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  • 1.
    Brew, Bronwyn K.
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gong, Tong
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Williams, Dylan M.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Deptartment of Medicine, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
    Almqvist, Catarina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Pediatric Allergy and Pulmonology Unit, Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden.
    Using fathers as a negative control exposure to test the Developmental Origins of Health and Disease Hypothesis: A case study on maternal distress and offspring asthma using Swedish register data2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 17, p. 36-40Article in journal (Refereed)
    Abstract [en]

    Background: Developmental Origins of Health and Disease Hypothesis (DOHaD) studies are often observational in nature and are therefore prone to biases from loss to follow-up and unmeasured confounding. Register-based studies can reduce these issues since they allow almost complete follow-up and provide information on fathers that can be used in a negative control analysis to assess the impact of unmeasured confounding.

    Aim: The aim of this study was to propose a causal model for testing DOHaD using paternal exposure as a negative control, and its application to maternal distress in pregnancy and offspring asthma.

    Methods: A causal diagram including shared and parent-specific measured and unmeasured confounders for maternal (fetal) and paternal exposures is proposed. The case study consisted of all children born in Sweden from July 2006 to December 2008 (n=254,150). Information about childhood asthma, parental distress and covariates was obtained from the Swedish national health registers. Associations between maternal and paternal distress during pregnancy and offspring asthma at age five years were assessed separately and with mutual adjustment for the other parent's distress measure, as well as for shared confounders.

    Results: Maternal distress during pregnancy was associated with offspring asthma risk; mutually adjusted odds ratio (OR) (OR 1.32, 95% CI 1.23, 1.43). The mutually adjusted paternal distress-offspring asthma analysis (OR 1.05, 95% CI 0.97, 1.13) indicated no evidence for unmeasured confounding shared by the mother and father.

    Conclusions: Using paternal exposure in a negative control model to test the robustness of fetal programming hypotheses can be a relatively simple extension of conventional observational studies but limitations need to be considered.

  • 2.
    Broberg, Gudrun
    et al.
    The Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Regional Cancer Centre, Western Health Care Region, Gothenburg, Sweden; Närhälsan Primary Care, Western Health Care Region, Sweden.
    Strander, Björn
    The Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; The Regional Cancer Centre, Western Health Care Region, Gothenburg, Sweden.
    Ellis, Joy
    The Regional Cancer Centre, Western Health Care Region, Gothenburg, Sweden; Närhälsan Primary Care, Western Health Care Region, Gothenburg, Sweden.
    Adolfsson, Annsofie
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Attending cervical cancer screening, opportunities and obstacles: a qualitative study on midwives' experiences telephoning non-attendees in Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, p. 691-697Article in journal (Refereed)
    Abstract [en]

    Aim: Aspart of a research project aimed at increasing participation in the cervical cancer screening program (CCS), we explored midwives’ unique experiences of telephoning non-attendees and offering Pap smear appointments.

    Methods: Twenty midwives, in four focus groups, discussed their experiences of a study investigating ways to increase participation in the CCS. The group discussions were tape-recorded and transcribed verbatim and underwent qualitative content analysis.

    Results: Speaking with more than 1000 non-attendees provided the midwives with new perspective on the CCS and they realisedthat improving it might address a number of reasons for not participating. These reasons were often related to logistics, such as scheduling flexibility and appointment booking. The telephone conversations revealed that some women required more individual attention, while it was discovered that others did not require screening. The midwives considered the CCS to be life-saving; participating in this screening activity gave them a sense of satisfaction and pride.

    Conclusions: This study shows that midwives can improve access and prevent non-attendance at the cervical cancer screening program when they are aware of women’s varying requirements for attending screening.

  • 3.
    Danermark, Berth
    et al.
    Örebro University, School of Health and Medical Sciences.
    Hanning, Marianne
    Swedish National Board of Health and Welfare, Stockholm, Sweden.
    Hearing and vision: health in Sweden: The National Public Health Report 2012. Chapter 172012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no suppl9, p. 287-292Article in journal (Other academic)
    Abstract [en]

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

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

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

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

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

  • 4.
    Eriksson, Charli C-G
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fredriksson, Ingela
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Fröding, Karin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Geidne, Susanna
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Pettersson, Camilla
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Academic practice-policy partnerships for health promotion research: experiences from three research programs2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 15 Suppl, p. 88-95Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The development of knowledge for health promotion requires an effective mechanism for collaboration between academics, practitioners, and policymakers. The challenge is better to understand the dynamic and ever-changing context of the researcher-practitioner-policymaker-community relationship.

