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  • 201.
    Nilsson, Håkan
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Mindful hållbart åldrande – holistiskt åldrande i ny belysning2016Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 93, nr 6, s. 692-703Artikel i tidskrift (Refereegranskat)
  • 202.
    Nilsson, Håkan
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Socioexistential mindfulness: Bringing empathy and compassion into health care practice2016Ingår i: Spirituality in Clinical Practice, ISSN 2326-4500, Vol. 3, nr 1, s. 22-31Artikel i tidskrift (Refereegranskat)
  • 203.
    Nilsson, Håkan
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Andersson, Gerhard
    Linköpings universitet / Karolinska Institutet.
    Mindfulness – terapier och paradoxer2016Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 93, nr 1, s. 106-112Artikel i tidskrift (Refereegranskat)
  • 204.
    Nilsson, Håkan
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Kazemi, Ali
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Mindfulness Therapies and Assessment Scales: A Brief Review2016Ingår i: International Journal of Psychological Studies, ISSN 1918-7211, E-ISSN 1918-722X, Vol. 8, nr 1, s. 11-19Artikel i tidskrift (Refereegranskat)
  • 205.
    Nilsson, Håkan
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Kazemi, Ali
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Reconciling and Thematizing Definitions of Mindfulness: The Big Five of Mindfulness2016Ingår i: Review of General Psychology, ISSN 1089-2680, E-ISSN 1939-1552, Vol. 20, nr 2, s. 183-193Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    [Correction Notice: An Erratum for this article was reported online in Review of General Psychology on Jul 11 2016 (see record 2016-33699-001). In the original article, there was an error in the abstract. The second core element of the concept of mindfulness yielded by the analysis was incorrectly listed as “nonjudgmental attitude.” It should be “present-centeredness.” The online version of this article has been corrected.] Mindfulness is an emerging concept in many professions and spheres of social life. However, mindfulness (or sati in Buddhism) can connote many plausible meanings. Thus, the concept is not easily defined and the definitions provided in the literature easily confuse the reader. Some mindfulness researchers offer definitions whereas others do not and take the definition of mindfulness for granted. Beyond the problem of defining mindfulness, the fact that the phenomenon is of great interest to various disciplines, each of which has its own theoretical and methodological approaches, different authors use different terms in describing this phenomenon. In the present article 33 definitions of mindfulness were extracted from a pool of 308 peer-reviewed full-length theoretical or empirical articles written in English, published between 1993 and March 2016, after systematic searches in Google Scholar, PsycARTICLES, and SocINDEX. The definitions were analyzed with a particular focus on the defining attributes or core elements of the concept of mindfulness. The analysis yielded 4 core elements of awareness and attention, present-centeredness, external events, and cultivation. Furthermore, an additional core element emerged from this analysis as being absent in Western definitions of mindfulness. This formed the basis for formulation of a new definition of mindfulness with an emphasis on ethical-mindedness. We argue that this core element is instrumental in filling in the gap that exists in current Western definitions, and with highlighting this element we hope to bridge the Western and Buddhist notions of mindfulness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

  • 206.
    Nollen, Louise
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Barns psykiska påverkan av att växa upp med en psykiskt sjuk förälder: Risk- och friskfaktorer2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Inledning: Globalt sett beräknas det att en av fyra familjer har minst en medlem med psykisk störning och de anhöriga är ofta de som är de främsta vårdarna. En majoritet av personer med psykisk sjukdom är eller kommer att bli föräldrar. Forskning visar på ett starkt samband mellan psykisk sjukdom hos föräldrarna och psykisk ohälsa hos barn. Syfte: Att identifiera riskfaktorer respektive friskfaktorer som uppträder hos barn som växer upp med en psykiskt sjuk förälder. Metod: En litteraturstudie där 15 artiklar både kvantitativa och kvalitativa ingick. Analysering av artiklarna har skett enligt en tematisk analysmetod. Resultat: Barn till föräldrar med psykisk sjukdom utgör en högriskgrupp för att själva utveckla beteendemässiga, känslomässiga och psykiatriska problem. Det finns ett starkt samband mellan förälderns psykiska sjukdom och stigmatisering samt bristande skolgång. Skyddande faktorer inbegriper stöd, kunskap om förälderns tillstånd, en aktiv coping strategi och en familjefokuserad vård, vilket kan öka familjens och barnens resiliens. Diskussion: Det finns stora behov av tidiga insatser för att stödja barn. Många gånger missas barnen då fokus på vården enbart är riktad till den psykiskt sjuka föräldern. Studien visar att stöd och information till barnen inte är implementerat eller är bristfällig i många fall.

  • 207.
    Norenius, Csilla
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Audhav, Eva
    Högskolan i Skövde, Institutionen för vård och natur.
    Svenska tjänstemäns uppfattning om organisatoriska stressförebyggande strategier: En kvalitativ studie2012Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Psykosocial ohälsa är en av de största orsakerna till sjukfrånvaro bland tjänstemän. Få studier syftar till att undersöka förebyggande aktiviteter för stress på organisationsnivå. Europeiska arbetsmiljöbyrån, EU-OSHA, erbjuder råd för att på företag förebygga stress. Syftet med detta examensarbete var att beskriva hur tjänstemän upplevde EU-OSHA:s råd för organisatoriska stressförebyggande insatser. Undersökningen sökte svar på om råden upplevdes genomförbara, om det fanns hinder som försvårade genomförandet och vilka förutsättningar som krävdes. Metoden som användes var en induktiv kvalitativ ansats, där 16 intervjuer genomfördes på sex stora svenska företag. Resultatet visade att EU-OSHA:s råd upplevdes generellt som genomförbara men ibland för övergripande och otydliga. De olika förutsättningarna och hindren som beskrevs formade följande teman: Kulturen på företaget, Krav, Kontroll & Stöd samt Kunskap & Kompetens.

    Diskussion: För att kunna jobba med stressförebyggande insatser på organisationsnivå och få de önskade effekterna, som välmående personal och förbättrad produktivitet,  måste alla delar av organisationen vara beredda att bidra i arbetet. Utmaningen i denna process är hur samverkan ska gå till och hur resurser ska tas fram  i form av tid och kompetent personal. Om företagsledningen lyckas med detta, skapas det förutsättningar för en bra psykosocial arbetsmiljö, vilket är ett nyckelord för ett friskt och lönsamt företag.

  • 208.
    Nyberg, Solja T.
    et al.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Batty, George David
    Department of Epidemiology and Public Health, University College London, UK.
    Pentti, Jaana
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland / Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland / Institute of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden / Stress Research Institute, University of Stockholm, Sweden.
    Alfredsson, Lars S.
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fransson, Eleonor I.
    Stress Research Institute, University of Stockholm, Sweden / School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Goldberg, Marcel
    Paris Descartes University, Paris, France / Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Heikkilä, Katriina V.
    Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom / Clinical Effectiveness Unit, The Royal College of Surgeons, London, United Kingdom.
    Jokela, Markus
    Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
    Knutsson, Anders K.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku J.
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Lallukka, Tea
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland / Finnish Institute of Occupational Health, Finland.
    Leineweber, Constanze
    Stress Research Institute, University of Stockholm, Sweden.
    Lindbohm, Joni Valdemar
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Magnusson Hanson, Linda L.
    Stress Research Institute, University of Stockholm, Sweden.
    Nordin, Maria
    Stress Research Institute, University of Stockholm, Sweden / Department of Psychology, Umeå University, Umeå, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pietiläinen, Olli
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Rahkonen, Ossi
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health and Department of Psychology, University of Copenhagen, Denmark.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, UK.
    Stenholm, Sari
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Faculty of Social Sciences (Health Sciences), University of Tampere, Finland.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Theorell, Töres
    Stress Research Institute, University of Stockholm, Sweden.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Westerholm, Peter J. M.
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, University of Stockholm, Stockholm, Sweden.
    Zins, Marie
    Paris Descartes University, Paris, France / Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France.
    Hamer, Mark
    National Centre for Sport and Exercise Medicine, Loughborough University, UK.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, UK / Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Bell, Jousha A.
    MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, UK / Bristol Medical School: Population Health Sciences, University of Bristol, UK.
    Kivimäki, Mika
    Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, UK.
    Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study2018Ingår i: The Lancet Public Health, ISSN 2468-2667, Vol. 3, nr 10, s. e490-e497Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight. Methods: We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium. BMI was assessed at baseline (1991–2008) and non-communicable diseases (incident type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease) were ascertained via linkage to records from national health registries, repeated medical examinations, or self-report. Disease-free years from age 40 years to 75 years associated with underweight (BMI <18·5 kg/m2), overweight (≥25 kg/m2 to <30 kg/m2), and obesity (class I [mild] ≥30 kg/m2 to <35 kg/m2; class II–III [severe] ≥35 kg/m2) compared with normal weight (≥18·5 kg/m2 to <25 kg/m2) were estimated. Findings: Of 137 503 participants from ten studies, we excluded 6973 owing to missing data and 10 349 with prevalent disease at baseline, resulting in an analytic sample of 120 181 participants. Of 47 127 men, 211 (0·4%) were underweight, 21 468 (45·6%) normal weight, 20 738 (44·0%) overweight, 3982 (8·4%) class I obese, and 728 (1·5%) class II–III obese. The corresponding numbers among the 73 054 women were 1493 (2·0%), 44 760 (61·3%), 19 553 (26·8%), 5670 (7·8%), and 1578 (2·2%), respectively. During 1 328 873 person-years at risk (mean follow-up 11·5 years [range 6·3–18·6]), 8159 men and 8100 women developed at least one non-communicable disease. Between 40 years and 75 years, the estimated number of disease-free years was 29·3 (95% CI 28·8–29·8) in normal-weight men and 29·4 (28·7–30·0) in normal-weight women. Compared with normal weight, the loss of disease-free years in men was 1·8 (95% CI −1·3 to 4·9) for underweight, 1·1 (0·7 to 1·5) for overweight, 3·9 (2·9 to 4·9) for class I obese, and 8·5 (7·1 to 9·8) for class II–III obese. The corresponding estimates for women were 0·0 (−1·4 to 1·4) for underweight, 1·1 (0·6 to 1·5) for overweight, 2·7 (1·5 to 3·9) for class I obese, and 7·3 (6·1 to 8·6) for class II–III obese. The loss of disease-free years associated with class II–III obesity varied between 7·1 and 10·0 years in subgroups of participants of different socioeconomic level, physical activity level, and smoking habit. Interpretation: Mild obesity was associated with the loss of one in ten, and severe obesity the loss of one in four potential disease-free years during middle and later adulthood. This increasing loss of disease-free years as obesity becomes more severe occurred in both sexes, among smokers and non-smokers, the physically active and inactive, and across the socioeconomic hierarchy. Funding: NordForsk, UK Medical Research Council, US National Institute on Aging, Academy of Finland, Helsinki Institute of Life Science, and Cancer Research UK. 

