School Buses for Students Supporting Seniors (SBFSSS) is an intergenerational program which utilizes school buses to transport high school students to visit homebound seniors for engagement in common occupations. It addresses current issues of social isolation of aging in place seniors and age-segregation communication of cell phone using teens. / 2021-06-18T00:00:00Z

This study aimed to characterize and assess the subjective impact of the COVID- 19 pandemic on symptom severity and psychosocial experiences of youth with chronic tic disorders (CTD), obsessive-compulsive disorder (OCD), and co-occurring tic and OCD (Tics+OCD) through the use of Likert scales and validated measures. Children and adolescents aged 6 to 18 and their parents were asked to complete an online survey from July 2020 to April 2021. Overall, youth in the study reported negative pandemic-related impact on several domains, particularly after-school activities, relationships with friends, and family and community gatherings. Though limited by the small sample size of the group, youth with OCD appeared to report more negative impact compared to the other diagnostic subgroups. The median screen use for youth in this study was 3-8 hours a day; youth who reported >8 hours of screen time per day on weekends trended towards a 13x greater odds of depression compared to those with <8 hours per day although not statistically significant. If future public health emergencies were to ensue, supports aimed at helping these particularly vulnerable youth navigate the impact of those restrictions would be welcome and important to their mental health and general well-being.

Mental health problems are the leading causes of disability in Canada. Nearly 70% of mental health problems have their onset during childhood or adolescence. Thus, identifying modifiable determinants of mental health problems in children and adolescents can inform future interventions intended to prevent them in this age group. Until recently, research has examined relationships of movement behaviours, including sleep, sedentary behaviour and physical activity mainly with physical health indicators (e.g., adiposity, cardiovascular disease risk factors, etc.). The few studies that have examined the relationships between movement behaviours and mental health indicators have considered the former individually and in isolation of each other, ignoring the intrinsic and empirical interactions between these behaviours. Adjusting for all these behaviours in a traditional regression model that assumes independence between variables has been shown to produce flawed and inconsistent findings. The purpose of this doctoral dissertation is to examine how the combinations of physical activity, sedentary behaviour, and sleep duration are associated with depression and other mental health outcomes in children and adolescents, through a series of five research studies (one systematic review, 3 cross-sectional studies, and one longitudinal study). Empirical studies used data from 3 large and diverse samples of children and adolescents from Canada and the United States. Conventional regression models and structural equation modelling, and novel analytical techniques, including compositional data analysis were used to analyze the data. The systematic review confirmed the paucity of existing research in this area and identified important research gaps to be filled. Collectively, the results from cross-sectional studies showed that meeting all three recommendations was associated with lower odds of depressive symptoms and other mental health outcomes. However, this association appeared to be mainly driven by meeting the sleep duration recommendation, and to a lesser extent the screen time + sleep duration recommendations. There was a dose-response gradient from meeting none of the recommendations up to meeting two recommendations. Results from the longitudinal study using compositional data analysis provided further evidence suggesting that increasing sleep duration relative to the remaining behaviours (i.e. screen time and physical activity) was associated with lower depressive symptoms among all age/sex subgroups. Results further indicated that predicted changes in depressive symptoms were strongest and most beneficial when removing screen time while adding sleep duration. Finally, results from both cross-sectional and longitudinal analyses suggest that age and sex moderate the association between movement behaviour recommendations (individual or combined) and mental health indicators, depending on the type of movement behaviour and the type of mental health indicators. The findings from this body of work have shed new light on the association between movement behaviours and mental health indicators in children and adolescents by demonstrating that meeting all three movement behaviour recommendations is associated with better mental health, and that sleep duration and screen time were more strongly associated with mental health compared with physical activity in our studies.

