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  • 1.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Kylberg, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hofvander, Yngve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Gebre-Medhin, Meharigm
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Growth under privileged conditions of healthy Swedish infants exclusively breastfed from birth to 4-6 months:  a longitudinal prospective study based on daily records of feeding2003In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, no 2, p. 145-151Article in journal (Refereed)
    Abstract [en]

    Aim:

    In most studies the methodology used to study growth in relation to breastfeeding patterns cannot ensure that exclusive breastfeeding has in fact occurred since birth. The aim of this study was to investigate the growth of healthy infants in Sweden in whom exclusive breastfeeding for the first 4–6 mo was ascertained through daily feeding records and to compare the results with the World Health Organization (WHO) “12-month breastfed pooled data set” and the Euro-Growth references for exclusively breastfed infants, as well as with the National Center for Health Statistics (NCHS)/WHO reference.

    Methods:

    147 exclusively breastfed infants and 325 non-exclusively breastfed Swedish infants, with a birthweight of ≥3 kg, were included. The mothers had previous breastfed at least one infant for at least 4 mo. Weight was recorded fortnightly and length monthly.

    Results:

    Infants exclusively breastfed since birth showed similar growth in weight and height to that of the non-exclusively breastfed infants. During the first 6 mo of life the growth of exclusively breastfed infants was also similar to that of the infants regularly receiving formula at 12–16 wk of age, mostly in addition to breast milk. The monthly growth increments were fairly similar to those of the “WHO pooled breastfed data set” and the Euro-Growth references for exclusively breastfed infants.

    Conclusion:

    In an affluent society truly exclusively breastfed infants seem to have the same growth during the first half year of life as non-exclusively breastfed infants with a high breastfeeding rate.

  • 2.
    Aarts, Clara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Kylberg, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hornell, A
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Hofvander, Yngve
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Gebre-Medhin, Mehari
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Greiner, Ted
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data:  2000In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 29, no 6, p. 1041-1046Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is no accepted and widely used indicator for exclusive breastfeeding since birth. Indeed, the difference between 'current status' data on exclusive breastfeeding and data on 'exclusive breastfeeding since birth' is rarely recognized. We used data from a longitudinal study to examine this issue.

    METHODS:

    A descriptive longitudinal, prospective study design was used in which 506 mother-infant pairs were included. The mothers completed daily recordings on infant feeding during the first nine months after birth. A research assistant conducted fortnightly home visits with structured interviews. The resulting data on breastfeeding patterns are presented in two different ways: analysis of 'current status' data based on a single 24-hour recording of infant feeding at 2, 4 and 6 months of age, and analysis of data 'since birth', i.e. data on infant feeding for every day, starting from birth until the ages of 2, 4 and 6 months.

    RESULTS:

    A wide discrepancy between the results obtained from the two analyses was found. The difference in the exclusive breastfeeding rate was over 40 percentage points at both 2 and 4 months of age (92% versus 51% at 2 months and 73% versus 30% at 4 months) and 9 percentage points at 6 months (11% versus 1.8%).

    CONCLUSIONS:

    Current status indicators based on a 24-hour period may be inadequate and even misleading for many purposes. We propose that in many studies an indicator called 'exclusive breastfeeding since birth' could be added.

  • 3.
    Abdulla, Salim
    et al.
    Ifakara Hlth Inst, Dar Es Salaam, Tanzania..
    Ashley, Elizabeth A.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Fac Trop Med, Bangkok 10700, Thailand..
    Bassat, Quique
    Univ Barcelona, Ctr Invest Saude Manhica Manhica Mozamb & ISGloba, Barcelona Ctr Int Hlth Res CRESIB, Hosp Clin, Barcelona, Spain..
    Bethell, Delia
    AFRIMS, Dept Immunol & Med, Bangkok, Thailand..
    Bjorkman, Anders
    Karolinska Inst, Dept Microbiol Tumour & Cell Biol, Malaria Res, Stockholm, Sweden..
    Borrmann, Steffen
    Kenya Govt Med Res Ctr, Wellcome Trust Res Programme, Kilifi, Kenya.;Univ Magdeburg, Sch Med, D-39106 Magdeburg, Germany..
    D'Alessandro, Umberto
    Inst Trop Med, Unit Malariol, B-2000 Antwerp, Belgium.;MRC Unit, Fajara, Gambia..
    Dahal, Prabin
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;WorldWide Antimalarial Resistance Network WWARN, Oxford, England..
    Day, Nicholas P.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Fac Trop Med, Bangkok 10700, Thailand..
    Diakite, Mahamadou
    Univ Bamako, Malaria Res & Training Ctr, Bamako, Mali..
    Djimde, Abdoulaye A.
    Dondorp, Arjen M.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Fac Trop Med, Bangkok 10700, Thailand..
    Duong, Socheat
    Ctr Parasitol Entomol & Malaria Control, Phnom Penh, Cambodia..
    Edstein, Michael D.
    Fairhurst, Rick M.
    NIAID, Lab Malaria & Vector Res, NIH, Rockville, MD USA..
    Faiz, M. Abul
    Malaria Res Grp MRG & Dev Care Fdn, Dhaka, Bangladesh..
    Falade, Catherine
    Univ Ibadan, Coll Med, Ibadan, Nigeria..
    Flegg, Jennifer A.
    Monash Univ, Sch Math Sci, Clayton, Vic 3800, Australia..
    Fogg, Carole
    Univ Portsmouth, Portsmouth, Hants, England..
    Gonzalez, Raquel
    Ctr Invest Saude Manhica Manhica Mozamb, Barcelona, Spain.;CRESIB, Barcelona, Spain..
    Greenwood, Brian
    London Sch Hyg & Trop Med, Fac Infect & Trop Dis, London WC1, England..
    Guerin, Philippe J.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;WorldWide Antimalarial Resistance Network WWARN, Oxford, England..
    Guthmann, Jean-Paul
    Epicentre, Paris, France..
    Hamed, Kamal
    Novartis Pharmaceut, E Hanover, NJ USA..
    Hien, Tran Tinh
    Htut, Ye
    Dept Med Res, Lower Myanmar, Yangon, Myanmar..
    Juma, Elizabeth
    Kenya Govt Med Res Ctr, Nairobi, Kenya..
    Lim, Pharath
    NIAID, Lab Malaria & Vector Res, NIH, Rockville, MD USA.;US & Natl Ctr Parasitol Entomol & Malaria Control, Phnom Penh, Cambodia..
    Mårtensson, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Karolinska Inst, Dept Microbiol Cell & Tumour Biol, Dept Publ Hlth Sci, Malaria Res, Stockholm, Sweden..
    Mayxay, Mayfong
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahosot Hosp, Lao Oxford Mahosot Hosp, Wellcome Trust Res Unit LOMWRU, Viangchan, Laos.;Univ Hlth Sci, Fac Postgrad Studies, Viangchan, Laos..
    Mokuolu, Olugbenga A.
    Univ Ilorin, Dept Paediat & Child Hlth, Ilorin, Nigeria..
    Moreira, Clarissa
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;WorldWide Antimalarial Resistance Network WWARN, Oxford, England..
    Newton, Paul
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahosot Hosp, Lao Oxford Mahosot Hosp, Wellcome Trust Res Unit LOMWRU, Viangchan, Laos..
    Noedl, Harald
    Med Univ Vienna, Inst Specif Prophylaxis & Trop Med, Vienna, Austria..
    Nosten, Francois
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahidol Univ, Shoklo Malaria Res Unit, Mahidol Oxford Trop Med Res Unit, Fac Trop Med, Bangkok 10700, Thailand..
    Ogutu, Bernhards R.
    Kenya Govt Med Res Ctr, US Army Med Res Unit, Kisumu, Kenya..
    Onyamboko, Marie A.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Kinshasa Sch Publ Hlth, Kinshasa, DEM REP CONGO..
    Owusu-Agyei, Seth
    Kintampo Hlth Res Ctr, Kintampo, Ghana..
    Phyo, Aung Pyae
    Mahidol Univ, Shoklo Malaria Res Unit, Mahidol Oxford Trop Med Res Unit, Fac Trop Med, Bangkok 10700, Thailand..
    Premji, Zul
    Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania..
    Price, Ric N.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;WorldWide Antimalarial Resistance Network WWARN, Oxford, England.;Menzies Sch Hlth Res, Global & Trop Hlth Div, Darwin, NT, Australia.;Charles Darwin Univ, Darwin, NT 0909, Australia..
    Pukrittayakamee, Sasithon
    Mahidol Univ, Fac Trop Med, Bangkok 10700, Thailand..
    Ramharter, Michael
    Med Univ Vienna, Div Infect Dis & Trop Med, Dept Med 1, Vienna, Austria.;Univ Tubingen, Inst Tropenmed, Tubingen, Germany.;Ctr Rech Med Lambarene, Lambarene, Gabon..
    Sagara, Issaka
    Univ Bamako, Fac Med Pharm & Odontostomatol, Dept Epidemiol Parasit Dis, Malaria Res & Training Ctr, Bamako, Mali..
    Se, Youry
    AFRIMS, Phnom Penh, Cambodia..
    Suon, Seila
    Natl Ctr Parasitol Entomol & Malaria Control, Phnom Penh, Cambodia..
    Stepniewska, Kasia
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;WorldWide Antimalarial Resistance Network WWARN, Oxford, England..
    Ward, Stephen A.
    Univ Liverpool, Liverpool Sch Trop Med, Dept Parasitol, Liverpool L3 5QA, Merseyside, England..
    White, Nicholas J.
    Univ Oxford, Nuffield Dept Clin Med, Ctr Trop Med & Global Hlth, Oxford, England.;Mahidol Univ, Mahidol Oxford Trop Med Res Unit MORU, Fac Trop Med, Bangkok 10700, Thailand..
    Winstanley, Peter A.
    Univ Warwick, Warwick Med Sch, Coventry CV4 7AL, W Midlands, England..
    Baseline data of parasite clearance in patients with falciparum malaria treated with an artemisinin derivative: an individual patient data meta-analysis2015In: Malaria Journal, ISSN 1475-2875, E-ISSN 1475-2875, Vol. 14, article id 359Article in journal (Refereed)
    Abstract [en]

    Background: Artemisinin resistance in Plasmodium falciparum manifests as slow parasite clearance but this measure is also influenced by host immunity, initial parasite biomass and partner drug efficacy. This study collated data from clinical trials of artemisinin derivatives in falciparum malaria with frequent parasite counts to provide reference parasite clearance estimates stratified by location, treatment and time, to examine host factors affecting parasite clearance, and to assess the relationships between parasite clearance and risk of recrudescence during follow-up. Methods: Data from 24 studies, conducted from 1996 to 2013, with frequent parasite counts were pooled. Parasite clearance half-life (PC1/2) was estimated using the WWARN Parasite Clearance Estimator. Random effects regression models accounting for study and site heterogeneity were used to explore factors affecting PC1/2 and risk of recrudescence within areas with reported delayed parasite clearance (western Cambodia, western Thailand after 2000, southern Vietnam, southern Myanmar) and in all other areas where parasite populations are artemisinin sensitive. Results: PC1/2 was estimated in 6975 patients, 3288 of whom also had treatment outcomes evaluate d during 28-63 days follow-up, with 93 (2.8 %) PCR-confirmed recrudescences. In areas with artemisinin-sensitive parasites, the median PC1/2 following three-day artesunate treatment (4 mg/kg/day) ranged from 1.8 to 3.0 h and the proportion of patients with PC1/2 > 5 h from 0 to 10 %. Artesunate doses of 4 mg/kg/day decreased PC1/2 by 8.1 % (95 % CI 3.2-12.6) compared to 2 mg/kg/day, except in populations with delayed parasite clearance. PC1/2 was longer in children and in patients with fever or anaemia at enrolment. Long PC1/2 (HR = 2.91, 95 % CI 1.95-4.34 for twofold increase, p < 0.001) and high initial parasitaemia (HR = 2.23, 95 % CI 1.44-3.45 for tenfold increase, p < 0.001) were associated independently with an increased risk of recrudescence. In western Cambodia, the region with the highest prevalence of artemisinin resistance, there was no evidence for increasing PC1/2 since 2007. Conclusions: Several factors affect PC1/2. As substantial heterogeneity in parasite clearance exists between locations, early detection of artemisinin resistance requires reference PC1/2 data. Studies with frequent parasite count measurements to characterize PC1/2 should be encouraged. In western Cambodia, where PC1/2 values are longest, there is no evidence for recent emergence of higher levels of artemisinin resistance.

