Aims: The few available studies on early-onset depression and future earnings offer ambiguous findings, and potential sources of heterogeneity are poorly understood. We examined the differences in adult earnings of males and females with and without a history of depressive disorder in adolescence, with specific focuses on (1) future earnings in clinical subtypes of adolescent depression; (2) the growth and distribution of earnings over time within these subgroups and (3) the mediating role of subsequent depressive episodes occurring in early adulthood. Methods: Data were drawn from the Uppsala Longitudinal Adolescent Depression Study, a community-based cohort study initiated in Uppsala, Sweden, in the early 1990s. Comprehensive diagnostic assessments were conducted at age 16–17 and in follow-up interviews 15 years later, while consecutive data on earnings for the years 1996 to 2016 (ages 20–40) were drawn from population-based registries. The current study included participants with a history of persistent depressive disorder (PDD) (n = 175), episodic major depressive disorder (MDD) (n = 82), subthreshold depression (n = 64) or no depression (n = 218) in adolescence. The association of adolescent depression with earnings in adulthood was analysed using generalised estimating equations. Estimates were adjusted for major child and adolescent psychiatric comorbidities and parental socioeconomic status. The indirect (mediated) effect of depression in early adulthood (ages 19–30) on earnings in mid-adulthood (31–40) was estimated in mediation analysis. The study followed the ‘STrengthening the Reporting of OBservational studies in Epidemiology’ (STROBE) guidelines. Results: Earnings across early to middle adulthood were lower for participants with a history of a PDD in adolescence than for their non-depressed peers, with an adjusted ratio of mean earnings of 0.85 (0.77–0.95) for females and 0.76 (0.60–0.95) for males. The differences were consistent over time, and more pronounced in the lower percentiles of the earnings distributions. The association was partially mediated by recurrent depression in early adulthood (48% in total; 61% for females, 29% for males). No reduction in earnings was observed among participants with episodic MDD in adolescence, while results for subthreshold depression were inconclusive. Conclusions: Our findings suggest that future earnings of adolescents with depressive disorders are contingent on the duration and natural long-term course of early-onset depression, emphasising the need for timely and effective interventions to avoid loss of human capital.

Background: Functional abdominal pain disorders (FAPDs) affect children, especially girls, all over the world. The evidence for existing treatments is mixed, and effective accessible treatments are needed. Dance, a rhythmic cardio‐respiratory activity, combined with yoga, which enhances relaxation and focus, may provide physiological and psychological benefits that could help to ease pain.Objectives: The aim of this study was to evaluate the effect of a dance and yoga intervention on maximum abdominal pain in 9‐ to 13‐year‐ old girls with FAPDs.Methods: This study was a prospective randomized controlled trial with 121 participants recruited from outpatient clinics as well as the general public. The intervention group participated in dance and yoga twice weekly for 8 months; controls received standard care. Abdominal pain, as scored on the Faces Pain Scale–Revised, was recorded in a pain diary. A linear mixed model was used to estimate the outcomes and effect sizes.Results: Dance and yoga were superior to standard health care alone, with a medium to high between‐group effect size and significantly greater pain reduction (b = −1.29, p = 0.002) at the end of the intervention.Conclusions: An intervention using dance and yoga is likely a feasible and beneficial complementary treatment to standard health care for 9‐ to 13‐year‐old girls with FAPDs.Significance: FAPDs affect children, especially girls, all over the world. The negative consequences such as absence from school, high consumption of medical care and depression pose a considerable burden on children and their families and effective treatments are needed. This is the first study examining a combined dance/yoga intervention for young girls with FAPDs and the result showed a reduction of abdominal pain. These findings contribute with new evidence in the field of managing FAPDs in a vulnerable target group.