    AIMS: The aims were to explore the factors that foster Academic Practice Policy (APP) partnerships, and to systematically and transparently to review three cases.

    METHODS: Three partnerships were included: Power and Commitment-Alcohol and Drug Prevention by Non-Governmental Organizations in Sweden; Healthy City-Social Inclusion, Urban Governance, and Sustainable Welfare Development; and Empowering Families with Teenagers-Ideals and Reality in Karlskoga and Degerfors. The analysis includes searching for evidence for three hypotheses concerning contextual factors in multi-stakeholder collaboration, and the cumulative effects of partnership synergy.

    RESULTS: APP partnerships emerge during different phases of research and development. Contextual factors are important; researchers need to be trusted by practitioners and politicians. During planning, it is important to involve the relevant partners. During the implementation phase, time is important. During data collection and capacity building, it is important to have shared objectives for and dialogues about research. Finally, dissemination needs to be integrated into any partnership. The links between process and outcomes in participatory research (PR) can be described by the theory of partnership synergy, which includes consideration of how PR can ensure culturally and logistically appropriate research, enhance recruitment capacity, and generate professional capacity and competence in stakeholder groups. Moreover, there are PR synergies over time.

    CONCLUSIONS: The fundamentals of a genuine partnership are communication, collaboration, shared visions, and willingness of all stakeholders to learn from one another

  • 5.
    Fredriksson, Ingela
    et al.
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Geidne, Susanna
    Örebro University, School of Health Sciences.
    Eriksson, Charli
    Örebro University, School of Health Sciences.
    Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no Suppl. 20, p. 72-79Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden.

    Methods: In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents (n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis.

    Results: As part of the youth centres’ strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills.

    Conclusions: There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people’s background and life situation plays a role for their participation in leisure time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

  • 6.
    Geidne, Susanna
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Quennerstedt, Mikael
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    The youth sports club as a health-promoting setting: an integrative review of research2013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 3, p. 269-283Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this review is to compile and identify key issues in international research about youth sports clubs as health-promoting settings, and then discuss the results of the review in terms of a framework for the youth sports club as a health-promoting setting.

    Methods: The framework guiding this review of research is the health-promoting settings approach introduced by the World Health Organization (WHO). The method used is the integrated review. Inclusion criteria were, first, that the studies concerned sports clubs for     young people, not professional clubs; second, that it be a question of voluntary participation in some sort of ongoing organized athletics outside of the regular school curricula; third, that the studies consider issues about youth sports clubs in terms of health-promoting settings as described by WHO. The final sample for the review consists of 44 publications.

    Results: The review shows that youth sports clubs have plentiful opportunities to be or become health-promoting settings; however this is not something that happens automatically. To do so, the club needs to include an emphasis on certain important elements in its strategies and daily practices. The youth sports club needs to be a supportive and healthy environment with activities designed for and adapted to the specific age-group or stage of development of the youth.

    Conclusions: To become a health-promoting setting, a youth sports club needs to take a comprehensive approach to its activities, aims,  and purposes.

  • 7. Hagquist, Curt
    et al.
    Sundh, Mona
    Eriksson, Charli
    Örebro University, Department of Health Sciences.
    Smoking habits before and after the introduction of a minimum-age law for tobacco purchase: analysis of data on adolescents from three regions of Sweden2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 4, p. 373-379Article in journal (Refereed)
    Abstract [en]

    Aims: The purpose of this study was to analyse changes in smoking habits among adolescents in three regions of Sweden following the introduction in 1997 of a law prohibiting sales of tobacco to persons under 18 years: the minimum-age law. Methods: The analysis is based on data collected among adolescents in compulsory school years 7 and 9 (about 13-14 and 15-16 years respectively), in 1996, 2000, and 2005, in three regions of Sweden. The samples comprise 43,857 students who completed a self-administered questionnaire anonymously in the classroom. The data were subjected to contingency-table analysis and logistic regression analysis. Results: The rates of smoking among students in year 9 were significantly lower in 2005 than in 1996 in two regions and unchanged in one region. This pattern held even after control for sex, parents' smoking habits, and academic orientation. In year 7 there were no changes over time (boys) or any clear pattern (girls). Conclusions: Based on outcomes from test purchases of tobacco products that were carried out in parallel to the collection of the questionnaire data, it is reasonable to hypothesize that the regional differences described may at least in part be due to differences in the availability of cigarettes. In 2005 it was significantly easier for adolescents to purchase tobacco products at retailers in the city of Malmo than at those in the counties of Varmland and Vasternorrland.