  • 4.
    Abeid, Muzdalifat
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania .
    Muganyizi, Projestine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania .
    Massawe, Siriel
    Department of Obstetrics/Gynecology, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
    Mpembeni, Rose
    Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Axemo, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway .
    Knowledge and attitude towards rape and child sexual abuse - a community-based cross-sectional study in Rural Tanzania2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 1, article id 428Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Violence against women and children is globally recognized as a social and human rights concern. In Tanzania, sexual violence towards women and children is a public health problem. The aim of this study was to determine community knowledge of and attitudes towards rape and child sexual abuse, and assess associations between knowledge and attitudes and socio-demographic characteristics.

    METHODS: A cross-sectional study was undertaken between May and June 2012. The study was conducted in the Kilombero and Ulanga rural districts in the Morogoro Region of Tanzania. Men and women aged 18-49 years were eligible for the study. Through a three-stage cluster sampling strategy, a household survey was conducted using a structured questionnaire. The questionnaire included socio-demographic characteristics, attitudes about gender roles and violence, and knowledge on health consequences of rape. Data were analyzed using the Statistical Package for Social Sciences (SPSS) software, version 21. Main outcome measures were knowledge of and attitudes towards sexual violence. Multivariate analyses were used to assess associations between socio-demographic characteristics and knowledge of and attitudes towards sexual violence.

    RESULTS: A total of 1,568 participants were interviewed. The majority (58.4%) of participants were women. Most (58.3%) of the women respondents had poor knowledge on sexual violence and 63.8% had accepting attitudes towards sexual violence. Those who were married were significantly more likely to have good knowledge on sexual violence compared to the divorced/separated group (AOR = 1.6 (95% CI: 1.1-2.2)) but less likely to have non-accepting attitudes towards sexual violence compared to the single group (AOR = 1.8 (95%CI: 1.4-2.3)). Sex of respondents, age, marital status and level of education were associated with knowledge and attitudes towards sexual violence.

    CONCLUSIONS: Our study showed that these rural communities have poor knowledge on sexual violence and have accepting attitudes towards sexual violence. Increasing age and higher education were associated with better knowledge and less accepting attitudes towards sexual violence. The findings have potentially important implications for interventions aimed at preventing violence. The results highlight the challenges associated with changing attitudes towards sexual violence, particularly as the highest levels of support for such violence were found among women.

  • 5.
    Abuelgasim, Khalda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
     “Who do I turn to?” The experiences of Sudanese women and Eritrean refugee women when trying to access healthcare services in Sudan after being subject to gender-based violence2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aim: To explore the experiences of Sudanese women and Eritrean refugee women in Sudan when seeking healthcare after being subject to gender-based violence.

    Background: In Sudan there is a general assumption that anyone who is subject violence, including gender-based violence, must first go to the police department to file a report and be given “Form Eight”, a legal document, which they must present to the healthcare provider before they receive any care. Without this form healthcare providers are, supposedly, by law not allowed to treat the person. This complicates an already vague system of services for women subject to gender-based violence.

    Methods: A qualitative study using semi-structured interviews of eight Sudanese women and seven Eritrean refugee women. Data was analyzed through a framework analysis (a form of thematic analysis).

    Results: Women had to bring Form Eight before they received any help, this led to a delay in the time to receive care. There was a general lack of cooperation by police officers. Some women feared the consequences of help seeking, apparent amongst those subject to domestic violence and the Eritrean refugee women. Generally, the healthcare provided to these women was inadequate.

    Conclusion: This study concludes the experiences of all the women in this study when seeking healthcare after being subject to gender-based violence were far from international standards. A lot needs to be done in order for women to know the clear answer to the question posed in the title of this study; “Who do I turn to?”.

  • 6.
    Accordini, Simone
    et al.
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Calciano, Lucia
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Johannessen, Ane
    Univ Bergen, Dept Global Publ Hlth & Primary Care, Ctr Int Hlth, Bergen, Norway.
    Portas, Laura
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Benediktsdottir, Bryndis
    Univ Iceland, Fac Med, Reykjavik, Iceland.
    Bertelsen, Randi Jacobsen
    Univ Bergen, Dept Clin Sci, Bergen, Norway;Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Braback, Lennart
    Umea Univ, Dept Publ Hlth & Clin Med, Div Occupat & Environm Med, Umea, Sweden.
    Carsin, Anne-Elie
    Ctr Res Environm Epidemiol CREAL, ISGlobal, Barcelona, Spain;UPF, Barcelona, Spain;CIBER Epidemiol & Salud PUbl CIBERESP, Barcelona, Spain.
    Dharmage, Shyamali C.
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy;Univ Melbourne, Sch Populat & Global Hlth, Melbourne, Vic, Australia.
    Dratva, Julia
    ZHAW Sch Hlth Profess, Inst Hlth Sci, Winterthur, Switzerland;Basel Univ, Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.
    Forsberg, Bertil
    Umea Univ, Dept Publ Hlth & Clin Med, Div Occupat & Environm Med, Umea, Sweden.
    Real, Francisco Gomez
    Univ Bergen, Dept Clin Sci, Bergen, Norway.
    Heinrich, Joachim
    Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Inner City Clin, Inst & Outpatient Clin Occupat,Social & Environm, Munich, Germany.
    Holloway, John W.
    Univ Southampton, Fac Med, Human Dev & Hlth, Southampton, Hants, England.
    Holm, Mathias
    Univ Gothenburg, Sahlgrenska Acad, Dept Occupat & Environm Med, Gothenburg, Sweden.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Jogi, Rain
    Tartu Univ Hosp, Lung Clin, Tartu, Estonia.
    Leynaert, Benedicte
    INSERM, Pathophysiol & Epidemiol Resp Dis, UMR 1152, Paris, France.
    Malinovschi, Andrei
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Marcon, Alessandro
    Univ Verona, Dept Diagnost & Publ Hlth, Unit Epidemiol & Med Stat, Verona, Italy.
    Martinez-Moratalla Rovira, Jesus
    CHUA, Hlth Serv Castilla La Mancha SESCAM, Pneumol Serv, Albacete, Spain;Univ Castilla La Mancha, Sch Med, Albacete, Spain.
    Raherison, Chantal
    Bordeaux Univ, INSERM, U1219, Bordeaux, France.
    Luis Sanchez-Ramos, Jose
    Univ Huelva, Dept Nursing, Huelva, Spain.
    Schlunssen, Vivi
    Aarhus Univ, Dept Publ Hlth, Aarhus, Denmark;Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Bono, Roberto
    Univ Turin, Dept Publ Hlth & Pediat, Turin, Italy.
    Corsico, Angelo G.
    Univ Pavia, IRCCS San Matteo Hosp Fdn, Div Resp Dis, Pavia, Italy.
    Demoly, Pascal
    Univ Montpellier, Hop Arnaud Villeneuve, Dept Pneumol & Addictol, Montpellier, France;Sorbonne Univ, INSERM, IPLESP, Paris, France.
    Dorado Arenas, Sandra
    Galdakao Usansolo Hosp, Pulmonol Dept, Biscay, Spain.
    Nowak, Dennis
    Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Inner City Clin, Inst & Outpatient Clin Occupat,Social & Environm, Munich, Germany;Comprehens Pneumol Ctr Munich, German Ctr Lung Res, Munich, Germany.
    Pin, Isabelle
    CHU Grenoble Alpes, Pediat, Grenoble, France;Inst Adv Biosci, INSERM 1209, Grenoble, France;Univ Grenoble Alpes, Grenoble, France.
    Weyler, Joost
    Univ Antwerp, Dept Epidemiol & Social Med, Antwerp, Belgium;Univ Antwerp, StatUA Stat Ctr, Antwerp, Belgium.
    Jarvis, Deborah
    Imperial Coll, Natl Heart & Lung Inst, Populat Hlth & Occupat Dis, London, England;Imperial Coll, MRC PHE Ctr Environm & Hlth, London, England.
    Svanes, Cecilie
    Univ Bergen, Dept Global Publ Hlth & Primary Care, Ctr Int Hlth, Bergen, Norway;Haukeland Hosp, Dept Occupat Med, Bergen, Norway.
    Ageing, Lungs European Cohorts A. L. E. C. Study
    A three-generation study on the association of tobacco smoking with asthma2018In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 47, no 4, p. 1106-1117Article in journal (Refereed)
    Abstract [en]

    Background: Mothers' smoking during pregnancy increases asthma risk in their offspring. There is some evidence that grandmothers' smoking may have a similar effect, and biological plausibility that fathers' smoking during adolescence may influence offspring's health through transmittable epigenetic changes in sperm precursor cells. We evaluated the three-generation associations of tobacco smoking with asthma. Methods: Between 2010 and 2013, at the European Community Respiratory Health Survey III clinical interview, 2233 mothers and 1964 fathers from 26 centres reported whether their offspring (aged <= 51 years) had ever had asthma and whether it had coexisted with nasal allergies or not. Mothers and fathers also provided information on their parents' (grandparents) and their own asthma, education and smoking history. Multilevel mediation models within a multicentre three-generation framework were fitted separately within the maternal (4666 offspring) and paternal (4192 offspring) lines. Results: Fathers' smoking before they were 15 [relative risk ratio (RRR) = 1.43, 95% confidence interval (CI): 1.01-2.01] and mothers' smoking during pregnancy (RRR = 1.27, 95% CI: 1.01-1.59) were associated with asthma without nasal allergies in their offspring. Grandmothers' smoking during pregnancy was associated with asthma in their daughters [odds ratio (OR) = 1.55, 95% CI: 1.17-2.06] and with asthma with nasal allergies in their grandchildren within the maternal line (RRR = 1.25, 95% CI: 1.02-1.55). Conclusions: Fathers' smoking during early adolescence and grandmothers' and mothers' smoking during pregnancy may independently increase asthma risk in offspring. Thus, risk factors for asthma should be sought in both parents and before conception.

