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  • 101.
    Ahlzén, Amanda
    Mälardalen University, School of Health, Care and Social Welfare.
    Konflikten mellan arbetsliv och familjeliv: En kvalitativ studie om småbarnsföräldrars upplevelser av psykisk hälsa och balans i tillvaron2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Today's career choices and ambitions impose different demands on the individuals than in the past. In a labour market that demands flexibility and responsibility, the individuals are expected to be able to work almost anytime and from anywhere. These factors have contributed to an imbalance between work and family life that can trigger various forms of illness. In this study, I investigate how parents of young children perceive their mental health in relation to the balance between work and family life. This is achieved through a study that employs qualitative methods and data collection based on six individual semi-structured interviews, where the material is then analysed based on a manifest content analysis. The results show that today’s parents are well aware of the imbalance between their work and family life, and that this negatively affects their health in several ways, ranging from stress and anxiety to sleep problems and personal conflicts. To address this imbalance the parents creates routines, shared responsibilities at home, and allow personal time for leisure, in an attempt to create a form of control over this imbalance. The conclusion of this study is that parent’s experience that they have to have routines at work and family life, where the parents have lower demands on their own health.

  • 102.
    Ahlzén, Rolf
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Evans, MartynLouhiala, PekkaPuustinen, Raimo
    Medical Humanities Companion: Volume two: Diagnosis2010Collection (editor) (Refereed)
    Abstract [en]

    When a person falls ill, their experience changes - sometimes in a very minor and transient way, sometimes in a decisive and lasting one. ‘Diagnosis’ is often seen as the process of scientifically and objectively identifying the causes of this subjective experience, but is the process and meaning of ‘diagnosis’ really as simple as this implies?

    As this volume of The Medical Humanities Companion argues, diagnoses are an answer to complex human needs that spring from being ill, and are in turn a complex, culturally mediated interaction between individuals, scientific discoveries, social negotiation and historical change. This volume makes visible the complexities and ambiguities involved in giving and receiving diagnoses, and how they shape and are shaped by views on what is real and acceptable, and how people relate to the phenomena of illness.

  • 103.
    Ahmad, Shafqat
    et al.
    Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Zhao, Wei
    Philadelphia, PA, US.
    Renström, Frida
    Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Rasheed, Asif
    Karachi, Pakistan.
    Samuel, Maria
    Karachi, Pakistan.
    Zaidi, Mozzam
    Karachi, Pakistan.
    Shah, Nabi
    Karachi, Pakistan; Abbottabad, Pakistan.
    Mallick, Nadeem Hayyat
    Punjab Institute of Cardiology, Lahore, Pakistan.
    Zaman, Khan Shah
    Karachi, Pakistan.
    Ishaq, Mohammad
    Karachi, Pakistan.
    Rasheed, Syed Zahed
    Karachi, Pakistan.
    Memon, Fazal-ur-Rheman
    Karachi, Pakistan.
    Hanif, Bashir
    Karachi, Pakistan.
    Lakhani, Muhammad Shakir
    Karachi, Pakistan.
    Ahmed, Faisal
    Karachi, Pakistan.
    Kazmi, Shahana Urooj
    Karachi, Pakistan.
    Frossard, Philippe
    Karachi, Pakistan; Nazarbayev University, Astana, Kazakhstan.
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
    Saleheen, Danish
    Philadelphia, PA, US; Karachi, Pakistan.
    Physical activity, smoking, and genetic predisposition to obesity in people from Pakistan: the PROMIS study2015In: BMC Medical Genetics, ISSN 1471-2350, E-ISSN 1471-2350, Vol. 16, article id 114Article in journal (Refereed)
    Abstract [en]

    Background: Multiple genetic variants have been reliably associated with obesity-related traits in Europeans, but little is known about their associations and interactions with lifestyle factors in South Asians.

    Methods: In 16,157 Pakistani adults (8232 controls; 7925 diagnosed with myocardial infarction [MI]) enrolled in the PROMIS Study, we tested whether: a) BMI-associated loci, individually or in aggregate (as a genetic risk score - GRS), are associated with BMI; b) physical activity and smoking modify the association of these loci with BMI. Analyses were adjusted for age, age(2), sex, MI (yes/no), and population substructure.

    Results: Of 95 SNPs studied here, 73 showed directionally consistent effects on BMI as reported in Europeans. Each additional BMI-raising allele of the GRS was associated with 0.04 (SE = 0.01) kg/m(2) higher BMI (P = 4.5 x 10(-14)). We observed nominal evidence of interactions of CLIP1 rs11583200 (P-interaction = 0.014), CADM2 rs13078960 (P-interaction = 0.037) and GALNT10 rs7715256 (P-interaction = 0.048) with physical activity, and PTBP2 rs11165643 (P-interaction = 0.045), HIP1 rs1167827 (P-interaction = 0.015), C6orf106 rs205262 (P-interaction = 0.032) and GRID1 rs7899106 (P-interaction = 0.043) with smoking on BMI.

    Conclusions: Most BMI-associated loci have directionally consistent effects on BMI in Pakistanis and Europeans. There were suggestive interactions of established BMI-related SNPs with smoking or physical activity.

  • 104.
    Ahmadi, Fereshteh
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Culture, Religion and Spirituality in Coping: The Example of Cancer Patients in Sweden2006Book (Other (popular science, discussion, etc.))
    Abstract [en]

    Recent research has shown significant associations (negative and positive) between religious and spiritual factors and mental health. Much of this research, however, has been conducted in the US, where religion is an integrated part of most people’s lives. Other studies on religious and spiritually oriented coping conducted outside the US have also focused on religious people. Yet many are non-believers, and many believers do not consider themselves religious, i.e. religion is not an important part of their life. There are also societies in which the dominant culture and ways of thinking dismiss the role of religion in people’s lives. Research on religious coping rarely takes these people into consideration. Thus, the following questions arise: How are religion and spirituality involved in coping when non-believers or non-religious people face difficult events? How do culture and ways of thinking affect people’s choice of religious and spiritual coping methods? Proceeding from a cultural approach to coping and health, this book attempts to address these questions by looking at the coping strategies of Swedish cancer patients.

  • 105.
    Ahmadi, Fereshteh
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Hard and Heavy Music: Can It Make a Difference in the Young Cancer Patients’ Life?2009In: Voices: A World Forum for Music Therapy, Vol. 9, no 2Article in journal (Refereed)
    Abstract [en]

     The aim of the study on the basis of which this article is written was to examine, from the patients’ perspective, the role music plays as a coping method when facing cancer. Here, using music as a coping method refers to using music (listening to and/or playing music individually or participating in a music therapy program) frequently in order to deal with the significant demands presented by cancer. A semi-structured interview with 17 cancer patients who have used music (listened to or played music) in order to cope with their illness was applied. Five of interviewees were men and twelve women. The youngest informant was 24 and the oldest 73 years old. In the paper presented in this conference I will discuss the result of my study concerning the effects of hard and heavy music in coping with cancer. The result of study shows that hard and heavy music as a coping method:

    - by calling in question the cultural demands of having control over their feelings, helps the young cancer patients to obtain their control,

    - by questioning what are conventionally defined as meaning of life, helps the young cancer patients to find a meaning,

    - by calling in question  the cultural requests of being calm and collected helps the young cancer patients to get their tranquility,  

    - by cheering unhealthy behaviors like using drug and having violent sex helps the young cancer patients to recover their mental health.

