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  • 251. Anchang-Kimbi, Judith K.
    et al.
    Achidi, Eric Akum
    Nkegoum, Blaise
    Mendimi, Joseph-Marie N.
    Sverremark-Ekström, Eva
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute.
    Troye-Blomberg, Marita
    Stockholm University, Faculty of Science, Department of Molecular Biosciences, The Wenner-Gren Institute.
    IgG isotypic antibodies to crude Plasmodium falciparum blood-stage antigen associated with placental malaria infection in parturient Cameroonian women2016In: African Health Sciences, ISSN 1680-6905, E-ISSN 1729-0503, Vol. 16, no 4, p. 1007-1017Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have reported an association between placental malaria (PM) infection and levels of isotypic antibodies against non-pregnancy associated antigens. Objective: To determine and evaluate IgG isotypic antibody levels to crude P. falciparum blood stage in women with and without PM infection. Methods: Levels of IgG (IgG1-IgG4) and IgM to crude P. falciparum blood stage antigen were measured by ELISA in 271 parturient women. Placental malaria infection was determined by placental blood microscopy and placental histology. Age, parity and intermittent preventive treatment during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) usage were considered during analysis. Results: P. falciparum-specific IgG1 (96.5%) and IgG3 (96.7%) antibodies were predominant compared with IgG2 (64.6%) and IgG4 (49.1%). Active PM infection was associated with significant increased levels of IgG1, IgG4 and IgM while lower levels of these antibodies were associated with uptake of two or more IPTp-SP doses. PM infection was the only independent factor associated with IgG4 levels. Mean IgG1 + IgG3/IgG2 + IgG4 and IgG1 + IgG2 + IgG3/IgG4 ratios were higher among the PM-uninfected group while IgG4/IgG2 ratio prevailed in the infected group. Conclusion: PM infection and IPTp-SP dosage influenced P. falciparum-specific isotypic antibody responses to blood stage antigens. An increase in IgG4 levels in response to PM infection is of particular interest.

  • 252. Andel, Ross
    et al.
    Crowe, Michael
    Hahn, Elizabeth A.
    Mortimer, James
    Pedersen, Nancy L.
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Johansson, Boo
    Gatz, Margaret
    Work-Related Stress May Increase the Risk of Vascular Dementia2012In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 60, no 1, p. 60-67Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine job control, job demands, social support at work, and job strain (ratio of demands to control) in relation to risk of any dementia, Alzheimer's disease (AD), and vascular dementia (VaD). DESIGN: Cohort study. SETTING: The population-based Study of Dementia in Swedish Twins. PARTICIPANTS: Two hundred fifty-seven people with dementia (167 AD, 46 VaD) and 9,849 without. MEASUREMENTS: Dementia diagnoses were based on telephone screening for cognitive impairment followed by in-person clinical examination. An established job exposure matrix was matched to main occupation categories to measure work characteristics. RESULTS: In generalized estimating equations (adjusted for the inclusion of complete twin pairs), lower job control was associated with greater risk of any dementia (odds ratio (OR) = 1.17, 95% confidence interval (CI) = 1.04-1.31) and VaD specifically (OR = 1.39, 95% CI = 1.07-1.81). Lower social support at work was associated with greater risk of dementia (OR = 1.15, 95% CI = 1.03-1.28), AD (OR = 1.14, 95% CI = 1.00-1.31), and VaD (OR = 1.28, 95% CI = 1.02-1.60). Greater job strain was associated with greater risk of VaD only (OR = 1.28, 95% CI = 1.02-1.60), especially in combination with low social support (OR = 1.35, 95% CI = 1.11-1.64). Age, sex, and education were controlled for. Work complexity, manual work, and vascular disease did not explain the results. No differences in work-related stress scores were observed in the 54 twin pairs discordant for dementia, although only two pairs included a twin with VaD. CONCLUSION: Work-related stress, including low job control and low social support at work, may increase the risk of dementia, particularly VaD. Modification to work environment, including attention to social context and provision of meaningful roles for employees, may contribute to efforts to promote cognitive health.

  • 253. Andel, Ross
    et al.
    Silverstein, Merril
    Kåreholt, Ingemar
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    Occupational and Leisure Time Engagement at Midlife and Cognitive Functioning in Advanced Old Age2012In: The 21st Nordic Congress of Gerontology, Dilemmas in Ageing Societies, Abstracts and Program, Copenhagen, Denmark, June 10th - 13th, 2012, 2012Conference paper (Refereed)
  • 254.
    Anderberg, Natasha
    Örebro University, School of Health and Medical Sciences.
    Ungdomars erfarenheter av vattenpipsrökning: En kvalitativ intervjustudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 255.
    Anderbro, Therese
    et al.
    Stockholm Univ, Dept Psychol, S-10691 Stockholm, Sweden.
    Gonder-Frederick, Linda
    Univ Virginia, Dept Psychiat & Neurobehav Sci, Charlottesville, VA USA.
    Bolinder, Jan
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Huddinge, Sweden.
    Lins, Per-Eric
    Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Div Med, Stockholm, Sweden.
    Wredling, Regina
    Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Div Med, Stockholm, Sweden.
    Moberg, Erik
    Karolinska Inst, Karolinska Univ Hosp, Dept Med, Huddinge, Sweden.
    Lisspers, Jan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology. Sophiahemmet Univ Coll, Stockholm, Sweden.
    Johansson, Unn-Britt
    Sophiahemmet Univ Coll, Stockholm, Sweden.
    Fear of hypoglycemia: relationship to hypoglycemic risk and psychological factors2015In: Acta Diabetologica, ISSN 0940-5429, E-ISSN 1432-5233, Vol. 52, no 3, p. 581-589Article in journal (Refereed)
    Abstract [en]

    The major aims of this study were to examine (1) the association between fear of hypoglycemia (FOH) in adults with type 1 diabetes with demographic, psychological (anxiety and depression), and disease-specific clinical factors (hypoglycemia history and unawareness, A(1c)), including severe hypoglycemia (SH), and (2) differences in patient subgroups categorized by level of FOH and risk of SH. Questionnaires were mailed to 764 patients with type 1 diabetes including the Swedish translation of the Hypoglycemia Fear Survey (HFS) and other psychological measures including the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Anxiety Sensitivity Index, Social Phobia Scale, and Fear of Complications Scale. A questionnaire to assess hypoglycemia history was also included and A(1c) measures were obtained from medical records. Statistical analyses included univariate approaches, multiple stepwise linear regressions, Chi-square t tests, and ANOVAs. Regressions showed that several clinical factors (SH history, frequency of nocturnal hypoglycemia, self-monitoring) were significantly associated with FOH but R (2) increased from 16.25 to 39.2 % when anxiety measures were added to the model. When patients were categorized by level of FOH (low, high) and SH risk (low, high), subgroups showed significant differences in non-diabetes-related anxiety, hypoglycemia history, self-monitoring, and glycemic control. There is a strong link between FOH and non-diabetes-related anxiety, as well as hypoglycemia history. Comparison of patient subgroups categorized according to level of FOH and SH risk demonstrated the complexity of FOH and identified important differences in psychological and clinical variables, which have implications for clinical interventions.