  • 209.
    Olafsdottir, S.
    et al.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, SE-40530 Gothenburg, Sweden.
    Berg, C.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, SE-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Lanfer, A.
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Reisch, L.
    Copenhagen Business Sch, DK-2000 Frederiksberg, Denmark.
    Ahrens, W.
    Leibniz Inst Prevent Res & Epidemiol BIPS GmbH, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Kourides, Y.
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Siani, A.
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Lissner, L.
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Young children's screen activities, sweet drink consumption and anthropometry: results from a prospective European study2014Ingår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, nr 2, s. 223-228Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/OBJECTIVES: This longitudinal study describes the relationship between young children's screen time, dietary habits and anthropometric measures. The hypothesis was that television viewing and other screen activities at baseline result in increased consumption of sugar-sweetened beverages (SSB) and increased BMI, BMI z-score and waist to height ratio (WHtR) two years later. A second hypothesis was that SSB consumption mediates the association between the screen activities and changes in the anthropometric measures. SUBJECTS/METHODS: The study is a part of the prospective cohort study IDEFICS ("Identification and prevention of dietary and lifestyle-induced health effects in children and infants"), investigating diet, lifestyle and social determinants of obesity in 2 to 9-year-olds in eight European countries (baseline n = 16 225, two-year follow-up; n = 11 038). Anthropometry was objectively measured, and behaviours were parent-reported. RESULTS: The main hypothesis was supported, but the second hypothesis was not confirmed. The odds ratio of being in the highest quintile of % change in WHtR was 1.26 (95% CI: 1.17-1.36) and in BMI 1.22 (95% CI: 1.13-1.31), for each hour per day watching television. The odds ratio of having increased SSB consumption was 1.19 (95% CI: 1.09-1.29) for each hour per day watching TV. The associations for total screen time were slightly weaker. CONCLUSIONS: The results indicate substantial effects of TV viewing and other screen activities for young children, both on their consumption of sugary drinks and on an increase in BMI and central obesity. Our findings suggest that television viewing seems to have a stronger effect on food habits and anthropometry than other screen activities in this age group.

  • 210.
    Olafsdottir, Steingerdur
    et al.
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Prell, Hillevi
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Hense, Sabrina
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Marild, Staffan
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Dept Publ Hlth & Community Med, S-40530 Gothenburg, Sweden.
    Reisch, Lucia
    Copenhagen Business Sch, DK-2000 Frederiksberg, Denmark.
    Berg, Christina
    Univ Gothenburg, Dept Food & Nutr & Sport Sci, S-40530 Gothenburg, Sweden.
    Young children's screen habits are associated with consumption of sweetened beverages independently of parental norms2014Ingår i: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 59, nr 1, s. 67-75Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigated the associations between children's screen habits and their consumption of sweetened beverages. Because parents might be disposed to regulate their child's screen and dietary habits in a similar direction, our specific aim was to examine whether these associations were independent of parental norms. In the Swedish sample of the European Identification and prevention of dietary and lifestyle-induced health effects in children and infants (IDEFICS) study, parents filled in questionnaires about their 2 to 9-year-old children's (n = 1,733) lifestyle and diets. Associations between screen habits and sweetened beverage consumption were found independent of parental norms regarding sweetened beverages. A longitudinal analysis revealed that sweetened beverage consumption at 2-year follow-up was predicted by exposure to commercial TV at baseline (OR 1.4, 95 % CI 1.1-1.9). Cross-sectional analysis showed that the likelihood of consuming sweetened beverages at least 1-3 times per week increased for each hour/day watching television (OR 1.5, 95 % CI 1.2-1.9), and for being exposed to commercials (OR 1.6, 95 % CI 1.3-2.1). TV viewing time and commercial exposure contributed to the associations independently of each other. The results strengthen the assumption that it is possible to influence children's dietary habits through their TV habits.

  • 211.
    Oli, Natalia
    et al.
    Kathmandu Medical College, Nepal.
    Vaidya, Abhinav
    Kathmandu Medical College, Nepal.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Sahlgrenska Academy at University of Gothenburg, Sweden / UiT The Arctic University of Norway, Tromsø.
    Changes in children’s diet and physical activity as perceived by their mothers: Impact of a health promotion intervention for mothers in a sub-urban area of Nepal2018Ingår i: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 7, nr 4, s. 140-146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Unhealthy diet and physical inactivity contribute to the growing burden of cardiovascular diseases in Nepal. Lifestyle is formed in childhood and in the Nepalese context influenced mainly by mothers, it is to date unknown how influential mothers are.

    Objectives:

    To assess changes in children’s diet and physical activity as perceived by their mothers after a health promotion intervention.

    Methodology:

    The Heart-Health Associated Research, Dissemination and Intervention in the Community is a community trial conducted in the Jhaukhel-Duwakot Health Demographic Surveillance site, in Bhaktapur district of Nepal. We conducted a health promotion intervention on diet and physical activity targeted at mothers with children aged one to nine years old in August-November 2016. Duwakot was randomized as the intervention site and Jhaukhel as the control. We conducted a follow-up study after three months to determine the outcome of the intervention. Nine trained enumerators conducted door-to-door visits to all households with eligible mothers. We calculated mean, frequency and percent changes for children’s behavior.

    Results:

    As responded by mothers, children in Duwakot consumed more healthy snacks after the intervention compared to Jhaukhel. Children in Duwakot increased consumption of water and milk. Children’s consumption of packet juices and soft drinks was decreased by 30% and 4% respectively. There was 21% increment in the duration of outdoor playing among the children at Duwakot during follow-up.

    Conclusion:

    The Heart-Health Associated Research, Dissemination and Intervention in the Community that focused on mothers showed indirect positive impact on their young children’s diet and physical activity behavior. In future, the longterm effects of such intervention should be assessed.

  • 212.
    Oli, Natalia
    et al.
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, Kathmandu Medical College, Nepal.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Nepal.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Effectiveness of health promotion regarding diet and physical activity among Nepalese mothers and their young children: The Heart-health Associated Research, Dissemination, and Intervention in the Community (HARDIC) trial2019Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 12, s. 1-12, artikel-id 1670033Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Nepal, like many low- and middle-income countries, exhibits rising burden of cardiovascular diseases. Misconceptions, poor behavior, and a high prevalence of risk factors contribute to this development. Health promotion efforts along with primary prevention strategies, including risk factor reduction in both adults and children, are therefore critical. Objectives: This study assessed the effectiveness of a health promotion intervention on mothers' knowledge, attitude and practice (KAP) and their children's behavior regarding diet and physical activity. Methods: The Heart-health Associated Research, Dissemination and Intervention in the Community (HARDIC), a community-based trial, used peer education to target mothers with 1-9-year-old children in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal, during August-November 2016. In the intervention area, 47 peer mothers were trained to conduct four education classes for about 10 fellow mothers (N = 391). After 3 months, all eligible mothers in the intervention and control areas were interviewed and the results were compared with the KAP of all eligible mothers at baseline. Results: Post-intervention, mothers' KAP median scores had improved regarding heart-healthy diet and physical activity. More mothers had 'good' KAP (>75% of maximum possible scores), and mothers with 'good' knowledge increased from 50% to 81%. Corresponding control values increased only from 58% to 63%. Mothers' attitude and practice improved. Additionally, mothers in the intervention area reported improvement in their children's diet and physical activity behavior. Moreover, Difference in Differences analysis showed that the HARDIC intervention significantly increased mothers' KAP scores and children's behavior scores in the intervention area compared to the control area. Conclusions: Our intervention improves KAP scores regarding diet and physical activity and shows potential for expansion via community health workers, volunteers, and/or local women. Moreover, HARDIC can contribute to Nepal's Package of Essential Noncommunicable Diseases Initiative, which currently lacks a specific package for health promotion.

  • 213.
    Oli, Natalia
    et al.
    Sahlgrenska Academy at University of Gothenburg, Sweden / Kathmandu Medical College, Kathmandu, Nepal.
    Vaidya, Abhinav
    Kathmandu Medical College, Kathmandu, Nepal.
    Pahkala, Katja
    University of Turku, Finland.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. University of Gothenburg, Sweden.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Sahlgrenska Academy at University of Gothenburg, Sweden / UiT The Arctic University of Norway, Tromsø, Norway.
    Knowledge, attitude and practice on diet and physical activity among mothers with young children in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Nepal2018Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, nr 7, artikel-id e0200329Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of cardiovascular diseases is increasing in low and middle-income countries; Nepal's population shows a high prevalence of behavioral risk factors. Our cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), located near the capital Kathmandu, explored knowledge, attitude, and practice (KAP) of mothers with young children regarding diet and physical activity and mothers' perception of their children's attitude and behavior toward the same issues. The purpose of our study was to assess needs of the mothers concerning cardiovascular health in general and more specifically regarding diet and physical activity, and to establish a baseline for future intervention in the community by comparing two villages of JD-HDSS. In August-November 2014, nine trained enumerators interviewed all mothers of children aged 1-7 years (N = 962). We scored responses on dietary and physical activity KAP, then categorized the scores based on the percentage obtained out of the maximum possible scores into "poor," "fair," and "good." More highly educated mothers scored higher for KAP (all p<0.001); the children's behavior score reflected their mother's education level (p = 0.007). Most respondents were unfamiliar with the concept of healthy and unhealthy food. Overall, 57% of respondents in JD-HDSS had "good" knowledge, 44.6% had "good" attitude, and most (90%) had "poor" practice. We observed no significant differences between the villages regarding mothers' knowledge and attitude or children's behavior. Practice score of mothers in Jhaukhel was higher than those in Duwakot regarding diet and physical activity (p<0.001). Mothers' perceived barriers for improving lifestyle were high cost of healthy food, taste preference of other family members, and lack of knowledge regarding healthy food. Barriers for physical activity were lack of leisure time, absence of parks and playgrounds, busy caring for children and old people, feeling lazy, and embarrassed to be physically active in front of others. Our findings suggest that a health education intervention promoting a healthy lifestyle for mothers and children might improve KAP and also improve cardiovascular health. To address mothers' gap between knowledge and practice, a future intervention should consider perceived barriers.

  • 214.
    Oli, Natalia
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Vaidya, Abhinav
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Subedi, Madhusudan
    Department of Community Health Sciences, Patan Academy of Health Sciences, Lalitpur, Nepal.
    Eiben, Gabriele
    Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
    Diet and physical activity for children's health: a qualitative study of Nepalese mothers' perceptions2015Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, nr 9, artikel-id e008197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: Non-communicable diseases account for 50% of all deaths in Nepal and 25% result from cardiovascular diseases. Previous studies in Nepal indicate a high burden of behavioural cardiovascular risk factors, suggesting a low level of knowledge, attitude and practice/behaviour regarding cardiovascular health. The behavioural foundation for a healthy lifestyle begins in early childhood, when mothers play a key role in their children's lives. This qualitative study, conducted in a Nepalese peri-urban community, aimed to explore mothers' perception of their children's diet and physical activity.

    DESIGN: We notated, tape-recorded and transcribed all data collected from six focus group discussions, and used qualitative content analysis for evaluation and interpretation.

    SETTING: The study was conducted in the Jhaukhel-Duwakot Health Demographic Surveillance Site in the Bhaktapur district of Nepal.

