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Wångdahl, J., Lytsy, P., Mårtensson, L. & Westerling, R. (2018). Comprehensive health literacy is associated with experiences of the health examination for asylum seekers - A Swedish cross-sectional study. Paper presented at 1st World Congress on Migration, Ethnicity, Race and Health, 17-19 May 2018, Edinburgh.. European Journal of Public Health, 28, 136-136
Open this publication in new window or tab >>Comprehensive health literacy is associated with experiences of the health examination for asylum seekers - A Swedish cross-sectional study
2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 136-136Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-358417 (URN)10.1093/eurpub/cky048.075 (DOI)000432430700391 ()
Conference
1st World Congress on Migration, Ethnicity, Race and Health, 17-19 May 2018, Edinburgh.
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Zhou, B., Bentham, J., Di Cesare, M., Bixby, H., Danaei, G., Hajifathalian, K., . . . Cisneros, J. Z. (2018). Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants. International Journal of Epidemiology, 47(3), 872-883i
Open this publication in new window or tab >>Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1018 population-based measurement studies with 88.6 million participants
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2018 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 47, no 3, p. 872-883iArticle in journal (Refereed) Published
Abstract [en]

Background

Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure.

Methods

We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure.

Results

In 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association.

Conclusions

Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2018
Keywords
Blood pressure, hypertension, population health, global health, non-communicable disease
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-361286 (URN)10.1093/ije/dyy016 (DOI)000438342200023 ()29579276 (PubMedID)
Funder
Wellcome trust, 101506/Z/13/Z
Note

NCD Risk Factor Collaboration (NCD-RisC) Members are listed at the end of the paper

Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2018-11-15Bibliographically approved
Wångdahl, J., Westerling, R., Lytsy, P. & Mårtensson, L. (2018). Experiences of the health examination for asylum seekers - focus group discussions with Arabic and Somali speaking refugees in Sweden. European Journal of Public Health, 28, 135-136
Open this publication in new window or tab >>Experiences of the health examination for asylum seekers - focus group discussions with Arabic and Somali speaking refugees in Sweden
2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 135-136Article in journal, Meeting abstract (Other academic) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-358415 (URN)000432430700389 ()
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2018-08-31Bibliographically approved
Berglund, E., Westerling, R., Sundström, J. & Lytsy, P. (2018). Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment. BMC Medical Informatics and Decision Making, 18, Article ID 106.
Open this publication in new window or tab >>Length of time periods in treatment effect descriptions and willingness to initiate preventive therapy: a randomised survey experiment
2018 (English)In: BMC Medical Informatics and Decision Making, ISSN 1472-6947, E-ISSN 1472-6947, Vol. 18, article id 106Article in journal (Refereed) Published
Abstract [en]

Background Common measures used to describe preventive treatment effects today are proportional, i.e. they compare the proportions of events in relative or absolute terms, however they are not easily interpreted from the patient's perspective and different magnitudes do not seem to clearly discriminate between levels of effect presented to people. Methods In this randomised cross-sectional survey experiment, performed in a Swedish population-based sample (n=1041, response rate 58.6%), the respondents, aged between 40 and 75years were given information on a hypothetical preventive cardiovascular treatment. Respondents were randomised into groups in which the treatment was described as having the effect of delaying a heart attack for different periods of time (Delay of Event,DoE): 1month, 6months or 18months. Respondents were thereafter asked about their willingness to initiate such therapy, as well as questions about how they valued the proposed therapy. ResultsLonger DoE:s were associated with comparatively greater willingness to initiate treatment. The proportions accepting treatment were 81, 71 and 46% when postponement was 18months, 6months and 1month respectively. In adjusted binary logistic regression models the odds ratio for being willing to take therapy was 4.45 (95% CI 2.72-7.30) for a DoE of 6months, and 6.08 (95% CI 3.61-10.23) for a DoE of 18months compared with a DoE of 1month. Greater belief in the necessity of medical treatment increased the odds of being willing to initiate therapy. ConclusionsLay people's willingness to initiate preventive therapy was sensitive to the magnitude of the effect presented as DoE. The results indicate that DoE is a comprehensible effect measure, of potential value in shared clinical decision-making.

