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  • 1151.
    Thorén, Ulrika
    et al.
    University of Skövde, School of Health and Education.
    Ljunghaga, Jenny
    University of Skövde, School of Health and Education.
    Faktorer som kan leda till övervikt och fetma hos mammor och barn med låg socioekonomisk status2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Övervikt och fetma är ett globalt, betydande växande hälsoproblem som verkar vara ett särskilt problem i familjer som lever under låga socioekonomiska förhållanden och ofta finns det ett samband mellan moderns och barnets övervikt och fetma.

    Syfte: Att undersöka vilka faktorer som kan leda till övervikt och fetma hos mödrar och barn med låg socioekonomisk status.

    Metod: Denna studie är en analytisk litteraturstudie med ett systematiskt tillvägagångssätt. Elva vetenskapliga artiklar har granskats och analyserats i syfte att finna möjliga samband mellan mammors och barns fetma.

    Resultat: Det finns flera multifaktoriella orsaker som kan bidra till ohälsa hos föräldrar, framför allt ensamstående mödrar. Inkomst, utbildning, familjeförhållanden, kunskap och känslomässiga aspekter är faktorer som kan ligga bakom övervikt och fetma hos både mamma och barn.

    Slutsats: Slutsatsen av denna litteraturstudie var att övergripande förstå och identifiera faktorer som kan kopplas till övervikt och fetma i familjer med låg socioekonomisk status och därigenom få kunskap om var insatser kan implementeras

  • 1152.
    Thräff, Madeleine
    et al.
    University of Skövde, School of Health and Education.
    Arvidsson, Amanda
    University of Skövde, School of Health and Education.
    Behov av stöd vid nydiagnostiserad bröstcancer: En litteraturöversikt som beskriver kvinnors upplevelser2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 1153.
    Thörn, Anton
    et al.
    University of Skövde, School of Health and Education.
    Ehn, Julia
    University of Skövde, School of Health and Education.
    Ett skadat hjärta: En litteraturbaserad studie ur ett patientperspektiv2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Myocardial infarction is one of the leading causes of premature death in Sweden. A myocardial infarction is largely lifestyle-related where habits such as smoking, unhealthy eating habits and low physical activity levels are risk factors. To suffer from a myocardial infarction requires a change in the patient’s invasive lifestyle. The nurse has the task of supporting the patient to a better health, provide person-centered care, identify risks and design an individual plan for recovery. The Aim: of this study was to illuminate patients’ experiences of life after a myocardial infarction. Method: A literature-based study with 10 qualitative articles. Results: After a myocardial infarction there were restraints in everyday life that consisted of physical and mental strains. It was found that mental health problems were the most difficult to control and of which many were unprepared. Receiving support in lifestyle changes, feeling a sense of security and daring to be active again was of significant importance. The results showed that support from close relatives and nurses was important for the patients’ recovery. Conclusion: After the myocardial infarction, patients got to learn how to live a new life. New habits and values needed to be created to achieve a sustainable and healthy life. Support, security, a good strategy and motivation were essential for a successful recovery.

  • 1154.
    Tilles-Tirkkonen, Tanja
    et al.
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
    Nuutinen, Outi
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland.
    Liukkonen, Jarmo
    Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland.
    Poutanen, Kaisa
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland / VTT—Technical Research Centre of Finland, Finland.
    Karhunen, Leila
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland / Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland.
    Preliminary Finnish measures of eating competence suggest association with health-promoting eating patterns and related psychobehavioral factors in 10-17 year old adolescents2015In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 7, no 5, p. 3828-3846Article in journal (Refereed)
    Abstract [en]

    Eating competence is an attitudinal and behavioral concept, based on The Satter Eating Competence Model. In adults, it has been shown to be associated with a higher quality of diet. Eating competence or its association with the quality of diet has not been studied in adolescents. The aim of the current study was to explore the utility of using a preliminary Finnish translation of the ecSI 2.0 for evaluating presumed eating competence and its association with food selection, meal patterns and related psychobehavioral factors in 10-17 year old adolescents. Altogether 976 10-17 years old Finnish adolescents filled in the study questionnaire. When exploring the construct validity of ecSI 2.0, the confirmatory factor analysis (CFA) indicated acceptable model fit and all four components of the ecSI 2.0 (eating attitudes, food acceptance, internal regulation of food intake, management of eating context) correlated with each other and were internally consistent. Over half (58%) of the adolescents scored 32 or higher and were thus classified as presumably eating competent (pEC). Eating competence was associated with greater meal frequency, more frequent consumption of vegetables and fruits, and more health-promoting family eating patterns. In addition the pEC, adolescents more often perceived their body size as appropriate, had less often tried to lose weight and had a higher self-esteem and a stronger sense of coherence than the not pEC ones. Family eating patterns and self-esteem were the main underlying factors of eating competence. In conclusion, this preliminary study suggests eating competence could be a useful concept to characterize eating patterns and related behaviors and attitudes in adolescents. However, these preliminary findings need to be confirmed in further studies with an instrument fully validated for this age group.

  • 1155.
    Timpka, Toomas
    et al.
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    Jacobsson, Jenny
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    Bickenbach, Jerome
    Department of Philosophy, Queen’s University, Kingston, ON, Canada.
    Finch, Caroline F.
    Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC, Australia.
    Ekberg, Joakim
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nordenfelt, Lennart
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    What is a Sports Injury?2014In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 44, no 4, p. 423-428Article in journal (Refereed)
    Abstract [en]

    Current sports injury reporting systems lack a common conceptual basis. We propose a conceptual foundation as a basis for the recording of health problems associated with participation in sports, based on the notion of impairment used by the World Health Organization. We provide definitions of sports impairment concepts to represent the perspectives of health services, the participants in sports and physical exercise themselves, and sports institutions. For each perspective, the duration of the causative event is used as the norm for separating concepts into those denoting impairment conditions sustained instantly and those developing gradually over time. Regarding sports impairment sustained in isolated events, sports injury denotes the loss of bodily function or structure that is the object of observations in clinical examinations; sports trauma is defined as an immediate sensation of pain, discomfort or loss of functioning that is the object of athlete self-evaluations; and sports incapacity is the sidelining of an athlete because of a health evaluation made by a legitimate sports authority that is the object of time loss observations. Correspondingly, sports impairment caused by excessive bouts of physical exercise is denoted as sports disease (overuse syndrome) when observed by health service professionals during clinical examinations, sports illness when observed by the athlete in self-evaluations, and sports sickness when recorded as time loss from sports participation by a sports body representative. We propose a concerted development effort in this area that takes advantage of concurrent ontology management resources and involves the international sporting community in building terminology systems that have broad relevance.

  • 1156.
    Timpka, Toomas
    et al.
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Schyllander, Jan
    Swedish Civil Contingencies Agency, Karlstad, Sweden.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Public Health Sciences, Walden University, Minneapolis, MN, USA.
    Ekman, Robert
    Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
    Dahlström, Örjan
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Hägglund, Martin
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Kristenson, Karolina
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Jacobsson, Jenny
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 1, p. 94-99Article in journal (Refereed)
    Abstract [en]

    Background: Despite the popularity of the sport, few studies have investigated community-level football injury patterns. This study examines football injuries treated at emergency medical facilities using data from three Swedish counties.

    Methods: An open-cohort design was used based on residents aged 0-59 years in three Swedish counties (pop. 645 520). Data were collected from emergency medical facilities in the study counties between 1 January 2007 and 31 December 2010. Injury frequencies and proportions for age groups stratified by sex were calculated with 95% confidence intervals (95% CIs) and displayed per diagnostic group and body location.

    Results: Each year, more than 1/200 person aged 0-59 years sustained at least one injury during football play that required emergency medical care. The highest injury incidence was observed among adolescent boys [2009 injuries per 100 000 population years (95% CI 1914-2108)] and adolescent girls [1413 injuries per 100 000 population years (95% CI 1333-1498)]. For female adolescents and adults, knee joint/ligament injury was the outstanding injury type (20% in ages 13-17 years and 34% in ages 18-29 years). For children aged 7-12 years, more than half of the treated injuries involved the upper extremity; fractures constituted about one-third of these injuries.

    Conclusions: One of every 200 residents aged 0-59 years in typical Swedish counties each year sustained a traumatic football injury that required treatment in emergency healthcare. Further research on community-level patterns of overuse syndromes sustained by participation in football play is warranted.

  • 1157.
    Tinasdotter, Camilla
    et al.
    University of Skövde, School of Health and Education.
    Hildingsson, Jacqueline
    University of Skövde, School of Health and Education.
    Skolsköterskors inställning till hälsofrämjande arbete på gruppnivå2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The school nurse’s duties have changed over time, from medical contributions at the individual level to a focus on promoting health at individual-, group- and organizational levels. Swedish school law, guidelines and competence description describes that school nurses’ work methods should be promoting health and be preventative at the group level. Nevertheless, today, the school nurse’s work is mainly done on an individual level. Purpose: The purpose of the study was to highlight school nurses’ attitude towards their assignment in focusing on health promoting work at the group level. Method: A qualitative method was used. Semi-structured telephone interviews with ten school nurses in Sweden were conducted. The data was analysed with a qualitative content analysis method and with an inductive approach, on a latent level. Result: The analysis resulted in two categories; The school nurse’s professional role and role change and Work Structure and Organization, with five subcategories; Focus from curative efforts to promote health promotion; School nurse's broad health promotion potential; No clear job descriptions; Priority of tasks and Responsibility of the whole school. Conclusion: The school nurses have unique skills being the only school profession that meets all students from a medical, care and salutogenic perspective. School nurses would like to work more health promotive at group level than what is currently done. With the right conditions, the school nurse would have a greater opportunity to work with health promotion at the group level.

