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  • 51.
    Blomkvist, Elin
    Linnéuniversitetet, Fakultetsnämnden för hälsa, socialt arbete och beteendevetenskap, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI.
    Fotisättningens betydelse för löparens rörelsemönster: En jämförelse mellan häl-till-tålöpnging och framfotalöpning hos vana löpare2012Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
  • 52.
    Boldeman, Cecilia
    et al.
    Karolinska Institutet.
    Dal, Henrik
    Karolinska Institutet.
    Cosco, Nilda
    North Carolina State University.
    Moore, Robin
    North Carolina State University.
    Bieber, Brad
    North Karolina State University.
    Blennow, Margaretha
    Södersjukhuset.
    Pagels, Peter
    Linnéuniversitetet, Fakultetsnämnden för hälsa, socialt arbete och beteendevetenskap, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI.
    Raustorp, Anders
    Linnéuniversitetet, Fakultetsnämnden för hälsa, socialt arbete och beteendevetenskap, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI.
    Söderström, Margareta
    Köpenhamns Universitet.
    Wester, Ulf
    Statens Strålskyddsinstitut.
    Mårtensson, Fredrika
    SLU.
    Preschool outdoor play environment may combine promotion of childrens physical activity and sun protection. Further evidence from Southern Sweden and North Carolina: Les aires de jeux extérieures en école maternelle peuvent associer promotion de l´activité physique et protection solaire. Noveaux arguments de Suéde du Sud et de Caroline Nord2011Inngår i: Science & sports, ISSN 0765-1597, E-ISSN 1778-4131, Vol. 26, nr 2, s. 72-82Artikkel i tidsskrift (Fagfellevurdert)
  • 53.
    Bonn, Stephanie E
    et al.
    Karolinska Institutet.
    Bergman, Patrick
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    Trolle-Lagerros, Ylva
    Karolinska Institutet;Karolinska University Hospital Huddinge.
    Sjölander, Arvid
    Karolinska Institutet.
    Bälter, Katarina
    Karolinska Institutet.
    A validation study of the web-based physical activity questionnaire Active-Q against the GENEA Accelerometer2015Inngår i: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 4, nr 3, artikkel-id e86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    Valid physical activity assessment in epidemiological studies is essential to study associations with various health outcomes.

    OBJECTIVE:

    To validate the Web-based physical activity questionnaire Active-Q by comparing results of time spent at different physical activity levels with results from the GENEA accelerometer and to assess the reproducibility of Active-Q by comparing two admissions of the questionnaire.

    METHODS:

    A total of 148 men (aged 33 to 86 years) responded to Active-Q twice and wore the accelerometer during seven consecutive days on two occasions. Time spent on six different physical activity levels including sedentary, light (LPA), moderate (MPA), and vigorous (VPA) as well as additional combined categories of sedentary-to-light and moderate-to-vigorous (MVPA) physical activity was assessed. Validity of Active-Q was determined using Spearman correlation coefficients with 95% confidence intervals (CI) and the Bland-Altman method. Reproducibility was assessed using intraclass correlation coefficients (ICCs) comparing two admissions of the questionnaire.

    RESULTS:

    The validity correlation coefficients were statistically significant for time spent at all activity levels; sedentary (r=0.19, 95% CI: 0.04-0.34), LPA (r=0.15, 95% CI: 0.00-0.31), sedentary-to-light (r=0.35, 95% CI: 0.19-0.51), MPA (r=0.27, 95% CI: 0.12-0.42), VPA (r=0.54, 95% CI: 0.42-0.67), and MVPA (r=0.35, 95% CI: 0.21-0.48). The Bland-Altman plots showed a negative mean difference for time in LPA and positive mean differences for time spent in MPA, VPA and MVPA. The ICCs of test-retest reliability ranged between r=0.51-0.80 for the different activity levels in Active-Q.

    CONCLUSIONS:

    More moderate and vigorous activities and less light activities were reported in Active-Q compared to accelerometer measurements. Active-Q shows comparable validity and reproducibility to other physical activity questionnaires used today.