  • 256.
    Andersen, C. D.
    et al.
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Bennet, L.
    Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
    Nyström, Lennarth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lindblad, U.
    Department of Primary Health Care, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Lindholm, E.
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Groop, L.
    Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Worse glycaemic control in LADA patients than in those with type 2 diabetes, despite a longer time on insulin therapy2013In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 56, no 2, p. 252-258Article in journal (Refereed)
    Abstract [en]

    Our aim was to study whether glycaemic control differs between individuals with latent autoimmune diabetes in adults (LADA) and patients with type 2 diabetes, and whether it is influenced by time on insulin therapy. We performed a retrospective study of 372 patients with LADA (205 men and 167 women; median age 54 years, range 35-80 years) from Swedish cohorts from SkAyenne (n = 272) and Vasterbotten (n = 100). Age- and sex-matched patients with type 2 diabetes were included as controls. Data on the use of oral hypoglycaemic agents (OHAs), insulin and insulin-OHA combination therapy was retrieved from the medical records. Poor glycaemic control was defined as HbA(1c) a parts per thousand yen7.0% (a parts per thousand yen53 mmol/mol) at follow-up. The individuals with LADA and with type 2 diabetes were followed for an average of 107 months. LADA patients were leaner than type 2 diabetes patients at diagnosis (BMI 27.7 vs 31.0 kg/m(2); p < 0.001) and follow-up (BMI 27.9 vs 30.2 kg/m(2); p < 0.001). Patients with LADA had been treated with insulin for longer than those with type 2 diabetes (53.3 vs 28.8 months; p < 0.001). There was no significant difference between the patient groups with regard to poor glycaemic control at diagnosis, but more patients with LADA (67.8%) than type 2 diabetes patients (53.0%; p < 0.001) had poor glycaemic control at follow-up. Patients with LADA had worse glycaemic control at follow-up compared with participants with type 2 diabetes (OR = 1.8, 95% CI 1.2, 2.7), adjusted for age at diagnosis, HbA(1c), BMI at diagnosis, follow-up time and duration of insulin treatment. Individuals with LADA have worse glycaemic control than patients with type 2 diabetes despite a longer time on insulin therapy.

  • 257. Andersen, Pia
    et al.
    Olander, Ewy
    Blekinge Institute of Technology, School of Health Science.
    Utvärdering av implementeringen av hälsotorgen i Blekinge -med fokus på hälsotorgens utvecklingsmöjligheter2008Other (Other academic)
    Abstract [en]

    I den svenska folkhälsopolitiken betonas hälso- och sjukvårdens roll i folkhälsoarbetet genom ett eget målområde, ”En hälsofrämjande hälso- och sjukvård” År 2000 påbörjade Landstinget i Blekinge ett samarbete med Apoteket AB för utveckling av Hälsotorg som en ny typ av offentlig arena för hälsofrämjande och förebyggande arbete. Den är tänkt som en mötesplats för hälsoinformation, egenvårdsrådgivning och hälsosamtal med professionell personal från landsting och apotek. Syftet med denna utvärdering är att beskriva implementeringen av hälsotorgen i Blekinge och hälsotorgens utvecklingsmöjligheter. Enskilda intervjuer har genomförts med nyckelinformanter för att ta del av deras erfarenheter och upplevelser av hälsotorgsarbetet. Verksamhetschefer och hälsotorgspersonal intervjuades, sammanlagt tolv personer. Idag finns hälsotorg som har byggts upp i samverkan mellan Apoteket AB och Landstinget Blekinge i fyra av länets fem kommuner. Hälsotorgen har startat vid olika tidpunkter mellan år 2000 och 2006. De är något olika utformande, bemannade och lokaliserade. Resultatet visar en övervägande positiv bild av hälsotorgens verksamhet och det finns en framtidstro på fortsatt utveckling av hälsotorgen. Såväl ”uppifrån” stöd i form av direktiv och ekonomiska medel som ”underifrån” stöd genom lokalt engagemang och delaktighet har varit betydelsefulla faktorer i implementeringsprocessen. Det finns en ganska samstämmig uppfattning om hur de övergripande målen för hälsotorgen uppfyllts men målen är inte väl förankrade i verksamheten. Varje hälsotorg har utformat sin egen verksamhet utifrån befintligt avtal mellan Apoteket AB och Landstinget Blekinge samt utifrån hälsotorgspersonalens engagemang. Den mest framträdande svagheten är en otillräcklig marknadsföring, vilket har medfört att hälsotorgens verksamhet inte har blivit förankrad i önskvärd omfattning bland befolkningen och övrig personal på vårdcentralerna. Det råder en osäkerhet om hur det fortsatta samarbetet med Apoteket AB kan utvecklas med anledning av omregleringen av apoteksmarknaden 2009. Utvärderingen ger en positiv bild av hälsotorg både som fenomen och verksamhet. Informanterna anser att hälsotorgen har potential till att kunna vara en hälsofrämjande arena. För fortsatt utveckling till en sådan arena är det betydelsefullt med utbildningsinsatser som kan stärka hälsotorgspersonalens kompetens för hälsofrämjande arbete. Det är också betydelsefullt med informationsinsatser bland befolkning och hälso- och sjukvårdspersonal för att öka medvetenheten om hälsotorgens verksamhet och därmed skapa grund för samarbete och ett ökat utnyttjande av hälsotorgens service.

  • 258. Andersen, Ronald
    et al.
    Smedby, Björn
    Vågerö, Denny
    Cost containment, solidarity and cautious experimentation: Swedish dilemmas2001In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 52, p. 1195-1204Article in journal (Refereed)
    Abstract [en]

    This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.

  • 259. Andersen, Zorana J.
    et al.
    Stafoggia, Massimo
    Weinmayr, Gudrun
    Pedersen, Marie
    Galassi, Claudia
    Jørgensen, Jeanette T.
    Oudin, Anna
    Forsberg, Bertil
    Olsson, David
    Oftedal, Bente
    Aasvang, Gunn Marit
    Aamodt, Geir
    Pyko, Andrei
    Pershagen, Göran
    Korek, Michal
    De Faire, Ulf
    Pedersen, Nancy L.
    Östenson, Claes-Göran
    Fratiglioni, Laura
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Eriksen, Kirsten T.
    Tjønneland, Anne
    Peeters, Petra H.
    Bueno-de-Mesquita, Bas
    Plusquin, Michelle
    Key, Timothy J.
    Jaensch, Andrea
    Nagel, Gabriele
    Lang, Alois
    Wang, Meng
    Tsai, Ming-Yi
    Fournier, Agnes
    Boutron-Ruault, Marie-Christine
    Baglietto, Laura
    Grioni, Sara
    Marcon, Alessandro
    Krogh, Vittorio
    Ricceri, Fulvio
    Sacerdote, Carlotta
    Migliore, Enrica
    Tamayo-Uria, Ibon
    Amiano, Pilar
    Dorronsoro, Miren
    Vermeulen, Roel
    Sokhi, Ranjeet
    Keuken, Menno
    de Hoogh, Kees
    Beelen, Rob
    Vineis, Paolo
    Cesaroni, Giulia
    Brunekreef, Bert
    Hoek, Gerard
    Raaschou-Nielsen, Ole
    Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project2017In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 125, no 10, article id UNSP 107005Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. OBJECTIVE: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. METHODS: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-usc regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Mattcr (TRANSPHORM) projects: particulate matter (PM) <= 2.5 mu m, <= 10 mu m, and 2.5-10 mu m in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. RESULTS: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 [hazard ratio (FIR) = 1.08 [95% confidence interval (Cl): 0.77, 1.51] per 5 mu g/m(3)}, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 mu g/m(3)], PMcoarse [1.20 (95% Cl: 0.96, 1.49 per 5 mu g/m(3)], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 mu g/m(3)], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 mu g/m(3), p = 0.04]. CONCLUSIONS: We-found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women.

  • 260. Anderson, Ian
    et al.
    Robson, Bridget
    Connolly, Michele
    Al-Yaman, Fadwa
    Bjertness, Espen
    King, Alexandra
    Tynan, Michael
    Madden, Richard
    Bang, Abhay
    Coimbra, Carlos E. A., Jr.
    Pesantes, Maria Amalia
    Amigo, Hugo
    Andronov, Sergei
    Armien, Blas
    Obando, Daniel Ayala
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Bhatti, Zaid Shakoor
    Bhutta, Zulfi Qar Ahmed
    Bjerregaard, Peter
    Bjertness, Marius B.
    Briceno-Leon, Roberto
    Broderstad, Ann Ragnhild
    Bustos, Patricia
    Chongsuvivatwong, Virasakdi
    Chu, Jiayou
    Deji, .
    Gouda, Jitendra
    Harikumar, Rachakulla
    Htay, Thein Thein
    Htet, Aung Soe
    Izugbara, Chimaraoke
    Kamaka, Martina
    King, Malcolm
    Kodavanti, Mallikharjuna Rao
    Lara, Macarena
    Laxmaiah, Avula
    Lema, Claudia
    Taborda, Ana Maria Leon
    Liabsuetrakul, Tippawan
    Lobanov, Andrey
    Melhus, Marita
    Meshram, Indrapal
    Miranda, J. Jaime
    Mu, Thet Thet
    Nagalla, Balkrishna
    Nimmathota, Arlappa
    Popov, Andrey Ivanovich
    Poveda, Ana Maria Penuela
    Ram, Faujdar
    Reich, Hannah
    Santos, Ricardo V.
    Sein, Aye Aye
    Shekhar, Chander
    Sherpa, Lhamo Y.
    Sköld, Peter
    Umeå University, Arctic Research Centre at Umeå University.
    Tano, Sofia
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Business Administration.
    Tanywe, Asahngwa
    Ugwu, Chidi
    Ugwu, Fabian
    Vapattanawong, Patama
    Wan, Xia
    Welch, James R.
    Yang, Gonghuan
    Yang, Zhaoqing
    Yap, Leslie
    Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration): a population study2016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10040, p. 131-157Article in journal (Refereed)
    Abstract [en]

    Background: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.

