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  • 1.
    Abarca-Gómez, Leandra
    et al.
    Caja Costarricense de Seguro Social, Costa Rica.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ezzati, Majid
    School of Public Health, Imperial College London, London, United Kingdom.
    Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, no 10113, p. 2627-2642Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.

    METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).

    FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m(2) per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m(2) per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m(2) per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m(2) per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m(2) per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.

    INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

    FUNDING: Wellcome Trust, AstraZeneca Young Health Programme.

  • 2.
    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
  • 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. 

  • 4.
    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)
  • 5.
    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.

  • 6.
    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.

  • 7.
    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.

  • 8.
    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. 

  • 9.
    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
  • 10.
    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.

  • 11.
    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.

  • 12.
    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.

     

  • 13.
    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.

  • 14.
    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. 

  • 15.
    Arvidsson, L.
    et al.
    University of Skövde, School of Health and Education.
    Bogl, L. H.
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med EPSO, Dept Publ Hlth & Community Med, Inst Med,Sahlgrenska Acad, S-40530 Gothenburg, Sweden.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Nagy, P.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Res Ctr, Tallinn, Estonia.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Lissner, L.
    Univ Gothenburg, Sect Epidemiol & Social Med EPSO, Dept Publ Hlth & Community Med, Inst Med,Sahlgrenska Acad, S-40530 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, p. 127-137Article in journal (Refereed)
    Abstract [en]

    BackgroundThe 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.

  • 16.
    Arvidsson, Louise
    et al.
    University of Skövde, School of Health and Education.
    Birkhed, Dowen
    Univ Gothenburg, Inst Odontol, Dept Cariol, Gothenburg, Sweden.
    Hunsberger, Monica
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, Sweden.
    Lanfer, Anne
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, Sweden.
    Mehlig, Kirsten
    Marild, Staffan
    Univ Gothenburg, Queen Silvia Childrens Hosp, Dept Paediat, Gothenburg, Sweden..
    Eiben, Gabriele
    Univ Gothenburg, Sect Epidemiol & Social Med, S-40530 Gothenburg, 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.

  • 17.
    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.

  • 18.
    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, ISSN 1471-2458, 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.

  • 19.
    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, ISSN 1756-0500, 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.

  • 20.
    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.

  • 21.
    Backström, Linus
    University of Skövde, School of Bioscience.
    Establishing a biopsychosocial model for conspiracy theory ideation2018Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    This paper aims to provide the grounds for a biopsychosocial understanding of the underpinnings of conspiracy theorist ideation by studying research articles from different scientific disciplines. Cross-disciplinary concurring results are presented and discussed, as well as some examples of how conspiracy theories have been used during the 20th century. Also discussed is how this is used in political discourse in the populist climate of today, with the rise of radical right-wing movements, the justification of “alternative facts” from higher governmental ranks, and religious fundamentalism, making it a societal issue of possible big magnitude. Neurological similarities was found between religiousness and proneness to conspiracy theory ideation, and the articles concerning neural correlates therefore stem from research on religious individuals due to the lack of neuro-biopsychological research on actual conspiracy theorists. Since conspiracy theory ideation has shown the ability to cause negative consequences it is also advised that governmental agencies and society as a whole revise its stance on populism and the spread of flawed information, in order to maintain an open society. Also presented are a few ideas on how to begin countering the rise of populism.

  • 22.
    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.

  • 23.
    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.

  • 24.
    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.

  • 25.
    Bammann, K.
    et al.
    Univ Bremen, Inst Publ Hlth & Nursing Res ipp, Fac Human & Hlth Sci, FB 11,Grazer Str 2a, D-28359 Bremen, Germany.;Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Pischke, C.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, Dept Phys Med & Nursing, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, Ghent, Belgium.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, Dept Phys Med & Nursing, Growth Exercise Nutr & Dev GENUD Res Grp, Zaragoza, Spain.
    Pitsiladis, Y.
    Univ Brighton, Ctr Sport & Exercise Sci & Med SESAME, Eastbourne, England.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Veidebaum, T.
    Natl Inst Hlth Dev, Dept Chron Dis, Tallinn, Estonia.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, Inst Stat, Bremen, Germany.
    The impact of familial, behavioural and psychosocial factors on the SES gradient for childhood overweight in Europe. A longitudinal study2017In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 41, no 1, p. 54-60Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In highly developed countries, childhood overweight and many overweight-related risk factors are negatively associated with socioeconomic status (SES). OBJECTIVE: The objective of this study is to investigate the longitudinal association between parental SES and childhood overweight, and to clarify whether familial, psychosocial or behavioural factors can explain any SES gradient. METHODS: The baseline and follow-up surveys of the identification and prevention of dietary and lifestyle induced health effects in children and infants (IDEFICS) study are used to investigate the longitudinal association between SES, familial, psychosocial and behavioural factors, and the prevalence of childhood overweight. A total of 5819 children (50.5% boys and 49.5% girls) were included. RESULTS: The risk for being overweight after 2 years at follow-up in children who were non-overweight at baseline increases with a lower SES. For children who were initially overweight, a lower parental SES carries a lower probability for a non-overweight weight status at follow-up. The effect of parental SES is only moderately attenuated by single familial, psychosocial or behavioural factors; however, it can be fully explained by their combined effect. Most influential of the investigated risk factors were feeding/eating practices, parental body mass index, physical activity behaviour and proportion of sedentary activity. CONCLUSION: Prevention strategies for childhood overweight should focus on actual behaviours, whereas acknowledging that these behaviours are more prevalent in lower SES families.

