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  • 1.
    Anderberg, Peter
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Abrahamsson, Linda
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Older people’s use and nonuse of the internet in Sweden2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, p. 1-11, article id 9050Article in journal (Refereed)
    Abstract [en]

    The use of the internet has considerably increased over recent years, and the importance of internet use has also grown as services have gone online. Sweden is largely an information society like other countries with high reported use amongst European countries. In line with digitalization development, society is also changing, and many activities and services today take place on the internet. This development could potentially lead to those older persons who do not use the internet or do not follow the development of services on the internet finding it difficult to take part in information and activities that no longer occur in the physical world. This has led to a digital divide between groups, where the older generations (60+), in particular, have been affected. In a large study of Sweden’s adult population in 2019, 95 percent of the overall population was said to be internet users, and the corresponding number for users over 66 years of age was 84%. This study shows that the numbers reported about older peoples’ internet use, most likely, are vastly overestimated and that real use is significantly lower, especially among the oldest age groups. We report that 62.4% of the study subjects are internet users and that this number most likely also is an overestimation. When looking at nonresponders to the questionnaire, we find that they display characteristics generally attributed to non-use, such as lower education, lower household economy, and lower cognitive functioning.

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  • 2.
    Barcala-Furelos, Roberto
    et al.
    REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain ; CLINURSID Network Research, Department of Psychiatry, Radiology and Public Health, University of Santiago de Compostela, Spain.
    González-Represas, Alicia
    Department of Functional Biology and Health Sciences, Physical Therapy Faculty, University of Vigo, Pontevedra, Spain.
    Rey, Ezequiel
    REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain.
    Martínez-Rodríguez, Alicia
    Department of Physiotherapy, Medicine and Biomedical Sciences, Universidade da Coruña, La Coruña, Spain.
    Kalén, Anton
    REMOSS Research Group, Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain.
    Marques, Olga
    Faculty of Sports Sciences and Physical Education, University of Coimbra, Portugal ; Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal.
    Rama, Luís
    Faculty of Sports Sciences and Physical Education, University of Coimbra, Portugal ; Research Unit for Sport and Physical Activity (CIDAF), Coimbra, Portugal.
    Is Low-Frequency Electrical Stimulation a Tool for Recovery after a Water Rescue?: A Cross-Over Study with Lifeguards2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 16, article id 5854Article in journal (Refereed)
    Abstract [en]

    This study aimed to evaluate the degree to which transcutaneous electrical stimulation (ES) enhanced recovery following a simulated water rescue. Twenty-six lifeguards participated in this study. The rescue consisted of swimming 100 m with fins and rescue-tube: 50 m swim approach and 50 m tow-in a simulated victim. Blood lactate clearance, rated perceived effort (RPE), and muscle contractile properties were evaluated at baseline, after the water rescue, and after ES or passive-recovery control condition (PR) protocol. Tensiomiography, RPE, and blood lactate basal levels indicated equivalence between both groups. There was no change in tensiomiography from pre to post-recovery and no difference between recovery protocols. Overall-RPE, legs-RPE and arms-RPE after ES (mean ± SD; 2.7 ± 1.53, 2.65 ± 1.66, and 2.30 ± 1.84, respectively) were moderately lower than after PR (3.57 ± 2.4, 3.71 ± 2.43, and 3.29 ± 1.79, respectively) (p = 0.016, p = 0.010, p = 0.028, respectively). There was a significantly lower blood lactate level after recovery in ES than in PR (mean ± SD; 4.77 ± 1.86 mmol·L−1 vs. 6.27 ± 3.69 mmol·L−1; p = 0.045). Low-frequency ES immediately after a water rescue is an effective recovery strategy to clear out blood lactate concentration.

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  • 3.
    Bärkås, Annika
    et al.
    Department of Women’s and Children’s Health, Uppsala University, Sweden.
    Scandurra, Isabella
    School of Business, Örebro University, Sweden.
    Rexhepi, Hanife
    University of Skövde, School of Informatics. University of Skövde, Informatics Research Environment.
    Blease, Charlotte
    General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, United States.
    Cajander, Åsa
    Department of Information Technology, Uppsala University, Sweden.
    Hägglund, Maria
    Department of Women’s and Children’s Health, Uppsala University, Sweden.
    Patients’ access to their psychiatric notes: Current policies and practices in Sweden2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 17, article id 9140Article in journal (Refereed)
    Abstract [en]

    Patients’ access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients’ access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region’s website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions’ guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients. 