  • 8.
    Hansson, Anders
    et al.
    Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Gothenburg, Sweden.
    Arvemo, Tobias
    Department of Economics and Informatics, Health and Culture, University West, Trollhättan, Sweden.
    Marklund, Bertil
    Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Gothenburg, Sweden.
    Gedda, Birgitta
    Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
    Mattsson, Bengt
    Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Gothenburg, Sweden.
    Working together: primary care doctors' and nurses' attitudes to collaboration2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 1, p. 78-85Article in journal (Refereed)
    Abstract [en]

    Background: Multidisciplinary teamwork is recommended for various disorders and it has been suggested that it is a way to meet the new challenges and demands facing general practitioners (GPs) in modern society. Attempts to introduce the method in primary care have failed partly due to GPs’ unwillingness to participate. The aim of this study was to measure attitudes towards collaboration among GPs and district nurses (DN) and to investigate whether there is a correlation between a positive attitude toward collaboration and high self-esteem in the professional role. Methods: The Jefferson Scale of Attitudes toward Physician Nurse Collaboration and the Professional Self-Description Form (PSDF) was used to study a cohort of 600 GPs and DNs in Västra Götaland region. The purpose was to map differences and correlations of attitude between DNs and GPs, between male and female GPs, and between older and younger DNs and GPs. Results: Four hundred and one answers were received. DNs (mean 51.7) were significantly more positive about collaboration than GPs (mean 49.4). There was no difference between younger and older, male and female GPs. DNs scored higher on the PSDF-scale than GPs. Conclusions: DNs were slightly more positive about collaboration than GPs. A positive attitude towards collaboration did not seem to be a part of the GPs’ professional role to the same extent as it is for DNs. Professional norms seem to have more influence on attitudes than do gender roles. DNs seem more confident in their profession than GPs.

  • 9.
    Hansson, Anders
    et al.
    Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Svensson, Ann
    School of Business, Economics and IT, University West, Sweden.
    Ahlström, Britt Hedman
    Department of Health Science, Section for Health Promotion and Care Sciences, University West, Sweden.
    Larsson, Lena G.
    Academy of Sahlgrenska, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Forsman, Berit
    Department of Health Sciences, Section for Nursing, Graduate Level, University West, Trollhättan, Sweden.
    Alsén, Pia
    Department of Health Sciences, Section for Nursing, Graduate Level, University West, Trollhättan, Sweden.
    Flawed communications: Health professionals' experience of collaboration in the care of frail elderly patients2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 7, p. 680-689Article in journal (Refereed)
    Abstract [en]

    Aims: Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals' experience of obstacles and opportunities for collaboration.

    Methods: Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories.

    Results: Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities.

    Conclusions: Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees' own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.

  • 10.
    Hedberg, Charlotte
    et al.
    Kvartersakuten Surbrunnsgatan, Centre for Family Medicine, Karolinska Institute, Stockholm, Sweden.
    Engström, Ingemar
    Centre for Psychiatric Research, Örebro, Sweden.
    Vickhoff, Renee
    Kärråkra vårdcentral, Eslöv, Sweden.
    Lynöe, Niels
    Centre for Healthcare Ethics, Karolinska Institute, Stockholm, Sweden.
    Can evidence-based medicine become counter-productive?2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 5, p. 553-4Article in journal (Refereed)
  • 11.
    Kokko, Sami
    et al.
    Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland.
    Martin, Leena
    Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland.
    Geidne, Susanna
    Örebro University, School of Health Sciences.
    Van Hoye, Aurelie
    APEMAC, University of Lorraine, Lorraine, France.
    Lane, Aoife
    Department of Sport and Health Science, Athlone Institute of Technology, Athlone, Ireland.
    Meganck, Jeroen
    Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven - University of Leuven, Leuven, Belgium.
    Scheerder, Jeroen
    Department of Movement Sciences, Policy in Sports & Physical Activity Research Group, KU Leuven – University of Leuven, Leuven, Belgium.
    Seghers, Jan
    Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven – University of Leuven, Leuven, Belgium.
    Villberg, Jari
    Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland.
    Kudlacek, Michal
    Department of Recreation and Leisure Studies, Palacký University, Olomouc, Czech Republik.
    Badura, Petr
    Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic.
    Mononen, Kaisu
    KIHU – Research Institute for Olympic Sports, Jyväskylä, Finland.
    Blomqvist, Minna
    KIHU – Research Institute for Olympic Sports, Jyväskylä, Finland.
    De Clercq, Bart
    Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium.
    Koski, Pasi
    Department of Teacher Education, University of Turku, Turku, Finland.
    Does sports club participation contribute to physical activity among children and adolescents? A comparison across six European countries2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed)
    Abstract [en]

    AIMS: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden.