  • 26.
    Barker, Dean
    et al.
    University of Gothenburg, Sweden.
    Nielsen, Jacob
    University of Gothenburg, Sweden.
    Wahlström, Martin
    University of Gothenburg, Sweden.
    Barker-Ruchti, Natalie
    University of Gothenburg, Sweden.
    Carlén, Urban
    University of West, Sweden.
    Maivorsdotter, Ninitha
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Jacob and Martin: Developing digital technology competence in physical education teacher education2017In: Digital technologies and learning in physical education: Pedagogical cases / [ed] Ashley Casey, Victoria A. Goodyear, Kathleen M. Armour, London: Routledge, 2017, p. 231-246Chapter in book (Other academic)
  • 27.
    Bel-Serrat, Silvia
    et al.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Pala, Valeria
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Boernhorst, Claudia
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Fernandez-Alvira, Juan Miguel
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Hebestreit, Antje
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Siani, Alfonso
    Inst Food Sci, Unit Epidemiol & Populat Genet, CNR, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Ctr Hlth & Behav Sci, Tallinn, Estonia.
    Krogh, Vittorio
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Relative validity of the Children's Eating Habits Questionnaire- food frequency section among young European children: the IDEFICS Study2014In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, no 2, p. 266-276Article in journal (Refereed)
    Abstract [en]

    Objective: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24h dietary recalls (24-HDR). Design: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (kappa(w)) and Bland-Altman analysis. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). Subjects: Children aged 2-9 years (n 2508, 50.4% boys). Results: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0.01 (sweetened fruit) to 0.48 (sweetened milk) in children aged 2-<6 years (mean = 0.25) and from 0.01 (milled cereal) to 0.44 (water) in children aged 6-9 years (mean = 0.23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was <= 12 % for all food groups in both age groups. Mean kappa(w) was 0.20 for 2-<6-year-olds and 0.17 for 6-9-year-olds. Conclusions: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.

  • 28.
    Bixby, Honor
    et al.
    Imperial College London, United Kingdom.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ezzati, Majid
    Imperial College London, United Kingdom.
    Rising rural body-mass index is the main driver of the global obesity epidemic in adults2019In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 569, no 7755, p. 260-264Article in journal (Refereed)
    Abstract [en]

    Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3-6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

  • 29.
    Bjerkeli, Pernilla J.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Clinical Sciences, Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.
    Vicente, Raquel Perez
    Department of Clinical Sciences, Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden.
    Mulinari, Shai
    Department of Sociology, Lund University, Lund, Sweden.
    Johnell, Kristina
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
    Merlo, Juan
    Department of Clinical Sciences, Unit for Social Epidemiology, Faculty of Medicine, Lund University, Malmö, Sweden / Center for Primary Health Care Research, Region Skåne, Malmö, Sweden.
    Overuse of methylphenidate: an analysis of Swedish pharmacy dispensing data2018In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 10, p. 1657-1665Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify overuse of methylphenidate and to investigate patterns of overuse in relation to sociodemographic and clinical characteristics. Patients and methods: Swedish national, pharmacy dispensing data were analyzed for all 56,922 individuals aged 6-79 years, who filled a methylphenidate prescription between 2010 and 2011. Overuse was defined as having above 150% days covered by the dispensed amount during 365 days from the first prescription fill, assuming use at the maximum recommended daily dose. Results: In total, 4,304 individuals (7.6% of the methylphenidate users) were categorized as overusers. The risk of overuse increased with age (OR for 46-65 years vs 6-12 years 17.5, 95% CI 14.3-21.3), and was higher in men (OR 1.4, 95% CI 1.3-1.5) and individuals with low income (OR 1.1, 95% CI 1.0-1.2), as well as in individuals with an attention deficit hyperactivity disorder (ADHD) diagnosis (OR 1.4, 95% CI 1.3-1.6), health care visits (OR 1.3, 95% CI 1.2-1.4), previous ADHD medication use (OR 2.6, 95% CI 2.4-2.8), and previous diagnosis of mental and behavioral disorders due to psychoactive substance use (OR 2.1 95% CI 2.0-2.3). Conclusion: Among individuals using methylphenidate in Sweden, 7.6% receive amounts that are larger than what they should have a medical need for, assuming that they were using the maximum recommended daily dose 365 days per year. Notably, the prevalence of overuse was associated with previous diagnosis of alcohol and drug misuse. The prevalence was also positively associated with higher age and previous use of ADHD medication. These findings may point toward a link between exposure time and overuse. However, future studies with long-term data are needed to investigate this.

  • 30.
    Björkelund, Cecilia
    et al.
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Andersson-Hange, Dominique
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Andersson, Kate
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Bengtsson, Calle
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Blomstrand, Ann
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Bondyr-Carlsson, Dorota
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Rödström, Kerstin
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Sjöberg, Agneta
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Sundh, Valter
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Weman, Lilian
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Zylberstein, Dimitri
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Hakeberg, Magnus
    Univ Gothenburg, Inst Odontol, Sahlgrenska Acad, Gothenburg, Sweden.;Jonkoping Univ, Sch Hlth Sci, Jonkoping, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med Primary Hlth Care, Sahlgrenska Acad, Gothenburg, Sweden.
    Secular trends in cardiovascular risk factors with a 36-year perspective: Observations from 38- and 50-year-olds in the Population Study of Women in Gothenburg2008In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 26, no 3, p. 140-146Article in journal (Refereed)
    Abstract [en]

    Objectives. To study secular trends in cardiovascular risk factors in four different cohorts of women examined in 1968-1969, 1980-1981, 1992-1993 and 2004-2005. Design. Comparison of four representative cohorts of 38- and 50-year-old women over a period of 36 years. Setting. Gothenburg, Sweden with similar to 450 000 inhabitants. Subjects. Four representative samples of 38- and 50-year-old women were invited to free health examinations (participation rate 59-90%, n =1901). Main outcome measures. Body mass index (BMI), systolic and diastolic blood pressure (SBP, DBP), leisure time exercise, use of antihypertensive medication, smoking, levels of haemoglobin, b-glucose, s-cholesterol, s-triglycerides and HDL-cholesterol. Results. There was no significant difference in mean BMI from 1968-1969 versus 2004-2005. Mean leisure time exercise was significantly higher in later born cohorts; in 1968, around 15% were physically active compared with 40% in 2004. SBP and DBP, mean s-cholesterol and s-triglyceride levels were significantly lower in both 38- and 50-year-old cohorts in 2004-2005 versus 1968-1969. HDL-cholesterol (not measured until 1992-1993), showed a significantly higher mean level in 2004-2005. Reduction of risk factors was apparent in women with a high as well as low level of physical activity. Smoking declined most in women with high levels of physical activity. Conclusions. Several cardiovascular risk factors related to lifestyle have improved in middle-aged women from the 1960s until today. Most of the positive trends are observed in women with both low and high physical activity.