  • 54.
    Borghi, Claudio
    et al.
    University of Bologna, Italy.
    Rodriguez-Artalejo, Fernando
    Univ Autonoma Madrid IdiPaz, Spain ; Inst Salud Carlos III, Spain.
    De Backer, Guy
    Univ Ghent, Belgium.
    Dallongeville, Jean
    Univ Lille Nord France, France.
    Medina, Jesús
    AstraZeneca Farmaceut Spain, Spain.
    Guallar, Eliseo
    Johns Hopkins Bloomberg Sch Publ Hlth, USA ; Johns Hopkins Bloomberg Sch Publ Hlth, USA.
    Perk, Joep
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Banegas, José R.
    Univ Autonoma Madrid IdiPaz, Spain ; Inst Salud Carlos III, Spain.
    Tubach, Florence
    Hop Bichat Claude Bernard, France ; ECEVE, France ; Univ Paris Diderot, France.
    Roy, Carine
    Hop Bichat Claude Bernard, France ; ECEVE, France ; Hop Bichat Claude Bernard, France.
    Halcox, Julian P.
    Swansea Univ, UK.
    The association between blood pressure and lipid levels in Europe: European study on cardiovascular risk prevention and management in usual daily practice2016Inngår i: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 34, nr 11, s. 2155-2163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives:Several studies have suggested a positive association between serum lipid levels and blood pressure (BP). This study investigated this association in a large population from 12 European countries.Methods:Data were taken from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (ClinicalTrials.gov identifier: NCT00882336). Associations between BP and lipid levels in patients free from cardiovascular disease and with at least one major cardiovascular disease risk factor (N=7641) were assessed using linear regression analyses.Results:Overall, 72.8 and 64.8% of patients had hypertension and dyslipidaemia, respectively; 47.0% had both conditions. Regression coefficients (95% confidence interval) for the associations of LDL cholesterol, non-HDL cholesterol, total cholesterol and apolipoprotein B levels with SBP, adjusted for age, sex and BMI, were 0.93mmHg/mmol per l (0.54-1.31), 1.07mmHg/mmol per l (0.73-1.40), 1.02mmHg/mmol per l (0.69-1.35) and 4.94mmHg/g per l (3.43-6.46), respectively. The corresponding values (95% confidence interval) for the associations with DBP were 0.96mmHg/mmol per l (0.73-1.19), 0.95mmHg/mmol per l (0.75-1.15), 0.87mmHg/mmol per l (0.67-1.07) and 4.33mmHg/g per l (3.42-5.23), respectively. Most of these associations remained significant whether patients were treated with statins or not.Conclusion:Small but statistically significant associations between lipid levels and BP were observed in a large, multinational European population. Further research is warranted to assess the causality of this association and its implications on the management of patients with both hypertension and dyslipidaemia.

  • 55.
    Brattberg, Jenny
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Aronsson, Niclas
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    BESLUTET ÄR MITT: En litteraturstudie om att belysa erfarenheter av att röka vid kroniskt obstruktiv lungsjukdom.2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Kroniskt obstruktiv lungsjukdom (KOL) är den fjärde vanligaste dödsorsaken i världen och beräknas öka i omfattning. Det är en irreversibel sjukdom som förvärras med tiden och som innebär att lungorna får svårare att ta upp syre. Rökning är den främsta orsaken att drabbas av KOL, vilket gör rökstopp till den viktigaste åtgärden för att begränsa sjukdomens förlopp. Trots det fortsätter många att röka efter att de har fått sin diagnos. Syfte: Syftet med litteraturstudien var att belysa patienters erfarenheter av att röka vid KOL. Metod: En kvalitativ litteraturstudie baserad på tio vetenskapliga artiklar genomfördes. Artiklarna analyserades enligt Lundman & Hällgren Graneheims (2008) kvalitativa innehållsanalys. Resultat: Fem kategorier och tre underkategorier framkom i resultatet. Känslor av tvivel och osäkerhet, motivationens betydelse, stigmatisering och skuldbeläggning, upplevelser av gemenskap och trygghet samt behov av autonomi. Det fanns en tveksamhet kring sambandet mellan rökning och KOL vilket bidrog till minskad motivation att sluta röka. Stigmatiserande attityder från vårdpersonal och omgivning gav upphov till skuld och skamkänslor. Rökningen upplevdes som en trygghet som skapade gemenskap och välmående. Beslutet att sluta röka var deras och ingen annans. Att bli tillsagd att sluta röka hade motsatt effekt. Slutsats: Litteraturstudien visar att patienter med KOL har ett ökat behov av mer information om sjukdomen. Sluta röka är för många en process som innebär livsstilsförändringar. Det innebär att ett öppet förhållningssätt från närstående och vårdpersonal kan vara till hjälp för patienterna att få motivation till att vilja bli rökfria. Avgörande är att se till patientens hela livsvärld för att kunna möta dessa patienter och lindra lidande och öka välbefinnande.

