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  • 1.
    Brattwall, M.
    et al.
    Sahlgrenska University Hospital.
    Warrén Stomberg, Margareta
    University of Skövde, School of Life Sciences.
    Rawal, N.
    Örebro University Hospital.
    Segerdahl, M.
    Karolinska Institute.
    Houltz, E.
    Sahlgrenska University Hospital.
    Jakobsson, J.
    Karolinska Institute.
    Patient assessed health profile: A six-month quality of life questionnaire survey after day surgery2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 6, p. 574-579Article in journal (Refereed)
    Abstract [en]

    Aim: Patient assessed quality of life is one of the principal end-points after day surgery. The aim of the present study was to describe the natural course, differences and timing of final evaluation for three common day surgical procedures; inguinal hernia repair (IHR), arthroscopic procedures (AS); and cosmetic breast augmentation (CBA). Method: A total of 355 patients prospectively completed an extended eight-item EQ-5D questionnaire (pain, mobility, mood, self-care, activities, sleep, sex, need for analgesic), preoperatively and at one, three and six months postoperatively. Results: Pain and mobility problems were frequently reported prior to surgery among IHR and AS patients, while CBA patients had less deviation from normal in the preoperative health profile. The proportions of patients reporting surgery-related deviations were 35%, 20% and 5% at one, three and six months respectively. After one month, 50% of AS patients still suffered subjective discomfort as compared to 13% and 20% of the IHR and CBA patients, respectively. Pain and ambulation problems were the most common symptoms in all groups. Six months after surgery, 94% of IHR, 89% of AS and 97% of CBA patients were fully recovered. Conclusions: No major morbidity or severe complications were observed and patients’ satisfaction was high overall. We found procedure-specific changes in the postoperative health profile after day surgery. AS patients recovered more slowly compared with IHR and CBA patients. We conclude that time for final evaluation differs significantly between procedures.

  • 2.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Matthiesen, Ann-Sofi
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden / Department of Statistics, University of Stockholm, Stockholm, Sweden.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Breastfeeding attitudes among counselling health professionals: Development of an instrument to describe breastfeeding attitudes2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 5, p. 353-359Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to develop an instrument that can be used for accurate assessment of nurses' and midwives' attitudes toward breastfeeding in a group of midwives, maternity-nursing staff and postnatal nurses experienced in breastfeeding counselling. Method: An instrument based on WHO standards was developed to measure breastfeeding attitudes. In all, 168 healthcare professionals filled in the instrument. A factor analysis using maximum likelihood and varimax rotation was performed. Spearman's correlation was used to correlate factorial dimensions and self-described interest in breastfeeding. Results: By means of factor analysis four factors were identified: the "regulating" factor focused on regulating the mothers' breastfeeding management, the "facilitating" factor focused on making it easy for mothers to manage their breastfeeding, the "disempowering" factor focused on giving advice, disregarding the needs of the mother being counselled, and the "breastfeeding antipathy" factor focused on insufficient, basic, breastfeeding knowledge and aversive reactions to breastfeeding. Midwives rated higher on the facilitating factor and breastfeeding antipathy factor and lower on the regulating factor than postnatal nurses. Breastfeeding interest was positively correlated with the facilitating factor, and negatively with the disempowering factor and the breastfeeding antipathy factor. Conclusion: This instrument provides a picture of health professionals' attitudes towards breastfeeding. Four factors were identified in order of importance: regulating, facilitating, disempowering, and breastfeeding antipathy factors. Harmful attitudes were identified and suggested a need for educational programmes to help health professionals to reconcile damaging values, in order to improve breastfeeding counselling

  • 3.
    Ekström, Anette
    et al.
    University of Skövde, School of Life Sciences.
    Widström, Ann-Marie
    Department of Woman and Child Health, Division of Reproductive and Perinatal Health Care, Karolinska Institutet, Stockholm, Sweden.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Process-oriented training in breastfeeding alters attitudes to breastfeeding in health professionals2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 6, p. 424-431Article in journal (Refereed)
    Abstract [en]

