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  • 1.
    Ahl, Rebecka
    et al.
    Örebro University, School of Medical Sciences. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Lindgren, Rickard
    Örebro University Hospital. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden.
    Cao, Yang
    Örebro University, School of Medical Sciences. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Riddez, Louis
    Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Solna, Sweden.
    Mohseni, Shahin
    Örebro University, School of Medical Sciences. Örebro University Hospital. Division of Trauma and Emergency Surgery, Department of Surgery, Orebro University Hospital, Örebro, Sweden; Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Risk factors for depression following traumatic injury: An epidemiological study from a scandinavian trauma center2017In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, no 5, p. 1082-1087Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: A significant proportion of patients suffer depression following traumatic injuries. Once manifested, major depression is challenging to overcome and its presence risks impairing the potential for physical rehabilitation and functional recovery. Risk stratification for early detection and intervention in these instances is important. This study aims to investigate patient and injury characteristics associated with an increased risk for depression.

    METHODS: All patients with traumatic injuries were recruited from the trauma registry of an urban university hospital between 2007 and 2012. Patient and injury characteristics as well as outcomes were collected for analysis. Patients under the age of eighteen, prescribed antidepressants within one year of admission, in-hospital deaths and deaths within 30days of trauma were excluded. Pre- and post-admission antidepressant data was requested from the national drugs registry. Post-traumatic depression was defined as the prescription of antidepressants within one year of trauma. To isolate independent risk factors for depression a multivariable forward stepwise logistic regression model was deployed.

    RESULTS: A total of 5981 patients met the inclusion criteria of whom 9.2% (n=551) developed post-traumatic depression. The mean age of the cohort was 42 [standard deviation (SD) 18] years and 27.1% (n=1620) were females. The mean injury severity score was 9 (SD 9) with 18.4% (n=1100) of the patients assigned a score of at least 16. Six variables were identified as independent predictors for post-traumatic depression. Factors relating to the patient were female gender and age. Injury-specific variables were penetrating trauma and GCS score of≤8 on admission. Furthermore, intensive care admission and increasing hospital length of stay were predictors of depression.

    CONCLUSION: Several risk factors associated with the development of post-traumatic depression were identified. A better targeted in-hospital screening and patient-centered follow up can be offered taking these risk factors into consideration.

  • 2.
    Ahmad, Irma
    et al.
    Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Edin, Alicia
    Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
    Granvik, Christoffer
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    Kumm Persson, Lowa
    Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
    Tevell, Staffan
    Örebro University, School of Medical Sciences. Department of Infectious Diseases, Karlstad Hospital, Karlstad, Sweden; Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden .
    Månsson, Emeli
    Centre for Clinical Research, Region Västmanland-Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden.
    Magnuson, Anders
    Center for Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Marklund, Ingela
    Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden; Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Persson, Ida-Lisa
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    Kauppi, Anna
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    Ahlm, Clas
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    Forsell, Mattias N. E.
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    Sundh, Josefin
    Örebro University, School of Medical Sciences. Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lange, Anna
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Infectious Diseases.
    Cajander, Sara
    Örebro University, School of Medical Sciences. Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Normark, Johan
    Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
    High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-192023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1104267Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infection, and explored risk factors for COVID-19 sequalae.

    METHODS: This was a prospective, multicenter, cohort study including 434 patients. At 6 months, physical exercise capacity was assessed by a 1-minute sit-to-stand test (1MSTST) and persistent symptoms were reported and HRQoL was evaluated through the EuroQol 5-level 5-dimension (EQ-5D-5L) questionnaire. Patients with both persistent symptoms and reduced HRQoL were classified into a new definition of post-acute COVID syndrome, PACS+. Risk factors for developing persistent symptoms, reduced HRQoL and PACS+ were identified by multivariable Poisson regression.

    RESULTS: Persistent symptoms were experienced by 79% of hospitalized, and 59% of non-hospitalized patients at 6 months. Hospitalized patients had a higher prevalence of self-assessed reduced overall health (28 vs. 12%) and PACS+ (31 vs. 11%). PACS+ was associated with reduced exercise capacity but not with abnormal pulse/desaturation during 1MSTST. Hospitalization was the most important independent risk factor for developing persistent symptoms, reduced overall health and PACS+.

    CONCLUSION: Persistent symptoms and reduced HRQoL are common among COVID-19 survivors, but abnormal pulse and peripheral saturation during exercise could not distinguish patients with PACS+. Patients with severe infection requiring hospitalization were more likely to develop PACS+, hence these patients should be prioritized for clinical follow-up after COVID-19.

  • 3.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ibsens princip bör styra vårdsektorn2014In: Sjukhusläkaren, ISSN 1651-2715, no 5, p. 26-26Article in journal (Other (popular science, discussion, etc.))
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  • 4.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Tid för klinisk analys2015In: Sjukhusläkaren, ISSN 1651-2715, no 1, p. 34-34Article in journal (Other (popular science, discussion, etc.))
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    fulltext
  • 5.
    AlGannas, Nayef S.
    et al.
    Department of MOI Clinics, Security Forces Hospital, Riyadh, Saudi Arabia.
    Alghamdi, Abdullah S.
    Department of MOI Clinics, Security Forces Hospital, Riyadh, Saudi Arabia.
    Hazazi, Ali M.
    Department of Laboratory Medicine, Security Forces Hospital, Riyadh, Saudi Arabia.
    Alqahtani, Nasser S.
    Department of MOI Clinics, Security Forces Hospital, Riyadh, Saudi Arabia.
    Alshareef, Mohammad N.
    Department of MOI Clinics, Security Forces Hospital, Riyadh, Saudi Arabia.
    Ahmed, Mohamed H.
    Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
    Omer, Abubakr
    Örebro University, School of Medical Sciences. Faculty of Medicine, University of Khartoum, Sudan.
    AlShehah, Abdulmajid A.
    Department of Ophthalmology, Security Forces Hospital, Riyadh, Saudi Arabia.
    Assessment of the levels of antispike SARS-CoV-2 IgG antibodies and their association with clinical characteristics in cohort of patients in Saudi Arabia2022In: Journal of Family Medicine and Primary Care, ISSN 2249-4863, Vol. 11, no 11, p. 7372-7377Article in journal (Refereed)
    Abstract [en]

    Background: Coronavirus disease 2019 (COVID-19) has caused a global public health crisis. The disease is known to be caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, but the detailed characteristics of the immune response to this novel virus have not been fully elucidated yet. In this study, we aimed to determine the level of immunoglobulin G (IgG) antibodies and their correlation with clinical features at three time points postinfection in a group of patients in Saudi Arabia.

    Method: In this prospective observational study, we collected the demographic and clinical data from 43 polymerase chain reaction (PCR)-confirmed patients and measured the COVID-19 antispike IgG levels at three different visits.

    Result: The seroconversion rate after COVID-19 infection was 88.4% in the study participants, with no significant changes in the IgG levels through the three visits. The duration of shortness of breath had a significant positive correlation with the IgG level of the patients. Using the logistic regression model, participants having coughs were found to be 12.48 times more likely to develop positive IgG. The IgG levels were less in smokers than nonsmokers [Odds ratio = 6.42 (95% CI 2.11-19.48); P = 0.001].

    Conclusion: Positive IgG levels have been developed in most COVID-19 patients and did not significantly change over 3 months following the diagnosis. The level of IgG antibodies was found to be significantly associated with the presence of cough, duration of shortness of breath, and the smoking habit of the patients. These findings have clinical and public health significance and need to be validated in larger studies in different populations.

  • 6.
    Algilani, Samal
    et al.
    Örebro University, School of Health Sciences. Health, University Health Care Research Centre.
    Tingö, Lina
    Örebro University, School of Medical Sciences.
    Kihlgren, Annica
    Örebro University, School of Health Sciences. Nutrition Gut Brain Interactions Research Centre.
    Schröder, Agneta
    Örebro University, School of Health Sciences. Örebro University Hospital. Department of Health Sciences, Faculty of Medicine and Health Science, NTNU - Norwegian University of Science and Technology, Gjøvik, Norway.
    Mental health as a prerequisite for functioning as optimally as possible in old age: A phenomenological approach2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 5, p. 2025-2034Article, review/survey (Refereed)
    Abstract [en]

    AIM: To describe the impact of mental health on the ability to function optimally among older adults experiencing mental health issues.