  • 1158.
    Tipán Diaz, Ana Belen
    et al.
    University of Skövde, School of Health and Education.
    Arrobang Diesta, Mary Ann
    University of Skövde, School of Health and Education.
    Sjuksköterskans upplevelser av transkulturell omvårdnad. –I palliativ vård-2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sweden has become a multicultural country which means that nurses encounter patients from diverse cultural backgrounds that in need of palliative care, this makes it important to examine the ability of nurse on how to deal with difficulties that may occur in the caring for patients in transcultural palliative care.The purpose of this study is to describe nurse’s experience in transcultural palliative care. A literature review based on 11 articles describing nurse’s experiences in transcultural palliative care. The articles used in the study are qualitative articles and has been researched in the database CINAHL, Medline and PubMed.The results show that communication has a vital part in providing a quality care for patients with different cultural backgrounds. An understanding of the patient's verbal and non-verbal communication is essential in order to create a good relationship between the nurse and the patient in palliative care. Using an interpreter requires that the nurse has the skills and knowledge of how to communicate through an interpreter in order to overcome communication barriers. The results show that different cultural beliefs can create challenges in transcultural nursing in palliative care. The nurse's knowledge of cultural differences is important in order to avoid misunderstandings and conflicts. The result also shows that awareness, cultural sensitivity, patient autonomy and the family, are the factors that are important to give a good transcultural nursing in palliative care.The thesis shows that nurses' general knowledge about cultural sensitivity, respect and openness to different cultural differences and empathy may be important prerequisites for avoiding cultural challenges in transcultural nursing in palliative care. The nurse's ability to provide care that is personalized with a holistic view of the patient's situation and good communication is essential in order to perform good transcultural nursing in palliative care.

  • 1159.
    Tivell, Frida
    University of Skövde, School of Health and Education. a15friti@student.his.se.
    Mäns erfarenheter av komplikationer efter radikal prostatektomi: En litteraturbaserad studie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Prostate cancer is the most common form of cancer among men and has increased over the past decade. Radical prostatectomy is a common treatment for prostate cancer, however, the procedure may involve a high risk of complications such as incontinence and erectile dysfunction. Aim: The aim was to describe men's experiences of complications after radical prostatectomy.Methods: A literature based study with a qualitative approach based on 10 scientific articles.Results: From the analysis two main categories emerged; A changed cohabitation and need for strategies with five subcategories.Conclusion: The Nurse's task is to provide individualized information prior to surgery about possible complications associated with surgery after surgery. In order to alleviate suffering, the nurse should listen to men, identify their needs, and teach them in sexuality to improve their quality of life. The nurse should also include men's partners in the care process as well as help men and support as well as advise to help them find a new positive sex life.

  • 1160.
    Tiverman, Margareta
    et al.
    University of Skövde, School of Health and Education.
    Harju, Sofia
    University of Skövde, School of Health and Education.
    ATT LÄRA UT SVENSKA TILL BARN MED ANNAT MODERSMÅL: En kvalitativ studie om hur pedagoger lär två och flerspråkiga barn svenska2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study is to examine how an educator within preschool is working in order to learn out the Swedish language to children with a mother tongue other than Swedish. By learning we mean that children actively and consciously appropriate themselves something new that they do not have knowledge of since before. The study is conducted with a focus on interactions in gatherings, and interviews with educators. Our theoretical support is based on a sociocultural perspective since we have examined different interactions as well as teachers' awareness at language learning. In the result, we have been able to see that clear communication, concretization of the language and repetition as a form of education has got a big significant impact in the learning of the Swedish language. We also investigated whether there were any deliberate strategies for teaching the Swedish language in preschools. Based on the results we alerted that most educators working for strategies that they are not aware of. The teachers believe that they are going far with the experience they have gained through working with children with a mother tongue. Most of the teachers who participated in the study does not consider that it requires no special knowledge to work with two and multilingual children.

  • 1161.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elaiwy, Orwa
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Obaid, Munzir
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Al-Yahri, Omer
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Abdelazim, Sherif
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    First sliding Amyand hernia harbouring appendicular schistosomiasis: Case report2019In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 63, p. 143-146Article in journal (Refereed)
    Abstract [en]

    Introduction: Amyand's hernia (AH) is rare, schistosomiasis of the appendix is very uncommon, and both conditions coexisting together is an extremely rare event. Pre-operative diagnosis of each of the two conditions is usually difficult. To the best of our knowledge, the current paper is first to report both these two conditions in coexistence. Presentation of case: A 31-year old man who had no comorbidities was admitted electively as a day case of non-complicated right indirect inguinal hernia. Further history and physical examination were unremarkable. Intraoperatively the patient was found to have right sliding AH with appendicular schistosomiasis (AS). The patient underwent Lichtenstein repair of the hernia with appendectomy. On follow up he was referred to infectious disease clinic, and the post-operative course was uneventful. Conclusions: Intraoperative identification of non-typical hernia sac before its opening should alert the surgeon to the possibility of sliding hernia and the presence of an organ as a part of the sac. Rare causes of appendicular masses like schistosomiasis granuloma should be considered in endemic areas or immigrants from these areas, despite the difficulty of preoperative diagnosis. Management should follow general guidelines of appendectomy, hernia repair and dealing with the associated pathology if present. 

  • 1162.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Ramzee, Ahmed Faidh
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Afana, Mohammad
    Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
    Aljohary, Hesham
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Rare presentation of primary varicella zoster as fatal fulminant hepatitis in adult on low-dose, short-term steroid: Case report2019In: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 48, p. 115-117Article in journal (Refereed)
    Abstract [en]

    Background: Varicella zoster virus presents clinically as primary (chickenpox) or secondary (herpes zoster) infection. Cutaneous and extracutaneous dissemination may occur, usually in immunocompromised patients. VZV hepatitis that progresses to fulminant hepatic failure is very rare and fatal. To the best of our knowledge, 9 cases have been reported to date, of which 7 were in immunocompromised adults, and only one patient was on short duration steroid therapy. Presentation of case: We present a 26-year old man who was admitted initially with acute abdomen as query persistent biliary colic. Later, he showed clinical and laboratory findings of VZV hepatitis that progressed rapidly despite maximal medical ICU support and he expired on day 3 of admission. Conclusions: Acute VZV infection may present as fulminant hepatitis. The presentation may initially be challenging for the diagnosis and should be considered if the patient has been in contact with a sick case. Low dose corticosteroid could carry a risk for fatal VZV fulminant hepatitis and should be used very cautiously especially with VZV patients’ contacts. Further causative relationships remain to be established. 

  • 1163.
    Tolonen, Emma
    et al.
    University of Skövde, School of Health and Education.
    Karlsson, Josephine
    University of Skövde, School of Health and Education.
    Kvinnor i Försvarsmakten: En kvalitativ studie om hur kvinnor påverkas inom ett mansdominerat yrke2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna studie syftar till att ge en djupare förståelse för hur kvinnor påverkas och svarar upp på förväntningar som förekommer vid en mansdominerad arbetsplats. Trots den svenska framgången inom jämställdhet finns det än idag arbetsplatser som fortfarande är mansdominerade där kvinnorna kan ha svårt att finna sin roll vilket bidrar till fortsatt ojämställd arbetsmarknad. Forskarna har valt en kvalitativ ansats med symbolisk interaktionism och rollidentitet som utgångspunkt. Studien genomfördes med semistrukturerade intervjuer med kvinnor som arbetar inom den svenska Försvarsmakten. Resultatet av studien visade att kvinnorna upplever förväntningar från andra både på fysisk prestation och kunskap vilket leder till höga förväntningar på sig själv. Kvinnorna svarade upp på dessa förväntningar genom att anpassa sig till den mansdominerade kulturen genom att skala av feminint beteende i sin yrkesidentitet. Detta påverkade i sin tur kvinnornas välbefinnande då de upplevde stress, ångest och besvikelse när de inte nådde upp till de förväntningarna.

  • 1164.
    Torsson, Mattias
    et al.
    University of Skövde, School of Health and Education.
    Örvell, Emma
    University of Skövde, School of Health and Education.
    Att balansera på en hängbro: Om upplevelsen av att leva med ALS2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Amyotrophic lateral sclerosis is a motor neuron disease that leads to total paralysis of the body's involuntary muscles and death within a few years, while consciousness is retained unaffected throughout the course of the disease. The disease contributes to physical, psychological and existential suffering. In order to offer the right support to the patient, the nurse should have a greater knowledge and understanding of how patients with ALS experience life with their disease.

    Purpose: To describe patients' experiences of living with ALS.

    Method: The study is based on a qualitative approach based on autobiographies that illuminate people's experience of living with ALS. To analyze the autobiographies the authors in the foregoing study used a significance analysis.

    Results: Five themes appeared after analyses which illustrate how individuals can experience life with ALS. It emerged in the results that despite the losses, sadness, uncertainty and suffering the informants could still accept, manage and find meaning in their illness.