    METHODS: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression.

    RESULTS: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4-6.4) and VPA recommendation (OR 2.8-5.0) than non-participants.

    CONCLUSIONS: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations.

  • 12.
    Larm, Peter
    et al.
    Uppsala universitet, Centrum för klinisk forskning, Västerås.
    Åslund, Cecilia
    Uppsala universitet, Centrum för klinisk forskning, Västerås.
    Starrin, Bengt
    Karlstad Univ, Dept Social Studies, Stockholm, Sweden..
    Nilson, Kent W.
    Uppsala universitet, Centrum för klinisk forskning, Västerås.
    How are social capital and sense of coherence associated with hazardous alcohol use?: Findings from a large population-based Swedish sample of adults2016In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 44, no 5, p. 525-533Article in journal (Refereed)
    Abstract [en]

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

  • 13. Lindahl, Bernt
    et al.
    Nilsson, Torbjörn K.
    Örebro University, School of Health and Medical Sciences.
    Borch-Johnsen, Knut
    Røder, Michael E.
    Söderberg, Stefan
    Widman, Lars
    Johnson, Owe
    Hallmans, Göran
    Jansson, Jan-Håkan
    A randomized lifestyle intervention with 5-year follow-up in subjects with impaired glucose tolerance: pronounced short-term impact but long-term adherence problems2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 434-442Article in journal (Refereed)
    Abstract [en]

    AIMS: To compare data on cardiovascular risk factor changes in lipids, insulin, proinsulin, fibrinolysis, leptin and C-reactive protein, and on diabetes incidence, in relation to changes in lifestyle. METHODS: The study was a randomized lifestyle intervention trial conducted in northern Sweden between 1995 and 2000, in 168 individuals with impaired glucose tolerance (IGT) and body mass index above 27 at start. The intensive intervention group (n = 83) was subjected to a 1-month residential lifestyle programme. The usual care group (n = 85) participated in a health examination ending with a single counselling session. Follow-up was conducted at 1, 3 and 5 years. RESULTS: At 1-year follow-up, an extensive cardio-metabolic risk factor reduction was demonstrated in the intensive intervention group, along with a 70% decrease of progress to type 2 diabetes. At 5-year follow-up, most of these beneficial effects had disappeared. Reported physical activity and fibre intake as well as high-density lipoprotein cholesterol were still increased, and fasting insulin and proinsulin were lower. CONCLUSIONS: The intervention affected several important cardio-metabolic risk variables beneficially, and reduced the risk for type 2 diabetes, but the effects persisted only as long as the new lifestyle was maintained. Increased physical activity seemed to be the behaviour that was most easy to preserve.

  • 14.
    Lindner, Helen Y.
    et al.
    Örebro University, School of Health Sciences.
    Montgomery, Scott
    Örebro University, School of Medical Sciences. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden; Department of Epidemiology and Public Health, University College London, UK.
    Hiyoshi, Ayako
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Public Health Sciences, Stockholm University, Sweden.
    Risk of depression following traumatic limb amputation: a general population-based cohort study2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 1403494819868038Article in journal (Refereed)
    Abstract [en]

    Background: Individuals with traumatic limb amputation (TLA) may be at risk of depression, but evidence of increased depression after TLA from longitudinal studies has been limited. It is also unknown whether physical function, cognitive function, and employment prior to amputation affects depression risk. We aimed to examine longitudinal associations between TLA and depression in working age men, and to explore the role of pre-amputation occupational and individual characteristics.

    Methods: A Swedish national register-based cohort of 189,220 men born between 1952 and 1956, and who attended conscription assessments in adolescence, was followed from 1985 to 2009. Physical, cognitive, and psychological characteristics were measured at the conscription examination, and occupational information was obtained from the 1985 census. Main outcome measures were hospital inpatient and outpatient admissions for depression.