    DESIGN: This study had a descriptive qualitative design.

    METHODS: Six older females with a Hospital Anxiety and Depression Scale (HADS) score of ≥8 on either of the subscales (depression or anxiety) participated in individual interviews. All data were analysed using a phenomenological approach influenced by Giorgi.

    RESULTS: The phenomenological analysis led to a structured synthesis comprising the following three themes: (a) life situations affecting mental health, (b) consequences of mental health in everyday life and (c) strategies for maintaining mental health.

  • 7.
    Algotson, S.
    et al.
    Allebarnsratten, Stockholm, Sweden; Sch Hosp Culinary Arts & Meal Sci, Univ Örebro, Örebro, Sweden.
    Öström, Åsa
    Örebro University, School of Humanities, Education and Social Sciences.
    Sapere-taste lessons in Swedish pre-schools2010In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 20, no Suppl. 1, p. 106-106Article in journal (Other academic)
  • 8.
    Ali, DK
    et al.
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden.
    Dalal, Koustuv
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden.
    Yousefzade-Chabok, S
    Trauma Research Center, Guilan University of Medical Science, Rasht, Iran.
    Jansson, B
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden.
    Mohammadi, R
    Division of Social Medicine, Department of Public Health Science, Karolinska Institutet, Stockholm, Sweden.
    Costs related to drowning and near drowning in northern Iran (Guilan province)2011In: Ocean and Coastal Management, ISSN 0964-5691, E-ISSN 1873-524X, Vol. 54, no 3, p. 250-255Article in journal (Refereed)
    Abstract [en]

    In Iran and many other low- and middle-income countries, few  studies have been carried out in order to assess which cost analysis methods should be  undertaken at the household and community level in relation to incidences of drowning. In this study, we have attempted to develop a model for  estimating the impact of the economic burden that drowning and near drowning events incur for victims’ families in the Guilan province in the north of  Iran by  using an  incidence approach. During the financial year of March 2007 to 2008,  the following cost-related aspects of  drowning episodes were evaluated: (note: main cost elements were income adjusted by family and years) medical costs, productivity loss  costs and death costs. A total of 137 drowning fatalities and 104 near drowning incidents were recorded. Males in the age  span of  10e29  years constitute a  majority of  the epidemiology and economy data. When the number of variables included in cost analysis was expanded, the estimated burden of economic duress increased dramatically; however, drowning cost for  one drowned victim was equivalent to 17  times the country’s  gross domestic product(GDP) per capital. Identification of  injured person-based costs in  this study will  enable development of  more effective prevention programs and provide indicators of  other costs related to drowning episodes such as  property damage and the impact of  these accidents on community services and the public health care system.

  • 9.
    Alm, Fredrik
    Örebro University, School of Health Sciences.
    Tonsilloperationer under Covid-19 pandemin: Data från svenska tonsilloperationsregistret och svenska intensivvårdsregistret2021Report (Other (popular science, discussion, etc.))
  • 10.
    Alm, Fredrik
    et al.
    Örebro University, School of Health Sciences. Department of Anaesthesia and Intensive Care.
    Ericsson, Elisabeth
    Örebro University, School of Health Sciences.
    Smärta och smärtbehandling i samband med tonsillkirurgi på barn: ett ständigt pågående förbättringsarbete med ett multidisciplinärt ansvar2018Conference paper (Other academic)
    Abstract [en]

    Smärta efter tonsillkirurgi på barn har varit och är fortfarande en utmaning för ÖNH-professionen. Trots ett stort antal publikationer inom området saknas nationellt och internationellt konsensus om vad som är den optimala smärtbehandlingen. Registerdata i Sverige visar på hög andel patienter/närstående som kontaktar hälso- och sjukvården efter tonsillkirurgi pga. bristfällig smärtbehandling. Under de senaste åren har flera förbättringsarbeten utförts med implementering av nationella riktlinjer för smärtbehandling och patientinformation på hemsidan tonsilloperation.se. Mot denna bakgrund pågår nu ett forskningsprojekt där smärta och smärtbehandling i samband med tonsillkirurgi utvärderas från professionens, barnets och anhörigas perspektiv. Studier i projektet har visat att den svenska ÖNH-professionens åsikt om och följsamhet till de nationella riktlinjerna är god. Vidare visar analys av registerdata att implementeringen av nationella riktlinjer har gjort avtryck i tonsilloperationsregistrets smärtrelaterade variabler, med längre postoperativ analgetikabehandling och en viss minskning av oplanerade kontakter med hälso- och sjukvård. Samtidigt visar data från registret att operationsmetoder och tekniker, men även patientfaktorer som ålder och indikation för kirurgi, påverkar smärtutfallet. Preliminära resultat från en större kvantitativ datainsamling via åldersanpassade smärtdagböcker och kvalitativa intervjuer med barn och anhöriga visar att återhämtningen efter tonsillkirurgi påverkas av vilken typ av smärtbehandling barnet ordinerats.

  • 11.
    Alping, Peter
    et al.
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Piehl, Fredrik
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden; Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
    Langer-Gould, Annette
    Clinical and Translational Neuroscience, Southern Clinical and Translational Neuroscience, Southern California Permanente Medical Group, Kaiser Permanente, Pasadena CA, USA.
    Frisell, Thomas
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Burman, Joachim
    Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Fink, Katharina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Fogdell-Hahn, Anna
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Gunnarsson, Martin
    Örebro University, School of Medical Sciences. Center for Health and Medical Psychology.
    Hillert, Jan
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Kockum, Ingrid
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lycke, Jan
    Department of Clinical Neuroscience and Rehabilitation, University of Gothenburg, Gothenburg, Sweden.
    Nilsson, Petra
    Department of Clinical Sciences/Neurology, Lund University, Lund, Sweden.
    Olsson, Tomas
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Salzer, Jonatan
    Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå.
    Svenningsson, Anders
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Virtanen, Suvi
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Vrethem, Magnus
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Validation of the Swedish Multiple Sclerosis Register Further Improving a Resource for Pharmacoepidemiologic Evaluations2019In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 30, no 2, p. 230-233Article in journal (Refereed)
    Abstract [en]

    The Swedish Multiple Sclerosis Register is a national register monitoring treatment and clinical course for all Swedish multiple sclerosis (MS) patients, with high coverage and close integration with the clinic. Despite its great value for epidemiologic research, it has not previously been validated. In this brief report, we summarize a large validation of >3,000 patients in the register using clinical chart review in the context of the COMBAT-MS study. While further improving the data quality for a central cohort of patients available for future epidemiologic research, this study also allowed us to estimate the accuracy and completeness of the register data.

  • 12.
    Anderberg, Natasha
    Örebro University, School of Health and Medical Sciences.
    Ungdomars erfarenheter av vattenpipsrökning: En kvalitativ intervjustudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 13.
    Anderson, Ian
    et al.
    The University of Melbourne, Melbourne, Australia.
    Tano, Sofia
    School of Business and Economy, Umeå University, Umeå, Sweden.
    Yap, Leslie
    Native Hawaiian Center of Excellence, John A Burns School of Medicine, University of Hawaii, Honolulu HI, United States.
    Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study2016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10040, p. 131-157Article in journal (Refereed)
    Abstract [en]

    Background: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.

    Methods: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated.

    Findings: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations.

    Interpretation: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.

  • 14.
    Andersson, Elin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ström, Josefin
    Örebro University, School of Health and Medical Sciences.
    Psykosocial arbetsmiljö samt självupplevd hälsa hos anställda inom idéella fotbolls- och gymnastikföreningar: En kvantitativ tvärsnittsstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 15. Andersson, Eva
    et al.
    Persson, Bodil
    Bryngelsson, Ing-Liss
    Magnuson, Anders
    Torén, Kjell
    Wingren, Gun
    Westberg, Håkan
    Örebro University, School of Health and Medical Sciences.
    Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, p. 470-478Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.

    Methods The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.

    Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98–1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90–0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12–1.32) and SMR 1.11 (95% CI 1.02–1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07–1.54), paper production (SMR 1.26, 95% CI 1.06–1.49), and maintenance (SMR 1.16, 95% CI 1.02–1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.

    Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).

  • 16.
    Andersson, Eva
    et al.
    Sahlgrens Univ Hosp, Gothenburg, Sweden.
    Westberg, Håkan
    Örebro University Hospital.
    Bryngelsson, Ing-Liss
    Dept Occupat & Environm Med, Örebro Univ Hosp, Örebro, Sweden.
    Magnuson, Anders
    Clin Epidemiol & Biostat Unit, Örebro Univ Hosp, Örebro, Sweden.
    Persson, Bodil
    Dept Occupat & Environm Med, Linköping Univ Hosp, Linköping, Sweden; Dept Occupat & Environm Med, Univ Lund Hosp, Lund, Sweden.
    Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 529-540Article in journal (Refereed)
    Abstract [en]

    Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers. The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with > 1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers' department and employment was obtained from the mills' personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference. Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37-17) and maintenance (SIR, 6.35; 95 % CI, 3.47-11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99-7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95-5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18-6.02). Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.

  • 17.
    Andersson G, Ulrika
    et al.
    Örebro University, School of Health and Medical Sciences.
    Jern, Camilla
    Örebro University, School of Health and Medical Sciences.
    " Det är som att vi bara ska få känna oss delaktiga, men att det bara är på låtsas": En kvalitativ studie om ungdomars syn på sin delaktghet i samhället2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 18.
    Andersson, Irene
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Werle, Frida
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    En kvalitativ analys av jämställdhetsplaner i offentlig verksamhet: - Vad säger de egentligen?2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background People who are discriminated have an increased risk for poor mental and physical health. The discrimination law regulates discrimination, and in it it's written that gender is one of the discrimination foundations. A gender equal society makes gender differences in life expectancy smaller, and there are more self reported health inconveniences in countries who are not gender equal. Sweden's labour market is characterized by gender segregation, and there's a correlation between gender segregation at work and illness for both genders. In the discrimination law it's written that every workplace with at least 25 employees are obligated to have a plan for gender equality.

    Aim The aim is to describe plans of gender equality of workplaces in the public area with a base in the Swedish discrimination law

    Method The plans for gender equality have been analysed with deductive qualitative content analyzis. Six plans from different employers in the public area have been collected in a medium big municipality in Sweden.

    Result Most of the plans follow the directions in the discrimination law. Employees shall be able to combine family life with working life and no one should be harassed because of gender. No one should be discriminated in the process of job seeking, but some affirmative action can occur if one of the genders are underrepresented. There should be no irrelevant salary differences.

    Discussion There may be other policy documents which regulate the gender equality work at some of the workplaces, and therefore there could be some missing parts in the plans. Social support and group identification are factors of protection against discrimination, and should be given more space in the plans. Affirmative actions can be discrimination of the gender who is not prioritized and this could be solved with an elimination of the society based gender roles. In order for gender equality to have a positive effect on public health, men should adopt traditional female roles.

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    En kvalitativ analys av jämställdhetsplaner i offentlig verksamhet
  • 19. Andersson, Johnny
    et al.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences.
    Järliden, Eva
    Från hälsoprojekt till partnerskap för hållbar välfärdsutveckling2010In: Partnerskap för hållbar välfärdsutveckling: utveckling och forskning under sex år i fyra städer / [ed] Charli Eriksson, Eva Järliden, Annika Larsson, Solveig Sandberg, Örebro: Örebro universitet , 2010, p. 3-11Chapter in book (Other academic)
  • 20.
    Andersson, Lena
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Occupational and Environmental Medicine.
    Hedbrant, Alexander
    Örebro University, School of Medical Sciences.
    Bryngelsson, Ing-Liss
    Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden.
    Vihlborg, Per
    Örebro University, School of Medical Sciences. Örebro University Hospital. Geriatric Clinic.
    Särndahl, Eva
    Örebro University, School of Medical Sciences.
    Westberg, Håkan
    Örebro University, School of Science and Technology. Inflammatory Response and Infection Susceptibility Centre (iRiSC), Faculty of Medicine and Health Örebro University, Örebro, Sweden; Department of Occupational and Environmental Medicine.
    Silica Exposure and Cardiovascular, Cerebrovascular, and Respiratory Morbidity in a Cohort of Male Swedish Iron Foundry Workers2023In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 65, no 9, p. 731-739Article in journal (Refereed)
    Abstract [en]

    In this study, we present quantitative exposure-response data on silica exposure in male Swedish iron foundry workers receiving inpatient care for cardiovascular, cerebrovascular, and respiratory morbidity. The study show a significantly increased COPD risk at cumulative silica exposures that correspond to TWA silica below the Swedish OEL of 0.1 mg/m3. ObjectiveWe present quantitative exposure-response data on silica exposure in male Swedish iron foundry workers for cardiovascular, cerebrovascular, and respiratory morbidity.MethodsThis research is a cohort study of 2063 male Swedish iron foundry workers. From the Swedish National Patient Registers, data on morbidity incidence were retrieved. A historical measurement database of 1667 respirable silica exposure measurements from 10 Swedish iron foundries was used to calculate the cumulative exposure dose for each worker.ResultsIncreased morbidity risk for the whole group of foundry workers was determined for ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), bronchitis, and pneumonia. In addition, an increased risk for COPD at cumulative silica exposures ranging from 0.11 to 0.84 mg/m3 year is presented.ConclusionsThe study presents a significantly increased COPD risk at cumulative silica exposures below the Swedish occupational exposure limit.

  • 21.
    Andersson, Robin
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dahlström, Albin
    Hälsofrämjande skolutveckling: En kvalitativ intervjustudie med rektorer i två kommuner2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 22.
    Andersson, Ulrika
    et al.
    Örebro University, School of Health and Medical Sciences.
    Karlsson, Jonas
    Örebro University, School of Health and Medical Sciences.
    Hälsofrämjande arbetsplats.....idag eller imorgon?: - En kvantitativ studie där salutogena indikatorer på hälsa samt upplevelse av arbete och arbetsplats kartläggs2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 23.
    Anderzen-Carlsson, Agneta
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Faculty of Health, Science and Technology, Department of Health Sciences, Karlstad University, Karlstad, Sweden.
    Bäccman, Charlotte
    Faculty of Arts and Social Sciences, Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden; Faculty of Arts and Social Sciences, Center for Service Research, Karlstad University, Karlstad, Sweden.
    Almqvist, Kjerstin
    Faculty of Arts and Social Sciences, Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    The professional relationship forms the base: Swedish child health care nurses' experiences of encountering mothers exposed to intimate partner violence2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1988043Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study aimed to explore child health care nurses' clinical experiences from encounters with mothers exposed to intimate partner violence (IPV), as little research has explored this topic.

    METHOD: Nine child health care nurses from two Swedish regions were interviewed. The interviews were analysed using thematic analysis.

    RESULTS: The narratives depicted the nurses' strong commitment to, and professional relationship with, the exposed mothers. The experience of working as a nurse and having encountered IPV in clinical practice made the nurses more confident, which impacted their performance and attitude towards this topic. The ability to uphold the professional relationship was threatened by lack of support and interprofessional collaborations.

    CONCLUSIONS: The professional relationship was central to the encounters, yet could impose an emotional burden on the nurses. While the nurses wanted to improve their knowledge of the process around the mother and child, they were happy to pass the primary responsibility over to other professionals. The findings highlight the challenge in establishing sustainable support for nurses, and building a transparent collaboration process between the health care sector and the social services, serving the well-being and safety of the mother and child.

  • 24.
    Andrews, Johanna Y.
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Dalal, Koustuv
    Department of Medical and Health Sciences, Centre for Medical Technology Assessment, Division of Social Medicine and Public Health Sciences, Linköping University, Linköping, Sweden.
    Umbilical cord-cutting practices and place of delivery in Bangladesh2011In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 114, no 1, p. 43-6Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate place of delivery, umbilical cord-cutting instruments used, and substances applied to the cord stump in Bangladesh.

    Methods: A cross-sectional data analysis was performed on a nationally representative sample of 4925 women of reproductive age (15-49 years) with at least 1 child.