    Conclusion: To suffer from ALS causes an existential suffering. It is important as a nurse to provide the right support and personalized information to provide guidance throughout the course of the disease, creating opportunities to promote manageability, meaningfulness and well-being for the patient

  • 1165.
    Torstensson, Maria
    et al.
    University of Skövde, School of Health and Education.
    Jäderlund, Veronica
    University of Skövde, School of Health and Education.
    Påverkas motivation och egenskattad förmåga?: Utvärdering av mätverktyg för finansiell samordning2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Background Poor health among the unemployed is a major social problem. The recession and rise in unemployment the community requires to take action in form of rehabilitation and employment programs to get people back into employment and hence economic autonomy. The purpose of this study is to evaluate if a change occur in the participators motivation and belief in their own abilities after completing Samordningsförbundet Östergötlands intervention. Method an empirical study was conducted with a quantitative method. Two validated models ORS and Self-efficiacy test with an added self-assessment question of individual motivation. Conclusion There is no significant data to ensure that a change has taken place between test occasion one and two. Based on the results we have, we can not conclude that the participants attitude has changed as a result of the intervention. Whether self-estimated ability or motivation. 

  • 1166.
    Truedsson, Karin
    University of Skövde, School of Health and Education.
    Skolsköterskors agerande när vårdnadshavare tackar nej till HPV-vaccination för flickor i årskurs 5-62018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Human papillomavirus, HPV, is the most common sexually transmitted infection. Most HPV infections disappear without intervention but HPV infection can also become chronic and lead to cancer. Since 2012, all girls in Sweden are offered vaccination against HPV to prevent cervical cancer, the most common HPV-related form of cancer. The vaccination is provided by school nurses in grade 5 or 6. HPV vaccination compliance is lower than other vaccinations in the National Vaccine Program for children in Sweden. School nurses play an important role in encouraging guardians to vaccinate their children, especially those who hesitate, to increase the number of girls getting vaccinated. Increasing compliance via school nurses´ actions can reduce the number of HPV related cancers in the long term. The aim of the study was to describe how school nurses in Halland, a province on the southwest coast of Sweden, react to guardians´ rejection of the HPV vaccination for girls in grade 5 or 6. Also queried was what these nurses hear as the reasons for refusal. The assessment method selected was a web-based survey. The survey link was provided to 101 school nurses at schools teaching 5th and 6th grade in the six municipalities of Halland. The response rate was 56 percent and the results show that the school nurses in Halland do not react at all when guardians decline vaccination. The reasons given are that they believe that vaccinations are voluntary and/or that vaccinations are offered again in later grades. School nurses perceive that disinformation on the internet, fear of side effects and the young age of the girls are the main reasons for guardians´ declining HPV vaccination. Conclusion: Further motivation among school nurses in Halland is needed to increase HPV vaccination compliance.

  • 1167.
    Törnberg, Mirjam
    et al.
    University of Skövde, School of Health and Education.
    Baldinger, Clara
    University of Skövde, School of Health and Education.
    Sjuksköterskors erfarenheter av att använda tolk i möten med patienter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In encounters between nurses and patients with another language could communication problem arise. In those situations, an authorized interpreter could be needed. The need of authorized interpreters arises when the immigration increased and the society became multilingual. There could be some communication challenges during the meetings when the nurse has difficulties to understand and to pass information to a patient from a different cultural with another language background. The responsibility of the nurse and the large part of the work is to make the patient involved and agreed upon the care service that is needed. Aim: The purpose was to describe nurses’ experiences of using an interpreter in encounters with patients. Method: A literature-based study with ten qualitative articles were chosen. Result: The analysis resulted in three categories; Different opinions regarding the importance of the interpreter, unclear guidelines and that relatives should not need to act as an interpreter and eight subcategories. Conclusion: There was an obvious conclusion how important it is for nurses to make the patient involved and agreed upon in the meetings regardless from earlier background and language. The patient involvement is of great importance to nurses to secure and meet a good care. If the patient’s wishes of not using an interpreter, it could lead to a suffering for the patient.

  • 1168.
    Törnblom, Kjell
    et al.
    ETH Zürich, Department of Environmental Systems Science, USYS TdLab, Switzerland.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Distributive Justice: Revisiting Past Statements and Reflecting on Future Prospects2015In: The Oxford Handbook of Justice in the Workplace / [ed] Russell S. Cropanzano & Maureen L. Ambrose, New York: Oxford University Press, 2015, p. 15-50Chapter in book (Refereed)
    Abstract [en]

    This chapter starts with brief discussions of the whens and whys of justice reasoning and acting, after which descriptions of several distributive justice theories are provided. These are analyzed on the basis of four dimensions: type of justice motivation, orientation of justice behavior, the source of justice behavior initiation, and the source of justice behavior direction. We suggest that the overemphasis in the distributive justice literature on the three principles of equity, equality, and need, ought to be tempered by finer distinctions among the varieties of each and increased attention to additional principles and combinations of principles. The chapter ends by outlining suggestions for future research. Four issues are featured: the nature of the object (social resource) that is distributed and the focus of justice judgments, how the way the resource was produced may affect its allocation and justice judgment, how justice relates to various types of conflict, and why people sometimes do not react to perceived injustices.

  • 1169.
    Ulfberg, Nina
    et al.
    University of Skövde, School of Health and Education.
    Wibergh, Sandra
    University of Skövde, Health and Education.
    Att främja mental hälsa genom fysisk aktivitet: En litteraturstudie2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
  • 1170.
    Usynina, Anna 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 Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Public Health, Hygiene and Bioethics, Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia.
    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 at University of Gothenburg, Gothenburg, Sweden.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Kudryavtsev, Alexander V.
    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.
    Anda, Erik Eik
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Risk factors for perinatal mortality in Murmansk County, Russia: a registry-based study2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, p. 1-10, article id 1270536Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Factors contributing to perinatal mortality (PM) in Northwest Russia remain unclear. This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry.

    OBJECTIVE: This study investigated possible associations between selected maternal and fetal characteristics and PM based on data from the population-based Murmansk County Birth Registry.

    METHODS: The study population consisted of all live- and stillbirths registered in the Murmansk County Birth Registry during 2006-2011 (n = 52,806). We excluded multiple births, births prior to 22 and after 45 completed weeks of gestation, infants with congenital malformations, and births with missing information regarding gestational age (a total of n = 3,666) and/or the studied characteristics (n = 2,356). Possible associations between maternal socio-demographic and lifestyle characteristics, maternal pre-pregnancy characteristics, pregnancy characteristics, and PM were studied by multivariable logistic regression. Crude and adjusted odds ratios with 95% confidence intervals were calculated.

    RESULTS: Of the 49,140 births eligible for prevalence analysis, 338 were identified as perinatal deaths (6.9 per 1,000 births). After adjustment for other factors, maternal low education level, prior preterm delivery, spontaneous or induced abortions, antepartum hemorrhage, antenatally detected or suspected fetal growth retardation, and alcohol abuse during pregnancy all significantly increased the risk of PM. We observed a higher risk of PM in unmarried women, as well as overweight or obese mothers. Maternal underweight reduced the risk of PM.

    CONCLUSIONS: Our results suggest that both social and medical factors are important correlates of perinatal mortality in Northwest Russia.

  • 1171.
    Usynina, Anna 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 International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / Department of Public Health, Hygiene and Bioethics, Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    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 at University of Gothenburg, Gothenburg, Sweden.
    Social correlates of term small for gestational age babies in a Russian Arctic setting2016In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 75, article id 32883Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Small for gestational age (SGA) births have been associated with both short- and long-term adverse health outcomes. Although social risk factors for SGA births have been studied earlier, such data are limited from Northern Russia.

    OBJECTIVE: We assessed maternal social risk factors for term SGA births based on data from the population-based Murmansk County Birth Registry (MCBR).

    DESIGN: Data on term live-born singleton infants born between 2006 and 2011 in Murmansk County were obtained from the MCBR. We applied the 10th percentile for only birth weight (SGAW) or for both birth weight and birth length (SGAWL). Binary logistic regression was used to estimate the effect of independent variables on SGA males and females with adjustment for known risk factors and potential confounders. Both crude and adjusted odds ratios with 95% confidence intervals for the studied risk factors were calculated.

    RESULTS: The proportions of term SGAW and SGAWL births were 9.7 and 4.1%, respectively. After adjustment for potential confounders, the risk of term SGA births among less educated, unemployed, unmarried, smoking and underweight women was higher compared with women from the reference groups. Evidence of alcohol abuse was also associated with birth of SGAWL and SGAW boys. Maternal overweight and obesity decreased the risk of SGA.

    CONCLUSIONS: Maternal low education, unemployment, unmarried status, smoking, evidence of alcohol abuse and underweight increased the risk of term SGA births in a Russian Arctic setting. This emphasizes the importance of both social and lifestyle factors for pregnancy outcomes. Public health efforts to reduce smoking, alcohol consumption and underweight of pregnant women may therefore promote a decrease in the prevalence of SGA births.

  • 1172.
    Usynina, Anna 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.
    Postoev, Vitaly A.
    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 International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / North-Eastern Federal University, Yakutsk, Russia.
    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 at University of Gothenburg, Gothenburg, Sweden.
    Nieboer, Evert
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Anda, Erik Eik
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Maternal Risk Factors for Preterm Birth in Murmansk County, Russia: A Registry-Based Study2016In: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 30, no 5, p. 462-472Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Globally, about 11% of all liveborn infants are preterm. To date, data on prevalence and risk factors of preterm birth (PTB) in Russia are limited. The aims of this study were to estimate the prevalence of PTB in Murmansk County, Northwestern Russia and to investigate associations between PTB and selected maternal factors using the Murmansk County Birth Registry.