    Aim: The purpose of the study was to measure the attitudes of antenatal midwives and postnatal nurses to breastfeeding before and after common, process-oriented breastfeeding training. Method: Antenatal centres and child-health centres in 10 municipalities were randomized to either an intervention or a control group. The antenatal midwives and postnatal nurses in the intervention group were together given process-oriented breastfeeding training and were, in addition, asked to develop a common breastfeeding policy. A previously developed instrument was used to measure the effects of a training programme on breastfeeding attitudes among midwives and postnatal nurses. It consisted of four scales measuring a person's attitudes toward breastfeeding in four dimensions: regulating, facilitating, disempowering, and breastfeeding-antipathy attitudes. A mean score was calculated for each individual on these four dimensional scales. The higher the score, the stronger the attitude. Results: After one year, the intervention group reduced their scores on the regulating scale when compared with the control group (p<0.001). The intervention group decreased their scores on the regulating scale and increased their scores on the facilitating scale over the first year after training. The control group also significantly increased their scores on the facilitating scale. When the results were analysed profession-wise, the postnatal nurses in the intervention group decreased their scores on the regulating and disempowering scales and increased their scores on the facilitating scale. In contrast, the midwives in the intervention group decreased their scores only on the breastfeeding antipathy scale. The control group midwives decreased their scores on the disempowering scale. No differences were found among the postnatal nurses in the control group. Conclusion: Process-oriented breastfeeding training made both antenatal midwives and postnatal nurses better disposed to breastfeeding; postnatal nurses in particular improved their attitudes. Attitudes to breastfeeding tended to be stable over time, but process-oriented training lowered the scores a little on the regulating scale, suggesting that after this kind of training counsellors would find it less necessary to schedule and control the mothers' breastfeeding behaviour.

  • 4.
    Hertfelt Wahn, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Nissen, Eva
    University of Skövde, School of Life Sciences.
    Sociodemographic background, lifestyle and psychosocial conditions of swedish teenage mothers and their perception of health and social support during pregnancy and childbirth2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 4, p. 415-423Article in journal (Refereed)
    Abstract [en]

    Aim: Among Swedish pregnant teenage girls it is unusual to continuepregnancy and to choose to have a baby. Swedish teenage motherscan therefore be expected to differ from adult mothers, at agroup level. The aim of this study was to describe and compareteenage mothers who were giving birth in hospital with adultmothers as to sociodemographic background, perception of healthand social support. Methods: A descriptive comparative studywas conducted over one year, in a county in south-western Sweden,which comprised a group of all teenage mothers aged 15—19,who gave birth at hospital (study group n=97) and the same numberof adult mothers aged 25—29, matched for parity and birthof a baby closest to the index mother (reference group). Bothgroups answered a questionnaire regarding sociodemographic variables,lifestyle, health, self-esteem, depressive symptoms, and support.Information on the mothers' pregnancy and delivery was obtainedfrom their maternal health and delivery charts. Results: Teenagemothers had more often been exposed to a difficult family situation,had more often experienced school failure than adult mothers,and showed health-risk behavior. Teenage mothers perceived lesssupport, had lower self-esteem, and more depressive symptomsthan adult mothers. Conclusions: Teenage mothers differed fromadult mothers regarding family situation and health behavioras well as perception of support, self-esteem, and depressivesymptoms, which may negatively influence their ability to copewith parenthood. Efforts should be made early in pregnancy tomeet both health and support needs of teenage mothers.