Bakgrund: Användning av sociala medier är idag ett utbrett fenomen och har blivit en naturlig del i, framför allt, skolungdomars liv. Skolungdomar tillbringar mycket tid framför digitala medier för att vara online och en del av det sociala sammanhanget. Samtidigt pekar statistiken på en försämrad sömn hos skolungdomar. I skolan arbetar skolsköterskan hälsofrämjande och förebyggande för att eleverna ska ha hälsa och nå målen. Syftet var därför att undersöka vad skolungdomars sociala medievanor har för betydelse för sömnen. Metoden som användes för att besvara syftet var en integrativ litteraturöversikt med induktiv ansats. Datainsamlingen genomfördes i databaserna Cinahl och Pubmed. Resultatet består av tretton vetenskapliga artiklar. Vid analysarbetet kunde några teman och subteman urskiljas som beskrev sociala mediers påverkansfaktorer på sömnen. Dessa var förlorad nattro, en oro för utanförskap samt en upplevelse av distraktion. Skolungdomars strategier för att främja den goda sömnen visade sig vara reglerad tillgänglighet och att se fördelarna av sociala medier. Slutsats: Ett tydligt samband kan ses mellan användning av sociala medier och sömn. Skolungdomars användning av sociala medier påverkar sömnen främst negativt både utifrån fysiska och psykiska aspekter. Skolsköterskan behöver arbeta aktivt med denna problematik både på individ- och gruppnivå samt involvera vårdnadshavare i problematiken för att kunna bidra till att skolungdomar ska känna välbefinnande och nå skolans mål. / Background: The use of social media is today a widespread phenomen and has become a natural part of, above all, the lives of the adolescents. Adolescents spend a lot of time in front of digital media to be online and part of the social context. At the same time, the statistics point to a deterioration in sleep among adolescents. In school, the school nurse works with health promotion and prevention so that the students have health and achieve the goals. The purpose was therefore to investigate what school-adolescent’s social media habits mean for sleep. The method used to answer the purpose was an integrative literature review with an inductive approach. The data collection was carried out in the databases Cinahl och Pubmed. The result consists of thirteen scientific articles. In the analysis work, some themes and sub-themes could be distinguished that describe the influencing factors on sleep in social media. These were lost faith in the night, a worry about exclusion and an experience of distraction. School-adolescent strategies for promoting good sleep turned out to be regulated accessibility and seeing the benefits of social media. Conclusion: A clear connection can be seen between the use of social media and sleep. Adolescents use of social media has a negative effect on sleep, both in terms of both physical and mental aspects. The school nurse needs to work actively with this problem at both individual and group level involve guardians in the problem to be able to contribute to adolescents feeling well and achieving the school’s goals.

As virtual experiences are rapidly substituting a significant proportion of in-person interactions during the COVID pandemic, it is critical to monitor the effect of screen exposure time on developing children’s behavior and nervous system. Screen use boosts information accessibility and, therefore, may delay the development of the inhibitory control networks in children, who are vulnerable to immediate reward-orientated tendencies and not yet capable of controlling their impulsivity. Therefore, it was hypothesized that as children become more exposed to screens, the development of the inhibitory control network would be delayed and their reward sensitivity will be augmented. Using the ABCD Study Data Repository, 8,334 children’s behavioral and neural data (aged 9-11) were included. Robust mediation analysis and correlation analysis were used to investigate how Screen Time interacts with children’s reward-orientated tendency (e.g. Behavioral approach system, BAS) and the brain's inhibitory network. Intrinsic Frontoparietal Network-Striatum (FPN-Striatum) connectivity strength was used as neural indices of the inhibitory control quality in children. Results showed that Screen Time significantly mediated the relationship between BAS and both waves of the intrinsic inhibitory process. A higher BAS was linked to a longer Screen Time and weaker inhibitory network connectivity. This complete/full mediation model indicates that Screen Time negatively influenced the strength of FPN-Striatum connectivity. In conclusion, the study revealed specific behavioral and neural correlates of screen exposure using a large database, and suggested that increasing screen exposure time may impair the inhibitory capability and increase impulsivity in children. / M.S. / The current study explored the effect of daily screen exposure in pre-adolescent children to provide an important springboard for future work in protecting developing children against the negative impacts of screen use, which has increased significantly during the COVID-19 pandemic. Over 8,000 children’s data from the Adolescent Brain Cognitive Development (ABCD) project was included and found that an increased daily screen exposure time is linked to an inefficient inhibitory control system in the brain. As children’s inhibitory control systems are still developing, this negative effect further hinder the maturation of inhibitory-control systems two years later. Given that the virtual movement is irreversible, the results provide scientific evidence that a balance between screen time and non-screen activities is required for developing children.