    METHODS: We conducted a registry-based study of 52 806 births (2006-2011). In total, 51 156 births were included in the prevalence analysis, of which 3546 were PTBs. Odds ratios with 95% confidence intervals of moderate-to-late PTB, very PTB and extremely PTB for a range of maternal characteristics were estimated using multinomial logistic regression, adjusting for potential confounders.

    RESULTS: The overall prevalence of PTB in Murmansk County was 6.9%. Unmarried status, prior PTBs, spontaneous and induced abortions were strongly associated with PTB at any gestational age. Maternal low educational level increased the risk of extremely and moderate-to-late PTB. Young (<18 years) or older (≥35 years) mothers, graduates of vocational schools, underweight, overweight/obese mothers, and smokers were at higher risk of moderate-to-late PTB. Secondary education, alcohol abuse, diabetes mellitus, or gestational diabetes were strongly associated with moderate-to-late and very PTB.

    CONCLUSIONS: The observed prevalence of PTB (6.9%) in Murmansk County, Russia was comparable with data on live PTB from European countries. Adverse prior pregnancy outcomes, maternal low educational level, unmarried status, alcohol abuse, and diabetes mellitus or gestational diabetes were the most common risk factors for PTB.

  • 1173.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Agriculture (SLU), Uppsala, Sweden.
    Ekström-Bergström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Health Sciences, University West, Trollhättan, Sweden.
    Berg, Marie
    Institute of Health and Care Sciences, University of Gothenburg, Sweden / Centre for Person-Centred Care, University of Gothenburg, Sweden.
    Buckley, Sarah
    School of Public Health, University of Queensland, Brisbane, Australia.
    Pajalic, Zada
    Faculty of Health Sciences, Oslo and Akershus University, College of Applied Sciences, Oslo, Norway.
    Hadjigeorgiou, Eleni
    Faculty of Health Sciences, Cyprus, University of Technology, Limassol, Cyprus.
    Kotłowska, Alicja
    Faculty of Health Sciences with Subfaculty of Nursing, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdańsk, Poland.
    Lengler, Luise
    Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
    Kielbratowska, Bogumila
    Faculty of Medical Sciences, Medical University of Gdańsk, Gdańsk, Poland.
    Leon-Larios, Fatima
    Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
    Magistretti, Claudia Meier
    Department of Social Work Center for Health Promotion and Social Participation, Lucerne University of Applied Sciences and Arts, Luzern, Switzerland.
    Downe, Soo
    Research in Childbirth and Health (ReaCH) Group, University of Central Lancashire, Preston, United Kingdom.
    Lindström, Bengt
    Norwegian University of Science and Technology, Trondheim, Norway.
    Dencker, Anna
    Institute of Health and Care Sciences, University of Gothenburg, Sweden / Centre for Person-Centred Care, University of Gothenburg, Sweden.
    Maternal plasma levels of oxytocin during physiological childbirth: A systematic review with implications for uterine contractions and central actions of oxytocin2019In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, no 1, article id 285Article, review/survey (Refereed)
    Abstract [en]

    Background: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies. Methods: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects. Results: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin. Conclusions: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does. 

  • 1174.
    Uvnäs-Moberg, Kerstin
    et al.
    Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden.
    Handlin, Linda
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kendall-Tackett, Kathleen
    Texas Tech University School of Medicine, Amarillo, TX, USA.
    Petersson, Maria
    Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Sweden.
    Oxytocin is a principal hormone that exerts part of its effects by active fragments2019In: Medical Hypotheses, ISSN 0306-9877, E-ISSN 1532-2777, Vol. 133, p. 1-9, article id 109394Article in journal (Refereed)
    Abstract [en]

    Oxytocin is a nonapeptide consisting of a cyclic six amino-acid structure and a tail of three amino acids. It was originally known for its ability to induce milk ejection and to stimulate uterine contractions. More recently, oxytocin has been shown to stimulate social behaviors, and exert pain-relieving, anti-stress/anti-inflammatory and restorative effects. We hypothesize that oxytocin is a principal hormone that, in part, exerts its effects after degradation to active fragments with more specific effect profiles. Experimental findings on rats show that administered oxytocin exerts biphasic effects. For example, after an initial increase in pain threshold, a second more long-lasting increase follows. Blood pressure and cortisol levels initially increase and then reverse into a long-lasting decrease in blood pressure and cortisol. Whereas the initial effects are, the second-phase effects are not blocked by an oxytocin antagonist, but by an opioid mu-antagonist and by an alpha 2-adrenoreceptor antagonist, respectively, suggesting that other receptors are involved. Repeated administration of oxytocin induces multiple anti-stress effects, which are mediated by alpha 2-adrenoreceptors. Repeated administration of linear oxytocin and linear oxytocin fragments with a retained C-terminal reduce spontaneous motor activity, a sedative or anti-stress effect, suggesting that alpha 2-adrenoreceptors have been activated. In contrast, linear mid-fragments stimulate motor activity. Low-intensity stimulation of cutaneous nerves in rats, as well as breastfeeding and skin-to-skin contact between mothers and babies, trigger immediate anti-stress effects. Some of these effects are likely caused by open ring/linear C-terminal fragments activating alpha 2-adrenoreceptors. Oxytocin fragments may be pre-formed and released in the brain or created by metabolic conversion of the principal hormone oxytocin in the central nervous system. Oxytocin and its fragments may also be released from peripheral sites, such as peripheral nerves, the gastrointestinal tract, and blood vessels in response to decreased sympathetic or increased parasympathetic nervous tone. Smaller fragments of oxytocin produced in the periphery may easily pass the blood-brain barrier to induce effects in the brain. In conclusion, oxytocin is linked to many different, sometimes opposite effects. The intact cyclic molecule may act to initiate social interaction and associated psychophysiological effects, whereas linear oxytocin and C-terminal fragments may induce relaxation and anti-stress effects following social interaction. In this way, the principal hormone oxytocin and its fragments may take part in a behavioral sequence, ranging from approach and interaction to calm and relaxation. Linear fragments, with an exposed cysteine-residue, may exert anti-inflammatory and antioxidant effects and thereby contribute to the health-promoting effects of oxytocin. 

  • 1175.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden.
    Handlin, Linda
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Petersson, Maria
    Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden.
    Self-soothing behaviors with particular reference to oxytocin release induced by non-noxious sensory stimulation2015In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 5, article id 1529Article, review/survey (Refereed)
  • 1176.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    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.
    The heart-health associated research, dissemination and intervention in the community (HARDIC) trial for nepalese mothers regarding diet and physical activity: A process evaluation2017In: Kathmandu University Medical Journal, ISSN 1812-2027, E-ISSN 1812-2078, Vol. 15, no 58, p. 107-116Article in journal (Refereed)
    Abstract [en]

    Background Mothers with young children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance site of Bhaktapur district have misconceptions and poor behavioural practice regarding diet and physical activity. We developed the Heart-health Associated Research, Dissemination and Intervention in the Community trial - a health promotion intervention for mothers. Objective The objective of this study was to evaluate the intervention’s feasibility, acceptability, potential for transferability and scaling up, and to determine its immediate outcome. Method Duwakot and Jhaukhel were randomly selected as the intervention and control communities, respectively. We trained 47 peer mothers from Duwakot, each of whom gave classes with 10 fellow mothers of their neighbourhood. The process evaluation was carried out on a continuous basis at different points of the intervention held from August to November 2016. Result In round one, the participation and completion rates were both > 90% for peer mothers; and 85% and 70%, respectively, for the fellow mothers. However, the participation rates fell in the round two of the intervention. On the whole, the mothers expressed satisfaction and acceptance of the course content and training modality. Immediate evaluation of the intervention showed improvement of knowledge, attitude and practice of diet and physical activity among both groups of mothers. Conclusion The successful implementation of the intervention targeting diet and physical activity clearly demonstrates the feasibility of health promotional activities in the Nepalese community for improvement of cardiovascular health. © 2017, Kathmandu University. All rights reserved.

  • 1177.
    Vaidya, Abhinav
    et al.
    Kathmandu Medical College, Kathmandu, Nepal.
    Oli, Natalia
    Kathmandu Medical College, Kathmandu, Nepal / University of Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Göteborgs universitet / UiT Norges Arktiska Universitet.
    High prevalence of prehypertension in mothers of young children in peri-urban Nepal2016In: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 5, no 2, p. 52-60Article in journal (Refereed)
    Abstract [en]

    Background: Prehypertension is clinically defined as a level of blood pressure between normal and hypertension, i.e. elevated systolic blood pressure between 120-139 or diastolic blood pressure between 80-89 mm Hg. Prehypertension remains neglected as a public health problem, and has not been explored in mothers with small children in Nepal.

    Objectives: We aimed to study prehypertension and its related factors including obesity-related parameters among mothers with children aged 1-7 years in Duwakot and Jhaukhel communities of Bhaktapur district, Nepal.

    Methods: We prepared a sampling frame of all the eligible mothers, and interviewed 962 mothers. The trained enumerators also measured their blood pressure, body weight, height, waist and hip circumferences. We analysed data with SPSS version 22. We received ethical approval from the Nepal Health Research Council to conduct the study, and obtained informed verbal consent from the participating mothers.

    Results: About one-third (31.8%) of the mothers had prehypertension. It was more common among Newars and those aged 30-34 years. Multivariate analysis did not reveal significant association with sociodemographic variables except for education. We found positive correlations between blood pressure and obesity parameters. Overweight and obese participants were 2.24 (95% confidence interval: 1.06-4.73) and 4.65 (95% confidence interval: 1.92-11.23) times, respectively, more likely to have prehypertension than underweight mothers.