  • 31.
    Boernhorst, C.
    et al.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Bel-Serrat, S.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Ottavaere, C.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Sioen, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Univ Coll Ghent, Dept Nutr & Dietet, Fac Hlth Care Vesalius, Ghent, Belgium.
    Mouratidou, T.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Mesana, M. I.
    Univ Zaragoza, Fac Hlth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Westerterp, K.
    Maastricht Univ, Dept Human Biol, Maastricht, Netherlands.
    Bammann, K.
    BIPS Inst Epidemiol & Prevent Res, Bremen, Germany / Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.
    Lissner, L.
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Pala, V.
    Fdn IRCSS Ist Nazl Tumori, Nutr Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Rayson, M.
    BioTel Ltd Clifton, Bristol, Avon, England.
    Krogh, V.
    Fdn IRCSS Ist Nazl Tumori, Nutr Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, L. A.
    Univ Zaragoza, Fac Hth Sci, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Validity of 24-h recalls in (pre-)school aged children: Comparison of proxy-reported energy intakes with measured energy expenditure2014In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 33, no 1, p. 79-84Article in journal (Refereed)
    Abstract [en]

    Background & aims: Little is known about the validity of repeated 24-h dietary recalls (24-HDR) as a measure of total energy intake (El) in young children. This study aimed to evaluate the validity of proxy-reported El by comparison with total energy expenditure (TEE) measured by the doubly labeled water (DLW) technique. Methods: The agreement between El and TEE was investigated in 36 (47.2% boys) children aged 4-10 years from Belgium and Spain using subgroup analyses and Bland-Altman plots. Low-energy-reporters (LER), adequate-energy-reporters (AER) and high-energy-reporters (HER) were defined from the ratio of El over TEE by application of age- and sex-specific cut-off values. Results: There was good agreement between means of El (1500 kcal/day) and TEE (1523 kcal/day) at group level though in single children, i.e. at the individual level, large differences were observed. Almost perfect agreement between El and TEE was observed in thin/normal weight children (EI: 1511 kcal/day; TEE: 1513 kcal/day). Even in overweight/obese children the mean difference between El and TEE was only 86 kcal/day. Among the participants, 28(78%) were classified as AER, five (14%) as HER and three (8%) as LER. Conclusion: Two proxy-reported 24-HDRs were found to be a valid instrument to assess El on group level but not on the individual level. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  • 32.
    Boernhorst, C.
    et al.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Huybrechts, I.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium / Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Ahrens, W.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Michels, N.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Pala, V.
    Fdn IRCSS Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, I-20133 Milan, Italy.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, H-7623 Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, I-83100 Avellino, Italy.
    Barba, G.
    CNR, Inst Food Sci, I-83100 Avellino, Italy.
    Bel-Serrat, S.
    Univ Zaragoza, Escuela Univ Ciencias Salud, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Moreno, L. A.
    Univ Zaragoza, Escuela Univ Ciencias Salud, GENUD Growth Exercise Nutr & Dev Res Grp, E-50009 Zaragoza, Spain.
    Papoutsou, S.
    Res & Educ Inst Child Hlth, CY-2027 Strovolos, Cyprus.
    Veidebaum, T.
    Natl Inst Hlth Dev, Ctr Hlth & Behav Sci, EE-11619 Tallinn, Estonia.
    Loit, H. M.
    Center of Health and Behavioral Science, National Institute for Health Development, Hiiu 42, 11619Tallinn, Estonia.
    Lissner, L.
    Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Pigeot, I.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls2013In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 109, no 7, p. 1257-1265Article in journal (Refereed)
    Abstract [en]

    Dietary assessment is strongly affected by misreporting (both under-and over-reporting), which results in measurement error. Knowledge about misreporting is essential to correctly interpret potentially biased associations between diet and health outcomes. In young children, dietary data mainly rely on proxy respondents but little is known about determinants of misreporting here. The present analysis was conducted within the framework of the multi-centre IDEFICS (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) study and is based on 6101 children aged 2-9 years with 24 h dietary recall (24-HDR) and complete covariate information. Adapted Goldberg cut-offs were applied to classify the 24-HDR as 'over-report', 'plausible report' or 'under-report'. Backward elimination in the course of multi-level logistic regression analyses was conducted to identify factors significantly related to under-and over-reporting. Next to characteristics of the children and parents, social factors and parental concerns/perceptions concerning their child's weight status were considered. Further selective misreporting was addressed, investigating food group intakes commonly perceived as more or less socially desirable. Proportions of under-, plausible and over-reports were 8.0, 88.6 and 3.4%, respectively. The risk of under-reporting increased with age (OR 1.19, 95% CI 1.05, 1.83), BMI z-score of the child (OR 1.23, 95% CI 1.10, 1.37) and household size (OR 1.12, 95% CI 1.01, 1.25), and was higher in low/medium income groups (OR 1.45, 95% CI 1.13, 1.86). Over-reporting was negatively associated with BMI z-scores of the child (OR 0.78, 95% CI 0.69, 0.88) and higher in girls (OR 1.70, 95% CI 1.27, 2.28). Further social desirability and parental concerns/perceptions seemed to influence the reporting behaviour. Future studies should involve these determinants of misreporting when investigating diet-disease relationships in children to correct for the differential reporting bias.