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  • 4.
    Christiansen, Line
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Lindberg, Catharina
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Using Mobile Health and the Impact on Health-Related Quality of Life: Perceptions of Older Adults with Cognitive Impairment2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 8, article id 2650Article in journal (Refereed)
    Abstract [en]

    Digital health technologies such as mobile health (mHealth) are considered to have the potential to support the needs of older adults with cognitive impairment. However, the evidence for improving health with the use of mHealth applications is of limited quality. Few studies have reported on the consequences of technology use concerning the older adults' quality of life. The purpose of this study was to describe perceptions of mHealth and its impact on health-related quality of life (HRQoL) among older adults with cognitive impairment. The study was conducted using a qualitative design with a phenomenographic approach. A total of 18 older participants with cognitive impairment were interviewed. The interviews were analyzed in order to apply phenomenography in a home-care context. The results showed variations in the older adults' perceptions that were comprised within three categories of description; Require technology literacy, Maintain social interaction, and Facilitate independent living. In conclusion, the development and design of mHealth technologies need to be tailored based on older adults´ needs in order to be understood and perceived as useful in a home-care context. For mHealth to support HRQoL, healthcare should be provided in a way that encourages various forms of communication and interaction.

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  • 5.
    Dallora, Ana Luiza
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Minku, Leandro
    School of Computer Science, University of Birmingham, United Kingdom.
    Mendes, Emilia
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Rennemark, Mikael
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Multifactorial 10-year prior diagnosis prediction model of dementia2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 18, p. 1-18, article id 6674Article in journal (Refereed)
    Abstract [en]

    Dementia is a neurodegenerative disorder that affects the older adult population. To date, no cure or treatment to change its course is available. Since changes in the brains of affected individuals could be evidenced as early as 10 years before the onset of symptoms, prognosis research should consider this time frame. This study investigates a broad decision tree multifactorial approach for the prediction of dementia, considering 75 variables regarding demographic, social, lifestyle, medical history, biochemical tests, physical examination, psychological assessment and health instruments. Previous work on dementia prognoses with machine learning did not consider a broad range of factors in a large time frame. The proposed approach investigated predictive factors for dementia and possible prognostic subgroups. This study used data from the ongoing multipurpose Swedish National Study on Aging and Care, consisting of 726 subjects (91 presented dementia diagnosis in 10 years). The proposed approach achieved an AUC of 0.745 and Recall of 0.722 for the 10-year prognosis of dementia. Most of the variables selected by the tree are related to modifiable risk factors; physical strength was important across all ages. Also, there was a lack of variables related to health instruments routinely used for the dementia diagnosis. 

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  • 6.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Salam, Abdul
    Department of Epidemiology and Biostatistics, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
    Is achieving the guidelines of four forms of physical activity associated with less self-reported health complaints?: Cross-sectional study of undergraduates at the University of Turku, Finland2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 15, p. 1-19, article id 5595Article in journal (Refereed)
    Abstract [en]

    Very little research has assessed the physical activity (PA) of university students in in Finland, and their associations with self-reported health complaints (HCs), whilst simultaneously accounting for a range of other potential confounders. Students at the University of Turku (1177) completed an online health and wellbeing questionnaire that assessed 22 physical and somatic HCs, and students’ achievement of the international guidelines of four forms of PA (moderate, vigorous, moderate-to-vigorous and muscle strengthening PA; MPA, VPA, MVPA, MSPA respectively). We also explored the associations between HCs and PA, controlling for sociodemographic and health confounders (age, sex, year of study, marital status, accommodation during semesters, health awareness). Factor analysis reduced the HCs into three factors (psychological, pains/aches, circulatory/breathing). Bivariate relationships (no controlling for confounders) between these 3 factors and four forms of PA guideline achievement showed significant effects of achieving the PA guidelines against various groups of HCs, where more strenuous PA was associated with significantly less HCs in a step-ladder pattern. Multiple regression analyses (controlling for confounders) showed that achievement of PA guidelines was significantly independently associated with self-reported HCs scores in most cases. Psychological HCs were negatively associated with achieving any type of PA; pains/aches were negatively associated with achieving two types of PA or with achieving MSPA guidelines; and circulatory/breathing HCs were negatively associated with achieving the VPA guidelines only. This is the first study in Finland to examine such relationships, and highlights the critical role of PA for the health of these young adults. Programs and policies to strengthen and improve the PA of university students would be beneficial, recognizing the benefits of instilling life-long PA habits among this group of young adults.