  • 7.
    Adamsson, Viola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    A Healthy Nordic Diet and Cardiometabolic Risk Factors: Intervention Studies with Special Emphasis on Plasma Lipoproteins2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A healthy diet is important in the prevention of cardiovascular disease (CVD). Several risk factors, modifiable by diet, are involved in the development of CVD, e.g. hyperlipidaemia, hyperglycaemia, insulin resistance, obesity and hypertension. Little data however exist on diets composed of foods originating from the Nordic countries, and their potential to reduce CVD risk.

    This thesis aimed to investigate whether an ad libitum healthy Nordic diet (ND), either provided as a whole diet, or as a prudent breakfast (PB) alone, could influence CVD risk factors in healthy, mildly hypercholesterolemic men and women. Another aim was to describe the nutrient and food composition of the ND, both by using self-reported data and serum biomarkers of dietary fat quality.

    The primary clinical outcome measure was LDL-cholesterol, and other cardiometabolic risk factors were secondary outcomes.

    Two parallel, randomised, controlled intervention studies were conducted in free-living subjects. Clinical and dietary assessments were performed at baseline and at the end of dietary interventions. All foods were provided to subjects randomised to ND, whereas only breakfast items were supplied to subjects randomised to PB. Control groups followed their habitual diet/breakfast.

    Compared with controls, ND reduced body weight and improved several CVD risk factors including LDL-cholesterol, insulin sensitivity and blood pressure. Several, but not all effects were probably partly mediated by diet-induced weight loss. ND accorded with Nordic nutrition recommendations and was defined as “a plant-based diet, where animal products are used sparingly as side dishes”. Compared with average Swedish diet, ND was high in dietary fibre, but low in sodium, meat, high-fat dairy products, sweets and alcohol. A decreased intake of saturated fat and increased intake of n-3 PUFA during ND was partly reflected in serum lipids. Eating a PB without other dietary changes did not improve lipid or glucose metabolism, but decreased markers of visceral fat and inflammation, without influencing body weight.

    This thesis suggests that a whole ND, but not PB alone, promotes weight loss and improves multiple CVD risk factors in healthy subjects after 6 weeks. These results suggest that ND could have a potential role in the prevention of cardiometabolic diseases.

    List of papers
    1. Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET)
    Open this publication in new window or tab >>Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET)
    Show others...
    2011 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 269, no 2, p. 150-159Article in journal (Refereed) Published
    Abstract [en]

    Objective. The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on cardiovascular risk factors. Design and subjects. In a randomized controlled trial (NORDIET) conducted in Sweden, 88 mildly hypercholesterolaemic subjects were randomly assigned to an ad libitum ND or control diet (subjects' usual Western diet) for 6 weeks. Participants in the ND group were provided with all meals and foods. Primary outcome measurements were low-density lipoprotein (LDL) cholesterol, and secondary outcomes were blood pressure (BP) and insulin sensitivity (fasting insulin and homeostatic model assessment-insulin resistance). The ND was rich in high-fibre plant foods, fruits, berries, vegetables, whole grains, rapeseed oil, nuts, fish and low-fat milk products, but low in salt, added sugars and saturated fats. Results. The ND contained 27%, 52%, 19% and 2% of energy from fat, carbohydrate, protein and alcohol, respectively. In total, 86 of 88 subjects randomly assigned to diet completed the study. Compared with controls, there was a decrease in plasma cholesterol (-16%, P < 0.001), LDL cholesterol (-21%, P < 0.001), high-density lipoprotein (HDL) cholesterol (-5%, P < 0.01), LDL/HDL (-14%, P < 0.01) and apolipoprotein (apo)B/apoA1 (-1%, P < 0.05) in the ND group. The ND reduced insulin (-9%, P = 0.01) and systolic BP by -6.6 +/- 13.2 mmHg (-5%, P < 0.05) compared with the control diet. Despite the ad libitum nature of the ND, body weight decreased after 6 weeks in the ND compared with the control group (-4%, P < 0.001). After adjustment for weight change, the significant differences between groups remained for blood lipids, but not for insulin sensitivity or BP. There were no significant differences in diastolic BP or triglyceride or glucose concentrations. Conclusions. A healthy ND improves blood lipid profile and insulin sensitivity and lowers blood pressure at clinically relevant levels in hypercholesterolaemic subjects.

    Keywords
    cardiovascular risk factors, cholesterol, diet, Nordic foods, nutrition
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-146074 (URN)10.1111/j.1365-2796.2010.02290.x (DOI)000286110100004 ()20964740 (PubMedID)
    Available from: 2011-02-15 Created: 2011-02-15 Last updated: 2017-12-11Bibliographically approved
    2. What is a healthy Nordic diet?: Foods and nutrients in the NORDIET study
    Open this publication in new window or tab >>What is a healthy Nordic diet?: Foods and nutrients in the NORDIET study
    Show others...
    2012 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 56, p. 18189-Article in journal (Refereed) Published
    Abstract [en]

    Background: A healthy Nordic diet (ND), a diet based on foods originating from the Nordic countries, improves blood lipid profile and insulin sensitivity and lowers blood pressure and body weight in hypercholesterolemic subjects. Objective: To describe and compare food and nutrient composition of the ND in relation to the intake of a Swedish reference population (SRP) and the recommended intake (RI) and average requirement (AR), as described by the Nordic nutrition recommendations (NNR). Design: The analyses were based on an estimate of actual food and nutrient intake of 44 men and women (mean age 53 +/- 8 years, BMI 26 +/- 3), representing an intervention arm receiving ND for 6 weeks. Results: The main difference between ND and SRP was the higher intake of plant foods, fish, egg and vegetable fat and a lower intake of meat products, dairy products, sweets and desserts and alcoholic beverages during ND (p<0.001 for all food groups). Intake of cereals and seeds was similar between ND and SRP (p>0.3). The relative intake of protein, fat and carbohydrates during ND was in accordance with RI. Intake of all vitamins and minerals was above AR, whereas sodium intake was below RI. Conclusions: When compared with the food intake of an SRP, ND is primarily a plant-based diet. ND represents a balanced food intake that meets the current RI and AR of NNR 2004 and has a dietary pattern that is associated with decreased morbidity and mortality.

    Keywords
    Nordic foods, nutrient intake, food intake, Swedish reference population, Nordic nutrition recommendations
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-200134 (URN)10.3402/fnr.v56i0.18189 (DOI)000317128500001 ()
    Available from: 2013-05-21 Created: 2013-05-20 Last updated: 2018-02-22Bibliographically approved
    3. Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins: results from the NORDIET study
    Open this publication in new window or tab >>Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins: results from the NORDIET study
    2014 (English)In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 24114-Article in journal (Other academic) Published
    Abstract [en]

    Background: The fatty acid (FA) composition of serum lipids is related to the quality of dietary fat. The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on the FA composition of serum cholesterol esters (CE-FA) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention.

    Methods: The NORDIET trial was a six-week randomised, controlled, parallel-group dietary intervention study that included 86 adults (53±8 years) with elevated low-density lipoprotein cholesterol LDL-C. Serum CE-FA composition was measured using gas chromatography. Diet history interviews were conducted, and daily intake was assessed using checklists.

    Results: Food and nutrient intake data indicated that there was a reduction in the fat intake from dairy and meat products and an increase in the consumption of fatty fish with the ND, decreasing the levels of saturated fatty acids (SFA) in the diet, slightly decreasing the levels of monounsaturated fatty acids (MUFA) and moderately increasing the levels of polyunsaturated fatty acids (PUFA). Concomitantly, the levels of CE-SFA 14:0, 15:0 and 18:0, but not 16:0, decreased during the ND, and these changes differed from those observed in the control diet group (p<0.01). In contrast, serum 22:6n-3 increased during the ND compared with the control diet (p<0.01). The changes in CE-SFA 14:0, 15:0 and 18:0 during the intervention correlated positively with those in LDL-C, HDL-C, LDL-C/HDL-C, ApoA1 and ApoB (p<0.01), whereas the changes in CE-PUFA 22:6n-3 were negatively correlated with changes in the corresponding serum lipids.

    Conclusions: The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy Nordic diet are partly reflected by changes in the serum CE-FA composition, which are associated with an improved serum lipoprotein pattern.

    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-211868 (URN)10.3402/fnr.v58.24114 (DOI)000345968000001 ()25476792 (PubMedID)
    Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2018-02-22Bibliographically approved
    4. Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial
    Open this publication in new window or tab >>Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trial
    (English)Article in journal (Other academic) Submitted
    Abstract [en]

    Background & Aims: It is unclear whether advising a prudent breakfast alone is sufficient to improve blood lipids and cardiometabolic risk factors in overweight hypercholesterolemic subjects.

    Methods: The aim of the present study was to investigate whether a prudent low-fat breakfast (PB) rich in dietary fiber lowers low-density lipoprotein cholesterol (LDL-C) and other cardiometabolic risk factors in subjects with elevated LDL-cholesterol levels. In a parallel, controlled, 12-week study, 79 healthy overweight subjects (all regular breakfast eaters) were randomly allocated to a group that received a PB based on Nordic foods provided ad libitum or a control group that consumed their usual breakfast. The PB was in accordance with national and Nordic nutrition recommendations and included oat bran porridge with low-fat milk or yogurt, bilberry or lingonberry jam, whole grain bread, low-fat spread, poultry or fatty fish, and fruit.

    Results: No differences were found in LDL-C, blood lipids, body weight, or glucose metabolism, but SAD, plasma CRP, and TNF-R2 were lower during PB compared with controls (p<0.05). In the overall diet, PB increased dietary fiber and b-glucan compared with controls (p<0.05).

    Conclusions: Advising a prudent breakfast for 3 months did not influence blood lipids, body weight, or glucose metabolism but reduced markers of visceral fat and inflammation.

     

    Keywords
    Prudent breakfast, LDL-cholesterol, cardiometabolic risk factors, Nordic diet, inflammation, visceral fat
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Nutrition
    Identifiers
    urn:nbn:se:uu:diva-211870 (URN)
    Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2014-01-24Bibliographically approved
  • 8.
    Adamsson, Viola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Riserus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Influence of a healthy Nordic diet on serum fatty acid composition and associations with blood lipoproteins: results from the NORDIET study2014In: Food & Nutrition Research, ISSN 1654-6628, E-ISSN 1654-661X, Vol. 58, p. 24114-Article in journal (Other academic)
    Abstract [en]

    Background: The fatty acid (FA) composition of serum lipids is related to the quality of dietary fat. The aim of this study was to investigate the effects of a healthy Nordic diet (ND) on the FA composition of serum cholesterol esters (CE-FA) and assess the associations between changes in the serum CE-FA composition and blood lipoproteins during a controlled dietary intervention.

