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  • 1.
    Andersson, Susanne
    et al.
    University of Skövde, School of Life Sciences. Institute of Health and Care Sciences, The Sahlgrenska Academy of the University of Gothenburg, Gothenburg, Sweden.
    Ekman, Inger
    Institute of Health and Care Sciences, The Sahlgrenska Academy of the University of Gothenburg, Gothenburg, Sweden / Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
    Friberg, Febe
    Institute of Health and Care Sciences, The Sahlgrenska Academy of the University of Gothenburg, Gothenburg, Sweden / Faculty of Social Sciences, Department of Health, University of Stavanger, Stavanger, Norway.
    Bøg-Hansen, Erik
    Institute of Medicine, Department of Primary Health Care, The Sahlgrenska Academy of the University of Gothenburg, Gothenburg, Sweden.
    Lindblad, Ulf
    Institute of Medicine, Department of Primary Health Care, The Sahlgrenska Academy of the University of Gothenburg, Gothenburg, Sweden / The Department of primary health care, University of Gothenburg, Gothenburg, Sweden.
    The association between self-reported lack of sleep, low vitality and impaired glucose tolerance: A Swedish cross-sectional study2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, no 1, article id 700Article in journal (Refereed)
    Abstract [en]

    Background: The increased incidence of impaired glucose tolerance (IGT), are serious public health issues, and several studies link sleeping disorders with increased risk of developing type 2 diabetes, impaired glucose tolerance and insulin resistance (IR). This study explore how self-reported lack of sleep and low vitality, are associated with IGT in a representative Swedish population. Methods. A cross-sectional survey conducted in two municipalities in South-western Sweden. Participants aged 30-75 were randomly selected from the population in strata by sex and age. Altogether, 2,816 participants were surveyed with a participation rates at 76%. Participants with normal glucose tolerance (n=2,314), and those with IGT (n=213) were retained for analyses. The participants answered a questionnaire before the oral glucose tolerance test (OGTT). Associations for questions concerning sleeping disorders, vitality and IGT were analysed using logistic regression and were expressed as odds ratios (OR) with 95% CI. Results: In men a statistically significant age-adjusted association was found between self-reported lack of sleep and IGT: OR 2.4 (95% CI: 1.1-5.4). It did not weaken after further adjustment for body mass index (BMI), smoking, education, and leisure time physical activity 2.3 (1.0-5.5, p=0.044). No such associations were found in females. Corresponding age-adjusted associations between low vitality and IGT in both men 2.8 (1.3-5.8), and women 2.0 (1.2-3.4) were successively lost with increasing adjustment. Conclusions: Insufficient sleep seems independently associated with IGT in men, while low vitality was not independently associated with IGT neither in men nor women, when multiple confounders are considered. IGT should be considered in patients presenting these symptoms, and underlying mechanisms further explored. © 2013 Andersson et al.; licensee BioMed Central Ltd.

  • 2.
    Arvidsson, Louise
    et al.
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hunsberger, Monica
    Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    De Bourdeaudhuij, Ilse
    Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium.
    Molnar, Denes
    Department of Paediatrics, Clinical Center, University of Pécs, Pecs, Hungary.
    Jilani, Hannah
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, Bremen, 283 59, Germany.
    Thumann, Barbara
    Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, Bremen, 283 59, Germany.
    Veidebaum, Toomas
    National Institute for Health Development, Tallinn, Estonia.
    Russo, Paola
    Institute of Food Sciences, CNR Via Roma, Avellino, 64-83100, Italy.
    Tornatitis, Michael
    Research and Education Institute of Child Health REF, Strovolos, Cyprus.
    Santaliestra-Pasías, Alba M
    GENUD (Growth Exercise, Nutrition, and Development) Research Group, University of Zaragoza; Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Pala, Valeria
    Nutritional Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCSS Istituto Nazionale Dei Tumori, Milan, Italy.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine (EPSO), Sahlgrenska Academy, University of Gothenburg, Box 453, Gothenburg, 405 30, Sweden.
    Bidirectional associations between psychosocial well-being and adherence to healthy dietary guidelines in European children: prospective findings from the IDEFICS study2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, no 1, article id 926Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In children the relationship between a healthy diet and psychosocial well-being has not been fully explored and the existing evidence is inconsistent. This study investigates the chronology of the association between children's adherence to healthy dietary guidelines and their well-being, with special attention to the influence of weight status on the association.