    Results: More than 80% of women delivered at home. In 6% of cases, blades from a clean-delivery kit (CDK) were used to cut the cord; in 90% of cases, the blades used were from another source; in 4% of cases, other instruments such as bamboo strips and scissors were used to cut the cord. In 51% of cases, a substance (e.g. antibiotic powder/ointment, alcohol/spirit, mustard oil with garlic, boric powder, turmeric, and chewed rice) was applied to the stump after the cord was cut.

    Conclusion: The present findings underscore the need for further advocacy, availability, and use of cord-cutting instruments from CDKs, especially for deliveries that occur outside healthcare facilities.

  • 25.
    Andrews-Chavez, Johanna
    et al.
    Friedman School of Nutrition Science and Policy, Tufts University, Boston, USA.
    Biswas, Animesh
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Gifford, Mervyn
    Department of Public Health Sciences, University of Skövde, Skövde, Sweden.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Identifying households with low immunisation completion in Bangladesh2012In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 4, no 11, p. 1088-1097Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to investigate if the mothers’ demographics and household characteristics—including type of use of cooking fuel, energy and toilet facilities—have any implication for complete immunisation rates among their children. A cross-sectional data analysis of a nationally representative sample of 4925 women with at least one child was performed. Chisquared tests and multivariate logistic regression analyses were used. Immunisation coverage was positively associated with the mother’s education and with household characteristics such as toilet facility, electricity and involvement in a microfinance group. These findings indicate the need for further advocacy for increased knowledge on the importance of vaccination and affordable public immunisation programs focusing on higher risk households such as those with pit facilities, lack of electricity and no participation in a microfinance group. Such households warrant further attention and can be targeted for immunisation coverage.

  • 26.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Apostolidou, E
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greec.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain .
    De Bourdeaudhuij, I
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Koletzko, B
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 74-80Article in journal (Refereed)
    Abstract [en]

    Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.

  • 27.
    Androutsos, O
    et al.
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Katsarou, C
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Payr, A
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Birnbaum, J
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Geyer, C
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Wildgruber, A
    State Institute of Early Childhood Research, Munich, Germany.
    Kreichauf, S
    State Institute of Early Childhood Research, Munich, Germany.
    Lateva, M
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    De Decker, E
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    De Craemer, M
    Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium.
    Socha, P
    The Children’s Memorial Health Institute, Warsaw, Poland.
    Moreno, L
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain; School of Health Science (EUCS), University of Zaragoza, Zaragoza, Spain.
    Iotova, V
    Department of Pediatrics, Medical University Varna, Varna, Bulgaria.
    Koletzko, B V
    Dr. von Hauner Children’s Hospital, University of Munich Medical Centre, Munich, Germany.
    Manios, Y
    Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
    Nilsen, Bente (Contributor)
    Oslo and Akershus University College of Applied Science, Oslo, Norway.
    Designing and implementing teachers' training sessions in a kindergarten-based, family-involved intervention to prevent obesity in early childhood: the ToyBox-study2014In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 15, no Suppl 3, p. 48-52Article in journal (Refereed)
    Abstract [en]

    Since school-based interventions are mainly delivered by the school staff, they need to be well-trained and familiarized with the programme's aims, procedures and tools. Therefore, the institute, research group, governmental or non-governmental body in charge of the coordination and implementation of the programme needs to devote time and resources to train the school staff before programme's implementation. This is particularly crucial in multi-centre studies where more than one research teams are involved. Both research teams and school staff need to be trained, using standard protocols and procedures, to ensure that the intervention will be delivered in a standardized manner throughout the intervention centres. The ToyBox-intervention, a multi-component, kindergarten-based, family-involved intervention, focusing on water consumption, snacking, physical activity and sedentary behaviours in preschool children, was implemented over the academic year 2012-2013 in six European countries. As part of this intervention, three teachers' training sessions were delivered to motivate and train teachers in implementing the intervention. The local researchers were trained centrally before delivering the training sessions for the teachers and followed a common protocol using standardized presentations and procedures. The aim of the current paper is to describe the protocol and methodological issues related to the teachers' training sessions conducted within the ToyBox-intervention.

  • 28.
    Angelin, Martin
    et al.
    Department of Clinical Microbiology, Infectious Diseases, Umeå University, Sweden.
    Sjölin, Jan
    Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden.
    Kahn, Fredrik
    Department of Clinical Sciences, Division of Infection Medicine, Lund University, Sweden.
    Ljunghill Hedberg, Anna
    Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden.
    Rosdahl, Anja
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Infectious Diseases.
    Skorup, Paul
    Department of Medical Sciences, Section of Infectious Diseases, Uppsala University, Sweden.
    Werner, Simon
    Department of Infectious Diseases, Skåne University Hospital, Malmö, Region Skåne, Sweden.
    Woxenius, Susanne
    Department of Infectious Diseases, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Askling, Helena H.
    Department of Medicine, Solna, Division of Infectious Diseases, Karolinska Institutet, Sweden; Academic Specialist Centre, Stockholm County Health Care Services, Region Stockholm, Sweden.
    Qdenga® - A promising dengue fever vaccine; can it be recommended to non-immune travelers?2023In: Travel Medicine and Infectious Disease, ISSN 1477-8939, E-ISSN 1873-0442, Vol. 54, article id 102598Article in journal (Refereed)
    Abstract [en]

    Qdenga® has been approved by the European Medicines Agency (EMA) for individuals > 4 years of age and for use according to national recommendations. The vaccine shows high efficacy against virologically confirmed dengue and severe dengue in clinical studies on 4-16-year old's living in endemic areas. For individuals 16-60 years old only serological data exists and there is no data for individuals > 60 years. Its use as a travel vaccine is still unclear. We present the studies behind the approval and the recommendations for travelers as issued by the Swedish Society for Infectious Diseases Physicians.

  • 29.
    Anjum, Muna F
    et al.
    Department of Bacteriology, Animal and Plant Health Agency, Weybridge, New Haw, Addlestone, Surrey, KT15 3NB, UK.
    Schmitt, Heike
    Centre for Zoonoses and Environmental Microbiology - Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3720 BA, Bilthoven, The Netherlands.
    Börjesson, Stefan
    Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute (SVA), 751 89, Uppsala, Sweden; Department of Microbiology, Public Health Agency of Sweden, 171 82 Solna, Sweden.
    Berendonk, Thomas U
    Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute (SVA), 751 89, Uppsala, Sweden Present address: Department of Microbiology, Public Health Agency of Sweden, 171 82 Solna, Sweden.
    The potential of using E. coli as an indicator for the surveillance of antimicrobial resistance (AMR) in the environment2021In: Current Opinion in Microbiology, ISSN 1369-5274, E-ISSN 1879-0364, Vol. 64, p. 152-158Article, review/survey (Refereed)
    Abstract [en]

    To understand the dynamics of antimicrobial resistance (AMR), in a One-Health perspective, surveillance play an important role. Monitoring systems already exist in the human health and livestock sectors, but there are no environmental monitoring programs. Therefore there is an urgent need to initiate environmental AMR monitoring programs nationally and globally, which will complement existing systems in different sectors. However, environmental programs should not only identify anthropogenic influences and levels of AMR, but they should also allow for identification of transmissions to and from human and animal populations. In the current review we therefore propose using antimicrobial resistant Escherichia coli as indicators for monitoring occurrence and levels of AMR in the environment, including wildlife.

  • 30.
    Appelberg, Jonas
    et al.
    Sundsvalls sjukhus, Sundsvall.
    Ahlander, Arne
    Sundsvalls sjukhus, Sundsvall.
    Olsson, Sten
    Sundsvalls sjukhus, Sundsvall.
    Framgångsrik behandling med nCPAP: Minne åter sedan sömnapnén botats: [Successful treatment with nCPAP. Regain of memory after cured sleep apnea]1996In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 93, no 36, p. 3045-3046Article in journal (Other academic)
    Abstract [sv]

    En medelålders man medgravt obstruktivt sömnapnésyn-drom medförande minnesförsämring behandlades med nasalkontinuerlig övertrycksandning,nCPAP. Behandlingen ledde tillregress av sjukdomen och minnesfunktionen förbättrades remarkabelt.

