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  • 1.
    Abrahamsson, Elinor
    et al.
    University of Skövde, School of Health and Education.
    Backlund, Carola
    University of Skövde, School of Health and Education.
    Vilka framgångsfaktorer är förknippade med en ökning av den fysiska aktiviteten hos tonåringar?: En litteraturöversikt2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
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  • 2.
    Addelyan Rasi, Hamideh
    et al.
    University of Skövde, School of Life Sciences.
    Timpka, Toomas
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Lindqvist, Kent
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Moula, Alireza
    Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Can a psychosocial intervention programme teaching coping strategies improve the quality of life of Iranian women?: A non-randomised quasi-experimental study2013In: BMJ Open, E-ISSN 2044-6055, Vol. 3, no 3, article id e002407Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess whether a psychosocial intervention teaching coping strategies to women can improve quality of life (QOL) in groups of Iranian women exposed to social pressures. Design: Quasi-experimental non-randomised group design involving two categories of Iranian women, each category represented by non-equivalent intervention and comparison groups. Setting: A large urban area in Iran. Participants: 44 women; 25 single mothers and 19 newly married women. Interventions: Seventh-month psychosocial intervention aimed at providing coping strategies. Primary outcome measures: Effect sizes in four specific health-related domains and two overall perceptions of QOL and health measured by the WHOQOL-BREF instrument. Results: Large effect sizes were observed among the women exposed to the intervention in the WHOQOLBREF subdomains measuring physical health (r=0.68; p<0.001), psychological health (r=0.72; p<0.001), social relationships (r=0.52; p<0.01), environmental health (r=0.55; p<0.01) and in the overall perception of QOL (r=0.72; p<0.001); the effect size regarding overall perception of health was between small and medium (r=0.20; not significant). Small and not statistically significant effect sizes were observed in the women provided with traditional social welfare services. Conclusions: Teaching coping strategies can improve the QOL of women in societies where gender discrimination is prevalent. The findings require reproduction in studies with a more rigorous design before the intervention model can be recommended for widespread distribution.

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    Can a psychosocial intervention programme teaching coping strategies improve the quality of life of Iranian women?
  • 3.
    Adolfsson, Maria
    et al.
    University of Skövde, School of Health and Education.
    Hellström, Mimmi
    University of Skövde, School of Health and Education.
    Fysisk aktivitet och den byggda miljön2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Trots vetskapen om vikten av fysisk aktivitet rör männiksor på sig allt mindre, vilket kan bero på ändrade förutsättningar i samhället. En väletablerad faktor, som påverkar intresset för att vara fysisk aktiv, är den byggda miljön. Syftet med litteraturöversikten är därför att beskriva vilka faktorer i den byggda miljön som främjar fysisk aktiviet hos vuxna kvinnor och män. Metod: Uppsatsen utgår från metoden litteraturöersikt och är baserad på tio vetenskapliga originalartiklar. Resultat: Genom analyser av de tio vetenskapliga artiklarna kunde fyra teman urskiljas; tillgänglighet till cyckel- och gångvägar, avstånd till grönområden och parker, miljömässiga faktorer och faciliteter samt antal parker/grönområden och deras areal. Diskussion: Faktorer som lättillgänglighet till cykel- och gångvägar, litet avstånd till grönområden och parker samt faciliteter i den byggda miljön visade sig främja rörelse. Även antal parker/grönområden och deras areal gynnade fysisk aktivitet hos vuxna kvinnor och män. Några resultat visade dock andra utgångar där avståndet till gröna ytor samt att antalet parker inte var av signifikant betydelse för fysisk aktivitet. 

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  • 4.
    Ahlstrand, Inger
    et al.
    Department of Rehabilitation, School of Health and Welfare, Jönköping University, Sweden.
    Larsson, Ingrid
    School of Health and Welfare, Halmstad University, Sweden.
    Larsson, Margaretha
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Ekman, Aimée
    Department of Social Work, School of Health and Welfare, Jönköping University, Sweden.
    Hedén, Lena
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden.
    Laakso, Katja
    Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Lindmark, Ulrika
    Department of Health Sciences, Karlstad University, Sweden ; Centre for Oral Health, School of Health and Welfare, Jönköping University, Sweden.
    Nunstedt, Håkan
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Oxelmark, Lena
    Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Pennbrant, Sandra
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Sundler, Annelie Johansson
    Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Sweden.
    Hallgren, Jenny
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1314Article in journal (Refereed)
    Abstract [en]

    Background

    Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

    Methods

    This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

    Results

    Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

    Conclusions

    Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

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  • 5.
    Ahmed, Duha
    University of Skövde, School of Health Sciences.
    Internetanvändning – en digital möjlighet för att minska ensamhet och social isolering bland äldre: En strukturerad litteraturstudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Loneliness and social isolation among elderly are public health problems found in large parts of the world. Elderly people are expected to increase exponentially within the next few decades. Thus, the prevalence of lonely elderly people is also expected to increase. Social contact decreases with increasing age as a result of, among other factors, an increased burden of illness.

    Aim: The purpose of this study was to investigate how internet use in the form of social connection can reduce loneliness and social isolation among older people.

    Method: The study was based on a structured literature review. A total of 11 scientific articles have been included in the literature review. The articles were investigated through a thematic analysis with a deductive approach.

    Results: The thematic analysis has resulted in four main themes; improved health status, distance-friendly communication, digital assets and resources, as well as participation – part of prevention. Additionally, seven sub-themes were identified; less loneliness and social isolation, maintaining social relationships, digital communication as a complement, easy-to-use devices and functions, lack of knowledge and experience, education and support, and the opportunity to influence own health and well-being.

    Conclusion: Altogether, there is some evidence that indicates that internet use can positively affect the health status of older people and thus reduce loneliness and social isolation. However, there are barriers, obstacles, and factors that should be taken into consideration to enable the target group to take advantage of digital opportunities that are available and also facilitate their use.

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  • 6.
    Ahrens, W.
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Siani, A.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Adan, R.
    Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
    De Henauw, S.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gwozdz, W.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Hebestreit, A.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Hunsberger, M.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Kaprio, J.
    Department of Public Health, University of Helsinki, Institute for Molecular Medicine (FIMM), Helsinki, Finland.
    Krogh, V.
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Lissner, L.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Molnár, D.
    Department of Paediatrics, University of Pe´cs, Pe´cs, Hungary.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Page, A.
    Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK.
    Picó, C.
    Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics), University of the Balearic Islands (UIB) and CIBER Fisiopatologıa de la Obesidad y Nutricion, Palma de Mallorca, Spain.
    Reisch, L.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Smith, R. M.
    Minerva Communications UK, Andover, UK.
    Tornaritis, M.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Williams, G.
    Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK.
    Pohlabeln, H.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Cohort Profile: The transition from childhood to adolescence in European children-how I.Family extends the IDEFICS cohort2017In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, no 5, p. 1394-1395Article in journal (Refereed)
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  • 7.
    Airaksinen, Jaakko
    et al.
    Medicum, University of Helsinki, Finland.
    Pentti, Jaana
    Clinicum, University of Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Public Health, University of Turku, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Finland / Turku University Hospital, Finland.
    Kivimäki, Mika
    Clinicum, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College, London, UK.
    An Example of How Immortal Time Bias Can Reverse the Results of an Observational Study2020In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 31, no 2, p. e19-e20Article in journal (Refereed)
  • 8.
    Akhavan, Sharareh
    University of Skövde, School of Life Sciences.
    Fermale immigrant' health and working conditions in Sweden2007In: International Journal of Diversity in Organisations, Communities and Nations, ISSN 1447-9532, E-ISSN 1447-9583, Vol. 7, no 2, p. 275-286Article in journal (Refereed)
    Abstract [en]

    Sweden is one of the European countries that has successively changed from a mainly ethnically homogeneous society into a multi-ethnic society. In 2001, almost 20 per cent of the Swedish population was classified as immigrants, i.e., they were either born abroad and naturalized, of foreign nationality or born in Sweden with at least one parent who had been born abroad. Reports, statistics and research have shown that the health of female immigrants is worse than that of the total population and that the incidence of long-term sickness absence and early retirement is higher in this group. The overall aim of this article is to describe, understand and analyze factors that contribute to poor health among female immigrants in Sweden from the perspective of class, gender and ethnicity. Being unemployed, on sick leave or working in occupation with low income and low status are examples that are related to class position, gender and ethnicity. The main three aspects based on class are wage, professional status and female immigrants position in the hierarchical work organisation. Other factors are discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and absence of opportunities for skills upgrade training. Experiences of rape, domestic violence, unanswered emotional and sexual needs and patriarchal culture are examples that are related to gender. And experiencing traumatic events (in pre-migration periods such as experiences of war, prison, etc. and in post-migration periods such as experiences of discrimination and racism) are examples that are related to ethnicity.

  • 9.
    Akhavan, Sharareh
    University of Skövde, School of Life Sciences. School of Health, Care and Social Welfare, University of Mälardalen, Sweden.
    Midwives' views on factors that contribute to health care inequalities among immigrants in Sweden: a qualitative study2012In: International Journal for Equity in Health, E-ISSN 1475-9276, Vol. 11, article id 47Article in journal (Refereed)
    Abstract [en]

    Introduction: Ethnic and socioeconomic inequalities in the Swedish health care system have increased. Most indicators suggest that immigrants have significantly poorer health than native Swedes. The purpose of this study was to explore the views of midwives on the factors that contribute to health care inequality among immigrants. Methods: Data were collected via semi-structured interviews with ten midwives. These were transcribed and related categories identified through content analysis. Results: The interview data were divided into three main categories and seven subcategories. The category "Communication" was divided into subcategories "The meeting", "Cultural diversity and language barriers" and "Trust and confidence". The category "Potential barriers to the use of health care services" contained two subcategories, "Seeking health care" and "Receiving equal treatment". Finally, the category "Transcultural health care" had subcategories "Education on transcultural health care" and "The concept". Conclusions: This study suggests that midwives believe that health care inequality among immigrants can be the result of miscommunication which may arise due to a shortage of meeting time, language barriers, different systems of cultural beliefs and practices and limited patient-caregiver trust. Midwives emphasized that education level, country of origin and length of stay in Sweden play a role when an immigrant seeks health care. Immigrants face more difficulties when seeking health care and in receiving adequate levels of care. However, different views among the midwives were also observed. Some midwives were sensitive to individual and intra-group differences, while some others viewed immigrants as a group of "others". Midwives' beliefs about subgroup-specific health services vs. integrating immigrants' health care into mainstream health care services should be investigated further. Patients' perspective should also be considered.