    PARTICIPANTS: Local health workers helped recruit 61 women with children aged 5-10 years. We distributed participants among six different groups according to educational status.

    RESULTS: Although participants understood the importance of healthy food, they misunderstood its composition, perceiving it as unappetising and appropriate only for sick people. Furthermore, participants did not prioritise their children's physical activities. Moreover, mothers believed they had limited control over their children's dietary habits and physical activity. Finally, they opined that health educational programmes would help mothers and recommended various intervention strategies to increase knowledge regarding a healthy lifestyle.

    CONCLUSIONS: Our data reveal that mothers of young children in a peri-urban community of Nepal lack adequate and accurate understanding about the impact of a healthy diet and physical activity. Therefore, to prevent future cardiovascular disease and other non-communicable diseases among children, Nepal needs health education programmes to improve mothers' cardiovascular health knowledge, attitude and behaviour.

  • 215.
    Oli, Natalia
    et al.
    Kathmandu Medical College, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg.
    Vaidya, Abhinav
    Kathmandu Medical College, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg.
    Subedi, Madhusudan
    Patan Academy of Health Sciences, Lalitpur, Nepal.
    Krettek, Alexandra
    Sahlgrenska Academy at University of Gothenburg / Nordic School of Public Health NHV, Gothenburg.
    Experiences and perceptions about cause and prevention of cardiovascular disease among people with cardiometabolic conditions: findings of in-depth interviews from a peri-urban Nepalese community.2014Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, artikel-id 24023Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Nepal currently faces an increasing burden of cardiovascular disease (CVD). Earlier studies on health literacy and the behavior dimension of cardiovascular health reported a substantial gap between knowledge and practice.

    OBJECTIVE: This qualitative study aimed to deepen understanding of the community perspective on cardiovascular health from the patients' viewpoint.

    DESIGN: We conducted in-depth interviews (IDIs) with 13 individuals with confirmed heart disease, hypertension, or diabetes mellitus. All participants provided verbal consent. We used an IDI guide to ask respondents about their perception and experiences with CVD, particularly regarding causation and preventability. We manually applied qualitative content analysis to evaluate the data and grouped similar content into categories and subcategories.

    RESULTS: Respondents perceived dietary factors, particularly consumption of salty, fatty, and oily food, as the main determinants of CVD. Similarly, our respondents unanimously linked smoking, alcohol intake, and high blood pressure with cardiac ailments but reported mixed opinion regarding the causal role of body weight and physical inactivity. Although depressed and stressed at the time of diagnosis, respondents learned to handle their situation better over time. Despite good family support for health care, the financial burden of disease was a major issue. All respondents understood the importance of lifestyle modification and relied upon health professionals for information and motivation. Respondents remarked that community awareness of CVD was inadequate and that medical doctors or trained local people should help increase awareness.

    CONCLUSIONS: This study provided insight into the perceptions of patients regarding CVD. Respondents embraced the importance of lifestyle modification only after receiving their diagnosis. Although better health care is important in terms of aiding patients to better understand and cope with their disease, interventions should be tailored to improve the community's cardiovascular health literacy and preventive practices.

  • 216.
    Onta, Sharad
    et al.
    Tribhuvan University, Kathmandu, Nepal .
    Choulagai, Bishnu
    Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy, University of Gothenburg, Sweden.
    Shrestha, Binjwala
    Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy, University of Gothenburg, Sweden.
    Subedi, Narayan
    Nepal Public Health Foundation, Kathmandu, Nepal .
    Bhandari, Gajananda P
    Nepal Public Health Foundation, Kathmandu, Nepal .
    Krettek, Alexandra
    Sahlgrenska Academy, University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study2014Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, s. 1-9, artikel-id 24580Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care.

    DESIGN: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers.

    RESULTS: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs), distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities.

    CONCLUSIONS: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  • 217.
    Pahrne, Sandra
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Chavez, Johanna Y. Andrews
    Tufts University, Boston, USA.
    Dalal, Koustuv
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Centre for Injury Prevention and Safety Promotion, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Economic Cost of Pedestrian Injuries in Stockholm City2014Ingår i: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 6, nr 19, s. 2736-2742Artikel i tidskrift (Refereegranskat)
  • 218.
    Papoutsoul, S.
    et al.
    Res & Educ Inst Child Hlth, CY-2027 Nicosia, Cyprus.
    Briassoulis, G.
    Univ Crete, Fac Med, Pediat Intens Care Unit, Iraklion, Greece / BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Wolters, M.
    BIPS GmbH, Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Peplies, J.
    Leibniz Institute for Prevention Research and Epidemiology–BIPS GmbH, Bremen, Germany.
    Iacoviello, L.
    IRCCS Ist Neurol Mediterraneo NEUROMED, Dept Epidemiol & Prevent, Lab Mol & Nutr Epidemiol, Pozzilli, Italy.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Molnar, D.
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Russo, P.
    CNR, Inst Food Sci, Avellino, Italy.
    Michels, N.
    Univ Ghent, Fac Med & Hlth Sci, Dept Publ Heath, B-9000 Ghent, Belgium.
    Moreno, L. A.
    Univ Zaragoza, Growth Exercise Nutr & Dev Res Grp, Zaragoza, Spain.
    Tornaritis, M.
    Res & Educ Inst Child Hlth, CY-2027 Nicosia, Cyprus.
    No breakfast at home: association with cardiovascular disease risk factors in childhood2014Ingår i: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, nr 7, s. 829-834Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Limited data exist regarding breakfast consumption and its association with cardiovascular disease (CVD) risk factors. This study investigates the relationship between breakfast routine and CVD risk factors in a multinational sample. SUBJECTS/METHODS: Cross-sectional data from eight European countries participating in the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) survey (2007-2008) were used. The sample included children 2 to <10 years of age (n=8863, 51.2% boys). The Mann-Whitney U-test and logistic regression were used to assess CVD risk factors among no breakfast (NBrH), occasional breakfast and daily breakfast at home (DBrH) consumption. RESULTS: Male school-aged NBrH consumers, compared with DBrH consumers, were more likely to be overweight/obese (odds ratio (OR): 1.37, 95% confidence interval (Cl) = 1.05-1.79), to have higher risk for high-density lipoprotein (HDL) cholesterol levels lower than 40 mg/dl (OR: 1.69, 95% CI = 1.24-2.30), triglycerides (TG) above 75 mg/dl (OR: 1.65, 95% CI = 1.24-2.19) and sum of skinfolds greater than the 90th percentile (OR: 1.32, 95% CI = 1.0-1.76). Female school-aged NBrH consumers compared with DBrH consumers had a higher risk for waist circumference greater than the 90th percentile (OR: 1.70, 95% CI = 1.14-2.51), HDL cholesterol levels lower than 40 mg/dl (OR: 1.65, 95% CI = 1.23-2.21), TG above 75 mg/dl (OR: 1.65, 95% CI = 1.26-2.17) and total cholesterol/HDL cholesterol ratio >3.5 (OR: 1.39, 95% CI = 1.09-1.77). Results remained significant after adjusting for daily physical activity in moderate-to-vigorous physical activity (MVPA) periods (in min/day). Male DBrH consumers, 6 to <10 years of age, had longer daily periods of MVPA compared with NBrH consumers (32.0 +/- 21.4 vs 27.5 +/- 18.8, P < 0.05). For preschoolers, breakfast consumption was negatively associated with CVD risk factors but results of regression models were mostly insignificant. CONCLUSIONS: Daily breakfast consumption contributes to controlling school-aged children's weight and lipid profile and promotes higher PA.

  • 219.
    Paul, Sudip Kumar
    et al.
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh / Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh.
    Islam, Md Shofikul
    Department of Applied Nutrition and Food Technology, Islamic University, Kushtia, Bangladesh.
    Hasibuzzaman, M. M.
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Hossain, Faruk
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Anjum, Adiba
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Saud, Zahangir Alam
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Haque, Md Mominul
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Sultana, Papia
    Department of Statistics, University of Rajshahi, Bangladesh.
    Haque, Azizul
    Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, United States.
    Andric, Klara Biljana
    Högskolan i Skövde, Institutionen för biovetenskap.
    Rahman, Aminur
    The Life Science Center, School of Science and Technology, Örebro University, Örebro, SE 701 82, Sweden.
    Karim, M. Rezaul
    Department of Applied Nutrition and Food Technology, Islamic University, Bangladesh.
    Siddique, Abu Eabrahim
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Karim, Yeasir
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Rahman, Mizanur
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Miyataka, Hideki
    Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Tokushima, Japan.
    Xin, Lian
    Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Japan.
    Himeno, Seiichiro
    Laboratory of Molecular Nutrition and Toxicology, Faculty of Pharmaceutical Sciences, Tokushima Bunri University, Japan.
    Hossain, Khaled
    Department of Biochemistry and Molecular Biology, University of Rajshahi, Bangladesh.
    Higher risk of hyperglycemia with greater susceptibility in females in chronic arsenic-exposed individuals in Bangladesh2019Ingår i: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 668, s. 1004-1012Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Arsenic (As) toxicity and diabetes mellitus (DM) are emerging public health concerns worldwide. Although exposure to high levels of As has been associated with DM, whether there is also an association between low and moderate As exposure and DM remains unclear. We explored the dose-dependent association between As exposure levels and hyperglycemia, with special consideration of the impact of demographic variables, in 641 subjects from rural Bangladesh. The total study participants were divided into three groups depending on their levels of exposure to As in drinking water (low, moderate and high exposure groups). Prevalence of hyperglycemia, including impaired glucose tolerance (IGT) and DM was significantly associated with the subjects’ drinking water arsenic levels. Almost all exposure metrics (As levels in the subjects’ drinking water, hair and nails) showed dose-dependent associations with the risk of hyperglycemia, IGT and DM. Among the variables considered, sex, age, and BMI were found to be associated with higher risk of hyperglycemia, IGT and DM. In sex-stratified analyses, As exposure showed a clearer pattern of dose-dependent risk for hyperglycemia in females than males. Finally, drinking water containing low-to-moderate levels of As (50.01–150 μg/L) was found to confer a greater risk of hyperglycemia than safe drinking water (As ≤10 μg/L). Thus the results suggested that As exposure was dose-dependently associated with hyperglycemia, especially in females. © 2019 Elsevier B.V.

  • 220.
    Pettersson, Veronica
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Thelander, Jacqueline
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Effekter av interventioner vid arbetsrelaterad stress2014Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Arbetsfrånvaro och långtidssjukskrivningar på grund av arbetsrelaterad stress och psykisk ohälsa ökar. Dess effekter påverkar både individen, organisationen och samhället. Ett bra fungerande arbetsliv bidrar till folkhälsan både genom att minska den arbetsrelaterade ohälsan och de sociala skillnaderna i ohälsa.Syfte: Syftet var att beskriva effekter av interventioner vid arbetsrelaterad stress.Metod: Denna studie var en litteraturstudie där tio vetenskapliga artiklar granskades. Artiklarna analyserades, sammanfattades och delades in i tre teman. Resultaten beskrivs med hjälp av dessa tre teman.Reslutat: Vår studie visade att de vanligaste effekterna av interventioner vid arbetsrelaterad stress var förändringar i stressnivåer, ökad kunskap och förståelse för arbetsrelaterad stress samt ökat stöd, förändrade beteenden och attityder. Kognitiv beteendeterapi, avslappningsövningar och aktivt lyssnande var metoder som visade sig vara effektiva.Slutsats: Förändringar i stressnivå, ökad kunskap och förståelse samt ökat stöd, förändrade beteenden och attityder visade sig vara de viktigaste effekterna av interventioner vid arbetsrelaterad stress. Genom att kombinera interventioner på både individ- och organisationsnivå kan resultatet bli både effektivt och långsiktigt.