    Conclusions: Our study demonstrated a high prevalence of prehypertension, coupled with high obesity parameters, among young mothers of peri-urban Nepal. Primordial preventive efforts at community level are needed not only for the mothers themselves, but for heart-health of their offspring as well.

  • 1178.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College, Kathmandu / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    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 / 4Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway .
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Preference of Food-items and Physical Activity of Peri-urban Children in Bhaktapur2017In: Journal of Nepal Health Research Council, ISSN 1727-5482, E-ISSN 1999-6217, Vol. 15, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Though cardiovascular diseases are mostly seen in adulthood, the foundation of diet and physical activity is largely formed during childhood. The study aimed to explore children's preference for diet and physical activity in a peri-urban area of Nepal because this is an important dimension to explore in the life-course approach to combat non-communicable diseases.

    METHODS: We conducted a cross-sectional study to enquire young peri-urban children of Duwakot and Jhaukhel villages of Bhaktapur district, Nepal on their preferences for diet and physical activity. All eligible households with children in the age range 5-10 years as enlisted from the Jhaukhel-Duwakot Health Demographic Surveillance Site database were selected for the study. Twelve enumerators visited the selected households and facilitated the eligible children to fill in the questionnaire. We used a child-friendly photo-assisted questionnaire with face-scales that easily enabled the children to select a particular preference for each of the food item and physical activity. During analysis, food items were categorized into 'green', 'yellow' and 'red' on the basis of their nutritive values. Physical activity was categorized based on severity of the activity.

    RESULTS: Four hundred and thirty seven children filled up the questionnaires. Overall, median preference scores for 'red' food were higher than for healthier 'green' food (4.16 vs. 4.03), particularly, if mothers were self-employed. Likewise, the children preferred low over moderate-to-severe physical activity (4.16 vs. 3.50), and preference was affected by parents' occupation and income.

    CONCLUSIONS: The study objectively revealed that most of the children preferred unhealthier food-items and low physical activities. It shall be useful to consider these findings while planning health promotional activities targeted at them.

  • 1179.
    van Meer, Floor
    et al.
    University Medical Center Utrecht, the Netherlands.
    van der Laan, Laura N.
    Tilburg University, the Netherlands.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lissner, Lauren
    Göteborg University, Sahlgrenska Academy, Gothenburg.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Rach, Stefan
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Herrmann, Manfred
    University of Bremen, Germany.
    Erhard, Peter
    University of Bremen, Germany.
    Molnár, Dénés
    University Medical School of Pécs, Hungary.
    Orsi, Gergely
    University Medical School of Pécs, Hungary / MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
    Viergever, Max A.
    University Medical Center Utrecht, the Netherlands.
    Adan, Roger A.H.
    University Medical Center Utrecht, the Netherlands.
    Smeets, Paul A.M.
    University Medical Center Utrecht, the Netherlands / Division of Human Nutrition & Health, Wageningen University & Research, the Netherlands.
    Development and body mass inversely affect children's brain activation in dorsolateral prefrontal cortex during food choice2019In: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 201, p. 1-10, article id 116016Article in journal (Refereed)
    Abstract [en]

    Childhood obesity is a rising problem caused in part by unhealthy food choices. Food choices are based on a neural value signal encoded in the ventromedial prefrontal cortex, and self-control involves modulation of this signal by the dorsolateral prefrontal cortex (dlPFC). We determined the effects of development, body mass (BMI Cole score) and body mass history on the neural correlates of healthy food choice in children. 141 children (aged 10-17y) from Germany, Hungary and Sweden were scanned with fMRI while performing a food choice task. Afterwards health and taste ratings of the foods were collected. In the food choice task children were asked to consider the healthiness or tastiness of the food or to choose naturally. Overall, children made healthier choices when asked to consider healthiness. However, children who had a higher weight gain per year chose less healthy foods when considering healthiness but not when choosing naturally. Pubertal development stage correlated positively while current body mass correlated negatively with dlPFC activation when accepting foods. Pubertal development negatively and current body mass positively influenced the effect of considering healthiness on activation of brain areas involved in salience and motivation. In conclusion, children in earlier stages of pubertal development and children with a higher body weight exhibited less activation in the dlPFC, which has been implicated in self-control during food choice. Furthermore, pubertal development and body mass influenced neural responses to a health cue in areas involved in salience and motivation. Thus, these findings suggest that children in earlier stages of pubertal development, children with a higher body mass gain and children with overweight may possibly be less susceptible to healthy eating interventions that rely on self-control or that highlight health aspects of food. 

  • 1180.
    Varinen, Aleksi
    et al.
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland / Nokia Health Centre, Nokia, Finland.
    Kosunen, Elise
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland / Pirkanmaa Hospital District, Centre for General Practice, Finland.
    Mattila, Kari
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku University Hospital, Finland.
    Sillanmäki, Lauri
    Department of Public Health, University of Turku, Turku University Hospital, Finland / Health care services, Welfare Division, Turku, Finland.
    Sumanen, Markku
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland.
    The association between bullying victimization in childhood and fibromyalgia: Data from the nationwide Finnish health and social support (HeSSup) study based on a sample of 64,797 individuals2019In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 117, p. 48-53Article in journal (Refereed)
    Abstract [en]

    Background: Fibromyalgia is a functional pain syndrome presenting with various psychological symptoms. Several studies have shown that adverse life events are associated with fibromyalgia. The aim of the current study is to explore the association between self-reported bullying victimization in childhood and self-reported fibromyalgia in adulthood. Methods: The basic study setting is cross-sectional - with focused use of retrospective data - derived from a large on-going postal follow up survey (sample N = 64,797) initiated in Finland in 1998. Only respondents having answered the questions on fibromyalgia in both follow ups in 2003 and 2012 were included (N = 11,924). Severity of bullying was divided into three groups starting from no bullying followed by minor and severe bullying. Covariates having shown statistically significant associations with fibromyalgia in cross tabulation using Pearson's chi-squared test were included in the final multiple logistic regression analyses. Results: In our study, 50.6% of the respondents reported victimization of minor and 19.6% of severe bullying in childhood. Participants reporting fibromyalgia in adulthood reported more bullying, and in females alone this association was statistically significant (p =.027). In multiple logistic regression analysis statistically significant associations between bullying victimization in childhood (reference: no bullying) and fibromyalgia were found: adjusted odds ratio (OR) for minor bullying was 1.35 (95% CI 1.09–1.67) and for severe bullying 1.58 (95% CI 1.21–2.06). However, in log-linear and logistic regression interaction models the association between bullying and fibromyalgia was not statistically significant when depression was included in the models. Conclusions: Our results suggest that peer bullying victimization might be associated with fibromyalgia. However, in logistic log linear and logistic interaction models there was no statistically significant association when depression was included. As a result, there is need for further, preferably prospective cohort studies. The findings also emphasize the importance of actions to prevent childhood bullying. 

  • 1181.
    Varnicke, Hanna
    et al.
    University of Skövde, School of Health and Education.
    Strand, Regina
    University of Skövde, School of Health and Education.
    Vad erbjuder förskolans leksaksförråd?: En kvalitativ studie om uteleksakernas möjligheter och begränsningar för barns lek i utevistelsen.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    According to the curriculum for preschool, the preschool should offer children a learning environment where they can switch between different activities both inside and outside. The purpose of this study is to investigate the conditions that different toys inventory’s offer children in their play and interaction during their time outdoors. Further is the purpose to investigate how the preschool teachers’ arguments concerning the selection of toy and material to play with in their time outdoors.

     The essay is based on a qualitative method through three observations and six interviews. Through these, we examine three preschools material that three preschool toys inventory’s  and materials that children have access to their time outdoors and six preschool teachers´ arguments surrounding the choice of these materials.

    The results show that preschool teachers have different arguments and purposes about the materials different functions concerning children's development and learning. These functions affect children’s availability and development of material use. These functions are influenced by children's availability and teachers' attitudes. Also highlights the material's capabilities and limitations.

     

  • 1182.
    Vesiaid, Kätlin
    University of Skövde, School of Health and Education.
    Inskolning av barn i behov av särskilt stöd i förskolan: En fenomenografisk intervjustudie av förskollärarnas erfarenheter2014Independent thesis Basic level (professional degree), 210 HE creditsStudent thesis
    Abstract [en]

    The aim of this study is to analyze the different ways for preschool teachers to work with the introduction period for children with special educational needs in preschools. The provided background literature highlights different governing documents that regulate the work with children in need of special support in Swedish preschools. The background literature also gives an overview of research about introduction period in preschools; concept and work with children with special educational needs in Sweden; how teachers’ expertise and educational bakground affects the work during introduction period; and an overview of Bowlby's attachment theory. The study uses a qualitative research methodology in form of phenomenography. The results of the study are based on three individual interviews with preschool teachers as well as one group interview with two preschool teachers.

    The results of the study demonstrate that teachers’ view on children in need of special support is the key factor in organizing the introduction to preschool. Introduction is seen as an individual process, regardless of the induction model used. The results show at the same time that introduction needs to be even more individually adapted for children in need of special support. The child’s confidence and sense of security was seen as fundamental to the child’s development. The biggest difference between working with confidence and sense of secutiry during the introduction of children with special educational needs in comparison with introduction of children without special educational needs was the increased amount of support aimed towards the guardians in their development of trust towards the preschool. The guardians are also considered to be in need of support when it comes to their adjustment with the child’s situation. Theoretical skills were considered to be the foundamental for preschool teachers in their work regarding the introduction of children in need of special support. At the same time as increased need for skills regarding the child’s specific needs became clear through the study’s results.