  • 33.
    Borg, Elin
    University of Skövde, School of Health and Education.
    Trygghetsarbetets hälsopåverkan hos elever ur ett personalperspektiv på en grundskola i en skånsk kommun2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Mental illness in students a growing problem. The Swedish school has the task of working with students' safety and to conduct systematic quality work against discrimination and offensive treatment. Purpose: The purpose was to investigate whether pedagogues and student health personnel at a primary school in a municipality in Skane felt that the safety efforts have a positive effect on the students' health. Method: A cross-sectional study with qualitative elements was conducted by educators (n = 65) at an elementary school in Skåne. The data collection was done through a digital survey that was sent out via e-mail. The collected data was analyzed in the statistics program SPSS. Qualitative answers were presented in text form. Result: The response rate was 34%, a too low response rate to be able to generalize the result. Of the respondents, 73% felt that they were participant in the safety work, 91% felt that safety had an effect on the students' health and 67% did not experience any health differences between the sexes. However, there are some differences in which efforts work best and worst in relation to gender. Student initiatives that involve social exchange are perceived to be most positive and punishment most negative. There is a demand for systematic security work. Conclusion: The result links to previous research that both confirms and demonstrates areas for improvement. The existence of the security plan is fundamental. Requested clarity and follow-up can be an expression of the area's size and the difficulty of obtaining a comprehensive picture of the safety work. Different forms of social exchange are what are considered to have an effect on the students' health and should therefore be given priority. Security work can benefit from collegial learning and the content of the safety plan may need to be supplemented. Success factors and improvement proposals can contribute to a clearer anchoring. However, the low response rate should be taken into account and any implementation of proposals should be reconciled with staff.

  • 34.
    Bortas, Jenny
    et al.
    University of Skövde, School of Health and Education.
    Wahll, Jenny
    University of Skövde, School of Health and Education.
    Insatser för att förebygga och minska risk för arbetsrelaterad stress: En litteraturöversikt2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
  • 35.
    Borén, Fanny
    University of Skövde, School of Health and Education.
    Barns möjlighet till naturkontakt: En kvalitativ studie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: A sedentary lifestyle is getting more common among children, and outdoor play today is challenged by television and computer games. Many families live in cities with limited access to nature. Nature provides spontaneous physical activities as well as it offers mental recovery. Children who experience early exposure to nature often demonstrate an interested in nature as adults. This study examines the possibilities of access to nature for Swedish children aged 5-12 years.Methods: Ten mothers were interviewed about their children’s interaction with nature. Group 1 included five mothers with children who had regular contact with nature, and group 2 included five mothers with children who didn’t have regular contact with nature.Results: The children of mothers who lived in the countryside and mothers who were involved with nature related associations had regular access to nature, while mothers who lived in urban areas ended up giving their children less opportunities to access to nature. Mothers who had regular access to nature as children were more likely to enjoy nature as adults. Contact with nature was more frequent during the summer months.Discussion: Residential context and parents commitment were important in relation to the aspect of whether children had regular nature contact or not.

  • 36.
    Brolin, Magnus
    et al.
    School of Health and Medical Sciences, Örebro University.
    Quennerstedt, Mikael
    School of Health and Medical Sciences, Örebro University.
    Maivorsdotter, Ninitha
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Casey, Ashley
    School of Sport, Exercise and Health Sciences, Loughborough University, UK.
    A salutogenic strengths-based approach in practice: an illustration from a school in Sweden2018In: Curriculum Studies in Health and Physical Education, ISSN 2574-2981, Vol. 9, no 3, p. 237-252Article in journal (Refereed)
    Abstract [en]

    Despite an extensive debate and an openness of teachers to a strength-based approach to health and physical education, it is not always clear what a salutogenic strengths-based approach might look like in practice, at least not in the day-to-day work in schools. The purpose of this article is to present a salutogenic strengths-based school initiative in Sweden and to identify health discourses in the school’s practice. An insider perspective is used to explore health in the school through Brook field’s four lenses fo exploring one’s own teaching practice. Two health discourses are identified: (1) an individual health discourse rooted in the fostering of personal development, and (2) a value-based health discourse build up around social relations and the fostering of democratic values. The individual health discourse can be understood as based in a pathogenic norm, and in the investigated school practice the individual health discourse dominated the school health initiative despite the salutogenic intentions.

  • 37.
    Brännmark, Marita
    et al.
    University of Skövde, School of Health and Education.
    Steisjö, Maria
    University of Skövde, School of Health and Education.
    Inomhusluftföroreningar orsakade av matlagning eller uppvärmning med förorenade bränslen och dess påverkan på barns hälsa2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction. According to WHO, about 3,8 million people die from indoor air pollution exposure each year and about 3 billion people cook and heat their homes with polluted fuels such as wood, coal, kerosene and manure. Both through short-term and prolonged exposure to these contaminants, health problems can arise.

    Aim. Our aim with this study is to describe the health effects for indoor air pollution in children living in households where cooking and heating takes place with polluted fuels.

    Method. A qualitative systematic review. The analysis was conducted with thematic analysis. The databases used were PubMed and WorldCat. Twenty articles were included in the study.

    Result. The analysis resulted in two themes and three sub-themes. Prevalence of polluted fuel use was higher in households where children died at age 1-4 years. Children living in countries with the highest levels of polluted fuel use experienced a sevenfold higher rate of pneumonia per child year. Polluted fuel use was also related to low birth weight. Two studies showed that the risk of suffering from Acute Respiratory infection (ARI) due to household use of polluted fuels was 1.5 times higher than for children from households using cleaner fuels.

    Conclusion. Based on the results of this study, it has emerged that respiratory symptoms and diseases are the most common health effects among children living in households where solid fuels are used for cooking or heating. Results also indicates that the location of the use of solid fuels is of great importance since indoor cooking without ventilation, has a higher outcome of respiratory symptoms in children, compared to children living in households where cooking takes place outdoors or where there are ventilation possibilities in the cooking area.