Place, publisher, year, edition, pages
BMC, 2018
Keywords
Medical decision-making, Risk communication, Risk perception, Necessity-concern framework
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-371868 (URN)10.1186/s12911-018-0662-2 (DOI)000450786000002 ()30458757 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Berglund, E., Anderzén, I., Andersén, Å., Carlsson, L., Gustavsson, C., Wallman, T. & Lytsy, P. (2018). Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 15(11), Article ID 2424.
Open this publication in new window or tab >>Multidisciplinary Intervention and Acceptance and Commitment Therapy for Return-to-Work and Increased Employability among Patients with Mental Illness and/or Chronic Pain: A Randomized Controlled Trial
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2018 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 11, article id 2424Article in journal (Refereed) Published
Abstract [en]

Background: People on long-term sick leave often have a long-lasting process back to work, where the individuals may be in multiple and recurrent states; i.e., receiving different social security benefits or working, and over time they may shift between these states. The purpose of this study was to evaluate the effects of two vocational rehabilitation programs, compared to a control, on return-to-work (RTW) or increased employability in patients on long-term sick leave due to mental illness and/or chronic pain. Methods: In this randomized controlled study, 427 women and men were allocated to either (1) multidisciplinary team management, i.e., multidisciplinary assessments and individual rehabilitation management, (2) acceptance and commitment therapy (ACT), or (3) control. A positive outcome was defined as RTW or increased employability. The outcome was considered negative if the (part-time) wage was reduced or ceased, or if there was an indication of decreased employability. The outcome was measured one year after entry in the project and analyzed using binary and multinomial logistic regressions. Results: Participants in the multidisciplinary team group reported having RTW odds ratio (OR) 3.31 (95% CI 1.39-7.87) compared to the control group in adjusted models. Participants in the ACT group reported having increased employability OR 3.22 (95% CI 1.13-9.15) compared to the control group in adjusted models. Conclusions: This study of vocational rehabilitation in mainly female patients on long-term sick leave due to mental illness and/or chronic pain suggests that multidisciplinary team assessments and individually adapted rehabilitation interventions increased RTW and employability. Solely receiving the ACT intervention also increased employability.

Keywords
return-to-work, vocational rehabilitation, multidisciplinary rehabilitation, chronic pain, mental illness, sick leave
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-372458 (URN)10.3390/ijerph15112424 (DOI)000451640500098 ()30384498 (PubMedID)
Funder
Swedish Social Insurance Agency
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Wångdahl, J., Lytsy, P., Mårtensson, L. & Westerling, R. (2018). Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study. International Journal of Public Health, 63(3), 409-419
Open this publication in new window or tab >>Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study
2018 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 63, no 3, p. 409-419Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives of the study were to explore the distributions of comprehensive health literacy (CHL), general health, psychological well-being and having refrained from seeking healthcare among refugees in Sweden. Further objectives were to examine associations between CHL and the above mentioned factors.

Methods: A cross-sectional study was conducted among 513 refugees speaking Arabic, Dari and Somali. Participants in the civic orientation course in Sweden responded to a questionnaire. CHL was measured using the HLS-EU-Q16 questionnaire. Uni- and multivariate logistic regression was used to investigate potential associations.

Results: The majority of the respondents had limited CHL, and about four of ten had reported poor health and/or having refrained from seeking healthcare. Limited CHL was associated with having reported poor health and having refrained from seeking healthcare. 

Conclusions: A considerable proportion of the refugees in Sweden have limited CHL, and report less than good health and impaired well-being, or that they have refrained from seeking healthcare. Further, CHL is associated with the above mentioned factors. Efforts are needed to promote refugees' CHL, optimal health seeking behavior, and health.

Keywords
health literacy, general health, psychological well-being, refrained from healthcare, refugees
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333397 (URN)10.1007/s00038-017-1074-2 (DOI)000428236500012 ()29480325 (PubMedID)
Note

The study was co-financed by the County Administrative Board in Stockholm.

Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-06-20Bibliographically approved
Andersén, Å., Larsson, K., Lytsy, P., Berglund, E., Kristiansson, P. & Anderzén, I. (2018). Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave: A Randomised Controlled Trial. Journal of occupational rehabilitation, 28(4), 691-700
Open this publication in new window or tab >>Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave: A Randomised Controlled Trial
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2018 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 28, no 4, p. 691-700Article in journal (Refereed) Published
Abstract [en]

Purpose To investigate the effects of two vocational rehabilitation interventions on self-efficacy, for women on long-term sick leave ≥ 1 year due to chronic pain and/or mental illness. Methods This study uses data from a randomised controlled trial consisting of two phases and comprising 401 women on long-term sick leave. They were allocated to either (1) a multidisciplinary team assessment and multimodal intervention (TEAM), (2) acceptance and commitment therapy (ACT), or (3) control group. Data were collected through repeated measurements from self-reported questionnaires before intervention, 6 and 12 months later and registry data. Data from measurements of general self-efficacy, sociodemographics, anxiety and depression were analysed with linear regression analyses. Results During the intervention period, the women in the TEAM group’s self-efficacy mean increased from 2.29 to 2.74. The adjusted linear regression model, which included group allocation, sociodemographics, self-efficacy pre-treatment, anxiety and depression showed increased self-efficacy for those in the TEAM intervention at 12 months (B = 0.25, 95% CI 0.10–0.41). ACT intervention had no effect on self-efficacy at 12 months (B = 0.02, 95% CI − 0.16 to 0.19). The results in the adjusted model also showed that higher self-efficacy at pre-treatment was associated with a higher level of self-efficacy at 12 months (B = 0.68, 95% CI 0.54–0.81). Conclusion A multidisciplinary team assessment and multimodal intervention increased self-efficacy in women on sick leave for an extremely long time (mean 7.8 years) who had a low mean level of self-efficacy prior to inclusion. Thus, self-efficacy needs to be addressed in vocational rehabilitation.