  • 1183.
    Vestin, Adam
    et al.
    University of Skövde, School of Health and Education.
    Spetz, Filip
    University of Skövde, School of Health and Education.
    Sjuksköterskans upplevelse av vårdande relationer med patienter med psykisk ohälsa inom somatisk akutsjukvård2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of people with mental illness is increasing in Sweden and thenumber of healthcare seekers increases. More and more patients are looking for somaticemergency care, which makes workload more challenging. A patient with mental illnesslives in a complex life situation and therefore it´s challenging for a nurse to create acomplete understanding of the patient's well-being. Strengthening the caring relationshipand preserve the nurse's role in nursing will therefore be a challenge. Objective: Thepurpose is to describe how nurses experiences caring relationships with patients withmental illness in somatic emergency care. Method: A literature review. Result: Fourthemes appear in the result. Each theme is highly influential in the caring relationship. Thethemes that emerge are: The importance of the environment, emotions and experiences,attitudes and lack of knowledge, and need of qualification. Conclusions: Unknowledge incombination with time pressure, lack of communication, attitudes and inadequate structuralenvironment adversely affects nurses' experiences of the care meetings with patients withmental illness.

  • 1184.
    Vestman, C.
    et al.
    Department of Dialysis, Skaraborgs Hospital, Skövde, Sweden.
    Hasselroth, M.
    Department of Dialysis, Skaraborgs Hospital, Skövde, Sweden.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Freedom and Confinement: Patients' Experiences of Life with Home Haemodialysis2014In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, article id 252643Article in journal (Refereed)
    Abstract [en]

    Patients with chronic end stage renal disease need dialysis to survive; however, they also need a treatment that suits their life situation. It is important that healthcare providers provide reliable, up-to-date information about different dialysis treatment options. Since home haemodialysis is a relatively new treatment, it is necessary to gather more knowledge about what the treatment entails from the patient’s perspective. The aim of this study was to describe patients’ experiences of having home haemodialysis. To gain access to the patients’ experiences, they were asked to write narratives, which describe both their good and bad experiences of life with the treatment. The narratives were analysed with a qualitative method. The results of this analysis are subdivided into five themes: freedom to be at home and control their own treatment, feeling of being alone with the responsibility, changes in the home environment, need for support, and security and well-being with home haemodialysis. The conclusion is that home haemodialysis provides a certain level of freedom, but the freedom is limited as the treatment itself is restrictive. In order to improve patients’ experiences with home haemodialysis, more research based on patients’ experiences is needed and it is necessary to involve the patients in the development of the care.

  • 1185.
    Viberg, Tove
    University of Skövde, School of Health and Education.
    Skolbaserade interventioner för stresshantering – vad fungerar?: En systematisk litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Stress is a large and growing problem in Sweden, where one of the most vulnerable groups are teenagers. Chronic stress can bring about devastating consequences for the individual as well as for the society, and measures must therefore be taken to reduce stress in this group. An important arena for this work is the school. The aim of this study was to investigate which factors that make school-based stress management interventions effective in reducing stress in teenagers. Methods: A systematic literature review was conducted, which included 15 quantitative articles published during the last ten years. The databases used were PubMed, CINAHL and PsycINFO. Results: The result showed that type of prevention, time factors and type of stress management tool had an impact on when school-based stress management interventions was effective. Discussion: The study identified three factors which had an impact on the effectiveness of stress management interventions in schools for teenagers. However, the studies are heterogenous and in several cases small, which makes it hard to draw conclusions and make recommendations. More research is needed and should be prioritized.

  • 1186.
    Videll, Isabella
    et al.
    University of Skövde, School of Health and Education.
    Wall, Filippa
    University of Skövde, School of Health and Education.
    "Att ett barn dör kan kännas orättvist": Sjuksköterskors upplevelser av att vårda barn i palliativt skede2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Annually about 560 children pass away in Sweden.  Nurses have a central role in the care of palliative children. Through their care, nurses should strive for a family-centered nursing method and meet the patients and family’s values and emotions in order to create a satisfactory and meaningful end of life. The care of a palliative child stands in direct contrast to the image of a long and happy life, which contributes to great emotional challenges for nurses. Purpose: To illuminate nurses' experience of caring for children in the palliative stage. Method: A literature-based study with a qualitative approach. Results: Four themes emerged from the collected data; to create a meaningful end of life, communication and to create a connection, a struggle against lack of organizational conditions and to accept a child's passing - a problematic process. Conclusion: Nurses feel that it´s an emotionally demanding job where it´s desirable to be able to create a satisfactory and meaningful end of life. However, there is a lack of education and competence for nurses to be able to provide the desired care and to handle their emotional burden. Further education and research are required to improve the nurse's knowledge of the subject.

  • 1187.
    Vikman, Stina
    et al.
    University of Skövde, School of Health and Education.
    Östman, Anne
    University of Skövde, School of Health and Education.
    Skolsköterskors erfarenheter av att arbeta med gymnasieelever som har långvarig ogiltig frånvaro2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Students who stay at home from school have attracted increasing attention in recent years. Despite the Swedish compulsory school attendance in primary school and the voluntary nature of high school, more and more students give up school. Students health has an important role in promoting students school attendance, the focus is to put in effort in the early stage at absence.

    Aim: The aim of the study is to investigate the school nurses experience of working with high school students who have a long term absenteeism.

    Method: The study was conducted with a qualitative approach. The study is based on sixteen mail interviews with nurses working in high schools that were analyzed using significance analysis.

    Results: Four meanings were found describing the school nurses experience of working with high school students who have a long term absenteeism; the health dialogues enables to get to know the students, to achieve a safe relationship with students, cooperation with other professions and guardians and the importance of routines to promote students attendance.

    Conclusion: School nurses need to build a trustful relationship with students so that a safe relationship can occur. It’s important that students are being seen and heard in a respectful way, in the meeting with school nurses so that the cause of long term absenteeism appears.

  • 1188.
    Virtanen, Marianna
    et al.
    Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Ervasti, Jenni
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Head, Jenny
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland / Department of Psychology, University of Turku, Turku, Finland.
    Pentti, Jaana
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Kouvonen, Anne
    Faculty of Social Sciences, University of Helsinki, Helsinki, Finland / SWPS University of Social Sciences and Humanities, Wroclaw, Poland.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland / School of Social Policy, Sociology and Social Research, University of Kent, United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Koskenvuo, Markku
    Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Elovainio, Marko
    Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland / National Institute for Health and Welfare, Helsinki, Finland.
    Zins, Marie
    Inserm, Population-based Epidemiologic Cohorts Unit UMS 011, Villejuif, France / Paris Descartes University, Paris, France.
    Goldberg, Marcel
    Inserm, Population-based Epidemiologic Cohorts Unit UMS 011, Villejuif, France / Paris Descartes University, Paris, France.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Lifestyle factors and risk of sickness absence from work: a multicohort study2018In: Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, p. E545-E554Article in journal (Refereed)
    Abstract [en]

    Background Lifestyle factors influence the risk of morbidity and mortality, but the extent to which they are associated with employees' absence from work due to illness is unclear. We examined the relative contributions of smoking, alcohol consumption, high body-mass index, and low physical activity to diagnosis-specific sickness absence. Methods We did a multicohort study with individual-level data of participants of four cohorts from the UK, France, and Finland. Participants' responses to a lifestyle survey were linked to records of sickness absence episodes, typically lasting longer than 9 days; for each diagnostic category, the outcome was the total number of sickness absence days per year. We estimated the associations between lifestyle factors and sickness absence by calculating rate ratios for the number of sickness absence days per year and combining cohort-specific estimates with meta-analysis. The criteria for assessing the evidence included the strength of association, consistency across cohorts, robustness to adjustments and multiple testing, and impact assessment by use of population attributable fractions (PAF), with both internal lifestyle factor prevalence estimates and those obtained from European populations (PAF external). Findings For 74 296 participants, during 446 478 person-years at risk, the most common diagnoses for sickness absence were musculoskeletal diseases (70.9 days per 10 person-years), depressive disorders (26.5 days per 10 person-years), and external causes (such as injuries and poisonings; 12.8 days per 10 person-years). Being overweight (rate ratio [adjusted for age, sex, socioeconomic status, and chronic disease at baseline] 1.30, 95% CI 1.21-1.40; PAF external 8.9%) and low physical activity (1.23, 1.14-1.34; 7.8%) were associated with absences due to musculoskeletal diseases; heavy episodic drinking (1.90, 1.41-2.56; 15.2%), smoking (1.70, 1.42-2.03; 11.8%), low physical activity (1.67, 1.42-1.96; 19.8%), and obesity (1.38, 1.11-1.71; 5.6%) were associated with absences due to depressive disorders; heavy episodic drinking (1.64, 1.33-2.03; 11.3%), obesity (1.48, 1.27-1.72; 6.6%), smoking (1.35, 1.20-1.53; 6.3%), and being overweight (1.20, 1.08-1.33; 6.2%) were associated with absences due to external causes; obesity (1.82, 1.40-2.36; 11.0%) and smoking (1.60, 1.30-1.98; 10.3%) were associated with absences due to circulatory diseases; low physical activity (1.37, 1.25-1.49; 12.0%) and smoking (1.27, 1.16-1.40; 4.9%) were associated with absences due to respiratory diseases; and obesity (1.67, 1.34-2.07; 9.7%) was associated with absences due to digestive diseases. Interpretation Lifestyle factors are associated with sickness absence due to several diseases, but observational data cannot determine the nature of these associations. Future studies should investigate the cost-effectiveness of lifestyle interventions aimed at reducing sickness absence and the use of information on lifestyle for identifying groups at risk. 