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    Midwives' views on factors that contribute to health care inequalities among immigrants in Sweden
  • 10.
    Akhavan, Sharareh
    et al.
    University of Skövde, School of Life Sciences. Department of Public Health, Mälardalen University, Västerås, Sweden.
    Karlsen, Saffron
    Department of Epidemiology and Public Health, University College London (UCL), UK.
    Practitioner and Client Explanations for Disparities in Health Care Use Between Migrant and Non-migrant Groups in Sweden: A Qualitative Study2013In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 15, no 1, p. 188-197Article in journal (Refereed)
    Abstract [en]

    To investigate variations in explanations given for disparities in health care use between migrant and nonmigrant groups, by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five ‘migrant’ health service clients and five physicians. The interview data generated three categories which were perceived by respondents to produce ethnic differences in health service use: ‘‘Communication issues’’, ‘‘Cultural differences in approaches to medical consultations’’ and ‘‘Effects of perceptions of inequalities in care quality and discrimination’’. Explanations for disparities in health care use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and those using cultural/behavioural explanations. The negative perceptions of ‘migrant’ clients held by some Swedish physicians place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage. The power disparity between doctors and ‘migrant’ patients encourages a sense of powerlessness and mistreatment among patients.

  • 11.
    Akl, Ziad
    et al.
    School of Health Sciences, Örebro University, Sweden / Youth Association for Social Awareness- YASA, Lebanon.
    Akl, Mona
    Youth Association for Social Awareness- YASA, Lebanon.
    Eriksson, Charli
    School of Health Sciences, Örebro University, Sweden.
    Gifford, Mervyn
    School of Health Sciences, Örebro University, Sweden.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Higher School of Public Health, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
    Evaluating seat belt use in Lebanon (1997-2017)2019In: Open Public Health Journal, ISSN 1874-9445, Vol. 12, no 1, p. 127-135Article in journal (Refereed)
    Abstract [en]

    Introduction: The use of seat belts has made a significant contribution to the reduction of road traffic casualties, and the risk inherent with not wearing seat belts in all seats of a vehicle is now well-known worldwide. The use of seat belts has a major role in reducing fatal and nonfatal injuries in all types of motor-vehicles crashes. Aim: The aim of this study is to understand the reasons behind the variation in seat belt use over the past two decades in Lebanon. It analyzes the situation and suggests recommendations to improve seat belt use in Lebanon. Design: Nine observational studies had been conducted in Lebanon during the last two decades between 1997 and 2017, and one qualitative study was performed in 2017. Results: The results show a significant variation in the use of the seat belt. When enforcement efforts are in progress, seat belt use increases. While when there are no checkpoints and the enforcement of seat belt use is almost absent, a significant fall was noticed. Discussion: The results of this study proved the failure of the Lebanese government in saving hundreds of lives just by a simple measure of enforcing seat belt law. Although experiences from various countries prove that such laws usually have a long-lasting effect on seat belt use, Lebanon failed to pursue the successful implementation of this law due to security and political problems. Conclusion: During the past two decades, Lebanon witnessed continuous fluctuations in seat belt use. Outside few short enforcement campaigns, our observations showed lack in seat belt use. Our observations of seat belt use among drivers and front seat passengers showed a significant correlation between seat belt use and the enforcement of seat belt law. The greatest national benefits from seat belt use are obtained when wearing rates are very high. This can be achieved only through a sustained enforcement campaign alongside other seat belt wearing interventions such as publicity and education. © 2019 Open Public Health Journal. All rights reserved.

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  • 12.
    Alfredsson, Pontus
    et al.
    University of Skövde, School of Health and Education.
    Hildorzon, Julia
    University of Skövde, School of Health and Education.
    Att främja fysisk aktivitet hos gravida kvinnor2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Background: There is a gradual percentage increase in pregnant women who are overweight or obese in the west hemisphere. In Sweden, nearly 40 percent of those women are overweight and 10 percent are obese. One third of them are physically inactive which makes the research within public health highly relevant. Aim: To promote physical activity amongst pregnant women. Method: Ten research articles on the topic were reviewed to achieve a deeper understanding. By summarizing the most important and relevant points brought up in each article, a conclusion was formed. Those points where then categorized into three themes, which turned the study into a type of literature. Results: There are many factors that impact the pregnant women’s physical activity. These factors can be triggered by the actual pregnancy, such as symptoms causing the body to change. Location and environment is seen as important to help the promotion, such as social support and access to activities close to home. Effective interventions are diet and exercise consultations and measurable goals by using pedometers. Conclusion: The conclusion of this study was that several factors promoting pregnant women’s physical activity. Pregnant women are likely to follow the prenatal cares advice and therefore can interventions designed with the promoting factors integrated to prenatal care to achieve goals of public health.

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    Att främja fysisk aktivitet hos gravida kvinnor
  • 13.
    Ali, Shaymaa Abdulreda
    et al.
    Unit of Orthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    Al-Qahtani, Abdul Mueen A.
    Unit of Orthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    Al Banai, Suhayla R.
    Unit of Prosthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    Albaker, Fatima J.
    Unit of Prosthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    Almarri, Alanoud E.
    Al Wakra Dental Hospital, Hamad Medical Corporation, Doha, Qatar.
    Al-Haithami, Khalid
    Unit of Endodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    Khandakji, Mohannad N.
    Unit of Orthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine—Qatar, Doha, Qatar.
    Role of Newly Introduced Teledentistry Service in the Management of Dental Emergencies During COVID-19 Pandemic in Qatar: A Cross-Sectional Analysis2022In: Telemedicine journal and e-health, ISSN 1530-5627, E-ISSN 1556-3669, Vol. 28, no 11, p. 1623-1632Article in journal (Refereed)
    Abstract [en]

    Introduction: The lockdown imposed by the COVID-19 pandemic rendered teledentistry (TD) necessary to maintain the continuity of oral health services and avoid missing emergency dental conditions, while minimizing face-to-face visits. Our objective was to evaluate the ability of a newly introduced triage-based TD service to deliver its goals, by evaluating its processes and outcomes and assessing the demand for TD. Methods: This cross-sectional report assessed the triage processes and outcomes (triage category, referral to emergency/dental facility undertaken, remote medications prescribed, and procedures performed at the point of referral); and evaluated the demand for the newly introduced TD service during 5 months of the first wave of the pandemic. Results: Of 850 calls, about 70.6% of the samples were managed remotely; 29.4% were categorized as emergency/urgent and referred to the emergency/dental facility. Compared with other complaints, orofacial dental pain was the most common reason for the calls (41.6%, p < 0.0001). About 14.71% of callers received prescription for medications remotely. The most demanded disciplines were general dentistry, orthodontics, and oral surgery, respectively (p < 0.0001). Of those referred to a dental facility, 31.84% required no clinical intervention, 28.7% received orthodontic appliance repair, and 14.3% and 11.2% had urgent dental extractions or root canal treatments. Demand on the service fluctuated through various distinct stages of the lockdown. Conclusions: There has been continuous demand for the newly introduced TD service throughout the period of the current report despite the fluctuations, with most complaints managed remotely. TD was effective and suitable for triage, service delivery, and care during the pandemic.

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  • 14.
    Ali, Shaymaa Abdulreda
    et al.
    Unit of Orthodontics, Hamad Dental Center, Hamad Medical Corporation, Doha, Qatar ; Institute of Dentistry, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, United Kingdom.
    El Ansari, Walid
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar ; Weill Cornell Medicine, Qatar, Doha, Qatar.
    Is tele-diagnosis of dental conditions reliable during COVID-19 pandemic?: Agreement between tentative diagnosis via synchronous audioconferencing and definitive clinical diagnosis2022In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 122, article id 104144Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the reliability of synchronous audioconferencing teledentistry (TD) in making tentative diagnosis compared to definitive clinical face-to-face (CFTF) diagnosis; and whether agreement was influenced by dentist's experience, caller-patient relationship, and time of call. Methods: All patients calling the TD hotline during COVID-19 pandemic, triaged as emergency/ urgent and referred for CFTF care were included (N=191). Hotline dentists triaged the calls, made tentative audio-dentistry (AD) diagnosis, while dentists at point of referral made the definitive CFTF diagnosis. Cohen's weighted kappa (κ) assessed the extent of agreement between AD vs CFTF diagnosis. Results: There was significantly very good pair-wise agreement (κ = 0.853, P < 0.0001) between AD and CFTF diagnosis. AD diagnosis of pulpitis and periodontitis exhibited the most frequent disagreements. Tele-dentists with ≥ 20 years’ experience exhibited the highest level of agreement (κ =0.872, P < 0.0001). There was perfect agreement when mothers mediated the call (κ = 1, P < 0.0001), and very good agreement for calls received between 7 am-2 pm (κ = 0.880, P < 0.0001) compared to calls received between 2-10 pm (κ = 0.793, P < 0.0001). Conclusions: Remote tentative diagnosis using AD is safe and reliable. Reliability was generally very good but varied by dentist's experience, caller-patient relationship, and time of call. Clinical significance: The findings suggest that using AD in the home environment is safe and reliable, deploying providers with variable years of experience. The findings have generalizability potential to a variety of similar circumstances, healthcare settings and epi/pandemic situations. 