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  • 7.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar ; College of Medicine, Qatar University, Doha, Qatar.
    Salam, Abdul
    Department of Epidemiology and Biostatistics, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
    Multi-substance use behaviors: Prevalence and correlates of alcohol, tobacco and other drug (ATOD) use among university students in Finland2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 12, article id 6426Article in journal (Refereed)
    Abstract [en]

    Virtually no studies appraised the co-use of alcohol, tobacco, and other drug (ATOD) among Finn undergraduates. We assessed the associations between sociodemographic, health, academic, policy, and lifestyle characteristics (independent variables); and individual, multiple and increasing ATOD use (dependent variables) using regression analyses. Data were collected by online questionnaire at the University of Turku, Finland (1177 students). Roughly 22% of the sample smoked, 21% ever used illicit drug/s, 41% were high frequency drinkers, and 31.4%, 16.3%, and 6.7% reported 1, 2, or 3 ATOD behaviors respectively. Individual ATOD use was significantly positively associated with the use of the other two substances [adjusted odds ratio (Adj OR range 1.893–3.311)]. Multiple ATOD use was negatively associated with being single (p = 0.021) or agreeing with total smoking or alcohol ban policy on campus (p < 0.0001 for each); but positively associated with not living with parents (p = 0.004). Increasing ATOD behaviors were significantly less likely among those agreeing with total smoking or alcohol ban policy on campus (p range 0.024 to <0.0001). Demographics significant to either individual, multiple, or increasing ATOD use included males, being single, not living with their parents during semesters, and to some extent, religiosity. Age, depressive symptoms, perceived stress, self-rated health, health awareness, income sufficiency, and academic variables were not associated with individual, multiple, or increasing ATOD use. Education and prevention efforts need to reinforce abstinence from ATOD, highlight their harmful outcomes, and target risk groups highlighted above. University strategies should be part of the wider country-wide successful ATOD control policies. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 

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  • 8.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Qatar / College of Medicine, Qatar University, Qatar.
    Salam, Abdul
    Neuroscience Institute, Hamad General Hospital, Qatar.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Is alcohol consumption associated with poor perceived academic performance?: Survey of undergraduates in Finland2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 4, article id 1369Article in journal (Refereed)
    Abstract [en]

    The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 9.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha Qatar.
    Salam, Abdul
    Department of Epidemiology and Biostatistics, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
    Suominen, Sakari
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Prevalence and socio-demographic, academic, health and lifestyle predictors of illicit drug/s use among university undergraduate students in Finland2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 14, p. 1-20, article id 5094Article in journal (Refereed)
    Abstract [en]

    Illicit drug/s use (IDU) among university students is a public health concern. We assessed the associations between socio-demographic, academic, and health and lifestyle characteristics (independent variables) and regular, occasional or never IDU (dependent variables). Data were collected across seven faculties (1177 students) at the University of Turku (Finland) via an online questionnaire. About 1.5% of the sample had regular IDU, 19% occasional IDU, and 79% never IDU. Independent predictors of ever (lifetime) IDU included males [adjusted odds ratio (AOR) 1.82, P = 0.001], not living with parents (AOR 2.59, P < 0.001), singles (AOR 0.51, P < 0.001), lower religiosity (AOR 1.49, P = 0.022), better self-rated general health (AOR 0.41, P = 0.003), higher health awareness (AOR 1.93, P = 0.014), more depressive symptoms (AOR 1.82, P = 0.004), daily smokers (AOR 3.69, P < 0.001), heavy episodic drinking (AOR 2.38, P < 0.001) and possible alcohol dependency (AOR 2.55, P < 0.001). We observed no independent associations between ever IDU with age, study discipline, perceived stress or academic performance. The 20.5% ever IDU is concerning. The compelling independent predictors of ever IDU included not living with parents, lower religiosity, daily smokers, heavy episodic drinking and possible alcohol dependency (AOR range 2.38–3.69). Education and prevention need to emphasize the negative consequences to reinforce abstinence from IDU. Health promotion could focus on beliefs and expectations about IDU and target students at risk for successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 10.
    Ghani, Zartashia
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Jarl, Johan
    Health Economics Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Andersson, Martin
    Department of Industrial Economics, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    The Cost-Effectiveness of Mobile Health (mHealth) Interventions for Older Adults: Systematic Review2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 15, article id 5290Article, review/survey (Refereed)
    Abstract [en]