  • 1189.
    Virtanen, Marianna
    et al.
    School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland / Stress Research Institute, Stockholm University, Sweden.
    Jokela, Markus
    Department of Psychology and Logopedics, University of Helsinki, Finland.
    Lallukka, Tea
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, Clinicum, University of Helsinki, Finland.
    Magnusson Hanson, Linda
    Stress Research Institute, Stockholm University, Sweden.
    Pentti, Jaana
    Department of Public Health, Clinicum, University of Helsinki, Finland / Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Nyberg, Solja T.
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Batty, G. David
    Department of Epidemiology & Public Health, University College London, London, United Kingdom / School of Biological & Population Health Sciences, Oregon State University, Corvallis, United States.
    Casini, Anna-Lisa
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Belgium.
    DeBacquer, Dirk
    Department of Public Health, Ghent University, Belgium.
    Ervasti, Jenni
    Finnish Institute of Occupational Health, Helsinki, Finland / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fransson, Eleonor
    Stress Research Institute, Stockholm University, Sweden / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / School of Health and Welfare, Jönköping University, Sweden.
    Halonen, Jaana I.
    Stress Research Institute, Stockholm University, Sweden / Finnish Institute of Occupational Health, Helsinki, Finland.
    Head, Jenny
    Department of Epidemiology & Public Health, University College London, United Kingdom.
    Kittel, France
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Leineweber, Constance
    Stress Research Institute, Stockholm University, Sweden.
    Nordin, Maria
    Department of Psychology, Umeå University, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pietiläinen, Olli
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Rahkonen, Ossi
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Finland.
    Singh-Manoux, Archana
    Department of Epidemiology & Public Health, University College London, United Kingdom / INSERM, Villejuif, U 1018, France.
    Stenholm, Sari
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Suominen, Sakari B
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Sweden.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Sweden.
    Kivimäki, Mika
    Department of Public Health, Clinicum, University of Helsinki, Finland / Department of Epidemiology & Public Health, University College London, United Kingdom.
    Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the relation between long working hours and change in body mass index (BMI). Methods: We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (&lt;35 h/week), standard weekly hours (35–40 h, reference), 41–48 h, 49–54 h and ≥55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI ≥ 25 kg/m2) or (2) overweight (BMI 25–29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI ≥ 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline. Results: Of the 61,143 participants without overweight/obesity at baseline, 20.2% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95% CI 0.90–1.00) for part-time work, 1.07 (1.02–1.12) for 41–48 weekly working hours, 1.09 (1.03–1.16) for 49–54 h and 1.17 (1.08–1.27) for long working hours (P for trend &lt;0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity. Conclusions: This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours. 

  • 1190.
    Virtanen, Marianna
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health and Caring Sciences, University of Uppsala, Sweden.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Magnusson Hanson, Linda L.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Lallukka, Tea
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, University of Helsinki, Finland.
    Nyberg, Solja T.
    Department of Public Health, University of Helsinki, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Batty, G David
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational Medicine, Koge Hospital, Koge, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Heikkilä, Katriina
    Department of Health Services and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Finland.
    Lahelma, Eero
    Department of Public Health, University of Helsinki, Finland.
    Nielsen, Martin L.
    Unit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Department of Public Health, University of Helsinki, Finland.
    Rahkonen, Ossi
    Department of Public Health, University of Helsinki, Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark / Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Turku, Finland.
    Schupp, Jürgen
    German Institute for Economic Research, Berlin, Germany / Free University of Berlin, Berlin, Germany.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Wagner, Gert G.
    German Institute for Economic Research, Berlin, Germany / Max Planck Institute for Human Development, Berlin, Germany / Berlin University of Technology, Berlin, Germany.
    Wang, Jian Li
    University of Ottawa Institute of Mental Health Research, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.
    Yiengprugsawan, Vasoontara
    Centre for Research on Ageing, Health and Wellbeing and the ARC Centre of Excellence on Population Ageing Research, The Australian National University, Canberra, Australia.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 3, p. 239-250, article id 3712Article, review/survey (Refereed)
    Abstract [en]

    Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies. Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95, 95% CI 0.70-1.29). Differences by other characteristics were small. Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.

  • 1191.
    Vithlani, Sharmila
    University of Skövde, School of Health and Education.
    Modersmålsundervisning: Det gemensamma ansvaret för hela organisationen i grundskolan2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bristande kunskaper om modersmålsundervisning och dess organisering bland grundskolelärare kan ge fel uppfattningar om ämnets innehåll. Denna studie utgick ifrån olika ledningsaktörers professionella ansvar att utveckla grundskolelärarnas existerande kunskaper om hur (vi) modersmålslärare arbetar och är organiserade. Ett professionellt ansvar, som samtliga pedagogiska aktörer i grundskolan bör ha. Studien tog del av föreställningar om modersmålsundervisning som framträdde hos anställda på ledningsnivå och fördjupades vidare på vilket sätt och varför dessa föreställningar kunde vara betydelsefulla för grundskolans kvalitativa utvecklingsarbete.

    Föreställningar som framträdde hos ledningsaktörerna om grundskolelärarnas existerande kunskaper om modersmålsundervisning och dess organisering sågs i relation till olika kunskapssyn: vetenskaplig kunskap, tyst kunskap och vardagskunskap utifrån erfarenheter. Dessa tre olika kunskapssyner hade tillägnats och var en del av den praxisgemenskapen inom skolans verksamhet som synliggjordes genom aktiv deltagande i samspel med andra. Detta har gjorts från individnivå genom interaktion med andra till ett större kollektiv d.v.s. organisationsnivå. Den tysta kunskapen behöver artikuleras och ledningsaktörerna behöver skapa mötesforum för detta.

    Studien visade en lärande process där den utgick ifrån ledningsaktörernas synpunkter kring grundskolelärarnas bristande kunskaper om ämnet modersmål och dess organisering. Dessa synpunkter sattes i relation till ett utvecklingsarbete där det systematiska kvalitetsarbetet blev en levande process. Denna lärande process kan leda till ett förbättringsarbete inom grundskolans verksamhet som i sin tur kan skapa likvärdiga förutsättningar inom utbildning för elever som har ett annat modersmål än svenska. 

  • 1192.
    Vixner, Linda
    et al.
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schytt, Erica
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Sweden / Centre for Clinical Research Dalarna, Falun, Sweden.
    Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience2015In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 15, no 1, article id 180Article in journal (Refereed)
  • 1193.
    Vixner, Linda
    et al.
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Schytt, Erica
    Centre for Clinical Research Dalarna, Falun, Sweden / Bergen University Collage, Bergen, Norway.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Associations between maternal characteristics and women's responses to acupuncture during labour: a secondary analysis from a randomised controlled trial2017In: Acupuncture in Medicine, ISSN 0964-5284, E-ISSN 1759-9873, Vol. 35, no 3, p. 180-188Article in journal (Refereed)
  • 1194.
    Vixner, Linda
    et al.
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Schytt, Erica
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / Centre for Clinical Research Dalarna, Falun, Sweden.
    Stener-Victorin, Elisabet
    Department of Physiology, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
    Waldenström, Ulla
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.
    Pettersson, Hans
    Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Acupuncture with manual and electrical stimulation for labour pain: a longitudinal randomised controlled trial2014In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 14, article id 187Article in journal (Refereed)
    Abstract [en]

    Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.

    Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals . 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.

    Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).

    Conclusions: Acupuncture does not reduce women’s experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated.

    These findings were obtained in a context with free access to other forms of pain relief.

  • 1195.
    Vojdani Moghaddam, Mohammad
    University of Skövde, School of Health and Education.
    Skyddsfaktorer som påverkar psykisk hälsa och välbefinnande hos ensamkommande barn: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of unaccompanied children seeking asylum in Europe has increased over the last decades and reached their peak so far in 2015 with 90,000 unaccompanied asylum seekers, of whom 35,000 came to Sweden. Unaccompanied children, who fled request asylum because war, conflict and poverty. The prolonged asylum process, temporary residence and previous trauma increase the risk of depression and PTSD. Even so, there are unaccompanied children who manage to do well in very difficult circumstances. Aim: The purpose of this paper was to highlight protection factors that promote mental health and well-being of unaccompanied children. Method: This study is a systematic literature review and 16 scientific articles have been included in the analysis. Results: Four themes were identified as protection factors; Social support, motivation, religion and distraction. Social support proved to be among the important protection factor for the mental health and well-being of unaccompanied children. Discussion: The outcome of this study showed that unaccompanied children in spite of the difficulties they have undergone, have strengths and strategies that help them to new circumstances. The study also demonstrated the importance of creating secure relationships and obtaining support from trusted persons in unaccompanied children's surroundings. This study can advantageously provide actors who directly or indirectly work with unaccompanied children, with knowledge and understanding which can hopefully contribute to increased mental health and well-being of this vulnerable group.