  • 221.
    Pinthorp, Margaretha
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Nord Larsson, Camilla
    Högskolan i Skövde, Institutionen för vård och natur.
    Hur familjen upplever och hanterar situationen när ett barn får diabetes: En litteraturstudie2010Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    När ett barn får diagnosen diabetes påverkas hela familjens livssituation. Sjukdomen påverkar familjen på flera olika sätt och olika reaktioner uppstår då det är en livslång sjukdom. För att ur ett folkhälsoperspektiv öka förståelsen för familjens situation när ett barn drabbas av diabetes och kunna stötta familjen behövs kunskap om familjens upplevelse och hantering av situationen. Syftet med studien är att belysa hur familjen upplever och hanterar situationen när ett barn får diagnosen typ 1 diabetes och fram till cirka ett år efter diagnosen. Följande frågeställningar formulerades: Hur upplever familjen att livet påverkas då ett barn drabbas av diabetes? Hur hanterar familjen den förändrade livssituationen? Studien bygger på en litteraturstudie på sammanlagt 11 artiklar. Resultatet av familjens upplevelser och hantering delades upp i sju respektive fyra teman. Hela familjen påverkas när en familj får ett barn med diagnosen typ 1 diabetes. Tiden närmast efter diagnosen kan liknas vid en krissituation. Föräldrarna hamnade i ett chocktillstånd och kände skuld. Hela familjen upplevde känslor av sorg och förlust. En del föräldrar hade svårt att acceptera diagnosen och både föräldrar och syskon upplevde stress och oro. Som förälder till ett barn med diabetes uppstår aldrig situationen ”faran över”, utan de konfronteras ofta med nya utmaningar som exempelvis då barnet blir tonåring och under ungdomsåren. Familjen använde sig av olika copingstrategier för att hantera situationen. De sökte bland annat kunskap om sjukdomen och stöd hos andra med liknande erfarenheter. Vardagslivet fick genomgå stora förändringar och familjen hittade en ny modell för det vardagliga livet där även det sjuka barnets behov ingick.

     

  • 222.
    Pohlabeln, Hermann
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Rach, Stefan
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, Fac Med & Hlth Sci, Ghent, Belgium.
    Eiben, Gabriele
    Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sect Epidemiol & Social Med, Gothenburg, Sweden.
    Gwozdz, Wencke
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Ctr Corp Social Responsibil, Copenhagen, Denmark.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Paediat, Pecs, Hungary.
    Moreno, Luis A.
    Univ Zaragoza, IA2, Inst Invest Sanitaria Aragon IIS Aragon,GENUS Gro, Res Grp,Ctr Invest Biomed Red Fisiopatol Obesidad, Zaragoza, Spain.
    Russo, Paola
    CNR, Inst Food Sci, Unit Epidemiol & Populat Genet, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Pigeot, Iris
    Leibniz Inst Prevent Res & Epidemiol BIPS, Achterstr 30, D-28359 Bremen, Germany.
    Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study2017Ingår i: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 26, nr 8, s. 957-967Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child's risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2-11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child's risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3-4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09-3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05-4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91-3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.

  • 223.
    Povlsen, Lene
    et al.
    Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
    Aryal, Umesh Raj
    Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Sweden / Public Health and Environment Research Centre, Katmandu, Nepal.
    Petzold, Max
    Centre for Applied Biostatistics, Occupational and Environmental Medicine, University of Gothenburg, Sweden.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Institute of Medicine, Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Sweden / Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
    Adolescents' knowledge and opinions about smoking: a qualitative study from the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal2018Ingår i: International Journal of Adolescent Medicine and Health, ISSN 0334-0139, E-ISSN 2191-0278, Vol. 30, nr 1, artikel-id 20150124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The use of tobacco products among adolescents in Southeast Asia represents a major public health burden. Two out of ten adolescents attending school are tobacco users and several factors influence them to initiate tobacco use. Most studies related to tobacco use are quantitative, whereas qualitative studies exploring adolescents' smoking behavior and their views, knowledge and experiences are scarce.

    OBJECTIVE: To gain a deep understanding of Nepalese adolescents' knowledge and opinions about smoking and reasons for smoking initiation.

    SUBJECTS: Adolescents from four secondary schools in the Bhaktapur district, Nepal.

    METHODS: Eight focus-group discussions were conducted with 71 adolescents aged 13-16 years and from grades 8-10. Data were analyzed using manifest qualitative content analysis.

    RESULTS: The participants knew that smoking represents health risks as well as socio-economic risks, but few described the addictive nature of tobacco and health risks related to passive smoking. Most participants related smoking initiation to the smoking behavior of peers and family members, but easy accessibility to cigarettes, ineffective rules and regulations, and exposure to passive smoking also created environments for smoking. Some expressed confidence to resist peer pressure and refuse to start smoking, but also expressed the need for prevention strategies in schools and for governmental initiatives, such as more strict implementation of tobacco control and regulations to prevent and reduce smoking.

    CONCLUSION: Curbing the tobacco epidemic in Nepal requires healthy public policies and multifaceted interventions to address the knowledge gap on health consequences associated with smoking among adolescents, teachers and parents/adults.

  • 224.
    Prättälä, Ritva
    et al.
    National Institute for Health and Welfare, Helsinki, Finland.
    Levälahti, Esko
    National Institute for Health and Welfare, Helsinki, Finland.
    Lallukka, Tea
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Männistö, Satu
    National Institute for Health and Welfare, Helsinki, Finland.
    Paalanen, Laura
    National Institute for Health and Welfare, Helsinki, Finland.
    Raulio, Susanna
    National Institute for Health and Welfare, Helsinki, Finland.
    Roos, Eva
    Department of Public Health, University of Helsinki, Helsinki, Finland / Folkhälsan Research Center, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Folkhälsan Research Center, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland / Department of Public Health, University of Turku, Turku, Finland.
    Mäki-Opas, Tomi
    National Institute for Health and Welfare, Helsinki, Finland.
    From margarine to butter: predictors of changing bread spread in an 11-year population follow-up2016Ingår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 19, nr 9, s. 1707-1717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Finland is known for a sharp decrease in the intake of saturated fat and cardiovascular mortality. Since 2000, however, the consumption of butter-containing spreads - an important source of saturated fats - has increased. We examined social and health-related predictors of the increase among Finnish men and women. Design: An 11-year population follow-up. Setting: A representative random sample of adult Finns, invited to a health survey in 2000. Subjects: Altogether 5414 persons aged 30-64 years at baseline in 2000 were re-invited in 2011. Of men 1529 (59 %) and of women 1853 (66 %) answered the questions on bread spreads at both time points. Respondents reported the use of bread spreads by choosing one of the following alternatives: no fat, soft margarine, butter-vegetable oil mixture and butter, which were later categorized into margarine/no spread and butter/butter-vegetable oil mixture (= butter). The predictors included gender, age, marital status, education, employment status, place of residence, health behaviours, BMI and health. Multinomial regression models were fitted. Results: Of the 2582 baseline margarine/no spread users, 24.6% shifted to butter. Only a few of the baseline sociodemographic or health-related determinants predicted the change. Finnish women were more likely to change to butter than men. Living with a spouse predicted the change among men. Conclusions: The change from margarine to butter between 2000 and 2011 seemed not to be a matter of compliance with official nutrition recommendations. Further longitudinal studies on social, behavioural and motivational predictors of dietary changes are needed.

  • 225.
    Quennerstedt, Mikael
    et al.
    Örebro University, Sweden.
    Maivorsdotter, Ninitha
    Örebro University, Sweden.
    The role of learning theory in learning to teach2017Ingår i: Routledge handbook of physical education pedagogies / [ed] Catherine D. Ennis, New York: Routledge, 2017, s. 417-427Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 226.
    Reeske, Anna
    et al.
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.
    Spallek, Jacob
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bielefeld, Sch Publ Hlth, Dept Epidemiol & Int Publ Hlth, D-33615 Bielefeld, Germany.
    Bammann, Karin
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    De Henauw, Stefaan
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Kourides, Yiannis
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Nagy, Peter
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Ahrens, Wolfgang
    Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany.;Univ Bremen, Inst Stat, D-28359 Bremen, Germany.
    Migrant Background and Weight Gain in Early Infancy: Results from the German Study Sample of the IDEFICS Study2013Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, nr 4, artikel-id e60648Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. Methods: We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Results: Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (beta = 0.35; 95% CI 0.14-0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (beta = 0.77; 95% CI 0.40-1.14) and infants of parents from Eastern European countries with high SES (beta = 0.72; 95% CI 0.13-1.32). Conclusions: Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy.

  • 227.
    Regber, S.
    et al.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Novak, M.
    Univ Gothenburg, Dept Emergency & Cardiovasc Med, Sahlgrenska Acad, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Sahlgrenska Acad, Publ Hlth Epidemiol Unit, Gothenburg, Sweden.
    Bammann, K.
    Univ Bremen, Inst Publ Hlth & Nursing Res, D-28359 Bremen, Germany.;BIPS Inst Epidemiol & Prevent Res, Bremen, Germany.
    De Henauw, S.
    Univ Ghent, Dept Movement & Sport Sci, B-9000 Ghent, Belgium.
    Fernandez-Alvira, J. M.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci EUCS, Zaragoza, Spain.
    Gwozdz, W.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Kourides, Y.
    Res & Educ Inst Child Hlth Strovolos, Strovolos, Cyprus.
    Moreno, L. A.
    Univ Zaragoza, GENUD Growth Exercise Nutr & Dev Res Grp, Univ Sch Hlth Sci EUCS, Zaragoza, Spain.
    Molnar, D.
    Univ Pecs, Dept Pediat, Pecs, Hungary.
    Pigeot, I.
    Univ Bremen, Dept Biometry & Data Management, BIPS Inst Epidemiol & Prevent Res, Fac Math & Comp Sci 03, D-28359 Bremen, Germany.
    Reisch, L.
    Copenhagen Business Sch, Dept Intercultural Commun & Management, Frederiksberg, Denmark.
    Russo, P.
    CNR, Inst Food Sci, Avellino, Italy.
    Veidebaum, T.
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Borup, I.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Marild, S.
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden.
    Parental perceptions of and concerns about child's body weight in eight European countries - the IDEFICS study2013Ingår i: Pediatric Obesity, ISSN 2047-6302, E-ISSN 2047-6310, Vol. 8, nr 2, s. 118-129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To evaluate parental perceptions of and concern about child's body weight and general health in children in a European cohort. Design Cross-sectional multi-centre study in eight European countries. Participants 16220 children, ages 29 years. Methods Parents completed a questionnaire regarding children's health and weight and concern about overweight and underweight. Objective children's weight categories from the International Obesity Task Force were used. Logistic regression models were utilized to identify predictors of accurate weight perception. Results Parental weight perception corresponded overall to children's mean body mass index (BMI) z-scores, with important exceptions. About one-third of the total indicated concern about underweight, paradoxically most often parents of children in the overweight or obesity categories. In 63%, parents of children in the overweight category marked proper weight'. The strongest predictor for accurate parental weight perception for children with overweight and obesity was BMI z-score (odds ratio [OR]=7.2, 95% confidence interval [CI] 6.18.7). Compared to Southern Europe, ORs for accurate parental weight perception were 4.4 (95% CI 3.36.0) in Northern Europe and 3.4 (95% CI 2.74.2) in Central Europe. Conclusion Parents of children categorized as being overweight or obese systematically underestimated weight. Parents differed regionally regarding accurate weight perception and concern about overweight and underweight.