    Results: In total, 401 men underwent TLA; mean age at amputation was 42.5 years (SD 7.4). Cox regression produced an unadjusted hazard ratio (95% confidence interval) of 2.61 (1.62–4.21) for risk of subsequent depression associated with TLA compared with the general population. Adjustment for occupational, physical, cognitive, and psychological characteristics did not change the association much, producing a hazard ratio of 2.53 (1.57–4.08).

    Conclusions: TLA is associated with an increased risk of depression in men over more than two decades of follow up. Occupational and individual characteristics prior to amputation did not greatly change depression risk following amputation. We speculate that a coordinated combination of social support and medical management may help reduce persistent depression risk in men who experience amputation.

  • 15.
    Lindén-Boström, Margareta
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Persson, Carina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Region Örebro County, Örebro, Sweden.
    Disparities in mental health among adolescents with and without impairments2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, p. 728-735Article in journal (Refereed)
    Abstract [en]

    Aim: To analyse whether there are differences in mental health among adolescents with and without various kinds of impairments, taking into account the number of impairments and gender.

    Methods: Data from the study Life & Health - Young People conducted in a Swedish county in 2011 was used. The survey included all students in grades 7 (13-14 years) and 9 (15-16 years) in compulsory school and grade 2 (17-18 years) in upper secondary school; there were 7793 respondents (81.0%). The students answered a questionnaire anonymously during school hours. Various measures of mental health were assessed in the groups: hard of hearing, visual impairment, motor impairment, difficulties in reading/writing/dyslexia, attention deficit hyperactive disorder/attention deficit disorder, other impairment, no impairment.

    Results: Of the studied impairments, difficulties in reading/writing/dyslexia are the most common (6.3%), followed by hard of hearing (5.4%). To have at least one impairment is more common among boys (18.2%) than girls (15.4%). In the impairment group, 21.5% have multiple impairments. Adolescents with impairments have worse mental health than those without, and those with multiple impairments have particularly higher odds ratio to have worse mental health. There are also differences in mental health between number and various kinds of impairments and between girls and boys.

    Conclusion: Adolescents with impairments, particularly girls and those with multiple impairments, have considerably worse mental health than others. These inequalities in health are an immense challenge, not only for those directly involved with the impaired: they affect everyone involved with the goal health equity for the whole population.

  • 16.
    Ludvigsson, Jonas F.
    et al.
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Paediatrics, Örebro University Hospital, Örebro, Sweden; Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, UK; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, USA.
    Choung, Rok Seon
    Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic, USA.
    Marietta, Eric V.
    Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic, USA.
    Murray, Joseph A.
    Division of Gastroenterology and Hepatology, Department of Immunology, Mayo Clinic, USA.
    Emilsson, Louise
    Department of Health Management and Health Economy, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA; Centre for clinical research & Vårdcentralen Värmlands Nysäter, County council of Värmland, Sweden.
    Increased risk of herpes zoster in patients with coeliac disease - nationwide cohort study2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 8, p. 859-866Article in journal (Refereed)
    Abstract [en]

    Background and aims: Clinical experience suggests that patients with coeliac disease (CD) are more prone to develop herpes zoster (HZ), but robust studies are lacking.

    Methods: We identified 29,064 patients with CD 1969-2008 using biopsy report data from Sweden's 28 pathology departments. CD was equalled to villous atrophy (Marsh histopathology grade III). Each patient was matched on age, sex, calendar year and county of residence to up to five reference individuals (n=144,342) from the general population. We then used Cox regression to estimate hazard ratios (HRs) for future HZ (defined as having a hospital-based inpatient or outpatient record of this diagnosis in the Swedish Patient Register).

    Results: During follow-up, 154 (0.53%) individuals with CD and 499 (0.35%) reference individuals developed HZ. Among individuals aged >= 60 years, 1.06% of CD individuals and 0.85% of reference individuals had a lifetime record of HZ. Overall, CD was associated with a 1.62-fold increased risk of HZ (95% CI=1.35-1.95), and was seen also when we considered comorbidity with lymphoproliferative disease, systemic lupus erythematosus, type 1 diabetes, thyroid disease, rheumatoid disease and excluded individuals with a record of dermatitis herpetiformis. The increased risk remained significant after more than five years of follow-up (1.46; 1.16-1.84)

    Conclusions: CD is associated with HZ, the increased relative risk persists over time from celiac diagnosis but the absolute risk is small.