Background Functional abdominal pain disorders (FAPDs) affect children worldwide, being more prevalent among girls. The individual and societal burdens of the disease are substantial, and evidence-based interventions are needed. Non-pharmacological treatments have generally produced promising results, with dance and yoga specifically having potential as an effective treatment option. Beside efficacy, the cost-effectiveness of interventions is important when prioritizing and allocating public resources. Objective This study evaluated the cost-effectiveness of an 8-month dance and yoga intervention for girls with functional abdominal pain or irritable bowel syndrome, based on a randomized control trial called ‘Just in TIME’. Methods The intervention, performed in Sweden, was studied using a decision analysis tool, i.e., a decision tree within the trial followed by a Markov model with a time horizon of 10 years. The base case considered healthcare costs as well as productivity losses, measuring the effects in gained quality-adjusted life-years (QALYs) and presenting an incremental cost-effectiveness ratio (ICER). Results The base case results show that the intervention, compared with current practice, was the dominant strategy from both the 12-month and long-term perspectives. The sensitivity analyses indicated that the long-term, but not the short-term, findings were robust for different assumptions and changes in parameter estimates, resulting in ICERs similar to those of the base case scenario. Conclusions Offering dance and yoga to young girls with FAPDs generates small QALY gains and monetary savings compared with standard healthcare and is likely cost-effective. These findings make a valuable contribution to an area where evidence-based and cost-effective treatment interventions are needed. Clinical Trials Registration Number ClinicalTrials.gov identifier: NCT02920268; Name: Just in TIME—Intervention With Dance and Yoga for Girls With Recurrent Abdominal Pain

Background: Functional abdominal pain disorders (FAPDs) affect many children worldwide, predominantly girls, and cause considerable long-term negative consequences for individuals and society. Evidence-based and cost-effective treatments are therefore strongly needed. Physical activity has shown promising effects in the practical management of FAPDs. Dance and yoga are both popular activities that have been shown to provide significant psychological and pain-related benefits with minimal risk. The activities complement each other, in that dance involves dynamic, rhythmic physical activity, while yoga enhances relaxation and focus. Objective: This study aims to evaluate the effects of a dance and yoga intervention among girls aged 9 to 13 years with FAPDs. Methods: The study is a prospective randomized controlled trial among girls aged 9 to 13 years with functional abdominal pain, irritable bowel syndrome, or both. The target sample size was 150 girls randomized into 2 arms: an intervention arm that receives dance and yoga sessions twice weekly for 8 months and a control arm that receives standard care. Outcomes will be measured at baseline and after 4, 8, 12, and 24 months, and long-term follow-up will be conducted 5 years from baseline. Questionnaires, interviews, and biomarker measures, such as cortisol in saliva and fecal microbiota, will be used. The primary outcome is the proportion of girls in each group with reduced pain, as measured by the faces pain scale-revised in a pain diary, immediately after the intervention. Secondary outcomes are gastrointestinal symptoms, general health, mental health, stress, and physical activity. The study also includes qualitative evaluations and health economic analyses. This study was approved by the Regional Ethical Review Board in Uppsala (No. 2016/082 1-2). Results: Data collection began in October 2016. The intervention has been performed in 3 periods from 2016 through 2019. The final 5-year follow-up is anticipated to be completed by fall 2023. Conclusions: Cost-effective and easily accessible interventions are warranted to reduce the negative consequences arising from FAPDs in young girls. Physical activity is an effective strategy, but intervention studies are needed to better understand what types of activities facilitate regular participation in this target group. The Just in TIME (Try, Identify, Move, and Enjoy) study will provide insights regarding the effectiveness of dance and yoga and is anticipated to contribute to the challenging work of reducing the burden of FAPDs for young girls.