    Methods: The NORDIET trial was a six-week randomised, controlled, parallel-group dietary intervention study that included 86 adults (53±8 years) with elevated low-density lipoprotein cholesterol LDL-C. Serum CE-FA composition was measured using gas chromatography. Diet history interviews were conducted, and daily intake was assessed using checklists.

    Results: Food and nutrient intake data indicated that there was a reduction in the fat intake from dairy and meat products and an increase in the consumption of fatty fish with the ND, decreasing the levels of saturated fatty acids (SFA) in the diet, slightly decreasing the levels of monounsaturated fatty acids (MUFA) and moderately increasing the levels of polyunsaturated fatty acids (PUFA). Concomitantly, the levels of CE-SFA 14:0, 15:0 and 18:0, but not 16:0, decreased during the ND, and these changes differed from those observed in the control diet group (p<0.01). In contrast, serum 22:6n-3 increased during the ND compared with the control diet (p<0.01). The changes in CE-SFA 14:0, 15:0 and 18:0 during the intervention correlated positively with those in LDL-C, HDL-C, LDL-C/HDL-C, ApoA1 and ApoB (p<0.01), whereas the changes in CE-PUFA 22:6n-3 were negatively correlated with changes in the corresponding serum lipids.

    Conclusions: The decreased intake of saturated fat and increased intake of n-3 PUFA in a healthy Nordic diet are partly reflected by changes in the serum CE-FA composition, which are associated with an improved serum lipoprotein pattern.

  • 9.
    Adamsson, Viola
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Reumark, Anna
    Lantmännen.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Riserus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Role of a prudent breakfast in improving cardiometabolic risk factors in subjects with hypercholesterolemia: a randomized controlled trialArticle in journal (Other academic)
    Abstract [en]

    Background & Aims: It is unclear whether advising a prudent breakfast alone is sufficient to improve blood lipids and cardiometabolic risk factors in overweight hypercholesterolemic subjects.

    Methods: The aim of the present study was to investigate whether a prudent low-fat breakfast (PB) rich in dietary fiber lowers low-density lipoprotein cholesterol (LDL-C) and other cardiometabolic risk factors in subjects with elevated LDL-cholesterol levels. In a parallel, controlled, 12-week study, 79 healthy overweight subjects (all regular breakfast eaters) were randomly allocated to a group that received a PB based on Nordic foods provided ad libitum or a control group that consumed their usual breakfast. The PB was in accordance with national and Nordic nutrition recommendations and included oat bran porridge with low-fat milk or yogurt, bilberry or lingonberry jam, whole grain bread, low-fat spread, poultry or fatty fish, and fruit.

    Results: No differences were found in LDL-C, blood lipids, body weight, or glucose metabolism, but SAD, plasma CRP, and TNF-R2 were lower during PB compared with controls (p<0.05). In the overall diet, PB increased dietary fiber and b-glucan compared with controls (p<0.05).

    Conclusions: Advising a prudent breakfast for 3 months did not influence blood lipids, body weight, or glucose metabolism but reduced markers of visceral fat and inflammation.

     

  • 10.
    Adel, Rabie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Challenges facing Pro-life and Pro-choice organisations within Warsaw, Poland2015Independent thesis Advanced level (degree of Master (Two Years)), 180 HE creditsStudent thesis
  • 11. Adeniran, Abosede
    et al.
    Likaka, Andrew
    Knutsson, Anneka
    Costello, Anthony
    Daelmans, Bernadette
    Maliqi, Blerta
    Burssa, Daniel
    Freer, Joseph
    Askew, Ian
    Bowen, Lisa
    Kak, Lily
    McDougall, Lori
    Zaka, Nabila
    Tunçalp, Özge
    Tenhoope-Bender, Petra
    Syed, Shamsuzzoha Babar
    Peterson, Stefan Swartling
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition.
    Luchesi, Thiago
    Zeck, Willibald
    Were, Wilson
    Barker, Pierre
    Naimy, Zainab
    Leadership, action, learning and accountability to deliver quality care for women, newborns and children.2018In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 96, no 3, p. 222-224Article in journal (Refereed)
  • 12.
    Adielsson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Distriktssköterskestudenters erfarenhet och tankar om att påverka beslutsfattare för att förbättra folkhälsan.2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 13.
    Adolfsson, Päivi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation. Centrum för forskning om funktionshinder.
    Lindstedt, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Janeslätt, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
    How people with cognitive disabilities experience electronic planning devices2015In: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 37, no 3, p. 379-392Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People with cognitive disabilities have difficulties in accomplishing everyday tasks. Electronic planning devices (EPDs) may compensate for the gap between a person’s capacity and everyday challenges. However, the devices are not always used as intended. Despite that, cognitive assistive technology has been investigated in several studies, knowledge regarding when and what makes adults decide to use EPDs is incomplete. People with cognitive disabilities have difficulties in accomplishing everyday tasks. Electronic planning devices (EPDs) may compensate for the gap between a person’s capacity and everyday challenges. However, the devices are not always used as intended. Despite that, cognitive assistive technology has been investigated in several studies, knowledge regarding when and what makes adults decide to use EPDs is incomplete. OBJECTIVE: The aim was to explore the subjective experiences of people with cognitive disabilities in relation to the use of EPDs. The aim was to explore the subjective experiences of people with cognitive disabilities in relation to the use of EPDs. METHODS: A qualitative approach was applied with a qualitative content analysis. Twelve respondents were interviewed with support from a study specific guide. A qualitative approach was applied with a qualitative content analysis. Twelve respondents were interviewed with support from a study specific guide. RESULTS: A model representing the respondents’ experiences in the use of EPDs, comprising one theme, Possibility to master my daily life , four categories, Degree of fit to my needs, I am aware of my cognitive disability, I get help to structure my everyday life and The EPD improves my volition and ten subcategories, was developed. A model representing the respondents’ experiences in the use of EPDs, comprising one theme, Possibility to master my daily life , four categories, Degree of fit to my needs, I am aware of my cognitive disability, I get help to structure my everyday life and The EPD improves my volition and ten subcategories, was developed. CONCLUSIONS: EPDs allow people with cognitive disabilities the possibility to deal with daily challenges; those who find EPDs beneficial tend to use them. EPDs can help people with cognitive disabilities in organisation, managing time and improve volition. EPDs allow people with cognitive disabilities the possibility to deal with daily challenges; those who find EPDs beneficial tend to use them. EPDs can help people with cognitive disabilities in organisation, managing time and improve volition.

  • 14.
    Adolphson, Katja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Axemo, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Högberg, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Midwives' experiences of working conditions, perceptions of professional role and attitudes towards mothers in Mozambique2016In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 40, p. 95-101Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: low- and middle-income countries still have a long way to go to reach the fifth Millennium Development Goal of reducing maternal mortality. Mozambique has accomplished a reduction of maternal mortality since the 1990s, but still has among the highest in the world. A key strategy in reducing maternal mortality is to invest in midwifery. AIM: the objective was to explore midwives' perspectives of their working conditions, their professional role, and perceptions of attitudes towards mothers in a low-resource setting. SETTING: midwives in urban, suburban, village and remote areas; working in central, general and rural hospitals as well as health centres and health posts were interviewed in Maputo City, Maputo Province and Gaza Province in Mozambique. METHOD: the study had a qualitative research design. Nine semi-structured interviews and one follow-up interview were conducted and analysed with qualitative content analysis. RESULTS: two main themes were found; commitment/devotion and lack of resources. All informants described empathic care-giving, with deep engagement with the mothers and highly valued working in teams. Lack of resources prevented the midwives from providing care and created frustration and feelings of insufficiency. CONCLUSIONS: the midwives perceptions were that they tried to provide empathic, responsive care on their own within a weak health system which created many difficulties. The great potential the midwives possess of providing quality care must be valued and nurtured for their competency to be used more effectively.

  • 15.
    af Wåhlberg, Anders E.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Meta-analysis of the difference in accident risk between long and short truck configurations2008In: Journal of Risk Research, ISSN 1366-9877, E-ISSN 1466-4461, Vol. 11, no 3, p. 315-333Article in journal (Refereed)
    Abstract [en]

    To investigate whether there is a difference in accident risk for differently sized truck configurations, a meta-analysis was undertaken of all available research. It was found that most studies had been made in the US, and that several methodological problems have plagued this area of investigation, mainly the lack of good exposure data. As larger trucks tend to drive on bigger, and therefore safer, roads, this needs to be taken into account. Some researchers have also suspected that there are systematic differences between drivers of different trucks, but the present analysis showed that this is probably a weak effect. Furthermore, it has been shown that the effects of accidents increase with increasing weight, at least up to a certain point, which makes the comparisons of accident risk sensitive to what type of accident has been investigated. Mean values of the risk ratios between long and short truck configurations were calculated from more than 20 studies, in the categories All, Injuries and Fatal. Also, separate values were computed for studies that had held the influence of road type constant in some way, and those that had not. Given that larger trucks replace a higher number of smaller ones on the roads, the differences in all categories of accidents would seem to indicate that, as a population, heavier trucks have fewer accidents, although the difference is small for Fatal. Unexpectedly, this positive traffic safety effect was more pronounced for the studies that had held road type constant. Furthermore, it was evident from the literature that although the overall effects were positive regarding truck size, larger vehicles have specific problems, which probably put them more at risk in certain environments, like towns.

  • 16.
    Agersten, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Invandrarkvinnors hälsa och arbtesmarknad: - En kvantitativ studie i Kristianstads och Klippans kommuner2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Today, Sweden is a multicultural country and the proportion of foreign-born population since the early 1900s has increased from less than one per cent to about 15% and it gives a percentage of foreign born in Sweden of about 1.4 million. It is of great importance that people of working age, who immigrants to Sweden are able to establish themselves on the Swedish labor market, as this would have a positive impact on the dependency ratio.

    Purpose: The purpose of the survey was to study immigrant women's health and their estimated establishment in the labor market.

    Method: The study was a quantitative study, and data were collected through questionnaires. The participants came from SFI in Kristianstad and Swedish as a second language in Klippan. The questionnaires were designed with 18 questions in three different categories. Background, health and labor and employment.

    Results: A total of 35 questionnaires were completed by women from two groups out of European and European. Over half of the women in the study had an academic education in her country of birth and 60% worked in their country of origin. Over half of the women thought they could be self-supporting within 5 years. Almost 70 % of respondents did not suffer from any long-term illness and over 10% suffered from many of the requested diseases. Half of the women considered their general health to be pretty good. The women's BMI was 50 % in normal and 50 % of overweight or obesity.