  • 38.
    Börnhorst, Claudia
    et al.
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.;IARC, Dietary Exposure Assessment Grp DEX, Lyon, France.
    Hebestreit, Antje
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Vanaelst, Barbara
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.;Res Fdn Flanders FWO, Brussels, Belgium.
    Molnar, Denes
    Univ Pecs, Dept Pediat, Fac Med, Pecs, Hungary.
    Bel-Serrat, Silvia
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Moreno, Luis A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Pala, Valeria
    Fdn IRCSS, Ist Nazl Tumori, Dept Prevent & Predict Med, Nutr Epidemiol Unit, Milan, Italy.
    Eha, Marge
    Natl Inst Hlth Dev, Dept Surveillance & Evaluat, Tallinn, Estonia.
    Kourides, Yiannis A.
    Res & Educ Fdn Child Hlth, Paphos, Cyprus.
    Siani, Alfonso
    CNR, Inst Food Sci, Avellino, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Pigeot, Iris
    BIPS Inst Epidemiol & Prevent Res, D-28359 Bremen, Germany.
    Diet-obesity associations in children: approaches to counteract attenuation caused by misreporting2013In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 16, no 2, p. 256-266Article in journal (Refereed)
    Abstract [en]

    Objective: Measurement errors in dietary data lead to attenuated estimates of associations between dietary exposures and health outcomes. The present study aimed to compare and evaluate different approaches of handling implausible reports by exemplary analysis of the association between dietary intakes (total energy, soft drinks, fruits/vegetables) and overweight/obesity in children. Design: Cross-sectional multicentre study. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS Study. Subjects: Children (n 5357) aged 2-9 years who provided one 24 h dietary recall and complete covariate information. Results: The 24 h recalls were classified into three reporting groups according to adapted Goldberg cut-offs: under-report, plausible report or over-report. In the basic logistic multilevel model (adjusted for age and sex, including study centre as random effect), the dietary exposures showed no significant association with overweight/obesity (energy intake: OR=0.996 (95% CI 0.983, 1.010); soft drinks: OR=0.999 (95% CI 0.986, 1.013)) and revealed even a positive association for fruits/vegetables (OR=1.009 (95% CI 1.001, 1.018)). When adding the reporting group (dummy variables) and a propensity score for misreporting as adjustment terms, associations became significant for energy intake as well as soft drinks (energy: OR=1.074 (95% CI 1.053, 1.096); soft drinks: OR=1.015 (95% CI 1.000, 1.031)) and the association between fruits/vegetables and overweight/obesity pointed to the reverse direction compared with the basic model (OR=0.993 (95% CI 0.984, 1.002)). Conclusions: Associations between dietary exposures and health outcomes are strongly affected or even masked by measurement errors. In the present analysis consideration of the reporting group and inclusion of a propensity score for misreporting turned out to be useful tools to counteract attenuation of effect estimates.

  • 39.
    Cabrera, C.
    et al.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Nordic School of Public Health, Göteborg, Sweden.
    Rothenberg, E.
    Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Department for Clinical Nutrition, Göteborg, Sweden / Sahlgrenska University Hospital, Göteborg, Sweden.
    Eriksson, B. G.
    Department of Sociology, Göteborg University, Göteborg, Sweden.
    Wedel, H.
    Nordic School of Public Health, Göteborg, Sweden.
    Eiben, Gabriele
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
    Steen, B.
    Geriatric Medicine, Sahlgrenska Academy at Göteborg University, Department for Clinical Nutrition, Göteborg, Sweden.
    Lissner, L.
    Department of Primary Health Care, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden / Nordic School of Public Health, Göteborg, Sweden.
    Socio-economic gradient in food selection and diet quality among 70-year olds2007In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 11, no 6, p. 466-473Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to assess social disparities in food choices and diet quality in a population of 70-year old Swedes. Design: Cross-sectional study among participants in the 2000 Gerontological and Geriatric Population Studies in Goteborg. Participants: A representative population of men (n=233) and women (n=321) from Goteborg, a city on the south western coast of Sweden. Methods: One hour diet history interviews were performed and 35 specific foods and food groups were identified; in addition a diet quality index (DQI) was calculated. Differences in food choices and diet quality scores were tested across educational and socio-economic index categories (SEI). Results: Men with higher education and SEI had higher diet quality scores than those with lower socio-economic status, while no differences in DQI were noted in women. Further analysis of women based on their husband's occupational group also yielded no differences in diet quality. When studying individual foods, socio-economic differences were observed in women and men. Conclusions: Selection of food varies by education and occupational status in both sexes although socio-economic disparities in diet quality were observed in men only.

  • 40.
    Carlén, Urban
    et al.
    Department of Social and Behavioural Studies, University West, Trollhättan, Sweden.
    Maivorsdotter, Ninitha
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Exploring the role of digital tools in running: The meaning-making of user-generated data in a social networking site2016In: Qualitative Research in Sport, Exercise and Health, ISSN 2159-676X, E-ISSN 2159-6778, Vol. 9, no 1, p. 18-32Article in journal (Refereed)
    Abstract [en]

    The aim of the study is to examine how runners make meaning of digital tools in the dialogues published on a social networking site (SNS) created by and for runners who choose to run alone. The study explores the digital data generated by the runners using global positioning systems, such as how many kilometres have been covered, the average pace, the geographical location, the total climb, health information related to pulse rate and the number of calories burned. Some runners share this kind of data when publishing postings on the SNS. The empirical data consists of published postings of visual graphs and photographs with comments in threads retrieved from the online archives. A transactional approach and practical epistemology analysis are employed to focus on and analyse the meaning-making processes that are located in the social practices that the runners create when participating online. The participants make meaning of digital tools (such as sport watches and associated apps) by: (1) sharing details about their running performances, (2) signalling their presence in the social network of lone runners and (3) planning running events. Digital information is primarily used to reinforce the runners’ identity formation. The meaning-making of digital tools thus becomes a way of highlighting an individual’s social affinity to a runners’ collective. Surprisingly, lone runners do not use the performance-related feedback and health information offered by the digital tools to enhance their running progress when participating in the SNS.