  • 228.
    Regber, Susann
    et al.
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Novak, Masuma
    Univ Gothenburg, Sahlgrenska Acad, Dept Mol & Clin Med, Gothenburg, Sweden.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Publ Hlth Epidemiol Unit, Sahlgrenska Acad, Gothenburg, Sweden.
    Hense, Sabrina
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Sandstrom, Tatiana Zverkova
    Nord Sch Publ Hlth NHV, SE-40242 Gothenburg, Sweden.
    Ahrens, Wolfgang
    Inst Epidemiol & Prevent Res BIPS, Dept Epidemiol Methods & Etiol Res, Bremen, Germany.
    Marild, Staffan
    Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Pediat, Gothenburg, Sweden.
    Assessment of selection bias in a health survey of children and families - the IDEFICS Sweden-study2013Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, artikel-id 418Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 229.
    Rittershausen, Kerstin
    Högskolan i Skövde, Institutionen för vård och natur.
    Coaching, empowerment och hälsa: En litteraturstudie2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Begreppen coaching och empowerment har blivit mycket populära. Coaching är att hjälpa människor att lyckas. Empowerment översätts på svenska med egenmakt och maktmobilisering. Syfte med denna studie är att undersöka hur coaching kan hjälpa till att främja empowerment och därmed bidra till att öka människornas hälsa. Frågeställningar är: Vilka samband finns det mellan coaching och empowerment? Hur påverkar empowerment människornas hälsa? Kan man öka individens hälsa med coaching? Uppsatsen grundas på en litteraturstudie. I resultatet analyseras elva vetenskapliga artiklar. Resultatet visar att empowerment och coaching har mycket gemensamt och att båda främjar människornas hälsa. Coaching kan förbättra självförtroendet (själv-efficacy), självkänslan (self-esteem), självmanagement, coping, autonomi, empowerment, smärt- och stresshanteringen, ledarkompetensen och den emotionella intelligensen. Coaching leder till en attitydförändring som underlättar livsstilsförändringar och höjer livskvalitén. Coaching främjar människans Känsla Av SAMmanhang (KASAM) som innebär mer hanterbarhet, begriplighet och meningsfullhet i livet. Studiens slutsats är att coaching är ett sätt att göra empowerment. Diskussionen behandlar skillnaderna mellan empowerment och paternalism, emotionell intelligens och dess betydelse och hur coaching påverkar hälsan. Dessutom diskuteras sambandet mellan psyke och kropp, betydelsen av coping och hur coaching främjar ledarkompetenserna. Slutligen behandlas coaching i kontexten till empowerment och Känslan Av SAMmanhang (KASAM).

  • 230.
    Roth, Anne-Sophie
    Högskolan i Skövde, Institutionen för vård och natur.
    Naturen – en resurs för stressåterhämtning: En systematisk litteraturstudie2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Stressrelaterad psykisk ohälsa har blivit ett växande problem för folkhälsan. Stress, som är en normal reaktion, är i sig inte farlig för hälsan men vid långvariga fysiska och psykiska påfrest-ningar och brist på återhämtning från stress leder det till olika stress- och sjukdomstillstånd. Ur ett folkhälsoperspektiv är det viktigt att lyfta fram förebyggande och hälsofrämjande faktorer mot stress, vilket möjligtvis naturen kan inneha. Syftet med denna studie har varit att belysa de möjliga restorativa och återhämtande effekter av naturen som förebyggande resurs mot stressrelaterad ohälsa. Frågeställningen är: På vilket sätt kan naturen användas som resurs för återhämtning från stress? Metoden i detta arbete är en systematisk litteraturstudie baserad på nio vetenskapliga artiklar. Resultatet visar fyra olika teman. Dessa teman är: naturens åter-hämtande effekter från stress, naturens restorativa effekter, naturens effekter utifrån olika typer av miljö samt naturens effekt i samband med olika aktiviteter. Studien visar på att närhet och tillgång till naturen är betydelsefulla faktorer till människors potentiella återhämtning från stress. Det handlar huvudsakligen om att ha tillgång till en stressfri miljö som kan tillgodose (utifrån dess egenskaper) den enskilda individens aktuella behov (utifrån dennes hälsa och välbefinnande) och inte lika stor betydelse ifall det är en skog eller ett grönområde. I samband med stressfulla livssituationer har mängden lättillgänglig natur från hemmet och tidsramen för utevistelsen visat på positiva samband. Naturen kan ha både fysiologisk och psykologisk inverkan på människan som oftast är den motsatta effekten till stressreaktioner. Den positiva effekten av naturen har setts öka ju mer stressad en person känt sig innan interventionen. Ut-övandet av fysisk aktivitet (FA) i samband med natur har uppvisat en synergisk effekt och ökat FAs faktiska hälsoeffekter. Studiens slutsats är att naturen kan vara en möjlig förebyg-gande resurs mot stressrelaterad ohälsa och därför är viktig ur ett folkhälsoperspektiv, men mer forskning krävs.

  • 231.
    Rundlöf, Amanda
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Utmattningssyndrom och arbetsmiljö bland undersköterskor i äldreomsorgen2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Introduktion: Utmattningssyndrom beskrivs som en konsekvens av långvarig stress utan möjlighet till återhämtning. De främsta orsakerna till ökad stress är obalans mellan krav och kontroll. Utmattningssyndrom drabbar främst kvinnor och personal i människovårdande yrken, däribland undersköterskor. Syfte: Syftet med denna tvärsnittsstudie var att undersöka vilka faktorer i arbetsmiljön som skulle kunna minska risken bland undersköterskor som arbetar inom äldreomsorgen att drabbas av utmattningssyndrom. Metod: Tvärsnittsstudien genomfördes med en enkätundersökning som undersökte självskattat utmattningssyndrom och arbetsmiljön. Enkäten besvarades av kvinnliga undersköterskor på tre äldreboenden. Resultat: Trettiotre undersköterskor deltog i studien, varav 36% uppfyllde kriterier för utmattningssyndrom. Denna grupp upplevde i lägre utsträckning att de kunde påverka och kontrollera/influera sin arbetssituation och kraven rapporterades mer orimliga. Respondenter som inte uppfyllde dessa kriterier visade en mer optimistisk uppfattning av arbetsmiljön. Slutsats: Data från enkätundersökningen rapporterar ett behov av förbättrad kommunikation mellan chefer/ledarskap och anställda då kraven har rapporterats vara höga, samt låga möjligheter till att kontrollera och influera, samt påverka, sin arbetssituation. Tvärsnittsstudien föreslår implementering av stresshantering för att förebygga stress i verksamheterna.

     

  • 232.
    Rundqvist Nedevska, Anne Mari
    Högskolan i Skövde, Institutionen för vård och natur.
    Förebyggande effekter av fysisk aktivitet på depression: – en litteraturstudie2012Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syfte: Att se huruvida belägg finns för fysisk aktivitet som effektiv förebyggande strategi mot depression.

    Metod: Sökning i elektroniska databaser gjordes efter både studier och litteraturgranskningar publicerade mellan 2007 och 2012 med avseende på kopplingen mellan fysisk aktivitet och depression hos barn, ungdomar och vuxna. Tre litteraturgranskningar, fem longitudinella och två tvärsnittsstudier inkluderades.

    Resultat: Fysisk aktivitet reducerade sannolikheten för att utveckla depression i många av de populationer som studerades och stillasittande eller inaktivt liv ökade risken för mental ohälsa såsom depression. En studie visade att låg fysisk aktivitet i barndomen ökade oddsen för depression som vuxen och andra studier såg en koppling och medlande funktion hos fysisk aktivitet och självkänsla hos tonåringar emedan fysisk kondition inte såg ha någon medlande effekt. Emellertid pekar många av författarna på en osäkerhet gällande dos-responssamband samt svårigheter i att bestämma kausalitet.

    Slutsatser: Fysisk aktivitet kan ha preventiv effekt mot depression. Viss evidens finns för att den i barndomen kan verka förebyggande mot depression i vuxen ålder. De komplexa sambanden och kausaliteten bör utforskas vidare och studier av hög kvalitet behövs för att bestämma orsaker och samband samt preventiva insatsers effektivitet. 

  • 233.
    Saafan, Tamer
    et al.
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Bashah, Moataz
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / Weill Cornell Medicine, Doha, Qatar.
    Compared to What? Is BMI Associated with Histopathological Changes in Laparoscopic Sleeve Gastrectomy Specimens?2019Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 29, nr 7, s. 2166-2173Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Obesity is a risk for many different cancers. Laparoscopic sleeve gastrectomy (LSG) is common, and benign or pre-malignant histopathology types are reported in the removed gastric specimens. We assessed whether higher BMI was associated with certain benign or pre-malignant histopathological changes. Method Retrospective chart review of all primary LSG patients (N = 1555). Demographic, clinical, and LSG histopathology data were retrieved. BMI of patients with specific benign or pre-malignant conditions in their gastric specimens was compared with the BMI of the rest of the patients with abnormal histopathology specimens and also compared with the BMI of patients with normal control specimens. Results Females comprised 70% of the patients. Mean BMI were 46.3 (females) and 48 (males). Normal LSG specimens comprised 52%. Most common abnormal histopathologies were chronic inactive gastritis (33%), chronic active gastritis (6.8%), follicular gastritis (2.7%), lymphoid aggregates (2.2%), intestinal metaplasia (1.4%) and GIST (0.7%). After controlling for confounders (age, gender, H. pylori, diabetes mellitus type 2, hypertension), no significant association was observed between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies. Conclusion When confounders were taken into account, there appeared no significant associations between the BMI of patients with specific benign or pre-malignant histopathology compared with the BMI of the rest of the patients with abnormal histopathologies and compared to the BMI of patients with normal histopathologies of their gastric specimens. There was a very weak correlation between BMI and other covariates.