  • 31.
    Aremu, Olatunde
    et al.
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden; College of Medicine, University of Ibadan Oyo State, Ibadan, Nigeria.
    Lawoko, Stephen
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
    Dalal, Koustuv
    Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköpings University, Linköping, Sweden.
    Childhood vitamin A capsule supplementation coverage in Nigeria: a multilevel analysis of geographic and socioeconomic inequities.2010In: Scientific World Journal, E-ISSN 1537-744X, Vol. 10, p. 1901-14Article in journal (Refereed)
    Abstract [en]

    Vitamin A deficiency (VAD) is a huge public health burden among preschool-aged children in sub-Saharan Africa, and is associated with a high level of susceptibility to infectious diseases and pediatric blindness. We examined the Nigerian national vitamin A capsule (VAC) supplementation program, a short-term cost-effective intervention for prevention of VAD-associated morbidity for equity in terms of socioeconomic and geographic coverage. Using the most current, nationally representative data from the 2008 Nigerian Demographic and Health Survey, we applied multilevel regression analysis on 19,555 children nested within 888 communities across the six regions of Nigeria. The results indicate that there was variability in uptake of VAC supplement among the children, which could be attributed to several characteristics at individual, household, and community levels. Individual-level characteristics, such as maternal occupation, were shown to be associated with receipt of VAC supplement. The results also reveal that household wealth status is the only household-level characteristic that is significantly associated with receipt of VAC, while neighborhood socioeconomic disadvantage and geographic location were the community-level characteristics that determined receipt of VAC. The findings from this study have shown that both individual and contextual socioeconomic status, together with geographic location, is important for uptake of VAC. These findings underscore the need to accord the VAC supplementation program the much needed priority with focus on characteristics of neighborhoods (communities), in addition to individual-level characteristics.

  • 32.
    Aremu, Olatunde
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; College of Medicine, University of Ibadan, Ibadan, Nigeria.
    Lawoko, Stephen
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Dalal, Koustuv
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Medicine and Health Sciences, Centre for Health Technology Assessment, Linköping University, Linköping, Sweden.
    Neighborhood socioeconomic disadvantage, individual wealth status and patterns of delivery care utilization in Nigeria: a multilevel discrete choice analysis.2011In: International Journal of Women's Health, E-ISSN 1179-1411, Vol. 3, p. 167-74Article in journal (Refereed)
    Abstract [en]

    Background: High maternal mortality continues to be a major public health problem in most part of the developing world, including Nigeria. Understanding the utilization pattern of maternal healthcare services has been accepted as an important factor for reducing maternal deaths. This study investigates the effect of neighborhood and individual socioeconomic position on the utilization of different forms of place of delivery among women of reproductive age in Nigeria.

    Methods: A population-based multilevel discrete choice analysis was performed using the most recent population-based 2008 Nigerian Demographic and Health Surveys data of women aged between 15 and 49 years. The analysis was restricted to 15,162 ever-married women from 888 communities across the 36 states of the federation including the Federal Capital Territory of Abuja.

    Results: The choice of place to deliver varies across the socioeconomic strata. The results of the multilevel discrete choice models indicate that with every other factor controlled for, the household wealth status, women's occupation, women's and partner's high level of education attainment, and possession of health insurance were associated with use of private and government health facilities for child birth relative to home delivery. The results also show that higher birth order and young maternal age were associated with use of home delivery. Living in a highly socioeconomic disadvantaged neighborhood is associated with home birth compared with the patronage of government health facilities. More specifically, the result revealed that choice of facility-based delivery is clustered around the neighborhoods.

    Conclusion: Home delivery, which cuts across all socioeconomic strata, is a common practice among women in Nigeria. Initiatives that would encourage the appropriate use of healthcare facilities at little or no cost to the most disadvantaged should be accorded the utmost priority.

  • 33. Aremu, Olatunde
    et al.
    Lawoko, Stephen
    Dalal, Koustuv
    The influence of individual and contextual socioeconomic status on obstetric care utilization in the democratic republic of Congo: a population-based study2012In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 3, no 4, p. 278-285Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Maternal health care utilization continues to focus on the agenda of health care planners around the world, with high attention being paid to the developing countries. The devastating effect of maternal death at birth on the affected families is untold. This study examines the utilization of obstetric care in the Democratic Republic of Congo.

    METHODS: We have used the nationally representative data from the 2007. Democratic Republic of Congo Demographic and Health Survey. Multilevel regression analysis has been applied to a nationally representative sample of 6,695 women, clustered around 299 communities in the country.

    RESULTS: The results show that there are variations in the use of antenatal care and delivery care. Individual-level characteristics, such as women's occupation and household wealth status are shown to be associated with the use of antenatal care. Uptake of facility-based delivery has been seen to be dependent on the household wealth status, women's education, and partner's education. The effect of the neighborhoods' socioeconomic disadvantage on the use of antenatal care and facility-based delivery are the same. Women from highly socioeconomically disadvantaged communities, compared to their counterparts from less socioeconomically disadvantaged neighborhoods, are less likely to utilize both the antenatal services and healthcare facility for child delivery. The result of this study has shown that both individual and contextual socioeconomic status play an important role in obstetric care uptake.

    CONCLUSION: Thus, intervention aimed at improving the utilization of obstetrics care should target both the individual economic abilities of the women and that of their environment when considering the demand side.

  • 34.
    Aremu, Olatunde
    et al.
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden; Southampton Health Technology Assessment Centre, School of Medicine University of Southampton, Southampton, UK; College of Medicine, University of Ibadan, Ibadan, Nigeria .
    Lawoko, Stephen
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Moradi, Tahereh
    Division of Epidemiology, The institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
    Dalal, Koustuv
    Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden; Departments of Medicine and Health Science, Centre for Health Technology Assessment Linköping University, Linköping, Sweden.
    Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: a multilevel model.2011In: The Italian Journal of Pediatrics, ISSN 1720-8424, E-ISSN 1824-7288, Vol. 37, no 13Article in journal (Refereed)
    Abstract [en]

    Background: Diarrhoea disease which has been attributed to poverty constitutes a major cause of morbidity and mortality in children aged five and below in most low-and-middle income countries. This study sought to examine the contribution of individual and neighbourhood socio-economic characteristics to caregiver's treatment choices for managing childhood diarrhoea at household level in sub-Saharan Africa.

    Methods: Multilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period.

    Results: There were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver's partners' occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors.

    Conclusion: In the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.

  • 35.
    Arnell, Susann
    et al.
    Örebro University, School of Health Sciences.
    Jerlinder, Kajsa
    Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden.
    Lundqvist, Lars-Olov
    Örebro University, School of Health Sciences.
    Feasibility of Using Q-Sort to Map Conditional Participation in Physical Activity in Adolescents With Autism Spectrum Disorder2023In: Adapted Physical Activity Quarterly, ISSN 0736-5829, E-ISSN 1543-2777, Vol. 40, no 1, p. 63-85Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Participation in physical activity among adolescents with autism is often conditional. However, there is a lack of methods for identifying these specific conditions. Therefore, the purpose of this study was to develop and investigate the feasibility of a Q-sort tool to map individual-specific conditions for participation in physical activity among adolescents with autism and to identify different viewpoints regarding conditions for such participation.

    METHOD: An exploratory mixed-methods design was employed to investigate the feasibility of using Q methodology and the Q-sort procedure to identify what individual-specific conditions are important for participation in physical activity for adolescents with autism.

    RESULTS: The adolescents ranked the statements with varying levels of ease. Two viewpoints were identified: Autonomous participation without surprises and Enjoyment of activity in a safe social context.

    CONCLUSION: Q-sort is a feasible method for mapping conditions for participation, which can guide the development of tailored physical activity interventions.

  • 36.
    Aronson, Olov
    Örebro University, School of Humanities, Education and Social Sciences.
    Differential effects of religiosity on the mental health problems of adolescent natives and immigrants in Sweden: A three-wave longitudinal study2022In: Mental health & prevention, E-ISSN 2212-6570, Vol. 27, article id 200242Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has suggested that religiosity contributes to preventing mental health problems, such as depression and anxiety, among adolescents. However, it is reasonable to suspect that the protective effect of religiosity on mental health problems is relatively stronger in immigrant populations than in native populations since immigrants are more likely to be challenged by experiences of migration, resettlement, and discrimination. The current study tests and compares the protective effects of religiosity on the mental health problems of adolescent natives and immigrants in Sweden.

