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  • 1. Aili, Katarina
    et al.
    Nyman, Teresia
    Hillert, Lena
    Svartengren, Magnus
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain: A 5-year prospective study2015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 3, s. 315-323Artikel i tidskrift (Refereegranskat)
    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.

  • 2.
    Andersén, Åsa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicinsk epidemiologi.
    Larsson, Kjerstin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicinsk epidemiologi.
    Pingel, Ronnie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Kristiansson, Per
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Anderzén, Ingrid
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    The relationship between self-efficacy and transition to work or studies in young adults with disabilities2018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 2, s. 272-278Artikel i tidskrift (Refereegranskat)
    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.

  • 3.
    André, Malin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna.
    Lissner, Lauren
    Bengtsson, Calle
    Hallström, Tore
    Sundh, Valter
    Björkelund, Cecilia
    Cohort differences in personality in middle-aged women during a 36-year period: Results from the Population Study of Women in Gothenburg2010Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, nr 5, s. 457-464Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To investigate secular trends in personality traits in adult female populations. Methods: Two representative, population-based cohorts of women, 38 (n = 318) and 50 (n = 593) years of age participated in a health examination in 1968 and 2004 in Gothenburg, Sweden. The Eysenck Personality Inventory (EPI) and Cesarec-Marke Personality Schedule (CMPS) were used to measure personality traits. Socioeconomic and lifestyle variables (personal income, education, marital status, children at home, physical activity and smoking) were reported. Results: In both age groups, secular comparisons in psychological profile subscales showed an increase in dominance, exhibition, aggression and achievement. Only small divergences were seen concerning affiliation, guilt feelings, nurturance and succorance. EPI showed a corresponding rise in extroversion. Social data showed a statistically significant increase in percentage of unmarried women, personal income levels, and higher educational achievement. While around 70% of women in 1968-69 had elementary school education only, around 90% had high school or university education in 2004-05. Conclusions: The results indicate major transitions in the adult Swedish female population in the direction of a more stereotypically "male'' personality profile, but not at the expense of traditionally socially important female traits, which remained constant. These results are consistent with the hypothesis that society and the environment influence personality.

  • 4.
    Annerbäck, Eva-Maria
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Sahlqvist, Lotta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Wingren, Gun
    A cross-sectional study of victimisation of bullying among schoolchildren in Sweden: background factors and self-reported health complaints2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 3, s. 270-277Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To examine background factors for bullying and associations between bullying victimisation and health problems. Methods: A cross-sectional study on all pupils in grades 7 and 9 in a Swedish county was conducted in 2011 (n=5248). Data have been analysed with bi- and multivariate models. Results: 14% of the children reported that they had been bullied during the past 2 months. Background factors for bullying were: gender (girls more often); age (younger students more often); disability/disease; high body mass index, and having parents born abroad. There were strong associations between being bullied and poor health and self-harm. Associations with poor general health for boys and girls and mental health problems for girls showed stronger associations with higher frequency of bullying than with lower. For boys, physical bullying had stronger correlations with poor general health than written-verbal bullying. Conclusions: Bullying is a serious public health problem among young people and healthcare professionals have an important task in identifying exposed children. Children who are "different" are more exposed to bullying, which implies that school personnel, parents, and other adults in these children's social networks can play an important role in paying attention to and preventing the risk of bullying.

  • 5.
    Berg, Noora J.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Livsstil och rehabilitering vid långvarig sjukdom. Natl Inst Hlth & Welf, POB 30, Helsinki 00271, Finland.
    Kiviruusu, Olli H.
    Natl Inst Hlth & Welf, POB 30, Helsinki 00271, Finland.
    Lintonen, Tomi P.
    Finnish Fdn Alcohol Studies, Helsinki, Finland;Univ Tampere, Tampere, Finland.
    Huurre, Taina M.
    Natl Inst Hlth & Welf, POB 30, Helsinki 00271, Finland.
    Longitudinal prospective associations between psychological symptoms and heavy episodic drinking from adolescence to midlife2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, nr 4, s. 420-427Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: This study examined whether development of psychological symptoms (PS) differed between persons with different longitudinal profiles of heavy episodic drinking (HED) from adolescence to midlife. In addition, the reciprocal associations between PS and HED were studied. Methods: Participants of a Finnish cohort study in 1983 at age 16 (N = 2194) were followed up at ages 22 (N = 1656), 32 (N = 1471), and 42 (N = 1334). HED was assessed with frequency of intoxication (16-22 years) and having six or more drinks in a session (32-42 years). Using latent class analysis, the participants were allocated to steady high, increased, moderate, and steady low groups according to their longitudinal profiles of HED. The PS scale (16-42 years) covered five mental complaints. The latent growth curve of PS was estimated in the HED groups for comparisons. In addition, the prospective associations between symptoms and HED were examined using cross-lagged autoregressive models. Results: PS grew from 16 to 32 years, but declined after that, with women having higher level of PS than men. PS trajectory followed a path at highest and lowest level in the steady high and steady low HED groups, respectively. Symptoms predicted later HED, but the association in the opposite direction was not found. Conclusions: The more the HED trajectory indicated frequent HED, the higher was the level of PS throughout the follow-up. Results support the self-medication hypothesis, suggesting that alcohol is used to ease the burden of PS. More attention should be paid to alcohol use of people with mental symptoms in health services.

  • 6.
    Bergström, Malin
    et al.
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Fransson, Emma
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Wells, Michael B.
    Köhler, Lennart
    Hjern, Anders
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Children with two homes: Psychological problems in relation to living arrangements in Nordic 2-9 year olds2018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Joint physical custody, children spending equal time in each parents’ respective home after a parental divorce, is particularly common in Nordic compared with other Western countries. Older children have been shown to fare well in this practice but for young children there are few existing studies. The aim of this paper is to study psychological problems in 2- to 9-year-old Nordic children in different family forms. Methods: Total symptom score according to the Strengths and Difficulties Questionnaire as well as scores showing externalizing problems were compared among 152 children in joint physical custody, 303 in single care and 3207 in nuclear families through multiple linear regression analyses. Results: Children in single care had more psychological symptoms than those in joint physical custody (B = 1.08; 95% CI 0.48 to 1.67) and those in nuclear families had the least reported symptoms (B = −0.53; 95% CI −0.89 to −0.17). Externalizing problems were also lower in nuclear families (B = −0.28, 95% CI −0.52 to −0.04) compared with joint physical custody after adjusting for covariates. Conclusions: Young children with non-cohabiting parents suffered from more psychological problems than those in intact families. Children in joint physical custody had a lower total problem score than those in single care after adjusting for covariates. Longitudinal studies with information on family factors before the separation are needed to inform policy of young children’s post-separation living arrangements.

  • 7.
    Bohlin, Anna
    et al.
    Umeå universitet, Allmänmedicin.
    Ahlgren, Christina
    Umeå universitet, Sjukgymnastik.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Gustafsson, Per E.
    Umeå universitet, Allmänmedicin.
    Perceived gender inequality in the couple relationship and musculoskeletal pain in middle-aged women and men2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 8, s. 825-831Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Musculoskeletal pain is a major health problem, especially in women, and is partially determined by psychosocial factors. The aim of the present study was to investigate whether gender inequality in the couple relationship was related to musculoskeletal pain. Methods: Participants (n=721; 364 women and 357 men) were all individuals living in a couple relationship in the Northern Swedish Cohort, a 26-year Swedish cohort study. Self-administered questionnaire data at age 42 years comprised perceived gender inequality in the couple relationship and musculoskeletal pain (in three locations, summarised into one score and median-split), concurrent demographic factors, psychological distress, and previous musculoskeletal pain at age 30 years. Associations were examined using logistic regression. Results: Gender inequality was positively associated with symptoms of musculoskeletal pain in the total sample, remaining significant after addition of possible confounders and of previous musculoskeletal pain. Separate adjustment for concurrent psychological distress attenuated the association but not below significance. The association was present and of comparable strength in both women and men. Conclusions: Gender inequality in the couple relationship might contribute to the experience of musculoskeletal pain in both women and men. The results highlight the potential adverse bodily consequences of living in unequal relationships.

  • 8.
    Borisova, Liubov
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Martinussen, Pål E.
    Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
    Rydland, Håvard T.
    Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
    Stornes, Per
    Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
    Eikemo, Terje A.
    Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
    Public evaluation of health services across 21 European countries: The role of culture2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 2, s. 132-139Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This work examined the role of cultural values in understanding people’s satisfaction with health services across Europe. Methods: We used multilevel linear regression analysis on the seventh round of the European Social Survey from 2014, including c. 40,000 respondents from 21 countries. Preliminary intraclass correlation analyses led us to believe that some explanations of variance in the dependent variable were to be found at the country level. In search of country level explanations, we attempted to account for the role of national culture in influencing citizens’ attitudes towards health systems. This was done by using Hofstede’s dimensions of power distance, individualism, masculinity and uncertainty avoidance, giving each country in the survey a mean aggregated score. Results: In our first model with individual level variables, being female, having low or medium education, experiencing financial strain, and reporting poor health and unmet medical needs were negatively associated with individual satisfaction with national healthcare systems, with the latter variable showing the strongest effect. After including Hofstede’s cultural dimensions in our multilevel model, we found that the power distance index variable had a negative effect on the dependent variable, significant at the 0.1 level. Conclusions: Citizens are likely to evaluate their national health system more negatively in national cultures associated with autocracy and hierarchy.

