The aim was to develop and test a brief revised version of the family affluence scale. A total of 7120 students from Denmark, Greenland, Italy, Norway, Poland, Romania, Scotland and Slovakia reported on a list of 16 potential indicators of affluence. Responses were subject to item screening and test of dimensionality. Bifactor analysis revealed a strong general factor of affluence in all countries, but with additional specific factors in all countries. The specific factors mainly reflected overlapping item content. Item screening was conducted to eliminate items with low discrimination and local dependence, reducing the number of items from sixteen to six: Number of computers, number of cars, own bedroom, holidays abroad, dishwasher, and bathroom. The six-item version was estimated with Samejima's graded response model, and tested for differential item functioning by country. Three of the six items were invariant across countries, thus anchoring the scale to a common metric across countries. The six-item Child Ind Res (2016) 9:771-784

Objective To investigate associations of daily breakfast consumption (DBC) with demographic and lifestyle factors in 41 countries. Methods Design: Survey including nationally representative samples of 11–15 year olds (n = 204,534) (HBSC 2005–2006). Statistics: Multilevel logistic regression analyses Results DBC varied from 33 % (Greek girls) to 75 % (Portuguese boys). In most countries, lower DBC was noticed in girls, older adolescents, those with lower family affluence and those living in single-parent families. DBC was positively associated with healthy lifestyle behaviours and negatively with unhealthy lifestyle behaviours. Conclusion Breakfast skipping deserves attention in preventive programs. It is common among adolescents, especially girls, older adolescents and those from disadvantaged families. The results indicate that DBC can serve as an indicator to identify children at risk for unhealthy lifestyle behaviours.

This paper examines differences in life satisfaction among children in different family structures in 36 western, industrialised countries (n = 184 496). Children living with both biological parents reported higher levels of life satisfaction than children living with a single parent or parent-step-parent. Children in joint physical custody reported significantly higher levels of life satisfaction than their counterparts in other types of non-intact families. Controlling perceived family affluence, the difference between joint physical custody families and single mother or mother-stepfather families became non-significant. Difficulties in communicating with parents were strongly associated with less life satisfaction but did not mediate the relation between family structure and life satisfaction. Children in the Nordic countries characterised by strong welfare systems reported significantly higher levels of life satisfaction in all living arrangements except in single father households. Differences in economic inequality between countries moderated the association between certain family structures, perceived family affluence and life satisfaction. Ó

Breakfast is often considered the most important meal of the day and children and adolescents can benefit from breakfast consumption in several ways. The purpose of the present study was to describe trends in daily breakfast consumption (DBC) among adolescents across 31 countries participating in the HBSC survey between 2002 to 2010 and to identify socio-demographic (gender, family affluence and family structure) correlates of DBC. Cross-sectional surveys including nationally representative samples of 11–15 year olds (n = 455,391). Multilevel logistic regression analyses modeled DBC over time after adjusting for family affluence, family structure and year of survey. In all countries, children in two-parent families were more likely to report DBC compared to single parent families. In most countries (n = 19), DBC was associated with family affluence. Six countries showed an increase in DBC (Canada, Netherland, Macedonia, Scotland, Wales, England) from 2002. A significant decrease in DBC from 2002 was found in 11 countries (Belgium Fr, France, Germany, Croatia, Spain, Poland, Russian Federation, Ukraine, Latvia, Lithuania and Norway), while in 5 countries (Portugal, Denmark, Finland, Ireland, Sweden) no significant changes were seen. Frequency of DBC among adolescents in European countries and North America showed a more uniform pattern in 2010 as compared to patterns in 2002. DBC increased significantly in only six out of 19 countries from 2002 to 2010. There is need for continued education and campaigns to motivate adolescents to consume DBC. Comparing patterns across HBSC countries can make an important contribution to understanding regional /global trends and to monitoring strategies and development of health promotion programs.

Objectives. To describe the health care system and health care delivery in Greenland. Study design and method. This was a literature study that included literature and articles searched in PubMed published from 1989 to 2009 about health care in Greenland. Results. The health care system is a publicly financed governmental responsibility. Its major challenges are limited economic resources, Greenland's demographic structure, rapid epidemiological changes, increased public demand for specialized treatment, difficulty in recruiting professionals and the economic burden imposed by around-the-clock maintenance of specialized staff in sparsely populated areas. To meet these challenges, a public health program focusing on health promotion and prevention, educational initiatives to improve recruitment and a system reorientation moving towards larger health care regions is proposed to be gradually implemented from 2010. One fundamental component of this plan is tying the system together with a telemedicine system and in the future also with a joint electronic patient file system. The importance of better surveillance and monitoring of health has been recognized, while securing best clinical practice and implementing better steering instruments on resource allocation and quality are areas needing focus in the future. Conclusion. Many of the challenges for the Greenlandic health care system are being addressed with promising strategies, but only the future will show whether they are successful.