    The objective of this study was to critically assess and review empirical evidence on the cost-effectiveness of Mobile Health (mHealth) interventions for older adults. We systematically searched databases such as Pubmed, Scopus, and Cumulative Index to Nursing and Allied Literature (CINAHL) for peer-reviewed economic evaluations published in English from 2007 to 2018. We extracted data on methods and empirical evidence (costs, effects, incremental cost-effectiveness ratio) and assessed if this evidence supported the reported findings in terms of cost-effectiveness. The consolidated health economic evaluation reporting standards (CHEERS) checklist was used to assess the reporting quality of the included studies. Eleven studies were identified and categorized into two groups: complex smartphone communication and simple text-based communication. Substantial heterogeneity among the studies in terms of methodological approaches and types of intervention was observed. The cost-effectiveness of complex smartphone communication interventions cannot be judged due to lack of information. Limited evidence of cost-effectiveness was found for interventions related to simple text-based communications. Comprehensive economic evaluation studies are warranted to assess the cost-effectiveness of mHealth interventions designed for older adults.

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  • 11.
    Ghazi, Sarah Nauman
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berner, Jessica
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Dallora, Ana Luiza
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Psychological Health and Digital Social Participation of the Older Adults during the COVID-19 Pandemic in Blekinge, Sweden—An Exploratory Study2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 6, article id 3711Article in journal (Refereed)
    Abstract [en]

    COVID-19 has affected the psychological health of older adults directly and indirectly through recommendations of social distancing and isolation. Using the internet or digital tools to participate in society, one might mitigate the effects of COVID-19 on psychological health. This study explores the social participation of older adults through internet use as a social platform during COVID-19 and its relationship with various psychological health aspects. In this study, we used the survey as a research method, and we collected data through telephonic interviews; and online and paper-based questionnaires. The results showed an association of digital social participation with age and feeling lack of company. Furthermore, in addition, to the increase in internet use in older adults in Sweden during COVID-19, we conclude that digital social participation is essential to maintain psychological health in older adults. 

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  • 12.
    Kharkova, Olga A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway,Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Grjibovski, Andrej M.
    International School of Public Health, Northern State Medical University, Arkhangelsk, Russia / Department of Public Health, North-Eastern Federal University, Yakutsk, Russia / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
    Odland, Jon Ø.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Effect of Smoking Behavior before and during Pregnancy on Selected Birth Outcomes among Singleton Full-Term Pregnancy: A Murmansk County Birth Registry Study2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 8, p. 1-11, article id E867Article in journal (Refereed)
    Abstract [en]

    The aim of our study was to assess associations between smoking behavior before and during pregnancy and selected adverse birth outcomes. This study is based on the Murmansk County Birth Registry (MCBR). Our study includes women who delivered a singleton pregnancy after 37 weeks of gestation (N = 44,486). Smoking information was self-reported and assessed at the first antenatal visit during pregnancy. We adjusted for potential confounders using logistic regression. The highest proportion of infants with low values of birth weight, birth length, head circumference, ponderal index and of the Apgar score at 5 min was observed for women who smoked both before and during pregnancy. We observed a dose-response relationship between the number of cigarettes smoked per day during pregnancy and the odds of the aforementioned adverse birth outcomes; neither were there significant differences in their occurrences among non-smokers and those who smoked before but not during pregnancy. Moreover, smoking reduction during pregnancy relative to its pre-gestation level did not influence the odds of the adverse birth outcomes. Our findings emphasize a continued need for action against tobacco smoking during pregnancy.