    Methods: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated.

    Findings: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations.

    Interpretation: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.

  • 261.
    Anderson, Peter
    et al.
    Newcastle University, England; Maastricht University, Netherlands.
    Kaner, Eileen
    Newcastle University, England.
    Keurhorst, Myrna
    Radboud University of Nijmegen, Netherlands; Saxion University of Appl Science, Netherlands.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    van Steenkiste, Ben
    Maastricht University, Netherlands.
    Reynolds, Jillian
    IDIBAPS, Spain.
    Segura, Lidia
    Govt Catalonia, Spain.
    Wojnar, Marcin
    Medical University of Warsaw, Poland.
    Kloda, Karolina
    Pomeranian Medical University, Poland.
    Parkinson, Kathryn
    Newcastle University, England.
    Drummond, Colin
    Kings Coll London, England; Maudsley NHS Fdn Trust, England.
    Okulicz-Kozaryn, Katarzyna
    State Agency Prevent Alcohol Related Problems, Poland.
    Mierzecki, Artur
    Pomeranian Medical University, Poland.
    Laurant, Miranda
    Radboud University of Nijmegen, Netherlands; HAN University of Appl Science, Netherlands.
    Newbury-Birch, Dorothy
    University of Teesside, England.
    Gual, Antoni
    IDIBAPS, Spain.
    Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 2, article id 121Article in journal (Refereed)
    Abstract [en]

    In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.

  • 262.
    Andersson, Anders-Petter
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Platform for Collaboration for Health.
    Cappelen, Birgitta
    The Oslo School of Architecture and Design.
    Musical interaction for health improvement2014In: Oxford handbook of interactive audio / [ed] Karen Collins, Bill Kapralos, Holly Tessler, Oxford: Oxford University Press , 2014, p. 247-262Chapter in book (Refereed)
    Abstract [en]

    During the past decade, tangible sensor technologies have matured and become less expensive and easier to use, leading to an explosion of innovative musical designs within video games, smartphone applications, and interactive art installations. Interactive audio has become an important design quality in commercially successful games like Guitar Hero , and a range of mobile phone applications motivating people to interact, play, dance, and collaborate with music. Parallel to the game, phone, and art scenes, an area of music and health research has grown, showing the positive results of using music to promote health and wellbeing in everyday situations and for a broad range of people, from children and elderly to people with psychological and physiological disabilities. Both quantitative medical and ecological humanistic research show that interaction with music can improve health, through music’s ability to evoke feelings, motivate people to interact, master, and cope with difficult situations, create social relations and experience shared meaning. Only recently, however, the music and health field has started to take interest in interactive audio, based on computer-mediated technologies’ potential for health improvement. Here, we show the potential of using interactive audio in what we call interactive musicking in the computer-based interactive environment Wave. Interactive musicking is based on musicologist Christopher Small’s concept “musicking”, meaning any form of relation-building that occurs between people, and people and things, related to activities that include music. For instance, musicking includes dancing, listening, and playing with music (in professional contexts and in amateur, everyday contexts). We have adapted the concept of "musicking" on the design of computer-based musical devices. The context for this chapter is the research project RHYME. RHYME is a multidisciplinary collaboration between the Centre for Music and Health at the Norwegian Academy of Music, the Oslo School of Architecture and Design (AHO), and Informatics at the University of Oslo. Our target group is families with children with severe disabilities. Our goal is to improve health and wellbeing in the families through everyday musicking activities in interactive environments. Our research approach is to use knowledge from music and health research, musical composition and improvisation, musical action research, musicology, music sociology, and soundscape studies, when designing the tangible interactive environments. Our focus here is interaction design and composition strategies, following research-by-design methodology, creating interactive musicking environments. We describe the research and design of the interactive musicking environment Wave, based on video documentation, during a sequence of actions. Our findings suggest some interactive audio design strategies to improve health. We base the design strategies on musical actions performed while playing an instrument, such as impulsive or iterative hitting, or sustainable stroking of an instrument. Musical actions like these can also be used for musicking in everyday contexts, creating direct sound responses to evoke feelings that create expectations and confirm interactions. In opposition to a more control-oriented, instrument and interface perspective, we argue that musical variation and narrative models can be used to design interactive audio, where the audio is seen as an actor taking many different roles, as instrument, co-musician, toy, etc. In this way, the audio and the interactive musicking environments will change over time, answering with direct response, as well as nose-thumbing and changing response, motivating creation, play, and social interaction. Musical variation can also be used to design musical backgrounds and soundscapes that can be used for creating layers of ambience. These models create a safe environment and contribute to shared meaning.

  • 263.
    Andersson, Anders-Petter
    et al.
    Institute of Design, The Oslo School of Architecture and Design.
    Cappelen, Birgitta
    Institute of Design, The Oslo School of Architecture and Design.
    Vocal and tangible interaction crossing borders2013In: Include Asia 2013 Proceedings: global challenges and local solutions in inclusive design, Conference on inclusive design / [ed] Jeremy Myerson, London: Helen Hamlyn Centre of Design, The Royal College of Art in London, The Hong Kong Design Centre , 2013Conference paper (Refereed)
    Abstract [en]

    Our voice and body are important parts of our self-expression and self-experience for all of us. They are also essential for our way to communicate and build relations cross borders such as abilities, ages, locations and backgrounds. Voice, body and tangibility gradually become more important for ICT, due to increased development of tangible interaction and mobile communication. The voice and tangible interaction therefore also become more important for the Universal Design field. In this paper we present and discuss our work with voice and tangible interaction in our ongoing research project RHYME. The goal is to improve health for families, adults and children with disabilities through use of collaborative, musical, tangible and sensorial media. We build on use of voice in Music Therapy, knowledge from multi-sensory stimulation and on a humanistic health approach. Our challenge is to design vocal and tangible interactive media that are sensorially stimulating. Interactive media that through use reduce isolation and passivity and increase empowerment for all the users. We use sound recognition, generative sound synthesis, vibrations and cross-media techniques, to create rhythms, melodies and harmonic chords to stimulate voice-body connections, positive emotions and structures for actions.

  • 264.
    Andersson, Anna Karin
    et al.
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Martin, Lene
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Strand Brodd, Katarina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Almqvist, Lena
    Malardalen Univ, Sch Hlth Care & Welf, Box 883, SE-72123 Vasteras, Sweden..
    Patterns of everyday functioning in preschool children born preterm and at term2017In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 67, p. 82-93Article in journal (Refereed)
    Abstract [en]

    Background/Aim: Children born preterm are at risk of neonatal complications but the long-term consequences for everyday functioning is not well known. The study aimed to identify patterns of everyday functioning in preschool children born preterm and at term in relation to perinatal data, neonatal risk factors, behaviour, and socioeconomic status. Registry data and data from parent rated questionnaires were collected for 331 children.

    Method: A person-oriented approach with a cluster analysis was used.

    Results: A seven cluster solution explained 65.91% of the variance. Most children (n = 232) showed patterns of strong everyday functioning. A minority of the children (n = 99), showed diverse patterns of weak everyday functioning. Perinatal characteristics, neonatal risk factors and socio-economics did not predict cluster group membership. Children born preterm were represented in all clusters.