Abstract Background: Prevalence of sleep disturbances, latency, and limited sleeping duration are highest during the adolescence phase. The possible cause is adoption of sedentary behavior that involves excessive screen time due to exposure to digital and electronic devices among adolescents. When the sleep quality is compromised it contributes to adverse health outcomes. Aim: The aim of this thesis is to explore the relationship between screen time and sleep quality among adolescents in Nordic countries Methods: The systematic literature review approach was considered in this research and a narrative synthesis was performed to determine whether there was a connection between screen time and sleep quality through the assessment of qualitative (n=4), quantitative (n=14), cross- sectional (n=9), and cohort (n=1) studies. A sample size of 28 articles was considered after the articles fulfilled the inclusion criterion standards. The population of the study comprised adolescents within the age bracket of 10 and 20 years in primary, high school, and university. The sleep quality outcomes that were measured include duration, latency, efficiency, and disturbances. Besides, the screen time outcomes that were measures are timing, type, and duration. Results: There is a significant association between sleep timing including daytime and nighttime use of digital and electronic devices with the sleep quality outcomes. Also, there is a positive relationship between duration of screen time and sleep quality outcomes among adolescents in Nordic countries. However, there was an insignificant relationship between type of digital devices either smartphone, tablet, computer, or television with the sleep quality outcomes of adolescents. 2Conclusions: The research outcomes showed that high screen time in regards to timing such as daytime and nighttime contributes to low quality sleep outcomes among adolescents in Nordic countries, but the type of devices is not important. There was significant evidence on prolonged screen time duration and low sleep quality. Insignificant relationships were found between the type of screen and screen time with sleep quality. Future researchers need to take a specific approach in regards to the topic by focusing on effects of high screen time on the sleep quality of adolescents. These findings might have positive implications in the public health context in consideration of increased digital devices across Nordic countries and the increased prevalence on low quality sleep among adolescents that is likely to increase their health risks. Keywords: Adolescents, screen time, sleep quality, Nordic region, Behavior, Health. / <p>This thesis uses a comprehensive literature review of 28 studies to investigate how screen time affects the quality of sleep that teenagers in Nordic countries get. Teenagers who use digital devices more often tend to have higher screen times, which contributes to their frequent sleep disruptions and poorer quality of sleep. In order to measure sleep length, latency, efficiency, and disruptions in connection to the timing, type, and duration of screen time, the study analysed qualitative, quantitative, cross-sectional, and cohort studies concentrating on teenagers aged 10 to 20. The results suggest that while the type of device used had no discernible effect, there are substantial connections between screen time—both during the day and at night—and poor sleep quality. These findings highlight the necessity for additional study on the relationship between screen time length and teenage sleep, which has significant ramifications for public health.</p>