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  • 15.
    Al-Saedi, Hasanain
    University of Skövde, School of Health Sciences.
    Vikten av rätt utövare: en strukturerad litteraturöversikt om sjuksköterskans roll i viktreducerande insatser som bedrivits inom hälso- och sjukvården på vuxna patienter med övervikt och fetma2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Overweight and obesity are today a growing public health challenge and are increasing in most age groups globally. They are a contributing cause of public health diseases such as cardiovascular disease, type 2 diabetes and certain types of cancer. Nurses often have the task of motivating patients to a healthier lifestyle in order to achieve both reduced weight and increased well-being. However, in general, nurses in care lack sufficient knowledge to be able to help patients. Aim: A structured literature review aimed to explore the role of the nurse had in health promotion and prevention intervention studies conducted in health care, where the intention was to help patients with overweight or obesity achieve weight loss. Method: The literature selection process was based on the PRISMA model to ensure a structured approach. Ten original scientific articles, both qualitative and quantitative, were retrieved from the databases PubMed and CINAHL. The checklists used to review the quality of the articles were the Critical Appraisal Skills Program. In the data analysis, appropriate themes were created based on the ten selected articles. Results: Four themes are reported in the results which are: Methods and tools to enable individual adaptation of the meeting between nurse and patient, Meeting structure that offers the patient continuous support, Digital tools have been shown effective in terms of follow-up and evaluation during a behavior change process and Many expectations of the nurse who do not always hold the right knowledge tool. Conclusion: The results showed that person-centered care, empowerment and FaR (physical activity) prescriptions seem to benefit the weight loss results. Nurses need guidance on how to best treat patients with overweight and obesity, and then building trust between nurse and patient seems to be essential for weight loss efforts to give good results.

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  • 16.
    Anderberg, Peter
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Eivazzadeh, Shahryar
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    A Novel Instrument for Measuring Older People's Attitudes Toward Technology (TechPH): Development and Validation2019In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 21, no 5, article id e13951Article in journal (Refereed)
    Abstract [en]

    Background: The use of health technology by older people is coming increasingly in focus with the demographic changes. Health information technology is generally perceived as an important factor in enabling increased quality of life and reducing the cost of care for this group. Age-appropriate design and facilitation of technology adoption are important to ensure functionality and removal of various barriers to usage. Development of assessment tools and instruments for evaluating older persons' technology adoption and usage as well as measuring the effects of the interventions are of high priority. Both usability and acceptance of a specific technology or service are important factors in evaluating the impact of a health information technology intervention. Psychometric measures are seldom included in evaluations of health technology. However, basic attitudes and sentiments toward technology (eg, technophilia) could be argued to influence both the level of satisfaction with the technology itself as well as the perception of the health intervention outcome. Objective: The purpose of this study is to develop a reduced and refined instrument for measuring older people's attitudes and enthusiasm for technology based on relevant existing instruments for measuring technophilia A requirement of the new instrument is that it should be short and simple to make it usable for evaluation of health technology for older people. Methods: Initial items for the TechPH questionnaire were drawn from a content analysis of relevant existing technophilia measure instruments. An exploratory factor analysis was conducted in a random selection of persons aged 65 years or older (N=374) on eight initial items. The scale was reduced to six items, and the internal consistency and reliability of the scale were examined. Further validation was made by a confirmatory factor analysis (CFA). Results: The exploratory factor analysis resulted in two factors. These factors were analyzed and labeled techEnthusiasm and techAnxiety. They demonstrated relatively good internal consistency (Cronbach alpha=.72 and .68, respectively). The factors were confirmed in the CFA and showed good model fit (chi(2)(8)=21.2, chi(2)/df=2.65, comparative fit index=0.97, adjusted goodness-of-fit index=0.95, root mean square error of approximation=0.067, standardized root mean square residual=0.036). Conclusions: The construed TechPH score showed expected relations to external real-world criteria, and the two factors showed interesting internal relations. Different technophilia personality traits distinguish clusters with different behaviors of adaptation as well as usage of new technology. Whether there is an independent association with the TechPH score against outcomes in health technology projects needs to be shown in further studies. The instrument must also be validated in different contexts, such as other countries.

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  • 17.
    Andersson, Anneli
    University of Skövde, School of Health Sciences.
    Främja skolnärvaro utifrån känslan av sammanhang: En litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Research has shown that there is a lack of precise statistics regarding the number of students with problematic school absence. Schools have a mission to promote students’ health and prevent problematic school absence. With students’ absence, there is a risk of them not achieving the goals that are in the curriculum, which might have negative consequences.

    Aim: The aim of this literature study is to examine how the school attendance of Swedish lower year students, with problematic school absenteeism, can be encouraged through the sense of coherence in a student’s schooling.

    Methods: A structured literature study was conducted based on twelve scientific articles collected from the databases Pubmed, SAGE Journals and Web of Science. The articles were thematically analysed.

    Results: The results of this study were divided into four themes: student, teacher, school nurse, and parent perspectives. Commitment, healthy relationships, a safe environment and cooperation between teachers, school nurses and parents appeared to contribute to a student’s experience with school being more understandable, manageable and meaningful.

    Conclusion: School absence is a complex problem. It is of high importance to create a feeling of belonging for the students, which in turn can encourage the student’s attendance in school.

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  • 18.
    Andersson, Christina
    et al.
    University of Skövde, School of Health and Education.
    Lindberg, Cecilia
    University of Skövde, School of Health and Education.
    Hälsorisker hos flickor vilka använde sociala medier: en litteraturöversikt2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction: Social media has created a new arena for integration. Social media seems to affect young girls mental health. The purpose of the literature review is to examine some health risks among girls aged 11 to 17 years born after 1993 witch has been exposed to through social media. Method: Ten original articles published in the past five years have been sought out through PubMed. Relevant articles were reviewed and thematized based on health risks which are found in the overview. Results: The literature review examined previous research on health risks in young girls born after 1993 in the use of social media. Girls tend to be more affected by the comments and are affected over time which can lead to depression and anxiety. Self-harm and suicidal tendencies are directly linked to depression. Self-confidence is affected by comments on social media. Girls tend increasingly to suffer from psychosomatic disorders due to use of social media. Social media can increase the feeling of fear and insecurity. The girls' body image is influenced by social media, which ultimately can lead to eating disorders. Discussion: The use of social media can be seen as a health risk in young girls. Nevertheless, the impact of social media is seen as on of the triggers for other underlying causes. Social media can also provide health benefits.

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    Hälsorisker hos flickor vilka använde sociala medier
  • 19.
    Andersson, Ewa K.
    et al.
    Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Dallora, Ana Luiza
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Marcinowicz, Ludmila
    Faculty of Health Sciences, Medical University of Bialystok, Poland.
    Stjernberg, Louise
    Department of Care Science, Malmö University, Sweden ; Swedish Red Cross University, Huddinge, Sweden.
    Björling, Gunilla
    School of Health and Welfare, Jönköping University, Sweden ; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden ; Faculty of Nursing, Kilimanjaro Christian Medical University College, Tanzania.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Bohman, Doris
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden ; Optentia Research Unit, North-West University, Vanderbijlpark Campus, South Africa.
    Self-Reported eHealth literacy among nursing students in Sweden and Poland: The eNursEd cross-sectional multicentre study2023In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 29, no 4Article in journal (Refereed)
    Abstract [en]

    This study aimed to provide an understanding of nursing students’ self-reported eHealth literacy in Sweden and Poland. This cross-sectional multicentre study collected data via a questionnaire in three universities in Sweden and Poland. Descriptive statistics, the Spearman’s Rank Correlation Coefficient, Mann–Whitney U, and Kruskal–Wallis tests were used to analyse different data types. Age (in the Polish sample), semester, perceived computer or laptop skills, and frequency of health-related Internet searches were associated with eHealth literacy. No gender differences were evidenced in regard to the eHealth literacy. Regarding attitudes about eHealth, students generally agreed on the importance of eHealth and technical aspects of their education. The importance of integrating eHealth literacy skills in the curricula and the need to encourage the improvement of these skills for both students and personnel are highlighted, as is the importance of identifying students with lacking computer skills. 

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  • 20.
    Andersson, Jenny
    University of Skövde, School of Health Sciences.
    Sjuksköterskors attityder till patientmedverkan i att förebygga vårdrelaterade infektioner: En kvalitativ intervjustudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Healthcare associated infections (HAI), are a threat to public health, both nationally and globally, due to the burden of affected patients, relatives, various parts of the healthcare system and the increasing effect it has on antimicrobial resistance, as HAI often require antibiotic treatment. HAIs are prevented by infection-prevention and control on all levels of the healthcare system including participating patients and relatives. Patient-participation in the prevention of HAI is an underused and underexplored area, where registered nurses can play a vital role as an expert in nursing care in so called partnership with the patient.

    Aim: The aim was to explore attitudes among nurses towards patient-participation in the prevention of HAI.

    Methods: Data collection was made by semistructured individual interviews with eight registered nurses, working in hospital inpatient care. The method for analysis was qualitative content analysis with an inductive approach.

    Results: Eleven subcategories, three categories and one all-embracing theme emerged. The categories were ”Patient-participation is positive”, ”The healthcare-system needs to invite patients” and ”Patients needs to come onboard”. The theme was ”Important topic, depending on the partnership caregiver-patient, in need of development and to be concretizised.”