    All this due to the possibility the heavy and hard music provides for the young cancer patients to get self-confidence by putting away the false mask one wear and be who she/he really is.

    The aim of the study on the basis of which this article is written was to examine, from the patients’ perspective, the role music plays as a coping method when facing cancer. Here, using music as a coping method refers to using music (listening to and/or playing music individually or participating in a music therapy program) frequently in order to deal with the significant demands presented by cancer. A semi-structured interview with 17 cancer patients who have used music (listened to or played music) in order to cope with their illness was applied. Five of interviewees were men and twelve women. The youngest informant was 24 and the oldest 73 years old. In the paper presented in this conference I will discuss the result of my study concerning the effects of hard and heavy music in coping with cancer. The result of study shows that hard and heavy music as a coping method:

    - by calling in question the cultural demands of having control over their feelings, helps the young cancer patients to obtain their control,

    - by questioning what are conventionally defined as meaning of life, helps the young cancer patients to find a meaning,

    - by calling in question  the cultural requests of being calm and collected helps the young cancer patients to get their tranquility,  

    - by cheering unhealthy behaviors like using drug and having violent sex helps the young cancer patients to recover their mental health.

    All this due to the possibility the heavy and hard music provides for the young cancer patients to get self-confidence by putting away the false mask one wear and be who she/he really is.

  • 106.
    Ahmadi, Fereshteh
    University of Gävle, Department of Caring Sciences and Sociology, Ämnesavdelningen för socialt arbete.
    Hard and Heavy Music: Can It Make a Difference in the Young Cancer Patients' Life?2009In: Voices: A World Forum for Music Therapy, ISSN 1504-1611, E-ISSN 1504-1611, Vol. 9, no 2Article in journal (Refereed)
    Abstract [en]

    The aim of the study on the basis of which this article is written was to examine, from the patients’ perspective, the role music plays as a coping method when facing cancer. Here, using music as a coping method refers to using music (listening to and/or playing music individually or participating in a music therapy program) frequently in order to deal with the significant demands presented by cancer. A semi-structured interview with 17 cancer patients who have used music (listened to or played music) in order to cope with their illness was applied. Five of interviewees were men and twelve women. The youngest informant was 24 and the oldest 73 years old. In the paper presented in this conference I will discuss the result of my study concerning the effects of hard and heavy music in coping with cancer. The result of study shows that hard and heavy music as a coping method:

    - by calling in question the cultural demands of having control over their feelings, helps the young cancer patients to obtain their control,

    - by questioning what are conventionally defined as meaning of life, helps the young cancer patients to find a meaning,

    - by calling in question  the cultural requests of being calm and collected helps the young cancer patients to get their tranquility,  

    - by cheering unhealthy behaviors like using drug and having violent sex helps the young cancer patients to recover their mental health.

    All this due to the possibility the heavy and hard music provides for the young cancer patients to get self-confidence by putting away the false mask one wear and be who she/he really is.

  • 107.
    Ahmadi, Fereshteh
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Social Sciences, Department of Sociology.
    Kultur och hälsa2008Book (Refereed)
    Abstract [en]

    Hälsa är en viktig fråga för varje individ och varje samhälle. I ett land med invandrare som har socialiserats i olika samhällen med skilda uppfattningar om hälsa och ohälsa, uppstår behov av att fördjupa såväl allmänhetens som hälso- och sjukvårdspersonalens kunskap om betydelsen av kultur, religion och etnicitet i medicin- och hälsofrågor.

    I denna bok belyser författaren, Fereshteh Ahmadi, hur viktig kunskap är om olika kulturers och religioners syn på hälsa och hälsa i bemötandet av patienter.

    Boken vänder sig i första hand till studenter på grundutbildningsnivå samt personal inom hälso- sjukvården men den kan även användas av andra som är intresserade av att skaffa sig kunskaper om kulturens och religionens betydelse för förståelse av ohälsa.

  • 108.
    Ahmadi, Nader
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work. University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Ljungqvist, ArneSvedsäter, GöranUniversity of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science. University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Doping and public health2016Collection (editor) (Other academic)
    Abstract [en]

    Doping – the use of performance-enhancing substances and methods – has long been a high-profile issue in sport but in recent years it has also become an issue in wider society. This important new book examines doping as a public health issue, drawing on a multi-disciplinary set of perspectives to explore the prevalence, significance and consequences of doping in wider society. It introduces the epidemiology of doping, examines the historical context, and explores the social, behavioural, legal, ethical and political aspects of doping. The book also discusses possible interventions for addressing the problem on organisational and societal levels.

  • 109.
    Ahmadi, Nader
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Ljungqvist, Arne
    Svedsäter, Göran
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    Introduction: Doping and Public Health2016In: Doping and Public Health / [ed] Nader Ahmadi, Arne Ljungqvist, Göran Svedsäter, Abingdon: Routledge, 2016, 1, , p. 151p. 1-10Chapter in book (Refereed)
    Abstract [en]

    The concept of “doping” is usually associated with sport, particularly elite sport. In fact, doping means the use of substances or methods that are banned in sport by the World Anti-Doping Agency (WADA) because of their potentially performance-enhancing effects. Their use is, therefore, considered to be against the fair play spirit of sport and can also include significant health risks for the user. However, the use of many doping substances is no longer limited to the world of sport. Doping substances such as anabolic androgenic steroids (AAS) are nowadays used also by people who are not competitive athletes but who want to make use of the effects of AAS in making their bodies more muscular, stronger and impressive in conformity with the current masculine body ideal. The use of AAS and similar substances appears to be growing and has been found in a range of countries previously not researched. At least, recent data obtained from customs seizures, court cases and some surveys suggest that the extent of AAS use outside sport has been underestimated, some reasons probably being an underground circulation of such drugs in the gym and fitness culture and the easy availability of them on the internet. One particular concern is the increasing use of nutritional supplements by growing segments of society. A significant percentage of these products have been shown to contain prohibited substances such as steroids that are not listed on the label. This shows that the nutritional supplement industry needs to be more strictly regulated. Until that happens, supplements of dubious value, content and quality will continue to be easily available around the world. What, then, are the possible reasons that active and health-conscious individuals are willing to take the risk to use preparations such as AAS? A review of the research shows that the most important motive behind the use of AAS outside the elite sports environment, i.e., in a fitness context, is to improve physical appearance. Although most users are boys and young and middle-aged men, also women of various ages use doping substances. Different types of slimming pills are popular among women (including hormone preparations), but possibly even more interesting are the new female fitness and appearance ideals that are connected to muscles and strength. The body has become increasingly important for saying something about who we are. The hunt for the perfect appearance creates a situation where denial instead of acceptance of one’s own body influences the individual’s self-image.