    Discussion: With regard to the social position of women this report showed that nearly half believe themselves to be self-sufficient in five years. Of the women who participated in the study nearly or over half of them have responded very important on the various factors that are seen as important in a job. This suggests that they have insight into the social function of a work and its importance to their well-being. Although women feel they have got quite a lot of information about how diet and exercise affect health, there are few who believe that their lifestyle affects their health in the future.

    Conclusion: This study shows that although women estimated their own health as good, it needs a good work with immigrant women's health. Interventions in the form of health promotion at various levels as part of the induction time could help women feel better, faster find the motivation and become more understanding of their own position, their value and their importance to society.

  • 17.
    Ahlberg, Beth Maina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Skaraborg Inst Res & Dev, Skovde, Sweden.
    Maina, Faith
    Department of Curriculum Studies and Teacher Education, Texas Tech University, USA.
    Kubai, Anne
    Khamasi, Wanjiku
    Dedan Kimathi University of Technology, Nyeri, Kenya.
    Ekman, Marianne
    Royal Institute of Technology, Stockholm, Sweden.
    Lundqvist-Persson, Cristina
    Skaraborg Institute for Research and Development, Skövde, Sweden;Lund Univ, Dept Psychol, Psychol, Lund, Sweden.
    ‘"A child, a tree": Challenges in building collaborative relations in a community research project in a Kenyan context2016In: Action Research, ISSN 1476-7503, E-ISSN 1741-2617, Vol. 14, no 3, p. 257-275Article in journal (Refereed)
    Abstract [en]

    This paper highlights the potential for basing participatory action research on priorities identified by communities. The case builds on a research project by the Social Science Medicine Africa Network (Soma-net) focusing on AIDS prevention among school youth in Kajiado in Kenya during 2003-2006. It became clear from that study just how complex it is to promote open communication on issues of sexuality considered critical for sexual health promotion. Towards the end of that study a spin-off in the form of a concept a child, a tree or tree planting evolved and the research thereafter continued as a partnership between the school community and the researchers. The focus then was on understanding how health promotion could be integrated into other aspects of community life. The concept and tree planting when implemented created a sense of ownership among the pupils largely because they were placed at the centre of the development activities. The story illuminates the nature of change developing in the course of the project, but also the challenges and complexity of creating and maintaining collaborative relations in the face of cultural and gender power dynamics and interventions imposed from outside the community.

  • 18.
    Ahlskog, Rafael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Är Leviathan giftig?: Autonomi och repression som förklaringar till regimskillnader i förväntad livslängd2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    During the last decade a number of studies have been published that investigate how the most fundamental aspect of political organization, the regime type, affects population health. The results unanimously show that citizens of democracies live longer and healthier lives than citizens of non-democracies. Many explanations for this have been suggested, among these are that democracies redistribute more and invest more in salutogenic resources, and that the tendency of dictatorships to control the media negatively affects the ability to spread information crucial to public health. When these mechanisms are controlled for, however, it turns out that democracy has a large residual correlation with for example life expectancy, which suggests that other mechanisms are also involved.

    In this paper two new mechanisms regarding the possible psychosocially mediated health effects of the regime type are investigated, namely political repression, and the possible negative effects this might have on the levels of chronic stress, and autonomy, which connects to a large previous literature in social epidemiology. In the paper an ecological cross-country design is used and country-level data, provided mainly by the World Bank and Freedom House, is analyzed with a simple multiple OLS-regression model. The results show that that all residual correlation is captured by autonomy, while there is no evidence for political repression as a mediating factor. This could suggest that the feeling of personal autonomy that democracies can fulfill is an equally important factor to take into account as distribution of resources and access to information.

  • 19.
    Ahlskog, Rafael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Är Leviathan giftig?: Autonomi och repression som förklaringar till regimskillnader i förväntad livslängd2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    During the last decade a number of studies have been published that investigate how the most fundamental aspect of political organization, the regime type, affects population health. The results unanimously show that citizens of democracies live longer and healthier lives than citizens of non-democracies. Many explanations for this have been suggested, among these are that democracies redistribute more and invest more in salutogenic resources, and that the tendency of dictatorships to control the media negatively affects the ability to spread information crucial to public health. When these mechanisms are controlled for, however, it turns out that democracy has a large residual correlation with for example life expectancy, which suggests that other mechanisms are also involved.In this paper two new mechanisms regarding the possible psychosocially mediated health effects of the regime type are investigated, namely political repression, and the possible negative effects this might have on the levels of chronic stress, and autonomy, which connects to a large previous literature in social epidemiology. In the paper an ecological cross-country design is used and country-level data, provided mainly by the World Bank and Freedom House, is analyzed with a simple multiple OLS-regression model. The results show that that all residual correlation is captured by autonomy, while there is no evidence for political repression as a mediating factor. This could suggest that the feeling of personal autonomy that democracies can fulfill is an equally important factor to take into account as distribution of resources and access to information.

  • 20.
    Ahmadi, Fereshteh
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hard and Heavy Music: Can It Make a Difference in the Young Cancer Patients’ Life?2009In: Voices: A World Forum for Music Therapy, Vol. 9, no 2Article in journal (Refereed)
    Abstract [en]

     The aim of the study on the basis of which this article is written was to examine, from the patients’ perspective, the role music plays as a coping method when facing cancer. Here, using music as a coping method refers to using music (listening to and/or playing music individually or participating in a music therapy program) frequently in order to deal with the significant demands presented by cancer. A semi-structured interview with 17 cancer patients who have used music (listened to or played music) in order to cope with their illness was applied. Five of interviewees were men and twelve women. The youngest informant was 24 and the oldest 73 years old. In the paper presented in this conference I will discuss the result of my study concerning the effects of hard and heavy music in coping with cancer. The result of study shows that hard and heavy music as a coping method:

    - by calling in question the cultural demands of having control over their feelings, helps the young cancer patients to obtain their control,

    - by questioning what are conventionally defined as meaning of life, helps the young cancer patients to find a meaning,

    - by calling in question  the cultural requests of being calm and collected helps the young cancer patients to get their tranquility,  

    - by cheering unhealthy behaviors like using drug and having violent sex helps the young cancer patients to recover their mental health.

    All this due to the possibility the heavy and hard music provides for the young cancer patients to get self-confidence by putting away the false mask one wear and be who she/he really is.

    The aim of the study on the basis of which this article is written was to examine, from the patients’ perspective, the role music plays as a coping method when facing cancer. Here, using music as a coping method refers to using music (listening to and/or playing music individually or participating in a music therapy program) frequently in order to deal with the significant demands presented by cancer. A semi-structured interview with 17 cancer patients who have used music (listened to or played music) in order to cope with their illness was applied. Five of interviewees were men and twelve women. The youngest informant was 24 and the oldest 73 years old. In the paper presented in this conference I will discuss the result of my study concerning the effects of hard and heavy music in coping with cancer. The result of study shows that hard and heavy music as a coping method:

    - by calling in question the cultural demands of having control over their feelings, helps the young cancer patients to obtain their control,

    - by questioning what are conventionally defined as meaning of life, helps the young cancer patients to find a meaning,

    - by calling in question  the cultural requests of being calm and collected helps the young cancer patients to get their tranquility,  

    - by cheering unhealthy behaviors like using drug and having violent sex helps the young cancer patients to recover their mental health.

    All this due to the possibility the heavy and hard music provides for the young cancer patients to get self-confidence by putting away the false mask one wear and be who she/he really is.

  • 21.
    Ahmadi, Fereshteh
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Sociology.
    Kultur och hälsa2008Book (Refereed)
    Abstract [en]

    Hälsa är en viktig fråga för varje individ och varje samhälle. I ett land med invandrare som har socialiserats i olika samhällen med skilda uppfattningar om hälsa och ohälsa, uppstår behov av att fördjupa såväl allmänhetens som hälso- och sjukvårdspersonalens kunskap om betydelsen av kultur, religion och etnicitet i medicin- och hälsofrågor.

    I denna bok belyser författaren, Fereshteh Ahmadi, hur viktig kunskap är om olika kulturers och religioners syn på hälsa och hälsa i bemötandet av patienter.

    Boken vänder sig i första hand till studenter på grundutbildningsnivå samt personal inom hälso- sjukvården men den kan även användas av andra som är intresserade av att skaffa sig kunskaper om kulturens och religionens betydelse för förståelse av ohälsa.

  • 22.
    Ahrne, M.
    et al.
    Karolinska Inst, Stockholm, Sweden.
    Adan, A.
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Shytt, Erica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna.
    Andersson, E.
    Karolinska Inst, Stockholm, Sweden.
    Small, R.
    La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia.
    Flacking, R.
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Byrskog, U.
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Antenatal care for Somali born women in Sweden - perspectives from mothers, fathers and midwives2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Supplement: 1, p. 104-104Article in journal (Other academic)
  • 23.
    Ahs, A
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ökad skillnad i självskattad hälsa mellan arbetslösa och personer i arbete.2000In: Svenska läkaresällskapets handlingar. Hygiea., p. 336-Article in journal (Other academic)
  • 24. Aila Gustafsson, Sanna
    et al.
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kjellin, Lars
    Norring, Claes
    Personal standards, self-evaluation and perceived benefits of thinness in girls and young women with disturbed eating2008In: European eating disorders review, ISSN 1072-4133, E-ISSN 1099-0968, Vol. 16, no 6, p. 463-471Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine personal standards, self-evaluation and perceived benefits of thinness in Swedish females 14-21 years with disturbed eating (DE) and to compare these to a group with other psychosocial problems and to a symptom free group. Seventy subjects with DE-group, 65 subjects with psychosocial problems and 70 symptom free subjects were compared regarding items selected from four questionnaires. High personal standards expressed in a competitive way were specific for the DE-group. In comparison with the other groups the DE-group also reported significantly more perceived benefits of thinness and they more frequently believed that thinness would make them more popular. The DE-group also reported a more negative self-evaluation, although this was a trait shared with the subjects with other psychosocial problems and consequently not specific for the DE-group. Identifying specific factors that perpetuate DE habits is important in order to improve our understanding and enhance the treatment of eating disorders.

  • 25. Aili, Katarina
    et al.
    Nyman, Teresia
    Hillert, Lena
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain: A 5-year prospective study2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 315-323Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is one of the most common causes of sickness absence. Sleep disturbances are often co-occurring with pain, but the relationship between sleep and pain is complex. Little is known about the importance of self-reported sleep, when predicting sickness absence among persons with musculoskeletal pain. This study aims to study the association between self-reported sleep quality and sickness absence 5 years later, among individuals stratified by presence of lower back pain (LBP) and neck and shoulder pain (NSP). Methods: The cohort (n = 2286) in this 5-year prospective study (using data from the MUSIC-Norrtalje study) was stratified by self-reported pain into three groups: no LBP or NSP, solely LBP or NSP, and oncurrent LBP and NSP. Odds ratios (ORs) for the effect of self-reported sleep disturbances at baseline on sickness absence (> 14 consecutive days), 5 years later, were calculated. Results: Within all three pain strata, individuals reporting the most sleep problems showed a significantly higher OR for all-cause sickness absence, 5 years later. The group with the most pronounced sleep problems within the concurrent LBP and NSP stratum had a significantly higher OR (OR 2.00; CI 1.09-3.67) also for long-term sickness absence (> 90days) 5 years later, compared to the group with the best sleep. Conclusions: Sleep disturbances predict sickness absence among individuals regardless of co-existing features of LBP and/or NSP. The clinical evaluation of patients should take possible sleep disturbances into account in the planning of treatments.