  • 41.
    Chang, Angela Y.
    et al.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, USA.
    Dalal, Koustuv
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Dieleman, Joseph L.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, USA / Univ Washington, Dept Hlth Metr Sci, Seattle, USA.
    Past, present, and future of global health financing: a review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995–20502019In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 393, no 10187, p. 2233-2260Article, review/survey (Refereed)
    Abstract [en]

    Background Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings Between 1995 and 2016, health spending grew at a rate of 4.00% (95% uncertainty interval 3.89-4.12) annually, although it grew slower in per capita terms (2.72% [2.61-2.84]) and increased by less than $ 1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5.55% [5.18-5.95]), mainly due to growth in government health spending, and in lower-middle-income countries (3.71% [3.10-4.34]), mainly from DAH. Health spending globally reached $ 8.0 trillion (7.8-8.1) in 2016 (comprising 8.6% [8.4-8.7] of the global economy and $ 10.3 trillion [10.1-10.6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$ 5252 (5184-5319) in high-income countries, $ 491 (461-524) in upper-middle-income countries, $ 81 (74-89) in lower-middle-income countries, and $ 40 (38-43) in low-income countries. In 2016, 0.4% (0.3-0.4) of health spending globally was in low-income countries, despite these countries comprising 10.0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($ 9.5 billion, 24.3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6.27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China's contribution to DAH ($ 644.7 million in 2018). Globally, health spending is projected to increase to $ 15.0 trillion (14.0-16.0) by 2050 (reaching 9.4% [7.6-11.3] of the global economy and $ 21.3 trillion [19.8-23.1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1.84% (1.68-2.02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0.6% (0.6-0.7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15.7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130.2 (122.9-136.9) in 2016 and is projected to remain at similar levels in 2050 (125.9 [113.7-138.1]). The decomposition analysis identified governments' increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets.

  • 42.
    Chardi, Emma
    et al.
    University of Skövde, School of Health and Education.
    Nilsson, My
    University of Skövde, School of Health and Education.
    Sociala mediers inverkan på ungdomars självbild: En litteraturöversikt2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction The majority of young people use social media to communicate with their friends through photos, chats and forums or to find information. Advertisement and content in social media often portrays gender stereotypes. Many young people feel pressured to live up to the stereotypes and uploads beautified images to mimic ideals. The aim of the study was to describe how the content in social media could influence the self-image of adolescents aged 13-25. Method Scientific articles were found in the databases CINAHL and PubMed. The articles were thematized and five themes emerged through a literature review. Results The five themes that emerged were the effect Peer pressure, Social comparison, Drive for thinness, Training and Food related content had on the self-image among adolescents. Peer pressure could lead to body dissatisfaction. The drive for thinness dominated among girls while the most dominating ideal for boys were a muscular body. Failure to live up to the ideals could lead to depressive symptoms and eating disorders. Discussion Consuming ideal images of men and women could lead to an unrealistic pressure on themselves but it could also serve as motivation.

  • 43.
    Choulagai, Bishnu
    et al.
    Sahlgrenska Academy at University of Gothenburg / Tribhuvan University, Kathmandu, Nepal.
    Onta, Sharad
    Tribhuvan University, Kathmandu, Nepal.
    Subedi, Narayan
    Nepal Public Health Foundation, Kathmandu, Nepal.
    Mehata, Suresh
    Nepal Public Health Foundation, Kathmandu, Nepal.
    Bhandari, Gajananda P
    Nepal Public Health Foundation, Kathmandu, Nepal.
    Poudyal, Amod
    Tribhuvan University, Kathmandu, Nepal.
    Shrestha, Binjwala
    Tribhuvan University, Kathmandu, Nepal.
    Mathai, Matthews
    World Health Organization, Geneva, Switzerland.
    Petzold, Max
    Sahlgrenska Academy at University of Gothenburg.
    Krettek, Alexandra
    Institute of Medicine, Sahlgrenska Academy at University of Gothenburg / Nordic School of Public Health NHV Gothenburg.
    Barriers to using skilled birth attendants' services in mid- and far-western Nepal: a cross-sectional study.2013In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 13, no 1, article id 49Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Skilled birth attendants (SBAs) provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. However, utilization and coverage of services by SBAs remain poor, especially in rural and remote areas of Nepal. This study examined the characteristics associated with utilization of SBA services in mid- and far-western Nepal.

    METHODS: This cross-sectional study examined three rural and remote districts of mid- and far-western Nepal (i.e., Kanchanpur, Dailekh and Bajhang), representing three ecological zones (southern plains [Tarai], hill and mountain, respectively) with low utilization of services by SBAs. Enumerators assisted a total of 2,481 women. All respondents had delivered a baby within the past 12 months. We used bivariate and multivariate analyses to assess the association between antenatal and delivery care visits and the women's background characteristics.

    RESULTS: Fifty-seven percent of study participants had completed at least four antenatal care visits and 48% delivered their babies with the assistance of SBAs. Knowing the danger signs of pregnancy and delivery (e.g., premature labor, prolonged labor, breech delivery, postpartum hemorrhage, severe headache) associated positively with four or more antenatal care visits (OR = 1.71; 95% CI: 1.41-2.07). Living less than 30 min from a health facility associated positively with increased use of both antenatal care (OR = 1.44; 95% CI: 1.18-1.77) and delivery services (OR = 1.25; CI: 1.03-1.52). Four or more antenatal care visits was a determining factor for the utilization of SBAs.

    CONCLUSIONS: Less than half of the women in our study delivered babies with the aid of SBAs, indicating a need to increase utilization of such services in rural and remote areas of Nepal. Distance from health facilities and inadequate transportation pose major barriers to the utilization of SBAs. Providing women with transportation funds before they go to a facility for delivery and managing transportation options will increase service utilization. Moreover, SBA utilization associates positively with women's knowledge of pregnancy danger signs, wealth quintile, and completed antenatal care visits. Nepal's health system must develop strategies that generate demand for SBAs and also reduce financial, geographic and cultural barriers to such services.