    Conclusion, implications: Most preschool children are perceived by their parents with strong everyday functioning despite being born preterm. However small groups of children are, for various reasons, perceived with weak functioning, but preterm birth is not the sole contributor to patterns of weak everyday functioning. More critical for all children's everyday functioning is probably the interaction between individual factors, behavioural factors and contextual factors. To gain a broader understanding of children's everyday functioning. Child Health Services need to systematically consider aspects of body function, activity and in addition participation and environmental aspects.

  • 265.
    Andersson, Björn
    Karlstad University, Faculty of Social and Life Sciences.
    Risklinjen: - Empowerment, men med olika perspektiv2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Injuries caused by accidents are one of the major health problems in Sweden. Risklinjen is a model to increase people’s awareness and possibilities to report risk for injuries. In spite of this several municipalities choose to leave Risklinjen. This thesis tries to find out how municipalities argue about Risklinjen and membership in this function.

  • 266.
    Andersson, Björn
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Avdelningen för hälsa och miljö.
    Dahl, Gunnar
    Karlstads kommun.
    Mårtensson, Ulf
    Karlstads kommun.
    Andersson, Ragnar
    Karlstad University, Faculty of Social and Life Sciences, Avdelningen för hälsa och miljö.
    Skolbränder och skolbrandsprevention: Underlag för planerade insatser enligt ”Karlstadsmodellen”2009Report (Other academic)
    Abstract [sv]

    Kan man förebygga anlagda bränder och annan skadegörelse i skolor med miljöinriktade åtgärder? Den bedömningen gör man i Karlstads kommun med stöd i kriminologisk teori och erfarenheter från andra sektorer. Den traditionella ansatsen är annars är att kombinera brandtekniska åtgärder med ett mer individorienterat perspektiv riktat mot gärningspersoner. Syftet med föreliggande rapport är att ge en djupare belysning av den teoretiska grundvalen för en bredare miljöinriktad strategi, samt att peka på möjligheter att följa och utvärdera effekter av en lokal tillämpning. I bilaga redovisas även en forskningsöversikt kring den vetenskapliga evidens som idag föreligger beträffande miljöinriktad brottsprevention.

  • 267.
    Andersson, Carolina
    et al.
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Johansson, Jennifer
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Visionen om ledarskapet: Hur förverkligas ledarskapsvisionen i den vardagliga verksamheten?2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose with our qualitative study is to investigate the vision of leadership but how does one perfect visionary leadership in an everyday activity? To help us find out the purpose of this we have conducted semi structured interviews involving leadership in occupations. These interviews have provided phenomenal inspiration since our main focus is the experiences of leadership. In our analysis we have used the method of phenomenal analysis and as well as the process of the data. Our empiricist consists of ten interviews, eight of which are conducted with co-workers and two of which are conducted with team leaders.

    Our result shows that the activity doesn't have an outspoken vision between co-workers and leaders. However both the leaders have a vision about their leadership which doesn't appear literally. Our study shows that if a leaders visions appears in practice, it therefore doesn't have to be official since it is already clearly expressed. We find that through our case study that occupation can evolve their leadership as well as their employeeship with the help of our results

  • 268.
    Andersson, Christina
    et al.
    University of Skövde, School of Health and Education.
    Lindberg, Cecilia
    University of Skövde, School of Health and Education.
    Hälsorisker hos flickor vilka använde sociala medier: en litteraturöversikt2016Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    Introduction: Social media has created a new arena for integration. Social media seems to affect young girls mental health. The purpose of the literature review is to examine some health risks among girls aged 11 to 17 years born after 1993 witch has been exposed to through social media. Method: Ten original articles published in the past five years have been sought out through PubMed. Relevant articles were reviewed and thematized based on health risks which are found in the overview. Results: The literature review examined previous research on health risks in young girls born after 1993 in the use of social media. Girls tend to be more affected by the comments and are affected over time which can lead to depression and anxiety. Self-harm and suicidal tendencies are directly linked to depression. Self-confidence is affected by comments on social media. Girls tend increasingly to suffer from psychosomatic disorders due to use of social media. Social media can increase the feeling of fear and insecurity. The girls' body image is influenced by social media, which ultimately can lead to eating disorders. Discussion: The use of social media can be seen as a health risk in young girls. Nevertheless, the impact of social media is seen as on of the triggers for other underlying causes. Social media can also provide health benefits.

  • 269.
    Andersson, David
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Magnusson, Henrik
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Borgquist, Lars
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Co-morbidity and health care utilisation five years prior to diagnosis for depression: A register-based study in a Swedish population2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 552-Article in journal (Refereed)
    Abstract [en]

    Background

    Depressive disorders have been associated with a number of co-morbidities, and we   hypothesized that patients with a depression diagnosis would be heavy users of health   care services, not only when first evaluated for depression, but also for preceding   years. The aim of this study was to investigate whether increased health care utilisation   and co-morbidity could be seen during five years prior to an initial diagnosis of   depression.

    Methods

    We used a longitudinal register-based study design. The setting comprised the general   population in the county of Östergötland, south-east Sweden. All 2470 patients who   were 20 years or older in 2006 and who received a new diagnosis of depression (F32   according to ICD-10) in 2006, were selected and followed back to the year 2001, five   years before their depression diagnosis. A control group was randomly selected among   those who were aged 20 years or over in 2006 and who had received no depression diagnosis   during the period 2001-2006.

    Results

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status.

    Patients who received a diagnosis of depression used twice the amount of health care   (e.g. physician visits and hospital days) during the five year period prior to diagnosis   compared to the control group. A particularly strong increase in health care utilisation   was seen the last year before diagnosis. These findings were supported with a high   level of co-morbidity as for example musculoskeletal disorders during the whole five-year   period for patients with a depression diagnosis.

    Conclusions

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status. To find early signs   of depression in the clinical setting and to use a preventive strategy to handle these   patients is important.

  • 270.
    Andersson, Elin
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ström, Josefin
    Örebro University, School of Health and Medical Sciences.
    Psykosocial arbetsmiljö samt självupplevd hälsa hos anställda inom idéella fotbolls- och gymnastikföreningar: En kvantitativ tvärsnittsstudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 271.
    Andersson, Elina
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Fredriksson, Jessica
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Kunskap och inställning till munvård och oral hälsa hos en grupp omsorgspersonal på äldreboende2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 272.
    Andersson, Elisabeth
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Jämställt föräldraskap: En kvalitativ litteraturstudie av aktuell forskning i Norden2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 273.
    Andersson, Ellinor
    University of Gävle, Faculty of Health and Occupational Studies.
    Har ett idrottsmedlemskap som barn någon betydelse för den fysiska aktiviteten som vuxen?2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to examine whether students' memberships in sports clubs has affected their attitudes towards physical activity and physical activity level. It was a qualitative descriptive survey based on individual interviews. Results showed that there was a pattern between the former sports membership and current patterns of physical activity.  For instance, those who liked playing football at a young age, continue to adopt the same type of exercise today. This pattern applies to other types of physical activity, with or without club membership. In addition, many respondents thought that a club membership at a young age could have an impact on their physical activity as adults. This was mainly due to the positive feeling that sportsmen perception, that physical activity was something good and fun. Social cohesion in sport was the one thing that many of those interviewed believed was a major reason why sports, was perceived as positive.

  • 274.
    Andersson, Emelie
    et al.
    Kristianstad University, School of Health and Society.
    Lindström, Emelie
    Kristianstad University, School of Health and Society.
    Ambassadörer inom tobaksprevention: en kvalitativ studie om peer education2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: In the project known as TBU, tobacco free adolescents in Blekinge, ambassadors in the ages 16-19 have been used for spreading information about tobacco to adolescents in the ages 13-15. This approach is related to the method peer education. The use of peers who are close in age or have similar experiences represents another way of learning than the more common situation between a teacher and a student. Objective: The objective of this study was to examine how ambassadors use peer education as tobacco prevention and how the ambassadors could be affected by their work as peer educators. Method: The methods used in this study were interviews with the ambassadors and a focus group interview with the project group of TBU. The material was analysed with a content analysis. Results: The results show that the ambassadors had, or had developed, an interest for their work and an ability to communicate with their target group, which they also stated as important parts of the role as an ambassador. The ambassadors had also been affected by their work. Their communication skills had been improved and they had had an increase in knowledge, which was thought to be a result of their education containing different parts and perspectives. Conclusion: The most important in the work of the ambassadors to prevent the use of tobacco in adolescents was the education the ambassadors had the first week of their work period. Therefore, we suggest that TBU develops a concrete material for the education with well- defined methods and targets which would aim to develop the ambassadors interest for the subject and their communication skills. Further studies could examine the relationship between students and ambassadors from the student's perspective.