  • 26.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hälsokommunikation i relation till samhällsorientering och etablering av nyanlända flyktingar i Sverige: Förstudie MILSA2015Report (Other academic)
    Abstract [sv]

    I etableringsprocessen för nyanlända flyktingar, där ansvaret delas av flera aktörer, ses hälsofrämjande åtgärder idag som en allt viktigare del. Som ett led i detta har länsstyrelserna prioriterat frågan om hälsokommunikation och hur den kan sprid as och utvecklas inom ramen för etableringen. Många kommuner och andra aktörer har också valt att utöka antalet timmar som ägnas åt hälsokommunikation och andra hälsoinsatser. Fördelarna räknas inte bara på den individuella nivån. Information, hälsopromotion och prevention är samhällsekonomiskt en god affär; preventiva åtgärder förhindrar onödig användning av primär- och akutvård och minskar belastningen på hälso- och sjukvården överlag.

    Förstudien har tagits fram inom ramen för projektet forskningsbaserad stödplattform för migration och hälsa (MILSA) och dess delprojekt MILSA 4 som har som mål att samla den kunskap och de erfarenheter som finns kring hälsokommunikation och att lyfta frågan om behovet av hälsokommunikation för nyanlända flyktingar i etableringen.(1)

    Syftet med förstudien är att kartlägga vilka modeller för hälsokommunikation som prövats i Sverige, framförallt inom etableringen, och erfarenheterna av dessa. I detta ingår en beskrivning av kommunikatörers bakgrunder, vilka ut bildningar som ges till gruppen idag samt vilka material och metoder som används. En sammanfattning av resultat från några utvärderingar som gjorts på hälsokommunikationsverksamhet bland annat i Stockholm, Östergötland och Skåne, presenteras också.

    Förstudien bygger på intervjuer med ett antal utvalda aktörer inom etablering, samhällsorientering och hälsokommunikation inom olika län med geografisk spridning samt på dokumentstudier.

    ---------

    (1) Parallellt tar projektet fram rekommendationer för hur rollen som hälsokommunikatör kan utvecklas och professionaliseras. Förstudien och annan dokumentation från MILSA 4 kommer att ligga till grund för en eventuell ansökan om finansiering för fortsatt utvecklingsarbete.

  • 27.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Utvärdering av pilotfasen i “Välkommen till Skåne”: Delprojekt 4, MILSA 2.02017Report (Other academic)
  • 28. Al-Ani, Amer N.
    et al.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Saaf, Maria
    Neander, Gustaf
    Blomfeldt, Richard
    Ekstrom, Wilhelmina
    Hedstrom, Margareta
    Low bone mineral density and fat-free mass in younger patients with a femoral neck fracture2015In: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 45, no 8, p. 800-806Article in journal (Refereed)
    Abstract [en]

    Background Reduced bone mineral density (BMD) together with muscle wasting and dysfunction, that is sarcopenia, emerges as a risk factor for hip fracture. The aim of this study was to examine body composition and BMD and their relationship with trauma mechanisms in young and middle-aged patients with femoral neck fracture. Materials and methods Altogether, 185 patients with femoral neck fracture aged 20-69 were included. BMD, body composition and fat-free mass index (FFMI) were determined by dual-X-ray absorptiometry (DXA), and trauma mechanisms were registered. Results Ninety per cent of the whole study population had a femoral neck BMD below the mean for age. In the young patients (<50years), 27% had a Z-score of BMD-2 SD. More than half of the middle-aged patients (50-69years) had osteopenia, that is T-score -1 to -25, and 35% had osteoporosis, that is T-score<-25, at the femoral neck. Patients with low-energy trauma, sport injury or high-energy trauma had a median standardised BMD of 0702, 0740 vs. 0803g/cm(2) (P=003), and a median FFMI of 159, 177 vs. 175kg/m(2) (P<0001), respectively. FFMI<10th percentile of an age- and gender-matched reference population was observed in one-third. Conclusions A majority had low BMD at the femoral neck, and one-third had reduced FFMI (i.e. sarcopenia). Patients with fracture following low-energy trauma had significantly lower femoral neck BMD and FFMI than patients with other trauma mechanisms. DXA examination of both BMD and body composition could be of value especially in those with low-energy trauma.

  • 29.
    Albihn, Ann
    et al.
    National Veterinary Institute, Uppsala, Sweden.
    Gustafsson, Hans
    Swedish University of Agricultural Sciences.
    O’Hara Ruiz, Marilyn
    University of Illinois at Urbana-Champaign.
    38. Preparing for Climate Change2012In: Ecology and Animal Health / [ed] Leif Norrgren and Jeffrey Levengood, Uppsala: Baltic University Press , 2012, 1, p. 311-328Chapter in book (Other (popular science, discussion, etc.))
  • 30.
    Alfonso-Sanchez, José L
    et al.
    Department of Preventive Medicine and Public Health, University of Valencia.
    Mackenbach, Johan
    Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands .
    Hoffman, Rasmus
    Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands .
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Alfonso-Landet, Gema
    Department of Preventive Medicine and Public Health, University of Valencia..
    Evidence on the Association between Socioeconomic Resources and Amenable Mortality2017In: International Journal of Health Sciences and Research, Vol. 7(4), p. 370-379Article in journal (Refereed)
  • 31.
    Alfonsson, Sven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
    Replacing the term “binge eating” with “loss of control over eating” affects eating disorder screening in clinical care2015In: Obesity Research and Clinical Practice, ISSN 1871-403X, E-ISSN 1878-0318, Vol. 9, no 5, p. 531-532Article in journal (Refereed)
    Abstract [en]

    Having episodes of binge eating is central to the binge eating disorder (BED) and bulimia nervosa (BN) diagnoses but may be difficult to assess accurately through self-report instruments and estimates of prevalence varies [1,2]. Some researchers have reported lower levels of binge eating in clinical interviews where interviewers may use follow up questions and correct misunderstandings, compared with self-report questionnaires [3]. Another reason for mixed results may be the negative stigma of binge eating behaviours and thus the embarrassment of admitting having binge eating episodes [4,5].

  • 32. Alfvén, Tobias
    et al.
    Axelson, Henrik
    Lindstrand, Ann
    Peterson, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Persson, Lars-Ake
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Dödligheten minskar, men fortfarande dör 7 miljoner barn varje år2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 1-2, p. 28-30Article in journal (Other academic)
    Abstract [sv]

    Millenniemål 4 lyder: »Barnadödligheten under de fem första levnadsåren ska minska med två tredjedelar till 2015 jämfört med år 1990«.

    Barnadödligheten minskar i ­stora delar av världen, men inte i tillräckligt snabb takt för att uppnå målet. Den skiljer sig också kraftigt mellan länder och mellan olika grupper inom länderna.

    Sex dödsorsaker står för mer än 90 procent av alla dödsfall före 5 års ålder: neonatal mortalitet, lunginflammation, diarré, ­malaria, mässling och HIV/aids. ­Undernäring beräknas vara ­delorsak till cirka en tredjedel av dessa dödsfall.

    Vi har kunskap och metoder att med kostnadseffektiva lösningar reducera barnadödligheten med två tredjedelar. Fortsatt inter­nationellt samarbete, utökade ­resurser samt lokal, nationell po­litisk vilja krävs för att lyckas.

  • 33.
    Ali, Iftikhar
    et al.
    Univ Swabi, Dept Pharm, Swabi, Pakistan;Northwest Gen Hosp & Res Ctr, Dept Pharm Serv, Peshawar, Pakistan;Parapleg Ctr, Peshawar, Pakistan.
    Ijaz, Muhammad
    Gajju Khan Med Coll, Dept Med, Swabi, Pakistan.
    Rehman, Inayat U.
    Monash Univ Malaysia, Sch Pharm, Bandar Sunway, Malaysia;Abdul Wali Khan Univ Mardan, Dept Pharm, Mardan, Pakistan.
    Rahim, Afaq
    Khyber Teaching Hosp, Dept Med, Peshawar, Pakistan.
    Ata, Humera
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Knowledge, Attitude, Awareness, and Barriers Toward Influenza Vaccination Among Medical Doctors at Tertiary Care Health Settings in Peshawar, Pakistan-A Cross-Sectional Study2018In: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, article id 173Article in journal (Refereed)
    Abstract [en]

    Objective: This study intends to evaluate the knowledge, attitude and awareness of medical doctors toward influenza vaccination and the reasons for not getting vaccinated. Methods: A cross-sectional study was carried out among medical doctors in three major tertiary care health settings in Peshawar, Khyber Pakhtunkhwa (KP), Pakistan. A web-based, pre-tested questionnaire was used for data collection. Results: A total of (n = 300) medical doctors were invited, however only (n = 215) participated in the study with a response rate of 71.7%. Among the participants, 95.3% (n = 205) were males with a mean age of 28.67 +/- 3.89 years. By designation, 121(56.3%) were trainee medical officers and 40 (18.6%) were house officers. The majority 102(47.4%) had a job experience of 1-2 years. Of the total sample, 38 (17.7%) doctors reported having received some kind of vaccination, whereas only 19 (8.84%) were vaccinated against influenza. The results identified that the major barriers toward influenza vaccinations included (1) Unfamiliarity with Influenza vaccination availability (Relative Importance Index RII = 0.830), (2) Unavailability of Influenza vaccines due to lack of proper storage area in the institution (RII = 0.634), (3) Cost of vaccine (RII = 0.608), and (4) insufficient staff to administer vaccine (RII = 0.589). Additionally, 156 (72.6%) of doctors were not aware of the influenza immunization recommendation and guidelines published by the Advisory Committee on Immunization Practices (ACIP) and Centre for Disease Control and Prevention (CDC). Physicians obtained a high score (8.27 +/- 1.61) of knowledge and understanding regarding influenza and its vaccination followed by medical officers (8.06 +/- 1.37). Linear Regression analysis revealed that gender was significantly associated with the knowledge score with males having a higher score (8.0 +/- 1.39) than females (6.80 +/- 1.61 beta = -1.254 and CI [-2.152 to -0.355], p = 0.006). Conclusion: A very low proportion of doctors were vaccinated against influenza, despite the published guidelines and recommendations. Strategies that address multiple aspects like increasing awareness and the importance of the influenza vaccine, the international recommendations and enhancing access and availability of the vaccine are needed to improve its coverage and health outcomes.