  • 17. Magnuson, Anders
    et al.
    Bodin, Lennart
    Montgomery, Scott M.
    Örebro University, School of Health and Medical Sciences.
    Father's occupation and sex ratio of offspring2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 5, p. 454-459Article in journal (Refereed)
    Abstract [en]

    Aims: Ecological studies have demonstrated that when national economies contract the proportion of male live births is reduced. It has been suggested that the relative disadvantage this causes influences sex ratio among births. Here the authors use individual data to investigate whether there is a persistent association of father's occupation with the sex of offspring and if it varies by industry sector. Associations with season of birth are also investigated. Methods: All fathers with a first singleton live birth in Sweden between 1940 and 1949 were identified using population registers (n=523,671). Fathers' occupations from the 1960 Census was categorized into: manual workers; agricultural sector (divided into workers and owners/ managers); and office sector (divided into workers and managers). Results: Compared with manual workers, the routine workers in other sectors were not statistically significantly more likely to have a male first offspring. Agricultural owners/ managers and office managers were both statistically significantly more likely to have male offspring with adjusted odds ratios (and 95% confidence intervals) of 1.045 (1.024—1.066, p<0.001) and 1.021 (1.003—1.039, p=0.022), respectively. Compared with autumn births, spring births were less likely to be male: 0.983 (0.967—0.998, p=0.029). Conclusions: Fathers' occupation level, even 10—20 years after childbirth, but not labour market sector is associated with the sex ratio of offspring, indicating that material or social conditions are responsible. Spring births are less likely to be male, probably due to infections differentially reducing male foetal survival.

  • 18.
    Molarius, Anu
    et al.
    Competence Centre for Health, Västmanland County Council, Karlstad University, Västerås, Sweden.
    Granström, Fredrik
    R&D Centre, Sörmland County Council, Eskilstuna, Sweden.
    Lindén-Boström, Margareta
    Örebro University Hospital. Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden.
    Elo, Sirkka
    Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden.
    Domestic work and self-rated health among women and men aged 25-64 years: Results from a population-based survey in Sweden2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 1, p. 52-59Article in journal (Refereed)
    Abstract [en]

    Aims: This study investigated the association between domestic work and self-rated health among women and men in the general population.

    Methods: The study is based on women (N = 12,910) and men (N = 9784) aged 25-64 years, who responded to a survey questionnaire in 2008 (response rate 56%). Logistic regression models were used to assess the association adjusting for age, educational level, employment status, family status and longstanding illness. Population attributable risks (PAR) were calculated to assess the contribution of domestic work to the prevalence of suboptimal self-rated health.

    Results: More women (29%) than men (12%) spent more than 20 hours per week in domestic work. Women also experienced domestic work more often as burdensome. Disability pensioners and single mothers reported highest levels of burdensome domestic work. There was a strong independent association between burdensome domestic work and suboptimal self-rated health both in women and men. The PAR for burdensome domestic work was 21% in women and 12% in men and comparable to other major risk factors.

    Conclusions: The results suggest that domestic work should not be omitted when considering factors that affect self-rated health in the general population.

  • 19.
    Nilsen, Bente B.
    et al.
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Nursing and Health Promotion, Oslo and Akershus University College, Oslo, Norway.
    Yngve, Agneta
    Örebro University, School of Hospitality, Culinary Arts & Meal Science. Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
    Monteagudo, Celia
    Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden; Research Group Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Tellström, Richard
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Scander, Henrik
    Örebro University, School of Hospitality, Culinary Arts & Meal Science.
    Werner, Bo
    Örebro University, School of Medical Sciences. School of Hospitality, Culinary Arts and Meal Sciences, Örebro University, Grythyttan, Sweden.
    Reported habitual intake of breakfast and selected foods in relation to overweight status among seven-to nine-year-old Swedish children2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 886-894Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to examine the reported frequency of breakfast intake and selected food and beverages in the investigated group of Swedish children in comparison with recommended intakes. Furthermore, the study analyses these food habits and some demographic and lifestyle factors in relation to overweight and obesity.

    Methods: This cross-sectional study builds on data collected in 2008 and 2010. Measured anthropometric data and parent questionnaire data were collected. A total of 2620 Swedish children (52.1% boys) aged seven to nine years were included.

    Results: The majority of parents reported that their children (95.4%) had breakfast every day. The majority of children had fresh fruit (84.7%) and vegetables (83.9%) most days a week. Only 1.6% of the children were reported to have fast food and 6.0% to have sugar containing soft drinks, four days a week or more. The prevalence of overweight including obesity (OW/OB) was 17.8% for boys, 18.6% for girls. The odds of being OW/OB was higher among those not having breakfast every day (odds ratio (OR) 1.9, 95% confidence interval (CI) 1.20-2.96), drinking diet soft drink (OR 2.6, 95% CI 1.52-4.42) and skimmed/semi-skimmed milk (OR 1.8, 95% CI 1.37-2.36) four days a week or more. Parents being overweight and having low education levels were also related to a higher risk of their children being overweight.