  • 9.
    Brännlund, Annica
    et al.
    Umeå universitet, Sociologiska institutionen.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Higher education and psychological distress: a 27-year prospective cohort study in Sweden2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 2, s. 155-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Research identifies a positive link between education and a reduction of psychological distress, but few studies have analysed the long-term impact of education on psychological distress. This study followed the same cohort for 27 years, investigating the association between education and adult psychological distress. Further, it discuss whether the link can be understood through the mediating mechanisms of social and labour-market resources, furthermore, if the mechanisms operate differently for men and women. Method: A 27-year prospective cohort study was performed at ages 16, 18, 21, 30 and 43. The cohort consisted of all students (n = 1083, of which 1001 are included in this study) in their final year of compulsory school in Sweden. Data were collected through comprehensive questionnaires (response rate 96.4%), and analysed with OLS regression, with psychological distress at age 21, 30 and 43 as dependent variable. Baseline psychological distress, measures of social and labour-market resources, and possible educational selection factors were used as independent variables. To compare the overall magnitude of educational differences, a kappa index was calculated. Results: A positive relation between higher education and less psychological distress was found. When becoming older this relation weakens and a link between social and labour-market resources and psychological distress is observed, indicating that education in a long-term perspective operates through the suggested mechanisms. Additionally, the mechanisms work somewhat differently for men than for women: labour-market resources were significant for men and social resources were important for women. Conclusions: Main findings: higher education is positively linked to less psychological distress, and the link can somewhat be understood through the mechanisms of social and labour-market resources.

  • 10.
    Brännlund, Annica
    et al.
    Umeå universitet, Sociologiska institutionen.
    Hammarström, Anne
    Umeå universitet, Allmänmedicin.
    Strandh, Mattias
    Umeå universitet, Sociologiska institutionen.
    Education and health-lifestyle among men and women in Sweden: a 27-year prospective cohort study2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 3, s. 284-292Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Previous research has found a positive association between health-behaviour and health. Only a few longitudinalstudies have been performed, and as far as we found, none have followed a cohort for 27 years. Methods: This study used acohort study, the “Northern Swedish Cohort”, which consisted of all graduates, n = 1080, from a compulsory school in aSwedish town. Data were collected with a comprehensive questionnaire; response rate 96.4%. Health-behaviour was analysedwith binary logistic regression, with health-behaviour at age 21, 30 and 43 years as dependent variable. Besides baselinehealth-behaviour, gender, somatic and psychological health and socioeconomic background, the analyses were adjustedfor work situation and social network. Results: The main findings were that education reduces the probability of unhealthybehaviour over the life course, which held after controlling for early life health-behaviour and possible confounders. Thegeneral education effect on health-behaviour was stronger among men than among women. Conclusions: Higher educationreduces the probability of unhealthy behavior. Thus, investments in higher education should be an important public goal.

  • 11.
    Byhamre, Marja Lisa
    et al.
    Umea Univ, Dept Publ Hlth & Clin Med, Family Med, SE-90185 Umea, Sweden..
    Gustafsson, Per E.
    Umea Univ, Dept Publ Hlth & Clin Med, Epidemiol & Global Hlth, Umea, Sweden..
    Jansson, Jan-Håkan
    Umea Univ, Dept Publ Hlth & Clin Med, Skelleftea Res Unit, Umea, Sweden..
    Wennberg, Maria
    Umea Univ, Dept Publ Hlth & Clin Med, Nutr Res, Umea, Sweden..
    Hammarström, Anne
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Folkhälsovetenskap.
    Wennberg, Patrik
    Umea Univ, Dept Publ Hlth & Clin Med, Family Med, SE-90185 Umea, Sweden..
    Snus use during the life-course and risk of the metabolic syndrome and its components2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 8, s. 733-740Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: We aimed to investigate the association between life-course exposure to snus and prevalence of the metabolic syndrome and its components in adulthood.

    Design and method: Tobacco habits at baseline (age 16) and three follow-ups (ages 21, 30 and 43) were assessed among 880 participants in a population-based cohort in Northern Sweden. Presence of the metabolic syndrome at age 43 was ascertained using the International Diabetes Federation criteria. Odds ratios and CIs for risk of the metabolic syndrome and its components by snus use at 16, 21, 30 and 43 years were calculated using logistic regression. Cumulative snus use was defined as number of life periods (1-4) with current snus use.

    Results: At age 43, 164 participants (18.6%) were current snus users. We found no association between exclusive snus use at the ages of 16, 21, 30 and 43 years and the metabolic syndrome at age 43 years. Snus use (among non-smokers) was associated with raised triglycerides and high blood pressure in crude analysis, but not in multivariable models. There was no association between cumulative snus use and risk of the metabolic syndrome. Cumulative snus use was associated with central obesity, raised triglycerides and impaired fasting glucose/diabetes mellitus type 2 in crude analyses, but not after adjustments.

    Conclusions: The health consequences of snus exposure from adolescence to mid-adulthood do not seem to include increased risk of the metabolic syndrome or its components. The cardio-metabolic risk of dual exposure to snus and cigarettes may warrant further attention.

  • 12.
    Danermark, Berth
    et al.
    1School of Health and Medical Science, Örebro University, Örebro, Sweden.
    Hanning, Marianne
    Swedish National Board of Health and Welfare, Stockholm, Sweden .
    Hearing and vision: Health in Sweden: The National Health Report 2012. Chapter 172012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 9(Suppl), s. 287-292Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Over a million people in Sweden have difficulty hearing what is said in a conversation between several people. Almost twice as many young people today consider themselves hard of hearing than was the case 10 years ago. However, this self-reported increase has not been confirmed by studies of hearing loss.

    At least 10,000 deaf and hearing-impaired people are under the age of 20. In most cases, their hearing impairments are the result of hereditary factors. People who have impaired hearing report having worse health than those with normal hearing. This is particularly true of younger, actively employed people.

    Many people who are hard of hearing suffer unnecessarily because they lack the hearing-aid devices they need. Almost half the people who would benefit from a hearing aid do not have one. Only a quarter of hearing-impaired people use other assistive listening devices, such as amplified sound in telephones and doorbells.

    One in every two Swedes over the age of 16 needs glasses to read plain text in a daily newspaper. One per cent of the population is unable to read text in a daily newspaper with or without glasses to help them. It is slightly less common today than 10 years ago for older women to have impaired vision. This is probably because cataracts, the most common cause of impaired vision, are operable. Most people given cataract surgery regain very good vision.

    The most common cause of blindness in older people is age-related degeneration of the macula lutea. The treatment currently available is only effective with a small group of people among those who suffer from acute problems. Strabism can result in vision impairment if not treated early. Child healthcare centres and schools offer screening procedures for detecting strabism. As a result, the percentage of people in the population with this condition has declined to just under 2 per cent.

  • 13.
    Danielsson, Maria
    et al.
    Swedish National Board of Health and Welfare, Stockholm, Sweden.
    Berglund, Torsten
    Swedish Institute for Communicable Disease Control, Solna, Sweden.
    Forsberg, Margareta
    Administration for Allocation of Social Welfare, City of Gothenburg, Sweden.
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Rogala, Christina
    RFSU, Stockholm, Sweden.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Sexual and reproductive health Health in Sweden: The National Public Health Report 2012. Chapter 92012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 9, s. 176-196Artikel i tidskrift (Refereegranskat)
  • 14. Durbeej, Natalie
    et al.
    Abrahamsson, Ninnie
    Papadopoulos, Fotios C
    Beijer, Karin
    Salari, Raziye
    Sarkadi, Anna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Outside the norm: Mental health, school adjustment and community engagement in non-binary youth.2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, artikel-id 1403494819890994Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: The aim of this study was to explore the role of self-reported non-binary gender identity in mental health problems, school adjustment, and wish to exert influence on municipal issues in a community sample of adolescents. Methods: In a cross-sectional design, data were collected through an anonymous survey in Uppsala County, Sweden, among 8385 students (response rate 58.2%) in grades 7, 9, and 11, aged 13-17 years. The Strengths and Difficulties Questionnaire (SDQ) self-report was used to assess mental health problems. Gender identity was measured with one item and youth were categorized into those who identified as male or female (i.e. binary youth), and those who did or could not identify with either gender (i.e. non-binary youth). Logistic regressions and qualitative content analysis were used to analyse data. Results: Youth with non-binary gender identity (n = 137; 1.6%) had higher odds of having mental problems according to the SDQ total score (OR=3.05; 1.77-5.25). The association between non-binary gender identity and mental health problems remained significant after adjusting for confounders. Additionally, compared to their binary peers, the non-binary youth reported more truancy (36.5% vs 49.6%), more often failed a subject (21.5% vs 36.5%), and were more interested in exerting influence on municipal issues such as sociopolitical development, education, municipal services, and drug and alcohol policies (25.3% vs 38.0%). Conclusions: Youth with non-binary gender identity constitute a vulnerable population regarding mental health problems and school adjustment. The willingness to exert influence on municipal issues suggests a possible pathway to engagement.