  • 34.
    Ali, Mohammad
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Boyshondhi Shikka is Obligatory for Religious and Medical Reasons: Bangladeshi Imams' perceptions about Adolescent Sexual and Reproductive Health Education: An In-depth Interview Study in Bangladesh2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this thesis is to explore Bangladeshi Imams’ perception about adolescent sexual andreproductive health education known in Bangla as Boyshondhi Shikka to shed light on Islamic rulings inthis education.

    Background: Despite of adolescent sexual and reproductive health (ASRH) education is a religious and cultural taboo in Bangladesh, there was no study investigates Bangladeshi religious leaders’ view on this education.

    Method: In-depth interviews with eight Bangladeshi Imams. Imams as the religious leaders who lead the Friday special prayer called Jummah and performing religious ritual around health and illness, and providing health-based message. The data were analyzed by qualitative content analysis.

    Findings: Four themes were made: 1) Boyshondhi Shikka is not Western Education: is a natural andnecessary part of their own religion and society 2) Boyshondhi Shikka is fard (Obligatory) for religion and medical reasons: prevent from sin and diseases, 3) Medically-based Sexual health and family planning education encourage premarital sex and 4) Boyshondhi Shikka is supported by Sharia, but should respect religious modesty.

    Conclusion: While some Imams stated that Boyshondhi Shikka should conform to their interpretation of Sharia; should stress religious modesty, should be given by religious teachers, separate class for girls and boys, the most important finding of this study was that half of the Imams believed adolescents ’sexual and reproductive health education was obligatory for religious and medical reasons. This finding suggests that some Imams may be willing to help, rather than fight, the building of a basic Boyshondhi Shikka.

  • 35. Al-Janabi, Hareth
    et al.
    Flynn, Terry N
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Coast, Joanna
    Development of a self-report measure of capability wellbeing for adults: the ICECAP-A.2012In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 21, no 1, p. 167-76Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The benefits of health and social care are not confined to patient health alone and therefore broader measures of wellbeing may be useful for economic evaluation. This paper reports the development of a simple measure of capability wellbeing for adults (ICECAP-A).

    METHODS: In-depth, informant-led, interviews to identify the attributes of capability wellbeing were conducted with 36 adults in the UK. Eighteen semi-structured, repeat interviews were carried out to develop a capability-based descriptive system for the measure. Informants were purposively selected to ensure variation in socio-economic status, age, sex, ethnicity and health. Data analysis was carried out inductively and iteratively alongside interviews, and findings were used to shape the questions in later interviews.

    RESULTS: Five over-arching attributes of capability wellbeing were identified for the measure: "stability", "attachment", "achievement", "autonomy" and "enjoyment". One item, with four response categories, was developed for each attribute for the ICECAP-A descriptive system.

    CONCLUSIONS: The ICECAP-A capability measure represents a departure from traditional health economics outcome measures, by treating health status as an influence over broader attributes of capability wellbeing. Further work is required to value and validate the attributes and test the sensitivity of the ICECAP-A to healthcare interventions.

  • 36. Allen, Elizabeth Palchik
    et al.
    Muhwezi, Wilson Winstons
    Henriksson, Dorcus Kiwanuka
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Child Health and Nutrition. Karolinska Institutet, Sweden..
    Mbonye, Anthony Kabanza
    Health facility management and access: a qualitative analysis of challenges to seeking healthcare for children under five in Uganda2017In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 32, no 7, p. 934-942Article in journal (Refereed)
    Abstract [en]

    While several studies have documented the various barriers that caretakers of children under five routinely confront when seeking healthcare in Uganda, few have sought to capture the ways in which caretakers themselves prioritize their own barriers to seeking services. To that end, we asked focus groups of caretakers to list their five greatest challenges to seeking care on behalf of children under five. Using qualitative content analysis, we grouped responses according to four categories: (1) geographical access barriers; (2) facility supplies, staffing, and infrastructural barriers; (3) facility management and administration barriers (e.g. health worker professionalism, absenteeism and customer care); and (4) household barriers related to financial circumstances, domestic conflicts with male partners and a stated lack of knowledge about health-related issues. Among all focus groups, caretakers mentioned supplies, staffing and infrastructure barriers most often and facility management and administration barriers the least. Caretakers living furthest from public facilities (8-10 km) more commonly mentioned geographical barriers to care and barriers related to financial and other personal circumstances. Caretakers who lived closest to health facilities mentioned facility management and administration barriers twice as often as those who lived further away. While targeting managerial barriers is vitally important-and increasingly popular among national planners and donors-it should be done while recognizing that alleviating such barriers may have a more muted effect on caretakers who are geographically harder to reach - and by extension, those whose children have an increased risk of mortality. In light of calls for greater equity in child survival programming - and given the limited resource envelopes that policymakers often have at their disposal - attention to the barriers considered most vital among caretakers in different settings should be weighed.

  • 37.
    Allvin, Marie Klingberg
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration.
    Atuhairwe, S
    Cleeve, A
    Byamugisha, J K
    Larsson, Elin C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH), International Maternal and Reproductive Health and Migration.
    Makenzius, M
    Oguttu, M
    Gemzell-Danielsson, K
    Co-creation to scale up provision of simplified high-quality comprehensive abortion care in East Central and Southern Africa.2018In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1490106Article in journal (Refereed)
    Abstract [en]

    Universal access to comprehensive abortion care (CAC) is a reproductive right and is essential to reduce preventable maternal mortality and morbidity. In East Africa, abortion rates are consistently high, and the vast majority of all abortions are unsafe, significantly contributing to unnecessary mortality and morbidity. The current debate article reflects and summarises key action points required to continue to speed the implementation of and expand access to CAC in the East, Central, and Southern African (ECSA) health community. To ensure universal access to quality CAC, a regional platform could facilitate the sharing of best practices and successful examples from the region, which would help to visualise opportunities. Such a platform could also identify innovative ways to secure women's access to quality care within legally restrictive environments and would provide information and capacity building through the sharing of recent scientific evidence, guidelines, and training programmes aimed at increasing women's access to CAC at the lowest effective level in the healthcare system. This type of infrastructure for exchanging information and developing co-creation could be crucial to advancing the Sustainable Development Goals 2030 agenda.

  • 38.
    Allwell-Brown, Gbemisola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    Individual and household-level determinants of malaria infection in under-5 children from north-west and southern Nigeria: A cross-sectional comparative study based on the 2015 Nigeria Malaria Indicator Survey2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction

    Nigeria has the highest malaria burden worldwide. The 2010 and 2015 Nigeria Malaria Indicator Surveys (NMIS) suggest an improvement in malaria indicators, with the North West zone lagging behind. This study aimed to identify the individual and household-level malaria determinants in north-west and southern Nigeria, using Rapid Diagnostic Testing (RDT) and microscopy for malaria diagnosis.

    Methods

    Data on 3,358 children aged 6-59 months from north-west and southern Nigeria from the 2015 NMIS was used. The two populations were compared using chi-square tests, and logistic regression analysis was done for determinants of malaria infection, based on RDT and microscopic malaria test results.

    Results

    Malaria prevalence by RDT in the north-west and south was 55.8% and 29.2%, respectively (37.0% and 14.9%, respectively by microscopy). In both populations, a higher age, positive RDT in an additional household member and rural residence increased the odds of malaria infection; while higher education of the head of household and greater household wealth lowered the odds of malaria infection. Household clustering of RDT-positive cases appeared to be stronger in the south compared to the north-west. There were no statistically significant differences between the results using RDT or microscopy.

    Conclusion

    Irrespective of the diagnostic tool used, malaria determinants were similar in north-west and southern Nigeria. However, poorer social circumstances were observed in the north-west, and may account for the delayed progress in malaria control in the region. There may be a need to intensify malaria control efforts, particularly in the north-west, while awaiting socio-economic development.

     

  • 39.
    Alm Stävlid, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH).
    A cross-sectional study on depression, anxiety, and perfectionism in students at Uppsala University and patients at Uppsala University hospital2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction Mental illness is one of the largest causes of disability worldwide and it is becoming more prevalent among adolescents. The aim of this thesis was to compare the levels of anxiety and depressive symptoms among students at Uppsala University in relation to patients at the psychiatric department of Uppsala University Hospital, and to see if there was a possible correlation between anxiety and depression and higher levels of perfectionism.

    Methods Students at Uppsala University and patients at Uppsala University hospital participated in the student group and the clinical group of the study (n=93 and n=109 respectively). Data on anxiety and depressive symptoms, and perfectionism traits were collected with questionnaires and analyzed. Linear regression analysis was performed to determine the relationship between perfectionism and anxiety and depression. Independent t-test was used to examine the difference of means between the student group and the clinical group.

    Results The clinical group had a significantly higher mean score in the anxiety and depression scale The same trend could also be seen for all sub scales; anxiety, depression, and perfectionism There was a significant positive association between perfectionism and anxiety and depression.

    Conclusion There was a significant difference in levels of anxiety and depression for the students compared to patients, and a positive association between perfectionism and anxiety and depression. Furthermore, half of the students in the study had scores that would qualify them for psychiatric treatment. This research highlights the need for further research on the mental health of students in Uppsala and Sweden.

  • 40.
    Almquist, Ylva B.
    et al.
    Stockholm Univ, Karolinska Inst, Stockholm, Sweden..
    Landstedt, E.
    Stockholm Univ, Karolinska Inst, Umea, Sweden..
    Jackisch, J.
    Stockholm Univ, Karolinska Inst, Stockholm, Sweden..
    Rajaleid, K.
    Stockholm Univ, Karolinska Inst, Stockholm, Sweden..
    Westerlund, H.
    Stockholm Univ, Karolinska Inst, Stockholm, Sweden..
    Hammarström, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Growing through asphalt: What counteracts the long-term negative health impact of youth adversity?2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 41.
    Almquist, Ylva B.
    et al.
    Stockholm Univ, Dept Publ Hlth Sci, Ctr Hlth Equ Studies CHESS, Stockholm, Sweden.
    Landstedt, Evelina
    Umeå Univ, Norrland Univ Hosp, Dept Publ Hlth & Clin Med Epidemiol & Global Hlth, Umeå, Sweden.
    Jackisch, Josephine
    Stockholm Univ, Dept Publ Hlth Sci, Ctr Hlth Equ Studies CHESS, Stockholm, Sweden.
    Rajaleid, Kristiina
    Stockholm Univ, Stress Res Inst, Stockholm, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, Stockholm, Sweden.
    Hammarström, Anne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Prevailing over Adversity: Factors Counteracting the Long-Term Negative Health Influences of Social and Material Disadvantages in Youth2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 9, article id 1842Article in journal (Refereed)
    Abstract [en]

    Disadvantaged circumstances in youth tend to translate into poor health development. However, the fact that this is not always the case has been seen as indicative of differential resilience. The current study highlights factors outside the context of the family with the potential to counteract the long-term negative influences of social and material adversity in adolescence on general health status. This study was based on two waves of questionnaire data from the Northern Swedish Cohort. From the wave in 1981 (age 16), indicators of social and material conditions as well as factors related to school, peers, and spare time were derived. From the wave in 2008 (age 43), information about self-rated health was used. Ordinal logistic regression models (n = 908) showed that adversity in youth was associated with poorer self-rated health in midlife among men and women alike, net of health status at baseline. However, having an advantaged situation with regard to school, peers, or spare time appeared to protect against the detrimental influences of disadvantaged circumstances in the family context on subsequent health. This suggests that health-promoting interventions may benefit from focusing on contexts outside the family in their effort to strengthen processes of resilience among disadvantaged youths.