  • 275.
    Andersson, Erica
    Halmstad University, School of Social and Health Sciences (HOS).
    Ungdomars upplevelser av skolidrott som motivation till fysisk aktivitet2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Obesity is currently a major problem in children and adolescents, especially because of physical inactivity and poorer eating habits. The school is an important element in the promotion of child and adolescent habits of physical activity. School sports are also important for children and adolescent´s habits of physical activity in a lifelong perspective. The aim of the study was to highlight adolescent´s experience of school sports as motivation for physical activity. Qualitative interviews were used as data collection methods, followed by content analysis method of analysis. The sample in the study was a strategic choice, a total of nine students from grades three to two high schools in southwestern Sweden participated. The analysis of the data collection resulted in three main categories with four subcategories. The first main category was Knowledge as motivation, with subcategories Knowledge of Physical Activity and Knowledge of the health conept. The second main category was Participation and acknowledgment, with the subcategories To get positive feedback/respond and To be involved in decison-making. The last main category was Lack of personal interest. Overall theme of the results was Teachers create opportunities for physical activity. This is because the overall result of the study was that the teachers had a crucial role in the informants' experiences of physical education as a motivational and inspirational to physical activity. Continued research in this area may advantageously be to also find out the PE teachers' attitudes towards creating conditions for motivation to physical activity among students who are not interested in the topic in their teaching.

  • 276.
    Andersson, Erica
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Andersson, Sandra
    Halmstad University, School of Social and Health Sciences (HOS).
    Sociala och mediala orsaker påverkar utvecklingen av Anorexia Nervosa bland unga kvinnor: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Mental illness among young woman is a public health problem. Anorexia nervosa is categorized as a mental illness. Young woman affected by Anorexia nervosa, wich for example may be due to earlier life events that gave rise to mental imbalance in their everyday lives. OBJECTIVE: The aim of this study was to describe the socio-cultural reasons that contribute to the development of Anorexia nervosa among girls and young women 12-25 years. METHOD: The study is a literature review, based on 21 differens aricles. The method has been to look up earlier research in the area through various databases on the internet. Databases that have been used is pubmed and psycinfo. The articles were divided into different themes, with main category and subcategory. RESULTS: The results of the study was divided into two main categories each with two subcategories. Social causes for the occurrence of Anorexia nervosa: School and youth culture and the second was lack of family relationship. Media reasons in the emergence of Anorexia nervosa: Media image of the feminine ideal and negative inspiration on the internet. Socio-cultural reasons, medial reasons, family reasons, and cultural reasons. IMPLICATION: For example, one can study the various reason in a more specific level, and studying each factors separately. The study can also be used as a form of inspiration that reinforces the importance of health promotion activities for mental illness is the focus.

  • 277.
    Andersson, Eva A.
    et al.
    Department of Neuroscience, Karolinska Institutet.
    Defaire, Gi
    Swedish School of Sport and Health Sciences, GIH.
    Hultgren, Staffan
    Swedish School of Sport and Health Sciences, GIH.
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH.
    Oddsson, Kristjan
    Swedish School of Sport and Health Sciences, GIH.
    Olin, Hedvig
    Swedish School of Sport and Health Sciences, GIH.
    Strand, Leif
    Swedish School of Sport and Health Sciences, GIH.
    Wahlgren, Lina
    Swedish School of Sport and Health Sciences, GIH.
    Wedman, Ingemar
    Swedish School of Sport and Health Sciences, GIH.
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH.
    Physical activity for persons with obesity—a health project reported2008In: Forum on Public Policy Online, ISSN 1938-9809, Vol. 4, no SpringArticle in journal (Refereed)
    Abstract [en]

    In public health contexts, increased physical activity habits and fitness (aerobic and strength capacities) are positively related for promoting health and preventing  and treating common diseases/problems, including obesity and overweight. A strongly graded inverse association between physical activity and obesity has been shown both for adults and children. However, a lower mortality risk has been shown for those with greater weight but good aerobic capacity than for those of recommended weight but less fit. On the basis of a health project with physical activity for persons with or without obesity, the paper discusses evidence-based methods for promoting physical activity. General guidelines for the amount of physical activity for persons are described, as are the numerous physiological and medical advantages of physical activity. The economic benefits are also illustrated. The paper exemplifies methods of measuring physical activity habits and physical fitness. These two factors must be observed when showing improvements in public-health contexts, including groups with obesity.

     

  • 278.
    Andersson, Eva
    et al.
    Sahlgrenska University Hospital.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hagberg, S.
    Sahlgrenska University Hospital.
    Nilsson, T.
    Sundsvall Hospital.
    Karlsson, B.
    Umeå University.
    Alfredsson, L.
    Karolinska Institute.
    Torén, K.
    Sahlgrenska University Hospital.
    Incidence of asthma among workers exposed to sulfur dioxide and other irritant gases2006In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 27, no 4, p. 720-725Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO2) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire. The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age. The incidence rate for asthma among sulphite mill workers reporting gassings of SO2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO2, the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males. In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.

  • 279. Andersson, Eva
    et al.
    Murgia, Nicola
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sundsvall, Sweden.
    Karlsson, Berndt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Torén, Kjell
    Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases2013In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 12, article id 113Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis.

    METHODS: The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970-2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated.

    RESULTS: The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22).

    CONCLUSIONS: Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment.

  • 280.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    och medarbetare, se rapport,
    Hälsoprojekt med fysisk aktivitet på Gymnastik- och idrottshögskolan, GIH - Läsåret 2005/20062007Report (Other academic)
    Abstract [sv]

    SYFTE SAMT KORT BESKRIVNING AV HÄLSOPROJEKTET. Syftet med undersökningen var att i samarbete med hälso- och sjukvården och andra intressenter genomföra ett kostnadsfritt hälsoprojekt med fr.a. ledarledd fysisk aktivitet speciellt för personer med olika folksjukdomar men även friska i varierande åldrar. Sammanlagt 228 personer deltog för första gången i hela hälsoprojektet under en termin, dels hösten 2005 (114 deltagare) och dels våren 2006 (114 andra nya deltagare) med för- och eftertester. Initialt och i slutet av respektive termin utfördes varierande fysiologiska tester rörande kondition, styrka, rörlighet och balans samt GIH:s hälsoenkät om upplevd hälsa och olika levnadsvanor såsom fysisk aktivitet, kost, alkohol, rökning, sömn och tid för rekreation.

    METODER. Deltagarna anmälde sig själva eller via hälso- och/eller sjukvårdspersonal på Stockholms vårdcentraler, psykiatriska mottagningar eller friskvårdsföretag. Utöver de sammanlagt 228 som medverkade i hela projektet var det fler som deltog i endast det initiala testerna och var närvarande till viss del under respektive termin. Således föll vissa deltagare bort under projektperioderna av olika anledningar. I denna rapport sammanställs data endast för dem som fullföljde projektet med deltagande vid såväl för- som eftertester (n=228, varav 46 män och 182 kvinnor). Bland dessa 228 deltagare (medelålder 57 år, 22-88 år) sågs vid det initiala testet att det endast var 5% som var fysiskt aktiva 30 minuter/dag samt att minst 2/3 var överviktiga och 1/3 obesa. Projekten utgjordes primärt av, 2 ggr/vecka, ledarledd fysisk aktivitet såsom stavgång, motionsgymnastik, vattengymnastik, styrketräning i gym samt i motionshall med den egna kroppen som belastning. Många andra typer av fysisk aktivitet/verksamheter utfördes även såsom afrikansk dans, yoga, massage, qigong, klättring, spinning, boxer size etc. I samband med den initiala hälsoenkätundersökningen och utförandet av de fysiologiska testerna genomfördes ett hälsosamtal. Hälsoprojekten utfördes inom undervisningen i regi av GIH-studenter under handledning av lärare/läkare på GIH samt externt.