    METHODS: Seven thousand six hundred seventy five children 2 to 9 years old from the eight-country cohort study IDEFICS were investigated. They were first examined between September 2007 and June 2008 and re-examined again 2 years later. Psychosocial well-being was measured using self-esteem and parent relations questions from the KINDL® and emotional and peer problems from the Strengths and Difficulties Questionnaire. A Healthy Dietary Adherence Score (HDAS) was calculated from a 43-item food frequency questionnaire as a measure of the degree to which children's dietary intake follows nutrition guidelines. The analysis employed multilevel logistic regression (country as random effect) with bidirectional modeling of dichotomous dietary and well-being variables as both exposures and outcomes while controlling for respective baseline values.

    RESULTS: A higher HDAS at baseline was associated with better self-esteem (OR 1.2, 95% CI 1.0;1.4) and fewer emotional and peer problems (OR 1.2, 95% CI 1.1;1.3 and OR 1.3, 95% CI 1.2;1.4) 2 years later. For the reversed direction, better self-esteem was associated with higher HDAS 2 years later (OR 1.1 95% CI 1.0;1.29). The analysis stratified by weight status revealed that the associations between higher HDAS at baseline and better well-being at follow-up were similar in both normal weight and overweight children.

    CONCLUSION: Present findings suggest a bidirectional relation between diet quality and self-esteem. Additionally, higher adherence to healthy dietary guidelines at baseline was associated with fewer emotional and peer problems at follow-up, independent of children's weight status.

  • 3.
    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.

  • 4.
    Lindmark, Ulrika
    et al.
    Centre for Oral Health, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Sweden.
    Ahlstrand, Inger
    Department of Rehabilitation, School of Health and Welfare, Jönköping University, Sweden.
    Ekman, A.
    Department of Social Work, School of Health and Welfare, Jönköping University, Sweden.
    Berg, L.
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hedén, Lena
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Sweden.
    Källstrand, Jeanette
    School of Health and Welfare, Halmstad University, Sweden.
    Larsson, Margaretha
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR).
    Nunstedt, Håkan
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Oxelmark, Lena
    Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Pennbrant, Sandra
    Department of Health Sciences, University West, Trollhättan, Sweden.
    Sundler, Annelie
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Sweden.
    Larsson, Ingrid
    School of Health and Welfare, Halmstad University, Sweden.
    Health-promoting factors in higher education for a sustainable working life: protocol for a multicenter longitudinal study2020In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 20, no 1, article id 233Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.

  • 5.
    Nilsson, Kerstin
    et al.
    University of Skövde, School of Life Sciences.
    Hertting, Anna
    National Institute for Psychosocial Medicine (IPM), Stockholm, Sweden.
    Petterson, Inga-Lill
    Department of Public Health Sciences, Department of Occupational and Environmental Health, Stockholm, Sweden.
    Theorell, Töres
    National Institute for Psychosocial Medicine (IPM), Stockholm, Sweden.
    Pride and confidence at work: potential predictors of occupational health in a hospital setting2005In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 5, p. 92-Article in journal (Refereed)
    Abstract [en]

    Background

    This study focuses on determinants of a healthy work environment in two departments in a Swedish university hospital. The study is based on previously conducted longitudinal studies at the hospital (1994–2001), concerning working conditions and health outcomes among health care personnel in conjunction with downsizing processes. Overall, there was a general negative trend in relation to mental health, as well as long-term sick leave during the study period. The two departments chosen for the current study differed from the general hospital trend in that they showed stable health development. The aim of the study was to identify and analyse experiential determinants of healthy working conditions.

    Methods

    Thematic open-ended interviews were carried out with seventeen managers and key informants, representing different groups of co-workers in the two departments. The interviews were transcribed verbatim and an inductive content analysis was made.

    Results

    In the two studied departments the respondents perceived that it was advantageous to belong to a small department, and to work in cooperation-oriented care. The management approaches described by both managers and co-workers could be interpreted as transformational, due to a strain of visionary, delegating, motivating, confirmative, supportive attitudes and a strongly expressed solution-oriented attitude. The daily work included integrated learning activities. The existing organisational conditions, approaches and attitudes promoted tendencies towards a work climate characterised by trust, team spirit and professionalism. In the description of the themes organisational conditions, approaches and climate, two core determinants, work-pride and confidence, for healthy working conditions were interpreted. Our core determinants augment the well-established concepts: manageability, comprehensiveness and meaningfulness. These favourable conditions seem to function as a buffer against the general negative effects of downsizing observed elsewhere in the hospital, and in the literature.

    Conclusion

    Research illuminating health-promoting aspects is rather unusual. This study could be seen as explorative. The themes and core dimensions we found could be used as a basis for further intervention studies in similar health-care settings. The result could also be used in future health promotion studies in larger populations. One of the first steps in such a strategy is to formulate relevant questions, and we consider that this study contributes to this.