    Conclusion: The attitudes among nurses towards patient-participation in preventing HAI includes that HAI represents a serious, real and present health-threath. Patient-participation in the prevention of HAI was perceived as a positive and potentially gainful phenomenon, depending on the caregiver-patient partnership. The topic needs to be noticed, concretized and elaborated in order to become a self-evident part of a person-centered, equal healthcare.

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  • 21.
    Andersson, Karin
    University of Skövde, School of Health Sciences.
    Unga mäns upplevelser av maskulinitet relaterat till psykisk ohälsa och självmord: En litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Mental illness is an alarming global public health problem. Surveys show that men rate their health higher than women and seek health care to a lesser extent for mental health problems. Paradoxically, men are overrepresented in the suicide statistics. It has shown that you have to use a connection between mental illness and socio-cultural patterns of gender expression. Many points to make a contribution cause are tight norms for masculinity and traditional masculinity can be linked to suicidal thoughts and works interact with the majority of stressors that reinforce suicidal thoughts.

    Aim: The purpose of the study is to describe what of young men’s experiences, related to masculinity, can be associated with an increased risk of mental illness and suicide.

    Method: A structured literature study was conducted which included both qualitative and quantitative research. Databases used were: MEDLINE; EBSCO. The method of analysis was thematic analysis.

    Results: Young men felt that they were under high pressure to follow traditional restrictive and restrictive gender norms for masculinity. It was clear that the men also experienced difficulties in living up to the ideal. Failure to achieve the hegemonic ideals of masculinity was seen as one of the main reasons why more men than women take their lives.

    Conclusion: This study has led to the realization that there is a need to develop suicide prevention strategies in young men. The efforts must be specifically focused on reducing the masculine ideal in works on mental ill-health and suicide in order to pave their way through barriers that see that one does not want to feel the feeling as support or care for mental ill-health but instead takes one's life.

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  • 22.
    Andersson, Kristin
    University of Skövde, School of Health Sciences.
    En litteraturstudie om det hälsofrämjande ledarskapets betydelse för medarbetares psykiska hälsa inom den svenska äldreomsorgen2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The health and well-being of the staff in elderly care are prominent issues as the number of elderly people who need support and care is expected to increase. Healthcare workers in Sweden are one of the largest groups of workers, and they have the highest number of sick days per employee. Social and organizational issues account for approximately 58% of sick leave due to work-related illnesses among staff in elderly care. Previous research shows that the quality of leadership is a valuable resource in a healthy organization and is considered to play a crucial role in promoting employees' psychological well-being and health. Aim. The aim was to investigate what health promoting leadership means for employees' mental health in municipal elderly care in Sweden. Method. A literature study was made including 10 scientific original articles were retrieved from the databases Medline and CINAHL the results of the articles were then analysed using a thematic analysis method. Results. The result of the analysis yielded two themes and four subthemes in response to the aim of the study. The health-promoting leader's way of being and the conditions that the leader creates to promote the employees' mental health. Conclusion. Health-promoting leadership in elderly care in Sweden is based on trust and the relationship with the employees and is important for the employees' mental health by contributing to increased well-being and job satisfaction.

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  • 23.
    Andersson, Sandra
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Dahlfors, Cecilia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Stillasittande som enskild riskfaktor: En litteraturöversikt om hur vuxna påverkas av ett stillasittande beteende2018Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction: In today's modern, well-developed and increasingly digitized society, people are given the opportunity to live much more sedentary lives than before. More research today indicates that long-term sedentary as a single risk factor is a contributing factor in developing illness and public health diseases such as diabetes, cardiovascular disease and obesity. Aim: The aim of the literature review is to investigate how sedentary behavior as an individual risk factor affects adult human health as well as highlight the factors that contributes to sedentary behavior. Method: In order to respond to the aim, an integrated literature survey has been conducted based on ten scientific original articles. The searches have been made through the databases Pubmed, Cinahl and PsycARTICLES. The articles were then examined and analyzed using the Whittemore and Knafl (2005) analytical method. Results: Longer moments of sedentary had a clear connection between several physiological effects in the body. When breaks were taken, it generated several health-promoting effects such as increased blood glucose absorption, increased calorie consumption, and reduced BMI. In those who were less seated, there was also a reduced risk of dying in e.g. Heart disease. Risk factors such as a poor work environment, where one lives, and an elevated BMI, were found to have adverse effects that led to increased sedentary behaviors. Conclusion: As much as 60% of the waking time is spent sedentary this is considered a risk factor in order to develop public health diseases in the long run. Important aspects that were seen to counteract this were to regularly take shorter breaks to interrupt longer moments of sedentary. Although a healthy level of physical activity is achieved, it is not enough if the rest of the day is spend sedentary. This constitutes a need for new, clearer and achievable guidelines for how people should limit their sedentary behavior. 

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  • 24.
    Andersson, Sandra Paolin
    et al.
    University of Skövde, School of Health and Education.
    Berg, Johanna
    University of Skövde, School of Health and Education.
    Hur unga flickor i åldrarna 12-19 årpåverkas psykiskt av media, i förhållande till sina kroppar: En litteraturstudie2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
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  • 25.
    Andersson, Sophia
    University of Skövde, School of Health and Education.
    Effekterna av fysisk aktivitet vid depression: En litteraturöversikt2018Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    INLEDNING Depression är en vanligt förekommande folksjukdom som växer globalt och kan innebära stort lidande för den drabbade. SYFTE Ge en översikt av effekterna av fysisk aktivitet vid depression. METOD En litteraturöversikt genomfördes genom att tio vetenskapliga originalartiklar valdes ut som studerade effekterna av fysisk aktivitet på depression. Dessa sammanställdes och analyserades fram till fyra gemensamma teman. RESULTAT Majoriteten av studierna visade signifikant förbättring av depressionsnivå efter intervention jämfört med kontrollgrupp. Fysisk aktivitet som komplement till antidepressiv medicinering har positiv effekt på depressionens svårighetsgrad och kan även minska behovet av höga doser antidepressiv medicin. Placeboeffekt kunde uteslutas. Enbart en studie observerade ingen påverkan på depression, hos vilken resultatet bör tolkas med hänsyn till ett begränsat studiedeltagande. DISKUSSION Fysisk aktivitet kan vara mer effektivt än traditionell behandling av antidepressiv medicinering. Den praktiska tillämpningen av att rekommendera fysisk aktivitet inom vården kan däremot vara komplex. Vinstintressen, okunskap och gamla vanor kan eventuellt försvåra en praktisk tillämpning av fysisk aktivitet som behandling. SLUTSATS Slutsatsen är att effekten av fysisk aktivitet på depression är behandlande och lindrande. Fysisk aktivitet står stark som effektiv behandlingsmetod mot depression såväl i sig eller i kombination med traditionell behandling, beroende på svårighetsgrad. Mer studier behövs för att identifiera de mest effektiva kombinationerna av fysisk aktivitet med andra behandlingsmetoder i förhållande till depressionsnivå och målgrupp.

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  • 26.
    Andersson, Susanne
    et al.
    University of Skövde, School of Life Sciences. Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Ekman, Inger
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden / University of Gothenburg, Centre for Person-Centred Care (GPCC), Sweden.
    Friberg, Febe
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden / Faculty of Social Sciences, Department of Health, University of Stavanger, Norway.
    Daka, Bledar
    Insitute of Medicine, Department of Primary Health Care, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Lindblad, Ulf
    Insitute of Medicine, Department of Primary Health Care, University of Gothenburg, Sahlgrenska Academy, Sweden.
    Larsson, Charlotte A.
    Insitute of Medicine, Department of Primary Health Care, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden / University of Lund, Department of Clinical Sciences, Malmö, Social Medicine and Global Health, Sweden.
    The association between self-rated health and impaired glucose tolerance in Swedish adults: A cross-sectional study2013In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 31, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate gender differences in the association between self-rated health (SRH) and impaired glucose tolerance (IGT) in subjects unaware of their glucose tolerance. Design. A cross-sectional population-based study. Setting. The two municipalities of Vara and Skovde in south-western Sweden. Subjects. A total of 2502 participants (1301 women and 1201 men), aged 30-75, were randomly selected from the population. Main outcome measures. IGT was regarded as the outcome measure and SRH as the main risk factor. Results. The prevalence of IGT was significantly higher in women (11.9%) than in men (10.1%), (p = 0.029), as was the prevalence of low SRH (women: 35.4%; men: 22.1%, p = 0.006). Both men and women with low SRH had a poorer risk factor profile than those with high SRH, and a statistically significant crude association between SRH and IGT was found in both men (OR = 2.8, 95% CI 1.8-4.4) and women (OR = 1.5, 95% CI 1.0-2.2, p = 0.033). However, after controlling for several lifestyle factors and biomedical variables, the association was attenuated and remained statistically significant solely in men (OR = 2.3, 95% CI 1.2-4.3). Conclusion. The gender-specific associations found between SRH and IGT suggest that SRH may be a better indicator of IGT in men than in women. Future studies should evaluate the utility of SRH in comparison with objective health measures as a potential aid to health practitioners when deciding whether to screen for IGT and T2DM.

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  • 27.
    Andreassen, Emelie
    et al.
    University of Skövde, School of Informatics.
    Olsson, Marissa
    University of Skövde, School of Informatics.
    Hur monster porträtteras grafiskt i relation till psykisk ohälsa2021Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Hur porträtteras monster grafiskt i relation till psykisk ohälsa? Frågeställningen undersöktes med hjälp av kvalitativa- och kvantitativa insamlingsmetoder. Intervjuer och enkäter utfördes där deltagarna svarade på frågor angående studiens artefakter vilket bestod av två monsterliknande illustrationer i 2D och 3D. Med hjälp av bland annat färg,form och evolution hittades inspiration för att skapa artefakterna. Slutsatsen med denna studie var att psykisk ohälsa kan påverka hur individer betraktar monster. Färg och fobi är förslag på två faktorer som påverkade deltagarnas syn på artefakterna. Personliga erfarenheter inom psykisk ohälsa kunde även avgöra om deltagarna kände medlidande till varelserna i studien.