  • 15.
    Elwér, Sofia
    et al.
    Umeå universitet, Institutionen för folkhälsa och klinisk medicin.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Strandh, Mattias
    Umeå universitet, Institutionen för socialt arbete.
    Gustafsson, Per
    Umeå universitet, Socialmedicin.
    Life course models of economic stress and poor mental health in mid-adulthood: results from the prospective Northern Swedish Cohort2015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 8, s. 833-840Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim was to analyse the association between economic stress during youth and adulthood, and poor mental health through life course models of (1) accumulation of risk and (2) sensitive period. Methods: The study was based on the Northern Sweden Cohort, a 26-year prospective cohort (N = 1010 in 2007; 94% of those participating in 1981 still alive) ranging from adolescence to middle age. Economic stress was measured at age 16, 21, 30 and 42 years. Two life course models of accumulation of risk and sensitive period were analysed using ordinal regression with internalized symptoms of mental health as outcome. Results: Exposure of economic stress at several life course periods was associated with higher odds of internalized mental health symptoms for both women and men, which supports the accumulated risk model. No support for a sensitive period was found for the whole sample. For men, however, adolescence appears to be a sensitive period during which the exposure to economic stress has negative mental health consequences later in life independently of economic stress at other ages. Conclusion: This study confirms that the duration of economic stress between adolescence and middle age is important for mental health. In addition, the results give some indication of a sensitive period of exposure to economic stress during adolescence for men, although more research is needed to confirm possible gender differences.

  • 16. Engström, Karin
    et al.
    Hallqvist, Johan
    Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm.
    Möller, Jette
    Laflamme, Lucie
    Do episodes of peer victimization trigger physical injury?: A case-crossover study of Swedish school children2005Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, nr 1, s. 19-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS

    The aim of this study was to investigate how long the effect of peer victimization on the occurrence of physical injury lasts and whether the effect varies according to how frequently an injured child is victimized.

    METHODS

    A case-crossover design was employed. Children aged 10-15 years residing in Stockholm County during two consecutive school years were eligible as cases. Further inclusion criteria were that the children had been hospitalized or called back for a medical check-up due to a physical injury. Information on children's exposure to peer victimization at school was gathered in interviews, and on their social characteristics through a questionnaire filled in by parents. A total of 575 children were included.

    RESULTS

    Our analyses show that there is an increase in risk of unintentional injury after an episode of peer victimization shortly after the end of exposure to victimization (RR = 5.5) but not thereafter. The risk is substantially higher among children seldom victimized (RR = 49.9) than among those victimized on a more regular basis (RR = 2.5). The extent to which family social circumstances modify the risk is difficult to establish from the material at hand.

    CONCLUSION

    Peer victimization may trigger the occurrence of unintentional injuries in childhood and the effect is short lasting. The results need to be replicated and special attention should be given to separating lesson time from break time to avoid confounding by time of day.

  • 17.
    Eriksson, A
    et al.
    Research Unit Skellefteå, Internal Medicine, Department of Public Health and Clinical Medicine, Umeå University, .
    Stenlund, H
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå.
    Ahlm, K
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå.
    Boman, K
    Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, .
    Bygren, LO
    Department of Biosciences and Nutrition, Preventive Nutrition, Karolinska Institutet, Stockholm.
    Johansson, Lars Age
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin. Centre for Epidemiology, Swedish National Board of Health and Welfare, Stockholm, Sweden .
    Olofsson, BO
    Department of Public Health and Clinical Medicine, Internal Medicine, Umeå University, Umeå.
    Wall, S
    2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå.
    Weinehall, L
    2Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå.
    Accuracy of death certificates of cardiovascular disease in a community intervention in Sweden2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 8, s. 883-889Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim was to investigate the possibility to evaluate the mortality pattern in a community intervention programme against cardiovascular disease by official death certificates.

    Methods: For all deceased in the intervention area (Norsjö), the accuracy of the official death certificates were compared with matched controls in the rest of Västerbotten. The official causes of death were compared with new certificates, based on the last clinical record, issued by three of the authors, and coded by one of the authors, all four accordingly blinded.

    Results: The degree of agreement between the official underlying causes of death in “cardiovascular disease” (CVD) and the re-evaluated certificates was not found to differ between Norsjö and the rest of Västerbotten. The agreement was 87% and 88% at chapter level, respectively, but only 55% and 55% at 4-digit level, respectively. The reclassification resulted in a 1% decrease of “cardiovascular deaths” in both Norsjö and the rest of Västerbotten.

    Conclusions: The disagreements in the reclassification of cause of death were equal but large in both directions. The official death certificates should be used with caution to evaluate CVD in small community intervention programmes, and restricted to the chapter level and total populations.

  • 18.
    Ferdous, Tamanna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Cederholm, Tommy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Klinisk nutrition och metabolism.
    Razzaque, Abdur
    icddr,b: Knowledge for Global Lifesaving Solutions, Dhaka, Bangladesh.
    Wahlin, Åke
    Department of Psychology, Stockholm University,.
    Kabir, Zarina Nahar
    Division of Nursing, NVS, Karolinska Institute.
    Nutritional status and self-reported and performance-based evaluationof physical function of elderly persons in rural Bangladesh2009Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, nr 5, s. 518-524Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To investigate the impact of nutritional status on self-reported as well as performance-based indicators of physical function in a rural elderly population in Bangladesh. Methods: A cross-sectional study conducted in Matlab, Bangladesh, included 457 randomly selected community living elderly persons aged 60 years or more (60-92years; 69±7years). Mobility, Activities of Daily Living (ADL), performance tests, handgrip strength, Mini Nutritional Assessment (MNA), and a structured questionnaire were used to assess physical function, nutritional status, socio-economic and health status respectively. Descriptive and linear hierarchical regression analyses were applied. Results: Seven percent of the participants reported limitations in mobility, and 8% reported limitations in ADL. However, more than half of the participants had difficulties performing one or more items in the performance tests. According to MNA, 26% of the participants were undernourished and 62% were at risk of malnutrition. More undernourished participants reported limited mobility, impaired ADL, and difficulties in the performance tests compared to the well-nourished participants. A corresponding reduction in grip strength was observed in the undernourished group. Accordingly, higher MNA scores, indicating better nutritional status, were significantly associated with higher mobility index, higher ADL index, higher performance tests index, and higher scores in handgrip strength. These associations remained after adjusting for demographic, socio-economic and health status differences. Conclusion: Good nutritional status is important for physical function of elderly people, even after controlling for possible confounders. Performance tests indicated a higher degree of functional impairment than that observed by self-reported estimation.

  • 19.
    Flacking, Renée
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Dykes, Fiona
    MAINN, School of Public Health and Clinical Sciences, University of Central Lancashire, Preston, UK.
    Ewald, Uwe
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    The influence of fathers' socioeconomic status and paternity leave on breastfeeding duration: a population-based cohort study2010Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, nr 4, s. 337-343Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM:

    The propensity to breastfeed is a matter of public concern because of the favourable effects for infants. However, very few studies have described the influence of paternal variables upon duration of breastfeeding. The aim of this study was to describe the effects of fathers' socioeconomic status and their use of paternity leave on breastfeeding duration for infants up to 1 year of age.

    METHODS:

    A prospective population-based cohort study was undertaken. Data on breastfeeding, registered in databases in two Swedish counties for 1993-2001, were matched with data on socioeconomic status and paternity leave obtained from Statistics Sweden. Fathers of 51,671 infants were identified and included.

    RESULTS:

    Infants whose fathers had a lower level of education, were receiving unemployment benefit and/or had a lower equivalent disposable household income were significantly less likely to be breastfed at 2, 4, 6, 9, and 12 months of age. Infants whose fathers did not take paternity leave during the infant's first year were significantly less likely to be breastfed at 2 (p < 0.001), 4 (p < 0.001), and 6 months (p < 0.001).

    CONCLUSIONS:

    This paper shows that an enabling of an increased involvement from fathers during the infants' first year of life, such as by paid paternity leave, may have beneficial effects on breastfeeding up to 6 months of age. A more systematic approach to supporting fathers' involvement may be particularly valuable to those infants whose fathers have a lower socioeconomic status.

  • 20.
    Forsman, Anna K.
    et al.
    Abo Akad Univ, Vaasa, Finland; Natl Inst Hlth & Welf THL, Vaasa, Finland.
    Freden, Lars
    Univ West, Trollhättan, Sweden.
    Lindqvist, Rafael
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Wahlbeck, Kristian
    Finnish Assoc Mental Hlth, Helsinki, Finland; Natl Inst Hlth & Welf, Helsinki, Finland.
    Contribution of the Nordic School of Public Health to the public mental health research field: a selection of research initiatives, 2007-20142015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, s. 66-72Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The field of public mental health has been defined by an expert group convened by the Nordic School of Public Health (NHV) as encompassing the experience, occurrence, distribution and trajectories of positive mental health and mental health problems and their determinants; mental health promotion and prevention of mental disorders; as well as mental health system policies, governance and organization. The mental health priorities of the Nordic Council of Ministers in 2010 signalled a mutual Nordic exchange of knowledge in the following thematic areas: child and adolescent mental health; working life and mental health; mental health in older people; strengthening the role of primary care in mental health service provision; stronger involvement of users and carers; and reduction of use of coercion in psychiatric care. Efforts to realize these priorities included commissioning the Nordic Research Academy for Mental Health, an NHV-based network of research institutions with a common interest in mental health research across the Nordic countries, to develop, organize and follow-up projects on public mental health. The research initiatives included mental health policy analysis, register-based research and research focused on the users' perspective in a Nordic context, as well as EU-level research policy analysis. The public mental health research conducted at the NHV highlighted the complexity of mental health and emphasized that the broad determinants of mental health need to be increasingly addressed in both public health research and practice. For example, health promotion actions, improved access to health care, a healthy alcohol policy and prevention of suicides and violence are all needed to reduce the life expectancy gap - a red flag indicator of public health inequalities. By exchanging knowledge and best practice, the collaboration between the Nordic countries contributes to the welfare of the region. The expertise and traditions developed at the NHV are of significant importance in this work.