Background: Children's screen usage has increased in recent years and parents' screen usage has strong association with children's screen usage. When the specialist nurse works based on family-centered nursing, conversations about screen usage can include the whole family. Purpose: To describe specialist nurses' experiences of working with children’s screen usage in Child Health Services.  Method: The study was conducted with qualitative design with inductive approach. Totally 11 specialist nurses in Child Health Services were interviewed. Qualitative content analysis according to Graneheim and Lundman (2004) was used to analyze that data material. Results: The analysis of the interview material collected led to two categories, dialogue and reflection and the challenges of screen usage.  Within these categories seven subcategories were identified. There was an opportunity to talk about children's screen usage in parental groups and health visits. Specialist nurses described that there were challenges depending on the parents' approaches to screen usage and that the screen competed with children's other activities. Conclusion: This study showed the importance of specialist nurses in child health services bringing up the topic of screen through dialogue and reflection with children and parents. Screen usage was described as a difficult subject and there were challenges in the work. / Bakgrund: Barns skärmanvändning har ökat de senaste åren och föräldrars skärmanvändning har starkt samband med barns skärmanvändning. När specialistsjuksköterskan arbetar utifrån familjecentrerad omvårdnad kan samtal om skärmanvändning inkludera hela familjen. Syfte: Att beskriva specialistsjuksköterskors erfarenheter av att arbeta med barns skärmanvändning inom barnhälsovården. Metod: Studien genomfördes med kvalitativ design med induktiv ansats. Totalt intervjuades 11 specialistsjuksköterskor inom barnhälsovården. Kvalitativ innehållsanalys enligt Graneheim och Lundman (2004) användes för att analysera datamaterialet. Resultat: Analysen av det insamlade intervjumaterialet ledde fram till två kategorier, dialog och reflektion samt skärmanvändningens utmaningar. Inom dessa kategorier identifierades sju subkategorier. Det fanns möjlighet att samtala om barns skärmanvändning i föräldragrupper och vid hälsobesök. Specialistsjuksköterskor beskrev att det fanns utmaningar beroende på föräldrars inställningar till skärmanvändning samt att skärmen konkurrerade med barns andra aktiviteter. Slutsats: Denna studie visade vikten av att specialistsjuksköterskor inom barnhälsovården tar upp ämnet skärmanvändning genom dialog och reflektion med barn och föräldrar. Skärmanvändning beskrevs som ett svårt ämne och att det fanns utmaningar i arbetet.

In the last decade, the use of digital devices such as television, smartphones, computers, laptops, and tablets has drastically increased. The development of technology has made it possible for the individual to be qickly stimulated and have information available at anytime and anywhere through various digital devices. This development has increased the screen time on these digital devices, which potentially can have psychological effects and influence attentional abilities. The aim of this study was therefore to investigate relationships between screen use in everyday life and different forms of attention (focused attention, devided attention, sustained attention, selective attention, motivated attention) in adults over 18 years of age. A questionnaire with questions about screen time and perceived attention in everyday life was sent out and answered online by total of 26 participants. A correlation analysis was performed on the collected data and the results showed no significant correlation between respective type of attention (including a measure of total attention) and screen time. Several factors may have influenced the results of this study, such as sample size, age group, choice of method, and that an objective measure of attention was not used.

Bakgrund: Skärmtid har ökat i samhället och även barn använder sig mycket av skärm såsom mobil, surfplattor och tv. Forskningen om hur barn påverkas av skärmar fortgår och visar på både positiva och negativa effekter. Barnhälsovårdssjuksköterskans [BHV-sjuksköterskans] uppdrag är att arbeta hälsofrämjande för barnet och stötta familjer till god hälsa. Syfte: Syftet var att undersöka BHV-sjuksköterskans erfarenheter av att samtala med föräldrar om barns hälsa i relation till skärmtid. Metod: Studien baserades på en kvalitativ metod där semistrukturerade intervjuer genomfördes med sju BHV-sjuksköterskor. Resultatet analyserades genom kvalitativ innehållsanalys. Resultat: Intervjuerna resulterade i två kategorier “Att vara ett stöd” och “Att samtala om ett svårt men viktigt ämne” och sex subkategorier “Att skapa en tillitsfull relation”, “Ge information och råd”, “Ge föräldrar stöd till egen reflektion”, “Betydelsen av kunskap”, “Betydelsen av att ha rutiner” och “Ett ökat behov av att samtala om skärmtid”. Diskussion: BHV-sjuksköterskan har en viktig stödjande roll för att främja barns hälsa relaterat till skärmtid. En tillitsfull relation med föräldrarna ligger till grund för att kunna ge bra stöd och rådgivning som kan leda till bättre hälsa för barnet. Flera deltagare upplevde svårigheter i samtalet på grund av föräldrars reaktioner samt brist på mer djupgående kunskap inom ämnet. Slutsats: BHV-sjuksköterskor behöver få mer djupgående kunskap i hur skärmtid påverkar barns hälsa och hur samtalet om skärmtid kan föras med föräldrar. Mer forskning behövs kring BHV-sjuksköterskans roll i att främja barns hälsa genom att stötta familjer till att ha ett hälsosamt förhållningssätt till skärmtid. / Background: Screen time has increased in society and even young children spend much time in front of screens such as mobile phones, tablets and televisions. New research on how children are affected by the screens is being made with both positive and negative effects. The task of the child health nurse is to promote and support families to achieve good health for the child. Aim: The aim was to investigate the experience of the child health nurse when talking to parents about their children’s health in relation to screen time. Method: The study was based on a qualitative method with semi-constructed interviews conducted with seven child health nurses. The results were analyzed with a qualitative content analysis. Results: Two categories “To be a support” and “To talk about a difficult but important subject” and six subcategories “To create a trustworthy relationship”, “To give information and advice”, “Parents support to their own reflections”, “The value of knowledge”, “The value of routines” and “An increased need to talk about screen time” was found. Discussion: The child health nurse has an important role when it comes to supporting and promoting the children’s health in relation to screen time. A trusting relationship with the parents is the foundation to fulfill this role. Several participants experienced difficulties in their conversations based on the parents' reactions and their own lack of deeper knowledge on the subject. Conclusion: Child health nurses need more knowledge in how screen time affects children's health and how to deal with this subject with parents in general. More research is needed on how the child health nurse work support families to promote children’s health in the relationship to screen time. / <p>Datum för godkännande: 2021-11-01.</p>