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  • 28.
    Andréasson, Linn
    et al.
    University of Skövde, School of Health Sciences.
    Olsson, Moa
    University of Skövde, School of Health Sciences.
    Transportfattigdomens betydelse för god hälsa: en litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Transport poverty is a new concept that includes limitations for individuals in their ability to travel, for example traveling to and from work, grocery shopping, and pleasure travel. It encompasses all types of transportation, for instance personal vehicles or public transportation (Trafikanalys, 2018). Piotr Zają (2016) highlights the intimate connection between transportation and public health, and how sustainable and healthy transportation infrastructure can improve the quality of life for the world’s population.

    Purpose: The purpose of the current literature study is to compile how transport poverty affects possibillity to good health from an equality perspective.

    Method: A systematic literature review was conducted. A total of 20 scientific articles were included from the databases Cinahl and PubMed. The search queries encompassed following terms: transport affordability, public health, mobility disadvantage, exclusion, access to transportation, and transportation poverty. The included articles had both qualitative and quantitative study designs and were conducted in Canada, Australia, USA, Korea, Nepal, Japan, Tajikistan, Malaysia, and Germany.

    Results: The study resulted in 19 different themes and subthemes (Figure 1). Out of these, five were categorized as overarching themes: Accessibility and access to transportation, Health and well-being, Social justice and health disparities, Aging and transportation, Limitations of transportation for people with disabilities.

    Conclusion: Transport poverty affects the possibility of good health. When planning and designing transport solutions, it is therefore important to ensure accessibility and access to transport for all social groups to create better conditions for equal health.

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  • 29.
    Andrée, Linnea
    et al.
    University of Skövde, School of Health and Education.
    Gillberg, Patrik
    University of Skövde, School of Health and Education.
    Orsaker till övervikt och fetma hos barn i Sverige: En litteraturöversikt2018Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction: Overweight and obesity among children in Sweden is becoming more frequent. In Sweden over 300 000 children is believed to be overweight or obese and the subject is therefore a public health problem. Overweight and obesity can cause large costs for the society and deteriorating health for the children.

    Purpose: The purpose of this literature review was to understand and highlight the causes for increased overweight and obesity among children under the age of 18 in Sweden.

    Method: The literature review was performed by using searches in the databases PubMed and CINAHL in which ten scientific articles were chosen.

    Result: Sleep, socioeconomic status, illness, diet, physical activity and mental illness are all reasons that have contributed to the increased overweight and obesity among children in Sweden.

    Discussion: The causes regarding overweight and obesity among swedish children is hard to determine, this literature review shows some reasons that in many cases are connected. The subject is complex and requires large-scale actions to deal with.

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  • 30.
    Annerfalk, Alice
    et al.
    University of Skövde, School of Health and Education. a.annerfalk@gmail.com.
    Svensson, Ida
    University of Skövde, School of Health and Education.
    Sociala mediers effekt på ungdomar och unga vuxnas psykiska hälsa: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: In recent years, the use of social media has increased significantly in young people. 92 percent of all 13 to 16-year-olds today use social media where the most common media are Facebook, Instagram and Snapchat. Something else that increases at the same rate as social media is mental illness in young people. Aim: The purpose of this literature study is to investigate whether adolescents and young adults (age 13-24) use of social media has any effects on their mental health and well-being. Method: The method is a literature study in which 21 peer reviewed articles have been analyzed to answer the questions. Result: Social media proved to have both a negative and a positive effect on young people. Psychological consequences could be demonstrated and explained by how social media are used, how often they are used and different mediating variables. The strongest mediation was shown to be FoMO, the fear of missing something out if not constantly checking through their social media. Social media was also shown to be a health-promoting tool if used in moderation, as the individual then develops his or her communication skills and strengthens the social interaction and support. Conclusion: Social media have both positive and negative effects on mental health. However, the conclusion in this literature study is that the negative effects outdo the positive effects, and social media should therefore be used with more caution and reflection.

     

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  • 31.
    Annica, Hammarlund
    University of Skövde, School of Health and Education.
    Stress, ångest & depression - faktorer hos kvinnor med bröstcancerdiagnos: Systematisk litteraturstudie om ångest, depression och stress hos kvinnor med en bröstcancer2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Over time, disease patterns affecting the population have changes. Today, many people are diagnosed with diseases that were not common decades ago, which have now become a global public health problem. One of these diseases is cancer. Breast cancer is the most common cancer form for women, and stressful in part because of the association of breasts with femininity.  

    Purpose: The purpose of this literature study is to describe the mental health of the woman after a breast cancer diagnosis focusing on anxiety, depression and stress.

    Method: The chosen method is a systematic literature review. Articles have been systematically searched in the PubMed database. During the search process, 15 scientific articles were selected with relevant information to respond to the purpose of the study. Three themes emerged during the analysis of the articles: Fear of breast cancer recurrence, femininity, and psychological health effects.

    Result: The results show that women feel less feminine and attractive when a breast has been removed. Women with breast cancer history are afraid of recurrence which affects their lives through anxiety, anxiety and stress. Younger women are more afraid of death than older women, which may be because younger women have young children and are fearful of not seeing them grow up.

    Discussion: A breast cancer diagnosis can strongly affect a woman. After a woman's diagnosis, she needs to change her planning for the future. This can create anxiety and anxiety about recovery and how she will feel and lead to worry about the outcome of the disease. There is a need for more training for doctors and nurses to better help breast cancer patients who experience stress, anxiety and depression.

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  • 32.
    Anttila, Cecilia
    University of Skövde, School of Health Sciences.
    Effekterna av mödrars utbildningsnivå på amningsfrekvensen: En strukturerad litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Breastfeeding provides great health benefits for both mothers and infants.Sweden supports the World Health Organisation’s recommendation to breastfeed exclusively for up to 6 months. Breastfeeding is low despite all the positive health effects of breastfeeding. Multiple socio economic factors affect breastfeeding. Aim The purpose of this study is to identify factors associated with maternal education and nursing behaviours, including length of nursing, and frequency of nursing Method Structured literature study with qualitative approach where 10 scientific articles were analyzed through thematic analysis. Results Four main themes emerged in the results, " Social factors related to mothers' education levels that affect breastfeeding frequency”, "Relationship between breastfeeding time and education level", “The intention to breastfeed is linked to the level of education" and "Support programs, efforts and parent training promote breastfeeding". These themes identified differences in the relationship between educational level in mothers and various factors that were important for breastfeeding. Conclusion: Breastfeeding frequency is affected by mothers' level of education, low educated mothers breastfeed less and higher educated mothers breastfeed to a greater extent. Current literature and research on breastfeeding show that there is knowledge about all the health benefits of breastfeeding and which factors affect the breastfeeding rate in a positive direction. Nevertheless, breastfeeding frequency is very low and does not reach the level of exclusive breastfeeding for 6 months as stated in the recommendations on breastfeeding. Breastfeeding should be given greater importance 4 beginning with pregnancy beginning with pregnancy, with a greater focus on more educational opportunities around th a greater focus on more educational opportunities around breastfeeding both for healthcare staff and parents in order to prevent inequalities in health.

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  • 33.
    Apell, Caroline
    University of Skövde, School of Health Sciences.
    Hälso- och sjukvårdspersonalens erfarenheter och strategier vid bemötande av vaccinationstveksamma föräldrar: En systematisk litteraturöversikt2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Every child in Sweden is being offered vaccination according to the national immunization program. Sweden has a high vaccination coverage, but a share of parents expresses some hesitancy. Vaccine hesitancy stretches from acceptance combined with questioning, over delayed or selective vaccination to being reluctant. Healthcare professionalsare playing a major role in encountering and addressing parental concerns regarding vaccination.

    Aim: This systematic literature review aims to highlight the experiences and strategies of healthcare professionals when meeting vaccine hesitant parents.

    Methods: A systematic literature review was used for the data collection. Qualitative content analysis was used for analyzing the material.

    Results: Two themes were identified. The first theme Experiences consisted of two categories, Professional legitimacy, frustration and moral conflictand Conditions, barriers and need for support, with associated subcategories. The second theme, Information and communication strategies, also consisted of two categories, Vaccine literacy and Strategies in the meeting with vaccination-hesitant parents, with associated subcategories.

    Conclusion: The results indicate that the health care staff needs training on vaccinations and on responding to misinformation, but also on developing their communication skills. The staff also needs support to deal with emotions that arise in the meeting with vaccination-hesitant parents.

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  • 34.
    Arnoldussen, Ilse A. C.
    et al.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands / Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
    Gustafson, Deborah R.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Neurology, The State University of New York Downstate Health Sciences University, Brooklyn, USA.
    Leijsen, Esther M. C.
    Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
    de Leeuw, Frank-Erik
    Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
    Kiliaan, Amanda J.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands / Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.
    Adiposity is related to cerebrovascular and brain volumetry outcomes in the RUN DMC study2019In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 93, no 9, p. e864-e878Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Adiposity predictors, body mass index (BMI), waist circumference (WC), and blood leptin and total adiponectin levels were associated with components of cerebral small vessel disease (CSVD) and brain volumetry in 503 adults with CSVD who were ≥50 years of age and enrolled in the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Imaging Cohort (RUN DMC).

    METHODS: RUN DMC participants were followed up for 9 years (2006-2015). BMI, WC, brain imaging, and dementia diagnoses were evaluated at baseline and follow-up. Adipokines were measured at baseline. Brain imaging outcomes included CSVD components, white matter hyperintensities, lacunes, microbleeds, gray and white matter, hippocampal, total brain, and intracranial volumes.