  • 110.
    Ahmadi, Nader
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology, Social work.
    Svedsäter, Göran
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science.
    "The winner takes it all": Individualization and Performance-Enhancing Drugs and Methods in Sport and in Society2016In: Doping and Public Health / [ed] Nader Ahmadi, Arne Ljungqvist, Göran Svedsäter, Abingdon: Routledge, 2016, 1, , p. 151p. 38-48Chapter in book (Refereed)
    Abstract [en]

    A common misconception in today's society is that everything is (or should be) rational and goal-oriented, which we summarized earlier as pragmatic rationalism. We call this pragmatic rationalism a misconception because it misses a historical fact that individuals' actions are and have never been governed entirely by rational motives. Emotional, ethical and existential considerations influence human actions extensively. Solidarity, willingness to share and even self-sacrifice and prioritizing the good of others before one's own are values that have survived many different economic cultures. Even today's extremely individualized society with its focus on reaching success and winning at any price cannot completely suppress these values. There is an inherent contradiction between the crude egoism of modern individualism and its historical development that largely has its origin in the care of humans.

  • 111.
    Ahmadi, Sumaiya
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Risk factors for self-perceived oral health in Northern Sweden:: a cross-sectional study2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Authors have reported socioeconomic inequalities in self-perceived oral health around the world, including Sweden. However, no study has been carried out in Northern Sweden.

    Purpose: the aim of this study is to investigate different risk factors such as age, education, civil status, occupational class, income, place of birth and smoking have an association with self- perceived oral health in Northern Sweden.

    Methods: A cross-sectional study design (N=22,975; 50% response rate), based on a survey questionnaire, Health on Equal Terms survey of 2014 in four Northern counties of Sweden. The age group was 16-84 years. The responses are linked to Statistics Sweden registry through Swedish Personal number. A multiple logistic regression while controlling for confounders, was used to analyze the differences in self-perceived oral health with respect to sex, age, educational level, civil-status, income and country of birth.

    Results: 75% of the respondents reported good self-perceived oral health. The higher odds of poor self-perceived oral health were observed among men, middle age, low education, blue-collar workers, low income, those who had their last visit to dentist in more than 5 years and those not born in Sweden.

    Conclusion: The results suggest the presence of a social gradient in Northern Sweden in self-perceived oral health. The inequity needs to be addressed by the researchers and policy makers.

  • 112.
    Ahmed Hassan Ahmed, Osama
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Rift Valley fever: challenges and new insights for prevention and control using the “One Health” approach2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Rift Valley fever (RVF) is an emerging viral zoonosis that causes frequent outbreaks in east Africa and on the Arabian Peninsula. The likelihood of RVF global expansion due to climate change and human anthropogenic factors is an important issue. The causative agent, RVF virus, is an arbovirus that is transmitted by several mosquito species and is able to infect a wide range of livestock as well as people. The infection leads to mass abortions and death in livestock and a potentially deadly hemorrhagic fever in humans. RVF has severe socio-economic consequences such as animal trade bans between countries, disruption of food security, and economic disaster for farmers and pastoralists as well as for countries. Human behavior such as direct contact with infected animals or their fluids and exposure to mosquito bites increases the risk for contracting the disease.

    To better understand the challenges associated with RVF outbreaks and to explore prevention and control strategies, we used the One Health approach. The local community had to be involved to understand the interaction between the environment, animals, and humans. We focused on Sudan, Saudi Arabia, and Kenya. First, we systematically reviewed the literature and then we performed cross sectional community-based studies using a special One Health questionnaire. Climatic and remote sensing data were used in combination with statistics to develop a sub-region predictive model for RVF.

    For both Saudi Arabia and Sudan, the ecology and environment of the affected areas were similar. These areas included irrigation canals and excessive rains that provide an attractive habitat for mosquito vectors to multiply. The surveillance systems were unable to detect the virus in livestock before it spread to humans. Ideally, livestock should serve as sentinels to prevent loss of human lives, but the situation here was reversed. Differences between countries regarding further spread of RVF was mainly determined by better economic and infrastructure resources.

    In Sudan, there was a lack of knowledge and appropriate practices at the studied community regarding RVF disease symptoms and risk factors for both animals and humans. The community was hesitant in notifying the authorities about RVF suspicion in livestock due to the lack of a compensation system. The perceived role of the community in controlling RVF was fragmented, increasing the probability of RVF transmission and disease.

    In Kenya, our study found that better knowledge about RVF does not always translate to more appropriate practices that avoid exposure to the disease. However, the combination of good knowledge, attitudes, and practices may explain why certain communities were less affected. Strategies to combat RVF should consider socio-cultural and behavioral differences among communities. We also noticed that RVF outbreaks in Kenya occurred in regions with high livestock density exposed to heavy rains and wet soil fluxes, which could be measured by evapotranspiration and vegetation seasonality variables. We developed a RVF risk map on a sub-regional scale. Future outbreaks could be better managed if such relevant RVF variables are integrated into early warning systems.

    To confront RVF outbreaks, a policy is needed that better incorporates ecological factors and human interactions with livestock and environment that help the RVF pathogen spread. Early detection and notification of RVF is essential because a delay will threaten the core of International Health Regulations (IHR), which emphasizes the share of information during a transboundary disease outbreak to avoid unnecessary geographical expansion.

  • 113.
    Ahmed, Iqra Shahzadi
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Preventing the spread of Tuberculosis via refugees, asylum seekers and immigrants entering Sweden: A study of health communication, prevention strategies, policies and recommendations2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sweden has for many decades witnessed a decrease of the spread of tuberculosis (TB), but between the years of 2003-2012 a new pattern has emerged with refugees carrying TB entering the country and contributing to a situation where the infection has slowly begun to spread again. The communication between the refugees and the health professionals has been inefficient, which inevitably results in fewer refugees undergoing health examinations. This in turn can lead to an increase of infections and diseases.

    The purpose of this study is to examine the current health communication between Swedish health professionals and immigrants, asylum seekers and refugees, and to give an overview of what type of health care currently exist for refugees with a high risk of TB. This is done to understand what is missing in the communication process, what has been done in order to improve the situation, and how it can be further improved in order to prevent TB. In order to fulfill the purpose of this study, a qualitative method has been used combining text analysis of interviews and secondary sources.

    This study has shown based on the interviews and secondary sources that the Swedish prevention work regarding TB is developing positively in general, but the communication between newly arrived refugees, health professionals and authorities in Sweden is lacking due to the fact that most of what is written and said in this communication process is in Swedish. This makes it difficult for the refugees to understand what is communicated and is stated as one of the main reasons why many refugees do not undergo health examinations, combined with the lack of awareness. Therefore a better functioning health communication between refugees, authorities and health professionals is required to support refugees seeking health care, as well as co-operating with health professionals to prevent the spread of not only TB but other infections and diseases in Sweden.

  • 114. Ahmed, N
    et al.
    Andersson, Ragnar
    Unintentional injury mortality and socio-economic development among the 15-44 year-olds: in a health transition perspective2000In: Public Health (2000) 114, 416-422Article in journal (Refereed)
  • 115.
    Ahmed Shire, F Sagal
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Healthcare professional´s experience of promoting maternal mental health: a qualitative study in Saudi Arabia.2015Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 116. Ahmed, Syed Masud
    et al.
    Hadi, Abdullahel
    Razzaque, Abdur
    Ashraf, Ali
    Juvekar, Sanjay
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Indonesia.
    Kanungsukkasem, Uraiwan
    Soonthornthada, Kusol
    Van Minh, Hoang
    Huu Bich, Tran
    Clustering of chronic non-communicable disease risk factors among selected Asian populations: levels and determinants2009In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 2, no 1, p. 68-75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs.

    OBJECTIVES: This study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine

    INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries. DESIGN: Data originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25-64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam.

    RESULTS: Findings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country.

    CONCLUSIONS: Since there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor.

  • 117.
    Aho, Nikolas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Victimization, Prevalence, Health and Peritraumatic Reactions in Swedish Adolescents2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to expand the knowledge of victimization in children and youth in Sweden. Victimization, prevalence, health and peritraumatic reactions were explored in a cross sectional, representative sample of 5,960 second grade high school students in Sweden. A computerized survey was developed and administered in class room setting.

    Lifetime victimization was found in 84.1% of the sample (m=83.0%, f=85.2%), and, in relation to the five domains, 66.4% had experienced conventional crime, 24% child maltreatment, 54.4% peer and sibling victimization, 21.8% sexual victimization, and 54% had experienced witness victimization. Females experienced significantly more child maltreatment, peer and sibling victimization, sexual victimization, and witnessed victimization, males more conventional crime (p<0.001). Using logistic regression risk factors for victimization were confirmed by a significant increase OR regarding gender, environment and lack of both parents.

    Symptoms (TSCC), were clearly associated with both victimizations per se and the number of victimizations. The results indicated a relatively linear increase in symptoms with an increase in number of events experienced. Mental health of the polyvictimized group was significantly worse than that of the non-polyvictimized group, with significantly elevated TSCC scores (t<0.001). Hierarchical regression analysis resulted in beta value reduction when polyvictimization was introduced supporting the independent effect on symptoms. Social anxiety was found in 10.2 % (n = 605) of the total group (n = 5,960). A significant gender difference emerged, with more females than males reporting social anxiety. Elevated PTSS was found in 14.8 % (n=883). Binary logistic regression revealed the highest OR for having had contact with child and adolescent psychiatry was found for the combined group with social anxiety and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73, p<001). Significant associations were also found between use of child and adolescent psychiatry and female gender (OR = 2.05, 95 % CI = 1.70–2.45), Swedish birth origin (OR = 1.68, 95 % CI = 1.16–2.42) and living in a small municipality (OR = 1.33, 95 % CI = 1.02–1.73).

    Mediation models used peritraumatic reactions (PT): total, physiological arousal (PA), peritraumatic dissociation (PD), and intervention thoughts (IT) and JVQ and TSCC. Of the n=5,332 cases, a total of n=4,483 (84.1%) reported at least one victimizing event (m = 83.0%, f = 85.2%). Of these, 74.9% (n=3,360) also experienced a PT reaction of some kind. The effect mediated by PT tot was b= 0.479, BCa CI [0.342 – 0.640], representing a relatively small effect of 7.6%, κ2=0.076, 95% BCa CI [0.054- 0.101]. The mediating effect of JVQ on TSCC was mediated by PD more for males (b=0.394 BCa CI [0.170-0.636]) than for females (b=0.247, BCa CI [0.021-0.469]). The indirect effect of the JVQ on the TSCC tot mediated by the different PT reactions was significant for PD (b=0.355, BCa CI [0.199- 0.523]. In males a mediating effect of PD could be seen in the different models, while females had a more mixed result. IT did not show any indirect effect in males, but had a mixed effect for females.

    The empirical findings in this thesis lead to the conclusion that victimization is highly prevalent in children and youth and is related to health issues. The association of victimization on symptoms was mediated by peritraumatic reactions. Using a comprehensive instrument such as the JVQ provides the researcher or clinician the opportunity to acquire more complete measurement and also makes it possible to identify polyvictimization, a high-level category of events with severe impact on health.  

  • 118.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Gren Landell, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Center for Social and Affective Neuroscience (CSAN).
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    The Prevalence of Potentially Victimizing Events, Poly-Victimization, and Its Association to Sociodemographic Factors: A Swedish Youth Survey2016In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 31, no 4, p. 620-651Article in journal (Refereed)
    Abstract [en]

    Studying the extent to which children are exposed to victimizing events is important to fully understand the effect of such exposure in shaping them as adults. The aim of this study was to use self-report by adolescents to measure the prevalence of victimizing events and of poly-victimization. A representative sample of 5,960 students (aged 17) from high schools in Sweden was given the self-administrated version of the Juvenile Victimization Questionnaire (JVQ) along with questions concerning gender, birthplace, parents birthplace and employment, residence, educational program, and municipality size. The results show that 84.1% (83.0% young men and 85.2% young women) of the students had experienced victimization during their lifetime, and 10.3% were categorized as poly-victims (8.1% young men and 12.5% young women; OR = 1.62, 95% confidence interval [CI] = [1.35, 1.94]). Adolescents living with both parents were at lower risk of any form of victimization for both genders, while females were at higher risk of maltreatment, peer victimization, and, most significantly, sexual victimization. In conclusion, the vast majority of young people have been victimized during their lifetime. A greater awareness of the impact of these victimizing events on children and adolescents is important as a basis for providing a safer milieu and establishing better interventions, especially for those that have been victimized on multiple occasions. The high-exposure group was determined by using 10 events as a cutoff. Findings on this group corresponded with findings in other international studies regarding distribution, elevated risk for females, and the possibility of limiting the effects of victimization by modifying living conditions.

  • 119.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Proczkowska-Björklund, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Victimization, polyvictimization , and health in Swedish adolescents2016In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 7, p. 89-99Article in journal (Refereed)
    Abstract [en]

    The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization) and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652), of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV]) proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization.

  • 120.
    Ahrens, W.
    et al.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Siani, A.
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Adan, R.
    Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
    De Henauw, S.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Eiben, Gabriele
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gwozdz, W.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Hebestreit, A.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Hunsberger, M.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Kaprio, J.
    Department of Public Health, University of Helsinki, Institute for Molecular Medicine (FIMM), Helsinki, Finland.
    Krogh, V.
    Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy.
    Lissner, L.
    Section for Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Molnár, D.
    Department of Paediatrics, University of Pe´cs, Pe´cs, Hungary.
    Moreno, L. A.
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.
    Page, A.
    Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK.
    Picó, C.
    Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics), University of the Balearic Islands (UIB) and CIBER Fisiopatologıa de la Obesidad y Nutricion, Palma de Mallorca, Spain.
    Reisch, L.
    Department of Intercultural Communication and Management, Copenhagen Business School, Copenhagen, Denmark.
    Smith, R. M.
    Minerva Communications UK, Andover, UK.
    Tornaritis, M.
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Veidebaum, T.
    National Institute for Health Development, Tallinn, Estonia.
    Williams, G.
    Department of Politics, Philosophy and Religion, Lancaster University, Lancaster, UK.
    Pohlabeln, H.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
    Pigeot, I.
    Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany / Institute of Statistics, Bremen University, Bremen, Germany.
    Cohort Profile: The transition from childhood to adolescence in European children-how I.Family extends the IDEFICS cohort2017In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 46, no 5, p. 1394-1395Article in journal (Refereed)
  • 121.
    Ahrén, Jennie
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Barn till överskuldsatta: underlagsrapport till Barns och ungas hälsa, vård och omsorg 20132013Report (Other academic)
  • 122.
    Ahs, A
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, R
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Ökad skillnad i självskattad hälsa mellan arbetslösa och personer i arbete.2000In: Svenska läkaresällskapets handlingar. Hygiea., p. 336-Article in journal (Other academic)
  • 123. Aila Gustafsson, Sanna
    et al.
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Kjellin, Lars
    Norring, Claes
    Personal standards, self-evaluation and perceived benefits of thinness in girls and young women with disturbed eating2008In: European eating disorders review, ISSN 1072-4133, E-ISSN 1099-0968, Vol. 16, no 6, p. 463-471Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine personal standards, self-evaluation and perceived benefits of thinness in Swedish females 14-21 years with disturbed eating (DE) and to compare these to a group with other psychosocial problems and to a symptom free group. Seventy subjects with DE-group, 65 subjects with psychosocial problems and 70 symptom free subjects were compared regarding items selected from four questionnaires. High personal standards expressed in a competitive way were specific for the DE-group. In comparison with the other groups the DE-group also reported significantly more perceived benefits of thinness and they more frequently believed that thinness would make them more popular. The DE-group also reported a more negative self-evaluation, although this was a trait shared with the subjects with other psychosocial problems and consequently not specific for the DE-group. Identifying specific factors that perpetuate DE habits is important in order to improve our understanding and enhance the treatment of eating disorders.

  • 124. Aili, Katarina
    et al.
    Nyman, Teresia
    Hillert, Lena
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Sleep disturbances predict future sickness absence among individuals with lower back or neck-shoulder pain: A 5-year prospective study2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 315-323Article in journal (Refereed)
    Abstract [en]

    Background: Musculoskeletal pain is one of the most common causes of sickness absence. Sleep disturbances are often co-occurring with pain, but the relationship between sleep and pain is complex. Little is known about the importance of self-reported sleep, when predicting sickness absence among persons with musculoskeletal pain. This study aims to study the association between self-reported sleep quality and sickness absence 5 years later, among individuals stratified by presence of lower back pain (LBP) and neck and shoulder pain (NSP). Methods: The cohort (n = 2286) in this 5-year prospective study (using data from the MUSIC-Norrtalje study) was stratified by self-reported pain into three groups: no LBP or NSP, solely LBP or NSP, and oncurrent LBP and NSP. Odds ratios (ORs) for the effect of self-reported sleep disturbances at baseline on sickness absence (> 14 consecutive days), 5 years later, were calculated. Results: Within all three pain strata, individuals reporting the most sleep problems showed a significantly higher OR for all-cause sickness absence, 5 years later. The group with the most pronounced sleep problems within the concurrent LBP and NSP stratum had a significantly higher OR (OR 2.00; CI 1.09-3.67) also for long-term sickness absence (> 90days) 5 years later, compared to the group with the best sleep. Conclusions: Sleep disturbances predict sickness absence among individuals regardless of co-existing features of LBP and/or NSP. The clinical evaluation of patients should take possible sleep disturbances into account in the planning of treatments.

  • 125. Ajeani, Judith
    et al.
    Ayiasi, Richard Mangwi
    Tetui, Moses
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Makerere University School of Public Health (MakSPH), Makerere University College of Health Sciences, Kampala, Uganda.
    Ekirapa-Kiracho, Elizabeth
    Namazzi, Gertrude
    Kananura, Rornald Muhumuza
    Kiwanuka, Suzanne Namusoke
    Beyeza-Kashesya, Jolly
    A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1345497Article in journal (Refereed)
    Abstract [en]

    Background: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers.

    Objectives: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model.

    Methods: The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors.

    Results: Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better.

    Conclusions: The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved capacity among local mentors to provide mentorship among local district staff.

  • 126.
    Akay, Altug
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Systems Safety and Management.
    Dragomir, Andrei
    University of Houston, Biomedical Engineering.
    Erlandsson, Björn-Erik
    KTH, School of Technology and Health (STH), Health Systems Engineering.
    Mining Social Media Big Data for Health2015In: IEEE PulseArticle, review/survey (Refereed)
    Abstract [en]

    Advances in information technology (IT) and big data are affecting nearly every facet of the public and private sectors. Social media platforms are one example of such advances: its nature allows users to connect, collaborate, and debate on any topic with comparative ease. The result is a hefty volume of user-generated content that, if properly mined and analyzed, could help the public and private health care sectors improve the quality of their products and services while reducing costs. The users of these platforms are the key to these improvements, as their valuable feedback will help improve health solutions.

  • 127.
    Akhavan, Sharareh
    University of Skövde, School of Life Sciences.
    Fermale immigrant' health and working conditions in Sweden2007In: International Journal of Diversity in Organisations, Communities and Nations, ISSN 1447-9532, E-ISSN 1447-9583, Vol. 7, no 2, p. 275-286Article in journal (Refereed)
    Abstract [en]

    Sweden is one of the European countries that has successively changed from a mainly ethnically homogeneous society into a multi-ethnic society. In 2001, almost 20 per cent of the Swedish population was classified as immigrants, i.e., they were either born abroad and naturalized, of foreign nationality or born in Sweden with at least one parent who had been born abroad. Reports, statistics and research have shown that the health of female immigrants is worse than that of the total population and that the incidence of long-term sickness absence and early retirement is higher in this group. The overall aim of this article is to describe, understand and analyze factors that contribute to poor health among female immigrants in Sweden from the perspective of class, gender and ethnicity. Being unemployed, on sick leave or working in occupation with low income and low status are examples that are related to class position, gender and ethnicity. The main three aspects based on class are wage, professional status and female immigrants position in the hierarchical work organisation. Other factors are discrimination due to ethnicity and gender, unfavourable physical and psychosocial work environment and absence of opportunities for skills upgrade training. Experiences of rape, domestic violence, unanswered emotional and sexual needs and patriarchal culture are examples that are related to gender. And experiencing traumatic events (in pre-migration periods such as experiences of war, prison, etc. and in post-migration periods such as experiences of discrimination and racism) are examples that are related to ethnicity.

  • 128.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Temaledare: Vård på lika villkor – Vad kan vi lära av Lärandeprojektet?2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 2, p. 103-106Article in journal (Other academic)
  • 129.
    akhavan, sharareh
    et al.
    National Institute for Working Life, Stockholm, Sweden .
    Bildt, C
    National Institute for Working Life, Stockholm, Sweden .
    wamala, S
    Karolinska Institute, Stockholm, Sweden .
    The health of female Iranian immigrants in Sweden: A qualitative six-year follow-up study2007In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Health Care for Women International, ISSN 0739-9332, Vol. 28, no 4, p. 339-359Article in journal (Refereed)
    Abstract [en]

    Immigration affects life and health in many different ways. The purpose of this study was to identify and analyze female Iranian immigrants' perception of various factors that influence their health over time. Data collection was based on semistructured interviews with 10 female Iranianimmigrants. Baseline interviews were conducted in 1996, with follow-up interviews in 2002. The results suggest that during the first decade after migration, female immigrants may overcome some health-related factors such as experiences of traumatic events. Other health determinants such as unemployment or experiences of discrimination and racism, however, were observed even two decades after migration.

  • 130.
    Akner, Gunnar
    Örebro University.
    Ibsens princip bör styra vårdsektorn2014In: Sjukhusläkaren, ISSN 1651-2715, no 5, p. 26-26Article in journal (Other (popular science, discussion, etc.))
  • 131.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ibsens princip bör styra vårdsektorn2014In: Sjukhusläkaren, ISSN 1651-2715, no 5, p. 26-26Article in journal (Other (popular science, discussion, etc.))
  • 132.
    Akner, Gunnar
    Örebro University.
    Tid för klinisk analys2015In: Sjukhusläkaren, ISSN 1651-2715, no 1, p. 34-34Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Hur lång tid tar det att göra en klinisk analys? Den erforderliga tiden varierar givetvis beroende på hälsoproblemets komplexitet, men beror även på ambitionsgraden för pedagogik och information samt läkarens kunskaper, erfarenheter och personlighet (stenisk/astenisk).

  • 133.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Tid för klinisk analys2015In: Sjukhusläkaren, ISSN 1651-2715, no 1, p. 34-34Article in journal (Other (popular science, discussion, etc.))
  • 134.
    Akuamoah-Boateng, Henrietta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Self-reported vision health status among older people in the Kassena-Nankana District, Ghana2013In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background: If current trends continue, Ghana's aged population will increase in the coming decades. Currently, there is little knowledge on the health of the aged in Ghana. Research on vision problems among this group is virtually non-existent. This research gap needs to be filled immediately in order to promote the general health among older people in Ghana.

    Objective: The objective of the study was to analyse vision health and its determinants among the older adult population in a district in one of the poorest regions in Ghana - the Kassena-Nankana district.

    Methods: Data were obtained from the WHO multi-country studies unit (SAGE). A total of 4,294 people over the age of 50 responded to the survey. Data analysis was conducted using Stata statistical package. The aim of the analysis was to identify the prevalence of self-reported vision problems and assistive device use. Age, level of education, marital status, living arrangement, socio-economic status and proportion of people aged 50 and over in a household were used as determinants of vision health.

    Results: In total, 54 and 63% (p-value, 0.00) of men and women reported having far-sightedness, while 35% of men and 40.6% of women reported having near-sightedness (p-value, 0.00). In total, 33.5% of men and 38.6% of women reported having both near-sightedness and far-sightedness (p-value, 0.00). Of those who reported having either vision problems, 2.9% reported the use of visual assistive devices. Men had a higher assistive device use of 4.5% compared to 2.1% among women (p = 0.002). Age and household socio-economic status was positively associated with reporting vision problems and assistive device use, respectively.

    Conclusions: The results from this analysis showed that despite the high reporting of vision problems, only 2.9% reported using assistive devices. This outcome shows that there is a need to prevent vision problems and increase access to assistive devices among older people in the Kassena-Nankana district in Ghana.

  • 135.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Hälsokommunikation i relation till samhällsorientering och etablering av nyanlända flyktingar i Sverige: Förstudie MILSA2015Report (Other academic)
    Abstract [sv]

    I etableringsprocessen för nyanlända flyktingar, där ansvaret delas av flera aktörer, ses hälsofrämjande åtgärder idag som en allt viktigare del. Som ett led i detta har länsstyrelserna prioriterat frågan om hälsokommunikation och hur den kan sprid as och utvecklas inom ramen för etableringen. Många kommuner och andra aktörer har också valt att utöka antalet timmar som ägnas åt hälsokommunikation och andra hälsoinsatser. Fördelarna räknas inte bara på den individuella nivån. Information, hälsopromotion och prevention är samhällsekonomiskt en god affär; preventiva åtgärder förhindrar onödig användning av primär- och akutvård och minskar belastningen på hälso- och sjukvården överlag.

    Förstudien har tagits fram inom ramen för projektet forskningsbaserad stödplattform för migration och hälsa (MILSA) och dess delprojekt MILSA 4 som har som mål att samla den kunskap och de erfarenheter som finns kring hälsokommunikation och att lyfta frågan om behovet av hälsokommunikation för nyanlända flyktingar i etableringen.(1)

    Syftet med förstudien är att kartlägga vilka modeller för hälsokommunikation som prövats i Sverige, framförallt inom etableringen, och erfarenheterna av dessa. I detta ingår en beskrivning av kommunikatörers bakgrunder, vilka ut bildningar som ges till gruppen idag samt vilka material och metoder som används. En sammanfattning av resultat från några utvärderingar som gjorts på hälsokommunikationsverksamhet bland annat i Stockholm, Östergötland och Skåne, presenteras också.

    Förstudien bygger på intervjuer med ett antal utvalda aktörer inom etablering, samhällsorientering och hälsokommunikation inom olika län med geografisk spridning samt på dokumentstudier.

    ---------

    (1) Parallellt tar projektet fram rekommendationer för hur rollen som hälsokommunikatör kan utvecklas och professionaliseras. Förstudien och annan dokumentation från MILSA 4 kommer att ligga till grund för en eventuell ansökan om finansiering för fortsatt utvecklingsarbete.

  • 136.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Utvärdering av pilotfasen i “Välkommen till Skåne”: Delprojekt 4, MILSA 2.02017Report (Other academic)
  • 137.
    Al Bitar, Ghiath
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Diabetes and Edentulism: Analysis of WHO Study on global AGEing and adult health (SAGE) Wave 12015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 138.
    Al Mamun, Mohammad Feroz
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Pokharel, Arpan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Reasons behind the use of tanning beds:: A Scoping Review2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Tanning beds emit short, energetic and harmful rays, UV-A and UV-B which leads to various ocular and skin diseases; moreover, DNA damage and the initiation of carcinogenic changes are associated with regular use of it. Basal cell carcinoma and melanoma incidence rate have been rapidly increasing over a few decades due to unregulated consumption of solar bed. It has been classified as carcinogenic device and different organizations regularly advice for the prohibition of it. Despite the proven association of ocular and skin diseases and cancer from the large epidemiological data solar bed consumption is not degraded; furthermore, tanning bed has been developed as a culture in the modern western world. The exploration of tanning bed displayed that it is interconnected with the ancient sun worshippers, an advent of vitamin D and carbon arc lamps with quartz lens, heliotherapy clinics and to the modern sun stimulated indoor tanning. This scoping review provides a broad understanding of the reasons behind the popularity and the current consumption of indoor tanning bed.