  • 21.
    Fransson, Emma
    et al.
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Turunen, Jani
    Stockholms universitet, Sociologiska institutionen.
    Hjern, Anders
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Östberg, Viveca
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Bergström, Malin
    Stockholms universitet, Centrum för forskning om ojämlikhet i hälsa (CHESS).
    Psychological complaints among children in joint physical custody and other family types: Considering parental factors2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 2, s. 177-183Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Increasing proportions of Scandinavian children and children in other Western countries live in joint physical custody, moving between parents’ homes when parents live apart. Children and parents in non-intact families are at risk of worse mental health. The potential influence of parental ill-health on child well-being in the context of differing living arrangements has not been studied thoroughly. This study investigates the psychological complaints of children in joint physical custody in comparison to children in sole parental care and nuclear families, while controlling for socioeconomic differences and parental ill-health. Methods: Data were obtained from Statistics Sweden’s yearly Survey of Living Conditions 2007–2011 and child supplements with children 10–18 years, living in households of adult participants. Children in joint physical custody (n=391) were compared with children in sole parental care (n=654) and children in nuclear families (n=3,639), using a scale of psychological complaints as the outcome measure. Results: Multiple regression modelling showed that children in joint physical custody did not report higher levels of psychological complaints than those in nuclear families, while children in sole parental care reported elevated levels of complaints compared with those in joint physical custody. Adding socioeconomic variables and parental ill-health only marginally attenuated the coefficients for the living arrangement groups. Low parental education and parental worry/anxiety were however associated with higher levels of psychological complaints. Conclusions: Psychological complaints were lower among adolescents in joint physical custody than in adolescents in sole parental care. The difference was not explained by parental ill-health or socioeconomic variables.

  • 22.
    Fredriksson, Mio
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Hälso- och sjukvårdsforskning. Aston Univ, Dept Sociol & Policy, Birmingham, W Midlands, England.
    Eriksson, Max
    Umea Univ, Dept Polit Sci, Umea, Sweden.
    Tritter, Jonathan Q.
    Aston Univ, Dept Sociol & Policy, Birmingham, W Midlands, England.
    Involvement that makes an impact on healthcare: Perceptions of the Swedish public2018Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 4, s. 471-477Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Participation and influence in society' is the first of 11 objective domains in Swedish public health policy. The aim of this article is to investigate the views of the Swedish general population on the impact of a range of health participation activities, and whether these views were associated with sociodemographic characteristics. Methods: The study utilizes a national representative survey of the Swedish population, aged 15 years and over (n = 1500). Results: Apart from voting in regional elections - which most of the respondents believed to be an influential way to make improvements in healthcare (74%) - respondents believed more in individual patient activities than activities associated with adopting a citizen role and acting collectively. A majority of respondents believed in the impact of replying to patient surveys (67%), making a complaint (61%), talking directly to staff (58%) or changing their healthcare provider (54%). Fewer believed in the impact of joining a patient organization (46%), taking part in a citizen council (35%) or joining a political party (34%). Beliefs in impact increased with educational attainment and decreased with age. Conclusions: The results suggest people have more confidence in the impact of participating as individual patients rather than collectively and as citizens. To ensure that activities enable participation and influence in society', complementary opportunities for collective involvement that also take into account under-represented voices such as those with a low level of education need to be developed.

  • 23. Fugelstad, Anna
    et al.
    Ramstedt, Mats
    Thiblin, Ingemar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Rättsmedicin.
    Johansson, Lars Age
    Drug-related deaths: Statistics based on death certificates miss one-third of cases.2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, artikel-id 1403494817745187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: Statistics on drug-related deaths (DRD) provide crucial information on the drug situation. The European Monitoring Centre for Drug and Drug Addiction (EMCDDA) has published a specification for extracting DRD from national mortality registers to be used in international comparisons. However, surprisingly little is known of the accuracy of DRD statistics derived from national mortality registers. This study assesses the accuracy of Swedish data derived from national mortality registers by comparing it with other sources of data.

    METHODS: We compared five Swedish datasets. Three were derived from national mortality registers, two according to a Swedish specification and one according to the EMCDDA specification. A fourth dataset was based on toxicological analyses. We used a fifth dataset, an inventory of DRD in Stockholm, to assess the completeness and coverage of the Swedish datasets.

    RESULTS: All datasets were extracted from high-quality registers, but still did not capture all DRD, and both the numbers and demographic characteristics varied considerably. However, the time trends were consistent between the selections. In international comparisons, data completeness and investigation procedures may impact even more on stated numbers.

    CONCLUSIONS: Basing international comparisons on numbers or rates of DRDs gives misleading results, but comparing trends is still meaningful.

  • 24.
    Fäldt, Anna
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Pediatrisk inflammationsforskning.
    Fabian, Helena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin/CHAP.
    Thunberg, Gunilla
    Dart Centre for Augmentative and Alternative Communication (AAC) and Assistive Technology (AT), Sahlgrenska University Hospital, Sweden.
    Lucas, Steven
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Pediatrisk inflammationsforskning. Uppsala universitet, Nationellt centrum för kvinnofrid (NCK).
    The study design of ComAlong Toddler: a randomised controlled trial of an early communication intervention2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, artikel-id 1403494819834755Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: This study design article aims to describe a research study focused on evaluating the use of the Infant-Toddler Checklist to identify children at 18 months with early communication difficulties, and to study the ComAlong Toddler intervention for parents to support their child's communication development.

    BACKGROUND: Communication disorders are a common public health problem affecting up to 20% of children. Evidence points to the importance of early detection and intervention to improve young children's communicative abilities and decrease developmental delay. Early identification of communication difficulties is possible with instruments such as Infant-Toddler Checklist. The ComAlong Toddler intervention is tailored to the needs of parents of young children with communication delay before definitive diagnosis. The parents are provided with guidance in communication enhancing strategies during home visit and five group sessions.

    METHODS: The study uses a prospective cohort design. Children were consecutively recruited during 2015-2017, and data will be collected 2015-2023. The screening was performed at the child health centre through use of the Infant-Toddler Checklist. An assessment and first consultation were then performed by a speech and language therapist for children with suspected communication delay according to the screen as well as for children referred for other reasons before the age of 2.5 years. Children with confirmed communication delay were randomised between two interventions: the ComAlong Toddler parental course or a telephone follow-up. Outcome measures include child communication and language skills and use of augmentative and alternative communication. To gain insight into the participants' perspectives, surveys have been collected from parents.

    CONCLUSION: The study will provide information regarding identification and intervention for 18-month old children with communication delay.

    TRIAL REGISTRATION: ISRCTN13330627.

  • 25.
    Granström, Fredrik
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Molarius, Anu
    Garvin, Peter
    Elo, Sirkka
    Feldman, Inna
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik.
    Kristenson, Margareta
    Exploring trends in and determinants of educational inequalities in self-rated health.2015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 7, s. 677-686Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: Educational inequalities in self-rated health (SRH) in European welfare countries are documented, but recent trends in these inequalities are less well understood. We examined educational inequalities in SRH in different age groups, and the contribution of selected material, behavioural and psychosocial determinants from 2000 to 2008.

    METHODS: Data were derived from cross-sectional surveys conducted in 2000, 2004 and 2008 including 37,478, 34,876 and 32,982 respondents, respectively, aged 25-75 in mid-Sweden. Inequalities were analysed by age-standardized and age-stratified rate ratios of poor SRH and age-standardized prevalence of determinants, and contribution of determinants by age-adjusted logistic regression.

    RESULTS: Relative educational inequalities in SRH increased among women from 2000 (rate ratio (RR) 1.70, 95% CI 1.55-1.85) to 2008 (RR 2.07, 95% CI 1.90-2.26), but were unchanged among men (RR 1.91-2.01). The increase among women was mainly due to growing inequalities in the age group 25-34 years. In 2008, significant age differences emerged with larger inequalities in the youngest compared with the oldest age group in both genders. All determinants were more prevalent in low educational groups; the most prominent were lack of a financial buffer, smoking and low optimism. Educational differences were unchanged over the years for most determinants. In all three surveys, examined determinants together explained a substantial part of the educational inequalities in SRH.

    CONCLUSIONS: Increased relative educational health inequalities among women, and persisting inequalities among men, were paralleled by unchanged, large differences in material/structural, behavioural and psychosocial factors. Interventions to reduce these inequalities need to focus on early mid-life.

  • 26. Gusdal, Annelie K
    et al.
    Beckman, Christel
    Wahlström, Rolf
    Department of Public Health Sciences, Division of Global Health (IHCAR), Stockholm, Sweden.
    Törnkvist, Lena
    District nurses' use for an assessment tool in their daily work with elderly patients' medication management2011Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, nr 4, s. 354-360Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To explore the capability of the Safe Medication Assessment (SMA) tool in identifying factors highly related to unsafe medication management among elderly patients and to investigate the district nurses' (DNs) opinions of the SMA's usefulness as a tool in their daily primary healthcare practice. Introduction: Elderly patients who experience many medical conditions often use multiple drugs. As well as the combined decline in physical and cognitive functions, the elderly are at high risk for medication-related problems. It is essential to develop a screening procedure to distinguish elderly at risk of an unsafe medication management.