    Design: Three waves of longitudinal data from 4,366 adolescents in Sweden were retrieved from Children of Immigrants Longitudinal Survey in Four European Countries (CILS4EU). The data were collected between 2010/2011 and 2012/2013, when the participants were on average 14-16 years old. Three subsamples were analysed separately, including natives (n = 2,459), first-generation immigrants (n = 560), and second-generation immigrants (n = 1,347). Latent growth curve models were estimated and plotted.

    Results: Religiosity predicted less mental health problems among first- and second-generation immigrants throughout the period of data collection, from age 14 to age 16. By contrast, religiosity was associated with more initial mental health problems among adolescent natives.

    Conclusion: To prevent mental health problems among adolescents, the findings of the current study suggest that it may be necessary to develop specific prevention strategies for specific adolescent populations. Also, early interventions to facilitate religiosity among adolescent immigrants may have lasting, preventive effects on their mental health problems.

  • 37.
    Aronson, Olov
    et al.
    Jönköping University, School of Health and Welfare, Jönköping, Sweden.
    Bergh, Daniel
    University of Gothenburg, Gothenburg, Sweden.
    Adolescents who feel depressed are rejected but do not withdraw: A longitudinal study of ethnically diverse friendship networks in England, Sweden, and Germany2021In: SSM - Population Health, ISSN 2352-8273, Vol. 15, article id 100889Article in journal (Refereed)
    Abstract [en]

    Adolescents who feel depressed are likely to experience social isolation from friends. Previous studies have put forward at least four hypotheses that can account for the association between felt depression and social isolation. The hypotheses are: (1) adolescents who are rejected tend to feel more depressed, (2) adolescents who feel depressed tend to become rejected, (3) adolescents who withdraw from friends tend to feel more depressed, and (4) adolescents who feel depressed tend to withdraw from friends. The present study aims to test these four hypotheses in ethnically diverse contexts in three countries. Two waves of data from England (n = 515), Sweden (n = 1,228), and Germany (n = 869) were obtained from the Children of Immigrants Longitudinal Survey in Four European Countries (CILS4EU). One separate stochastic actor-oriented model of the longitudinal coevolution of friendship networks and felt depression was estimated for each of the three countries using the statistical package RSiena. The results consistently indicated that, in all three countries, adolescents who felt depressed were rejected by their peers. Also, the results consistently indicated that adolescents who felt depressed sought more friends, and the results therefore refuted the suggestion that adolescents who feel depressed withdraw from their friends. The findings of the study can inform health-promotion interventions that attempt to limit the social isolation of adolescents who feel depressed in ethnically diverse contexts. More specifically, the study suggests that the social isolation of adolescents who feel depressed may be limited through interventions that reduce the rejection that these adolescents experience from their peers.

  • 38.
    Aronson, Olov
    et al.
    School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Bergh, Daniel
    Karlstad University, Karlstad, Sweden.
    Smoking motivation in the face of stigmatization: A Bourdieusian analysis of impressions2019In: Stigma and Health, ISSN 2376-6972, Vol. 4, no 1, p. 30-37Article in journal (Refereed)
    Abstract [en]

    Earlier research from Western countries has indicated that individuals with low socioeconomic status (SES) initiate tobacco smoking even though smoking is a stigmatized practice. We propose that theoretical developments of Bourdieu's theories on capital can reveal a plausible mechanism that explains smoking motivation in the face of stigmatization, and we perform a double-blind randomized controlled experiment with the impressions of a smoking adolescent girl to test and elaborate on our proposition. The empirical data was collected through questionnaires distributed to 622 Swedish adolescents during the fall of 2015. Half the questionnaires included a picture of a smoking girl and half the questionnaires included an identical picture without the act of smoking. Binary logistic regressions indicate that the girl in the picture was perceived as significantly less likable, more popular, less kind, less compassionate, more deceitful, more conceited, and more liable to bully when she smoked a cigarette than when she did not smoke. The theoretical analysis implies that adolescents with low SES may seek to smoke in the face of stigmatization because of a motivating mechanism that functions in accordance with Bourdieu's economic logic of action. The concluding section presents implications for tobaccocontrol policies.

  • 39.
    Asghar, Naveed
    et al.
    School of Natural Sciences,Technology and Environmental Studies, Södertörn University, Huddinge, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden; Inflammatory Response and Infection Susceptibility Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Petersson, Mona
    School of Natural Sciences, Technology and Environmental Studies, Södertörn University, Huddinge, Sweden.
    Johansson, Magnus
    Örebro University, School of Medical Sciences. School of Natural Sciences, Technology and Environmental Studies, Södertörn University, Huddinge, Sweden.
    Dinnetz, Patrik
    School of Natural Sciences, Technology and Environmental Studies, Södertörn University, Huddinge, Sweden.
    Local landscape effects on population dynamics of Ixodes ricinus2016In: Geospatial health, ISSN 1827-1987, Vol. 11, no 3, p. 283-289, article id 487Article in journal (Refereed)
    Abstract [en]

    Ixodes ricinus, a common tick in Europe, transmits severe tickborne pathogens (TBPs). In Sweden, both prevalence and incidence of tick-borne infections have increased during the last few decades, and a majority of the cases is reported from the area around Stockholm. Among ticks, transmission of TBPs involves co-feeding of susceptible larvae or nymphs with infected ticks on the same host. Seasonal synchrony of immature stages and total tick abundance are important factors for the probability of horizontal transmission of TBPs. We have studied the association between local landscape characteristics and population dynamics and the probability of co-occurrence of different life cycle stages of I. ricinus at different locations south of Stockholm, Sweden. We found significant spatiotemporal variation in tick activity patterns. Mean tick abundance varied with a tenfold difference among study sites. The probability of co-occurrence of larvae, nymphs and female adults was highest in June and decreased significantly with vegetation height. In addition, the amount of forest habitat and open water in the surrounding landscape of the study sites expressed significant negative effects on tick abundance and co-occurrence, indicating that environmental heterogeneity may increase the likelihood of good rodent habitats, which in turn, are suitable hosts for immature ticks.

  • 40.
    Atiya Ali, M.
    et al.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Strandvik, B.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Sabel, K-G.
    Borås Children Hospital (SÄS), Borås, Sweden.
    Palme Kilander, C.
    Division of Neonatology, Department of Paediatrics, Karolinska Institute, Stockholm, Sweden.
    Strömberg, R.
    Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden.
    Polyamine levels in breast milk are associated with mothers' dietary intake and are higher in preterm than full-term human milk and formulas2014In: Journal of human nutrition and dietetics (Print), ISSN 0952-3871, E-ISSN 1365-277X, Vol. 27, no 5, p. 459-467Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Polyamine intake from milk is considered essential for post-natal maturation of the immune system and small intestine. The present study aimed to determine polyamine content in human milk after preterm delivery and the association with mothers' dietary intake. In comparison, the polyamine levels were compared with those in term breast milk and some corresponding formulas.

    METHODS: Transitional breast milk was collected from 40 mothers delivering after 24-36 weeks of gestation, and from 12 mothers delivering after full term. Food intake was assessed in mothers delivering preterm babies using a 3-day diary. Polyamines were analysed by high-performance liquid chromatography.

    RESULTS: The dietary intake of polyamines was significantly associated with breast milk content but weaker for spermine than for spermidine and putrescine. Total polyamine level was higher in preterm than term milk and lower in the corresponding formulas. Putrescine, spermidine and spermine contents [mean (SEM)] in preterm milk were 165.6 (25), 615.5 (80) and 167.7 (16) nmol dL(-1) , respectively, with the levels of putrescine and spermidine being 50% and 25% higher than in term milk. The content of spermine did not differ.

    CONCLUSIONS: Dietary intake of polyamines has an impact on the content in breast milk. The difference between human milk after preterm and term delivery might be considered when using donor human milk for preterm infants. The corresponding formulas had lower contents. Further studies are important for determining the relationship between tissue growth and maturation and optimal intake.