    Aim:

    The aim of our study is to analyse and summarize the factors that contribute to the practice of indoor tanning beds in an overall population; furthermore, attitudes, perception, belief, behaviour and motivation factors of indoor tanners were undertaken to explore and find gaps in the existing literatures.

     Method:

    By using a scoping review twenty articles both qualitative and quantitative were identified and selected from the Umeå University Library website by using only one database, “Web of Science TM Core Collection Studies (v.5.21)” during the months of March and April 2016.  Boolean logic was used to identify both qualitative and quantitative studies with keywords such as “Indoor tanning”, “Tanning bed”, “Qualitative Study”, “attitude”, “belief”, “behaviour”, “motivation” and “perception”. The relevant articles that were published and written only in English language and free to download a full copy of the articles through the Umeå University Library website and without any financial transactions and contacts with organizations and authors were included. In terms of population, our target study group is broad which includes both male and female population who are active and passive users of the tanning beds. The age of the participants in our study range from 11 years to 94 years.

    Results:

    Seven themes are reported to be the main reasons behind the consumption of carcinogenic tanning bed. These are: - (1) Modern Healthism, (2) Influence from family and friends, (3) Social occasions and holidays, (4) Physical and Mental Gain, (5) Complex cognition, (6) Addiction and (7) Tactful marketing.  Modern healthism, tanning industries and salon’s tactful marketing help to set up image-based modern norms, attractive, healthy golden brown skin, in societal level influencing families and friends, which further develops indoor tanning as a culture and beautifying practice during special events like social occasions and holidays. The cognition regarding physical and mental gain perceived from an individual and societal perspective and contradictory findings from ongoing researches with respect to the hazards of solar beds create complex cognition among active and passive tanners, like ambivalence, cognitive dissonance, temporal discounting, rationalization and optimistic bias. However, in the adolescent phase, there is increasing consumption of the tanning beds which can be further explained by complex cognitive, the adolescent egocentrism. The complex cognition enhances the regular use of addictive tanning bed which further leads to dependence and skin cancers or the diseases of the eyes and the skin.

    Conclusions: Consumption of risky tanning bed has been developed as a culture or beauty norms that are still ingrained in the mind of tanners, i.e., golden brown tanned skin is attractive, which is created under the influence of modern healthism. The reasons behind the use of carcinogenic solar bed can be well explained by the concepts of cognitive science and psychology, i.e., ambivalence, adolescent egocentrism, cognitive dissonance, temporal discounting, rationalization, optimistic bias, and addiction. In order to tackle with solar bed dependence and its health related hazards, health workers should develop and implement promotive and preventive health programs which incorporate social norms and factors, tanner’s cognition and psychology. Policy makers and health actors should ban solar beds or avoid the use of it in the minors, i.e., under 18 years through embracing the evidence suggested by epidemiological studies.

  • 139.
    Alabi, Olusola
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Exploring awareness and knowledge of tuberculosis spread among household members of tuberculosis patients in Nigeria2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 140.
    Al-Alawi, Kamila
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Johansson, Helene
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Al Mandhari, Ahmed
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Are the resources adoptive for conducting team-based diabetes management clinics? An explorative study at primary health care centers in Muscat, Oman.2018In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, p. 1-28Article in journal (Refereed)
    Abstract [en]

    AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches.

    BACKGROUND: The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines.

    METHOD: A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.

  • 141. Al-Ani, Amer N.
    et al.
    Cederholm, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Saaf, Maria
    Neander, Gustaf
    Blomfeldt, Richard
    Ekstrom, Wilhelmina
    Hedstrom, Margareta
    Low bone mineral density and fat-free mass in younger patients with a femoral neck fracture2015In: European Journal of Clinical Investigation, ISSN 0014-2972, E-ISSN 1365-2362, Vol. 45, no 8, p. 800-806Article in journal (Refereed)
    Abstract [en]

    Background Reduced bone mineral density (BMD) together with muscle wasting and dysfunction, that is sarcopenia, emerges as a risk factor for hip fracture. The aim of this study was to examine body composition and BMD and their relationship with trauma mechanisms in young and middle-aged patients with femoral neck fracture. Materials and methods Altogether, 185 patients with femoral neck fracture aged 20-69 were included. BMD, body composition and fat-free mass index (FFMI) were determined by dual-X-ray absorptiometry (DXA), and trauma mechanisms were registered. Results Ninety per cent of the whole study population had a femoral neck BMD below the mean for age. In the young patients (<50years), 27% had a Z-score of BMD-2 SD. More than half of the middle-aged patients (50-69years) had osteopenia, that is T-score -1 to -25, and 35% had osteoporosis, that is T-score<-25, at the femoral neck. Patients with low-energy trauma, sport injury or high-energy trauma had a median standardised BMD of 0702, 0740 vs. 0803g/cm(2) (P=003), and a median FFMI of 159, 177 vs. 175kg/m(2) (P<0001), respectively. FFMI<10th percentile of an age- and gender-matched reference population was observed in one-third. Conclusions A majority had low BMD at the femoral neck, and one-third had reduced FFMI (i.e. sarcopenia). Patients with fracture following low-energy trauma had significantly lower femoral neck BMD and FFMI than patients with other trauma mechanisms. DXA examination of both BMD and body composition could be of value especially in those with low-energy trauma.

  • 142. Albert, Jan
    et al.
    Berglund, Torsten
    Gisslen, Magnus
    Groon, Peter
    Sonnerborg, Anders
    Tegnell, Anders
    Alexandersson, Anders
    Berggren, Ingela
    Blaxhult, Anders
    Brytting, Maria
    Carlander, Christina
    Carlson, Johan
    Flamholc, Leo
    Follin, Per
    Haggar, Axana
    Hansdotter, Frida
    Josephson, Filip
    Karlström, Olle
    Liljeros, Fredrik
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Naver, Lars
    Pettersson, Karin
    Johansson, Veronica Svedhem
    Svennerholm, Bo
    Tunback, Petra
    Widgren, Katarina
    Risk of HIV transmission from patients on antiretroviral therapy: A position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy2014In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 46, no 10, p. 673-677Article, review/survey (Refereed)
    Abstract [en]

    The modern medical treatment of HIV with antiretroviral therapy (ART) has drastically reduced the morbidity and mortality in patients infected with this virus. ART has also been shown to reduce the transmission risk from individual patients as well as the spread of the infection at the population level. This position statement from the Public Health Agency of Sweden and the Swedish Reference Group for Antiviral Therapy is based on a workshop organized in the fall of 2012. It summarizes the latest research and knowledge on the risk of HIV transmission from patients on ART, with a focus on the risk of sexual transmission. The risk of transmission via shared injection equipment among intravenous drug users is also examined, as is the risk of mother-to-child transmission. Based on current knowledge, the risk of transmission through vaginal or anal intercourse involving the use of a condom has been judged to be minimal, provided that the person infected with HIV fulfils the criteria for effective ART. This probably also applies to unprotected intercourse, provided that no other sexually transmitted infections are present, although it is not currently possible to fully support this conclusion with direct scientific evidence. ART is judged to markedly reduce the risk of blood-borne transmission between people who share injection equipment. Finally, the risk of transmission from mother to child is very low, provided that ART is started well in advance of delivery.

  • 143. Alberts, Marianne
    et al.
    Dikotope, Sekgothe A
    Choma, Solomon R
    Masemola, Matshane L
    Modjadji, Sewela EP
    Mashinya, Felistas
    Burger, Sandra
    Cook, Ian
    Brits, Sanette J
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesberg, South Africa.
    Health & Demographic Surveillance System Profile: The Dikgale Health and Demographic Surveillance System.2015In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 44, no 5, p. 1565-1571Article in journal (Refereed)
  • 144.
    Albihn, Ann
    et al.
    National Veterinary Institute, Uppsala, Sweden.
    Gustafsson, Hans
    Swedish University of Agricultural Sciences.
    O’Hara Ruiz, Marilyn
    University of Illinois at Urbana-Champaign.
    38. Preparing for Climate Change2012In: Ecology and Animal Health / [ed] Leif Norrgren and Jeffrey Levengood, Uppsala: Baltic University Press , 2012, 1, p. 311-328Chapter in book (Other (popular science, discussion, etc.))
  • 145.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ekberg, Jan
    Lunds universitet.
    Elmståhl, Sölve
    Linnaeus University, Faculty of Business, Economics and Design, Linnaeus School of Business and Economics.
    County Differences in Mortality among Foreign-Born Compared to Native Swedes 1970-19992012In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, p. Article ID 136581-Article in journal (Refereed)
    Abstract [en]

    Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations. 

  • 146.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ekberg, Jan
    Linnaeus University, Faculty of Business, Economics and Design, Linnaeus School of Business and Economics.
    Elmståhl, Sölve
    Hälsa, Vård och Samhälle, Lunds universitet.
    Utilization of In-Hospital Care among Foreign-Born Compared to Native Swedes 1987-1999 (Open Access)2012In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, p. Article ID 713249-Article in journal (Refereed)
    Abstract [en]

    In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987–1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970–1999, was used. Persons were selected if they were admitted to hospital during 1987–1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care.

  • 147.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Lund Univ.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Lund Univ.
    Elmståhl, Sölve
    Lund University.
    Comparison of Stroke mortality in Finnish-born migrants living in Sweden 1970-1999 and in Swedish-born individuals2014In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 1, p. 18-23Article in journal (Refereed)
    Abstract [en]

    A limited number of studies have been found on stroke mortality in migrants showing higher mortality for some groups. Influence of time of residence has been studied by one research group. An earlier study showed a significantly higher number of deaths in Diseases of the circulatory system in Finnish migrants compared with native Swedes. To test the hypothesis of a higher mortality in and a decrease in mortality over time in stroke among Finnish migrants in Sweden. The study was based on National Population data, the study population included 321,407 Swedish and 307,174 foreign born persons living in Sweden 1987-1999. Mean age was lower at time for death for Finnish migrants than native Swedes, men 5.1 years difference and women 2.3 years. The difference decreased over time. The risk of death by stroke was higher for migrants with short time of residence than with long time (<= 10 years, OR 1.61-1.36 vs >= 11 year, OR 1.18). Migrants with short time of residence died 9.8-5.3 years earlier than native Swedes. The hypothesis was confirmed and an indication of adjustment to life in the new country was found. International studies show similar results for other migrant groups but further studies are needed to verify if the same pattern can be found in other migrants groups in Sweden and to generalise the findings.

  • 148.
    Albin, Björn
    et al.
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Elmståhl, Sölve
    Lund University, Universitetssjukhuset MAS, Malmö, Sweden.
    Comparison of Stroke Mortality in Finnish-Born Migrants Living in Sweden 1970-1999 and in Swedish-Born Individuals2014In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 1, p. 18-23Article in journal (Refereed)
    Abstract [en]

    A limited number of studies have been found on stroke mortality in migrants showing higher mortality for some groups. Influence of time of residence has been studied by a previous  research group. A previous study showed a significantly higher number of deaths in Diseases of the circulatory system in Finnish migrants compared to native Swedes. The aim was to test the hypothesis of a higher mortality in and a decrease in mortality over time in stroke among Finnish migrants in Sweden. The study was based on National Population registry data. The study population included 321,407 Swedish and 307,174 foreign born persons living in Sweden 1987-1999. Mean age was lower at time for death for Finnish migrants than native Swedes, men 5.1 years difference and women 2.3 years. The dissimilarity decreased over time. The risk of death by stroke was higher for migrants with short time of residence in Sweden than with long time (≤10 years, OR 1.61-1.36 vs ≥11 year, OR 1.18). Migrants with short time of residence in Sweden died 9.8-5.3 years earlier than native Swedes. The hypothesis was confirmed and an indication of adjustment to life in the new host country was found. International studies show similar results for other migrant groups but further studies are needed to verify if a similar pattern can be found in other migrant groups living in Sweden and to be able to generalise the findings.

  • 149.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Jiang, Qin
    The mental health of children left behind in rural China by migrating parents: a literature treview2010In: Journal of Public mental health, ISSN 1746-5729, Vol. 9, no 3, p. 4-16Article in journal (Refereed)
  • 150.
    Albrecht, Sophie C.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The longitudinal relationship between control over working hours and depressive symptoms: Results from SLOSH, a population-based cohort study2017In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 215, p. 143-151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychosocial work factors can affect depressive moods, but research is inconclusive if flexibility to self-determine working hours (work-time control, WTC) is associated with depressive symptoms over time. We investigated if either sub-dimension of WTC, control over daily hours and control over time off, was related to depressive symptoms over time and examined causal, reversed-causal, and reciprocal pathways.

    METHODS: The study was based on four waves of the Swedish Longitudinal Occupational Survey of Health which is a follow-up of representative samples of the Swedish working population. WTC was measured using a 5-item index. Depressive symptoms were assessed with a brief subscale of the Symptom Checklist. Latent growth curve models and cross-lagged panel models were tested.

    RESULTS: Best fit was found for a model with correlated intercepts (control over daily hours) and both correlated intercepts and slopes (control over time off) between WTC and depressive symptoms, with stronger associations for control over time off. Causal models estimating impacts from WTC to subsequent depressive symptoms were best fitting, with a standardised coefficient between -0.023 and -0.048.

    LIMITATIONS: Results were mainly based on self-report data and mean age in the study sample was relatively high.

    CONCLUSION: Higher WTC was related to fewer depressive symptoms over time albeit small effects. Giving workers control over working hours - especially over taking breaks and vacation - may improve working conditions and buffer against developing depression, potentially by enabling workers to recover more easily and promoting work-life balance.

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