    METHODS: An explorative study. During a 3-6-month period, 25 voluntary DNs used SMA with 160 patients (consecutively chosen and meeting four specified criteria) in their daily practice. Furthermore, DNs responded to questions regarding SMA's usefulness.

    RESULTS: The result showed that SMA had the capability to identify factors highly related to unsafe medication management among the elderly included in the study. In 64% of assessments DNs identified areas of new information and in 23% of the assessments DNs intervened. They found SMA to be satisfactory regarding its level of simplicity, relevance, completeness, intelligibility, and time for implementation.

    CONCLUSIONS: SMA alerted the DNs to patients' attitudes about medication and empowered them in identifying elderly patients who had unsafe medication management. SMA was also perceived as a useful assessment tool by the DNs.

  • 27.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Gustafsson, Per E
    Umeå universitet, Allmänmedicin.
    Strandh, Mattias
    Umeå universitet, Sociologiska institutionen.
    Virtanen, Pekka
    Umeå universitet, Epidemiologi och global hälsa.
    Janlert, Urban
    Umeå universitet, Epidemiologi och global hälsa.
    It´s no surprise! Men are not hit more than women by the health consequences of unemployment in the Northern Swedish Cohort2011Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, nr 2, s. 187-193Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Research often fails to ascertain whether men and women are equally hit by the health consequences of unemployment. The aim of this study was to analyze whether men’s self-reported health and health behaviour were hit more by unemployment than women’s in a follow-up of the Northern Swedish Cohort.

    Methods: A follow-up study of a cohort of all school leavers in a middle-sized industrial town in northern Sweden was performed from age 16 to age 42. Of those still alive of the original cohort, 94% (n = 1,006) participated during the whole period. A sample was made of participants in the labour force and living in Sweden (n = 916). Register data were used to assess the length of unemployment from age 40 to 42, while questionnaire data were used for the other variables.

    Results: In multivariate logistic regression analyses significant relations between unemployment and mental health/smoking were found among both women and men, even after control for unemployment at the time of the investigation and indicators of health-related selection. Significant relations between unemployment and alcohol consumption were found among women, while few visits to a dentist was significant among men.

    Conclusions: Men are not hit more by the health consequences of unemployment in a Swedish context, with a high participation rate of women in the labour market. The public health relevance is that the study indicates the need to take gendered contexts into account in public health research.

  • 28.
    Hammarström, Anne
    et al.
    Umeå universitet, Allmänmedicin.
    Phillips, Susan P.
    Gender inequity needs to be regarded as a social determinant of depressive symptoms: Results from the Northern Swedish cohort2012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 8, s. 746-752Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The importance of social and avoidable determinants of depressive symptoms has been increasingly recognized in public health research. However, when it comes to determinant of gender differences in depressive symptoms the focus is predominantly on biological unavoidable determinants. Thus, there is a need for more focus on gendered social determinants of health. The aim of this study was to analyse the importance of gender relations for depressive symptoms after taking socioeconomic factors and earlier depressive symptoms into account in the Northern Swedish cohort. Methods: A 26-year follow-up study of a cohort of all school leavers in a middle-sized industrial town in Northern Sweden was performed from age 16 until age 42. Of those still alive of the original cohort, 94% participated during the whole period and answered extensive questionnaires. Exposure was measured as socioeconomic status, financial strain, perceived gender inequity in the couple relationship and division of responsibility for domestic work. The outcome was depressive symptoms at age 42, while depressive symptoms were controlled at age 30. Results: In multivariate logistic regression analyses significant relations between financial strain and, among women only, also perceived gender equity in the couple relationship and depressive symptoms after adjustment for earlier health status, as well as for all other exposure measures. Conclusions: Financial strain, and among women, also gender inequity in the couple relationship was related to depressive mood. There is a need to pay more attention to gender relations in future research on social determinants of depressive mood.

  • 29.
    Hartig, Terry
    et al.
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutet för bostads- och urbanforskning (IBF).
    Fransson, Urban
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Institutet för bostads- och urbanforskning (IBF).
    Housing tenure and early retirement for health reasons in Sweden2006Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 34, nr 5, s. 472-479Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To assess the association between housing tenure and early retirement for health reasons in Sweden with a view to psychosocial vs. material values of home ownership. Methods: The data come from linked registers that cover all people resident in Sweden during 1990-2000. The study population consists of 449,233 people aged 40-63 years in 1997. Of these, 19,350 retired early for health reasons in 1998-99. The remaining 429,883 continued their employment without extended sick leave or income decline. None moved during 1990-2000. We calculated the odds of early retirement for four forms of juridical relationship to one's housing ( private owner; part owner in a cooperative; private rental; rental from a public housing company), for men and women separately, controlling for age, education, employment income, household disposable income, region, foreign birth, and housing type. Results: Men in cooperative ownership had lower odds of early retirement than those in the three other tenure forms, for which the odds were similar. Among women, public and private renters had similar odds of early retirement, which were higher than those of women in private or cooperative ownership. For both genders, inclusion of housing type in the model after housing tenure explained little additional variance. Conclusions: The odds of early retirement for health reasons varied across different housing tenure forms in Sweden in 1998-99. The pattern of associations differed as a function of gender. Home ownership appears to involve health resources independent of basic sociophysical factors captured with differences in housing type.

  • 30.
    Herzig Van Wees, Sibylle L.
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Global hälsa - implementering och hållbarhet.
    Målqvist, Mats
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH), Global hälsa - implementering och hållbarhet.
    Irwin, Rachel
    Lund Univ, Dept Arts & Cultural Sci, Lund, Sweden.
    Achieving the SDGs through interdisciplinary research in global health2019Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, nr 8, s. 793-795Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Swedish Global Health Research Conference held in Stockholm, 18-19 April 2018, convened researchers from across Sweden's universities to foster collaboration and new research. In response to the theme of the conference, How can Sweden contribute to the Sustainable Development Goals? From research to action, many of the plenary and keynote speakers highlighted the importance of interdisciplinary research and teaching. This commentary draws upon a workshop discussing interdisciplinarity, which took place at the conference. Participants included senior professors, lecturers, students and collaborators from the private sector and civil society and we discussed the conceptual and structural challenges that prevent engagement in interdisciplinary research. Although the workshop focused on the Swedish context, issues will be familiar to researchers working outside of Sweden. The 17 Sustainable Development Goals highlight the grand challenges for global society and are intertwined, with progress in one affecting progress in all others. With this starting point, we argue that interdisciplinary research is the way to achieve them. Accordingly, we need to overcome the conceptual and structural challenges that can hinder it. We therefore argue for a paradigm shift of how we value knowledge. We also call for fundamental changes in external and internal (university-level) funding structures, and for the strengthening of interdisciplinary global health teaching.

  • 31.
    Jerdén, Lars
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning Dalarna.
    Bildt-Ström, Pia
    Burell, Gunilla
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Weinehall, Lars
    Bergström, Erik
    Personal health documents in school health education: A feasibility study2007Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, nr 6, s. 662-665Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To examine the feasibility of a school intervention using a personal health document adapted for adolescents. Methods: The health document was developed in close cooperation with groups of adolescents and tested among seventh-grade students at two junior high schools (n=339). The document was presented to the students by their regular teachers. For evaluation, an adolescent questionnaire was used at baseline and after one year. Results: After one year, 87% of adolescents reported having written in the health document, and 77% reported having had classes with discussions on subjects in the document. The health document was perceived as useful by 35% of the adolescents. Factors significantly related to personal usefulness were being born outside Sweden, experiencing fair treatment by teachers, being a nonsmoker, and having a positive school experience. Conclusions: Implementation of a personal health document in junior high-school health education was feasible and well accepted.

  • 32.
    Jonsson, Frida
    et al.
    Umeå universitet, Socialmedicin.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Gustafsson, Per E.
    Umeå universitet, Socialmedicin.
    Social capital across the life course and functional somatic symptoms in mid-adulthood2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 7, s. 581-588Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To examine social capital across life and functional somatic symptoms in middle-age, according to life-course models of cumulative risk and sensitive periods.

    METHODS: Data from the 26-year prospective study the Northern Swedish Cohort enabled complete case analyses on 940 individuals (451 women and 489 men) participating in questionnaire surveys at ages 16, 21, 30 and 42. Social capital was operationalized at the individual level, comprising items on social participation, social influence and social support. Functional somatic symptoms were a summary measure of self-reported physical symptoms, palpitation and sleeping difficulties occuring during the 12 months prior to the data collection. Linear regression was used as the main statistical method, examining the relationship between functional somatic symptoms at age 42 and social capital across life.