Keywords
Chronic pain, Mental illness, Multidisciplinary rehabilitation, Self-efficacy, Sick leave, Vocational rehabilitation, Women
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-339109 (URN)10.1007/s10926-017-9752-8 (DOI)000450856600011 ()29318421 (PubMedID)
Funder
Swedish Social Insurance AgencySwedish Association of Local Authorities and RegionsVårdal Foundation
Available from: 2018-01-16 Created: 2018-01-16 Last updated: 2019-01-22Bibliographically approved
Lytsy, P. (2017). Creating falseness - How to establish statistical evidence of the untrue. Journal of Evaluation In Clinical Practice, 23(5), 923-927
Open this publication in new window or tab >>Creating falseness - How to establish statistical evidence of the untrue
2017 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, no 5, p. 923-927Article in journal (Refereed) Published
Abstract [en]

Null hypothesis significance testing is the typical statistical approach in search of the truthfulness of hypotheses. This method does not formally consider the prior credence in the hypothesis, which affects the chances of reaching correct conclusions. When scientifically implausible or empirically weakly supported hypotheses are tested, there is an increased risk that a positive finding in a test in fact is false positive. This article argues that when scientifically weakly supported hypotheses are tested repeatedlysuch as when studying the clinical effects of homeopathythe accumulation of false positive study findings will risk providing false evidence also in systematic reviews and meta-analyses. False positive findings are detrimental to science and society, as once published, they accumulate persistent untrue evidence, which risks giving rise to nonpurposive research programmes, policy changes, and promotion of ineffective treatments. The problems with false positive findings are discussed, and advice is given on how to minimize the problem. The standard of evidence of a hypothesis should depend not only on the results of statistical analyses but also on its a priori support. Positive findings from studies investigating hypotheses with poor theoretical and empirical foundations should be viewed as tentative until the results are replicated and/or the hypothesis gains more empirical evidence supporting it as likely to be true.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
epidemiology, randomized controlled trials, statistics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-337086 (URN)10.1111/jep.12823 (DOI)000411864200003 ()28960726 (PubMedID)
Available from: 2018-01-31 Created: 2018-01-31 Last updated: 2018-01-31Bibliographically approved
Lytsy, P., Carlsson, L. & Anderzén, I. (2017). Effectiveness of two vocational rehabilitation programmes in women with long-term sick leave due to pain syndrome or mental illness: 1-year follow-up of a randomized controlled trial. Journal of Rehabilitation Medicine, 49(2), 170-177
Open this publication in new window or tab >>Effectiveness of two vocational rehabilitation programmes in women with long-term sick leave due to pain syndrome or mental illness: 1-year follow-up of a randomized controlled trial
2017 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 2, p. 170-177Article in journal (Refereed) Published
Abstract [en]

Objective: Mental illness and chronic pain are common reasons for long-term sick leave, typically more so for women. This study investigated the effects on return to work of 2 vocational rehabilitation programmes. Methods: In this randomized controlled study, 308 women were allocated to treatment with acceptance and commitment therapy, to multidisciplinary assessment and individualized rehabilitation interventions, or to a control group. Return-to-work at 12 months was assessed as: (i) returning to health insurance; (ii) number of reimbursed health insurance days during follow-up; (iii) self-reported change in working hours; (iv) a composite measure of self-reported change in work-related engagement. Results: The mean age of the Swedish study population was 48.5 years (standard deviation (SD) 6.3 years) and the mean time on sick leave 7.5 years (SD 3.2 years). There were no significant differences in reimbursed days or returning to the health insurance at 12 months. The multidisciplinary assessment and individualized rehabilitation interventions group, compared with control, reported a significant increase in working hours per week, as well as a significant increase in work-related engagement. Conclusion: Multidisciplinary assessments and individual rehabilitation interventions may improve the chance of return-to-work in women with long-term sick leave due to pain condition or mental illness.

Keywords
return to work, vocational rehabilitation, multidisciplinary rehabilitation, acceptance and commitment therapy, chronic pain
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:uu:diva-317212 (URN)10.2340/16501977-2188 (DOI)000396799000010 ()28101560 (PubMedID)
Funder
Swedish Social Insurance Agency
Available from: 2017-03-11 Created: 2017-03-11 Last updated: 2018-09-06Bibliographically approved
Wångdahl, J., Lytsy, P., Westerling, R. & Mårtensson, L. (2017). Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden. In: : . Paper presented at U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017.
Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-342969 (URN)
Conference
U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-02-23
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1949-6299

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