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  • 201.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Promotion2015In: The SAGE Encyclopedia of Economics and Society / [ed] Frederick F. Wherry & Juliet B. Schor, Thousand Oaks: Sage Publications, 2015, p. 1336-1337Chapter in book (Refereed)
  • 202.
    Kazemi, Ali
    University of Skövde, School of Technology and Society. University of Skövde, Health and Education.
    Välbefinnande2009In: Välbefinnande i arbetslivet: socialpsykologiska perspektiv / [ed] Ali Kazemi, Lund: Studentlitteratur, 2009, 1, p. 23-33Chapter in book (Refereed)
  • 203.
    Kazemi, Ali
    University of Skövde, School of Technology and Society. University of Skövde, Health and Education.
    Välbefinnande i arbetslivet: socialpsykologiska perspektiv2009Collection (editor) (Other academic)
  • 204.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eek, Daniel
    Department of Psychology, Göteborg University, Sweden.
    Gärling, Tommy
    Department of Psychology, Göteborg University, Sweden.
    Allocation of Public Goods: The Interplay of Self-Interest, Fairness, and Group Goal2016In: Social Psychology, ISSN 1864-9335, E-ISSN 2151-2590, Vol. 47, no 4, p. 214-222Article in journal (Refereed)
    Abstract [en]

    Seventy-two undergraduates participating in a step-level asymmetric public good dilemma were requested to distribute the provided public good among the group members to achieve different group goals. In Line with the hypotheses, economic productivity resulted in equitable allocations, harmony in equal allocations, and social concern in need-based allocations. The results also supported the hypotheses that salience of group goal minimizes influences of self-interest on allocations and that perceived fairness accounts for why people pursuing different group goals differ in their preferences for allocation of public goods.

  • 205.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eek, Daniel
    Department of Psychology, University of Gothenburg, Göteborg, Sweden.
    Gärling, Tommy
    Department of Psychology, University of Gothenburg, Göteborg, Sweden.
    Equity, Equal Shares or Equal Final Outcomes?: Group Goal Guides Allocations of Public Goods2017In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 8, p. 1-7, article id 36Article in journal (Refereed)
    Abstract [en]

    In an experiment we investigate preferences for allocation of a public good among group members who contributed unequally in providing the public good. Inducing the group goal of productivity resulted in preferences for equitable allocations, whereas inducing the group goals of harmony and social concern resulted in preferences for equal final outcomes. The study makes a contribution by simultaneously treating provision and allocation of a public good, thus viewing these as related processes. Another contribution is that a new paradigm is introduced that bears closer resemblance to real life public good dilemmas than previous research paradigms do.

  • 206.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kajonius, Petri
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre.
    Variations in user-oriented elderly care: a multilevel approach2017In: International Journal of Quality and Service Sciences, ISSN 1756-669X, E-ISSN 1756-6703, Vol. 9, no 2, p. 138-147Article in journal (Refereed)
  • 207.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kajonius, Petri J.
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre.
    Cost and satisfaction trends in Swedish elderly home care2016In: Home Health Care Management & Practice, ISSN 1084-8223, E-ISSN 1552-6739, Vol. 28, no 4, p. 250-255Article in journal (Refereed)
  • 208.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kajonius, Petri J.
    Division of Gerontology, Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    User-oriented elderly care: A validation study in two different settings using observational data2015In: Quality in Ageing and Older Adults, ISSN 1471-7794, Vol. 16, no 3, p. 140-152Article in journal (Refereed)
    Abstract [en]

    Purpose - User-oriented care, defined as individualized assisting behaviors, is the dominant approach within elderly care today. Yet, there is little known about its conceptual structure. This paper proposes that user-oriented care has a bi-partite structure which may be decomposed into the two dimensions of task and relation. Design/methodology/approach - Care workers were "shadowed" (i.e. observed) at their work (n=391 rated interactions). User-oriented care was assessed along ten process quality indicators targeting the acts of caregiving (i.e. task focus, relation focus, involvement, time-use, body language, autonomy, respect, warmth, encouragement, and information) in two elderly care settings, i.e. home care and nursing home. Observations added up to 45 hours. Findings - Principal component analyses confirmed the proposed two-factor structure of user-oriented care. Specifically, the user-oriented care indicators loaded on two distinct factors, i.e. task and relation. The underlying structure of user-oriented care revealed to be invariant across the two settings. However, the results revealed interesting structural differences in terms of explained variance and the magnitude of factor loadings in the home care and nursing home settings. Differences also emerged specifically pertaining to the indicators of autonomy and time-use. These findings suggest that user-oriented behavior may to some extent denote different acts of caregiving and what may be called task- and relation-orientation may be loaded with different meanings in these two care settings. Originality/value - This is the first study investigating user-oriented behavior in the context of elderly care using a quantitative observational approach. The authors propose that the observed differences between the two care settings are primarily not due to better elderly care work in home care, but due to some inherent differences between these two contexts of care (e.g. better health and living at home). © Ali Kazemi and Petri J. Kajonius. Published by Emerald Group Publishing Limited.

  • 209.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Pilotstudie om psykisk ohälsa och utanförskap bland unga vuxna: Personliga berättelser och reflektioner kring vägar som bär till förändring2014Report (Other academic)
  • 210.
    Kazemi, Ali
    et al.
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Stark Ekman, Diana
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Kylberg, Elisabeth
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Differing attitudes toward health and sickness2014In: Encyclopedia of human services and diversity / [ed] Linwood H. Cousins, Sage Publications, 2014, p. 616-618Chapter in book (Refereed)
  • 211.
    Kazemi, Ali
    et al.
    University of Skövde, School of Technology and Society. University of Skövde, Health and Education.
    Törnblom, Kjell
    University of Skövde, School of Technology and Society. University of Skövde, Health and Education.
    Rättvist ledarskap2009In: Välbefinnande i arbetslivet: socialpsykologiska perspektiv / [ed] Ali Kazemi, Lund: Studentlitteratur, 2009, 1, p. 37-63Chapter in book (Refereed)
  • 212.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellDepartment of Environmental Systems Science, ETH Zurich, Switzerland.
    Social Justice Research2016Collection (editor) (Other academic)
  • 213.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellDepartment of Environmental Systems Science, ETH Zurich, Switzerland.
    Social Justice Research2016Collection (editor) (Other academic)
  • 214.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellDepartment of Environmental Systems Science, ETH Zurich, Switzerland.
    Social Justice Research2016Collection (editor) (Other academic)
  • 215.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2015Collection (editor) (Other academic)
  • 216.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2015Collection (editor) (Other academic)
  • 217.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2014Collection (editor) (Other academic)
  • 218.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2014Collection (editor) (Other academic)
  • 219.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2014Collection (editor) (Other academic)
  • 220.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellUniversity of Skövde, School of Health and Education.
    Social Justice Research2014Collection (editor) (Other academic)
  • 221.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, KjellDepartment of Environmental Systems Science, ETH Zurich, Switzerland.
    Social Justice Research2016Collection (editor) (Other academic)
  • 222.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, Kjell
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Third-Party Allocation of Rewards: The Effects of Categorization and Request for Justice2014In: Small Group Research, ISSN 1046-4964, E-ISSN 1552-8278, Vol. 45, no 4, p. 435-450Article in journal (Refereed)
    Abstract [en]

    The present study shows that categorization of reward recipients into different entities affects distributive preferences by third-party non-recipient allocators. Rewards were allocated more equally to members of one group than to members of two dyads or to independent recipients. Moreover, allocators who were explicitly requested to allocate rewards justly were more egalitarian than those who were not requested to do so. More interestingly, rewards were allocated more equally between members in each of two dyads and between independent recipients, when a just allocation request was made, than when such a request was not made. This implies that a request for just allocation modifies the effects of recipient entity categorization toward more equal reward allocations. © The Author(s) 2014.

