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  • 101.
    Ahmadi, Nader
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology.
    Ljungqvist, Arne
    Svedsäter, Göran
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    Introduction: Doping and Public Health2016In: Doping and Public Health / [ed] Nader Ahmadi, Arne Ljungqvist, Göran Svedsäter, Abingdon: Routledge, 2016, 1, , 151 p.1-10 p.Chapter in book (Other academic)
  • 102.
    Ahmadi, Nader
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Social Work and Psychology.
    Svedsäter, Göran
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences.
    "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, , 151 p.38-48 p.Chapter in book (Other academic)
    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.

  • 103.
    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.

    The full text will be freely available from 2017-11-01 00:00
  • 104.
    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.

  • 105. 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)
  • 106.
    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
  • 107. 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 1654-9880, Vol. 2, no 1, 68-75 p.Article 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.

  • 108.
    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.  

  • 109.
    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, 620-651 p.Article 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.

  • 110.
    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, 89-99 p.Article 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.

  • 111.
    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., 336- p.Article in journal (Other academic)
  • 112. 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, 463-471 p.Article 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.

  • 113. 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, 315-323 p.Article 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.

  • 114.
    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.

  • 115.
    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, Vol. 7, no 2, 275-286 p.Article 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.

  • 116.
    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, 103-106 p.Article in journal (Other academic)
  • 117.
    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, 339-359 p.Article 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.

  • 118.
    Akner, Gunnar
    Örebro University.
    Ibsens princip bör styra vårdsektorn2014In: Sjukhusläkaren, ISSN 1651-2715, no 5, 26-26 p.Article in journal (Other (popular science, discussion, etc.))
  • 119.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Ibsens princip bör styra vårdsektorn2014In: Sjukhusläkaren, ISSN 1651-2715, no 5, 26-26 p.Article in journal (Other (popular science, discussion, etc.))
  • 120.
    Akner, Gunnar
    Örebro University.
    Tid för klinisk analys2015In: Sjukhusläkaren, ISSN 1651-2715, no 1, 34-34 p.Article 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).

  • 121.
    Akner, Gunnar
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Tid för klinisk analys2015In: Sjukhusläkaren, ISSN 1651-2715, no 1, 34-34 p.Article in journal (Other (popular science, discussion, etc.))
  • 122.
    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 1654-9880, Vol. 6, 1-7 p.Article 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.

  • 123.
    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.

  • 124.
    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)
  • 125.
    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
  • 126.
    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.

  • 127.
    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
  • 128. 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, 800-806 p.Article 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.

  • 129. 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, 673-677 p.Article, 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.

  • 130. 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, 1565-1571 p.Article in journal (Refereed)
  • 131.
    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, 311-328 p.Chapter in book (Other (popular science, discussion, etc.))
  • 132.
    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, Article ID 136581- p.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. 

  • 133.
    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, Article ID 713249- p.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.

  • 134.
    Albin, Björn
    et al.
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Linnaeus University, Växjö, 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 Individuals2013In: Journal of Immigrant and Minority Health, ISSN 1557-1912, Vol. 17Article 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.

  • 135.
    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, 18-23 p.Article 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.

  • 136.
    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, 4-16 p.Article in journal (Refereed)
  • 137.
    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, 143-151 p.Article 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.

  • 138. Aldrich, Rosemary
    et al.
    Mahoney, Mary
    Harris, Elizabeth
    Simpson, Sarah
    Stewart-Williams, Jenny
    Newcastle Institute of Public health, University of Newcastle, New South Wales, Australia.
    Building an equity focus in health impact assessment2005In: New South Wales Public Health Bulletin, ISSN 1034-7674, Vol. 16, no 7-8, 118-119 p.Article in journal (Refereed)
  • 139. Aldén, Lina
    et al.
    Björklund, Anders
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Hammarstedt, Mats
    Early Health and School Outcomes for Children with Lesbian Parents: Evidence from Sweden2017Report (Other academic)
    Abstract [en]

    Sweden was early to legalize same-sex partnership (1995), to allow same-sex couples to adopt children (2003), and to offer same-sex couples fertility treatment through the national health system (2005). Using population data, we identify children of lesbian parents as those whose biological mother was a registered same-sex partner no later than six months after the child's birth. The number of such children increased markedly from 1995 to 2010 with a total of 750 children for the whole period. We find that boys and girls with lesbian parents had 2.4 percent lower birth weight than other children, a difference that is statistically significant from zero at the 5 percent level. Girls, but not boys, also have a higher probability of having a low birth weight. We follow these children until age ten and observe diseases of the respiratory system. Boys with lesbian parents have a significantly lower probability of such diseases (-3.4 percentage points), and girls with lesbian parents an insignificantly higher probability (+2.4 percentage points). Our analysis of school outcomes at age ten uses a small sample so precision is low. The point estimates show that boys with lesbian parents outperform other children by around 10 percentiles higher test scores in Math and Swedish. These differences are barely significant, while estimates for girls are lower and not significant. For all outcomes, we find that children with lesbian parents benefit from their mother's socio-economic status, whereas they suffer in terms of birth weight from having been exposed to fertility treatment.

  • 140.
    Alehagen, Urban
    et al.
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Johansson, Peter
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Björnstedt, Mikael
    Division of Pathology F42, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Rosén, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Post, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Aaseth, Jan
    Research Department, Innlandet Hospital Trust and Hedmark University College, Norway.
    Relatively high mortality risk in elderly Swedish subjects with low selenium status2016In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 70, no 1, 91-96 p.Article in journal (Refereed)
    Abstract [en]

    Background/Objectives: 

    The daily dietary intake of selenium (Se), an essential trace element, is still low in Sweden in spite of decades of nutritional information campaigns and the effect of this on the public health is presently not well known. The objective of this study was to determine the serum Se levels in an elderly Swedish population and to analyze whether a low Se status had any influence on mortality.

    Subjects/Methods: 

    Six-hundred sixty-eight (n=668) elderly participants were invited from a municipality and evaluated in an observational study. Individuals were followed for 6.8 years and Se levels were re-evaluated in 98 individuals after 48 months. Clinical examination of all individuals included functional classification, echocardiography, electrocardiogram and serum Se measurement. All mortality was registered and endpoints of mortality were assessed by Kaplan–Meier plots, and Cox proportional hazard ratios adjusted for potential confounding factors were calculated.

    Results: 

    The mean serum Se level of the study population (n=668) was 67.1 μg/l, corresponding to relatively low Se intake. After adjustment for male gender, smoking, ischemic heart disease, diabetes, chronic obstructive pulmonary disease and impaired heart function, persons with serum Se in the lowest quartile had 43% (95% confidence interval (CI): 1.02–2.00) and 56% (95% CI: 1.03–2.36) increased risk for all-cause and cardiovascular mortality, respectively. The result was not driven by inflammatory effects on Se concentration in serum.

    Conclusion: 

    The mean serum Se concentration in an elderly Swedish population was 67.1 μg/l, which is below the physiological saturation level for several selenoprotein enzymes. This result may suggest the value of modest Se supplementation in order to improve the health of the Swedish population.

  • 141.
    Alehagen, Urban
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Slind Olsen, Renate
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. County Hospital Ryhov, Sweden.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Matussek, Andreas
    County Hospital Ryhov, Sweden.
    Wågsäter, Dick
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    PDGF-D gene polymorphism is associated with increased cardiovascular mortality in elderly men2016In: BMC Medical Genetics, ISSN 1471-2350, E-ISSN 1471-2350, Vol. 17, no 62Article in journal (Refereed)
    Abstract [en]

    Background: Platelet-derived growth factor (PDGF) D has been reported to be active in fibroblasts, and in areas of myocardial infarction. In this longitudinal study we evaluated the association between PDGF-D polymorphism and cardiovascular mortality, and attempted to discover whether specific genotype differences regarding risk could be observed, and if gender differences could be seen. Methods: Four hundred seventy-six elderly community participants were included in this study. All participants underwent a clinical examination, echocardiography, and blood sampling including PDGF-D single nucleotide polymorphism (SNP) analyses of the rs974819 A/A, G/A and G/G SNP. The follow-up time was 6.7 years. Results: No specific genotype of rs974819 demonstrated increased cardiovascular mortality in the total population, however, the male group with genotypes A/A and G/A demonstrated an increased risk that persisted in a multivariate evaluation where adjustments were made for well-known cardiovascular risk factors (2.7 fold compared with the G/G genotype). No corresponding finding was observed in the female group. Conclusion: We report here for the first time that the genotypes G/A or A/A of the SNP rs974819 near PDGF-D exhibited a 2.7 fold increased cardiovascular mortality risk in males. Corresponding increased risk could not be observed in either the total population and thus not in the female group. However, the sample size is was small and the results should be regarded as hypothesis-generating, and thus more research in the field is recommended.

  • 142. Aleksandrova, Krasimira
    et al.
    Pischon, Tobias
    Jenab, Mazda
    Bueno-de-Mesquita, H Bas
    Fedirko, Veronika
    Norat, Teresa
    Romaguera, Dora
    Knüppel, Sven
    Boutron-Ruault, Marie-Christine
    Dossus, Laure
    Dartois, Laureen
    Kaaks, Rudolf
    Li, Kuanrong
    Tjønneland, Anne
    Overvad, Kim
    Quirós, José Ramón
    Buckland, Genevieve
    Sánchez, María José
    Dorronsoro, Miren
    Chirlaque, Maria-Dolores
    Barricarte, Aurelio
    Khaw, Kay-Tee
    Wareham, Nicholas J
    Bradbury, Kathryn E
    Trichopoulou, Antonia
    Lagiou, Pagona
    Trichopoulos, Dimitrios
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Naccarati, Alessio
    Panico, Salvatore
    Siersema, Peter D
    Peeters, Petra HM
    Ljuslinder, Ingrid
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ericson, Ulrika
    Ohlsson, Bodil
    Weiderpass, Elisabete
    Skeie, Guri
    Borch, Kristin
    Rinaldi, Sabina
    Romieu, Isabelle
    Kong, Joyce
    Gunter, Marc J
    Ward, Heather A
    Riboli, Elio
    Boeing, Heiner
    Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study2014In: BMC Medicine, ISSN 1741-7015, Vol. 12, no 1, 168- p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Excess body weight, physical activity, smoking, alcohol consumption and certain dietary factors are individually related to colorectal cancer (CRC) risk; however, little is known about their joint effects. The aim of this study was to develop a healthy lifestyle index (HLI) composed of five potentially modifiable lifestyle factors - healthy weight, physical activity, non-smoking, limited alcohol consumption and a healthy diet, and to explore the association of this index with CRC incidence using data collected within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. METHODS: In the EPIC cohort, a total of 347,237 men and women, 25- to 70-years old, provided dietary and lifestyle information at study baseline (1992 to 2000). Over a median follow-up time of 12 years, 3,759 incident CRC cases were identified. The association between a HLI and CRC risk was evaluated using Cox proportional hazards regression models and population attributable risks (PARs) have been calculated. RESULTS: After accounting for study centre, age, sex and education, compared with 0 or 1 healthy lifestyle factors, the hazard ratio (HR) for CRC was 0.87 (95% confidence interval (CI): 0.44 to 0.77) for two factors, 0.79 (95% CI: 0.70 to 0.89) for three factors, 0.66 (95% CI: 0.58 to 0.75) for four factors and 0.63 (95% CI: 0.54 to 0.74) for five factors; P-trend <0.0001. The associations were present for both colon and rectal cancers, HRs, 0.61 (95% CI: 0.50 to 0.74; P for trend <0.0001) for colon cancer and 0.68 (95% CI: 0.53 to 0.88; P-trend <0.0001) for rectal cancer, respectively (P-difference by cancer sub-site = 0.10). Overall, 16% of the new CRC cases (22% in men and 11% in women) were attributable to not adhering to a combination of all five healthy lifestyle behaviours included in the index. CONCLUSIONS: Combined lifestyle factors are associated with a lower incidence of CRC in European populations characterized by western lifestyles. Prevention strategies considering complex targeting of multiple lifestyle factors may provide practical means for improved CRC prevention.

  • 143. Aleman, J
    et al.
    Brännström, Inger
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Liljestrand, J
    Peña, R
    Persson, L A
    Steidinger, J
    Saving more neonates in hospital: an intervention towards a sustainable reduction in neonatal mortality in a Nicaraguan hospital1998In: Tropical doctor, ISSN 0049-4755, Vol. 28, no 2, 88-92 p.Article in journal (Refereed)
    Abstract [en]

    A process of change was initiated in a Nicaraguan regional hospital in order to achieve a sustainable reduction of early neonatal mortality. A series of organizational, educational and hygienic measures was introduced, involving all staff in antenatal care, delivery care and neonatal care. Neonatal mortality decreased from 56/1000 live births in 1985 to 11/1000 in 1993. A commission of maternal and child health, a weekly perinatal audit, the active involvement of all staff and dedicated work of key individuals, as well as national policy decisions, are considered important determinants of the process. Keeping neonatal mortality in focus through continuous analysis of care routines, and through external exchange of ideas is important in order to sustain improvements and to decrease further the mortality.

  • 144.
    Alemu, Andinet Worku
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Determinants of survival in adult HIV patients on antiretroviral therapy in Oromiyaa, Ethiopia2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3, 5398Article in journal (Refereed)
    Abstract [en]

    Background: The antiretroviral treatment (ART) scale-up service has been a recent development in Ethiopia, but its impact on mortality has not been well investigated. The aim of this study was to assess the early survival outcome of the scale-up service by utilizing routine hospital data.

    Methods: All adult HIV/AIDS patients who started on antiretroviral treatment in Shashemene and Assela hospitals from January 1, 2006 to May 31, 2006 were included and followed up for 2 years. Data were extracted from standard patient medical registrations. Kaplan-Meier curves were used to estimate survival probability and the Cox proportional hazard model was applied to determine predictors of mortality. Two alterative assumptions (real case and worst case) were made in determining predictors of mortality.

    Results: The median age of patients was 33 years and 57% were female. Eighty-five percent had CD4 <200 cells/mu L with a median CD4 count of 103 cells/mu L. The median survival time was 104.4 weeks. A total of 28 (10.3%) deaths were observed during the 2-year period and 48 patients (18%) were lost to follow up. The majority of deaths occurred in the first 4 months of treatment. In multivariate analysis, 2-year survival was significantly associated with the clinical stage of the disease, baseline hemoglobin, and cotrimoxazole prophylaxis therapy (CPT) at or before ART initiation in both assumptions. The median CD4 count and body weight showed a marked improvement during the first 6 months of treatment, followed by stagnation thereafter.

    Conclusion: The study has shown an overall low mortality but a high loss to follow-up rate of the cohort. Advanced clinical stage, anemia, low body weight, and lack of CPT initiation were independent predictors of mortality - but not gender. CPT initiation should be encouraged in routine HIV care services, and patient retention mechanisms have to be strengthened. Stagnation in immunological and weight recovery after the first 6 months should be further investigated. The utilization of routine data should be encouraged in order to facilitate appropriate decision making.

  • 145. Alemu, Yihun Mulugeta
    et al.
    Awoke, Worku
    Wilder-Smith, Annalies
    Institute of Public Health, Heidelberg University, Heidelberg, Germany; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
    Determinants for tuberculosis in HIV-infected adults in Northwest Ethiopia: a multicentre case-control study2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 4, e009058Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this study was to identify determinants for tuberculosis (TB) among HIV-infected adults in Northwest Ethiopia.

    DESIGN: Case-control study.