    RESULTS: Lower levels of social capital accumulated over the life course were associated with higher levels of functional somatic symptoms at age 42, for both women and men. Social capital was, especially among adolescent men, related to functional somatic symptoms at age 42, independently of social capital later in life and baseline material circumstances. CONCLUSIONS THE HEALTH IMPACT OF POOR SOCIAL CAPITAL MAY BE DUE TO ACCUMULATION ACROSS THE LIFE COURSE AND TO ADOLESCENCE BEING A PARTICULARLY SENSITIVE PERIOD IT IS RELEVANT FOR PREVENTIVE WORK TO ACKNOWLEDGE EFFECTS OF SOCIAL CAPITAL THROUGHOUT LIFE:

  • 33. Karlsson, Magnus K
    et al.
    Ribom, Eva L
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Nilsson, J-Å
    Karlsson, Caroline
    Cöster, Maria
    Vonschewelov, Thord
    Mallmin, Hans
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Ortopedi.
    Ljunggren, Östen
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Endokrinologi och mineralmetabolism.
    Ohlsson, Claes
    Mellström, Dan
    Lorentzon, Mattias
    Leung, P C
    Lau, Edith
    Cauley, Jane A
    Barrett-Connor, Elizabeth
    Stefanick, Marcia L
    Orwoll, Eric
    Rosengren, Björn E
    International and ethnic variability of falls in older men2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 2, s. 194-200Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: Fallers and especially recurrent fallers are at high risk for injuries. The aim of this study was to evaluate fall epidemiology in older men with special attention to the influence of age, ethnicity and country of residence. Methods: 10,998 men aged 65 years or above recruited in Hong Kong, the United States (US) and Sweden were evaluated in a cross-sectional retrospective study design. Self-reported falls and fractures for the preceding 12 months were registered through questionnaires. Group comparisons were done by chi-square test or logistic regression. Results: The proportion of fallers among the total population was 16.5% in ages 65-69, 24.8% in ages 80-84 and 43.2% in ages above 90 (P <0.001). The corresponding proportions of recurrent fallers in the same age groups were 6.3%, 10.1% and 18.2%, respectively (P <0.001), and fallers with fractures 1.0%, 2.3% and 9.1%, respectively (P <0.001). The proportion of fallers was highest in the US, intermediate in Sweden and lowest in Hong Kong (in most age groups P <0.05). The proportion of fallers among white men in the US was higher than in white men in Sweden (all comparable age groups P <0.01) but there were no differences in the proportion of fallers in US men with different ethnicity. Conclusions: The proportion of fallers in older men is different in different countries, and data in this study corroborate with the view that society of residence influences fall prevalence more than ethnicity.

  • 34.
    Kerstis, Birgitta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Berglund, Anders
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Engström, Gabriella
    5Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA.
    Edlund, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Sylven, Sara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Aarts, Clara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Depressive symptoms postpartum among parents are associated with marital separation: A Swedish cohort study2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 7, s. 660-668Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6–8 years after childbirth, among couples in Sweden.

    Methods: At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents’ addresses were followed up after 6–8 years, to study the marital separation rate.

    Results: We found, 6–8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001; fathers p < 0.001), depressive symptoms (mothers p = 0.022; fathers p = 0.041) and parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28–0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01–2.84) and fathers (HR 1.92; 95% CI 1.12–3.28), and the mother’s parental stress (HR 2.16; 95% CI 1.14–4.07).

    Conclusions: Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals. It could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood. This knowledge is also important for the public. Parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.

  • 35.
    Kerstis, Birgitta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Engstrom, Gabriella
    Edlund, Birgitta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Aarts, Clara
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Association between mothers' and fathers' depressive symptoms, sense of coherence and perception of their child's temperament in early parenthood in Sweden2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 3, s. 233-239Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To examine whether there was any association between mothers' and fathers' post-partum depressive symptoms and sense of coherence and perception of their child's temperament. The hypotheses were that parents with depressive symptoms: 1) have more often a poor sense of coherence, and 2) perceive their child's temperament to be more difficult than parents without depressive symptoms. Methods: A total of 401 Swedish-speaking couples, who were the parents of children born through the years 2004-2006 in the northern part of the county of Vastmanland, Sweden, were invited to participate in the study. The parents answered 3 questionnaires including: at inclusion of the study: demographic data (n = 393 couples); at 3 months: the Edinburgh Postnatal Depression Scale and the Sense of Coherence Scale (n = 308 couples); and at 18 months: the Infant Characteristics Questionnaire (n = 272 couples). Results: Depressive symptoms measured at 3 months, were reported by 17.7% of mothers and 8.7% of fathers, and correlated significantly between mothers and fathers within couples (rho = 0.165, p = 0.003). Mothers and fathers with depressive symptoms had a poorer sense of coherence (p < 0.001, p < 0.001) and perceived their child's temperament as more difficult than mothers and fathers without depressive symptoms at 3 (p = 0.028, p < 0.001) and 18 months (p = 0.145, p = 0.012 respectively). Conclusions: Early parenthood has been studied thoroughly in mothers, but few studies have included fathers. Identifying problems in early parenthood could help predict later problems exhibited by the preschool child, which might be prevented by supportive programmes.

  • 36.
    Kettis, Åsa
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
    Ring, Lena
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
    Viberth, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Farmaceutiska fakulteten, Institutionen för farmaci.
    Hansson, Mats G.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Perceptions of potential donors in the Swedish public towards information and consent procedures in relation to use of human tissue samples in biobanks: a population-based study2007Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, nr 2, s. 148-156Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To assess the Swedish public's preferences for information and consent procedures when being asked for permission to use previously collected tissue samples for new research studies. Methods: Cross-sectional study employing postal questionnaires to a random sample of the Swedish general public (n = 6,000) in October 2002-February 2003. The response rate was 49% (n = 2,928). This paper includes only respondents who reportedly would approve of samples being taken and stored (n = 2,122). Results: When potential tissue sample donors in the general public have to strike a balance between the values at stake, i.e. the autonomy of the donor versus the research value, most (72%) prefer general consent, i.e. where consent is asked for at the outset only. They want the research ethics committee (REC) alone to decide on the use of stored samples, and they would allow storage as long as the sample is useful for research. The minority of respondents who were in favour of specific consent were more likely to be young, well educated, have negative experiences of healthcare and low trust in healthcare authorities. Conclusions: The majority of the Swedish general public prefer general consent, and are thus willing to delegate some decisions to the RECs. However, preferences for information and consent procedures depend on the context, e.g. the risks for the donor and the purpose of the research. If feasible, procedures should be differentiated according to the preferences of individual donors, thus protecting the interests of both the minority and the majority.

  • 37. Krantz, Ingela
    et al.
    Eriksson, Bo
    Lundquist-Persson, Cristina
    Ahlberg, Beth Maina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Nilstun, Tore
    Screening for postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS): An ethical analysis2008Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, nr 2, s. 211-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To assess the Edinburgh Postnatal Depression Scale (EPDS), a self-administered questionnaire created to screen for symptoms of postpartum depression in the community, from an epidemiological and ethical perspective. Screening, as the practice of investigating apparently healthy individuals to detect unrecognised disease or its precursors, has interpretation problems and is complicated by deliberations on probabilities for something to occur, on which the scientific community is unanimous. Methods: Our ethical analysis is made using a framework with two different dimensions, the ethical principles autonomy and beneficence and the affected persons. To balance the ethical costs and the ethical benefits of EPDS an analogy with the assessment of pharmaceutics is used. Results: In this article we argue that routine EPDS screening of Swedish postpartum women would lead to considerable ethical problems due to the weak scientific foundation of the screening instrument. Despite a multitude of published studies, the side-effects in terms of misclassifications have not been considered carefully. The EPDS does not function very well as a routine screening instrument. The dualism created is too reductive and fails to recognize the plurality of difference that exists in the social word. Conclusions: Public health authorities should not advocate screening of unproved value. Screening is not just a medical issue but also an ethical one.

  • 38.
    Lagerberg, Dagmar
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Magnusson, Margaretha
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Utilization of child health services, stress, social support and child characteristics in primiparous and multiparous mothers of 18-month-old children2013Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, nr 4, s. 374-383Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Traditionally, the child health services have laid emphasis on first-time mothers. Some researchers have argued that the needs of multiparous mothers must be considered equally important. The aim of this paper was to analyse parity-related characteristics in pairs of mothers and 18-month-old children. Methods: The study was population-based and cross-sectional. 586 primiparous mothers and 821 mothers with at least one previous child completed a questionnaire. Additional information was extracted from the child health records by the nurses. Data were collected in 2002–2003 and 2004–2005. Results: Compared to multiparous mothers, primiparous mothers had a higher utilization of child health services. Multiparous mothers scored higher on parental incompetence stress and felt that their work load was more demanding. Multiparous mothers reported less social support, particularly in practical respects such as baby-sitting. They considered their interaction with the child as less satisfactory than did primiparous mothers; their children participated less in shared reading and had a more restricted vocabulary. Fewer multiparous mothers assessed their own and their child’s total situation as very good. Conclusions: The child health services should develop competence and methods to support multiparous mothers and alleviate their workload when caring for several children.

  • 39. Lagerin, Annica
    et al.
    Carlsson, Axel C.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Nilsson, Gunnar
    Westman, Jeanette
    Tornkvist, Lena
    District nurses' preventive home visits to 75-year-olds: An opportunity to identify factors related to unsafe medication management2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 8, s. 786-794Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To investigate factors related to unsafe medication management among 75-year-olds during preventive home visits, and to describe the interventions district nurses used. Methods: An explorative study. During a 9- to 12-month period, 36 DNs used the Safe Medication Assessment (SMA) tool during preventive home visits to 75-year-olds who used at least one drug (n=113). Results: One or more factors related to unsafe medication management were identified in 84% of the 75-year-olds. More than 40% used five or more drugs, and 34.5% reported symptoms potentially indicative of adverse effects of their drugs. Nearly 30% had prescribers from more than two medical units, and 7.1% of the older persons were appraised as having reduced cognitive ability. DNs intervened in more than two-thirds of the cases and used a variety of nursing care interventions to improve the safety of medication management. Conclusions: Preventive home visits seem to provide a unique opportunity to promote safe medication management. Several factors related to unsafe medication management were identified, and several different nursing care interventions were carried out to ensure safe medication management. Use of the SMA tool in preventive home visits seems to be advantageous in improving the safety of medication management among older persons.