  • 223.
    Kazemi, Ali
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, Kjell
    ETH Zürich, Zürich, Switzerland.
    Mikula, Gerold
    University of Graz, Graz, Austria.
    Justice: Social Psychological Perspectives2015In: International Encyclopedia of the Social & Behavioral Sciences / [ed] James D. Wright, Oxford: Elsevier, 2015, 2, p. 949-955Chapter in book (Refereed)
    Abstract [en]

    This article discusses the concept of justice from a social psychological perspective. The authors begin by briefly outlining some theoretical precursors of current social psychological research on justice. Another part is devoted to an overview of theories and empirical research in the areas of distributive and procedural justice. The article furthermore addresses interactional justice, why people care about justice, and reactions to injustice in the context of which individual differences in conceptions of justice are briefly discussed. The article ends by discussing some current trends, social applications, and some future challenges in social psychological inquiries of social justice.

  • 224.
    Kenne Sarenmalm, Elisabeth
    et al.
    Research and Development Centre, Skaraborg Hospital, Skövde, Sweden / Institute of Health and Caring Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden / Johns Hopkins University, Baltimore, Maryland, USA / Johns Hopkins University, School of Nursing, Baltimore, Maryland, USA.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Johns Hopkins University, Baltimore, Maryland, USA / Institute of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden / Johns Hopkins University, School of Nursing, Baltimore, Maryland, USA / Institute of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institute, Stockholm, Sweden.
    Gaston-Johansson, Fannie
    Johns Hopkins University, School of Nursing, Baltimore, Maryland, USA.
    Symptom Burden Clusters: A Challenge for Targeted Symptom Management. A Longitudinal Study Examining Symptom Burden Clusters in Breast Cancer2014In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 47, no 4, p. 731-741Article in journal (Refereed)
    Abstract [en]

    Context: Although there has been a growing interest in cancer symptom clusters, less is known about symptom burden clusters. Objectives: To explore clusters of burdensome symptoms over time, the impact on health status and quality of life, and coping capacity in patients with breast cancer. Methods: In this longitudinal study, a sample of 206 patients completed the Memorial Symptom Assessment Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, and the Sense of Coherence scale, at diagnosis of primary or recurrent breast cancer, and at one-, three-, and six-month follow-ups. Results: Three clusters of burdensome symptoms were identified: emotional symptom burden, gastrointestinal symptom burden, and unwellness symptom burden. Most burdensome were emotional symptoms, with worrying, feeling sad, and feeling nervous as the core or defining symptoms. Over time, additional symptoms escalated the emotional symptom burden. The gastrointestinal symptom burden, with "change in the way food tastes" as a core symptom, was more often associated with chemotherapy. Less stable over time, the unwellness symptom burden could be interpreted as short- and long-term side effects of hormonal therapy. Of these clusters, only the emotional symptom burden cluster significantly diminished health status and quality of life. Patients reporting lower coping capacity experienced higher levels of symptom burden. Conclusion: This study provides insights into symptom burden clusters over time. A challenging approach toward symptom management in clinical oncology is to target the burden of a symptom cluster and to recognize the need for individually designed interventions to ameliorate symptom burden in cancer patients. © 2013 U.S. Cancer Pain Relief Committee.

  • 225.
    Kenne Sarenmalm, Elisabeth
    et al.
    Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersson, Bengt A.
    Department of Clinical immunology and transfusion medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Karlsson, Per
    Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital,Sweden University of Gothenburg, Gothenburg, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mindfulness and its efficacy for psychological and biological responses in women with breast cancer2017In: Cancer Medicine, ISSN 2045-7634, E-ISSN 2045-7634, Vol. 6, no 5, p. 1108-1122Article in journal (Refereed)
    Abstract [en]

    Many breast cancer survivors have to deal with a variety of psychological andphysiological sequelae including impaired immune responses. The primary purposeof this randomized controlled trial was to determine the efficacy of amindfulness-basedstress reduction (MBSR) intervention for mood disorders inwomen with breast cancer. Secondary outcomes were symptom experience, healthstatus, coping capacity, mindfulness, posttraumatic growth, and immune status.This RTC assigned 166 women with breast cancer to one of three groups: MBSR(8 weekly group sessions of MBSR), active controls (self-instructingMBSR) andnon-MBSR.The primary outcome measure was the Hospital Anxiety and DepressionScale. Secondary outcome measures were: Memorial Symptom AssessmentScale, SF-36,Sense of Coherence, Five Facets of Mindfulness Questionnaire,and Posttraumatic Growth Index. Blood samples were analyzed using flow cytometryfor NK-cellactivity (FANKIA) and lymphocyte phenotyping; concentrationsof cytokines were determined in sera using commercial high sensitivityIL-6and IL-8ELISA (enzyme-linkedimmunosorbent assay) kits. Results provideevidence for beneficial effects of MBSR on psychological and biological responses.Women in the MBSR group experienced significant improvements in depressionscores, with a mean pre-MBSRHAD-scoreof 4.3 and post-MBSRscore of 3.3(P = 0.001), and compared to non-MBSR(P = 0.015). Significant improvementson scores for distress, symptom burden, and mental health were also observed.Furthermore, MBSR facilitated coping capacity as well as mindfulness and posttraumaticgrowth. Significant benefits in immune response within the MBSRgroup and between groups were observed. MBSR have potential for alleviatingdepression, symptom experience, and for enhancing coping capacity, mindfulnessand posttraumatic growth, which may improve breast cancer survivorship.MBSR also led to beneficial effect on immune function; the clinical implicationsof this finding merit further research.

  • 226.
    Kharkova, Olga A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway,Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Grjibovski, Andrej M.
    International School of Public Health, Northern State Medical University, Arkhangelsk, Russia / Department of Public Health, North-Eastern Federal University, Yakutsk, Russia / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
    Odland, Jon Ø.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Effect of Smoking Behavior before and during Pregnancy on Selected Birth Outcomes among Singleton Full-Term Pregnancy: A Murmansk County Birth Registry Study2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 8, p. 1-11, article id E867Article in journal (Refereed)
    Abstract [en]

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

  • 227.
    Kharkova, Olga A.
    et al.
    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, Kazakhstan / Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, Hamilton, ON, Canada.
    Odland, Jon Ø.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    First-trimester smoking cessation in pregnancy did not increase the risk of preeclampsia/eclampsia: A Murmansk County Birth Registry study2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 8, article id e0179354Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although prior studies have shown that smoking reduces preeclampsia/eclampsia risk, the consequence of giving up this habit during pregnancy should be assessed. The aims of the current study were threefold: (i) describe maternal characteristics of women with preeclampsia/eclampsia; (ii) examine a possible association between the number of cigarettes smoked daily during pregnancy and the development of this affliction; and (iii) determine if first-trimester discontinuation of smoking during pregnancy influences the risk.

    METHODS: A registry-based study was conducted using data from the Murmansk County Birth Registry (MCBR). It included women without pre-existing hypertension, who delivered a singleton infant during 2006-2011 and had attended the first antenatal visit before 12 week of gestation. We adjusted for potential confounders using logistic regression.

    RESULTS: The prevalence of preeclampsia/eclampsia was 8.3% (95%CI: 8.0-8.6). Preeclampsia/eclampsia associated with maternal age, education, marital status, parity, excessive weight gain and body mass index at the first antenatal visit. There was a dose-response relationship between the number of smoked cigarettes per day during pregnancy and the risk of preeclampsia/eclampsia (adjusted OR1-5 cig/day = 0.69 with 95%CI: 0.56-0.87; OR6-10 cig/day = 0.65 with 95%CI: 0.51-0.82; and OR≥11 cig/day = 0.49 with 95%CI: 0.30-0.81). There was no difference in this risk among women who smoked before and during pregnancy and those who did so before but not during pregnancy (adjusted OR = 1.10 with 95%CI: 0.91-1.32).