  • 42. Almquist-Tangen, Gerd
    et al.
    Bergström, Marianne
    Lindfors, Anncharlotte
    Holmberg, Lena
    Magnusson, Margaretha
    Barnhälsovårdens länsavdelning, Akademiska sjukhuset, Uppsala.
    Minskat antal hembesök inom barnhälsovården: Sjuksköterskornas attityder avgörande för hur verksamheten utvecklas2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 47, p. 2968-2971Article in journal (Refereed)
    Abstract [en]

    Home visitations to newly become parents have a long tradition in Sweden. The aim is to give the parents an opportunity to talk about their new situation, to give information on child care and nurse- examine the infant. In recent years, the proportion of families receiving home visits has decreased.The purpose of this study was to explore the attitudes of the child health care nurses to home visitations, the frequency in which they were made and to study the organizational conditions for making these visits.The study consisted of a survey of the frequency in which visits were performed and a questionnaire to all CHC nurses in Sweden exploring their attitudes to home visitations.The questionnaire was sent to 2355 nurses and 1834 responded (78.3%). According to the nurses there were three main reasons for not doing home visitations: the parents declined, lack of time and large districts. There were no differences either in terms of various organizational arrangements or the individual nurse’s work-experience. Remarkably the reasons for not doing home visitation do not correlate with the statements made by them indicating how important they declared these visits to be. Indications are that nurse’s attitudes to home visits as a primary child health care practice is a critical factor that should be studied further. Likewise further exploration is needed on parental attitudes to home visitation. Above all, the nurses need more support and training in such matters, which each respective county child health unit should take more responsibility for.

  • 43.
    Anandavadivelan, Poorna
    et al.
    Karolinska Inst, Stockholm, Sweden..
    Wikman, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.
    Johar, Asif
    Karolinska Inst, Stockholm, Sweden..
    Lagergren, Pernilla
    Karolinska Inst, Stockholm, Sweden..
    Influence of weight loss and eating difficulties on postoperative health-related quality of life across a 10 year trajectory in oesophageal cancer survivors2016In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, p. 25-26Article in journal (Refereed)
  • 44.
    Ancillotti, Mirko
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Eriksson, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology.
    Veldwijk, Jorien
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Institute of Health Policy and Management, Erasmus University, Bayle (J) building - Campus Woudestein, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands.
    Nihlén Fahlquist, Jessica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Andersson, Dan I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Godskesen, Tove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Ersta Sköndal Bräcke högskola, Stigbergsgatan 30, 100 61 Stockholm, Sweden.
    Public awareness and individual responsibility needed for judicious use of antibiotics: a qualitative study of public beliefs and perceptions2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 1153Article in journal (Refereed)
    Abstract [en]

    Background

    High consumption of antibiotics has been identified as an important driver for the increasing antibiotic resistance, considered to be one of the greatest threats to public health globally. Simply informing the public about this consequence is insufficient to induce behavioral change. This study explored beliefs and perceptions among Swedes, with the aim of identifying factors promoting and hindering a judicious approach to antibiotics use. The study focused primarily on the medical use of antibiotics, also considering other aspects connected with antibiotic resistance, such as travelling and food consumption.

    Methods

    Data were collected through focus group discussions at the end of 2016. Twenty-three Swedes were recruited using an area-based approach and purposive sampling, aiming for as heterogeneous groups as possible regarding gender (13 women, 10 men), age (range 20–81, mean 38), and education level. Interview transcripts were analyzed using qualitative content analysis. The Health Belief Model was used as a theoretical framework.

    Results

    Antibiotic resistance was identified by participants as a health threat with the potential for terrible consequences. The severity of the problem was perceived more strongly than the actual likelihood of being affected by it. Metaphors such as climate change were abundantly employed to describe antibiotic resistance as a slowly emerging problem. There was a tension between individual (egoistic) and collective (altruistic) reasons for engaging in judicious behavior. The individual effort needed and antibiotics overprescribing were considered major barriers to such behavior. In their discussions, participants stressed the need for empowerment, achieved through good health communication from authorities and family physicians.

    Conclusions

    Knowledge about antibiotic consumption and resistance, as well as values such as altruism and trust in the health care system, has significant influence on both perceptions of individual responsibility and on behavior. This suggests that these factors should be emphasized in health education and health promotion. To instead frame antibiotic resistance as a slowly emerging disaster, risks diminish the public perception of being susceptible to it.

  • 45.
    Andersson, Anna Karin
    et al.
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Martin, Lene
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Strand Brodd, Katarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Almqvist, Lena
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Patterns of everyday functioning in preschool children born preterm and at term2017In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 67, p. 82-93Article in journal (Refereed)
    Abstract [en]

    Background/Aim: Children born preterm are at risk of neonatal complications but the long-term consequences for everyday functioning is not well known. The study aimed to identify patterns of everyday functioning in preschool children born preterm and at term in relation to perinatal data, neonatal risk factors, behaviour, and socioeconomic status. Registry data and data from parent rated questionnaires were collected for 331 children.

    Method: A person-oriented approach with a cluster analysis was used.

    Results: A seven cluster solution explained 65.91% of the variance. Most children (n = 232) showed patterns of strong everyday functioning. A minority of the children (n = 99), showed diverse patterns of weak everyday functioning. Perinatal characteristics, neonatal risk factors and socio-economics did not predict cluster group membership. Children born preterm were represented in all clusters.

    Conclusion, implications: Most preschool children are perceived by their parents with strong everyday functioning despite being born preterm. However small groups of children are, for various reasons, perceived with weak functioning, but preterm birth is not the sole contributor to patterns of weak everyday functioning. More critical for all children's everyday functioning is probably the interaction between individual factors, behavioural factors and contextual factors. To gain a broader understanding of children's everyday functioning. Child Health Services need to systematically consider aspects of body function, activity and in addition participation and environmental aspects.

  • 46.
    Andersson, Henrik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ljungberg, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sjuksköterskors förutsättningar att handleda studenter2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Nurses conditions when preceptoring students

    Preceptoring student-nurses is a field that concerns all clinical registered nurses. This field has been an obvious task for nurses but not been visible and acknowledged. The aim of this study is to explore what conditions nurses percept they need to precept student in clinical settings.

    Method used is a systematic literature study where 11 scientific articles been critically reviewed and analysed.

    The study identified three main categories to be important conditions for nurses when preceptoring students. They are about:

    • cooperation
    • knowledge and competence
    • organizational conditions and resource requirement

    To these categories occur a number of sub-categories. They deal with the need of cooperation between university, clinical setting, preceptor and student. Education and preparation of the preceptor is necessary to increase the knowledge of methods when preceptoring. The preceptors' motivation and level of interest in preceptoring is important. To obtain a good quality on preceptorship- the nurse need to be educated, get knowledge about preceptor strategies, get support and time for reflection. They also need feedback and rewards. The workload for the nurse need to be adjusted when preceptoring students so it can take the time needed.

  • 47. Andersson, P
    et al.
    Bratt, J
    Heimburger, M
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Palmblad, J
    Inhibition of neutrophil dependent cytotoxicity for human endothelial cells by ACE inhibitors2014In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 80, no 5, p. 339-345Article in journal (Refereed)
    Abstract [en]

    Angiotensin-converting enzyme inhibitors (ACEi) have immunomodulating properties and have been suggested to protect against endothelial injury, for example myocardial infarction and reperfusion injury. We tested whether two ACEi (captopril and enalapril), differing in a thiol group, protected human umbilical vein endothelial cells (HUVEC) from cytotoxicity induced by polymorphonuclear neutrophils (PMN) in vitro, when cells were activated by tumour necrosis factor-α (TNFα) or the arachidonate derivative lipoxin-A4 (LXA4), using separate cytotoxicity pathways. When 51Cr labelled HUVEC were treated with captopril (0–500 μm) or enalapril (0–100 μm) for 2 h and then activated by TNFα (100 ng/ml) for 24 h, a significant, dose-dependent reduction of 51Cr release was observed. Similarly, captopril reduced 51Cr release when LXA4 (0.1 μm) was used to stimulate PMN for 4 h. Among previously defined mechanisms of significance for the cytotoxic reaction, expression of ICAM-1, but not intracellular Ca2+ changes in PMN or PMN adherence to HUVEC, were reduced by ACEi treatment. Moreover, both ACEi inhibited HUVEC surface expression of TNFα receptor I (but not II). Thus, these ACEi, particularly captopril, interfere with PMN-induced cytotoxicity for endothelial cells by modulating pro-inflammatory surface receptors, which is a novel effect that might be explored for further therapeutic approaches.

  • 48.
    Andersén, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Christian, Ståhl
    National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University.
    Anderzén, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Larsson, Kjerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 790Article in journal (Refereed)
    Abstract [en]

    Background: The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual’s ability to work. The aim of this study was to investigate clients’ experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. 

    Methods: A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis.

    Results: The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support.  2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development.

    Conclusions: The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

  • 49.
    Andersén, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Larsson, Kjerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Berglund, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Anderzén, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Strengthened General Self-Efficacy with Multidisciplinary Vocational Rehabilitation in Women on Long-Term Sick Leave: A Randomised Controlled Trial2018In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688Article in journal (Refereed)
    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.

  • 50.
    Andersén, Åsa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Larsson, Kjerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Pingel, Ronnie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Anderzén, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    The relationship between self-efficacy and transition to work or studies in young adults with disabilities2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 2, p. 272-278Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate perceived self-efficacy in unemployed young adults with disabilities and the association between self-efficacy and transition to work or studies.

    Methods: This prospective cohort study collected data through self-report questionnaires and registry data from a vocational rehabilitation project with young adults, aged 19-29 years. The Swedish Social Insurance Agency, the Swedish Public Employment Service and the participating municipalities identified potential participants to the study. A total of 531 participants were included in the study, of which 249 (47%) were available for analysis. Multinomial logistic regression models were carried out to estimate the associations between self-efficacy, demographic, health and employment status. The latter was coded as: “no transition to work or studies”, “transition to studies”, and “transition to work”.

    Results: A higher level of self-efficacy was associated with increased odds for “transition to work” (OR=2.37, p<0.05). This finding remained consistent when adjusting for possible confounders. The mean value of self-efficacy was low, and participants with lower self-efficacy reported worse self-rated health (p<0.001) compared with participants with higher self-efficacy.

    Conclusions: The results from this study suggest that self-efficacy should be addressed in vocational rehabilitation of young adults with disabilities in order to support their transition and integration into the labour market.

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