  • 44.
    Choulagai, Bishnu P.
    et al.
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Aryal, Umesh Raj
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Shrestha, Binjwala
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Onta, Sharad
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Petzold, Max
    Health Metrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    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, University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal: 2012 follow-up survey and use of skilled birth attendants2015In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, article id 29396Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Estimates of disease burden in Nepal are based on cross-sectional studies that provide inadequate epidemiological information to support public health decisions. This study compares the health and demographic indicators at the end of 2012 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) with the baseline conducted at the end of 2010. We also report on the use of skilled birth attendants (SBAs) and associated factors in the JD-HDSS at the follow-up point.

    DESIGN: We used a structured questionnaire to survey 3,505 households in the JD-HDSS, Bhaktapur, Nepal. To investigate the use of SBAs, we interviewed 434 women who had delivered a baby within the prior 2 years. We compared demographic and health indicators at baseline and follow-up and assessed the association of SBA services with background variables.

    RESULTS: Due to rising in-migration, the total population and number of households in the JD-HDSS increased (13,669 and 2,712 in 2010 vs. 16,918 and 3,505 in 2012). Self-reported morbidity decreased (11.1% vs. 7.1%, respectively), whereas accidents and injuries increased (2.9% vs. 6.5% of overall morbidity, respectively). At follow-up, the proportion of institutional delivery (93.1%) exceeded the national average (36%). Women who accessed antenatal care and used transport (e.g. bus, taxi, motorcycle) to reach a health facility were more likely to access institutional delivery.

    CONCLUSIONS: High in-migration increased the total population and number of households in the JD-HDSS, a peri-urban area where most health indicators exceed the national average. Major morbidity conditions (respiratory diseases, fever, gastrointestinal problems, and bone and joint problems) remain unchanged. Further investigation of reasons for increased proportion of accidents and injuries are recommended for their timely prevention. More than 90% of our respondents received adequate antenatal care and used institutional delivery, but only 13.2% accessed adequate postnatal care. Availability of transport and use of antenatal care was associated positively with institutional delivery.

  • 45.
    Choulagai, Bishnu P.
    et al.
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Nepal Public Health Foundation, Kathmandu, Nepal.
    Onta, Sharad
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Nepal Public Health Foundation, Kathmandu, Nepal.
    Subedi, Narayan
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Nepal Public Health Foundation, Kathmandu, Nepal.
    Bhatta, Dharma N.
    Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkla, Thailand.
    Shrestha, Binjwala
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Petzold, Max
    Health Metrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden, / School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    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.
    A cluster-randomized evaluation of an intervention to increase skilled birth attendant utilization in mid- and far-western Nepal2017In: Health Policy and Planning, ISSN 0268-1080, E-ISSN 1460-2237, Vol. 32, no 8, p. 1092-1101Article in journal (Refereed)
    Abstract [en]

    Skilled birth attendant (SBA) utilization is low in remote and rural areas of Nepal. We designed and implemented an evaluation to assess the effectiveness of a five-component intervention that addressed previously identified barriers to SBA services in mid- and far-western Nepal. We randomly and equally allocated 36 village development committees with low SBA utilization among 1-year intervention and control groups. The eligible participants for the survey were women that had delivered a baby within the past 12 months preceding the survey. Implementation was administered by trained health volunteers, youth groups, mothers' groups and health facility management committee members. Post-intervention, we used difference-in-differences and mixed-effects regression models to assess and analyse any increase in the utilization of skilled birth care and antenatal care (ANC) services. All analyses were done by intention to treat. Our trial registration number was ISRCTN78892490 (http://www.isrctn.com/ISRCTN78892490). Interviewees included 1746 and 2098 eligible women in the intervention and control groups, respectively. The 1-year intervention was effective in increasing the use of skilled birth care services (OR = 1.57; CI 1.19-2.08); however, the intervention had no effect on the utilization of ANC services. Expanding the intervention with modifications, e.g. mobilizing more active and stable community groups, ensuring adequate human resources and improving quality of services as well as longer or repeated interventions will help achieve greater effect in increasing the utilization of SBA.

  • 46.
    Dahl, Amanda
    University of Skövde, School of Health and Education.
    Hundar i utbildningssyfte för främjande av elevers läslust eller läsutveckling samt för att underlätta inlärning för barn med särskilda behov2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: This literature study will examine how reading- and/or therapy dogs can promote children´s motivation to read and develop their reading skills. In many countries, primarily in USA and Canada, dog based education is an accepted tool in schools. 

    Aim:  The aim of the thesis is via a literature study explore whether students improve their reading ability and motivation to read with use of a dog. Also, the aim is to explore if dogs can facilitate learning to read for children with special needs.  

    Method: This thesis presents the results of 15 articles. The results have been categorized according to different themes and are presented in a table and in the current text. 

    Results: According to the studies there a positive development regarding reading ability, pronunciation and comprehension of the children who read out loud for a dog could be detected. The children experience higher joy, motivation and pleasure to read if a dog is present. Even children with special needs benefit from dog based therapy. 

    Discussion: This literature study supports previous research and the conclusion is that children who reads for dogs can develop their reading ability and increase the motivation to read.  

  • 47.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Centre for Injury Prevention and Safety Promotion (CIPSP), School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Örebro, Sweden.
    Svanström, Leif
    University of Skövde, School of Health and Education. Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
    Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries2015In: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 7, no 4, p. 487-494Article in journal (Refereed)
  • 48.
    Dalal, Koustuv
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Centre for Injury Prevention and Safety Promotion (CIPSP), School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Örebro, Sweden.
    Wang, Shumei
    School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China.
    Svanström, Leif
    University of Skövde, School of Health and Education. WHO CC Community Safety Promotion, Karolinska Institutet, Stockholm, Sweden.
    Intimate Partner Violence against Women in Nepal: An Analysis through Individual, Empowerment, Family and Societal Level Factors2014In: Journal of Research in Health Sciences, ISSN 1682-2765, Vol. 14, no 4, p. 251-257Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The current study estimated the national prevalence rate of intimate partner violence against women (IPVAW) in Nepal. Besides, the individual level, empowerment level, family and societal level factors were assessed to relate with the victims of IPAVW in Nepal.