    CONCLUSIONS: Preeclampsia/eclampsia was associated with maternal age, education, marital status, parity, excessive weight gain, and body mass index at the first antenatal visit. There was a negative dose-response relationship between the number of smoked cigarettes per day during pregnancy and the odds of preeclampsia/eclampsia. However, women who gave up smoking during the first trimester of gestation had the same risk of preeclampsia/eclampsia as those who smoked while pregnant. Consequently, antenatal clinic specialists are advised to take these various observations into account when counselling women on smoking cessation during pregnancy.

  • 228.
    Kharkova, Olga A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    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.
    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-Easten Federal University, Yakutsk, Russia.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, Hamilton, ON, Canada.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Prevalence of smoking before and during pregnancy and changes in this habit during pregnancy in Northwest Russia: a Murmansk county birth registry study2016In: Reproductive Health, ISSN 1742-4755, E-ISSN 1742-4755, Vol. 13, no 1, p. 1-9, article id 18Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Smoking during pregnancy leads to adverse maternal and birth outcomes. However, the prevalence of smoking among women in Russia has increased from < 5 % in the 1980s to > 20 % in the 2000s. We conducted a registry-based study in Murmansk County, Northwest Russia. Our aims were twofold: (i) assess the prevalence of smoking before and during pregnancy; and (ii) examine the socio-demographic factors associated with giving up smoking or reducing the number of cigarettes smoked once pregnancy was established.

    METHODS: This study employs data from the population-based Murmansk County Birth Registry (MCBR) collected during 2006-2011. We used logistic regression to investigate associations between women's socio-demographic characteristics and changes in smoking habit during pregnancy. To avoid departure from uniform risk within specific delivery departments, we employed clustered robust standard errors.

    RESULTS: Of all births registered in the MCBR, 25.2 % of the mothers were smokers before pregnancy and 18.9 % continued smoking during pregnancy. Cessation of smoking during pregnancy was associated with education, marital status and parity but not with maternal age, place of residence, and ethnicity. Women aged ≤ 20-24 years had higher odds of reducing the absolute numbers of cigarettes smoked per day during pregnancy than those aged ≥ 30-34 years. Moreover, smoking nulliparae and pregnant women who had one child were more likely to reduce the absolute numbers of cigarettes smoked per day compared to women having ≥ 2 children.

    CONCLUSIONS: About 25.0 % of smoking women in the Murmansk County in Northwest Russia quit smoking after awareness of the pregnancy, and one-third of them reduced the number cigarettes smoked during pregnancy. Our study demonstrates that women who have a higher education, husband, and are primiparous are more likely to quit smoking during pregnancy. Maternal age and number of children are indicators that influence reduction in smoking during pregnancy. Our findings are useful in identifying target groups for smoking intervention campaigns.

  • 229.
    Khidir, N.
    et al.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Al Dhaheri, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, 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, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Al Kuwari, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Sargsyan, D.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar.
    Bashah, M.
    Department of Metabolic & Bariatric Surgery, Hamad General Hospital, Doha, Qatar / Weill Cornell Medicine-Qatar, Doha, Qatar / Qatar Metabolic Institute, Doha, Qatar.
    Outcomes of Laparoscopic Gastric Greater Curvature Plication in Morbidly Obese Patients2017In: Journal of Obesity, ISSN 2090-0708, E-ISSN 2090-0716, Vol. 2017, article id 7989714Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Laparoscopic gastric greater curvature plication (LGGCP) is a restrictive bariatric procedure without gastrectomy. However, limited literature on effectiveness of gastric plication exists.

    OBJECTIVES: We assessed LGGCP's efficacy, effects on associated comorbidities, safety and the rate of complications, and patient satisfaction with LGGCP's outcomes among morbidly obese patients.

    METHOD: Analysis of retrospectively data collected from medical records of 26 patients who had undergone LGGCP at Hamad General Hospital, Qatar, during 2011-2012.

    RESULTS: Most patients (92%) were Qatari nationals. The sample's mean age was 35.1 years. Mean duration of hospital stay was 3.9 ± 1.2 days. Mean preoperative BMI was 40.7 kg/m(2) that decreased at 2 years to 34.6 kg/m(2). LGGCP's effects on comorbidities were such that 7.6% of patients experienced resolutions of their comorbidities. There were no mortality or postoperative complications that required reoperation. Six patients (23%) were satisfied with the LGGCP's outcomes while 10 patients (38.5%) underwent sleeve gastrectomy subsequently.

    CONCLUSION: LGGCP had acceptable short term weight loss results, exhibited almost no postoperative complications, and improved patients' comorbidities. Despite the durability of the gastric fold, some patients regained weight. Future research may assess the possibility of an increase in the gastric pouch size postplication associated with weight regain.

  • 230.
    Kimmo, Eriksson
    et al.
    School of Education, Culture and Communication, Mälardalen University, Västerås, Sweden.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Törnblom, Kjell
    ETH Zürich, Zürich, Switzerland.
    A New Look at Individual Differences in Perceptions of Unfairness: The Theory of Maximally Unfair Allocations in Multiparty Situations2015In: Social Justice Research, ISSN 0885-7466, E-ISSN 1573-6725, Vol. 28, no 4, p. 401-414Article in journal (Refereed)
    Abstract [en]

    Previous research has demonstrated that unfairness judgments of resource allocations become more complex when there are more than two recipients. In order to explain some of this complexity, we propose a set of psychological mechanisms that may underlie four different choices of maximally unfair resource allocations (MUA): Self-Single-Loser, Self-One-Loser-of-Many, Self-Single-Winner, and Self-One-Winner-of-Many. From this psychological theory, several predictions are derived and tested in vignette studies involving a total of 708 participants recruited online using MTurk. As predicted by our theory, (1) choices of MUA where there is a single loser were much more common when the allocated resource was of negative rather than positive valence, and (2) the amount of egoistic bias individuals exhibited when judging the unfairness in receiving a small rather than a large share in a non-extreme multi-party allocation was predicted by their choices of MUA. These findings suggest that an individual’s choice of MUA reveals some generally relevant principles of how unfairness is perceived in multi-party allocations. This opens up new lines of inquiry, especially regarding research on social dilemmas and social value orientation.

  • 231.
    Kivimäki, Mika
    et al.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Fransson, Eleonor I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / School of Health Sciences, Jönköping University, Jönköping, Sweden / Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational Medicine, Koege Hospital, Copenhagen, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Casini, Annalisa
    School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium.
    De Bacquer, Dirk
    Department of Public Health, Ghent University, Ghent, Belgium.
    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.
    Geuskens, Goedele A.
    TNO, Hoofddorp, Netherlands.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Hooftman, Wendela E.
    TNO, Hoofddorp, Netherlands.
    Houtman, Irene L.
    TNO, Hoofddorp, Netherlands.
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
    Kittel, France
    School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Nielsen, Martin L.
    Unit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark.
    Nordin, Maria
    Stress Research Institute, Stockholm University, Stockholm, Sweden / Department of Psychology, Umeå University, Umeå, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Pejtersen, Jan H.
    The Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, 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, Tampere and Turku, Finland / Department of Psychology, University of Turku, Turku, Finland.
    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.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Suominen, Sakari B.
    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
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland / Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Westerholm, Peter J. M.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    O'Reilly, Dermot
    Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
    Kumari, Meena
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Cognitive Ageing and Cognitive Epidemiology and Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals2015In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 386, no 10005, p. 1739-1746Article in journal (Refereed)
    Abstract [en]

    Background Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. Methods We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. Findings We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5.1 million person-years (mean 8.5 years), in which 4768 events were recorded, and for stroke was 3.8 million person-years (mean 7.2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35-40 h per week), working long hours (>= 55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1.13, 95% CI 1.02-1.26; p=0.02) and incident stroke (1.33, 1.11-1.61; p=0.002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1.30-1.42). We recorded a dose-response association for stroke, with RR estimates of 1.10 (95% CI 0.94-1.28; p=0.24) for 41-48 working hours, 1.27 (1.03-1.56; p=0.03) for 49-54 working hours, and 1.33 (1.11-1.61; p=0.002) for 55 working hours or more per week compared with standard working hours (p(trend)<0.0001). Interpretation Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours. 