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  • 13.
    Kholmatova, Kamila
    et al.
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway ; International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russia.
    Krettek, Alexandra
    University of Skövde, Digital Health Research (DHEAR). University of Skövde, School of Health Sciences. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway ; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Leon, David A.
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway ; Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, UK.
    Malyutina, Sofia
    Research Institute of Internal and Preventive Medicine, Branch of Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia ; Department of Therapy, Hematology and Transfusiology, Novosibirsk State Medical University, Novosibirsk, Russia.
    Cook, Sarah
    Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK ; Faculty of Medicine, National Heart and Lung Institute, Imperial College London, UK.
    Hopstock, Laila A.
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Løvsletten, Ola
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Kudryavtsev, Alexander V.
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway ; International Research Competence Centre, Northern State Medical University, Arkhangelsk, Russia.
    Obesity Prevalence and Associated Socio-Demographic Characteristics and Health Behaviors in Russia and Norway2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 15, article id 9428Article in journal (Refereed)
    Abstract [en]

    Associations between obesity and socio-demographic and behavioral characteristics varybetween populations. Exploring such differences should throw light on factors related to obesity. Weexamined associations between general obesity (GO, defined by body mass index) and abdominalobesity (AO, defined by waist-to-hip ratio) and sex, age, socio-economic characteristics (education,financial situation, marital status), smoking and alcohol consumption in women and men aged40–69 yearsfrom the Know Your Heart study (KYH, Russia,N= 4121, 2015–2018) and the seventhTromsø Study (Tromsø7, Norway,N= 17,646, 2015–2016). Age-standardized prevalence of GO andAO was higher in KYH compared to Tromsø7 women (36.7 vs. 22.0% and 44.2 vs. 18.4%, respectively)and similar among men (26.0 vs. 25.7% and 74.8 vs. 72.2%, respectively). The positive associationof age with GO and AO was stronger in KYH vs. Tromsø7 women and for AO it was stronger inmen in Tromsø7 vs. KYH. Associations between GO and socio-economic characteristics were similarin KYH and Tromsø7, except for a stronger association with living with spouse/partner in KYHmen. Smoking had a positive association with AO in men in Tromsø7 and in women in both studies.Frequent drinking was negatively associated with GO and AO in Tromsø7 participants and positivelyassociated with GO in KYH men. We found similar obesity prevalence in Russian and Norwegianmen but higher obesity prevalence in Russian compared to Norwegian women. Other results suggestthat the stronger association of obesity with age in Russian women is the major driver of the higherobesity prevalence among them compared to women in Norway.

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  • 14.
    Kovalenko, Anton A.
    et al.
    The Arctic University of Norway, Tromsø, Norway / Northern State Medical University, Arkhangelsk, Russia.
    Anda, Erik Eik
    The Arctic University of Norway, Tromsø, Norway.
    Odland, Jon Øyvind
    The Arctic University of Norway, Tromsø, Norway.
    Nieboer, Evert
    McMaster University, Hamilton, ON, Canada.
    Brenn, Tormod
    The Arctic University of Norway, Tromsø, Norway.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. The Arctic University of Norway, Tromsø, Norway / Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Risk Factors for Ventricular Septal Defects in Murmansk County, Russia: A Registry-Based Study2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 7, article id E1320Article in journal (Refereed)
    Abstract [en]

    Cardiovascular malformations are one of the most common birth defects among newborns and constitute a leading cause of perinatal and infant mortality. Although some risk factors are recognized, the causes of cardiovascular malformations (CVMs) remain largely unknown. In this study, we aim to identify risk factors for ventricular septal defects (VSDs) in Northwest Russia. The study population included singleton births registered in the Murmansk County Birth Registry (MCBR) between 1 January 2006 and 31 December 2011. Infants with a diagnosis of VSD in the MCBR and/or in the Murmansk Regional Congenital Defects Registry (up to two years post-delivery) constituted the study sample. Among the 52,253 infants born during the study period there were 744 cases of septal heart defects (SHDs), which corresponds to a prevalence of 14.2 [95% confidence interval (CI) of 13.2⁻15.3] per 1000 infants. Logistic regression analyses were carried out to identify VSD risk factors. Increased risk of VSDs was observed among infants born to mothers who abused alcohol [OR = 4.83; 95% CI 1.88⁻12.41], or smoked during pregnancy [OR = 1.35; 95% CI 1.02⁻1.80]. Maternal diabetes mellitus was also a significant risk factor [OR = 8.72; 95% CI 3.16⁻24.07], while maternal age, body mass index, folic acid and multivitamin intake were not associated with increased risk. Overall risks of VSDs for male babies were lower [OR = 0.67; 95% CI 0.52⁻0.88].