  • 234.
    Salakari, Minna
    et al.
    Department of Public Health, University of Turku, Turku, Finland.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Public Health, University of Turku, Turku, Finland.
    Nurminen, Raija
    University of Applied Science Turku, Turku, Finland.
    Sillanmäki, Lauri
    Department of Occupational Health, University of Helsinki, Helsinki, Finland.
    Pylkkänen, Liisa
    Cancer Society of Finland, Helsinki, Finland.
    Rautava, Päivi
    Turku University Hospital, Turku, Finland.
    Koskenvuo, Markku
    Department of Occupational Health, University of Helsinki, Helsinki, Finland.
    Life satisfaction and sense of coherence of breast cancer survivors compared to women with mental depression, arterial hypertension and healthy controls2016Ingår i: Building Sustainable Health Ecosystems: 6th International Conference on Well-Being in the Information Society, WIS 2016, Tampere, Finland, September 16-18, 2016, Proceedings / [ed] Hongxiu Li, Pirkko Nykänen, Reima Suomi, Nilmini Wickramasinghe, Gunilla Widén, Ming Zhan, Springer, 2016, s. 253-265Konferensbidrag (Refereegranskat)
    Abstract [en]

    The purpose of the study was to compare the life satisfaction (LS) and sense of coherence (SOC) of women recovering from breast cancer (BC) to LS and SOC of women with depression or hypertension and of healthy controls. Finnish Health and Social Support (HeSSup) follow-up survey data in 2003 was linked with national health registries. BC patients were followed up for mortality until the end of 2012. The statistical computations were carried out with SAS®. There were no significant differences in LS and SOC between the groups with BC, arterial hypertension or healthy controls. Women recovering from BC are as satisfied with their life as healthy controls, and their perceived LS is better and SOC is stronger compared to women with depression. SOC correlated positively (r2 = 0.36, p &lt; 0.001) with LS. However, more studies on determinants of the LS are needed for designing and organizing health care services for BC survivors. 

  • 235.
    Samuelsson, Jessica
    et al.
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Rothenberg, Elisabet
    Food and Meal Science, Kristianstad University, Sweden.
    Lissner, Lauren
    Department of Community Medicine and Public Health, University of Gothenburg, Sweden.
    Eiben, Gabriele
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande.
    Zettergren, Anna
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Skoog, Ingmar
    Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AgeCap), University of Gothenburg, Sweden.
    Time trends in nutrient intake and dietary patterns among five birth cohorts of 70-year-olds examined 1971-2016: results from the Gothenburg H70 birth cohort studies, Sweden2019Ingår i: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 18, nr 1, artikel-id 66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Nutrition is a key factor in healthy ageing but there are still gaps in knowledge about risk- and protective factors linking diet and healthy ageing. The aim of this study was to investigate time trends in dietary patterns and nutrient intake in an older population, in order to increase the understanding of whether dietary recommendations are followed and if nutrient needs are met. Methods Cross-sectional data was derived from five samples of 70-year-olds examined 1971-72, 1981-83, 1992-93, 2000-02 and 2014-16 from the Gothenburg H70 birth cohort studies in Sweden. A total of 2246 individuals (56% women) participated. Dietary intake was determined by the diet history method, which is an interview including questions on usual frequencies and portion sizes of food intake during the preceding three months. Recommended values of nutrient intake and determinants of healthful dietary patterns were based on the Nordic Nutrition Recommendations 2012. Statistical analyses were performed using general linear models, student's t-test and chi-square test, stratified by sex. Results The intake of fruits and vegetables, fish and seafood, whole grain products and nuts and seeds increased during the study period (p < 0.0001), among both sexes. However, there was also an increase in alcohol intake (p < 0.0001), especially from wine and beer, and in 2014-16 more than 30% had an alcohol intake above recommendations. Protein intake increased (p < 0.0001 for women and p = 0.0004 for men), and 48% of the women and 37% of the men had a protein intake above recommended 1.2 g/kg body weight and day in 2014-16. The proportion of participants at risk of inadequate intake of vitamins C, D and folate decreased during the study period, among both sexes (p < 0.0001). However, vitamin D intake from diet was still below average requirement level of 7.5 mu g/day for 49% of the women and 32% of the men in 2014-16. Conclusions Dietary patterns have changed among 70-year-olds during the past five decades, with an increase in healthful foods and a higher nutrient density in later born birth cohorts. However, the intake of alcohol increased, especially among women. Results from this study can be useful as a basis for dietary guidelines and used for prevention strategies involving older adults in population-based and health care settings.

  • 236.
    Sandberg, Sara
    et al.
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Wijk, Nathalie
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Samhällets kostnader för övervikt och fetma: En litteraturstudie2016Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
  • 237.
    Sandgren, Ellinore
    Högskolan i Skövde, Institutionen för vård och natur.
    Hälsoeffekter av dans: - en litteraturstudie2013Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Dagens samhälle har förändrats på många sätt och tidsbrist är det gott om. Följden blir att samhällets utformning minskar den naturliga fysiska aktiviten och tidsbristen minskar den planerade fysiska aktiviteten. Fysisk aktivitet i form av dans har visats sig ha många positiva hälsoeffekter som kan förbättra både den fysiska och psykiska hälsan. Syfte: Syftet med litteraturstudien är att undersöka olika hälsoeffekter som dans kan bidra till på både fysisk, psykisk och social nivå. Metod: Studien är genomförd som en litteraturstudie där tio vetenskapliga artiklar använts. Sammanställning, granskning och analys genomfördes för att få fram bärande kategorier. Resultat: Studien visar på att dans bidrar med flera positiva hälsoeffekter, både på det fysiska och psykiska planet; förbättrad hjärtpuls, kondition, självkänsla och kroppsuppfattning. Dans visar också på förbättring av den sociala förmågan, kreativitet, gruppkontakt, ökad tillit och som hjälp för personer att hantera svåra situationer. Slutsats: Dans är en rolig, hälsosam och anpassningsbar form av fysisk aktivitet som passar de flesta. Dansens många positiva hälsoeffekter gör att den skulle passa utmärkt som en insats inom vården för att få patienterna att må bättre och få en förbättrad läkningsförmåga.

  • 238.
    Sandman, Nils
    et al.
    Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland / Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland.
    Merikanto, Ilona
    Department of Health, National Institute for Health and Welfare, Helsinki, Finland / Department of Biosciences, University of Helsinki, Helsinki, Finland.
    Määttänen, Hanna
    Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland.
    Valli, Katja
    Högskolan i Skövde, Institutionen för biovetenskap. Högskolan i Skövde, Forskningscentrum för Systembiologi. Department of Psychology and Speech Language Pathology, Centre for Cognitive Neuroscience, Turku Brain and Mind Centre, University of Turku, Turku, Finland.
    Kronholm, Erkki
    Department of Health, National Institute for Health and Welfare, Turku, Finland.
    Laatikainen, Tiina
    Department of Health, National Institute for Health and Welfare, Helsinki, Finland / Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland / Hospital District of North Karelia, Joensuu, Finland .
    Partonen, Timo
    Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
    Paunio, Tiina
    Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland / Department of Psychiatry, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
    Winter is coming: nightmares and sleep problems during seasonal affective disorder2016Ingår i: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 25, nr 5, s. 612-619Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Sleep problems, especially nightmares and insomnia, often accompany depression. This study investigated how nightmares, symptoms of insomnia, chronotype and sleep duration associate with seasonal affective disorder, a special form of depression. Additionally, it was noted how latitude, a proxy for photoperiod, and characteristics of the place of residence affect the prevalence of seasonal affective disorder and sleep problems. To study these questions, data from FINRISK 2012 study were used. FINRISK 2012 consists of a random population sample of Finnish adults aged 25–74 years (n = 4905) collected during winter from Finnish urban and rural areas spanning the latitudes of 60°N to 66°N. The Seasonal Pattern Assessment Questionnaire was used to assess symptoms of seasonal affective disorder. Participants with symptoms of seasonal affective disorder had significantly increased odds of experiencing frequent nightmares and symptoms of insomnia, and they were more often evening chronotypes. Associations between latitude, population size and urbanicity with seasonal affective disorder symptoms and sleep disturbances were generally not significant, although participants living in areas bordering urban centres had less sleep problems than participants from other regions. These data show that the prevalence of seasonal affective disorder was not affected by latitude. 

  • 239.
    Sandor, Maria
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Dalal, Koustuv
    Högskolan i Skövde, Institutionen för vård och natur. School of Health and Medical Science, Örebro University, Sweden.
    Influencing factors on time of breastfeeding initiation among a national representative sample of women in India2013Ingår i: Health, ISSN 1949-4998, E-ISSN 1949-5005, Vol. 5, nr 12, s. 2169-2180Artikel i tidskrift (Refereegranskat)
  • 240.
    Santaliestra-Pasías, Alba M.
    et al.
    Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragosa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Dios, Jaime E. Llamas
    Universidad de Zaragoza, Spain.
    Sprengeler, Ole
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Hebestreit, Antje
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    De Henauw, Stefaan
    Ghent University, Belgium.
    Eiben, Gabriele
    University of Gothenburg, Sweden.
    Felsö, Regina
    University of Pécs, Hungary.
    Lauria, Fabio
    National Research Council, Avellino, Italy.
    Tornaritis, Michael
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, Toomas
    National Institute for Health Development, Center of Health and Behavioral Science, Tallinn, Estonia.
    Pala, Valeria
    Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
    Moreno, Luis A.
    Universidad de Zaragoza, Spain / Instituto Agroalimentario de Aragón (IA2), Zaragosa, Spain / Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain.
    Food and beverage intakes according to physical activity levels in European children: the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study2018Ingår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 21, nr 9, s. 1717-1725Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Physical activity (PA) levels and dietary habits are considered some of the most important factors associated with obesity. The present study aimed to examine the association between PA level and food and beverage consumption in European children (2-10 years old).Design/Setting/SubjectsA sample of 7229 children (49·0 % girls) from eight European countries participating in the IDEFICS (Identification and prevention of Dietary and lifestyle induced health EFfects In Children and infantS) study was included. Moderate-to-vigorous PA (MVPA) was assessed objectively with accelerometers. FFQ was used to register dietary habits. ANCOVA and binary logistic regression were applied.

    RESULTS: Boys who spent less time in MVPA reported lower consumption of vegetables, fruits, cereals, yoghurt, milk, bread, pasta, candies and sugar-sweetened beverages (SSB) than boys who spent more time in MVPA (P<0·05). Moreover, boys who spent less time in MVPA were more likely to consume fast foods and water than those in the highest MVPA tertile (P<0·05). Girls who spent less time in MVPA reported lower consumption frequencies of vegetables, pasta, bread, yoghurt, candies, jam/honey and SSB than girls in the highest MVPA tertile (P<0·05). Also, girls in the lowest MVPA tertile were more likely to consume fast foods and water than those with high levels of MVPA (P<0·05).

    CONCLUSIONS: Food intake among European children varied with different levels of daily MVPA. Low time spent in MVPA was associated with lowest consumption of both high- and low-energy-dense foods and high fast-food consumption.

  • 241.
    Seger, Angelica
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Jaktlund, Malena
    Högskolan i Skövde, Institutionen för vård och natur.
    FaR- Fysisk aktivitet på recept: En del i det hälsofrämjande arbetet.  En litteraturstudie2012Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Trots all forskning och kunskap om vikten av fysisk aktivitet ökar livsstilrelaterade sjukdomar. WHO (Världshälsoorganisationen) har klassificerat fysisk inaktivitet som en av fyra ohälsosamma levnadsvanor som vid minimering kan förebygga sjukdom och för tidig död. Fysisk aktivitet på recept (FaR) inkluderar hälsofrämjande hälso- och sjukvård och ökad fysisk aktivitet som är två av Sveriges elva folkhälsomål. Syftet med litteraturstudien var att undersöka hur fysisk aktivitet på recept påverkar den fysiska aktivitetsnivån. Metod: En litteraturstudie gjordes och sökning utfördes i LibHub och Academic Search Elite av artiklar publicerade mellan 2005 och 2012. Inklusionskriterier var artiklar som innefattade hälsofrämjande arbete och undersökte fysisk aktivitet på recept, ordinerad till vuxna. Av 60 lästa abstract och 19 lästa artiklar valdes tio ut vilka delades in efter studiedesign.  Inledningen av analysprocessen gjordes oberoende av forskarna därefter sammanställdes materialet och följande tema framkom: Motivation, Implementering, Hälsoekonomiska konsekvenser och Hälsovinster. Resultat: FaR kan leda till ökad fysisk aktivitet och ökad livskvalitet. Framgångsfaktorer var motivation, stöd, samarbete, kunskap samt delaktighet. Resultatet från de olika studiemetoderna visade ingen signifikant skillnad. Resultatet påvisade behov av ytterligare implementering och utveckling av metoden FaR. Slutsats: All typ av beteendeförändring kräver tid och tålamod. För att nå målet ”en mer fysisk aktiv befolkning”, krävs noggrann uppföljning av de som fått FaR utskrivet samt stöd genom motiverande samtal (MI). Utmaningen är att övertyga samhället att FaR är en kostnadseffektiv metod som främjar en god folkhälsa, vilket är en investering för framtiden. 

  • 242.
    Sellberg, Jessica
    Högskolan i Skövde, Institutionen för hälsa och lärande. a15jesse@student.his.se.
    Att införa fysisk aktivitet hos inaktiva vuxna med övervikt: Vad bidrar det med?2018Självständigt arbete på grundnivå (högskoleexamen), 5 poäng / 7,5 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Introduktion: Övervikt och inaktivitet är vanligt förekommande i samhället. Syftet med denna litteraturöversikt var att beskriva vad införande av fysisk aktivitet kan bidra med hos inaktiva överviktiga vuxna personer.

    Metod: En tematisk analys användes där artiklar söktes, identifierades och analyserades till teman.

    Resultat: Fyra teman identifierades som områden där fysisk aktivitet kunde bidra med hos överviktiga personer. Dessa var fysiologiska förändringar och ökat välbefinnande där lägre blodtryck, minskad risk för diabetes och förbättrade kroniska tillstånd sågs. Viktminskning där både vikten och midjemått minskade. Ökad motivation där en ökad tilltro till den egna förmågan fanns och högre livskvalitet med ökad balans i livet gjorde det mer innehållsrikt.

    Diskussion: Forskningen visar att det finns stöd i att fysisk aktivitet bidrar med flera hälsofrämjande egenskaper, som till exempel högre livskvalitet och mindre risk för sjukdomar, hos inaktiva människor.

  • 243.
    Shakya-Vaidya, Suraj
    et al.
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Aryal, Umesh Raj
    Department of Community Medicine, Kathmandu Medical College, Kathmandu, Nepal.
    Grjibovski, Andrej M.
    Department of International Public Health, Norwegian Institute of Public Health, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Krettek, Alexandra
    Nordic School of Public Health NHV, Gothenburg, Sweden / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Visual status in primary open-angle glaucoma: a hospital-based report from Nepal2014Ingår i: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 3, nr 2, s. 49-57Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Primary open-angle glaucoma (POAG) is the commonest cause of irreversible blindness. Most hospitals in Nepal are carrying out opportunistic glaucoma screening for those attending hospitals for any eye consultation. However, there are no reports detailing the visual damage at the time of diagnosis confirming the early detection of cases.

    Objectives: This study aimed to investigate the clinical features and visual status at the time of diagnosis of POAG in the Nepalese population.

    Methods: We evaluated 173 newly diagnosed consecutive cases of POAG from three hospitals across Nepal. Glaucoma evaluation was carried out detailing the findings of visual acuity and visual fields. Continuous data were presented as means and standard deviations (SD) and categorical data as proportions (95% CI). Unpaired t-tests compared continuous variables with p value set at a 5% level of significance.

    Results: Out of total patients, 82.1% were diagnosed incidentally while they visited the hospital for symptoms not expected to be for glaucoma. Only 9.8% of cases were aware of them being at risk of developing glaucoma and thus attended hospitals for regular check-up. Visual field examination revealed mean scores of mean deviation (MD) as low as -13.24 dB and pattern standard deviation of 7.34 dB. Glaucoma hemifield test was outside normal limits in 61.5% of eyes tested. Additionally, 4.7% patients were blind.

    Conclusion: POAG cases presented late with significant visual damage. Existing opportunistic screening for glaucoma in Nepal needs to be combined with community-based glaucoma awareness programs to bring more people to hospital at the early stage of the disease.

  • 244.
    Shakya-Vaidya, Suraj
    et al.
    Nepal Medical College Teaching Hospital, Kathmandu, Nepal / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Aryal, Umesh Raj
    Nordic School of Public Health NHV, Gothenburg, Sweden / Kathmandu Medical College, Kathmandu, Nepal.
    Upadhyay, Madan
    B.P. Eye Foundation, Kathmandu, Nepal.
    Krettek, Alexandra
    Nordic School of Public Health NHV, Gothenburg, Sweden / Sahlgrenska Academy at University of Gothenburg, Sweden.
    Do non-communicable diseases such as hypertension and diabetes associate with primary open-angle glaucoma?: Insights from a case-control study in Nepal2013Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, s. 22636-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Non-communicable diseases (NCDs) such as hypertension and diabetes are rapidly emerging public health problems worldwide, and they associate with primary open-angle glaucoma (POAG). POAG is the most common cause of irreversible blindness. The most effective ways to prevent glaucoma blindness involve identifying high-risk populations and conducting routine screening for early case detection. This study investigated whether POAG associates with hypertension and diabetes in a Nepalese population.

    METHODS: To explore the history of systemic illness, our hospital-based case-control study used non-random consecutive sampling in the general eye clinics in three hospitals across Nepal to enroll patients newly diagnosed with POAG and controls without POAG. The study protocol included history taking, ocular examination, and interviews with 173 POAG cases and 510 controls. Data analysis comprised descriptive and inferential statistics. Descriptive statistics computed the percentage, mean, and standard deviation (SD); inferential statistics used McNemar's test to measure associations between diseases.

    RESULTS: POAG affected males more frequently than females. The odds of members of the Gurung ethnic group having POAG were 2.05 times higher than for other ethnic groups. Hypertension and diabetes were strongly associated with POAG. The overall odds of POAG increased 2.72-fold among hypertensive and 3.50-fold among diabetic patients.

    CONCLUSION: POAG associates significantly with hypertension and diabetes in Nepal. Thus, periodic glaucoma screening for hypertension and diabetes patients in addition to opportunistic screening at eye clinics may aid in detecting more POAG cases at an early stage and hence in reducing avoidable blindness.

  • 245.
    Shakya-Vaidya, Suraj
    et al.
    Sahlgrenska Academy, University of Gothenburg, Sweden.
    Povlsen, Lene
    Nordic School of Public Health NHV, Gothenburg, Sweden .
    Shrestha, Binjwala
    Sahlgrenska Academy University of, Gothenburg, Sweden / Tribhuvan University, Maharajgunj, Kathmandu, Nepal .
    Grjibovski, Andrej M
    Norweigan Institute of Public Health, Oslo, Norway .
    Krettek, Alexandra
    Sahlgrenska Academy, University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg Sweden.
    Understanding and living with glaucoma and non-communicable diseases like hypertension and diabetes in the Jhaukhel-Duwakot Health Demographic Surveillance Site:: a qualitative study from Nepal2014Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, s. 25358-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Primary open-angle glaucoma (POAG) is one of the most common causes of irreversible blindness. A possible association between POAG and non-communicable diseases such as hypertension and diabetes suggests that the incidence of POAG may increase. People with POAG in Nepal usually present late to hospital and have poor knowledge of glaucoma.

    OBJECTIVES: Anticipating a knowledge gap regarding these diseases, this study aimed to explore the knowledge of POAG, hypertension, and diabetes in the community and barriers to health care.

    DESIGN: We conducted this qualitative study in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS), a peri-urban community near Kathmandu, a capital city of Nepal. To study how disease influences knowledge, we conducted focus group discussions separately for men and women with and without pre-existing POAG, hypertension, and diabetes. Data were analyzed using the framework analysis approach.

    RESULTS: Although people suffering from POAG, hypertension, and/or diabetes exhibited adequate knowledge of hypertension and diabetes, they lacked in-depth knowledge of POAG. People believed mostly in internal health locus of control. Perception of disease consequences and impact of disease on daily life was influenced by pre-existing POAG, hypertension, and/or diabetes but only in men. Gender disparity was observed regarding health literacy, health perception, and health barriers, which put women in a more difficult situation to tackle their health. We also revealed a gap between knowledge, attitude, and practice of health among women and healthy men.

    CONCLUSION: Although people in JD-HDSS exhibited adequate knowledge regarding hypertension and diabetes, they lacked in-depth knowledge about POAG. This study demonstrated gender difference in health literacy and access to health care, making women more vulnerable towards disease. We also demonstrated a gap between knowledge, attitude, and practice of health. However, tailored health literacy programs may bring changes in the health status in the community.

  • 246.
    Shrestha, Binjwala
    et al.
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Devkota, Bhimsen
    Development Resource Centre, Kathmandu, Nepal / Institute of Education, Tribhuvan University, Kathmandu, Nepal.
    Khadka, Badri Bahadur
    National Health Education Information and Communication Centre, Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal.
    Choulagai, Bishnu
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Pahari, Durga Prasad
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Onta, Sharad
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Petzold, Max
    Akademistatistik – Centre for Applied Biostatistics, Occupational and Environmental Medicine, University of Gothenburg, Sweden.
    Krettek, Alexandra
    Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden.
    Knowledge on uterine prolapse among married women of reproductive age in Nepal2014Ingår i: International Journal of Women's Health, ISSN 1179-1411, E-ISSN 1179-1411, Vol. 6, s. 771-779Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Uterine prolapse (UP), which affects about 10% of women of reproductive age in Nepal, is the most frequently reported cause of poor health in women of reproductive age and postmenopausal women. Currently, women's awareness of UP is unknown, and attempts to unravel the UP problem are inadequate. This study aims to assess UP knowledge among married reproductive women, and determine the association between UP knowledge and socioeconomic characteristics.