  • 232.
    Kivimäki, Mika
    et al.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki, Finland.
    Kuosma, Eeva
    Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    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.
    Luukkonen, Ritva
    Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland .
    Nyberg, Solja T.
    Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland .
    Alfredsson, Lars
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Batty, G David.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Brunner, Eric J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Fransson, Eleonor
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Stress Research Institute, Stockholm University, Stockholm, Sweden / School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Goldberg, Marcel
    Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Nordin, Maria
    Stress Research Institute, Stockholm University, Stockholm, Sweden / Department of Psychology, Umeå University, Umeå, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Rugulies, Reiner
    Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark / National Research Centre for the Working Environment, Copenhagen, Denmark.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Suominen, Sakari B.
    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
    Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Westerholm, Peter
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, United Kingdom.
    Bell, Joshua A.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.
    Tabak, Adam G.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe2017In: The Lancet Public Health, ISSN 2468-3667, Vol. 2, no 6, p. e277-e285Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although overweight and obesity have been studied in relation to individual cardiometabolic diseases, their association with risk of cardiometabolic multimorbidity is poorly understood. Here we aimed to establish the risk of incident cardiometabolic multimorbidity (ie, at least two from: type 2 diabetes, coronary heart disease, and stroke) in adults who are overweight and obese compared with those who are a healthy weight.

    METHODS: ) to achieve sufficient case numbers for analysis. The main outcome was cardiometabolic multimorbidity (ie, developing at least two from: type 2 diabetes, coronary heart disease, and stroke). Incident cardiometabolic multimorbidity was ascertained via resurvey or linkage to electronic medical records (including hospital admissions and death). We analysed data from each cohort separately using logistic regression and then pooled cohort-specific estimates using random-effects meta-analysis.

    FINDINGS: Participants were 120  813 adults (mean age 51·4 years, range 35-103; 71 445 women) who did not have diabetes, coronary heart disease, or stroke at study baseline (1973-2012). During a mean follow-up of 10·7 years (1995-2014), we identified 1627 cases of multimorbidity. After adjustment for sociodemographic and lifestyle factors, compared with individuals with a healthy weight, the risk of developing cardiometabolic multimorbidity in overweight individuals was twice as high (odds ratio [OR] 2·0, 95% CI 1·7-2·4; p<0·0001), almost five times higher for individuals with class I obesity (4·5, 3·5-5·8; p<0·0001), and almost 15 times higher for individuals with classes II and III obesity combined (14·5, 10·1-21·0; p<0·0001). This association was noted in men and women, young and old, and white and non-white participants, and was not dependent on the method of exposure assessment or outcome ascertainment. In analyses of different combinations of cardiometabolic conditions, odds ratios associated with classes II and III obesity were 2·2 (95% CI 1·9-2·6) for vascular disease only (coronary heart disease or stroke), 12·0 (8·1-17·9) for vascular disease followed by diabetes, 18·6 (16·6-20·9) for diabetes only, and 29·8 (21·7-40·8) for diabetes followed by vascular disease.

    INTERPRETATION: The risk of cardiometabolic multimorbidity increases as BMI increases; from double in overweight people to more than ten times in severely obese people compared with individuals with a healthy BMI. Our findings highlight the need for clinicians to actively screen for diabetes in overweight and obese patients with vascular disease, and pay increased attention to prevention of vascular disease in obese individuals with diabetes.

    FUNDING: NordForsk, Medical Research Council, Cancer Research UK, Finnish Work Environment Fund, and Academy of Finland.

  • 233.
    Kivimäki, Mika
    et al.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Luukkonen, Ritva
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Cognitive Ageing and Cognitive Epidemiology, Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom.
    Ferrie, Jane E.
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Pentti, Jaana
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Nyberg, Solja T.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Fransson, Eleonor I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / School of Health Sciences and Welfare, Jönköping University, Jönköping, Sweden / Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm.
    Goldberg, Marcel
    Population-based Epidemiologic Cohort Unit, Villejuif, France.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Kuosma, Eeva
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
    Nordin, Maria
    Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden / Department of Psychology, Umeå University, Umeå, Sweden.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Folkhälsan Research Center, Folkhälsan, Helsinki, Finland / Turku University Hospital, Turku, Finland.
    Theorell, Töres
    Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Vuoksimaa, Eero
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Division of Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Population-based Epidemiologic Cohort Unit, France.
    Kivipelto, Miia
    Department of Neurobiology, Karolinska Institute, Stockholm, Sweden / National Institute for Health and Welfare, Helsinki, Finland.
    Vahtera, Jussi
    Turku University Hospital, Turku, Finland / University of Turku, Turku, Finland.
    Kaprio, Jaakko
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Institute for Molecular Medicine (FIMM), University of Helsinki, Helsinki, Finland.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Population-based Epidemiologic Cohort Unit, France / Department of Psychology, Umeå University, Umeå, Sweden.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland / Department of Psychology, Umeå University, Umeå, Sweden.
    Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals2018In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, no 5, p. 601-609Article in journal (Refereed)
    Abstract [en]

    Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up using linkage to electronic health records (N = 6894). We assumed BMI is little affected by preclinical dementia when assessed decades before dementia onset and much affected when assessed nearer diagnosis. Results: Hazard ratios per 5-kg/m(2) increase in BMI for dementia were 0.71 (95% confidence interval = 0.66-0.77), 0.94 (0.89-0.99), and 1.16 (1.05-1.27) when BMI was assessed 10 years, 10-20 years, and >20 years before dementia diagnosis. Conclusions: The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