    SETTING: Three hospitals and 10 health centres in Northwest Ethiopia.

    PARTICIPANTS: A total of 446 individuals consented to participate in the study (150 cases and 296 controls). Cases were HIV-infected adults diagnosed with active TB, and controls were HIV-infected adults without active TB.

    MAIN OUTCOME MEASURE: The link between TB and determinants was assessed using logistic regression. Determinants were categorised as sociodemographic, host-related, clinical and environmental.

    RESULTS: Smoking (adjusted OR (AOR) 5.47; 95% CI 2.26 to 13.22), presence of a TB patient in the family (AOR 2.66; 95% CI 1.25 to 5.66), alcohol consumption (AOR 2.49; 95% CI 1.29 to 4.80) and chewing khat (AOR 2.22; 95% CI 1.11 to 4.41) were independent determinants for increased occurrence of TB. Highly active antiretroviral therapy (HAART) (AOR 0.25; 95% CI 0.13 to 0.51), isoniazid preventive therapy (IPT) (AOR 0.22; 95% CI 0.11 to 0.41) and cotrimoxazole preventive therapy (AOR 0.32; 95% CI 0.19 to 0.55) had a protective effect against TB.

    CONCLUSIONS: HIV-infected adults with substance abuse (tobacco smoking, khat chewing and alcohol) should be prioritised for TB screening. This study reaffirmed that HAART and IPT are some of the best strategies for reducing TB occurrence in HIV-infected adults. These findings provide impetus to intensify tracing of TB household contacts.

  • 146.
    Alenius, Gerd-Marie
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Reumatology.
    A Clinical and Genetic Study of Psoriatic Arthritis2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Psoriatic arthritis (PsA) is an inflammatory joint disease associated with psoriasis. PsA has a heterogeneous pattern, expressed by different manifestations such as mild mono-oligoarthritis or very severe, erosive and destructive polyarthritis. Measurable inflammatory activity is not always prominent. The aetiology is unknown but genetic factors are believed to be of importance. The pattern of inheritance is proposed to be polygenic. The aim of this study was to estimate the prevalence of joint and axial manifestations, characterise the disease in relation to inflammatory and genetic markers, and to identify disease susceptibility gene(s) for PsA in patients from northern Sweden.

    All patients from the city of Umeå (n=276), selected from a community and hospital based psoriasis register (n=1737) at the Dept of Dermatology, were invited to a prevalence study. Two hundred-two patients were examined and 97 (48%) had inflammatory manifestations such as peripheral arthritis, axial disease, undifferentiated spondylarthropathy (uSpA) and enthesopathies. Of the 67 patients (33 %) with peripheral arthritis and/or axial disease, 30 were not previously diagnosed.

    The association of clinical manifestations and potential markers of aggressive joint disease with HLA associations were analysed in 88 patients with PsA. We were not able to confirm findings of other groups reporting strong association with several HLA-antigens. The prevalence of HLA-B17, B37 and B62 was increased compared with controls, but the strongest predictive factors among our patients for an aggressive disease, in a multiple logistic analysis, were polyarthritic disease and distal interphalangeal engagement.

    In order to investigate for disease susceptibility genes, five genetic loci were analysed with microsatellites and single nucleotide polymorphisms in an association study of 120 patients with PsA. There was a significant association with the TNFB locus on chromosome 6p but not with any other loci examined; 1q21 (PSORS4), 3q21 (PSORS5), 8q24 and CTLA4. When stratifying for the TNFB alleles the association was confined to allele 123. In a subgroup of patients who were HLA-typed (n=83), we were not able to verify linkage disequilibrium with the TNFB allele 123 and the HLA antigens; B17, B27, B37, B62 or Cw*0602.

    The presence of renal abnormalities was evaluated as a manifestation of systemic inflammation in 73 patients with PsA. Renal abnormalities defined as decreased creatinine-clearance (≤ mean - 2SD) and/or urinary albumin >25 mg/24 h was found in 23% of the patients. The predictive factors for renal abnormalities was inflammatory activity (ESR > 25 mm/h and/or CRP >15 mg/L) indicating a systemic effect in some of the patients.