    RESULTS: Cross-sectionally among men at baseline, higher BMI, WC, and leptin were associated with lower gray matter and total brain volumes, and higher BMI and WC were associated with lower hippocampal volume. At follow-up 9 years later, higher BMI was cross-sectionally associated with lower gray matter volume, and an obese WC (>102 cm) was protective for ≥1 lacune or ≥1 microbleed in men. In women, increasing BMI and overweight or obesity (BMI ≥25 kg/m2 or WC >88 cm) were associated with ≥1 lacune. Longitudinally, over 9 years, a baseline obese WC was associated with decreasing hippocampal volume, particularly in men, and increasing white matter hyperintensity volume in women and men.

    CONCLUSIONS: Anthropometric and metabolic adiposity predictors were differentially associated with CSVD components and brain volumetry outcomes by sex. Higher adiposity is associated with a vascular-neurodegenerative spectrum among adults at risk for vascular forms of cognitive impairment and dementias.

  • 35.
    Arveståhl, Louise
    University of Skövde, School of Health Sciences.
    Unga och ovilja till vaccination mot Covid-19: En litteraturstudie2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Covid-19 has affected millions of people and taken the lives of many, created physical and mental illness and negatively affected societies around the world. During the autumn of 2021, young people were the group in Sweden where most were ill with Covid-19 but also those with the lowest vaccination coverage.

    Aim: The aim of this study is to shed light on the opinions and background factors among adolescents and young adults aged 12 to 35 years that are associated with not wanting to be vaccinated against Covid-19.

    Method: A structured literature study with search in PubMed, Cinahl and MEDLINE. 15 studies were included in the results and a thematic analysis was used to report the results.

    Results: Four themes was identified in the analysis: Socio-economic differences, Biological conditions, Vaccination resistance and Knowledge that influences vaccination choices. The results were then discussed on the basis of the theoretical framework Health Literacy.

    Conclusion: The young people were worried about the vaccine and its side effects. Many of those who opted out of vaccination described that they wanted to wait for more people to test the vaccine. Many lacked information and wanted more transparency in the development of the vaccine. Who provided information and advice influenced the young people's choices. Lower level of education and lower income was associated with a lower willingness to vaccinate.

  • 36.
    Arvidsson, Andrea
    University of Skövde, School of Bioscience.
    Meditation, attention and the brain: function, structure and attentional performance2018Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Meditation has been practiced around the world for thousands of years and has during the past decade become increasingly popular in the Western world. Meditation can be seen as a form of mental exercise and refers to a family of complex emotional and attentional regulatory practices that involves different attentional, cognitive monitoring and awareness processes. Clinical research on meditation has demonstrated that meditation seem to reduce stress, anxiety, and depression. Recent interest in how meditation affect the human brain and body have lead to an increase in research regarding the neural correlates of meditation, structural changes induced by meditation, and the potential attentional and emotional benefits mediated by meditation. This thesis investigates expert related changes in neural activity, brain structure, and attentional performance induced by focused attention meditation (FAM) and open monitoring meditation (OMM). The research on meditation and the brain is still in its infancy but despite this, there seem to be some converging evidence of meditation’s impact on the human brain and mind. The results from the included studies in this thesis indicates that expert meditators show greater activation in some meditation related brain areas, as well as less activation in other areas when compared to novice meditators. The results also suggest that long-term meditation practice induce some structural changes in the brain and that meditation seem to enhance the practitioners’ attentional control. 

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    MEDITATION, ATTENTION AND THE BRAIN: FUNCTION, STRUCTURE AND ATTENTIONAL PERFORMANCE
  • 37.
    Arvidsson, Louise
    et al.
    Section for Epidemiology and Social Medicine, University of Gothenburg, Göteborg, Sweden.
    Birkhed, Dowen
    Department of Cariology, Institute of Odontology, University of Gothenburg, Sweden.
    Hunsberger, Monica
    Section for Epidemiology and Social Medicine, University of Gothenburg, Göteborg, Sweden.
    Lanfer, Anne
    Leibniz Institute for Prevention Research and Epidemiology – BIPS GmbH, Bremen, Germany.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, University of Gothenburg, Göteborg, Sweden.
    Mehlig, Kirsten
    Section for Epidemiology and Social Medicine, University of Gothenburg, Göteborg, Sweden.
    Mårild, Staffan
    Department of Paediatrics, Queen Silvia Children’s Hospital, University of Gothenburg, Sweden.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine, University of Gothenburg, Göteborg, Sweden.
    BMI, eating habits and sleep in relation to salivary counts of mutans streptococci in children - the IDEFICS Sweden study2016In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, no 6, p. 1088-1092Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of the present study was to investigate the association between salivary counts of mutans streptococci (MS) and children's weight status, while considering associated covariates. MS ferments carbohydrates from the diet and contributes to caries by lowering the pH in dental plaque. In adults, high counts of MS in saliva have been associated with overweight, but this has not been shown in children. Design: Cross-sectional study investigating salivary counts of MS, BMI Z-score, waist circumference, meal frequency, sugar propensity and sleep duration, in children. Setting: West Sweden. Subjects: Children (n 271) aged 4-11 years. Results: Medium-high counts of MS were positively associated with higher BMI Z-score (OR=1.6; 95 % CI 1.1, 2.3). Positive associations were also found between medium-high counts of MS and more frequent meals per day (OR=1.5; 95 % CI 1.1, 2.2), greater percentage of sugar-rich foods consumed (OR=1.1; 95 % CI 1.0, 1.3) and female sex (OR=2.4; 95 % CI 1.1, 5.4). A negative association was found between medium-high counts of MS and longer sleep duration (OR=0.5; 95 % CI 0.3, 1.0). Conclusions: BMI Z-score was associated with counts of MS. Promoting adequate sleep duration and limiting the intake frequency of sugar-rich foods and beverages could provide multiple benefits in public health interventions aimed at reducing dental caries and childhood overweight.

  • 38.
    Arvidsson, Louise
    et al.
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Bogl, L. H.
    Department of Public Health, University of Helsinki, Finland.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hebestreit, A.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Nagy, P.
    Department of Pediatrics, University of Pécs, Hungary.
    Tornaritis, M.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition, and Development) research group, University of Zaragoza, Spain.
    Siani, A.
    Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy.
    Veidebaum, T.
    Research Centre, National Institute for Health Development, Tallinn, Estonia.
    De Henauw, S.
    Department of Public Health, University of Ghent, Belgium.
    Lissner, L.
    Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Fat, sugar and water intakes among families from the IDEFICS intervention and control groups: first observations from I.Family2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, no Suppl. 2, p. 127-137Article in journal (Refereed)
    Abstract [en]

    Background

    The objective of this paper is to investigate differences in diets of families in intervention versus control communities 5years after the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants intervention ended. MethodsAltogether, 4,691 families from the I.Family study with at least one participating parent and one child are included in this analysis. Diet quality indicators, defined as propensities to consume fat, sugar, water and fruit and vegetables, are calculated from a 59-item food frequency questionnaire. Multilevel linear models with random intercepts for study centre are used to determine whether mean diet indicators, calculated at the family level, differed as a function of previous exposure to the intervention. ResultsFamilies in the intervention communities reported a significantly lower sugar propensity (19.8% vs. 20.7% of total food items, p<0.01) and a higher water propensity (47.3% vs. 46.0% of total beverages, p<0.05) compared with families in the control communities, while fat and fruit and vegetables propensities were similar. No significant diet differences between intervention and control children were present at the Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants baseline. DiscussionThis result indicates better diet quality in intervention families, which was not present in children when their diets were assessed before the intervention, and gives some cause for optimism regarding the sustainability of some aspects of the diet intervention.

  • 39.
    Aryal, Umesh R.
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Petzold, Max
    Akademistatistik - Centre for Applied Biostatistics, Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bondjers, Göran
    Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Correlates of smoking susceptibility among adolescents in a peri-urban area of Nepal: a population-based cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site2014In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, no 1, p. 1-14, article id 24488Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Susceptibility to smoking is defined as an absence of firm commitment not to smoke in the future or when offered a cigarette by best friends. Susceptibility begins in adolescence and is the first step in the transition to becoming an established smoker. Many scholars have hypothesized and studied whether psychosocial risk factors play a crucial role in preventing adolescent susceptibility to smoking or discourage susceptible adolescents from becoming established smokers. Our study examined sociodemographic and family and childhood environmental factors associated with smoking susceptibility among adolescents in a peri-urban area of Nepal.

    DESIGN: We conducted a population-based cross-sectional study during October-November 2011 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) located in a peri-urban area near Kathmandu, the capital city of Nepal, where tobacco products are easily available. Trained local enumerators conducted face-to-face interviews with 352 respondents aged 14-16. We used stepwise logistic regression to assess sociodemographic and family and childhood environmental factors associated with smoking susceptibility.

    RESULTS: The percentage of smoking susceptibility among respondents was 49.70% (95% CI: 44.49; 54.93). Multivariable analysis demonstrated that smoking susceptibility was associated with smoking by exposure of adolescents to pro-tobacco advertisements (AOR [adjusted odds ratio] =2.49; 95% CI: 1.46-4.24), the teacher (2.45; 1.28-4.68), adolescents attending concerts/picnics (2.14; 1.13-4.04), and smoking by other family members/relatives (1.76; 1.05-2.95).

    CONCLUSIONS: Smoking susceptible adolescents are prevalent in the JD-HDSS, a peri-urban community of Nepal. Several family and childhood environmental factors increased susceptibility to smoking among Nepalese non-smoking adolescents. Therefore, intervention efforts need to be focused on family and childhood environmental factors with emphasis on impact of role models smoking, refusal skills in social gatherings, and discussing harmful effects of smoking with family members and during gatherings with friends.