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  • 15.
    Piculell, Erik
    et al.
    Department of Health, Faculty of Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Faculty of Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Faculty of Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Faculty of Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Bohman, Doris
    Department of Health, Faculty of Engineering, Blekinge Institute of Technology, Karlskrona, Sweden ; Optentia Research Unit, North-West University, Potchefstroom, South Africa.
    Using a mobile application for health communication to facilitate a sense of coherence: experiences of older persons with cognitive impairment2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 21, article id 11332Article in journal (Refereed)
    Abstract [en]

    The increasing use of technology by older persons and their preferences for living at home and being independent have created an avenue for self-care and care delivery using mobile technologies and health communication. This study aimed to explain how older persons with cognitive impairment experienced technology-based health communication through the use of a mobile application to facilitate a sense of coherence. Individual, semi-structured interviews with 16 participants in the SMART4MD project were conducted. The interviews were transcribed then coded deductively and thematically, creating themes that corresponded to the central components of the sense of coherence model: comprehensibility, manageability, and meaningfulness. The findings produced an overall theme: a challenging technology that can provide support, based on the three identified themes: making sense of mobile technologies, mastering mobile technologies, and the potential added value to use mobile technologies. The participants’ experiences were influenced by their previous use and expectations for the application. Personal support, cognitive and physical ability, and different sources for information impacted use. The participants experienced that using the application created an ambiguity to be challenging and have possible benefits. The study suggests that the sense of coherence model may be used as a method to understand the use of technology by older populations. 

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  • 16.
    Quintana, María
    et al.
    Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Spain.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Frögren, Joakim
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Cano, Neus
    Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Spain.
    Cellek, Selim
    Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, Essex, England.
    Zhang, Jufen
    Clinical Trials Unit, Anglia Ruskin University, Chelmsford, Essex, England.
    Garolera, Maite
    Brain, Cognition and Behavior: Clinical Research, Consorci Sanitari de Terrassa, Spain ; Neuropsychology Unit, Hospital de Terrassa, Consorci Sanitari de Terrassa, Spain .
    Feasibility-usability study of a tablet app adapted specifically for persons with cognitive impairment—SMART4MD (Support monitoring and reminder technology for mild dementia)2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 18, p. 1-21, article id 6816Article in journal (Refereed)
    Abstract [en]

    Population ageing within Europe has major social and economic consequences. One of the most devastating conditions that predominantly affects older people is dementia. The SMART4MD (Support Monitoring and Reminder Technology for Mild Dementia) project aims to develop and test a health application specifically designed for people with mild dementia. The aim of this feasibility study was to evaluate the design of the SMART4MD protocol, including recruitment, screening, baseline examination and data management, and to test the SMART4MD application for functionality and usability before utilization in a full-scale study. The feasibility study tested the protocol and the app in Spain and Sweden. A total of nineteen persons with cognitive impairment, and their informal caregivers, individually performed a task-based usability test of the SMART4MD app model in a clinical environment, followed by four-week testing of the app in the home environment. By employing a user-centered design approach, the SMART4MD application proved to be an adequate and feasible interface for an eHealth intervention. In the final usability test, a score of 81% satisfied users was obtained. The possibility to test the application in all the procedures included in the study generated important information on how to present the technology to the users and how to improve these procedures. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 17.
    Vaidya, Abhinav
    et al.
    Nordic School of Public Health, Gothenburg, Sweden / Kathmandu Medical College, Duwakot, Bhaktapur, Nepal.
    Shakya, Suraj
    Nordic School of Public Health, Gothenburg, Sweden / Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu.
    Krettek, Alexandra
    Nordic School of Public Health, Gothenburg, Sweden / Sahlgrenska Academy at University of Gothenburg, Sweden .
    Obesity Prevalence in Nepal: Public Health Challenges in a Low-Income Nation during an Alarming Worldwide Trend2010In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 7, no 6, p. 2726-2744Article, review/survey (Refereed)
    Abstract [en]

    The future toll of the obesity epidemic will likely hit hardest in low- and middle-income countries. Ongoing urbanization promotes risk factors including sedentary lifestyle and fat- and sugar-laden diets. Low-income countries like Nepal experience a double disease burden: infectious diseases as well as rising incidence of noncommunicable diseases (e.g., cardiovascular disease and diabetes mellitus) frequently characterized by obesity. Nepal currently directs efforts towards curing disease but pays little attention to preventive actions. This article highlights obesity prevalence in Nepal, delineates the challenges identified by our pilot study (including low health literacy rates), and suggests strategies to overcome this trend.

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