  • 234.
    Kivimäki, Mika
    et al.
    UCL, Dept Epidemiol & Publ Hlth, London, United Kingdom / Univ Helsinki, Fac Med, Clinicum, Helsinki, Finland / Finnish Inst Occupat Hlth, Helsinki, Finland.
    Nyberg, Solja T.
    Univ Helsinki, Fac Med, Clinicum, Helsinki, Finland.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, United Kingdom / Univ Edinburgh, Ctr Cognit Ageing & Cognit Epidemiol, Edinburgh, Scotland, United Kingdom.
    Kawachi, Ichiro
    Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Sci, Boston, USA.
    Jokela, Markus
    Univ Helsinki, Fac Med, Dept Psychol & Logoped, Helsinki, Finland.
    Alfredsson, Lars
    Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden / Karolinska Inst, Inst Environm Med, Stockholm, Sweden.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Borritz, Marianne
    Bispebjerg Univ Hosp Copenhagen, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth BAuA, Berlin, Germany.
    Dragano, Nico
    Univ Düsseldorf, Inst Med Sociol, Fac Med, Düsseldorf, Germany.
    Fransson, Eleonor I.
    Jönköping Univ, Sch Hlth & Welf, Jönköping, Sweden / Stockholm Univ, Stress Res Inst, Stockholm, Sweden.
    Heikkilä, Katriina
    London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London, United Kingdom / Royal Coll Surgeons England, Clin Effectiveness Unit, London, United Kingdom.
    Knutsson, Anders
    Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden.
    Koskenvuo, Markku
    Univ Helsinki, Fac Med, Clinicum, Helsinki, Finland.
    Kumari, Meena
    Univ Essex, Inst Social & Econ Res, Wivenhoe Pk, Colchester, Essex, England, United Kingdom.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Nielsen, Martin L.
    AS3 Co, AS3 Employment, Viby, Denmark.
    Nordin, Maria
    Stockholm Univ, Stress Res Inst, Stockholm, Sweden / Umeå Univ, Dept Psychol, Umeå, Sweden.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, Copenhagen, Denmark.
    Pentti, Jaana
    Univ Helsinki, Fac Med, Clinicum, Helsinki, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark / Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark / Univ Copenhagen, Dept Psychol, Copenhagen, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Helsinki, Finland / Univ Turku, Dept Psychol, Turku, Finland.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London, England, United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Univ Turku, Dept Publ Hlth, Turku, Finland.
    Theorell, Töres
    Stockholm Univ, Stress Res Inst, Stockholm, Sweden.
    Vahtera, Jussi
    Univ Turku, Dept Publ Hlth, Turku, Finland / Turku Univ Hosp, Turku, Finland.
    Westerholm, Peter
    Uppsala Univ, Dept Med Sci, Akad Sjukhuset, Uppsala, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, Stockholm, Sweden.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London, England, United Kingdom.
    Singh-Manoux, Archana
    Hop Paul Brousse, INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Hamer, Mark
    Loughborough Univ Technol, Natl Ctr Sport & Exercise Med, Sch Sport Exercise & Hlth Sci, Loughborough, Leics, England, United Kingdom.
    Ferrie, Jane E.
    Univ Bristol, Sch Social & Community Med, Bristol, Avon, England, United Kingdom.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Tabak, Adam G.
    UCL, Dept Epidemiol & Publ Hlth, London, England, United Kingdom / Semmelweis Univ, Fac Med, Dept Med 1, Budapest, Hungary.
    Long working hours as a risk factor for atrial fibrillation: a multi-cohort study2017In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, no 34, p. 2621-2628Article in journal (Refereed)
    Abstract [en]

    Aims Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (>= 55 per week) and those working standard 35-40 h/week. Methods and results In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991-2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI= 1.13-1.80, P= 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I-2= 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association. Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

  • 235.
    Kivimäki, Mika
    et al.
    Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Pentti, Jaana
    Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Public Health, University of Turku, Turku, Finland.
    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.
    Batty, G David.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Nyberg, Solja T.
    Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.
    Jokela, Markus
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
    Virtanen, Marianna
    Institute of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden.
    Alfredsson, Lars
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Fransson, Eleonor I.
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden / School of Health and Welfare, Jönköping University, Jönköping, Sweden / Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Goldberg, Marcel
    Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France / Versailles St-Quentin University, UMS 011, Villejuif, France.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kouvonen, Anne
    Faculty of Social Sciences, University of Helsinki, Helsinki, Finland / Division of Health Psychology, SWPS University of Social Sciences and Humanities in Wroclaw, Wroclaw, Poland / Administrative Data Research Centre Northern Ireland, Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
    Luukkonen, Ritva
    Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, 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.
    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 / Inserm UMR 1018, 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 / School of Social Policy, Sociology and Social Research, University of Kent, Canterbury, United Kingdom.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Westerholm, Peter J. M.
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France / Versailles St-Quentin University, UMS 011, Villejuif, France.
    Strandberg, Timo
    Clinicum, Faculty of Medicine, and Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland / Department of Internal Medicine, Helsinki University Hospital, Helsinki, Finland / Center for Life Course Health Research, University of Oulu, Oulu, Finland.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Deanfield, John
    National Centre for Cardiovascular Prevention and Outcomes, University College London, London, United Kingdom.
    Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study2018In: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 6, no 9, p. 705-713, article id S2213-8587(18)30140-2Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although some cardiovascular disease prevention guidelines suggest a need to manage work stress in patients with established cardiometabolic disease, the evidence base for this recommendation is weak. We sought to clarify the status of stress as a risk factor in cardiometabolic disease by investigating the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease.

    METHODS: In this multicohort study, we used data from seven cohort studies in the IPD-Work consortium, initiated between 1985 and 2002 in Finland, France, Sweden, and the UK, to examine the association between work stress and mortality. Work stress was denoted as job strain or effort-reward imbalance at work. We extracted individual-level data on prevalent cardiometabolic diseases (coronary heart disease, stroke, or diabetes [without differentiation by diabetes type]) at baseline. Work stressors, socioeconomic status, and conventional and lifestyle risk factors (systolic and diastolic blood pressure, total cholesterol, smoking status, BMI, physical activity, and alcohol consumption) were also assessed at baseline. Mortality data, including date and cause of death, were obtained from national death registries. We used Cox proportional hazards regression to study the associations of work stressors with mortality in men and women with and without cardiometabolic disease.

    RESULTS: We identified 102 633 individuals with 1 423 753 person-years at risk (mean follow-up 13·9 years [SD 3·9]), of whom 3441 had prevalent cardiometabolic disease at baseline and 3841 died during follow-up. In men with cardiometabolic disease, age-standardised mortality rates were substantially higher in people with job strain (149·8 per 10 000 person-years) than in those without (97·7 per 10 000 person-years; mortality difference 52·1 per 10 000 person-years; multivariable-adjusted hazard ratio [HR] 1·68, 95% CI 1·19-2·35). This mortality difference for job strain was almost as great as that for current smoking versus former smoking (78·1 per 10 000 person-years) and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups (mortality difference 5·9-44·0 per 10 000 person-years). Excess mortality associated with job strain was also noted in men with cardiometabolic disease who had achieved treatment targets, including groups with a healthy lifestyle (HR 2·01, 95% CI 1·18-3·43) and those with normal blood pressure and no dyslipidaemia (6·17, 1·74-21·9). In all women and in men without cardiometabolic disease, relative risk estimates for the work stress-mortality association were not significant, apart from effort-reward imbalance in men without cardiometabolic disease (mortality difference 6·6 per 10 000 person-years; multivariable-adjusted HR 1·22, 1·06-1·41).

    INTERPRETATION: In men with cardiometabolic disease, the contribution of job strain to risk of death was clinically significant and independent of conventional risk factors and their treatment, and measured lifestyle factors. Standard care targeting conventional risk factors is therefore unlikely to mitigate the mortality risk associated with job strain in this population.

    FUNDING: NordForsk, UK Medical Research Council, and Academy of Finland.