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  • 40.
    Aryal, Umesh Raj
    et al.
    Kathmandu Medical College, Nepal / Nordic School of Public Health NHV, Gothenburg.
    Petzold, Max
    Nordic School of Public Health NHV, Gothenburg, Sweden / Sahlgrenska Academy at University of Gothenburg.
    Krettek, Alexandra
    Nordic School of Public Health NHV, Gothenburg / Sahlgrenska Academy at University of Gothenburg.
    Perceived risks and benefits of cigarette smoking among Nepalese adolescents: a population-based cross-sectional study2013In: BMC Public Health, E-ISSN 1471-2458, Vol. 13, article id 187Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The perceived risks and benefits of smoking may play an important role in determining adolescents' susceptibility to initiating smoking. Our study examined the perceived risks and benefits of smoking among adolescents who demonstrated susceptibility or non susceptibility to smoking initiation.

    METHODS: In October-November 2011, we conducted a population-based cross-sectional study in Jhaukhel and Duwakot Villages in Nepal. Located in the mid-hills of Bhaktapur District, 13 kilometers east of Kathmandu, Jhaukhel and Duwakot represent the prototypical urbanizing villages that surround Nepal's major urban centers, where young people have easy access to tobacco products and are influenced by advertising. Jhaukhel and Duwakot had a total population of 13,669, of which 15% were smokers. Trained enumerators used a semi-structured questionnaire to interview 352 randomly selected 14- to 16-year-old adolescents. The enumerators asked the adolescents to estimate their likelihood (0%-100%) of experiencing various smoking-related risks and benefits in a hypothetical scenario.

    RESULTS: Principal component analysis extracted four perceived risk and benefit components, excluding addiction risk: (i) physical risk I (lung cancer, heart disease, wrinkles, bad colds); (ii) physical risk II (bad cough, bad breath, trouble breathing); (iii) social risk (getting into trouble, smelling like an ashtray); and (iv) social benefit (looking cool, feeling relaxed, becoming popular, and feeling grown-up). The adjusted odds ratio of susceptibility increased 1.20-fold with each increased quartile in perception of physical Risk I. Susceptibility to smoking was 0.27- and 0.90-fold less among adolescents who provided the highest estimates of physical Risk II and social risk, respectively. Similarly, susceptibility was 2.16-fold greater among adolescents who provided the highest estimates of addiction risk. Physical risk I, addiction risk, and social benefits of cigarette smoking related positively, and physical risk II and social risk related negatively, with susceptibility to smoking.

    CONCLUSION: To discourage or prevent adolescents from initiating smoking, future intervention programs should focus on communicating not only the health risks but also the social and addiction risks as well as counteract the social benefits of smoking.

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  • 41.
    Aryal, Umesh Raj
    et al.
    Kathmandu Medical College Nepal / Nordic School of Public Health NHV.
    Vaidya, Abhinav
    Kathmandu Medical College Nepal / Nordic School of Public Health NHV.
    Shakya-Vaidya, Suraj
    Nordic School of Public Health NHV / Nepal Medical College, Kathmandu Nepal.
    Petzold, Max
    Nordic School of Public Health NHV / Sahlgrenska Academy at University of Gothenburg.
    Krettek, Alexandra
    Nordic School of Public Health NHV / Sahlgrenska Academy at University of Gothenburg.
    Establishing a health demographic surveillance site in Bhaktapur district, Nepal: initial experiences and findings2012In: BMC Research Notes, E-ISSN 1756-0500, Vol. 5, article id 489Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A health demographic surveillance system (HDSS) provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal.

    RESULTS: We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%); headache, vertigo and dizziness (16.7%); bone and joint pain (14.4%); gastrointestinal problems (13.9%); heart disease, including hypertension (8.8%); accidents and injuries (2.9%); and diabetes mellitus (2.6%). The prevalence of non-communicable disease (NCD) was 4.3% (95% CI: 3.83; 4.86) among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD.

    CONCLUSION: Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns.

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  • 42.
    Aråb, Kaydar Sabri
    University of Skövde, School of Health Sciences.
    Faktorer som orsaker ökningen av typ 1-diabetes bland barn och unga ur ett folkhälsoperspektiv: En strukturerad litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Diabetes is a group of diseases that cause elevated blood sugar levels. Type 1 diabetes typically develops in children and adolescents, but some people may develop the disease later in adulthood. In addition to type 1 diabetes, there is also gestational diabetes, type 2 diabetes, LADA (Latent Autoimmune Diabetes in Adults), MODY (Maturity Onset Diabetes in Youth), and a few other rare forms of diabetes.

    Aim: The aim of this study is to investigate thefactors contributing to the significant increase in type 1 diabetes among children in many countries worldwide.

    Method: The method used in this study is a structured literature review. The literature review only includes scientific original articles with 11 scientific articles being carefully examined.

    Results : This study aimed to answer the question: What factors can explain the increasing prevalence of type 1 diabetes among children and adolescents? The results are presented below, divided into four main themes that emerged from the analysis of the material. These themes are immunological factors, the influence of diet, lifestyle and environment, and the role of parents.

    Conclusion: Several possible risk factors in addition to genetics can be seen as contributing to the increase in type 1 diabetes among children and young people. Among these risks are early growth due to incorrect or excessive amount of diet, viral infections and parents level of education and social status.

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  • 43.
    Audhav, EvA
    et al.
    University of Skövde, School of Life Sciences.
    Norenius, Csilla
    University of Skövde, School of Life Sciences.
    SVENSKA TJÄNSTEMÄNS UPPFATTNING OM ORGANISATORISKA STRESSFÖREBYGGANDE STRATEGIER: EN KVALITATIV STUDIE2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Psychosocial health is one of the biggest causes of absenteeism among employees. Few studies are designed to investigate prevention activities for stress at the organizational level. EU-OSHA offers recommendation to companies about stress prevention. The purpose of this study was to describe how officials experience EU-OSHA´s recommendation on organizational stress prevention. The study aimed to clarify whether the recommendations may be considered feasible, if there are any obstacles making implementation difficult and what conditions are required to fulfill implementation. The method used had an inductive qualitative approach, in which 16 interviews were conducted at six large Swedish companies. The result showed that the recommendations were considered feasible but they were at times experienced too general and vague. The various conditions and constrains described formed the following theses: Company Culture, Requirements, Control & Support and Knowledge & Skills. Discussion: The recommendations may seem simple but it was found that they do not give practical support to companies. All respondents found them good but sometimes ambiguous and consequently interpreted differently. Moreover, the recommendations are given no particular order of priority. The respondents listed different barriers that made implementation difficult. The conditions needed for a successful implementation seem to depend on good company culture, the possibility to influence and manage your own working environment as well as the chance to turn personal knowledge into practical skills.

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    stress_prevention_strategies
  • 44.
    Babovic, Elvir
    University of Skövde, School of Health and Education.
    ADHD och risken för kriminellt beteende senare i livet: en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction

    ADHD is a neuropsychiatric disorder belonging to the spectrum of neuro-cognitive functional that increases the risk of getting into crime later in life. Individuals with the disorder may be incapable of controlling their impulses, which means that the individuals with the problem is not capable of evaluating consequences of his/her behavior. ADHD is also something that increases the risk of becoming a victim of abuse and destructive behavior

    Method

    A literature review with 10 knowledge-based articles was used in the study for the basis of the result. The articles were reviewed and processed to obtain as strong a reliability as possible. The database launched was Pubmed which gave many hits according to the keywords but the included studies were carefully selected based on the delimitation by the aim of the study and the relevance of the chosen area.

    Purpose

    The aim of the work was to explore the connection between the diagnosis of ADHD and subsequent risk of criminal behavior.

    Results

    Adolescents diagnosed with ADHD showed a clear increased risk of developing addiction problems. The ADHD symptoms had often become more difficult during childhood or adolescence and persons with ADHD were also more probably imprisoned as adults. The most common drugs that were used by the individuals with ADHD and had developed addiction were stimulants such as alcohol and benzodiazepines. The adolescents with ADHD and developed addiction had performed significantly poorer in tests and in school and showed poorer results than those who had not diagnosed ADHD

    Discussion Clear results were common to many of the selected articles as there was a clear correlation between ADHD and risk of becoming a victim of abuse and subsequent criminal behavior. Several of the articles mention that young people with the diagnosis of ADHD have obvious problems in gaining education and that this in turn leads to exclusion and poor social adaptation

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  • 45.
    Backlund, Per
    et al.
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Bai, Hua
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Bankler, Victor
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Krettek, Alexandra
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Wilhelmsson, Ulf
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Zhang, Ran
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Teaching cardiovascular health through a purposeful game2022In: Collection of materials: II International Scientific and Practical Internet Conference "Innovative Solutions in Economy, Business, Public Communications and International Relationships", April 21, 2022, Dnipro: Volume 2, Dnipro: Університет митної справи та фінансів / Universytet mytnoyi spravy ta finansiv , 2022, Vol. 2, p. 5p. 391-396Conference paper (Other academic)
    Abstract [en]

    Games for health is one of the most prominent areas for serious games, i.e. games with a purpose beyond only entertainment. The purpose of a health game may be to inform about health related issues; promote healthy lifestyles and even to drive behavioral change. This paper outlines the initial game design considerations and some future research directions for a game focusing on cardiovascular health. As the overall aim of the project is to promote a healthy lifestyle through diet and physical activity to prevent future cardiovascular disease, we focused on “taking care of your heart” as the basis for the game. Hence we call the game Happy Heart and use a heart symbol as a non-playable character (NPC) that the player needs to take care of. To some extent we are inspired by the electronic Tamagochi toys (Bandai) where players need to take care of a digital pet. The heart symbol is universal and is also an ideograph that expresses the concept of love and as such it transcends language barriers.

