however, there is a lack of broader evidence reviews. This systematic review aims to map out and categorize the existing literature related to higher education students and sleep. The present evidence map is based on a comprehensive systematic literature search of ten electronic databases, which resulted in 15,286 unique citations. After title/abstract, and full-text screening: 515 studies were included in the final map. Most of the studies were cross-sectional ( n = 357, 69%), while 77 (15%) studies assessed the effectiveness of an intervention. Sixty-eight (13%) studies followed a cohort prospectively over time, and 8 (2%) studies utilized a qualitative design. The most frequent outcome was the proportion of sleep problems, which was reported in 226 (44%) studies. Weekday sleep duration was reported in 156 (30%) studies. Results from this mapping process suggest that evidence about students` sleep health is emerging; however, the evidence base is mostly quantitative and descriptive, and there is a lack of sleep health programs designed for students.

Aims and objectives To gain a better understanding of school nurses’ perceptions of the challenges involved in implementing national guidelines on managing overweight and obesity in adolescents. Background National guidelines for the management of childhood overweight and obesity are developed in many countries to translate scientific knowledge into practice. However, several challenges are involved in their implementation. Design and methods A qualitative design with focus group interviews was chosen for data collection. Six focus group interviews with 21 school nurses were conducted. Data were analysed by qualitative content analyses. Results National guidelines provided new directions for managing overweight and obesity in school health services. School nurses were assigned new tasks and responsibilities, which they felt they were not sufficiently prepared for, nor were they supported by extra resources. Challenges in implementation of the guidelines were identified at various levels: system level (implementation strategy, available resources, training and support, professional collaboration, referral options); individual school nurse level (perceived competence, burden of responsibility, attitudes and emotions); subject level (sensitivity of weight-related issues); and professional level (scepticism to a body mass index cut-off of 25 kg/m2 as the starting point for intervention). Conclusions School nurses felt overwhelmed in terms of implementing the guidelines. This indicates barriers not being sufficiently identified or acted upon during implementation. Further, the nurses’ scepticism about the body mass index cut-off for intervention, and their experience that measuring and follow-up of adolescents’ weight development was their responsibility alone, indicates that important discussions are needed on this as an adequate measure as well as on the professional division of responsibilities. Relevance to clinical practice Having a proper strategy for implementation, and ensuring that necessary clinical structures and resources are available, is crucial. Including school nurses in developing and implementing such strategies is vital for success in implementing national guidelines.

Randi Andenæs,Sølvi Helseth,Nina Misvær,Milada C Småstuen,Lis Ribu Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway Objective: The aim of this study was to examine how neuroticism, stressful life events, self-rated health, life satisfaction, and selected lifestyle factors were related to insomnia both by sex and among users and nonusers of prescribed sleep medication (PSM).Design: Cross-sectional data from the Norwegian Nord-Trøndelag Health Study (HUNT3, 2006–2008), a population-based health survey, were linked to individual data from the Norwegian Prescription Database.Methods: Logistic regression analyses were used to investigate the associations between the selected variables and insomnia in both males and females and among subjects using and not using PSM. Individuals were considered to have a presumptive diagnosis of insomnia disorder if they reported difficulty with sleep initiation, sleep maintenance, or early morning awakening several days per week for the last 3months. PSMs were categorized as anxiolytics or hypnotics; the dose was estimated according to defined daily dose (DDD).Results: Of the total 50,805 participants, 6,701 (13.2%) used PSM. The proportions of PSM users were larger among elderly participants. Increased risk of insomnia was strongly associated with poor self-rated health and higher level of neuroticism. These associations were evident for both sexes and were similar among both users and nonusers of PSM. Low satisfaction with life was strongly related to insomnia, but only among nonusers of PSM. Increased doses of PSM were not associated with reduced likelihood of insomnia.Conclusion: Insomnia is a problem among both users and nonusers of PSM and is associated with psychosocial factors. Our findings suggest that successful treatment for sleep problems should take individual variation into account, such as age, sex, personality traits, satisfaction with life, and health perception. Keywords: prescription sleep medication, hypnotics, anxiolytics, insomnia, life satisfaction, self-rated health, neuroticism, sex, HUNT

Aim. The aim of this study is to explore and describe adolescents’ own perceptions of quality of life; what it is and what matters. Background. Quality of life has become an important concept in evaluating health care, in both child and adult populations. As nurses concerned with quality of life and well-being, it is important for us to identify the main factors that contribute to the promotion and sustenance of young people’s well-being. Design. A qualitative hermeneutic design was chosen. Method. The method was in-depth interviews with 31 healthy adolescents (14–15 years) in the school health service. The interviews were taped, transcribed and analysed as text according to Kvale’s three contexts of interpretation: self-understanding, critical common sense and theory. Results. According to the adolescents, quality of life is about the positive cycles of life. Feeling good, being satisfied with oneself and having an overall positive attitude are in most cases described as the starting points of a positive cycle. To get into and stay in the positive cycle, a positive self-image, good friends and good family relations are important. Consequently, adolescents’ quality of life is threatened when these factors are negative. Friends seem to be the most significant factor. It is extremely difficult to be without friends and none of the adolescents would admit that they were, not even to themselves, although it was rather obvious in some cases. Self-image and popularity are factors associated with the ability to get friends. Conclusions. Understanding the adolescents’ view of quality of life emphasises the importance of focusing on their psychosocial health and in particular their peer relations, to promote and sustain their quality of life. Relevance to clinical practice. Knowledge about the factors most significant to adolescents’ quality of life is applicable to all clinical settings where nurses meet adolescents; i.e., hospitals, outpatient clinics and school health services.

Background (i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses. Methods This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway. Results The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent. Conclusion Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum.