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  • 401.
    Thorstensson, Stina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    To be Supportive or to Care for2014In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 3, no 6, article id 1000e114Article in journal (Other academic)
  • 402.
    Thorstensson, Stina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Fröden, Marie
    Public Health Center, Molkom, Sweden.
    Vikström, Viktoria
    Herrhags School, Karlstad, Sweden.
    Andersson, Susanne
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Swedish school nurses’ experiences in supporting students with type 1 diabetes in their school environment2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 142-147Article in journal (Refereed)
  • 403.
    Thorstensson, Stina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nilsson, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Olsson, Linda
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Hertfelt Wahn, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Women's Experiences of Midwifery Support during Pregnancy A step in the Validation of the Scale: "The Mother Perceived Support from Professionals"2015In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 4, no 2, article id 1000241Article in journal (Refereed)
    Abstract [en]

    Background: Pregnancy can be physically and emotionally stressful for the parents, which means they need adequate professional support. Easy-to-use, validated scales are important in order to develop professional support in Antenatal care as well as in research.

    The aim: Our aim was to illuminate pregnant women’s experience of professional support at the Antenatal care, in relation to the Mother-Perceived-Professionals-Support (MoPPS) scale.

    Method: A qualitative study design using the method “Think aloud” with both inductive and deductive approaches, was used. Five first-time mothers were interviewed with open questions followed by questions related to the MoPPS scale items. Data was analyzed using inductive and deductive qualitative content analyses.

    Results: The inductive analysis resulted in one theme: “Professional support from midwives made women created a feeling of security and unique or rejected and lonely during pregnancy” and three categories: “Continuity and competence”, “Perceiving trust or not” and “Parental groups or individual visits”. The deductive analysis described the mothers’ understanding of each item. However, coherence between the inductive and deductive analyses varied and the MoPPS-scale needs development.

    Conclusion: The result shows that women's experience of professional support affects their sense of feeling safe or lonely during pregnancy. Important for midwives were to meet the women’s unique individual needs. The MoPPS scale was considered to be relevant and easy to understand, but it needs development to include questions about continuity, parental groups and the perception of midwives’ competence, which all were important for the women during their pregnancies.

    Clinical implications: To offer adequate professional support for women during pregnancy, midwives need to meet the women’s unique individual needs with both medical and supportive knowledge.

  • 404.
    Tilles-Tirkkonen, Tanja
    et al.
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
    Nuutinen, Outi
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland.
    Liukkonen, Jarmo
    Department of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland.
    Poutanen, Kaisa
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland / VTT—Technical Research Centre of Finland, Finland.
    Karhunen, Leila
    Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland / Institute of Clinical Medicine, Internal Medicine, Kuopio University Hospital, Kuopio, Finland.
    Preliminary Finnish measures of eating competence suggest association with health-promoting eating patterns and related psychobehavioral factors in 10-17 year old adolescents2015In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 7, no 5, p. 3828-3846Article in journal (Refereed)
    Abstract [en]

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

  • 405.
    Timpka, Toomas
    et al.
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    Jacobsson, Jenny
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    Bickenbach, Jerome
    Department of Philosophy, Queen’s University, Kingston, ON, Canada.
    Finch, Caroline F.
    Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC, Australia.
    Ekberg, Joakim
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nordenfelt, Lennart
    Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.
    What is a Sports Injury?2014In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 44, no 4, p. 423-428Article in journal (Refereed)
    Abstract [en]

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

  • 406.
    Timpka, Toomas
    et al.
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Schyllander, Jan
    Swedish Civil Contingencies Agency, Karlstad, Sweden.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Public Health Sciences, Walden University, Minneapolis, MN, USA.
    Ekman, Robert
    Department of Architecture, Chalmers University of Technology, Gothenburg, Sweden.
    Dahlström, Örjan
    Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
    Hägglund, Martin
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Kristenson, Karolina
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Jacobsson, Jenny
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Community-level football injury epidemiology: traumatic injuries treated at Swedish emergency medical facilities2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 1, p. 94-99Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 407.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Elaiwy, Orwa
    Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar.
    Obaid, Munzir
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Al-Yahri, Omer
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Abdelazim, Sherif
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    First sliding Amyand hernia harbouring appendicular schistosomiasis: Case report2019In: International journal of surgery case reports, ISSN 2210-2612, E-ISSN 2210-2612, Vol. 63, p. 143-146Article in journal (Refereed)
    Abstract [en]

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

  • 408.
    Toffaha, Ali
    et al.
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Ramzee, Ahmed Faidh
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Afana, Mohammad
    Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
    Aljohary, Hesham
    Department of General Surgery, Hamad Medical Corporation, Doha, Qatar.
    Rare presentation of primary varicella zoster as fatal fulminant hepatitis in adult on low-dose, short-term steroid: Case report2019In: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 48, p. 115-117Article in journal (Refereed)
    Abstract [en]

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

  • 409.
    Törnblom, Kjell
    et al.
    ETH Zürich, Department of Environmental Systems Science, USYS TdLab, Switzerland.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Distributive Justice: Revisiting Past Statements and Reflecting on Future Prospects2015In: The Oxford Handbook of Justice in the Workplace / [ed] Russell S. Cropanzano & Maureen L. Ambrose, New York: Oxford University Press, 2015, p. 15-50Chapter in book (Refereed)
    Abstract [en]

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

  • 410.
    Ulfberg, Nina
    et al.
    University of Skövde, School of Health and Education.
    Wibergh, Sandra
    University of Skövde, Health and Education.
    Att främja mental hälsa genom fysisk aktivitet: En litteraturstudie2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
  • 411.
    Usynina, Anna A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Grjibovski, Andrej M.
    International School of Public Health, Northern State Medical University, Arkhangelsk, Russia / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Public Health, Hygiene and Bioethics, Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Kudryavtsev, Alexander V.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Anda, Erik Eik
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Risk factors for perinatal mortality in Murmansk County, Russia: a registry-based study2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, p. 1-10, article id 1270536Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 412.
    Usynina, Anna A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Grjibovski, Andrej M.
    International School of Public Health, Northern State Medical University, Arkhangelsk, Russia / Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / Department of Public Health, Hygiene and Bioethics, Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Social correlates of term small for gestational age babies in a Russian Arctic setting2016In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 75, article id 32883Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 413.
    Usynina, Anna A.
    et al.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Postoev, Vitaly A.
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / International School of Public Health, Northern State Medical University, Arkhangelsk, Russia.
    Grjibovski, Andrej M.
    International School of Public Health, Northern State Medical University, Arkhangelsk, Russia / Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway / Department of Preventive Medicine, International Kazakh-Turkish University, Turkestan, Kazakhstan / North-Eastern Federal University, Yakutsk, Russia.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Nieboer, Evert
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Canada.
    Odland, Jon Øyvind
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway / Department of Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
    Anda, Erik Eik
    Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Maternal Risk Factors for Preterm Birth in Murmansk County, Russia: A Registry-Based Study2016In: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 30, no 5, p. 462-472Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 414.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Agriculture (SLU), Uppsala, Sweden.
    Ekström-Bergström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Health Sciences, University West, Trollhättan, Sweden.
    Berg, Marie
    Institute of Health and Care Sciences, University of Gothenburg, Sweden / Centre for Person-Centred Care, University of Gothenburg, Sweden.
    Buckley, Sarah
    School of Public Health, University of Queensland, Brisbane, Australia.
    Pajalic, Zada
    Faculty of Health Sciences, Oslo and Akershus University, College of Applied Sciences, Oslo, Norway.
    Hadjigeorgiou, Eleni
    Faculty of Health Sciences, Cyprus, University of Technology, Limassol, Cyprus.
    Kotłowska, Alicja
    Faculty of Health Sciences with Subfaculty of Nursing, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdańsk, Poland.
    Lengler, Luise
    Midwifery Research and Education Unit, Hannover Medical School, Hannover, Germany.
    Kielbratowska, Bogumila
    Faculty of Medical Sciences, Medical University of Gdańsk, Gdańsk, Poland.
    Leon-Larios, Fatima
    Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.
    Magistretti, Claudia Meier
    Department of Social Work Center for Health Promotion and Social Participation, Lucerne University of Applied Sciences and Arts, Luzern, Switzerland.
    Downe, Soo
    Research in Childbirth and Health (ReaCH) Group, University of Central Lancashire, Preston, United Kingdom.
    Lindström, Bengt
    Norwegian University of Science and Technology, Trondheim, Norway.
    Dencker, Anna
    Institute of Health and Care Sciences, University of Gothenburg, Sweden / Centre for Person-Centred Care, University of Gothenburg, Sweden.
    Maternal plasma levels of oxytocin during physiological childbirth: A systematic review with implications for uterine contractions and central actions of oxytocin2019In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, no 1, article id 285Article, review/survey (Refereed)
    Abstract [en]

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

  • 415.
    Uvnäs-Moberg, Kerstin
    et al.
    Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden.
    Handlin, Linda
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kendall-Tackett, Kathleen
    Texas Tech University School of Medicine, Amarillo, TX, USA.
    Petersson, Maria
    Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Sweden.
    Oxytocin is a principal hormone that exerts part of its effects by active fragments2019In: Medical Hypotheses, ISSN 0306-9877, E-ISSN 1532-2777, Vol. 133, p. 1-9, article id 109394Article in journal (Refereed)
    Abstract [en]

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

  • 416.
    Uvnäs-Moberg, Kerstin
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Skara, Sweden.
    Handlin, Linda
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Petersson, Maria
    Department of Molecular Medicine and Surgery, Endocrine and Diabetes Unit, Karolinska Institutet, Stockholm, Sweden.
    Self-soothing behaviors with particular reference to oxytocin release induced by non-noxious sensory stimulation2015In: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 5, article id 1529Article, review/survey (Refereed)
  • 417.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Sweden.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    The heart-health associated research, dissemination and intervention in the community (HARDIC) trial for nepalese mothers regarding diet and physical activity: A process evaluation2017In: Kathmandu University Medical Journal, ISSN 1812-2027, E-ISSN 1812-2078, Vol. 15, no 58, p. 107-116Article in journal (Refereed)
    Abstract [en]

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

  • 418.
    Vaidya, Abhinav
    et al.
    Kathmandu Medical College, Kathmandu, Nepal.
    Oli, Natalia
    Kathmandu Medical College, Kathmandu, Nepal / University of Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Göteborgs universitet / UiT Norges Arktiska Universitet.
    High prevalence of prehypertension in mothers of young children in peri-urban Nepal2016In: Journal of Kathmandu Medical College, ISSN 2091-1785, Vol. 5, no 2, p. 52-60Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 419.
    Vaidya, Abhinav
    et al.
    Department of Community Medicine, Kathmandu Medical College, Kathmandu.
    Oli, Natalia
    Department of Community Medicine, Kathmandu Medical College, Kathmandu / Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Krettek, Alexandra
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden / 4Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway .
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden.
    Preference of Food-items and Physical Activity of Peri-urban Children in Bhaktapur2017In: Journal of Nepal Health Research Council, ISSN 1727-5482, E-ISSN 1999-6217, Vol. 15, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 420.
    van Meer, Floor
    et al.
    University Medical Center Utrecht, the Netherlands.
    van der Laan, Laura N.
    Tilburg University, the Netherlands.
    Eiben, Gabriele
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lissner, Lauren
    Göteborg University, Sahlgrenska Academy, Gothenburg.
    Wolters, Maike
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Rach, Stefan
    Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
    Herrmann, Manfred
    University of Bremen, Germany.
    Erhard, Peter
    University of Bremen, Germany.
    Molnár, Dénés
    University Medical School of Pécs, Hungary.
    Orsi, Gergely
    University Medical School of Pécs, Hungary / MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.
    Viergever, Max A.
    University Medical Center Utrecht, the Netherlands.
    Adan, Roger A.H.
    University Medical Center Utrecht, the Netherlands.
    Smeets, Paul A.M.
    University Medical Center Utrecht, the Netherlands / Division of Human Nutrition & Health, Wageningen University & Research, the Netherlands.
    Development and body mass inversely affect children's brain activation in dorsolateral prefrontal cortex during food choice2019In: NeuroImage, ISSN 1053-8119, E-ISSN 1095-9572, Vol. 201, p. 1-10, article id 116016Article in journal (Refereed)
    Abstract [en]

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

  • 421.
    Varinen, Aleksi
    et al.
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland / Nokia Health Centre, Nokia, Finland.
    Kosunen, Elise
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland / Pirkanmaa Hospital District, Centre for General Practice, Finland.
    Mattila, Kari
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku University Hospital, Finland.
    Sillanmäki, Lauri
    Department of Public Health, University of Turku, Turku University Hospital, Finland / Health care services, Welfare Division, Turku, Finland.
    Sumanen, Markku
    Department of General Practice, Faculty of Medicine and Life Sciences, Tampere University, Finland.
    The association between bullying victimization in childhood and fibromyalgia: Data from the nationwide Finnish health and social support (HeSSup) study based on a sample of 64,797 individuals2019In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 117, p. 48-53Article in journal (Refereed)
    Abstract [en]

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

  • 422.
    Vestman, C.
    et al.
    Department of Dialysis, Skaraborgs Hospital, Skövde, Sweden.
    Hasselroth, M.
    Department of Dialysis, Skaraborgs Hospital, Skövde, Sweden.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Freedom and Confinement: Patients' Experiences of Life with Home Haemodialysis2014In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, article id 252643Article in journal (Refereed)
    Abstract [en]

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

  • 423.
    Virtanen, Marianna
    et al.
    Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden / Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Ervasti, Jenni
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Head, Jenny
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland / Department of Psychology, University of Turku, Turku, Finland.
    Pentti, Jaana
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Kouvonen, Anne
    Faculty of Social Sciences, University of Helsinki, Helsinki, Finland / SWPS University of Social Sciences and Humanities, Wroclaw, Poland.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki and Turku, Finland / School of Social Policy, Sociology and Social Research, University of Kent, United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Koskenvuo, Markku
    Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Elovainio, Marko
    Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland / National Institute for Health and Welfare, Helsinki, Finland.
    Zins, Marie
    Inserm, Population-based Epidemiologic Cohorts Unit UMS 011, Villejuif, France / Paris Descartes University, Paris, France.
    Goldberg, Marcel
    Inserm, Population-based Epidemiologic Cohorts Unit UMS 011, Villejuif, France / Paris Descartes University, Paris, France.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Clinicum, Faculty of Medicine, University of Helsinki, Finland.
    Lifestyle factors and risk of sickness absence from work: a multicohort study2018In: Lancet Public Health, ISSN 2468-2667, Vol. 3, no 11, p. E545-E554Article in journal (Refereed)
    Abstract [en]

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

  • 424.
    Virtanen, Marianna
    et al.
    School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland / Stress Research Institute, Stockholm University, Sweden.
    Jokela, Markus
    Department of Psychology and Logopedics, University of Helsinki, Finland.
    Lallukka, Tea
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, Clinicum, University of Helsinki, Finland.
    Magnusson Hanson, Linda
    Stress Research Institute, Stockholm University, Sweden.
    Pentti, Jaana
    Department of Public Health, Clinicum, University of Helsinki, Finland / Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Nyberg, Solja T.
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Batty, G. David
    Department of Epidemiology & Public Health, University College London, London, United Kingdom / School of Biological & Population Health Sciences, Oregon State University, Corvallis, United States.
    Casini, Anna-Lisa
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Clays, Els
    Department of Public Health, Ghent University, Belgium.
    DeBacquer, Dirk
    Department of Public Health, Ghent University, Belgium.
    Ervasti, Jenni
    Finnish Institute of Occupational Health, Helsinki, Finland / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Fransson, Eleonor
    Stress Research Institute, Stockholm University, Sweden / Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / School of Health and Welfare, Jönköping University, Sweden.
    Halonen, Jaana I.
    Stress Research Institute, Stockholm University, Sweden / Finnish Institute of Occupational Health, Helsinki, Finland.
    Head, Jenny
    Department of Epidemiology & Public Health, University College London, United Kingdom.
    Kittel, France
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Leineweber, Constance
    Stress Research Institute, Stockholm University, Sweden.
    Nordin, Maria
    Department of Psychology, Umeå University, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pietiläinen, Olli
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Rahkonen, Ossi
    Department of Public Health, Clinicum, University of Helsinki, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Finland.
    Singh-Manoux, Archana
    Department of Epidemiology & Public Health, University College London, United Kingdom / INSERM, Villejuif, U 1018, France.
    Stenholm, Sari
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Suominen, Sakari B
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Sweden.
    Vahtera, Jussi
    Department of Public Health, University of Turku and Turku University Hospital, Finland / Centre for Population Health Research, University of Turku and Turku University Hospital, Finland.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Sweden.
    Kivimäki, Mika
    Department of Public Health, Clinicum, University of Helsinki, Finland / Department of Epidemiology & Public Health, University College London, United Kingdom.
    Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497Article in journal (Refereed)
    Abstract [en]

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

  • 425.
    Virtanen, Marianna
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health and Caring Sciences, University of Uppsala, Sweden.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Magnusson Hanson, Linda L.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Lallukka, Tea
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, University of Helsinki, Finland.
    Nyberg, Solja T.
    Department of Public Health, University of Helsinki, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden.
    Batty, G David
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational Medicine, Koge Hospital, Koge, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Heikkilä, Katriina
    Department of Health Services and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Finland.
    Lahelma, Eero
    Department of Public Health, University of Helsinki, Finland.
    Nielsen, Martin L.
    Unit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Department of Public Health, University of Helsinki, Finland.
    Rahkonen, Ossi
    Department of Public Health, University of Helsinki, Finland.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark / Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Turku, Finland.
    Schupp, Jürgen
    German Institute for Economic Research, Berlin, Germany / Free University of Berlin, Berlin, Germany.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Research in Epidemiology and Population Health, Villejuif, France.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Wagner, Gert G.
    German Institute for Economic Research, Berlin, Germany / Max Planck Institute for Human Development, Berlin, Germany / Berlin University of Technology, Berlin, Germany.
    Wang, Jian Li
    University of Ottawa Institute of Mental Health Research, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.
    Yiengprugsawan, Vasoontara
    Centre for Research on Ageing, Health and Wellbeing and the ARC Centre of Excellence on Population Ageing Research, The Australian National University, Canberra, Australia.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health, University of Helsinki, Finland / Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 3, p. 239-250, article id 3712Article, review/survey (Refereed)
    Abstract [en]

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

  • 426.
    Vixner, Linda
    et al.
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Sweden.
    Mårtensson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schytt, Erica
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Sweden / Centre for Clinical Research Dalarna, Falun, Sweden.
    Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience2015In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 15, no 1, article id 180Article in journal (Refereed)
  • 427.
    Vixner, Linda
    et al.
    Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Schytt, Erica
    Centre for Clinical Research Dalarna, Falun, Sweden / Bergen University Collage, Bergen, Norway.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Associations between maternal characteristics and women's responses to acupuncture during labour: a secondary analysis from a randomised controlled trial2017In: Acupuncture in Medicine, ISSN 0964-5284, E-ISSN 1759-9873, Vol. 35, no 3, p. 180-188Article in journal (Refereed)
  • 428.
    Vixner, Linda
    et al.
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / School of Health and Social Studies, Dalarna University, Falun, Sweden.
    Schytt, Erica
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden / Centre for Clinical Research Dalarna, Falun, Sweden.
    Stener-Victorin, Elisabet
    Department of Physiology, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden.
    Waldenström, Ulla
    Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, Stockholm, Sweden.
    Pettersson, Hans
    Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet, Stockholm, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Acupuncture with manual and electrical stimulation for labour pain: a longitudinal randomised controlled trial2014In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 14, article id 187Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 429.
    Volanen, Salla-Maarit
    et al.
    Folkhälsan Research Center, Helsinki, Finland / Clinicum, Department of Public Health, University of Helsinki, Finland.
    Lassander, Maarit
    Institute of Behavioural Sciences, University of Helsinki, Finland.
    Hankonen, Nelli
    Social Psychology Unit, Faculty of Social Sciences, University of Helsinki, Finland.
    Santalahti, Päivi
    National Institute for Health and Welfare, Finland.
    Hintsanen, Mirka
    Unit of Psychology, University of Oulu, Finland.
    Simonsen, Nina
    Folkhälsan Research Center, Helsinki, Finland / Clinicum, Department of Public Health, University of Helsinki, Finland.
    Raevuori, Anu H.
    Clinicum, Department of Public Health, University of Helsinki, Finland / Department of Adolescent Psychiatry, Helsinki University Central Hospital, Finland / Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
    Mullola, Sari
    Institute of Behavioural Sciences, University of Helsinki, Finland / Department of Teacher Education, University of Helsinki, Finland.
    Vahlberg, Tero Juhani
    Department of Biostatistics, University of Turku, Finland.
    But, Anna
    Clinicum, Department of Public Health, University of Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Finland.
    Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial2020In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 660-669Article in journal (Refereed)
    Abstract [en]

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

  • 430.
    Volanen, Salla-Maarit
    et al.
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Lassander, Maarit
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
    Hankonen, Nelli
    School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
    Santalahti, Päivi
    National Institute for Health and Welfare, Helsinki, Finland.
    Hintsanen, Mirka
    Unit of Psychology, University of Oulu, Oulu, Finland.
    Simonsen, Nina
    Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Helsinki, Helsinki, Finland.
    Raevuori, Anu
    Department of Public Health, University of Helsinki, Helsinki, Finland / Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland / Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland.
    Mullola, Sari
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland / Department of Teacher Education, University of Helsinki, Helsinki, Finland.
    Vahlberg, Tero
    Department of Biostatistics, University of Turku, Turku, Finland.
    But, Anna
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Folkhälsan Research Center, Helsinki, Finland / Department of Public Health, University of Turku, Turku, Finland.
    Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial2016In: BMC Psychology, E-ISSN 2050-7283, Vol. 4, article id 35Article in journal (Refereed)
    Abstract [en]

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

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

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

    TRIAL REGISTRATION: ISRCTN18642659 . Retrospectively registered 13 October 2015.

  • 431.
    Vuorio, Tina
    et al.
    Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland.
    Kautiainen, Hannu
    Folkhälsan Research Center, Helsinki, Finland / Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
    Korhonen, Päivi
    Department of Family Medicine, Institute of Clinical Medicine, University of Turku and Turku University Hospital, Turku, Finland / Health Center of Harjavalta, Central Satakunta Health Federation of Municipalities, Harjavalta, Finland.
    Determinants of sickness absence rate among Finnish municipal employees2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

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

  • 432.
    Wallander, Marit
    et al.
    Department of Medicine Huddinge, Karolinska Institute, Stockholm, Sweden / Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Center for Bone Research at the Sahlgrenska Academy, University of Gothenburg, Sweden.
    Axelsson, Kristian F.
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Center for Bone Research at the Sahlgrenska Academy, University of Gothenburg, Sweden / Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden.
    Lundh, Dan
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lorentzon, Mattias
    Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Center for Bone Research at the Sahlgrenska Academy, University of Gothenburg, Sweden / Geriatric Medicine, Institute of Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, Sweden.
    Patients with prostate cancer and androgen deprivation therapy have increased risk of fractures: a study from the fractures and fall injuries in the elderly cohort (FRAILCO)2019In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 30, no 1, p. 115-125Article in journal (Refereed)
    Abstract [en]

    Summary: Osteoporosis is a common complication of androgen deprivation therapy (ADT). In this large Swedish cohort study consisting of a total of nearly 180,000 older men, we found that those with prostate cancer and ADT have a significantly increased risk of future osteoporotic fractures. Introduction: Androgen deprivation therapy (ADT) in patients with prostate cancer is associated to increased risk of fractures. In this study, we investigated the relationship between ADT in patients with prostate cancer and the risk of incident fractures and non-skeletal fall injuries both compared to those without ADT and compared to patients without prostate cancer. Methods: We included 179,744 men (79.1 ± 7.9 years (mean ± SD)) from the Swedish registry to which national directories were linked in order to study associations regarding fractures, fall injuries, morbidity, mortality and medications. We identified 159,662 men without prostate cancer, 6954 with prostate cancer and current ADT and 13,128 men with prostate cancer without ADT. During a follow-up of approximately 270,300 patient-years, we identified 10,916 incident fractures including 4860 hip fractures. Results: In multivariable Cox regression analyses and compared to men without prostate cancer, those with prostate cancer and ADT had increased risk of any fracture (HR 95% CI 1.40 (1.28–1.53)), hip fracture (1.38 (1.20–1.58)) and MOF (1.44 (1.28–1.61)) but not of non-skeletal fall injury (1.01 (0.90–1.13)). Patients with prostate cancer without ADT did not have increased risk of any fracture (0.97 (0.90–1.05)), hip fracture (0.95 (0.84–1.07)), MOF (1.01 (0.92–1.12)) and had decreased risk of non-skeletal fall injury (0.84 (0.77–0.92)). Conclusions: Patients with prostate cancer and ADT is a fragile patient group with substantially increased risk of osteoporotic fractures both compared to patients without prostate cancer and compared to those with prostate cancer without ADT. We believe that this must be taken in consideration in all patients with prostate cancer already at the initiation of ADT. 

  • 433.
    Wang, Shu Mei
    et al.
    Key Laboratory of Public Health Safety, School of Public Health, Fudan University, China.
    Zou, Jin Liang
    Key Laboratory of Public Health Safety, School of Public Health, Fudan University, China.
    Gifford, Mervyn
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Dalal, Koustuv
    School of Health & Medical Sciences, Department of Public Health Science, Örebro University, Sweden.
    Young students' knowledge and perception of health and fitness: A study in Shanghai, China2014In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 73, no 1, p. 20-27Article in journal (Refereed)
    Abstract [en]

    Objective: This study investigated how young urban students conceptualize health and fitness and tried to identify their sources of information about health-related issues. The findings are intended to help make suggestions for policy makers to design and develop effective health-education strategies. Methods: Focus group discussions (FGDs) of 20 groups, each comprised of eight 10th-grade students, were carried out. In total 160 students participated in the FGDs. Results: Young students' knowledge and perceptions about health and fitness had certain limitations, although most of the students emphasized the importance of good health and felt that they knew the meaning of health and fitness. They were most concerned with physical health and failed to consider other aspects of health such as mental/psychological, behavioural and social aspects. This represents a lack of awareness of contemporary conceptions of health and illness. Conclusion: These findings are important when considering the design of effective high school health education strategies that meet state content standards and for influencing students to continue participating in health-promoting activities.

  • 434.
    Wengström, Y.
    et al.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Bolam, K. A.
    Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden / School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
    Mijwel, S.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Sundberg, C. J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden / Unit for Bioentrepreneurship, Karolinska Institutet, Solna, Sweden.
    Backman, M.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Norrbom, J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Rundqvist, H.
    Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden.
    Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy2017In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, article id 100Article in journal (Refereed)
    Abstract [en]

    Background: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy. The second aim is to examine if any effects are sustained 1, 2, and 5 years following the completion of the intervention and to monitor return to work, recurrence and survival. The third aim of the study is to examine the effect of attendance and adherence rates on the effects of the exercise programme. Methods: This study is a randomised controlled trial including 240 women with breast cancer receiving chemotherapy in Stockholm, Sweden. The participants are randomly allocated to either: group 1: Aerobic training, group 2: Combined resistance and aerobic training, or group 3: usual care (control group). During the 5-year follow-up period, participants in the exercise groups will receive a physical activity prescription. Measurements for endpoints will take place at baseline, after 16 weeks (end of intervention) as well as after 1, 2 and 5 years. Discussion: This randomised controlled trial will generate substantial information regarding the effects of different types of exercise on the health of patients with breast cancer undergoing chemotherapy. We expect that dissemination of the knowledge gained from this study will contribute to developing effective long term strategies to improve the physical and psychosocial health of breast cancer survivors.

  • 435.
    Westin, Lars
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Students' experiences of learning in relation to didactic strategies during the first year of a nursing programme: a qualitative study2015In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 15, article id 49Article, review/survey (Refereed)
    Abstract [en]

    In university undergraduate nursing programmes, didactic strategies that enable students to learn nursing skills, solve problems and develop reflective and critical thinking and practice are needed. The aim of this study was to explore how different didactic strategies support nursing students’ experiences of learning during the first year of a reconstructed nursing curriculum.

    Methods

    This study employed a qualitative approach. The data were gathered through written narratives that were analysed using qualitative content analysis.

    Results

    Nursing students’ experiences of learning through different didactic strategies, were evident in the text. These perspectives were organised into the following themes: To focus on the patient perspective and paying more attention to others, Learning from discussions and reflections on one’s own learning, Training for the professional role and becoming more courage, and Gaining insights into nursing and increasing one’s self-awareness. The education increased the students’ self-awareness, which helped them to pay greater attention to patients and their relative. During the learning process, the students became more courageous, reflected and discovered their shortcomings.

    Conclusion

    Stated didactic strategies supported a broad base of knowledge on nursing and the professional role of nurses. Educators are challenged to strengthen meaningful learning in nursing and to facilitate the progression of nursing programmes.

  • 436.
    Wongsala, Manothai
    et al.
    Mälardalen University, Sweden.
    Anbäcken, Els-Marie
    Mälardalen University, Sweden.
    Rosendahl, Sirpa
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Perspectives of Health, Participation and Security among Older Adults in Northeastern Thailand2018Conference paper (Other academic)
  • 437.
    Wongsala, Manothai
    et al.
    Mälardalen University, Sweden.
    Anbäcken, Els-Marie
    Mälardalen University, Sweden.
    Rosendahl, Sirpa
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Manasatchakun, Pornpun
    Boromarajonani College of Nursing Chaing Mai, Thailand.
    Rungkawatt, Vilaiporn
    Boromarajonani College of Nursing Nakhonratchasima, Thailand.
    "Lomwong Saansook": A Group Meeting Using PDSA Wheel to Improve Health, Participation and Security among Thai Older Adults2019In: iHSEP2019 Conference Abstract Book: International Conference on Advancement in Health Sciences Education and Professions (iHSEP2019): Synergy and Reform for Better Health, Ministry of Public Health, Thailand , 2019Conference paper (Refereed)
    Abstract [en]

    Background In general, activities to promote well being among the elderly in Thailand are not selfinitiated Therefore, older people need to be encouraged to find out how to manage their daily life and activities This study applied the concept of the PDSA wheel Plan Do Study Act in order to enhance their wellbeingThe activity called Lomwong SaansookThai wordsLSmeetings implemented among older adults aged 60 and above The PDSA concepts are used to encourage participants to plan a goal, do it by themselves, and use the group dynamic with other participants in studying evaluating to improve the activities Topics of meetings included health issues, participation, and security related to the active aging concepts Objective To describe older adults¶ perceptions of changes and improvement in their daily lives after participating in LSmeetings Methodology This qualitative study employed the phenomenography method using focus group interviews which were conducted two weeks after four LSmeetings with 15 participants They were divided into two focus groups contained seven and eight participants including males and females Data were collected by field notetaking and video recordingData were analyzed by the multistage coding process to identify themes of description Results The participants described their perceptions of changes and improvements by five themes, including not familiar but possible with supporting, behaviors improving, meaningful knowledge needs, learn with each other, and success factors DiscussionConclusion Thai older people in this area had difficulties to make goals of lifestyle changes by themselves, but it was possible with the support of the moderator As a result, their healthrelated behaviors had improved The examples of a lifestyle change were improvements in fooddrink intake, exercise, and saving money; however, the causes of changing behaviors were not confirmed clearly The important factors of changing behaviors were meaningful new knowledge, group process, support from the moderator, and good relationships with health personnelAccording to the results of this study, it can be concluded that the meeting using the PDSA wheel may be able to use as a guideline providing sustainable activities for Thai older people to encourage improving individual implementation of lifestyle changes, in order to enhance their wellbeing.

  • 438.
    Wongsala, Manothai
    et al.
    Mälardalen University, Sweden.
    Rosendahl, Sirpa
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Anbäcken, Els-Marie
    Mälardalen University, Sweden.
    Lomwong Saansook: Improving Health, Participation and Security among Thai Older Adults Using PDSA Wheel2019Conference paper (Refereed)
  • 439.
    Yngman-Uhlin, Pia
    et al.
    Department of Research and Development Unit, Department of Medical and Health Sciences, Linköping University, Sweden.
    Kjellsdotter, Anna
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Uhlin, F.
    Department of Nephrology and Medical and Health Sciences, Linköping University, Sweden / Region Östergötland, Linköping, Sweden / Department of Health Technologies, Tallinn University of Technology, Estonia.
    Edéll-Gustafsson, U.
    Department of Medical and Health Sciences, Linköping University, Sweden.
    Sleep Quality, Fatigue, and Health-Related Quality of Life in Patients on Initial Peritoneal Dialysis and Multiple Modalities after Two Years: A Prospective Study2019In: Nephrology Nursing Journal : Journal of The American Nephrology Nurses Association, ISSN 1526-744X, E-ISSN 2163-5390, Vol. 46, no 6, p. 615-649Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate changes in sleep quality, fatigue, mental health, and health-related quality of life (HRQoL) over a two-year period among patients undergoing peritoneal dialysis treatment at home. We further explored the extent to which sleep quality, fatigue, and mental health predicted health-related quality of life outcomes. This prospective study included 55 patients. Sleep parameters changed over two years, independently of treatment. Sleep variables at baseline, to some extent, predicted sleep quality after two years. Daytime sleepiness can be a long-term problem. Findings indicate improvements in nocturnal sleep over a two-year time period, independently of dialysis treatment. In contrast, fatigue remained unchanged over the same time period. Transplantation seems to generally benefit the outcome of HRQoL. Strategies to improve sleep and HRQoL may include systematic risk factor modification and efforts to optimise symptomatic treatment. 

  • 440.
    Zare, Zahra
    et al.
    Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Iran.
    Sadeghi-Bazargani, Homayoun
    Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Iran.
    Ranjbar, Fatemeh
    Research Center of Psychiatry and Behavioral sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Farahbakhsh, Mostafa
    Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Maghsoudi, Hemmat
    Department of Surgery, Sina Burn Center, Tabriz University of Medical Sciences, Iran.
    Ekman, Robert
    Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden.
    Nasiri, Farideh
    Sociologist at Tabriz University of Medical Sciences, Iran.
    Psychometric Properties of a New Instrument for Assessing Irrational Thoughts in Burn Victims (Scale of Irrational Thoughts After Burn Injuries)2017In: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 38, no 5, p. e834-e841Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to develop and evaluate a scale for assessing irrational thoughts among burned patients. The present study was mixed (qualitative-methodologic) which was performed in several stages such as investigating similar or related scales, interviewing with patients and psychologists. Content validity was calculated by modified KAPPA basis on relevance and clarity. The reliability of the scale was measured using internal consistency and the test-retest method. To determine the construct validity, exploratory factor analysis approach using maximum likelihood extraction with varimax rotation was conducted. A total of 329 burned patients were recruited from Tehran, Tabriz, and Kermanshah provinces of Iran. Modified kappa scores were 0.80 and 0.91 for relevance and clarity of the items included in scale. The Cronbach alpha for overall scale, subscale 1, and subscale 2 were 0.89, 0.88, and 0.8, respectively. Test-retest reliability was also acceptable (intraclass correlation coefficient = 0.80). The best solution from the maximum likelihood analysis of the 39 items of the scale revealed two factors corresponding to the two subscales with 14 items that subscale 1 (self-acceptance) consisted of 10 statements accounting for 60% of the variance (eigenvalue = 5.04) and subscale 2 (distastefulness and pity) consisted of four statements accounting for 40% of the variance (eigenvalue = 1.53). The scale reflects acceptable levels of validity and reliability in assessing the irrational thoughts among Iranian patients. Moreover, the testing populations of both patients with burned faces and patients with other burned body parts indicates that the scale may also be applicable for patients' burn disfigurements on any part of their bodies.

  • 441.
    Zare, Zahra
    et al.
    Tabriz University of Medical Sciences, Tabriz, Iran.
    Sadeghi-Bazargani, Homayoun
    Tabriz University of Medical Sciences, Tabriz, Iran.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ranjbar, Fatemeh
    Tabriz University of Medical Sciences, Tabriz, Iran.
    Ekman, Robert
    Chalmers University of Technology, Göteborg, Sweden.
    Farahbakhsh, Mostafa
    Tabriz University of Medical Sciences, Tabriz, Iran.
    Maghsoudi, Hemmat
    Tabriz University of Medical Sciences, Tabriz, Iran.
    Cognitive Distortions as Trauma-Specific Irrational Beliefs Among Burn Patients2019In: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 40, no 3, p. 361-367Article in journal (Refereed)
    Abstract [en]

    Burn injuries are most certainly stressful events, particularly when permanent disfigurement is a result. This situation can lead to the onset of irrational beliefs which can in turn lead to long-term psychological problems such as depression, anxiety, shame, guilt, posttraumatic stress, etc. The objective of this study is to explore the irrational beliefs among burn patients and its correlates in an Iranian sample. This cross-sectional study included 329 patients who had experienced disfigurement, as result of burn injuries. In order to assess irrational beliefs, a Scale for Irrational Thoughts after Burning was used. To identify correlated variables with irrational beliefs, both bivariate and multivariate analysis methods were conducted. In multivariate linear regression, forward strategy was used for building the model. The results of bivariate analysis showed that the location of the burn on bodies (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), marital status, urbanities, age group, geographical areas, etiology of burning, and intent of injury had significant relationships with irrational beliefs (P < .05). Using forward linear regression, gender, marital status, geographical areas, etiology of burning, body burn by location (body parts generally exposed in social environment or parts culturally perceived as sensitive areas of body), and intent of injury had significant correlation with irrational beliefs. The models predicted 15.5% (P < .001) of irrational beliefs. Considering to irrational beliefs and development of facilities for screening is necessary. Moreover, consultation with mental health experts after burn injuries is highly recommended. 

  • 442.
    Åberg, Cecilia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Att lära i den verksamhetsförlagda delen av utbildningen2015In: Reflektion i lärande och vård - en utmaning för sjuksköterskan / [ed] Mia Berglund, Margaretha Ekebergh, Lund: Studentlitteratur AB, 2015, 1, p. 145-162Chapter in book (Refereed)
  • 443.
    Åhlfeldt, Rose-Mharie
    et al.
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Fischer Hübner, Simone
    Karlstad University.
    Carlén, Urban
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersén, Annelie
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eriksson, Nomie
    University of Skövde, School of Business. University of Skövde, Enterprises for the Future.
    Björck, Fredrik
    Stockholms Universitet.
    Nohlberg, Marcus
    University of Skövde, School of Informatics. University of Skövde, The Informatics Research Centre.
    Förstudie kompetensbehov informationssäkerhet2014Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    På uppdrag av Myndigheten för samhällsskydd och beredskap (MSB) har en förstudie genomförts med syftet att sammanställa forskningsresultat om kompetenshöjande åtgärder inom informationssäkerhetsområdet för att kartlägga utbildningsbehov och identifierade nyttoeffekter. Arbetet har genomförts av forskare från tre olika lärosäten, Högskolan Skövde, Karlstad Universitet och Stockholms Universitet, samt inom tre forskningsdiscipliner nämligen pedagogik, informationssäkerhet och företagsekonomi.

    Förstudien har haft i uppdrag att besvara följande frågeställningar:

    • Hur definieras kompetens?

    • Hur mäter man kompetens?

    • Hur skiljer sig olika typer av utbildningsinsatser avseende nyttoeffekter? Vilka erfarenheter,

      utvärderingar förklaringsfaktorer kan identifieras?

    • Hur och i vilken utsträckning tillgodogörs olika typer av utbildningar?

    • Vad kännetecknar framgångsrika utbildningsinsatser?

      Resultatet visar att kompetensbegreppet är svårdefinierat och det finns ingen tydlig definition av begreppet. Ett försök till en sammanfattande beskrivning av kompetensbegreppet utifrån granskningen är att kompetens innebär en viss uppsättning kunskaper, färdigheter, etik och attityder i en viss kontext. Kompetens innefattar både egenskaper och intentioner där egenskap inkluderar kunskap och färdighet, och intentioner innefattar etik och attityder. Allt måste dock relatera till en kontext och alltid ses i sitt sammanhang.

      Ytterst få studier har fokus på mätning av kompetens både generellt och inom informationssäkerhetsområdet. De studier som genomfört någon form av mätning mäter främst kompetens utifrån det akademiska fältet och då i första hand utifrån ett kunskapsperspektiv. Forskning av mätning på yrkesverksamma är minimal inom de sökområden som granskats i denna förstudie.

      Avseende kompetensbehov, nyttoeffekter, erfarenheter och framgångsfaktorer visar granskningen att framgångsfaktorer generellt är när utbildningsinsatserna för yrkesverksamma har ett praktiknära fokus. Motivationen och engagemanget hos de som går en utbildning är av avgörande betydelse. Det går inte direkt att avgöra vilka utbildningstyper eller aktiviteter som är av störst betydelse utan granskningen visar att en kombination av olika utbildningsformer och aktiviteter är att föredra. Vidare är dialog och diskussion i den dagliga verksamheten av stor betydelse för att bygga upp en hållbar säkerhetskultur i organisationen. Den s k tysta kunskapen ska inte underskattas utan behöver tas i beaktande och stödjas.

      Ytterligare är ledningens engagemang, delaktighet och stöd för utbildningens genomförande av avgörande betydelse om en utbildning ska uppnå en tydlig effekt i verksamheten.

      Granskningen visar att det finns behov av ytterligare forskning avseende kompetensbehov och på vilket sätt olika utbildningsinsatser ger effekt i organisationer. Förslag på ett diskussionsunderlag för framtida arbete har tagits fram. Förslagen innefattar bl a behov av kompetensanalyser, metoder och verktyg för att mäta utbildningseffekter, riktade kompetenshöjande insatser för managementnivån, longitudinella studier för uppföljning av effekter samt utveckling av metoder och verktyg för ett situerat lärande.

    Granskningen har genomförts inom olika disciplinområden vilket har uppfattats mycket positivt av de deltagande forskarna. Eftersom informationssäkerhet är ett interdisciplinärt område krävs också att bredare perspektiv och ytterligare discipliner bör ingå i framtida fördjupade analyser i området. Exempel på tillkommande discipliner är beteendevetenskap, psykologi och juridik. Behovet av kompetens inom informationssäkerhetsområdet lär inte minska i framtiden och ytterligare forskning behövs för att rätt utbildning ska nå rätt person vid rätt tidpunkt och på rätt plats.

    Skövde i mars 2014

  • 444.
    Österlind, Jane
    et al.
    Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden / Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
    Prahl, Charlotte
    Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden / Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
    Westin, Lars
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Strang, Susann
    Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Sweden / Angered Hospital, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Henoch, Ingela
    Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden / Angered Hospital, Sweden / University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hammarlund, Kina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nursing students' perceptions of caring for dying people, after one year in nursing school2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 41, p. 12-16Article in journal (Refereed)
    Abstract [en]

    Aim: To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. Methods: Interviews (n = 17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. Results: The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. Conclusion: Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening. 

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