    METHODS: Our cross-sectional descriptive study investigated 25 districts representing all five administrative regions, three ecological zones, and urban and rural settings. We used structured questionnaires to interview 4,693 married women aged 15-49 years. We assessed UP knowledge by asking women whether they had ever heard about UP, followed by specific questions about symptoms and preventive measures. Descriptive statistics characterized the study population regarding socioeconomic status, assessed how many participants had ever heard about UP, and determined UP knowledge level among participants who had heard about the condition. Simple regression analysis identified a possible association between socioeconomic characteristics, ever heard about UP, and level of UP knowledge.

    RESULTS: Mean age of participants was 30 years (SD [standard deviation] 7.4), 67.5% were educated, 48% belonged to the advantaged Brahmin and Chhetri groups, and 22.2% were Janajati from the hill and terai zones. Fifty-three percent had never heard about UP. Among women who had heard about UP, 37.5% had satisfactory knowledge. Any knowledge about UP was associated with both urban and rural settings, age group, and education level. However, satisfactory knowledge about UP was associated with administrative region, ecological zones, caste/ethnic group, and age group of women.

    CONCLUSION: Fifty-three percent of participants had never heard about UP, and UP knowledge level was satisfactory in 37.% of those who had ever heard about UP. Any knowledge was associated with urban/rural setting, age group, and education level, whereas satisfactory knowledge was associated with geography, caste/ethnic group, and age group. UP-related health promotion programs should target women from all caste/ethnic groups, age groups, and education levels, including urban and rural communities.

  • 247.
    Shrestha, Binjwala
    et al.
    Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg.
    Onta, Sharad
    Tribhuvan University, Kathmandu, Nepal.
    Choulagai, Bishnu
    Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg.
    Paudel, Rajan
    Tribhuvan University, Kathmandu, Nepal.
    Petzold, Max
    University of Gothenburg / University of the Witwatersrand, Johannesburg, South Africa.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Sahlgrenska Academy at University of Gothenburg / UiT The Arctic University of Norway.
    Uterine prolapse and its impact on quality of life in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur, Nepal2015Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, s. 1-9, artikel-id 28771Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Uterine prolapse (UP) is a reproductive health problem and public health issue in low-income countries including Nepal.

    OBJECTIVE: We aimed to identify the contributing factors and stages of UP and its impact on quality of life in the Jhaukhel-Duwakot Health Demographic Surveillance Site of Bhaktapur, Nepal.

    DESIGN: Our three-phase study used descriptive cross-sectional analysis to assess quality of life and stages of UP and case-control analysis to identify contributing factors. First, a household survey explored the prevalence of self-reported UP (Phase 1). Second, we used a standardized tool in a 5-day screening camp to determine quality of life among UP-affected women (Phase 2). Finally, a 1-month community survey traced self-reported cases from Phase 1 (Phase 3). To validate UP diagnoses, we reviewed participants' clinical records, and we used screening camp records to trace women without UP.

    RESULTS: Among 48 affected women in Phase 1, 32 had Stage II UP and 16 had either Stage I or Stage III UP. Compared with Stage I women (4.62%), almost all women with Stage III UP reported reduced quality of life. Decreased quality of life correlated significantly with Stages I-III. Self-reported UP prevalence (8.7%) included all treated and non-treated cases. In Phase 3, 277 of 402 respondents reported being affected by UP and 125 were unaffected. The odds of having UP were threefold higher among illiterate women compared with literate women (OR=3.02, 95% CI 1.76-5.17), 50% lower among women from nuclear families compared with extended families (OR=0.56, 95% CI 0.35-0.90) and lower among women with 1-2 parity compared to >5 parity (OR=0.33, 95% CI 0.14-0.75).

    CONCLUSIONS: The stages of UP correlated with quality of life resulting from varied perceptions regarding physical health, emotional stress, and social limitation. Parity, education, age, and family type associated with UP. Our results suggest the importance of developing policies and programs that are focused on early health care for UP. Through family planning and health education programs targeting women, as well as women empowerment programs for prevention of UP, it will be possible to restore quality of life related to UP.

  • 248.
    Shrestha, Binjwala
    et al.
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Sahlgrenska Academy at University of Gothenburg, Sweden .
    Onta, Sharad
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Choulagai, Bishnu
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden .
    Poudyal, Amod
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Pahari, Durga Prasad
    Institute of Medicine, Tribhuvan University, Kathmandu, Nepal .
    Uprety, Aruna
    Rural Health and Education Trust, Kathmandu, Nepal .
    Petzold, Max
    University of Gothenburg, Sweden .
    Krettek, Alexandra
    Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Nordic School of Public Health NHV, Gothenburg, Sweden .
    Women's experiences and health care-seeking practices in relation to uterine prolapse in a hill district of Nepal2014Ingår i: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, nr 1, artikel-id 20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Although uterine prolapse (UP) occurs commonly in Nepal, little is known about the physical health and care-seeking practices of women with UP. This study aimed to explore women's experiences of UP and its effect on daily life, its perceived causes, and health care-seeking practices.

    METHODS: Using a convenience sampling method, we conducted 115 semi-structured and 16 in-depth interviews with UP-affected women during September-December 2012. All interviews occurred in outreach clinics in villages of the Dhading district.

    RESULTS: Study participants were 23-82 years of age. Twenty-four percent were literate, 47.2% had experienced a teenage pregnancy, and 29% had autonomy to make healthcare decisions. Most participants (>85%) described the major physical discomforts of UP as difficulty with walking, standing, working, sitting, and lifting. They also reported urinary incontinence (68%) bowel symptoms (42%), and difficulty with sexual activity (73.9%). Due to inability to perform household chores or fulfill their husband's sexual desires, participants endured humiliation, harassment, and torture by their husbands and other family members, causing severe emotional stress. Following disclosure of UP, 24% of spouses remarried and 6% separated from the marital relationship. Women perceived the causes of UP as unsafe childbirth, heavy work during the postpartum period, and gender discrimination. Prior to visiting these camps some women (42%) hid UP for more than 10 years. Almost half (48%) of participants sought no health care; 42% ingested a herb and ate nutritious food. Perceived barriers to accessing health care included shame (48%) and feeling that care was unnecessary (12.5%). Multiple responses (29%) included shame, inability to share, male service provider, fear of stigma and discrimination, and perceiving UP as normal for childbearing women.

    CONCLUSIONS: UP adversely affects women's daily life and negatively influences their physical, mental, and social well-being. The results of our study are useful to generate information on UP symptoms and female health care seeking practices. Our findings can be helpful for effective development of UP awareness programs to increase service utilization at early stages of UP and thereby might contribute to both primary and secondary prevention of UP.

  • 249.
    Shrestha, Binjwala
    et al.
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Onta, Sharad
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Choulagai, Bishnu
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Shrestha, Khadga B.
    Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
    Petzold, Max
    Health Metrics at Sahlgrenska Academy, University of Gothenburg, Sweden / School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Krettek, Alexandra
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway.
    Knowledge, prevalence and treatment practices of uterine prolapse among women of reproductive age in the Jhaukhel-Duwakot Health Demographic Surveillance Site, Bhaktapur, Nepal2014Ingår i: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 3, nr 4, s. 136-143Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Uterine prolapse (UP) is a main contributor to reproductive health problems that influence women’s quality of life. In Nepal, the UP prevalence ranges from 7-27%. Women experience various difficulties and symptoms due to UP, which are determined by the type as well as thestage of UP.

    Objectives: This study aimed to explore the knowledge, prevalence and treatment practices of uterine prolapse among women of reproductive age in the peri-urban Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) in the Bhaktapur district of Nepal.

    Methods: This cross-sectional study collected data in two stages. A structured survey of 3,124 households in JD-HDSS, incorporating 60% of all women of reproductive age, assessed knowledge of uterine prolapse and identified self-reported disease prevalence (symptomatic). Next, we organised a five day clinical screening camp at JD-HDSS to identify the prevalence of uterine prolapse in attendees. The household survey was conducted on September-December 2012 and the UP screening camp on May-June 2013. Descriptive statistics was used to analyse the proportion of comprehensive knowledge regarding UP and the prevalence of UP.

    Results: Ninety-three percent of women in JD-HDSS had heard of uterine prolapse and 55% of those had comprehensive knowledge. Self-reported (symptomatic) prevalence was 2.11% (8.5% including women who had undergone hysterectomy for uterine prolapse). Among these, 52.6% had received no treatment. The most common reported treatments of uterine prolapse included surgery (53.2%), exercise and medicine (35.5%) and pessary (11.3%). Among women attending the outreach camp (N=303), UP prevalence was 15.18%.

    Conclusion: Knowledge of uterine prolapse among women in JD-HDSS is almost double that reported in a national survey. Similarly, the prevalence of self-reported uterine prolapse in JD-HDSS is almost three fold less than the national prevalence. Knowledge, early healthcare practices and availability of surgical care for uterine prolapse might have contributed to these findings.

  • 250.
    Simonsen, Nina
    et al.
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koponen, Anne M.
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Suominen, Sakari
    Högskolan i Skövde, Institutionen för hälsa och lärande. Högskolan i Skövde, Forskningsspecialiseringen Hälsa och Lärande. Department of Public Health, University of Turku, Turku, Finland.
    Patients' assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland2018Ingår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, artikel-id 412Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: To meet the challenges of the rising prevalence of chronic diseases, such as type 2 diabetes, new approaches to healthcare delivery have been initiated; among these the influential Chronic Care Model (CCM). Valid instruments are needed to evaluate the public health impact of these frameworks in different countries. The Patient Assessment of Chronic Illness Care (PACIC) is a 20-item quality of care measure that, from the perspective of the patient, measures the extent to which care is congruent with the CCM. The aim of this study was to evaluate the psychometric properties of the Finnish translation of the PACIC questionnaire, in terms of validity and reliability, in a large register-based sample of patients with type 2 diabetes.

    Method: The PACIC items were translated into Finnish in a standardized forward-backward procedure, followed by a cross-sectional survey among patients with type 2 diabetes (response rate 56%; n = 2866). We assessed the Finnish version of the PACIC scale for the following psychometric properties: content validity, internal consistency reliability, convergent and construct validity. We also present descriptive data on total scale as well as predetermined subscale levels.

    Results: The item-response on the PACIC scale was high with only small numbers of missing data (0.5-1.1%). Ceiling effects were low (0.3-5.3%) whereas floor effects were over 20% for two of the predetermined subscales (problem solving and follow-up/coordination). The total PACIC scale showed a reasonable distribution and excellent internal consistency (alpha 0.94) while the internal consistency of the subscales were at least acceptable (0.74-0.86). The principal component analysis identified a two-or three-factor solution instead of the proposed five-dimensional. In other respects, the PACIC scale showed the hypothesized relationships with quality of care and outcome measures, thus demonstrating convergent and construct validity.

    Conclusion: A Finnish version of the PACIC scale is now validated in the primary care setting among patients with type 2 diabetes. The findings suggest comparable psychometric properties of the Finnish scale as of the original English instrument and earlier translations, and reasonable levels of validity and reliability.

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