  • 41.
    Atorkey, Prince
    et al.
    School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, New South Wales, Australia; Hunter New England Population Health, Hunter New England Local Health District, Wallsend, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Australia .
    Owiredua, Christiana
    Örebro University, School of Law, Psychology and Social Work.
    Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: A latent class analysis2021In: SSM - Population Health, ISSN 2352-8273, Vol. 13, article id 100707Article in journal (Refereed)
    Abstract [en]

    This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, the association between socio-demographic characteristics, psychological distress and clusters and the relationship between number of health risk behaviours and psychological distress among adolescents in Ghana. Participants were senior high school (SHS) students aged 11-19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Participants were classified to be at risk if they indicated they smoked tobacco, did not eat fruit >= 2 times a day and vegetables = 5 a day, drank alcohol during the past 30 days and did not engage in physical activity for >= 60 min per day during the past 7 days. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively. Multiple logistic regression was used to determine the relationship between number of health risk behaviours and psychological distress. The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: Cluster 1 ("Poor nutrition, inactive, low substance use cluster"; 91%); Cluster 2 ("High Risk Cluster"; 9%). Using cluster 1 as a reference group, adolescents in the 11-15 years category had lower odds of belonging to cluster 2 (OR = 0.21 CI 0.05-0.91, rho = 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45 CI 1.45-4.14, rho = 0.001). No significant relationship was found between number of health risk behaviour and psychological distress. Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.

  • 42.
    Atorkey, Prince
    et al.
    School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter New England Population Health, Wallsend, Australia; Hunter Medical Research Institute, Newcastle, Australia; Priority Research Centre for Health Behaviour, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, Australia.
    Owiredua, Christiana
    Örebro University, School of Law, Psychology and Social Work. Centre for Health and Medical Psychology.
    Clustering of multiple health risk behaviours and association with socio-demographic characteristics and psychological distress among adolescents in Ghana: a latent class analysis2021In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 28, no Suppl. 1, p. S166-S166Article in journal (Other academic)
    Abstract [en]

    Background/purpose: This study examined the prevalence of multiple health risk behaviours, the clustering patterns of health risk behaviours, and the association between socio-demographic characteristics, psychological distress and clusters among adolescents in Ghana.

    Methods: Participants were senior high school (SHS) students aged 11-19 years who participated in the 2012 Global School-based Students Health Survey (n = 1763). Five health risk behaviours (smoking tobacco, inadequate fruit intake, inadequate vegetable intake, alcohol intake and physical inactivity) were measured. Latent class analysis and latent regression were used to identify the clusters and factors associated with the clusters respectively.

    Results: The prevalence of multiple health risk behaviours (2 or more) was 94.8%. Two clusters emerged: cluster1 ("Poor nutrition, inactive, low substance use cluster";91%); cluster 2 ("High Risk Cluster"; 9%). Using cluster 1 as a reference group, adolescents in the 11-15 years category had lower odds of belonging to cluster 2 (OR = 0.21, CI 0.05-0.91,ρ= 0.036) while those experiencing symptoms of depression had higher odds of belonging to cluster 2 (OR = 2.45, CI 1.45-4.14,ρ=0.001.

    Conclusions and implications: Health risk behaviours cluster among adolescents with age and depression associated with the identified clusters. Early interventions that target these clusters are needed at the individual, school and community level to mitigate the burden of non-communicable diseases.

  • 43.
    Atterby, Clara
    et al.
    Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Osbjer, Kristina
    Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden; Food and Agriculture Organization of the United Nations, Phnom Penh, Cambodia.
    Tepper, Viktoria
    Institute of Environmental Engineering, ETH Zürich, Switzerland.
    Rajala, Elisabeth
    Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden.
    Hernandez, Jorge
    Center for Ecology and Evolution in Microbial Model Systems Linnaeus University, Kalmar, Sweden; Department of Infectious Diseases, Kalmar County Council, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Diagnostic Centrum, Clinic Microbiologic Laboratory, Kalmar County Hospital, Kalmar, Sweden.
    Seng, Sokerya
    Food and Agriculture Organization of the United Nations, Phnom Penh, Cambodia.
    Holl, Davun
    General Directorate of Animal Health and Production, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia.
    Bonnedahl, Jonas
    Center for Ecology and Evolution in Microbial Model Systems Linnaeus University, Kalmar, Sweden; Department of Infectious Diseases, Kalmar County Council, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Börjesson, Stefan
    Department of Animal Health and Antimicrobial strategies, National Veterinary Institute (SVA), Uppsala, Sweden; Department of Clinical and Experimental Medicine, Linköping University, Sweden.
    Magnusson, Ulf
    Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Uppsala, Sweden.
    Järhult, Josef D
    Zoonosis Science Center, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Carriage of carbapenemase- and extended-spectrum cephalosporinase-producing Escherichia coli and Klebsiella pneumoniae in humans and livestock in rural Cambodia; gender and age differences and detection of blaOXA-48 in humans.2019In: Zoonoses and Public Health, ISSN 1863-1959, E-ISSN 1863-2378, Vol. 66, no 6, p. 603-617Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study investigates the frequency and characteristics of carbapenemase-producing Escherichia coli/Klebsiella pneumoniae (CPE/K) and extended-spectrum cephalosporinase-producing E. coli/K. pneumoniae (ESCE/K) in healthy humans and livestock in rural Cambodia. Additionally, household practices as risk factors for faecal carriage of ESCE/K are identified.

    METHODS: Faecal samples were obtained from 307 humans and 285 livestock including large ruminants, pigs and poultry living in 100 households in rural Cambodia in 2011. Each household was interviewed, and multilevel logistic model determined associations between household practices/meat consumption and faecal carriage of ESCE/K. CPE and ESCE/K were detected and further screened for colistin resistance genes.

    RESULTS: CPE/K isolates harbouring blaOXA-48 were identified in two humans. The community carriage of ESCE/K was 20% in humans and 23% in livestock. The same ESBL genes: blaCTX-M-15 , blaCTX-M-14 , blaCTX-M-27 , blaCTX-M-55 , blaSHV-2 , blaSHV-12 , blaSHV-28 ; AmpC genes: blaCMY-2 , blaCMY-42, blaDHA-1 ; and colistin resistance genes: mcr-1-like and mcr-3-like were detected in humans and livestock. ESCE/K was frequently detected in women, young children, pigs and poultry, which are groups in close contact. The practice of burning or burying meat waste and not collecting animal manure indoors and outdoors daily were identified as risk factors for faecal carriage of ESCE/K.

    CONCLUSIONS: Faecal carriage of E. coli and K. pneumoniae harbouring extended-spectrum cephalosporinase genes are common in the Cambodian community, especially in women and young children. Exposure to animal manure and slaughter products are risk factors for intestinal colonization of ESCE/K in humans.

  • 44.
    Augustsson, Kristin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Rydqvist, Amanda
    Sömn och tvättstugescheman: En studie kring vårdanställda skiftarbetares sömn och risk för trötthet, misstag samt olyckor2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 45.
    Axelsson, Per
    et al.
    Centrum för samisk forskning (CeSam), Umeå universitet, Umeå, Sverige.
    Sköld, Peter
    Centrum för samisk forskning (CeSam), Umeå universitet, Umeå, Sweden.
    Tano, Sofia
    Arctic Research Centre at Umeå University (Arcum), Umeå, Sweden.
    Sweden: The Sami2016In: A Global Snapshot of Indigenous and Tribal Peoples' Health: The Lancet–Lowitja Institute Collaboration / [ed] Kate Silburn, Hannah Reich & Ian Anderson, Carlton South, Victoria, Australia: The Lowitja Institute , 2016, , p. 2p. 46-47Chapter in book (Refereed)
  • 46. Axelsson, Roland
    et al.
    Jansson, Charlotte
    Järliden, Eva
    Westblad, Johan
    Jendteg, Stefan
    Sedelius, Thomas
    Sandberg, Andreas
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences.
    Indikatorer för hållbar välfärdsutveckling på stadsdelsnivå2010In: Partnerskap för hållbar välfärdsutveckling: utveckling och forskning under sex år i fyra städer / [ed] Charli Eriksson, Eva Järliden, Annika Larsson, Solveig Sandberg, Örebro: Örebro universitet , 2010, p. 219-240Chapter in book (Other academic)
  • 47.
    Badache, Andreea
    et al.
    Örebro University, School of Health Sciences.
    Hachem, Hany
    Örebro University, School of Humanities, Education and Social Sciences.
    Mäki-Torkko, Elina
    Örebro University, School of Medical Sciences. Swedish Institute of Disability Research, Örebro, Sweden.
    The perspectives of successful ageing among older adults aged 75+: a systematic review with a narrative synthesis of mixed studies2023In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, p. 1203-1239Article, review/survey (Refereed)
    Abstract [en]