    RESULTAT. GIH:s HÄLSOENKÄT. Signifikant förbättring sågs för gruppen som helhet (n: 228) vid sluttestet jämfört med initialt under projektperioden för följande enkätparametrar: kroppslig hälsa; själslig hälsa; samtliga upplevelsefrågor kring såväl arbetsliv som fritid; sömn; tid för reflektion; tid för avkoppling; samt socialt nätverk. Särskilt hög signifikans sågs för majoriteten av frågorna kring fysiska aktivitetsvanor. Den enda frågan om fysisk aktivitetsvanor som inte förändrades signifikant för gruppen som helhet var frågan kring kroppslig ansträngningsgrad i det dagliga arbetet. Däremot sågs det dagliga stillasittandet minska signifikant. Spridda signifikanta förbättringar gällande kost noterades. Dessa var val av fettsnåla produkter; grönsaksintag; konsumtion av chips och jordnötter; samt kaffebröd. Ingen signifikant förändring sågs för frågor kring övriga kulturella vanor, regelbundenhet i måltider eller för frukt- och fiberintag. Konsumtion av choklad/godis, glass, läsk/saft samt kaffe, te, alkohol och tobak förändrades inte heller signifikant.

    FYSIOLOGISKA TESTER. Val av olika fysiologiska tester var upp till GIH-studenterna som projektledare att själva välja ut. Därmed är här antalet testade lägre jämfört med dem som fyllde i hälsoenkäten, vilken generellt alla deltagare genomförde. Signifikant förbättring mellan efter- och förtest sågs för konditions och gångtesterna Åstrands cykelergometertest (l/min, 9%, n:74), gångtest (9%, n:89) samt steptest (14%, n:7), men inte för Åstrands test uttryckt i ml/kg x min (7%, n:65). Vid statisk ryggmuskeltest med bålen i horisontalläge utanför en bänk med fixerade ben sågs en signifikant förbättring med 62% för de 53 deltagare som utförde detta test. Av de olika buk- inklusive höftböjarmuskeltesterna, utförda som höftböjningssit-up med böjda ben och stöd, sågs en signifikant förbättring för alla dynamiska och statiska testerna sammantagna (68%, n:64) samt vid bentestet stående med höft- och knäleder i 90 graders vinkel stödjandes bålen mot en vägg (40%, n: 40). Bland styrketester för skuldra-, arm- och handmuskulatur sågs en signifikant förbättring i axelpress, dvs växelvisa sträckningar med en 2- eller 4kg´s hantel från axelhöjd till raka armar upp mot taket maximalt antal gånger, (55%, n:9); vid push-ups, då antalet armhävningar antingen utförda med knäna eller fötterna i golvet räknades, (136%, n:17); samt i gripstyrka höger hand (17%, n:113). En liten förbättring, dock signifikant (knappt 1%), sågs både för uppmätt vikt (n: 169) samt för BMI (n:154) beräknat på denna vikt mellan det initiala och slutliga hälsotestet. Detsamma gällde midje- (2%) och höftmått (1%) samt midje-/höftkvot (knappt 1%) med en signifikant förbättring för män och kvinnor sammantagna (n: minst 34). Ingen signifikant skillnad i uppmätt vilopuls noterades. En signifikant förbättring sågs för rörlighetstesterna stående bålflexion (24%, n:20) och majoriteten av sidböjningstester av bålen (6-12%, n: upp till 37). För det speciellt utformade skulderrörlighetstestet framkom inga klara generella förändringar. Balanstestet stående på ett ben där man registrerade antal nedtramp på en minut visade ingen signifikant förändring mellan för- och eftertest vare sig på höger (n:24) eller vänster ben (n=23).

    SLUTKOMMENTAR. För ledare, hälso- och sjukvårdspersonal samt utövare inom varierande hälso-, idrotts-, arbets- eller rehabiliteringssammanhang kan det vara av vikt att få kunskaper om vilka typer av fysiologiska tester och hälsoenkätfrågor som kan påverkas av hälsoprojekt med ledarledd fysisk aktivitet och andra hälsofrämjande åtgärder. Av speciell vikt är att se om projekt som dessa kan resultera i ökade fysisk aktivitetsvanor och ökad fysisk kapacitet som båda är faktorer positivt korrelerade till en mängd folksjukdomar. I så fall stärks det faktum att liknande hälsofrämjande åtgärder med ledarledd fysisk aktivitet kan bidra till sjukdomsprevention och sjukdomsbehandling.

  • 281.
    Andersson, Eva
    et al.
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Oddsson, Kristjan
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Wahlgren, Lina
    Gymnastik- och idrottshögskolan, GIH, FoU-gruppen för rörelse, hälsa och miljö.
    Kjellman, Bengt
    Jonsson, Bo
    Taube, Jill
    Improved Physical Capacity in a Project with Guided Physical Activity for Persons with Depression or Anxiety.2010Conference paper (Refereed)
    Abstract [en]

    Background: Higher physical capacity is correlated with increased health. Knowledge in this area regarding psychiatric diseases is sparse. 

    Purpose: The aim was to study aerobic and several strength capacities in a physical activity project for persons with depression or anxiety.

    Methods: Eighty-four persons (56 women and 28 men) with depression or anxiety were recruited from psychiatric out-patient clinics in Stockholm. Their mean age and BMI was 46 (21-80) years and 26 (17-41) kg/m2, respectively. 50% were sick-listed. 50% had BMI>25. Aerobic and strength tests were chosen by each subgroup´s project leaders. Directed physical activity was given, in groups 10-15, 1 hour twice/week during 8-12 weeks.

    Results: Significant changes (p<0.05, of all n=84) between pre- and post tests were seen in submaximal cycle test (11% enhanced values, n=56) and distance of 6 minutes walk test (16%, n=15) as well as in strength tests for the back for the back (i.e. time in static horizontal belly-back, 40%, n=44), abdominal and hip flexors (i.e. number of hip flexion sit-ups, 45%, n=38), leg (i.e. standing with 90O in hips and knees, 48%, n=56) and arm with shoulder muscles (i.e. number of raising weights alternately with the arms, 46%, n=32). Hand grip tests, BMI or blood pressure values did not change significantly.

    Conclusions: Directed 8-12 weeks physical activity programs can improve physical fitness in individuals with depression or anxiety.

  • 282.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Oddsson, Kristjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Nilsson, Johnny
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Laboratory of Applied Sports Science (LTIV).
    Ekblom, Örjan
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Björn Ekblom's research group.
    Wahlgren, Lina
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, The Research Unit for Movement, Health and Environment.
    Kjellman, Bengt
    Jonsson, Bo
    Taube, Jill
    Improved Physical Capacity in a Project with Guided Physical Activity for Persons with Depression or Anxiety.2010Conference paper (Refereed)
    Abstract [en]

    Background: Higher physical capacity is correlated with increased health. Knowledge in this area regarding psychiatric diseases is sparse. 

    Purpose: The aim was to study aerobic and several strength capacities in a physical activity project for persons with depression or anxiety.

    Methods: Eighty-four persons (56 women and 28 men) with depression or anxiety were recruited from psychiatric out-patient clinics in Stockholm. Their mean age and BMI was 46 (21-80) years and 26 (17-41) kg/m2, respectively. 50% were sick-listed. 50% had BMI>25. Aerobic and strength tests were chosen by each subgroup´s project leaders. Directed physical activity was given, in groups 10-15, 1 hour twice/week during 8-12 weeks.

    Results: Significant changes (p<0.05, of all n=84) between pre- and post tests were seen in submaximal cycle test (11% enhanced values, n=56) and distance of 6 minutes walk test (16%, n=15) as well as in strength tests for the back for the back (i.e. time in static horizontal belly-back, 40%, n=44), abdominal and hip flexors (i.e. number of hip flexion sit-ups, 45%, n=38), leg (i.e. standing with 90O in hips and knees, 48%, n=56) and arm with shoulder muscles (i.e. number of raising weights alternately with the arms, 46%, n=32). Hand grip tests, BMI or blood pressure values did not change significantly.

    Conclusions: Directed 8-12 weeks physical activity programs can improve physical fitness in individuals with depression or anxiety.

  • 283. Andersson, Eva
    et al.
    Persson, Bodil
    Bryngelsson, Ing-Liss
    Magnuson, Anders
    Torén, Kjell
    Wingren, Gun
    Westberg, Håkan
    Örebro University, School of Health and Medical Sciences.
    Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, p. 470-478Article in journal (Refereed)
    Abstract [en]

    Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.

    Methods The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.

    Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98–1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90–0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12–1.32) and SMR 1.11 (95% CI 1.02–1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07–1.54), paper production (SMR 1.26, 95% CI 1.06–1.49), and maintenance (SMR 1.16, 95% CI 1.02–1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.

    Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).

  • 284.
    Andersson, Eva
    et al.
    Sahlgrens Univ Hosp, SE-40530 Gothenburg, Sweden..
    Westberg, Håkan
    Örebro University Hospital.
    Bryngelsson, Ing-Liss
    Orebro Univ Hosp, Dept Occupat & Environm Med, Orebro, Sweden..
    Magnuson, Anders
    Orebro Univ Hosp, Clin Epidemiol & Biostat Unit, Orebro, Sweden..
    Persson, Bodil
    Linkoping Univ Hosp, Dept Occupat & Environm Med, S-58185 Linkoping, Sweden.;Univ Lund Hosp, Dept Occupat & Environm Med, S-22185 Lund, Sweden..
    Cancer incidence among Swedish pulp and paper mill workers: a cohort study of sulphate and sulphite mills2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 529-540Article in journal (Refereed)
    Abstract [en]

    Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers. The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with > 1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers' department and employment was obtained from the mills' personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference. Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37-17) and maintenance (SIR, 6.35; 95 % CI, 3.47-11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99-7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95-5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18-6.02). Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.

  • 285.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Borglin, Gunilla
    Willman, Ania
    Younger people’s experiences of life after having survived an acute myocardial infarction: An interview study2011Conference paper (Refereed)
  • 286.
    Andersson G, Ulrika
    et al.
    Örebro University, School of Health and Medical Sciences.
    Jern, Camilla
    Örebro University, School of Health and Medical Sciences.
    " Det är som att vi bara ska få känna oss delaktiga, men att det bara är på låtsas": En kvalitativ studie om ungdomars syn på sin delaktghet i samhället2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 287.
    Andersson, H. Ingemar
    Kristianstad University, School of Health and Society.
    Biomedicin: viktig grund men också hinder2009In: Andersson, Ingemar & Ejlertsson, Göran (red.). Folkhälsa som tvärvetenskap: möten mellan ämnen, Lund: Studentlitteratur , 2009, p. 63-85Chapter in book (Other academic)
  • 288.
    Andersson, H. Ingemar
    Department of Community Health Sciences, Lund University, Sweden.
    Chronic pain: epidemiological studies in a general population1998Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim was to study the epidemiology of chronic pain (> 3 months duration) and factors associated to pain prevalence, prognosis, health care and medication in a general population. A cross-sectional mailed survey to a random population sample (n = 1806) was followed by a clinical examination and a prospective study of three selected groups. Pain related diagnoses from primary health care was monitored and compared with pain prevalence. The most important findings were: - a high total prevalence of chronic pain, 55.2%, without gender difference but varying by age and socioeconomic level. About one fourth (12.8%) reported high pain intensity and functional impairments. Women experienced pain at more locations and with higher intensity. - in a multivariate analysis increasing age, female gender, low education, high work strain, depression and insomnia were associated with chronic pain. - widespread pain showed a worse 2- year prognosis compared with neck shoulder pain. - musculoskeletal location of pain dominated, myalgia and myofascial pain being the most common symptom descriptions. - co-morbidity with chronic pain was common. More hypertensives and an increased level of serum uric acid associated to widepread pain indicated possible metabolic connections to pain. - smoking (current and previous) was associated with low-back and widespread pain. - chronic pain had a substantial influence of primary health care-seeking and medication; high pain intensity being the most important predictor of care and medication. - pain related diagnoses in primary health care increased between 1987 and 1996. Chronic pain, mainly with musculoskeletal location, is a community health problem. A multi-factorial approach in prevention and treatment on the basis of present knowledge is necessary.

  • 289.
    Andersson, H. Ingemar
    Kristianstad University, School of Health and Society.
    Epidemiologi: att bestämma folkhälsans innehåll och orsaker2009In: Andersson, Ingemar & Ejlertsson Göran (red.). Folkhälsa som tvärvetenskap: möten mellan ämnen, Lund: Studentlitteratur , 2009, p. 157-180Chapter in book (Other academic)
  • 290.
    Andersson, H. Ingemar
    Kristianstad University, School of Health and Society.
    Increased mortality among individuals with chronic widespread pain relates to lifestyle factors: a prospective population-based study2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Purpose. Widespread chronic pain has been related to disability and loss of quality of life, but in a few epidemiological studies also to increased mortality. The aim of this study was to further investigate the relationship between chronic pain, lifestyle factors and all cause mortality. Methods. A random sample of an adult (age 25-74) Swedish population (n = 1609) responded to a comprehensive questionnaire on pain, other symptoms, lifestyle, work and socioeconomic factors in 1988. Mortality data for this cohort between 1988 and 2002 were analysed. Survival analysis (Kaplan-Meier) and Cox proportional regression were used to study initially reported factors influencing survival. Results. Individuals with widespread chronic pain showed an increased mortality risk (hazard ratio, HR = 1.95, CI: 1.26-3.03) compared to the group without chronic pain. Death due to cardiovascular disease accounted for the increased mortality. Adjustment for lifestyle factors eliminated the excess risk. Conclusions. Increased mortality among individuals with widespread chronic pain is related to factors like smoking, sleep disturbances and low physical activity. The result emphasises the importance of including lifestyle factors in a cognitive-behavioural rehabilitation process. It remains to be shown whether health promotion activities aimed at lifestyle could change mortality among individuals with chronic pain.

  • 291.
    Andersson, H. Ingemar
    Kristianstad University, Department of Health Sciences.
    The course of non-malignant chronic pain: a 12-year follow-up of a cohort from the general population2004In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 8, no 1, p. 47-53Article in journal (Refereed)
    Abstract [en]

    The high prevalence of chronic pain (duration >3 months) reported from different populations indicates a public health problem. Knowledge of the long-term course of chronic non-malignant pain is incomplete and scarce.This paper describes a follow-up of a cohort recruited from a survey in the general population. The cohort (n=214) consisted initially of individuals with widespread or located (neck-shoulder) pain or without chronic pain. The individuals were initially examined and replied to questionnaires on pain, social factors, lifestyle, medication and health care after two and 12 years. The deaths during the period were obtained from the population register. Complete data exist for 77% of the eligible individuals.After 12 years one-third of the individuals initially without pain reported chronic pain, and among those with initial chronic pain 85% still reported chronic pain. The number of painful areas was the strongest predictor of chronic pain 12 years later (OR 15.8; >3 locations vs. 0) whereas a social factor (having a close friend) decreased the risk (OR 0.44). The onset of chronic pain during the same period was related to the physical workload (work with bent positions; OR 5.31; yes vs. no). Mortality was significantly higher in the group initially reporting widespread pain compared with the other groups. The chronicity of widespread chronic pain supports early and intense intervention among individuals with located pain. The association between chronic widespread pain and increased mortality needs further investigation but may deepen the view of chronic pain as a public health problem.