  • 236.
    Kivimäki, Mika
    et al.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England / Univ Helsinki, Clinicum, Finland /Univ Helsinki, Helsinki Inst Life Sci, Finland.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, England / INSERM, U1153, Epidemiol Ageing & Neurodegenerat Dis, Paris, France.
    Pentti, Jaana
    Univ Helsinki, Clinicum, Finland / Univ Turku, Dept Publ Hlth, Finland.
    Sabia, Séverine
    UCL, Dept Epidemiol & Publ Hlth, England / INSERM, U1153, Epidemiol Ageing & Neurodegenerat Dis, Paris, France.
    Nyberg, Solja T.
    Univ Helsinki, Clinicum, Finland.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden.
    Goldberg, Marcel
    INSERM, UMS 011, Populat Based Epidemiol Cohorts Unit, Villejuif, France.
    Knutsson, Anders
    Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden.
    Koskenvuo, Markku
    Univ Helsinki, Clinicum, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kouvonen, Anne
    Univ Helsinki, Fac Social Sci, Finland / SWPS Univ Social Sci & Humanities Wroclaw, Poland / Queens Univ Belfast, Ctr Publ Hlth, Adm Data Res Ctr Northern Ireland, Belfast, Antrim, North Ireland.
    Nordin, Maria
    Stockholm Univ, Stress Res Inst, Sweden / Umea Univ, Dept Psychol, Sweden.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Strandberg, Timo
    Univ Helsinki, Clinicum, Finland / Helsinki Univ Hosp, Finland / Univ Oulu, Ctr Life Course Hlth Res, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Univ Turku, Dept Publ Hlth, Finland.
    Theorell, Töres
    Stockholm Univ, Stress Res Inst, Sweden.
    Vahtera, Jussi
    Univ Turku, Dept Publ Hlth, Finland / Turku Univ Hosp, Finland.
    Väänanen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Virtanen, Marianna
    Univ Eastern Finland, Sch Educ Sci & Psychol, Joensuu, Finland.
    Westerholm, Peter
    Uppsala Univ, Dept Med Sci, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, Sweden.
    Zins, Marie
    INSERM, UMS 011, Populat Based Epidemiol Cohorts Unit, Villejuif, France.
    Seshadri, Sudha
    Univ Texas Hlth Sci Ctr San Antonio, Glenn Biggs Inst Alzheimers & Neurodegenerat Dis, San Antonio, TX 78229 USA / Framingham Heart Dis Epidemiol Study, Framingham, MA USA.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Sipilä, Pyry N.
    Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Lindbohm, Joni V.
    Univ Helsinki, Clinicum, Finland.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England / Univ Bristol, Bristol Med Sch, Populat Hlth Sci, Bristol, Avon, England.
    Jokela, Markus
    Univ Helsinki, Biomedicum, Fac Med, Finland.
    Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis2019In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 365, article id l1495Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To examine whether physical inactivity is a risk factor for dementia, with attention to the role of cardiometabolic disease in this association and reverse causation bias that arises from changes in physical activity in the preclinical (prodromal) phase of dementia. DESIGN Meta-analysis of 19 prospective observational cohort studies. DATA SOURCES The Individual-Participant-Data Meta-analysis in Working Populations Consortium, the Inter-University Consortium for Political and Social Research, and the UK Data Service, including a total of 19 of a potential 9741 studies. REVIEW METHOD The search strategy was designed to retrieve individual-participant data from prospective cohort studies. Exposure was physical inactivity; primary outcomes were incident all-cause dementia and Alzheimer's disease; and the secondary outcome was incident cardiometabolic disease (that is, diabetes, coronary heart disease, and stroke). Summary estimates were obtained using random effects meta-analysis. RESULTS Study population included 404 840 people (mean age 45.5 years, 57.7% women) who were initially free of dementia, had a measurement of physical inactivity at study entry, and were linked to electronic health records. In 6.0 million person-years at risk, we recorded 2044 incident cases of all-cause dementia. In studies with data on dementia subtype, the number of incident cases of Alzheimer's disease was 1602 in 5.2 million person-years. When measured < 10 years before dementia diagnosis (that is, the preclinical stage of dementia), physical inactivity was associated with increased incidence of all-cause dementia (hazard ratio 1.40, 95% confidence interval 1.23 to 1.71) and Alzheimer's disease (1.36, 1.12 to 1.65). When reverse causation was minimised by assessing physical activity >= 10 years before dementia onset, no difference in dementia risk between physically active and inactive participants was observed (hazard ratios 1.01 (0.89 to 1.14) and 0.96 (0.85 to 1.08) for the two outcomes). Physical inactivity was consistently associated with increased risk of incident diabetes (hazard ratio 1.42, 1.25 to 1.61), coronary heart disease (1.24, 1.13 to 1.36), and stroke (1.16, 1.05 to 1.27). Among people in whom cardiometabolic disease preceded dementia, physical inactivity was non-significantly associated with dementia (hazard ratio for physical activity assessed > 10 before dementia onset 1.30, 0.79 to 2.14). CONCLUSIONS In analyses that addressed bias due to reverse causation, physical inactivity was not associated with all-cause dementia or Alzheimer's disease, although an indication of excess dementia risk was observed in a subgroup of physically inactive individuals who developed cardiometabolic disease.

  • 237.
    Kjellsdotter, Anna
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Research and Development Centre, Skaraborg Hospital, Skövde, Sweden.
    Lantz, Björn
    Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden.
    Ottosson, Cornelia
    Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Healthcare Professionals' Views on Parental Participation in the Neonatal Intensive Care Units2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 41, no S1, p. 3-8Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To examine the associations between age, gender, and profession in relation to the perceived importance of parental participation in Neonatal Intensive Care Units.

    DESIGN AND METHODS: A quantitative cross-sectional design was used. Participants were recruited consecutively from all 40 existing NICU units in Sweden. A total of 443 healthcare professionals (372 nurses and 71 physicians) participated in the study. Participants completed the Swedish version of the Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N) questionnaire. Data were analyzed using multiple regression analyses.

    RESULTS: The findings indicated that profession and age, but not gender, had an overall perceived importance on how nurses and physicians rated specific aspects of parental participation in NICUs.

    CONCLUSIONS: Being a nurse, compared to a physician, was associated with an increase in overall perceived importance of parental participation in NICUs. These differences may affect and may be crucial for how parents take a part in the care of their infant and also for how they adapt to the parental role.

    PRACTICE IMPLICATIONS: Nurses and physicians require education and training that support parental participation based on age and their different roles, rather than simply conveying information about the technical medical aspects of NICU care. For a sustainable outcome all team members should be invited to discuss cases from their perspectives.

  • 238.
    Klaar, Susanne
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Öhman, Johan
    School of Humanities, Education and Social Sciences, Örebro University, Sweden.
    Children's meaning-making of nature in an outdoor-oriented and democratic Swedish preschool practice2014In: European Early Childhood Education Research Journal, ISSN 1350-293X, E-ISSN 1752-1807, Vol. 22, no 2, p. 229-253Article in journal (Refereed)
    Abstract [en]

    Previous research has shown that the Swedish preschool educational tradition is characterised by outdoor-oriented and democratic approaches. The purpose of this study is to empirically investigate what consequences these approaches have for preschool children's meaning-making of nature, when studied in practice, in children's spontaneous outdoor activities. The methodology is based on John Dewey's pragmatism with a specific focus on transaction, habits and customs. A transactional analysis method has been developed to fulfil the purpose of the investigation. The analysis illuminates relations between: (1) the Swedish preschool's educational tradition in terms of national customs; and (2) the local customs expressed in practice. Fifty-seven events were chosen for further analysis including play with water and sand, and sliding on snow. Consequences for children's meaning-making of nature are shown as possibilities for experience-based inquiry based on children's own choices and also for enjoying and feeling good in nature. The results show fewer possibilities for scientific concept learning. The results can thus be seen as a contribution to the early childhood educational discussion about how to arrange learning situations of natural phenomena and processes in preschools and at the same time maintain their democratic/outdoor-oriented characteristics.

  • 239.
    Klaeson, Kicki
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborgs Hospital, Department of Oncology, Skövde, Sweden.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gustavsson, Susanne
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    The character of nursing students' critical reflection at the end of their education2017In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 7, no 5, p. 55-61Article in journal (Refereed)
    Abstract [en]

    Background: In nursing education, theoretical and practical knowledge are intertwined and integrated in the prospective nurses’ lifeworld. To enable this, and to develop a critical reflective approach, students should adopt a critical attitude. This study aims to gain a deeper understanding of the character of prospective nurses’ critical reflection.