    Older adults 75 and above are a fast-growing segment of the population. However, few studies have investigated what it means to age successfully from their perspective. This group of older adults face challenges that might characteristically differ from younger older adults. Therefore, the aim of this study was to conduct a systematic review of the perspectives of older adults aged 75 and above regarding what it means to age successfully and to summarise the findings through a narrative synthesis. We also aimed to provide a snapshot of inhibitors and facilitators to achieve successful ageing. A systematic review of the 75+ older adults’ perspectives was conducted across PubMed, CINAHL, Scopus, Web of Science and PsycINFO. Qualitative, quantitative and mixed-methods original peer-reviewed studies were included. After reviewing 4,661 articles, 15 articles met the inclusion criteria and 15 themes were identified. They ranged from biomedical components such as physical functioning to psychosocial components such as relationships, reflections on life and past experiences, preparations for death and environmental factors. The findings revealed that as people age, their definition of successful ageing changes, expanding the current conceptualisation of successful ageing by including additional factors that can act as facilitators and/or inhibitors, such as death and environmental factors. The findings also highlight the need for further research on theory development by considering age-related differences and the perspectives of under-studied populations.

  • 48.
    Badache, Andreea
    et al.
    Örebro University, School of Health Sciences.
    Rehnberg, Johan
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Mäki-Torkko, Elina
    Örebro University, School of Medical Sciences.
    Widén, Stephen
    Örebro University, School of Health Sciences.
    Fors, Stefan
    Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
    Longitudinal associations between sensory and cognitive functioning in adults 60 years or older in Sweden and Denmark2024In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 121, article id 105362Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The objective of this study is to explore the bidirectional, longitudinal associations between self-reported sensory functions (hearing/vision) and cognitive functioning among older adults in Sweden and Denmark during the period 2004-2017.

    METHODS: The study is based on data from The Survey of Health, Ageing and Retirement in Europe and consists of 3164 persons aged 60 to 93 years. Within-person associations between sensory and cognitive functions were estimated using random intercept cross-lagged panel models.

    RESULTS: The results indicated that cognitive and sensory functions were associated within their respective domains over time. The results on the bidirectional associations between sensory functions and cognition over time showed weak and statistically non-significant estimates.

    CONCLUSION: Our study showed no clear evidence for cross-lagged effects between sensory functions and cognitive functioning. Important to note, however, is that using longitudinal data to estimate change within persons is a demanding statistical test and various factors may have contributed to the absence of conclusive evidence in our study. We discuss several of these factors.

  • 49.
    Badi, Safaa
    et al.
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Babiker, Loai Abdelgadir
    Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan.
    Aldow, Abdullah Yasseen
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Abas, Almigdad Badr Aldeen
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Eisa, Mazen Abdelhafiez
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Abu-Ali, Mohamed Nour
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Abdella, Wagass Abdelrhman
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Marzouq, Mohamed Elsir
    Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan .
    Ahmed, Musaab
    College of Medicine, Ajman University, Ajman, United Arab Emirates.
    Omer, Abubakr Ali M
    Örebro University, School of Medical Sciences. Faculty of Medicine, University of Khartoum, Sudan .
    Ahmed, Mohamed H.
    Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK .
    Knowledge and attitudes toward COVID-19 vaccination in Sudan: A cross-sectional study2023In: AIMS Public Health, E-ISSN 2327-8994, Vol. 10, no 2, p. 310-323Article in journal (Refereed)
    Abstract [en]

    Background: Vaccines are an essential part of public health interventions to mitigate the devastating health and non-health impacts of COVID-19 pandemic. Despite the fact that Sudan launched the COVID-19 vaccination program in March 2021, only 10% of the population received their two primary doses of vaccines by the end of May 2022. This delayed uptake of vaccines obviously warrants investigation. Therefore, we have conducted this study to evaluate the knowledge, attitude and acceptance of the general population in Sudan toward COVID-19 vaccines.

    Methodology: A descriptive cross-sectional community-based study. The data were collected using an electronic questionnaire from 403 individuals living in Khartoum, Sudan. The data were processed using the Statistical Package for Social Sciences (SPSS), and data analysis was performed using appropriate tests.

    Results: 51% of the participants were found to have sufficient knowledge about the COVID-19 vaccine, and the knowledge level is higher among those educated beyond the secondary school and those who were employed. Among those unvaccinated, only 47% of the participants expressed their intention to take the vaccine when offered to them. The major reason for not trusting the vaccine is safety concerns expressed by 65.5% of the unvaccinated.

    Conclusion: Higher education levels and employment were associated with an increase in sufficient knowledge about the vaccine in around half of the participants. However, most of participants had not taken the vaccine at the time of the study, and the trust in vaccines is not high. Effective interventions by the health authorities are needed to address these issues in order to accelerate the COVID-19 vaccination program in Sudan.

  • 50.
    Baravelli, C. M.
    et al.
    Centre of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway; CHAIN – Centre for Global Health Inequalities, NTNU, Trondheim, Norway.
    Chen-Xu, J.
    Public Health Unit, Primary Healthcare Cluster Baixo Mondego, Coimbra, Portugal.
    Varga, O.
    Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary.
    Grad, D. A.
    Department of Public Health, Babes-Bolyai University, Cluj-Napoca, Romania.
    Mahrouseh, N.
    Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary.
    Charalampous, P.
    Department of Public Health, Erasmus MC University, Rotterdam, Netherlands.
    Unim, B.
    Department of Cardiovascular Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy.
    Economou, M.
    Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Greece.
    Badache, Andreea
    Örebro University, School of Health Sciences. Department of Disability Research.
    Haneef, R.
    Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice, France.
    Subnational inequalities in YLLs and associated socioeconomic factors: a disease burden study2023In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 33, no Suppl. 2, p. ii142-ii143, article id ckad160.361Article in journal (Other academic)
    Abstract [en]

    Background: Health inequalities are an unjust and avoidable problem. Thiss tudy examines subnational geographical inequalities in all-cause years of life lost (YLLs) and the association of socioeconomic factors in pre-coronavirus European Economic Area (EEA) countries.

    Methods: In this ecological study complimented with a longitudinal analysis, demographic and socioeconomic data for 1390 small regions and 285 basic regions of 32 EEA countries were extracted from Eurostat. Age-standardised YLL rates per 100,000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease Study. Inequalities were assessed using the Gini coefficient (GC) and slope index of inequality (SII). The association between socioeconomic factors by YLLs were assessed using negative binomial mixed models in 2019.

    Findings: Over the period 2009-2019, YLLs have decreased in almost all subnational regions. The GC of YLLs across EEA regions was 14% for females (95% CI = 135 to 146%) and 17% for males (CI = 161 to 175%). Greece (GC = 101%, CI = 78 to 25%) and Belgium (GC = 108%, CI = 95 to 120%) had the highest relative inequalities in YLLs for women and men, respectively. Subnational regions with the lowest income (incident rate ratio (IRR) = 139, CI = 123 to 158) and levels of educational attainment (IRRfemales = 119, CI = 113 to 126; IRRmales = 122, CI = 116 to 128), and highest poverty risk (IRR = 118, CI = 112 to 125) were associated with increased YLLs, with stronger associations observed in Central and Eastern Europe.

    Interpretation: Differences in YLLs remain within and between EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing specific health inequities to improve overall disease burden within the EEA.

    Key messages:

    • The study highlights the need for public health policies targeted at the subnational level to reduce health inequalities in the EEA.
    • The study describes the effect of existing public health policies targeting socioeconomic factors.
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