Tekniken utvecklas kontinuerligt och vår miljö har gradvis blivit mer digitaliserad med åren. Numera finns det således en ständig närvaro av olika digitala enheter i våra liv, såsom smartphonen. Syftet med forskningsstudien är att undersöka hur användarens beteendemönster vid användning av smartphones påverkas av ett svartvitt tema. För att svara på forskningsmålet valde författarna till studien att undersöka hur unga vuxnas spenderade tid på sina smartphones digitala skärmar påverkas av ett svartvitt tema, samt hur unga vuxna upplever den spenderade tiden på deras smartphones digitala skärmar när dessa är inställda på ett svartvitt tema. Litteraturstudien, som baserades på tidigare forskning om visualisering och digitalt beroende, gav en grund för att analysera, förklara och diskutera de insamlade empiriska data. Studien genomfördes med en mixad metod, där kvantitativa data som samlades in från sju deltagare analyserades med hjälp av det statistiska analysprogrammet SPSS; och kvalitativa data som samlades in genom individuella intervjuer med de sju deltagarna analyserades tematiskt. Resultaten visade att användarnas spenderade skärmtid på deras smartphones minskade när de ställdes in på ett svartvitt tema. Således har gråskalan en signifikant effekt på den spenderade skärmtiden. Dessutom visade resultaten att enheten inte var lika tilltalande och intressant för användarna. Gråskalan påverkade dessutom användarnas förmåga att koncentrera sig när de använde smartphone-enheten samt att användarnas koncentration blev svårare att underhålla, och navigeringen på skärmarna blev mer komplicerad. / The technology is under continuous development and our environment has gradually become more digitalized over the years. Nowadays, thus, there is a constant presence of various digital devices in our lives, such as the smartphone. The purpose of the research study is to investigate how user’s behavior patterns of the use of smartphones is affected by a black and white theme. To answer the research aim, the authors of the study chose to investigate how young adults' spent time on their smartphones’ digital screens is affected by a black and white theme, and how young adults experience the time spent on their smartphones’ digital screens when these are set on a black and white theme. The literature review, which was based on previous research on visualization and digital addiction, provided a basis for analyzing, explaining and discussing the collected empirical data. The study was conducted using a mixed methods approach, where quantitative data collected from seven participants were analyzed using the statistical analysis program SPSS; and qualitative data collected through individual interviews with the seven participants were analyzed thematically. The findings showed that the users’ spent screen time on their smartphones was reduced when it was turned into black and white theme. Thus, the gray scale has a significant effect on the spent screen time.  In addition, the findings showed that the device was not appealing and interesting for the users. Furthermore, the gray scale affected the ability of the users to concentrate, when using the smartphone device. Users’ concentration became more difficult to maintain, and the navigation on the screens became more complicated.