    Conclusions: The parental reports of children's food habits pointed at favourable eating patterns for most investigated children. Breakfast skipping, diet soft drinks and low-fat milk consumption were more frequent among OW/OB children. Longitudinal studies are needed to determine the causal relationships.

  • 20.
    Nilsing Strid, Emma
    et al.
    Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Söderberg, Elsy
    Linköping University, Linköping, Sweden.
    Normelli, Helena
    Linköping University, Linköping, Sweden.
    Öberg, Birgitta
    Linköping University, Linköping, Sweden.
    Description of functioning in sickness certificates2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, no 5, p. 508-516Article in journal (Refereed)
    Abstract [en]

    Aims: Sickness certificates are to provide information on a disease and its consequences on the patients functioning. This information has implications for the patients rights to sickness benefits and return-to-work measures. The objective of this study was to investigate the description of functioning in sickness certificates according to WHOs International Classification of Functioning, Disability, and Health (ICF), and to describe the influence of patients age, gender, diagnostic group, and affiliation of certifying physician.

    Method: A content analysis of written statements regarding how the disease limits the patients functioning with ICF as a framework was performed in 475 sickness certificates, consecutively collected in Ostergotland County, Sweden.

    Results: Musculoskeletal diseases (MSD) were the largest diagnostic group, followed by mental disorders (MD). Certificates were mainly issued from physicians at hospitals and in primary health care (PHC). ICF was applicable for classifying statements regarding functioning in 311 certificates (65%). The distribution of components was 58% body functions, 26% activity, and 7% participation. The descriptions were primarily restricted to the use of at least one component; namely, body functions. Subgroup analysis showed that descriptions of activity and participation were more common in certificates for MD and MSD, or those issued by PHC physicians. A multiple regression analysis with the activity component as dependent variable confirmed the results by showing that activity was related to both diagnosis and affiliation.

    Conclusions: In a consecutive sample of sickness certificates, it was shown that information on functioning is scarce. When functioning was described, it was mainly body oriented.

  • 21.
    Pettersson, Camilla
    et al.
    Örebro University, School of Health and Medical Sciences.
    Lindén-Boström, Margareta
    Department of Community Medicine, Örebro County Council .
    Eriksson, Charli
    Örebro University, School of Health and Medical Sciences.
    Parental attitudes and behaviour concerning adolescent alcohol consumption: do sociodemographic factors matter?2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 5, p. 509-517Article in journal (Refereed)
    Abstract [en]

    Aims: Parental attitudes and behaviour with regard to young people and alcohol are associated with teenagers' drinking behaviour. This study examined the association between sociodemographic factors among parents and parental attitudes and behaviour with regard to alcohol and adolescents. Methods: Postal questionnaires were sent to parents of children aged 12—16 years in six Swedish municipalities. Seven hundred and ninety-five parents were included in the study. Seven sociodemographic factors and four questions identifying parental attitudes and behaviour were examined. Logistic regression was used to compute odds ratios and confidence intervals. Results: The study showed that fathers were more likely than mothers to report that children had been drinking or tasting alcohol at home. Parents who answered the questionnaire together also stated that their children had been served alcohol at home to a larger extent than mothers. Fathers, single parents and parents with older children were more likely to have non-restrictive attitudes towards adolescents and alcohol than mothers, parents living in a household with more than one adult, and parents with younger children. Factors such as age of the parents, employment status and numbers of children in the household were not associated with either parental attitudes or behaviour. Conclusions: The sex of the responding parent was the only sociodemographic factor that was associated with both parental attitudes and behaviour. Fathers were more likely than mothers to have a non-restrictive attitude. The fathers also reported to a greater extent than mothers that children had been drinking or tasting alcohol at home.