    Methods: This is a descriptive qualitative study. Data were gathered using written narratives, individual and focus group interviews. Qualitative content analysis was employed.

    Results: Three themes were identified: being open to changes, distancing oneself, and challenging one’s understanding. In the first theme, students’ critical reflection was expressed through an openness to changes of self-perception and openness to professional development during the education. In the second theme, critical reflection was identified as variations on distancetaking.

    Inserting distance from a direct experience makes the experience easier to process, understand and relate to the learner’s concept of nursing. In the third theme, courage to question what was taken for granted is identified as a necessity to challenging self-understanding and willingness to engage in uncertainty.

    Conclusions: It would appear that the academic part of training, with the possibility of reflection in small groups, provides students with conceptual tools for reflective learning as well as giving them the opportunity to relate critically to professional practice and to the professional nurse role.

  • 240.
    Klaeson, Kicki
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Oncology Department, Skaraborgs hospital, Sweden.
    Hovlin, Lina
    Home care, Skara Municipality, Skara, Sweden .
    Guvå, Hanna
    Psychiatric Department, Skaraborgs hospital, Sweden.
    Kjellsdotter, Anna
    University of Skövde, Health and Education. University of Skövde, School of Health and Education.
    Sexual Health in Primary Healthcare: A Qualitative Study of Nurses' Experiences2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 11-12, p. 1545-1554Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: To illuminate nurses’ experiences and opportunities to discuss sexual health with patients in primary healthcare.

    Background: Sexual health is a concept associated with many taboos and research shows that nurses feel uncomfortable talking to patients about sexual health and therefore avoid it. This avoidance forms a barrier between patient and nurse which prevents nurses from giving satisfactory healthcare to patients.

    Design: A qualitative descriptive design.

    Method: Semi-structured interviews were conducted with nine nurses in primary healthcare in Sweden. Data were analysed by using qualitative content analysis.

    Results: During the analysis phase, five subcategories and two main categories were identified. The two main categories were: “Factors that influence nurses’ opportunities to talk to patients about sexual health” and “Nurses’ experiences of talking to patients about sexual health”. Social norms in society were an obstacle for health professionals’ opportunities to feel comfortable and act professionally. The nurses’ personal attitude and knowledge were of great significance in determining if they brought up the topic of sexual health or not. The nurses found it easier to bring up the topic of sexual health with middle-aged men with for example diabetes. One reason for this is that they found it easier to talk to male patients. A further reason is the fact that they had received training in discussing matters of sexual health in relation to diabetes and other conditions affecting sexual health.

    Conclusion: Nurses in primary care express the necessity of additional education and knowledge on the subject of sexual health. The healthcare organization must be reformed to put focus on sexual health.

    Relevance for clinical practiceGuidelines for addressing the topic of sexual health must be implemented to establish conditions that will increase nurse's knowledge and provide them with the necessary tools for discussing sexual health with patients.

  • 241.
    Kokosar, Milana
    et al.
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Benrick, Anna
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Perfilyev, Alexander
    Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden.
    Nilsson, Emma
    Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden.
    Källman, Thomas
    Department of Medical Biochemistry and Microbiology, NBIS - National Bioinformatics Infrastructure Sweden, SciLifeLab, Uppsala University, Uppsala, Sweden.
    Ohlsson, Claes
    Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ling, Charlotte
    Epigenetics and Diabetes, Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, Clinical Research Centre, Scania University Hospital, Malmö, Sweden.
    Stener-Victorin, Elisabet
    Department of Physiology and Pharmacology, Karolinska Institutet, 17177, Stockholm, Sweden.
    A Single Bout of Electroacupuncture Remodels Epigenetic and Transcriptional Changes in Adipose Tissue in Polycystic Ovary Syndrome2018In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 1878Article in journal (Refereed)
    Abstract [en]

    A single bout of electroacupuncture results in muscle contractions and increased whole body glucose uptake in women with polycystic ovary syndrome (PCOS). Women with PCOS have transcriptional and epigenetic alterations in the adipose tissue and we hypothesized that electroacupuncture induces epigenetic and transcriptional changes to restore metabolic alterations. Twenty-one women with PCOS received a single bout of electroacupuncture, which increased the whole body glucose uptake. In subcutaneous adipose tissue biopsies, we identified treatment-induced expression changes of 2369 genes (Q < 0.05) and DNA methylation changes of 7055 individual genes (Q = 0.11). The largest increase in expression was observed for FOSB (2405%), and the largest decrease for LOC100128899 (54%). The most enriched pathways included Acute phase response signaling and LXR/RXR activation. The DNA methylation changes ranged from 1-16%, and 407 methylation sites correlated with gene expression. Among genes known to be differentially expressed in PCOS, electroacupuncture reversed the expression of 80 genes, including PPAR gamma and ADIPOR2. Changes in the expression of Nr4 alpha 2 and Junb are reversed by adrenergic blockers in rats demonstrating that changes in gene expression, in part, is due to activation of the sympathetic nervous system. In conclusion, low-frequency electroacupuncture with muscle contractions remodels epigenetic and transcriptional changes that elicit metabolic improvement.

  • 242.
    Koponen, Anne M.
    et al.
    University of Helsinki, Finland / Folkhälsan Research Center, Finland.
    Simonsen, Nina
    University of Helsinki, Finland / Folkhälsan Research Center, Finland.
    Laamanen, Ritva
    University of Helsinki, Finland / Folkhälsan Research Center, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Folkhälsan Research Center, Finland / University of Turku, Finland.
    Health-care climate, perceived self-care competence, and glycemic control among patients with type 2 diabetes in primary care2015In: Health Psychology Open, ISSN 2055-1029, Vol. 2, no 1Article in journal (Refereed)
    Abstract [en]

    This study showed, in line with self-determination theory, that glycemic control among patients with type 2 diabetes (n=2866) was strongly associated with perceived self-care competence, which in turn was associated with autonomous motivation and autonomy-supportive health-care climate. These associations remained after adjusting for the effect of important life-context factors. Autonomous motivation partially mediated the effect of health-care climate on perceived competence, which fully mediated the effect of autonomous motivation on glycemic control. The results of the study emphasize health-care personnel's important role in supporting patients' autonomous motivation and perceived self-care competence.

  • 243.
    Koponen, Anne M.
    et al.
    Folkhälsan Research Center, Finland / University of Helsinki, Finland.
    Simonsen, Nina
    Folkhälsan Research Center, Finland / University of Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. University of Turku, Finland.
    How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care?: A self-determination theory perspective2019In: Health Psychology Open, E-ISSN 2055-1029, Vol. 6, no 1Article in journal (Refereed)
    Abstract [en]

    The results of this study showed the importance of autonomous motivation for healthy eating. Autonomous motivation and female gender were the determinants most strongly associated with fruits, vegetables, and berries intake among patients with type 2 diabetes. Other determinants of fruits, vegetables, and berries intake were high education, high social support, high age, and a strong sense of coherence. Autonomous motivation and self-care competence mediated the effect of perceived autonomy support from a physician on fruits, vegetables, and berries intake. Thus, physicians can promote patients’ fruits, vegetables, and berries intake by supporting their autonomous motivation and self-care competence. The results are in line with self-determination theory.