  • 40.
    Landstedt, Evelina
    et al.
    Umeå universitet, Socialmedicin.
    Hammarström, Anne
    Umeå universitet, Socialmedicin.
    Winefield, Helen
    How well do parental and peer relationships in adolescence predict health in adulthood?2015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 5, s. 460-468Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Although health effects of social relationships are well-researched, long-term health consequences of adolescent family as well as peer relationships are poorly understood. The aim of the study was to explore the prospective importance of parental and peer social relationships in adolescence on internalising and functional somatic symptoms in adulthood. Methods: Data were drawn from four waves of the Northern Swedish Cohort Study, response rate 94.3%, N=1001. Outcome variables were internalising and functional somatic symptoms at the ages of 21, 30 and 42. Relationship variables at age 16 were poor parental contact and three indicators of poor peer relationships. Associations were assessed in multivariate ordinal logistic regressions with adjustment for confounders and baseline health. Results: Results show that the main relationships-related predictors of adult internalising symptoms were self-rated poor peer relationships in terms of spending time alone during after-school hours and poor parental relationship. Functional somatic symptoms on the other hand were most strongly associated with poor parental contact and not being happy with classmates at age 16. Conclusions: The quality of parental and peer relationships in adolescence predicts adult mental and functional somatic health as much as 26 years later, even when accounting for confounders and adolescent symptomatology. This study extends past research by exploring how both adolescent parental and peer relationships (self-reported as well as teacher reported) predict adult self-reported health.

  • 41.
    Larm, Peter
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås. Malardalens Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Åslund, Cecilia
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Starrin, Bengt
    Karlstad Univ, Dept Social Studies, Stockholm, Sweden..
    Nilson, Kent W.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    How are social capital and sense of coherence associated with hazardous alcohol use?: Findings from a large population-based Swedish sample of adults2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 5, s. 525-533Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: This study examined whether social capital and a sense of coherence are associated with hazardous alcohol use in a large population-based Swedish sample. In particular, the objectives were (a) to examine which of five subdimensions of social capital is associated with hazardous alcohol use, (b) to investigate the moderating role of sense of coherence and (c) to examine possible sex differences. Methods: A postal survey was distributed to a sample of respondents (aged 18-84 years) from five Swedish counties that was stratified by sex, age and city; 40,674 (59.2%) participants responded, of which 45.5% were men and 54.5% were women with a mean +/- SD age of 53.8 +/- 17.9 years. Results: Structural dimensions of social capital were associated with an increased probability of hazardous alcohol use among both men and women, whereas the increased probability associated with cognitive dimensions occurred mostly among women. Sense of coherence was robustly associated with a decreased probability of hazardous alcohol use among both men and women. There were few moderating effects of sense of coherence and sex differences emerged mainly for the cognitive dimension of social capital. Conclusions: Associations between social capital dimensions and hazardous alcohol use were partly sex-specific, whereas the benefits of a sense of coherence accrued to both sexes. Social capital dimensions and sense of coherence were generally unrelated to each other. Only associations between the cognitive dimensions of social capital and hazardous alcohol use differed by sex.

  • 42.
    Larsson, Kjerstin
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap. Karolinska Inst, Sect Social Work, Dept Neurobiol Care Sci & Soc, S-10401 Stockholm, Sweden..
    Nehlin, Christina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Psykiatri, Akademiska sjukhuset.
    Screening accuracy of brief alcohol screening instruments in a general hospital setting2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 6, s. 599-603Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aim of this study was to examine the screening accuracy of four brief alcohol screening instruments in a general hospital setting.

    Methods: Ten outpatient clinics were recruited to ensure a representative mix of demographics (e.g. sex, age and diagnosis). The staff at the reception desk handed out pre-sorted envelopes with questionnaires and information letters to the visitors. The questionnaires consisted of the 10-item Alcohol Use Disorders Identification Test (AUDIT), the Weekly Consumption Question (WCQ), the Heavy Episodic Drinking (HED) question and two questions on sex and age. Sensitivity and specificity were calculated for the AUDIT-C, AUDIT-3, WCQ and HED using the full 10-item AUDIT for comparison, with cut-off points of 6 for women and 8 for men.

    Results: In all, 898 questionnaires were included (52% women). According to the full AUDIT, 12.0% of the women and 14.8% of the men were drinking above the hazardous level. Corresponding percentages for the brief screening instruments for women and men, respectively, were as follows: AUDIT-C: 17.2% and 27.4%; the AUDIT-3: 6% and 16.2%; the WCQ: 2% and 1.6%; and the HED screener: 12.9% and 21.2%.

    Conclusions: The AUDIT-C may be used as a brief screener in a general hospital setting. The WCQ, as a stand-alone screening tool, may underestimate hazardous drinking habits. Screening results from the AUDIT-3 and the HED should be interpreted with caution when applied to women because of the risk of underestimation.

  • 43.
    Larsson, Margareta
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Eurenius, Karin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Westerling, Ragnar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Socialmedicin.
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    Evaluation of a Sexual Education Intervention among Swedish High School Students2006Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 34, nr 2, s. 124-131Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To evaluate an intervention aimed at improving knowledge of, attitudes to, and practices regarding condoms and emergency contraception (ECP) among Swedish high school students. METHODS: An intervention study with quasi-experimental design. A strategic sample of classes from two vocational high school programs was divided into an intervention group and a comparison group. All students completed questionnaires before and after the intervention, which included sexual education lessons by a nurse-midwife and medical students, free condoms on request and access to telephone counseling. RESULTS: Of the 461 eligible students, mean age 17 years, 390 (85%) completed the pre-test and 326 (71%) the post-test. Three out of four (77%) had experienced sexual intercourse. The majority (76%) had used contraception, mostly condoms at first intercourse. The students already had good knowledge of condoms with no change after the intervention, but attitudes improved and condom use increased. Knowledge of, and attitudes towards ECP improved but use remained stable (29%). The most important source of information about ECP changed from "friends" to "school" after the intervention. More than one out of four (28%) had opted for free condoms but only 3% had requested telephone counseling. CONCLUSIONS: Condom use increased after the intervention whereas the use of ECP remained stable. Knowledge of ECP improved and the attitudes towards both condoms and ECP became more positive. Participation of nurse-midwives and medical students, skill rehearsal, and improved access to condoms may be useful elements in sexual education.

  • 44. Leijon, Ola
    et al.
    Josephson, Malin
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Osterlund, Niklas
    How common is change of primary diagnosis during an episode of sickness benefit?: A register study of medical sickness certificates issued 2010-2012 in Sweden2015Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, nr 1, s. 44-51Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: The aims of this study were to investigate how common it is to change primary diagnosis between different diagnostic chapters during a sick-leave spell, and to explore patterns of diagnostic changes. Methods: The unit for analysis was episode of sickness benefit, that is, sick leave >14 days, which commenced between 2010 and 2012 in Sweden. For each case, the primary diagnosis was retrieved from the first and last/latest medical sickness certificate, respectively. The number of days of sickness benefit was linked to the cases. Any change of primary diagnosis was analysed by diagnostic chapter according to the ICD-10, and this was done separately for women and men. Results: In total, 803,041 cases of sickness benefit (63% women) were included in the study. During a sick-leave spell, 7.1% of female cases and 6.6% of male cases changed their primary diagnosis to a diagnosis from another diagnostic chapter. The change of primary diagnosis increased with the number of days with sickness benefit. For female cases, this increase was from 2.0% for cases that lasted 15-30 days to 20.2% for cases that lasted >365 days. For male cases, the corresponding increase was from 1.8% to 21.2%. A change of primary diagnosis was least common among those initially sick-listed for mental disorders and musculoskeletal disorders. The patterns of diagnostic changes were rather similar for women and men. Conclusions: A change of diagnosis during a sick-leave spell needs to be taken into consideration by the sickness insurance system and in the actions taken by its administration. Registry-based studies of sickness insurance need to consider diagnostic changes in both the study design and the interpretation of results.

  • 45. Ljung, Rikard
    et al.
    Hallqvist, Johan
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden, Division of Epidemiology, Stockholm Center for Public Health, Stockholm County Council, Stockholm, Sweden .
    Misclassification of occupation-based socioeconomic position and gender comparisons socieconomic risk2007Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, nr 1, s. 17-22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims:

    Because occupational classification systems tend to be less precise in the female sector of the working market there has been concern that this might imply more misclassification of socioeconomic position among women, biasing comparisons of gender-specific socioeconomic differences in risk.

    Methods:

    The Stockholm Heart Epidemiology Program (SHEEP) is a population-based case-control study of risk factors for incident myocardial infarction. The study base included all Swedish citizens aged 45-70 in Stockholm County during 1992-94, 550 female and 1201 male cases, and 776 female and 1538 male controls. The use of an occupational classification as the base for categorizing socioeconomic position was compared with socioeconomic position based on detailed self-reported information on job titles and work tasks.