    In conclusion, we found high prevalence of inflammatory manifestations in patients with psoriasis. There was no strong association between PsA and HLA antigens and predictive factors for aggressive disease were polyarthritic disease and DIP joint engagement. The TNFB locus was associated with PsA and there were no linkage disequilibrium with the HLA antigens B17, B27, B62 or Cw*0602. There were evidence for systemic effects as renal abnormalities in patients with PsA and measurable inflammatory activity.

  • 147.
    Alers, Margret
    et al.
    Unit Gender and Women’s Health, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands .
    Pepping, Tess
    Unit Gender and Women’s Health, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.
    Bor, Hans
    Unit Gender and Women’s Health, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.
    Verdonk, Petra
    Department of Medical Humanities, School of Medical Sciences, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands .
    Hamberg, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Lagro-Janssen, Antoine
    Unit Gender and Women’s Health, Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands.
    Speciality preferences in Dutch medical students influenced by their anticipation on family responsibilities2014In: Perspectives on Medical Eduction, ISSN 2212-277X, Vol. 3, no 6, 443-454 p.Article in journal (Refereed)
    Abstract [en]

    Physician gender is associated with differences in the male-to-female ratio between specialities and with preferred working hours. We explored how graduating students’ sex or full-time or part-time preference influences their speciality choice, taking work-life issues into account. Graduating medical students at Radboud University Medical Centre, the Netherlands participated in a survey (2008–2012) on career considerations. Logistic regression tested the influence of sex or working hour preference on speciality choice and whether work-life issues mediate. Of the responding students (N = 1,050, response rate 83, 73.3 % women), men preferred full-time work, whereas women equally opted for part time. More men chose surgery, more women family medicine. A full-time preference was associated with a preference for surgery, internal medicine and neurology, a part-time preference with psychiatry and family medicine. Both male and female students anticipated that foremost the career of women will be negatively influenced by family life. A full-time preference was associated with an expectation of equality in career opportunities or with a less ambitious partner whose career would affect family life. This increased the likelihood of a choice for surgery and reduced the preference for family medicine among female students. Gender specifically plays an important role in female graduates’ speciality choice making, through considerations on career prospects and family responsibilities.

  • 148. Alexander, Anneli
    et al.
    Bergman, Patrick
    Hagströmer, Maria
    Sjöström, Michael
    IPAQ environmental module; Reliability testing2006In: Journal of Public Health, Vol. 14, no 2, 76-81 p.Article in journal (Refereed)
  • 149. Alexander, Anneli
    et al.
    Bergman, Patrick
    Hagströmer, Maria
    Sjöström, Michael
    Metodprövning av IPAQs miljömodul2005In: Läkarstämman, Stockholm, 2005Conference paper (Refereed)
  • 150.
    Alexanderson, Kristina
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Leijon, Margareta
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Rydh, Hillevi
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bjurulf, Per
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Epidemiology of sickness absence in a Swedish county in 1985, 1986 and 1987: A three year longitudinal study with focus on gender, age and occupation1994In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 22, no 1, 27-34 p.Article in journal (Refereed)
    Abstract [en]

    In order to get a better epidemiological base for preventive intervention in the county of Östergötland, Sweden, a comprehensive study of sickness absence was done. During the years 1985, 1986 and 1987, all new periods of sick-leave exceeding seven days were registered with demographic variables. This information was related to data about the total population of Östergötland. Each year approx. 45,000 persons had approx. 61,000 sickness spells. These figures were stable over the years while the number of sick-leave days increased. Blue-collar occupations had the highest sick-leave rates and the female sick-leave rate was higher in general and much higher in most male-dominated occupations. The male rate was lower within female-dominated areas, except among secretaries and textile workers. Females in extremely male-dominated groups had the highest rates, while both male and female sick-leave rates were lower in more gender-integrated occupations.

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