    METHODS: Nationally representative sample of 4210 women of reproductive age (15-49 yr) were included in the study. Household surveys using two stage sampling procedures, face to face interview with pre-tested questionnaires were performed. Emotional, physical and sexual violence were target variables. A violence variable was constructed from these three types of violence. Individual level factors were measured by age, residency, education, religion and husband's education. Empowerment factors included employment status and various decision making elements. Family and societal factors included economic status, neighborhood socioeconomic disadvantage index, history of family violence, husband's controlling behavior and other issues. Cross tabulation with chi-square tests and multivariate logistic regression were employed.

    RESULTS: Prevalence of emotional IPVAW was 17.5%, physical IPAVW 23.4% and sexual IPAVW 14.7%. Overall the prevalence of IPVAW in Nepal was 32.4%. Joint decision making for contraception, husband's non-controlling behavior to wives and friendly feelings were emerged as less likely to be IPVAW perpetration.

    CONCLUSIONS: The findings have immense policy importance as a nationally representative study and indicating necessity of more gender equality.

  • 49.
    De Bourdeaudhuij, I.
    et al.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Verbestel, V.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    De Henauw, S.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Maes, L.
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Huybrechts, I.
    Int Agcy Res Canc, Dietary Exposure Assessment Grp, F-69372 Lyon, France.
    Marild, S.
    Univ Gothenburg, Dept Pediat, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Barba, G.
    CNR, Inst Food Sci, Avellino, Italy.
    Kovacs, E.
    Univ Pecs, Dept Paediat, Pecs, Hungary / Univ Munich, Inst Med Informat Proc Biometr & Epidemiol, Munich, Germany.;Univ Munich, German Ctr Vertigo & Balance Disorders, Munich, Germany.
    Konstabel, K.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Gallois, K.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Hebestreit, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Fac Math & Comp Sci, D-28359 Bremen, Germany.
    Behavioural effects of a community-oriented setting-based intervention for prevention of childhood obesity in eight European countries. Main results from the IDEFICS study2015In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 16, p. 30-40Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe objective of this paper is to evaluate the behavioural effects, as reported by the parents of the participating boys and girls, of the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) intervention. MethodsThe effectiveness of the IDEFICS intervention was evaluated through a cluster-controlled trial in eight European countries (control and intervention communities in each country) including more than 16,000 children. The 2- to 9.9-year-old children in the intervention group were exposed to a culturally adapted intervention that aimed to prevent childhood obesity through the community, schools/kindergartens and family. Parents completed questionnaires to measure water, soft drink and fruit juice intake; fruit and vegetable intake; daily TV viewing and other sedentary behaviours; daily physical activity levels and strengthening of the parent-child relationships at baseline and follow-up (2years later). Mixed models with an additional random effect for country were used to account for the clustered study design, and results were stratified by sex. ResultsThe pan-European analysis revealed no significant time by condition interaction effects, neither for boys nor girls, i.e. the analysis revealed no intervention effects on the behaviours of the IDEFICS children as reported by their parents (F=0.0 to 3.3, all p>0.05). Also very few significances were found in the country-specific analyses. Positive intervention effects were only found for sport club participation in Swedish boys, for screen time in weekends for Spanish boys and for TV viewing in Belgian girls. ConclusionAlthough no expected intervention effects as reported by the parents on diet, physical activity and sedentary behaviours could be shown for the overall IDEFICS cohort, a few favourable intervention effects were found on specific behaviours in some individual countries. More in-depth analyses of the process evaluation data are needed to obtain more insight into the relationship between the level of exposure to the intervention and its effect. 

  • 50.
    De Decker, Annelies
    et al.
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium.
    Verbeken, Sandra
    Univ Ghent, Fac Psychol & Educ Sci, Dept Dev Personal & Social Psychol, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
    Sioen, Isabelle
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium / Univ Ghent, Fac Biosci Engn, Dept Food Safety & Food Qual, Coupure Links 653, B-9000 Ghent, Belgium.
    Van Lippevelde, Wendy
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium.
    Braet, Caroline
    Univ Ghent, Fac Psychol & Educ Sci, Dept Dev Personal & Social Psychol, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
    Eiben, Gabrielle
    Univ Gothenburg, Dept Publ Hlth & Community Med, Box 453, S-40530 Gothenburg, Sweden.
    Pala, Valeria
    Fdn IRCSS Ist Nazl Tumori, Dept Prevent & Predict Med, Via Venezian 1, I-20133 Milan, Italy.
    Reish, Lucia A.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Porcelaenshaven 18a, DK-2000 Frederiksberg, Denmark.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, De Pintelaan 185 UZ 4K3, B-9000 Ghent, Belgium / Vesalius Univ Coll Ghent, Dept Hlth Sci, Keramiekstr 80, B-9000 Ghent, Belgium.
    Palatable food consumption in children: interplay between (food) reward motivation and the home food environment2017In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 176, no 4, p. 465-474Article in journal (Refereed)
    Abstract [en]

    To understand the importance of the home food environment on unhealthy food consumption in children high in reward sensitivity, this study tested the hypothesis that the home availability of unhealthy food moderates the effect of reward sensitivity on children's fast-food consumption frequency, exerted via food cue responsiveness. Children between 7.5 and 14 years (n = 174, 50.6% boys) reported on reward sensitivity and food cue responsiveness (by means of the subscale 'external eating'). Their height and weight were measured. Parents reported on their children's fast-food consumption frequency, food cue responsiveness (by means of the subscale 'food responsiveness'), and on the home availability of unhealthy foods. Two moderated mediation models were conducted, one with the parent- and one with the child-reported food cue responsiveness as mediator. Findings suggested that with a high home availability of unhealthy foods, (a) a higher fast-food consumption frequency was found in children high in reward sensitivity and (b) the relation between reward sensitivity and the fast-food consumption frequency was mediated by external eating. Conclusions: The findings point at the importance of the home food environment in children high in reward sensitivity. They suggest to limit the home availability of unhealthy foods.

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