  • 22.
    Sandmark, Hélène
    Örebro University, School of Health and Medical Sciences.
    Job mismatching, unequal opportunities and long-term sickness absence in female white-collar workers in Sweden2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 1, p. 43-49Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate associations between long-term sick-listing and factors at work and in family life. Methods: Associations were investigated in a cross-sectional case-referent study. The study base included women in white-collar jobs, aged 30—55 years, living in three urban areas in Sweden between February 2004 and October 2004. A postal questionnaire was constructed with questions on occupational and family circumstances, and sent to 513 randomly selected female white-collar workers, of whom 233 had ongoing sick-leave of 90 days or more. The response rate was 81% (n = 413). Results: Most of the women in this study were in managerial positions. The unadjusted associations showed that sick-listed women with children showed the highest estimates regarding reported long working hours, bullying, high mental strain, low control and low influence at work, and work—family imbalance. In a regression model, the strongest associations were: experiencing too high mental strain in work tasks (odds ratio (OR) = 2.57, 95% confidence interval (CI) = 2.09—3.15) and low control and influence at work (OR=2.17, 95% CI= 1.60—2.94). Sick-listed women reported an overall higher dissatisfaction with their workplace and working life. Conclusions: There seems to be a greater tendency for the sick-listed women in this study to experience low control and too high mental strain at work and to live in traditional family relationships with unequal opportunities. The women who were sick-listed were probably less able to cope with work stress and to find a balance between work and family life.

  • 23.
    Svensson, Mikael
    et al.
    Örebro University, Swedish Business School at Örebro University. Ctr Res Child & Adolescent Mental Hlth, Karlstad Univ, Karlstad, Sweden.
    Hagquist, Curt
    Ctr Res Child & Adolescent Mental Hlth, Karlstad Univ, Karlstad, Sweden.
    Adolescent alcohol and illicit drug use among first- and second-generation immigrants in Sweden2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 2, p. 184-191Article in journal (Refereed)
    Abstract [en]

    Aim: This article compares adolescent alcohol and illicit drug use among first- and second-generation immigrants from Nordic, non-Nordic European and non-European countries with that of the native Swedish majority population. Methods: Using data from a 2005 survey, multilevel logistic regression analysis was performed on a sample of 13,070 adolescents. The survey was conducted in three Swedish regions containing 24 municipalities. Results: Second-generation immigrants from Nordic countries were more likely to use alcohol and to binge drink, while first generation immigrants from non-European countries were less likely to; this difference is mainly explained by the relatively low use by girls from non-European countries. All immigrant groups were more likely to use illicit drugs than were the majority population. The highest drug use was found among first-generation Nordic immigrants and non-European immigrants. Consumption patterns among second-generation immigrants were more similar to those of the Swedish majority population, implying more alcohol use and less illicit drug use. Conclusions: Preventive policy for alcohol use should target Nordic immigrants in Sweden (second generation), while preventive policy for drug use, which is a more general immigrant phenomena, should mostly target both Nordic and non-European immigrants.

  • 24.
    Swahnberg, Katarina
    et al.
    Division of Gender and Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Davidsson-Simmons, Julia
    Division of Gender and Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Hearn, Jeff
    Örebro University, School of Humanities, Education and Social Sciences. Department of Gender Studies, Faculty of Arts and Sciences, Linköping University, Linköping, Sweden.
    Wijma, Barbro
    Division of Gender and Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Men’s experiences of emotional, physical and sexual violence and abuse, and abuse in health care: a cross-sectional study of a Swedish random male population sample2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, p. 191-202Article in journal (Refereed)
    Abstract [en]

    Aims: This article addresses the under-researched area of men's experiences of abuse. The aims were to estimate prevalence of emotional, physical, and sexual abuse and abuse in health care in a random sample of Swedish adult men, to compare these estimates with previously collected prevalence rates in a male clinical sample to see if prevalence rates were dependant on response rate and sampling method. We also wanted to contribute to a more general analysis of men's experiences of victimisation.

    Methods: Cross-sectional study design. The NorVold Abuse Questionnaire that measures the prevalence of four kinds of abuse was sent to 6000 men selected at random from the population of Astergötland, Sweden.

    Results: The response rate was 50% (n = 2924). Lifetime experiences of emotional abuse were reported by 16.7%, physical abuse by 48.9%, sexual abuse by 4.5%, and abuse in health care by 7.3%. The proportion of men who currently suffered from abusive experiences was highest for emotional abuse and abuse in health care. No difference in prevalence was seen between the random population sample and the clinical sample despite significant differences regarding response rate and background characteristics.

    Conclusions: Abuse against men is prevalent and men are victimised as patients in health care. Response rate and sampling method did not influence prevalence rates of abuse. Men's victimisation from emotional abuse and abuse in health care was associated with low income and being born outside of the Nordic countries and hence needs to be analysed in the intersections of gender, class, and ethnicity.

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