  • 1196.
    Volanen, Salla-Maarit
    et al.
    Folkhälsan Research Center, Helsinki, Finland / Clinicum, Department of Public Health, University of Helsinki, Finland.
    Lassander, Maarit
    Institute of Behavioural Sciences, University of Helsinki, Finland.
    Hankonen, Nelli
    Social Psychology Unit, Faculty of Social Sciences, University of Helsinki, Finland.
    Santalahti, Päivi
    National Institute for Health and Welfare, Finland.
    Hintsanen, Mirka
    Unit of Psychology, University of Oulu, Finland.
    Simonsen, Nina
    Folkhälsan Research Center, Helsinki, Finland / Clinicum, Department of Public Health, University of Helsinki, Finland.
    Raevuori, Anu H.
    Clinicum, Department of Public Health, University of Helsinki, Finland / Department of Adolescent Psychiatry, Helsinki University Central Hospital, Finland / Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
    Mullola, Sari
    Institute of Behavioural Sciences, University of Helsinki, Finland / Department of Teacher Education, University of Helsinki, Finland.
    Vahlberg, Tero Juhani
    Department of Biostatistics, University of Turku, Finland.
    But, Anna
    Clinicum, Department of Public Health, University of Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Finland.
    Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial2020In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 660-669Article in journal (Refereed)
    Abstract [en]

    Background: Mindfulness-Based Interventions (MBIs) have shown promising effects on mental health among children and adolescents, but high-quality studies examining the topic are lacking. The present study assessed the effects of MBI on mental health in school-setting in an extensive randomised controlled trial. Methods: Finnish school children and adolescents (N = 3519), aged 12–15 years (6th to 8th graders), from 56 schools were randomized into a 9 week MBI group, and control groups with a relaxation program or teaching as usual. The primary outcomes were resilience, socio-emotional functioning, and depressive symptoms at baseline, at completion of the programs at 9 weeks (T9), and at follow-up at 26 weeks (T26). Results: Overall, mindfulness did not show more beneficial effects on the primary outcomes compared to the controls except for resilience for which a positive intervention effect was found at T9 in all participants (β=1.18, SE 0.57, p = 0.04) as compared to the relaxation group. In addition, in gender and grade related analyses, MBI lowered depressive symptoms in girls at T26 (β=−0.49, SE 0.21, p = 0.02) and improved socio-emotional functioning at T9 (β=−1.37, SE 0.69, p = 0.049) and at T26 (β=−1.71, SE 0.73, p = 0.02) among 7th graders as compared to relaxation. Limitations: The inactive control group was smaller than the intervention and active control groups, reducing statistical power. Conclusions: A short 9-week MBI in school-setting provides slight benefits over a relaxation program and teaching as usual. Future research should investigate whether embedding regular mindfulness-based practice in curriculums could intensify the effects. 

  • 1197.
    Volanen, Salla-Maarit
    et al.
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Lassander, Maarit
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
    Hankonen, Nelli
    School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
    Santalahti, Päivi
    National Institute for Health and Welfare, Helsinki, Finland.
    Hintsanen, Mirka
    Unit of Psychology, University of Oulu, Oulu, Finland.
    Simonsen, Nina
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Raevuori, Anu
    Department of Public Health, University of Helsinki, Helsinki, Finland / Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland / Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
    Mullola, Sari
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland / Department of Teacher Education, University of Helsinki, Helsinki, Finland.
    Vahlberg, Tero
    Department of Biostatistics, University of Turku, Turku, Finland.
    But, Anna
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Turku, Turku, Finland.
    Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial2016In: BMC Psychology, E-ISSN 2050-7283, Vol. 4, article id 35Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Mindfulness has shown positive effects on mental health, mental capacity and well-being among adult population. Among children and adolescents, previous research on the effectiveness of mindfulness interventions on health and well-being has shown promising results, but studies with methodologically sound designs have been called for. Few intervention studies in this population have compared the effectiveness of mindfulness programs to alternative intervention programs with adequate sample sizes.

    METHODS/DESIGN: Our primary aim is to explore the effectiveness of a school-based mindfulness intervention program compared to a standard relaxation program among a non-clinical children and adolescent sample, and a non-treatment control group in school context. In this study, we systematically examine the effects of mindfulness intervention on mental well-being (primary outcomes being resilience; existence/absence of depressive symptoms; experienced psychological strengths and difficulties), cognitive functions, psychophysiological responses, academic achievements, and motivational determinants of practicing mindfulness. The design is a cluster randomized controlled trial with three arms (mindfulness intervention group, active control group, non-treatment group) and the sample includes 59 Finnish schools and approx. 3 000 students aged 12-15 years. Intervention consists of nine mindfulness based lessons, 45 mins per week, for 9 weeks, the dose being identical in active control group receiving standard relaxation program called Relax. The programs are delivered by 14 educated facilitators. Students, their teachers and parents will fill-in the research questionnaires before and after the intervention, and they will all be followed up 6 months after baseline. Additionally, students will be followed 12 months after baseline. For longer follow-up, consent to linking the data to the main health registers has been asked from students and their parents.

    DISCUSSION: The present study examines systematically the effectiveness of a school-based mindfulness program compared to a standard relaxation program, and a non-treatment control group. A strength of the current study lies in its methodologically rigorous, randomized controlled study design, which allows novel evidence on the effectiveness of mindfulness over and above a standard relaxation program.

    TRIAL REGISTRATION: ISRCTN18642659 . Retrospectively registered 13 October 2015.

  • 1198.
    Vuorio, Tina
    et al.
    Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland.
    Kautiainen, Hannu
    Folkhälsan Research Center, Helsinki, Finland / Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
    Korhonen, Päivi
    Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland / Health Center of Harjavalta, Central Satakunta Health Federation of Municipalities, Harjavalta, Finland.
    Determinants of sickness absence rate among Finnish municipal employees2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    Objective: In addition to acute health problems, various aspects of health behavior, work-related and sociodemographic factors have been shown to influence the rate of sickness absence. The aim of this study was to concomitantly examine factors known to have an association with absenteeism. We hypothesized the prevalence of chronic diseases being the most important factor associated with sickness absence. Design: A cross-sectional study. Setting: Occupational health care in the region of Pori, Finland. Subjects: 671 municipal employees (89% females) with a mean age of 49 (SD 10) years. Information about the study subjects was gathered from medical records, by physical examination and questionnaires containing information about physical and mental health, health behavior, work-related and sociodemographic factors. The number of sickness absence days was obtained from the records of the city of Pori. Main outcome measures: The relationship of absenteeism rate with sociodemographic, health- and work-related risk factors. Results: In the multivariate analysis, the mean number of chronic diseases (IRR 1.24, 95% CI 1.13 to 1.36), work ability (IRR 0.83, 95% CI 0.76 to 0.91), and length of years in education (IRR 0.90, 95% CI 0.85 to 0.95) remained as independent factors associated with absenteeism. Conclusion: According to our results, chronic diseases, self-perceived work ability and length of years in education are the most important determinants of the rate of sickness absence. This implies that among working-aged people the treatment of chronic medical conditions is also worth prioritizing, not only to prevent complications, but also to avoid sickness absences. KEY POINTS Various sociodemographic, health- and work- related risk factors have been shown to influence sickness absence. The study aimed to find the most important determinants of absenteeism among several known risk factors in Finnish municipal employees. Chronic diseases, self-perceived work ability and education years remained as the most important determinants of sickness absence rates. Treatment of chronic medical conditions should be prioritized in order to reduce sickness absence rate. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 1199.
    Wahlgren, Emma
    et al.
    University of Skövde, School of Health and Education.
    Larsson, Therese
    University of Skövde, School of Health and Education.
    Förstföderskors upplevelser av socialt stöd under graviditet2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: One of the major events in human life is childbearing and the transition to becoming a parent.  It is a momentous time when women are especially vulnerable and the possibility of increased support should be available to create conditions for health and wellbeing. According to previous research, there is a clear correlation between perceived social support and numerous health benefits. Problem: However, there is barely research on pregnant women's experiences of social support during pregnancy. Aim: The aim of this study was to describe pregnant women's experiences of social support before childbirth and parenting. Method: A qualitative content analysis with an inductive approach was used as a method. Semi-structured telephone interviews were conducted and totally 15 first-time pregnant women were included in the study. Results: The results are presented in three categories with an overall theme. The result showed that social support during pregnancy had a keyrole in women's experiences of mental preparation and security for childbirth and parenthood. Conclusion: The women described the social support like a big puzzle, where each piece of the puzzle of social support contributed to a complete puzzle of mental preparation. Professional support, through for example, midwives, could facilitate social support. To meet the needs of pregnant women it is important that the professional who comes in contact with them are aware of how they can provide support, in order to facilitate social support.

  • 1200.
    Waldholm, Therese
    University of Skövde, School of Health and Education.
    Är fysisk aktivitet lösningen på framtidens sömnlöshetsproblem?: En systematisk litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Insomnia is a major and growing public health problem for the adult population. Currently recommend medication and cognitive behavior therapy as treatment for the diagnosis, but no special recommendations are available for the purpose of preventing chronic insomnia och insomnia symptoms. Research shows that peoples living habits appear to be determining factors for their sleep quality, but it is still estimated that the area is relatively unexplored. Aim: This study investigate whether physical activity can prevent chronic insomnia and symptoms of insomnia in adults. Method: Systematic literature study in PubMed. Result: Physical activity was found to be associated with chronic insomnia and insomnia symptoms, and the association was affected by the body mass index (BMI) of the individual. Differences in intensity levels and physical activity were observed between the sexes and in different age groups. Discussion: The prescription of physical activity to individuals at risk for insomnia, or for treatment of those suffering from insomnia, represents a potential future public health strategy for the management and prevention of insomnia, however, cost-effectiveness of these strategies must be evaluated.

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