  • 5.
    Hertting, Anna
    et al.
    Natl. Inst. for Phychosocial Med., Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Nilsson, Kerstin
    University of Skövde, School of Life Sciences.
    Theorell, Töres
    Natl. Inst. for Phychosocial Med., Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Sätterlund Larsson, Ullabeth
    Institute of Health Care Pedagogics, The Sahlgrenska Academy, Göteborg University, Gothenburg, Sweden.
    Assistant Nurses in the Swedish Healthcare Sector during the 1990s: A Hard-hit Occupational Group with a Tough Job2005In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 33, no 2, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of the study was to explore hospital-based assistant nurses' experiences of psychosocial “stressors”, following a period of substantial layoffs (43%) and ongoing healthcare reorganizations. Methods: An interview study was carried out with 11 assistant nurses working in the same hospital. The interviews took place in 1997, in connection with the last round of redundancies, and were followed up in 1998 and then in 2001. Interviews were audiotaped and transcribed; the content was then analysed. Results: Two main themes were identified from the women's perceived stressors: (a) a hard-hit occupational group experiencing “energy-consuming adjustments”, and a “weak position” at the continuing workplace. Job insecurity meant fear of losing valued work tasks in nursing care (de-skilling). The common feature was the duality in the women's descriptions of feeling qualified in nursing care but being treated like a maid, or having intimate practical knowledge but no formal competence; (b) a tougher but underpaid job including “heavy workload” concurrent with “organizational shortcomings”, and “frozen salary trends” with a simultaneous feeling of lacking the power to improve their situation. Conclusions: Our results underscore the importance of the employer's attention to the remaining workers in connection with downsizing, particularly when the reduction of the workforce has been as dramatic as in this case. It is also important to understand the ongoing dilemma (strain) for the assistant nurses, who are faced with increasing demands for further formal qualifications in hospital care, while maintaining a strong occupational desire to keep their highly valued job working close to the patient.

  • 6.
    Jakobsson, Eva
    et al.
    University of Skövde, School of Life Sciences.
    Gaston-Johansson, Fannie
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, SE-40530 Gothenburg, Sweden / Johns Hopkins Sch Nursing, Baltimore, MD USA.
    Öhlén, Joakim
    Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, SE-40530 Gothenburg, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 2, p. 177-182Article in journal (Refereed)
    Abstract [en]

    To improve the understanding of specific clinical problemsat the end of life, including the role of advancing age, physicalfunction and cognitive function. Methods: The study is partof an explorative survey of data relevant to end-of-life healthcareservices during the last 3 months of life of a randomly selectedsample of the population of a Swedish county. Data were selectedthrough retrospective reviews of death certificates and medicalrecords, and comprise information from 12 municipalities and229 individuals. Results: A range of prevalent concerns wasfound. Overall deterioration, urinary incontinence, constipation,impaired skin integrity, anxiety and sleep disturbances weresignificantly associated with dependency on others for activitiesof daily living; pulmonary rattles and swallowing disturbanceswere associated with cognitive disorientation; excepting cough,advancing age did not have significant impacts on these prevalentclinical concerns. Conclusions: A range of distressing conditionsconstitute a common pathway for many individuals at or nearthe end of life. The incorporation of health promotion as aprinciple of palliative care will probably benefit individualsat the end of life, and includes a proactive focus and emphasison enhanced well-being at the time of diagnosis of a life-threateningillness. For individuals with physical and cognitive limitationsimparting a state of dependency, it is reasonable to provideassurance of care for individuals' specific needs by professionalswith both training for and competence in this special and sometimesunique clinical environment.

  • 7.
    Krettek, Alexandra
    et al.
    Nordic School of Public Health NHV, Gothenburg, Sweden / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Leena Eklund
    Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
    Toan, Tran Khanh
    Department of Family Medicine, Hanoi Medical University, Hanoi, Vietnam.
    Thi Kim Chuc, Nguyen
    Department of Family Medicine, Hanoi Medical University, Hanoi, Vietnam.
    Nordic School of Public Health NHV and its legacy in global health2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 16 suppl, p. 36-45Article in journal (Refereed)
    Abstract [en]

    This article describes the legacy of the Nordic School of Public Health NHV (NHV) in global health. We delineate how this field developed at NHV and describe selected research and research training endeavours with examples from Vietnam and Nepal as well as long-term teaching collaborations such as BRIMHEALTH (Baltic RIM Partnership for Public HEALTH) in the Baltic countries and Arkhangelsk International School of Public Health in Russia.