  • 6.
    Regber, Susann
    et al.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Novak, Masuma
    Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Hense, Sabrina
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Sandstrom, Tatiana Zverkova
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Ahrens, Wolfgang
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Marild, Staffan
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Assessment of selection bias in a health survey of children and families - the IDEFICS Sweden-study2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 418Article in journal (Refereed)
    Abstract [en]

    Background: A health survey was performed in 2007-2008 in the IDEFICS/Sweden study (Identification and prevention of dietary-and lifestyle-induced health effects in children and infants) in children aged 2-9 years. We hypothesized that families with disadvantageous socioeconomic and -demographic backgrounds and children with overweight and obesity were underrepresented. Methods: In a cross-sectional study, we compared Swedish IDEFICS participants (N=1,825) with referent children (N=1,825) using data from Statistics Sweden population registers. IDEFICS participants were matched for age and gender with a referent child living in the same municipality. Longitudinal weight and height data from birth to 8 years was collected for both populations (n=3,650) from the children's local health services. Outcome measures included the family's socioeconomic and demographic characteristics, maternal body mass index (BMI) and smoking habits before pregnancy, the children's BMI standard deviation score (SDS) at the age of inclusion in the IDEFICS study (BMISDS-index), and the children's BMI-categories during the age-span. Comparisons between groups were done and a multiple logistic regression analysis for the study of determinants of participation in the IDEFICS study was performed. Results: Compared with IDEFICS participants, referent families were more likely to have lower education and income, foreign backgrounds, be single parents, and have mothers who smoked before pregnancy. Maternal BMI before pregnancy and child's BMISDS-index did not differ between groups. Comparing the longitudinal data-set, the prevalence of obesity was significantly different at age 8 years n=45 (4.5%) versus n=31 (2.9%) in the referent and IDEFICS populations, respectively. In the multivariable adjusted model, the strongest significant association with IDEFICS study participation was parental Swedish background (odds ratio (OR) = 1.91, 95% confidence interval (CI) (1.48-2.47) followed by parents having high education OR 1.80, 95% CI (1.02-3.16) and being married or co-habiting OR 1.75 95% CI (1.38-2.23). Conclusion: Families with single parenthood, foreign background, low education and income were underrepresented in the IDEFICS Sweden study. BMI at inclusion had no selection effect, but developing obesity was significantly greater among referents.

  • 7.
    Ydreborg, Berit
    et al.
    Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden / National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Ekberg, Kerstin
    National Centre for Work and Rehabilitation, Department of Health and Society, Linköping University, Linköping, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Swedish social insurance officers' experiences of difficulties in assessing applications for disability pensions: an interview study2007In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 7, p. 128-Article in journal (Refereed)
    Abstract [en]

    Background

    In this study the focus is on social insurance officers judging applications for disability pensions. The number of applications for disability pension increased during the late 1990s, which has resulted in an increasing number of disability pensions in Sweden. A more restrictive attitude towards the clients has however evolved, as societal costs have increased and governmental guidelines now focus on reducing costs. As a consequence, the quantitative and qualitative demands on social insurance officers when handling applications for disability pensions may have increased. The aim of this study was therefore to describe the social insurance officers' experiences of assessing applications for disability pensions after the government's introduction of stricter regulations.

    Methods

    Qualitative methodology was employed and a total of ten social insurance officers representing different experiences and ages were chosen. Open-ended interviews were performed with the ten social insurance officers. Data was analysed with inductive content analysis.

    Results

    Three themes could be identified as problematic in the social insurance officers' descriptions of dealing with the applications in order to reach a decision on whether the issue qualified applicants for a disability pension or not: 1. Clients are heterogeneous. 2. Ineffective and time consuming waiting for medical certificates impede the decision process. 3. Perspectives on the issue of work capacity differed among different stakeholders. The backgrounds of the clients differ considerably, leading to variation in the quality and content of applications. Social insurance officers had to make rapid decisions within a limited time frame, based on limited information, mainly on the basis of medical certificates that were often insufficient to judge work capacity. The role as coordinating actor with other stakeholders in the welfare system was perceived as frustrating, since different stakeholders have different goals and demands. The social insurance officers experience lack of control over the decision process, as regulations and other stakeholders restrict their work.

    Conclusion

    A picture emerges of difficulties due to disharmonized systems, stakeholder-bound goals causing some clients to fall between two stools, or leading to unnecessary waiting times, which may limit the clients' ability to take an active part in a constructive process. Increased communication with physicians about how to elaborate the medical certificates might improve the quality of certificates and thereby reduce the clients waiting time.

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