    Results:

    Women are categorized into fewer occupational categories than men and the socioeconomic heterogeneity within occupational categories is substantial for women as has been reported by others. However, despite more occupational categories for male types of jobs the socioeconomic heterogeneity within occupational categories is actually larger for men, implying larger misclassification among men. In simulations with different levels of socioeconomic misclassification among women, the effects on the gender comparison of socioeconomic differences in disease risk were small and they were mostly compensated for by less misclassification among men.

    Conclusions:

    The findings do not support the assumption that misclassification of socioeconomic position among women due to a restricted working market and a crude occupational classification for female jobs is an important issue when comparing measures of socioeconomic inequalities in health between men and women.

  • 46.
    Lucas, Steven
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Jernbro, Carolina
    Division of Public Health Sciences, Department of Health Sciences, Karlstad University, Sweden.
    Tindberg, Ylva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Pediatrik. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i D län (CKFD).
    Janson, Staffan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Bully, bullied and abused. Associations between violence at home and bullying in childhood2016Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, nr 1, s. 27-35Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: The aim was to examine experiences of bullying among Swedish adolescents and whether victims and perpetrators were also exposed to violence in the home, with particular focus on how abuse severity affected the risk of exposure to bullying.

    METHODS: A nationally representative sample of pupils aged 14-15 responded to a questionnaire exploring exposure to corporal punishment and other types of violence. Results were analysed using Pearson's chi-square and multiple logistic regression, adjusting for factors regarding the child, the parents and the families' socioeconomic status.

    RESULTS: Among the 3197 respondents, a significant proportion reported at least one incident of either bullying victimisation (girls 36%, boys 26%) or bullying perpetration (girls 24%, boys 36%). Physical and emotional violence in the home, including witnessed intimate partner violence, were significantly associated with both bullying victimisation and bullying perpetration. Odds ratios for exposure to bullying rose with increasing frequency and severity of abuse. Adjusted odds ratios ranged from 1.6 for any event of abuse vs. single episodes of bullying to 20.3 for multiple types of abuse vs. many episodes of bullying. The child's gender and the presence of a chronic health condition were consistently associated with nearly all levels of abuse and bullying.

    CONCLUSIONS: Bullying experiences are common among youth and are clearly associated with abuse. Frequent bullying, whether as victim or perpetrator, warrants particular vigilance, as it appears to be an indicator of severe violence in the home.

  • 47. Lundberg, Michael
    et al.
    Diderichsen, Finn
    Hallqvist, Johan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet.
    Is the association between short stature and myocardial infarction explained by childhood exposures--a population-based case referent study (SHEEP).2002Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 30, nr 4, s. 249-58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: This study was undertaken to examine the association between short stature and acute non-fatal myocardial infarction and to analyse causal mechanisms related to height with a focus on childhood risk factors.

    METHOD: The SHEEP (Stockholm Heart Epidemiology Program) is a population-based case-referent study. The outcome was incident first events of myocardial infarction. The study base included all Swedish citizens aged 45 to 70, who lived in Stockholm County during 1992-94. This analysis is based on 967 male cases, 412 female cases and 1696 referents. Exposure information was obtained through questionnaires, interviews, health examinations, and obstetric records.

    RESULTS: Adult height was inversely related to myocardial infarction. The odds ratio for men in the shortest quartile (< 173 cm) compared with the tallest was 1.78 (95% CI: 1.39, 2.28). For women the corresponding odds ratio in the shortest quartile (<159 cm) was 1.86 (95% CI: 1.28, 2.71). Height was also inversely associated with fetal growth and indicators of material resources during childhood. Within each social class of origin short stature was associated with number of siblings, lack of higher education, and absence of upward social mobility. Adjustment for childhood risk factors decreased the excess relative risk of short stature with around 25%. Adult social, behavioural, and biological risk factors could not explain the association. The findings were similar for men and women.

    CONCLUSION: Height is associated with many risk factors of myocardial infarction, which increase the risk of disease through many different causal pathways. Childhood exposures have no dominant role in explaining the association between short stature and myocardial infarction.

  • 48.
    Lundin, Andreas
    et al.
    Karolinska Inst, Dept Publ Hlth Sci, SE-17177 Stockholm, Sweden.;Stockholm Cty Council, Ctr Epidemiol & Community Med, Stockholm, Sweden..
    Leijon, Ola
    Swedish Social Insurance Inspectorate, Stockholm, Sweden.;Karolinska Inst, Inst Environm Med, Stockholm, Sweden..
    Vaez, Marjan
    Karolinska Inst, Div Insurance Med, Dept Clin Neurosci, Stockholm, Sweden..
    Hallgren, Mats
    Karolinska Inst, Dept Publ Hlth Sci, SE-17177 Stockholm, Sweden..
    Torgén, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Arbets- och miljömedicin.
    Predictive validity of the Work Ability Index and its individual items in the general population2017Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, nr 4, s. 350-356Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: This study assesses the predictive ability of the full Work Ability Index (WAI) as well as its individual items in the general population.

    Methods: The Work, Health and Retirement Study (WHRS) is a stratified random national sample of 25-75-year-olds living in Sweden in 2000 that received a postal questionnaire (n = 6637, response rate = 53%). Current and subsequent sickness absence was obtained from registers. The ability of the WAI to predict long-term sickness absence (LTSA; 90 consecutive days) during a period of four years was analysed by logistic regression, from which the Area Under the Receiver Operating Characteristic curve (AUC) was computed.

    Results: There were 313 incident LTSA cases among 1786 employed individuals. The full WAI had acceptable ability to predict LTSA during the 4-year follow-up (AUC = 0.79; 95% CI 0.76 to 0.82). Individual items were less stable in their predictive ability. However, three of the individual items: current work ability compared with lifetime best, estimated work impairment due to diseases, and number of diagnosed current diseases, exceeded AUC > 0.70. Excluding the WAI item on number of days on sickness absence did not result in an inferior predictive ability of the WAI.

    Conclusions: The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.

  • 49.
    Löfvander, Monica
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Rosenblad, Andreas
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Wiklund, Tony
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    Bennström, Halina
    Leppert, Jerzy
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning, Västerås.
    A case-control study of self-reported health, quality-of-life and general functioning among recent immigrants and age- and sex-matched Swedish-born controls2014Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, nr 8, s. 734-742Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To examine whether new immigrants had inferior quality-of-life, well-being and general functioning compared with Swedish age- and sex-matched controls.

    Methods: A prospective case-control study was designed including immigrants from non-European countries, 18-65 years of age, with recent Permanent Permits to Stay (PPS) in Sweden, and age- and sex-matched Swedish-born (SB) persons from the general population in Västmanland County, Sweden. The General Health Questionnaire (GHQ-12), the brief version of the World Health Organization Quality-of-Life (WHOQOL-BREF) Scale and the General Activity Functioning Assessment Scale (GAF) from DSM-IV were posted (SB), or applied in personal interviews (PPS) with interpreters. Differences between the PPS and SB groups were measured using McNemar's test and Wilcoxon signed-rank test conducted separately for observations at baseline, 6- and 12-month follow-up.

    Results: There were 93 pairs (mean age 36 years). Persons from Somalia (67%) and Iraq (27%) dominated the PPS group. The differences between the groups were statistically significant for all time points for the Psychological health and Social relationship domains of WHOQOL-BREF, and for the baseline and 6-month follow-up time points of GHQ-12 where the PPS-group had a higher degree of well-being, health and quality-of-life than the SB. This tendency applied for both sexes in the immigrant group.

    Conclusions: These new immigrants did not have inferior physical or psychological health, quality-of-life, well-being or social functioning compared with their age- and sex-matched Swedish born pairs during a 1-year follow-up. Thus, there is reason to advocate immigrants' fast integration into society.

  • 50.
    Makenzius, Marlene
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Tydén, Tanja
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
    Darj, Elisabeth
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH).
    Larsson, Margareta
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Obstetrik & gynekologi.
    Risk factors among men who have repeated experience of being the partner of a woman who requests an induced abortion2012Ingår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, nr 2, s. 211-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Prevention of unintended pregnancies is a public health objective; however, the profiles of male partners of women who choose to abort are relatively unexplored.

    OBJECTIVE:

    To investigate risk factors among men who have repeated experience of being the partner of a woman electing an induced abortion.

    METHODS:

    A questionnaire was used to collect information from 590 men recruited through their pregnant partner who applied for an abortion in Sweden during 2009. A binary logistic regression model assessed risk factors associated with repeated experience of abortion.

    RESULTS:

    One-third of the men had previous experience of a pregnant partner electing an induced abortion. Univariate analysis indicated these men were older, had a lower educational level and less emotional support, and were more often tobacco users than men for whom it was the first experience of a partner choosing to abort. Independent risk factors were being a victim of physical, psychological, or sexual violence or abuse over the past year (OR 2.62, 95% CI 1.36-5.08), unemployment or sick leave (OR 2.58, 95% CI 1.57-4.25), and having children (OR 2.00, 95% CI 1.22-3.28). The men suggested improved sex and relationship education in school and lower unemployment rates could prevent unintended pregnancies and abortions.

    Conclusions:

    Men with experience of repeat abortions present a picture of vulnerability that should be recognised in the prevention of unintended pregnancies. Increased work opportunities might be one important intervention to reduce the number of abortions.

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