  • 244.
    Koponen, Anne M.
    et al.
    Folkhälsan Research Center and Department of Public Health, University of Helsinki, Finland.
    Simonsen, Nina
    Folkhälsan Research Center and 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.
    Success in increasing physical activity (PA) among patients with type 2 diabetes: a self-determination theory perspective2018In: Health Psychology and Behavioral Medicine, ISSN 2164-2850, Vol. 6, no 1, p. 104-119Article in journal (Refereed)
    Abstract [en]

    Background: Increased physical activity (PA) is crucial for achieving and maintaining glycemic control and is beneficial for overall well-being of patients with type 2 diabetes as well. Despite that, many patients fail to make changes in their exercise behavior. Self-determination theory (SDT) addresses this problem and suggests that perceived autonomy support, autonomous motivation and self-care competence play a key role in the process of health behavior change. This study investigated the impact of these three factors on success in increasing PA among patients with type 2 diabetes but considered also the role of other important life-context factors, such as mental health, stress and social support. The effect of these other factors may outweigh the effect of SDT constructs; however, previous studies based on SDT have largely overlooked them. Methods: This cross-sectional mail survey was carried out in 2011. Out of 2866 respondents, those who had been over 2 years in care in their present and principal primary care health center and had during the past two years tried to increase PA either with or without success (n = 1256, mean age 63 years, 52% men), were included in this study. Logistic regression and mediation analyses were the main methods used in the data analysis. Results: Autonomous motivation predicted success in increasing PA even after controlling for the effect of other important life-context factors. Other predictors of success were felt energy, good perceived health, younger age and less social support. Autonomous motivation mediated the effect of perceived autonomy support from a doctor on success in increasing PA. Conclusion: The results were in line with SDT showing the importance of autonomous motivation for success in increasing PA. Doctor-patient relationships and lifestyle interventions should focus on promoting self-motivated reasons for health behavior change.

  • 245.
    Kovalenko, Anton A.
    et al.
    The Arctic University of Norway, Tromsø, Norway / Northern State Medical University, Arkhangelsk, Russia.
    Anda, Erik Eik
    The Arctic University of Norway, Tromsø, Norway.
    Odland, Jon Øyvind
    The Arctic University of Norway, Tromsø, Norway.
    Nieboer, Evert
    McMaster University, Hamilton, ON, Canada.
    Brenn, Tormod
    The Arctic University of Norway, Tromsø, Norway.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. The Arctic University of Norway, Tromsø, Norway / Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Risk Factors for Ventricular Septal Defects in Murmansk County, Russia: A Registry-Based Study2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 7, article id E1320Article in journal (Refereed)
    Abstract [en]

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

  • 246.
    Kovalenko, Anton A.
    et al.
    Department of Community Medicine, UiT -The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Brenn, Tormod
    Department of Community Medicine, UiT -The Arctic University of Norway, Tromsø, Norway.
    Odland, Jon Øyvind
    Department of Community Medicine, UiT -The Arctic University of Norway, Tromsø, Norway.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, UiT -The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Anda, Erik Eik
    Department of Community Medicine, UiT -The Arctic University of Norway, Tromsø, Norway.
    Risk Factors for hypospadias in Northwest Russia: A Murmansk County Birth Registry Study2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 4, article id e0214213Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Hypospadias is the most common congenital anomaly of the penis, but its causes are mainly unknown. Of the risk factors identified, the most plausible are hormonal and genetic. The aim of this study was to identify risk factors for hypospadias in Northwest Russia based on registry data.

    METHODS: The study population included male infants registered in the Murmansk County Birth Registry between 1 January 2006 and 31 December 2011 (n = 25 475). These infants were followed-up for 2 years using the Murmansk Regional Congenital Defects Registry to identify cases of hypospadias not diagnosed at birth. We used logistic regression analysis to examine the contributions of hypospadias risk factors.

    RESULTS: Out of 25 475 male infants born during the study period, 148 had isolated hypospadias. The overall prevalence rate was 54.2 (95% CI 53.6-54.8) per 10 000 male infants. Those born to mothers with preeclampsia (OR = 1.65; 95% CI 1.03-2.66) or infant birthweight < 2500 g (OR = 2.06; 95% CI 1.18-3.60) exhibited increased risk for hypospadias. Maternal age, smoking during pregnancy, folic acid intake during pregnancy or hepatitis B surface antigen positivity did not associate with increased risk of hypospadias.

    CONCLUSIONS: Combining data from a birth registry with those from a congenital defects registry provided optimal information about the prevalence of hypospadias and its association with low infant birthweight and preeclampsia. These factors have in common changes in hormone levels during pregnancy, which in turn may have contributed to hypospadias development.

  • 247.
    Kovalenko, Anton A.
    et al.
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Brenn, Tormod
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Odland, Jon Øyvind
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Nieboer, Evert
    Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Anda, Erik Eik
    Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Under-reporting of major birth defects in Northwest Russia: a registry-based study2017In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 76, no 1, p. 1-10, article id 1366785Article in journal (Refereed)
    Abstract [en]

    The objective was to assess the prevalence of selected major birth defects, based on data from two medical registries in Murmansk County, and compare the observed rates with those available for Norway and Arkhangelsk County, Northwest Russia. It included all newborns (≥22 completed weeks of gestation) registered in the Murmansk County Birth Registry (MCBR) and born between 1 January 2006 and 31 December 2009 (n=35,417). The infants were followed-up post-partum for 2 years through direct linkage to the Murmansk Regional Congenital Defects Registry (MRCDR). Birth defects identified and confirmed in both registries constituted the "cases" and corresponded to one or more of the 21 birth defect types reportable to health authorities in Moscow. The overall prevalence of major birth defects recorded in the MRCDR was 50/10,000 before linkage and 77/10,000 after linkage with the MCBR. Routine under-reporting to the MRCDR of 40% cases was evident. This study demonstrates that birth registry data improved case ascertainment and official prevalence assessments and reduced the potential of under-reporting by physicians. The direct linkage of the two registries revealed that hypospadias cases were the most prevalent among the major birth defects in Murmansk County.

    ABBREVIATIONS: ICD-10, International Classification of Diseases, 10th revision; MCBR, Murmansk County Birth Registry; MRCDR, Murmansk Regional Congenital Defects Registry; MGC, Murmansk Genetics Center.

  • 248.
    Krettek, Alexandra
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Avdelningen för invärtesmedicin och klinisk nutrition, Institutionen för medicin, Sahlgrenska akademin, Göteborgs universitet.
    Magnusson, Maria
    Enheten för kommunikation och folkhälsa, Angereds närsjukhus.
    Hallmyr, Moa
    Enheten för kommunikation och folkhälsa, Angereds närsjukhus.
    Ascher, Henry
    Avdelningen för samhällsmedicin och folkhälsa, Institutionen för medicin, Sahlgrenska akademin, Göteborgs universitet / FoU-enheten och flyktingbarnteamet, Angereds närsjukhus.
    Apropå! »Alla vet att man ska äta frukt och grönt och röra på sig«2018In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, article id E3YZArticle in journal (Other (popular science, discussion, etc.))
  • 249.
    Krettek, Alexandra
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Folkhälsovetenskaplig utbildning på distans med unik profil för framtiden2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 3, p. 327-339Article in journal (Refereed)
    Abstract [en]

    Public Health at University of Skövde is expanding as a strategic effort by the University. The ambition is to provide unique public health education that gives students preparedness to work with current and future public health challenges. To date, University of Skövde offers three educational programmes in public health; the two-year Health Coach, the three-year Public Health Sciences Study Programme and the master’s programme in Public Health Science: Infection Prevention and Control. The latter is unique and one-of-a-kind in both Sweden and the Nordic countries. All educational programmes are given as distance education with a few gatherings on campus. The article therefore also highlights challenges and possibilities with distance education and provides advice on how to make students successfully progress through such educational programmes.

  • 250.
    Kylberg, Elisabeth
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nutritional services and assessment2014In: Encyclopedia of Human Services and Diversity / [ed] Linwood H. Cousins, Thousand Oaks, California: Sage Publications, 2014, p. 975-977Chapter in book (Refereed)
2345678 201 - 250 of 421
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