Introduction: Same‐day discharge after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) is increasing, but the optimal anaesthetic technique for outpatient pathways remains uncertain. Neuraxial anaesthesia is widely recommended based on observational evidence, whereas fast‐track programmes using short‐acting total intravenous anaesthesia may facilitate early mobilisation and discharge. No randomised controlled trial has compared general anaesthesia (GA) with spinal anaesthesia (SA) specifically in outpatient primary THA/TKA using a same‐day discharge target. Methods and Analysis: GASPS is a pragmatic, multicentre, parallel‐group superiority randomised controlled trial. Adults scheduled for outpatient primary THA or TKA will be randomised 1:1 to GA or SA, with stratification by site and procedure (THA/TKA). The primary outcome is successful same‐day discharge (discharge on the day of surgery) without readmission within 48 h after discharge. The five key secondary outcomes are time to fulfilment of hospital discharge indicators, quality‐of‐recovery (QoR‐15) trajectories over postoperative Days 1–35, patients' qualitative experiences of anaesthesia and recovery, cost per quality‐adjusted life‐year and safety (adverse events); all remaining outcomes—including pain, postoperative nausea and vomiting, opioid consumption, mobilisation and patient‐reported outcomes (EQ‐5D‐5L and HOOS/KOOS)—are exploratory. An embedded qualitative study will explore patient experiences using semi‐structured interviews, and an economic evaluation will compare costs and outcomes from healthcare and societal perspectives. Analyses will follow the intention‐to‐treat principle; a group sequential design with O'Brien‐Fleming boundaries is planned for an interim analysis. Approval has been obtained from the Swedish Medical Products Agency. Written informed consent will be obtained from all participants. Results will be disseminated through peer‐reviewed publications, conference presentations and reporting in the EU Clinical Trials Information System (CTIS). Conclusion: This study is designed to determine the most effective anaesthetic method for same‐day discharge after primary TKA and THA. With increasing outpatient surgeries, this study will be helpful for optimisation of outpatient processes. Trial Registration: EU CT/CTIS: 2024‐520127‐89‐00. ClinicalTrials.gov : NCT07334132

To examine the inter-rater agreement between parent- and child-reported measures of somatic distress, gastrointestinal symptoms, mental health, and general health in girls aged 9–13 years with functional abdominal pain disorders (FAPDs). This secondary analysis used data from the Just in TIME randomized controlled trial, including girls aged 9–13 years with FAPDs. Both girls and their parents completed the Children’s Somatic Symptoms Inventory (gastrointestinal distress (CSSI-GI) and somatic distress (CSSI-nonGI) subscales) and answered questions about general health and mental health symptoms, measures at baseline and after 8 months. Agreement was assessed using intra-class correlation (ICC) and linear-weighted Cohen’s kappa. Data from 121 girls (mean age 10.6 years) and their parents were analysed. For CSSI-GI, mean scores were similar at baseline (girls 6.98, parents 7.27; ICC 0.84, p < .001) and follow-up (girls 4.25, parents 4.16; ICC 0.91, p < .001). For CSSI-nonGI, girls reported higher mean scores than parents at baseline (8.75 vs. 6.79; ICC 0.75, p < .001) and follow-up (7.14 vs. 5.43; ICC 0.78, p < .001). Agreement for general health was fair (kappa 0.31 at baseline, 0.41 at follow-up, both p < .001). For mental health symptoms, agreement ranged from slight to moderate (kappa 0.20–0.52 at baseline; 0.11–0.46 at follow-up, all significant). Conclusion : Findings indicated good parent– and child agreement for gastrointestinal and general somatic symptoms, but lower agreement for mental health and general health. Clinical trial registration: ClinicalTrials.gov, ID: NCT02920268, Name: Just in TIME–Intervention with Dance and Yoga for Girls with Recurrent Abdominal Pain, registered 29 September 2016. What is Known: • Parent reports are commonly used in paediatric assessment, but it is recommended that children’s perspectives should be integrated in clinical practice and research. • Discrepancies between child and parent reports are frequent and may influence assessment accuracy and treatment planning. What is New: • Parent–child agreement was higher for observable somatic symptoms, particularly gastrointestinal complaints, but lower for subjective experiences such as emotional states and perceived well-being. • Agreement for some items was higher at follow-up, suggesting potential gains in parental awareness or child–parent communication over time.