  • 8.
    Medin, Jennie
    et al.
    Nordic Council of Ministers, Nordic School of Public Health, Göteborg, Sweden.
    Krettek, Alexandra
    Nordic Council of Ministers, Nordic School of Public Health, Göteborg, Sweden.
    An apple a day keeps the doctor away: interdisciplinary approaches to solving major public health threats2008In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 36, no 8, p. 857-858Article in journal (Refereed)
  • 9.
    Weimann, Hanna
    et al.
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Björk, Jonas
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Rylander, Lars
    Lund Univ, Div Occupat & Environm Med, S-22185 Lund, Sweden.
    Bergman, Patrick
    Linnaeus Univ, Dept Sport Sci, Kalmar, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Neighborhood environment and physical activity among young children: A cross-sectional study from Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 283-293Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to investigate the association between the neighbourhood environment and physical activity among young children in a Scandinavian setting, and to assess the influences of seasonal variations, age, sex and parental education. Methods: Physical activity was assessed with an accelerometer and neighbourhood resources were estimated using geographic information systems for 205 Swedish children aged 4-11 years. Neighbourhood resources were generated as the sum of three neighbourhood attributes: (a) foot and bike paths, (b) non-restricted destinations and (c) recreational area, all within 300 m of each child's home. Physical activity was assessed as: (a) total volume of physical activity (i.e. counts per minute), (b) sedentary time and (c) moderate to vigorous physical activity (MVPA). The association between neighbourhood resources and physical activity was analysed using mixed linear models weighted by measurement time and adjusted for sex, age, season of activity measurement, type of housing and parental education. Results: Children were more physically active in areas with intermediate access to neighbourhood resources for physical activity compared to areas with worst access, while the difference between intermediate and best neighbourhood resource areas was less clear. The association between physical activity and neighbourhood resources was weaker than with seasonal variations but compatible in magnitude with sex, age, type of housing and parental education. Among specific neighbourhood attributes, the amount of foot and bike paths was associated with less sedentary time and more MVPA. Conclusions:This study provides some, not entirely consistent, evidence overall for an association between the neighbourhood environment and physical activity among young children in Scandinavia.

  • 10.
    Wiberger, Maja
    et al.
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Lisner, Lauren
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Mehlig, Kirsten
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Papoutsou, Stalo
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Hunsberger, Monica
    Univ Gothenburg, Dept Publ Hlth Epidemiol & Community Med, SE-40530 Gothenburg, Sweden.
    Children consuming milk cereal drink are at increased risk for overweight: The IDEFICS Sweden study, on behalf of the IDEFICS Consortium2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 6, p. 518-524Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to characterize milk cereal drink (MCD) consumption among Swedish children and to investigate the association between MCD and overweight in a longitudinally followed cohort of children over 2 years of age. Methods: In the Swedish cohort from IDEFICS (Identification and prevention of Dietary-and lifestyle-induced health EFfects In Children and infantS) we examined early feeding practices and weight status when children were aged 2-9 years (2007/2008) and at 2-year follow-up. Weight and height were measured at both time points in 1077 children. Characteristics of MCD consumers were explored with logistic regression. Body mass index (BMI) z-scores at both time points and weight status at follow-up were regressed on explanatory factors using mixed linear and logistic regression, respectively. Results: Nearly 69% of children had consumed MCD. The MCD consumers were more likely than never-consumers to have two native Swedish parents, parents with less than 2 years of post-secondary education, and a shorter period of breastfeeding. MCD consumers had a higher BMI z-score at follow-up compared with baseline (difference in BMI z-score=0.12, 95% confidence interval (CI)= 0.07, 0.17), while the average BMI z-score in non-consumers remained stable over time (0.00, 95% CI= -0.07, 0.07). MCD consumers were nearly five times more likely than non-consumers to become overweight during the follow-up (odds ratio (OR)= 4.78, 95% CI= 1.68, 13.59), independent of breastfeeding. Conclusions: MCD was consumed by the majority of children in this study. MCD consumption is associated with an increased risk for overweight and less exposure to breastfeeding. Our findings motivate future research aimed at investigating how MCD should be recommended.

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