  • 292.
    Andersson, H. Ingemar
    Department of Community Medicine, Lund University, Sweden.
    The epidemiology of chronic pain in a Swedish rural area.1994In: Quality of Life Research, 1994 3(Suppl. 1), 1994, Vol. 3 Suppl 1, p. S19-S26Conference paper (Refereed)
    Abstract [en]

    In order to establish basic epidemiological data on chronic pain (duration > 3 months) in a rural population, a survey of pain symptoms was conducted by means of a postal questionnaire. The questionnaire was sent to a random sample (from the population register) of 15% of the population aged 25-74 (n = 1806) in two Swedish primary health care districts. The response rate was 90%. In a follow-up study individuals selected among the responders (neck-shoulder pain, widespread pain and controls without pain; n = 213) were examined and interviewed. They were requestioned about pain symptoms 24 months after the initial survey. Without sex differences 55% of the population had perceived persistent pain for 3 months and 49% for 6 months. Women experienced more multiple localizations of pain and had pain in neck, shoulder, arm and thigh to a greater extent than men. Prevalence of pain increased by age up to 50-59 years for both genders and then slowly decreased. The neck-shoulder area was the most common site of pain (women 32.9%, men 27.5%). Blue-collar workers and employers (including farmers) reported chronic pain to a greater extent than other groups. In 13% of the population, manifest pain problems were associated with reduced functional capacity. Examination of selected pain groups indicated a high proportion of unspecific musculoskeletal symptoms. Diagnosis with definite definitions, explaining the pains, were found in 40% of the individuals. Individuals with widespread pain had a higher pain intensity, more somatic symptoms, were more depressive and had the lowest scores for quality of life.(ABSTRACT TRUNCATED AT 250 WORDS)

  • 293.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Folkhälsovetenskap: perspektiv och framtid2009In: Folkhälsa som tvärvetenskap: möten mellan ämnen / [ed] Andersson, Ingemar & Ejlertsson, Göran, Lund: Studentlitteratur , 2009, p. 367-375Chapter in book (Other academic)
  • 294.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Salutogenetic and pathogenetic factors of equal importance to predict mortality in a Swedish general population2008In: European Journal of Public Health, 18(Suppl. 1), 2008, Vol. 18, no Suppl. 1, p. 193-194Conference paper (Other academic)
    Abstract [en]

    Social support and physical exercise seem to be salutogenetic factors of importance for longterm survival to balance traditional risk factors such as smoking and defined diseases. The results support health promotion initiatives focused on salutogenetic factors and not only prevention in relation to traditional risk factors and diseases.

  • 295.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, Department of Health Sciences.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Sleep disturbances predict long-term mortality in men: a prospective Swedish study2007In: European Journal of Public Health, 17(Suppl. 2), 2007, Vol. 17, no Suppl. 2, p. 225-Conference paper (Other academic)
  • 296.
    Andersson, H. Ingemar
    et al.
    Department of Community Medicine, Lund University, Sweden.
    Ejlertsson, Göran
    Kristianstad College of Health Professions.
    Leden, Ido
    Department of Medicine, Rheumatology Section, Central Hospital, Kristianstad, Sweden.
    Widespread musculoskeletal chronic pain associated with smoking: an epidemiological study in a general rural population1998In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 30, no 3, p. 185-191Article in journal (Refereed)
    Abstract [en]

    Data on smoking and pain symptoms from a random sample (n = 1806) of a general population were used to evaluate the association between chronic pain at various locations and smoking. In both genders current smoking was associated with reports of increased pain in low back, neck and with multiple locations. In a multiple logistic regression analysis current smoking was associated with an increase in widespread chronic musculoskeletal pain (OR 1.60, CI 1.04-2.46, in relation to non-smokers) and chronic low back pain (OR 1.58, CI 1.13-2.20, in relation to non-smokers). A dose-response relationship was found between the daily cigarette consumption and the prevalence of chronic low back pain. Smoking is associated not only with low back pain but also with chronic widespread musculoskeletal pain. No conclusive decrease in pain prevalence was found after quitting smoking. Further studies are necessary to elucidate an aetiologic relationship between smoking and chronic pain.

  • 297.
    Andersson, H. Ingemar
    et al.
    Department of Community Health Medicine, Lund University, Sweden.
    Ejlertsson, Göran
    Kristianstad College for Health Professions.
    Leden, Ido
    Department of Medicine, Central Hospital, Kristianstad.
    Rosenberg, Claes
    Simrishamn Health Care Centre.
    Characteristics of subjects with chronic pain, in relation to local and widespread pain report: a prospective study of symptoms, clinical findings and blood tests in subgroups of a geographically defined population1996In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 25, no 3, p. 146-154Article in journal (Refereed)
    Abstract [en]

    The relation between reported chronic pain and clinical findings was studied by comparing survey data six months before and eighteen months after a clinical examination. Studied individuals (n = 165) were randomly selected from subsamples of an initial survey (n = 1806) to a general population. Among individuals reporting chronic pain 85% were assessed to have chronic pain at the examination. Diagnoses were found in 22% of examined pain individuals. Myofascial pain syndrome and myalgia were the most common findings. Compared with located neck-shoulder pain, widespread pain had a greater impact on the individual, a worse prognosis regarding pain duration and working capacity, and revealed a raised serum urate level of unclear significance. Although no specific cause of pain is found in individuals with widespread pain it is important to identify and treat this group due to the great effects on functional capacity and the worse prognosis.

  • 298.
    Andersson, H. Ingemar
    et al.
    Department of Community Medicine, Lund University, Sweden.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Leden, Ido
    Department of Medicine, Rheumatology section, Central Hospital, Kristianstad.
    Rosenberg, Claes
    Simrishamn Health Care Centre.
    Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization.1993In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 9, no 3, p. 174-182Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To establish basic epidemiological data on chronic pain (duration > 3 months) in a defined population. Relationships between age, gender, and social class were tested. DESIGN: A survey of pain symptoms, including location, intensity, duration, and functional capacity, was conducted by means of a mail questionnaire. SETTING: General populations in two Swedish primary health care districts. Medical care was provided in a state health system. SUBJECTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1,806). The response rate was 90%. OUTCOME MEASURES: Descriptive epidemiologic data in relation to objectives of the study. RESULTS: Without sex differences, 55% (95% confidence interval, 53-58%) of the population had perceived persistent pain for 3 months and 49% for 6 months. Among individuals with chronic pain, 90% localized their pain to the musculoskeletal system to a variable extent. Women experienced more multiple localizations of pain and had pain in the neck, shoulder, arm, and thigh to a greater extent than men. Prevalence of pain increased by age up to 50-59 years for both genders and then slowly decreased. The neck-shoulder area was the most common site of pain (30.2%), followed by the lower back (23.2%). Even in the youngest age groups more than one of four reported chronic pain. Blue-collar workers and employers (including farmers) reported chronic pain to a greater extent than other groups. In 13% of the population, manifest pain problems were associated with reduced functional capacity. CONCLUSION: Chronic pain symptoms are common but unevenly distributed in a general population. The results may influence planning and consultation in primary health care as well as warranting selective prevention activities.

  • 299.
    Andersson, H. Ingemar
    et al.
    Kristianstad University, School of Health and Society.
    Nilsson, P.
    Kristianstad University, School of Health and Society.
    Bringsén, Åsa
    Kristianstad University, School of Health and Society.
    Ejlertsson, Göran
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
    Positive work experience factors relate to salutogenic health-a survey among Swedish hospital employees2012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no Suppl. 2, p. 156-156Article in journal (Refereed)
  • 300.
    Andersson, Hanna
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Ohlsson, Elin
    Halmstad University, School of Social and Health Sciences (HOS).
    Hälsofrämjande åtgärder på arbetsplatser-: Enkätstudie bland stora och medelstora företag i Halmstad kommun2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to examine how enterprises in Halmstad municipality, Sweden, worked with health promotion. A survey, in the form of a questionnaire was performed on large- and medium-sized enterprises in Halmstad. The respondents can be described as staff responsible for health promotion and work environmental issues. The results show that of 34 companies, 31 offer health promotion benefits, 23 actively work on improving the work environment by introducing ergonomic measures and 21 works with health services. The analysis indicates that by having these benefits and services in place, the absence due to sickness decreases while the employee’s health status increases. However, the study also found that there were difficulties in promoting health in these enterprises; mainly lack of time, economy and lack of motivation among employees. To further improve health promotion in work places we recommend educating responsible staff in particular and employees in general.

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