    The burden of non-communicable diseases (NCD) is rapidly increasing across the world. Today they are the main drivers of morbidity, disability, and mortality in low- and middle income countries (LMICs), and are expected to increase due to unhealthy lifestyles in the wake of ongoing societal changes [1]. Among the major risk factors in many LMICs are poor diet, insufficient physical activity, tobacco and alcohol consumption, and exposure to hazardous substances, e.g. from air pollution. LMICs currently contribute three quarters of the deaths from NCD.

    Among the NCD, cardiovascular diseases are the most common cause of hospitalization in Nepal [1]. Digitalization and collaboration with the education sector (e.g. community schools) in health promotion interventions could further improve children’s behavior by targeting factors that affect their lifestyle outside the family environment [4]. Hence, the Digital Game Based Learning approach.

  • 46.
    Bai, Ge
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Szwajda, Agnieszka
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Wang, Yunzhang
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Li, Xia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bower, Hannah
    Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Ida K.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden ; School of Health and Welfare, Institute of Gerontology and Aging Research Network—Jönköping (ARN-J), Jönköping University, Sweden.
    Johansson, Boo
    Department of Psychology, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Dahl Aslan, Anna K.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Hägg, Sara
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Jylhävä, Juulia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Frailty trajectories in three longitudinal studies of aging: Is the level or the rate of change more predictive of mortality?2021In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 50, no 6, p. 2174-2182Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.

    OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.

    METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.

    RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.

    CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.

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  • 47.
    Baldursdottir, Birna
    et al.
    Department of Psychology, School of Business, Reykjavik University, Iceland / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Taehtinen, Richard E.
    Department of Psychology, School of Business, Reykjavik University, Iceland / ICSRA (Icelandic Centre for Social Research and Analysis), Reykjavik University, Iceland.
    Sigfusdottir, Inga Dora
    Department of Psychology, School of Business, Reykjavik University, Iceland / ICSRA (Icelandic Centre for Social Research and Analysis), Reykjavik University, Iceland / Department of Health & Behavior Studies, Teachers College, Columbia University, New York, NY, USA.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Valdimarsdottir, Heiddis B.
    Department of Psychology, School of Business, Reykjavik University, Iceland / Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA.
    Impact of a physical activity intervention on adolescents' subjective sleep quality: a pilot study2017In: Global Health Promotion, ISSN 1757-9759, E-ISSN 1757-9767, Vol. 24, no 4, p. 14-22Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The aim of this pilot study was to examine the impact of a brief physical activity intervention on adolescents' subjective sleep quality. Cross-sectional studies indicate that physically active adolescents have better subjective sleep quality than those with more sedentary habits. However, less is known about the effectiveness of physical activity interventions in improving adolescents' subjective sleep quality.

    METHODS: In a three-week physical activity intervention, four Icelandic upper secondary schools were randomized to either an intervention group with pedometers and step diaries or a control group without pedometers and diaries. Out of 84, a total of 53 students, aged 15-16 years, provided complete data or a minimum of two days step data (out of three possible) as well as sleep quality measures at baseline and follow-up. Subjective sleep quality, the primary outcome in this study, was assessed with four individual items: sleep onset latency, nightly awakenings, general sleep quality, and sleep sufficiency. Daily steps were assessed with Yamax CW-701 pedometers.

    RESULTS: The intervention group (n = 26) had significantly higher average step-count (p = 0.03, partial η(2) = 0.093) compared to the control group (n = 27) at follow-up. Subjective sleep quality improved (p = 0.02, partial η(2) = 0.203) over time in the intervention group but not in the control group.

    CONCLUSIONS: Brief physical activity interventions based on pedometers and step diaries may be effective in improving adolescents' subjective sleep quality. This has important public health relevance as the intervention can easily be disseminated and incorporated into school curricula.

  • 48.
    Baldursdottir, Birna
    et al.
    Department of Psychology, School of Business, Reykjavik University, Reykjavik, Iceland / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Valdimarsdottir, Heiddis B.
    Department of Psychology, School of Business, Reykjavik University, Reykjavik, Iceland / Department of Oncological Sciences, Mount Sinai School of Medicine, New York, USA.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Gylfason, Haukur Freyr
    School of Business, Reykjavik University, Reykjavik, Iceland.
    Sigfusdottir, Inga Dora
    Department of Psychology, School of Business, Reykjavik University, Reykjavik, Iceland / ICSRA (Icelandic Centre for Social Research and Analysis), Reykjavik University, Reykjavik, Iceland / Department of Health & Behavior Studies, Teachers College, Columbia University, New York, USA .
    Age-related differences in physical activity and depressive symptoms among 10-19-year-old adolescents: A population based study2017In: Psychology of Sport And Exercise, ISSN 1469-0292, E-ISSN 1878-5476, Vol. 28, p. 91-99Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to examine age- and gender-related patterns of PA and depressive symptoms among students through their adolescent years. Design: Data from three population-based surveys were analysed to determine levels of moderate- to vigorous-intensity PA (MVPA), participation in organized sports and depressive symptoms among 10-19-year-old adolescents. Method: Questionnaires assessing PA and depressive symptoms were administered to 32 860 students in compulsory and upper-secondary schools in Iceland. Results: As age increased, depressive symptoms increased and PA decreased with over half of the adolescents in upper-secondary schools not achieving recommended daily PA. There were gender differences in PA and depressive symptoms with girls being less active and reporting higher levels of depressive symptoms than boys. MVPA was associated with lower levels of depressive symptoms among both genders while organized sports had more impact on depressive symptoms among girls. Conclusions: To our knowledge, this study is the first to simultaneously examine patterns of PA and depressive symptoms among students through their adolescent years. Our findings show that the decrease in PA and increase in depressive symptoms is most pronounced around the transition from compulsory to upper-secondary school, or around the age of 15-16. Thus the findings provide important information about when to tailor public health efforts to reduce the burden of depressive symptoms among adolescents, for example by employing PA interventions. (C) 2016 Elsevier Ltd. All rights reserved.

  • 49.
    Baldwin, Hanna
    et al.
    University of Skövde, School of Health Sciences.
    Bergmark, Johanna
    University of Skövde, School of Health Sciences.
    Delivery of Abortion Services in the United Kingdom and Republic of Ireland, in Relation to the World Health Organization's Framework for Best Practices: A Literature Review2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Accessible abortion services is a fundamental human right and in March 2022, the World Health Organization (WHO) updated their recommendations for best abortion services practice covering the components Abortion regulation, Services across the continuum of care, Pre abortion care, Abortion care, Post abortion care and Service-delivery options and Self-management approaches. England, Scotland and Wales, the Republic of Ireland, and Northern Ireland have different abortion laws, both currently and historically, but they have strong historical ties to each other, offering a good comparison on how regional difference can impact abortion services.

    Aim: The aim of this literature review is to investigate the three regions’ abortion service provision using the WHO guidelines as a framework.

    Methods: A literature review in which 20 articles describing abortion services in the three regions were thematically analyzed using a deductive approach.

    Results: Access to abortion in all regions is currently safe. However, non-legal barriers, such as lack of trained medical practitioners and conscientious objection, hinder accessibility of care, especially in the Irish regions. Moreover, the accessibility of abortions decreases with higher gestational ages in all regions and women describe a narrative of shame maintained by media and medical staff. The telemedical models introduced during the COVID-19 pandemic has been evaluated as safe, effective and accepted among care recipients

    Conclusion: Other factors than legal barriers impact the provision of abortion services. These barriers need to be considered when developing abortion service systems. The WHO guidelines serve as a useful tool to evaluate and improve abortion services.

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  • 50.
    Bammann, K.
    et al.
    Univ Bremen, Fac Human & Hlth Sci, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.;BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Lanfer, A.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Barba, G.
    CNR, Inst Food Sci, Avellino, Italy.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Kovacs, E.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Socioeconomic factors and childhood overweight in Europe: results from the multi-centre IDEFICS study2013In: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 8, no 1, p. 1-12Article in journal (Refereed)
    Abstract [en]

    What is already known about this subject Overweight and obesity can be linked to different parental socioeconomic factors already in very young children. In Western developed countries, the association of childhood overweight and obesity and parental socioeconomic status shows a negative gradient. Ambiguous results have been obtained regarding the association between socioeconomic factors and childhood overweight and obesity in different countries and over time. What this study adds European regions show heterogeneous associations between socioeconomic factors and overweight and obesity in a multi-centre study with highly standardized study protoco. The strength of association between SES and overweight and obesity varies across European regions. In our study, the SES gradient is correlated with the regional mean income and the country-specific Human development index indicating a strong influence not only of the family but also of region and country on the overweight and obesity prevalence. Objective To assess the association between different macro- and micro-level socioeconomic factors and childhood overweight. Methods Data from the IDEFICS baseline survey is used to investigate the cross-sectional association between socioeconomic factors, like socioeconomic status (SES), and the prevalence of childhood overweight. Differences and similarities regarding this relationship in eight European regions (located in Belgium, Cyprus, Estonia, Germany, Hungary, Italy, Spain and Sweden) are explored. 11?994 children (50.9% boys, 49.1% girls) and their parents were included in the analyses. Results In five of the eight investigated regions (in Belgium, Estonia, Germany, Spain and Sweden), the prevalence of childhood overweight followed an inverse SES gradient. In the other three regions (in Cyprus, Hungary and Italy), no association between SES and childhood overweight was found. The SES-overweight association in a region was best explained by the country-specific human development index and the centre-specific mean income. For the investigated association between other socioeconomic factors and overweight, no clear pattern could be found in the different regions. Conclusion The association between socioeconomic factors and childhood overweight was shown to be heterogeneous across different European regions. Further research on nationwide European data is needed to confirm the results and to identify target groups for prevention.

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