  • 56.
    Bremer, Anders
    University of Borås, Sweden.
    Caring for families at sudden cardiac death: A balance between closeness and distance2012Inngår i: The 26th Conference of the European Society for Philosophy of Medicine and Health Care, 2012Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects more than half a million people in the United States and Europe each year. As resuscitation attempts are unsuccessful in most of the cases, ambulance professionals often face the needs of bereaved family members. Decisions to continue or terminate resuscitation attempts at OHCA are influenced by factors other than patient clinical characteristics, such as the personnel’s knowledge, attitudes, and beliefs regarding family emotional preparedness. Research exploring how ambulance personnel are affected by family dynamics and the emotional context, and how they are able to provide care for bereaved family members is sparse. It is also a lack of research into why ambulance professionals sometimes administer physiologically futile cardiopulmonary resuscitation (CPR) to patients with cardiac arrest to benefit family members. This way of meeting families’ grief reactions implies ethical problems. Based on an empirical study of ambulance professional’s experiences of caring for families when patients suffer cardiac arrest and sudden death, and an ethical analysis exploring arguments for providing physiologically futile CPR, the issue of caring for bereaved family members in ethical good and bad ways is explored. The empirical study results show that ambulance personnel experience a concomitant responsibility, sometimes failing to prioritize between responsibilities as a result of their own perceptions, feelings and reactions. Moving from patient care to family care imply a movement from well-structured guidance to a situational response where the personnel are forced to balance between interpretive reasoning and a more direct emotional response at their own discretion. With such affective response in decision-making, the personnel risk erroneous conclusions and care relationships with elements of dishonesty, misguided benevolence and false hopes. The ability to recognize and respond to people’s existential questions and needs is essential, and dependent on the ambulance personnel’s balance between closeness and distance, and on their courage to meet emotional expressions of the families, as well as the personnel’s own vulnerability. A need for ethical competence is invoked by the presence of family members, placing great demands on mobility in the decision-making process, between medical care of the patient and caring for family members. The conclusion is that the strategy of ambulance professionals in the care of bereaved family members should be to avoid additional suffering by focusing on the relevant care needs of the family members and provide support, arrange for a peaceful environment and administer acute grief counseling at the scene, which might call for a developed ethical caring competence. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Ambulance personnel also need training in awareness of the needs of families suffering sudden bereavement, as well as support and help to deal with personal discomfort.

  • 57.
    Bremer, Anders
    University of Borås, Sweden.
    En andra chans2012Inngår i: Forskning för hälsa, ISSN 1653-9753, nr 3, s. 18-19Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Överlevare av plötsligt hjärtstopp utanförsjukhus är en unik och växande patientgrupp.Men hur blir livet efteråt?Frågeställningen finns med i denforskning Anders Bremer bedriver och som tidigarei år utmynnade i en avhandling. I syfte att beskrivasamtliga inblandades erfarenheter vid plötsligthjärtstopp intervjuade han överlevare, närståendeoch ambulanspersonal, som inte sällan ställs införetiska frågeställningar vid hjärtstopp.

  • 58.
    Chandler, Rebecca E.
    et al.
    Uppsala Monitoring Centre (UMC).
    Juhlin, Kristina
    Uppsala Monitoring Centre (UMC).
    Fransson, Jonas
    Uppsala Monitoring Centre (UMC).
    Caster, Ola
    Uppsala Monitoring Centre (UMC) ; Stockholm University.
    Edwards, Ralph I.
    Uppsala Monitoring Centre (UMC).
    Norén, Niklas G.
    Uppsala Monitoring Centre (UMC).
    Current Safety Concerns with Human Papillomavirus Vaccine: A Cluster Analysis of Reports in VigiBase®2017Inngår i: Drug Safety, ISSN 0114-5916, E-ISSN 1179-1942, Vol. 40, nr 1, s. 81-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: A number of safety signals-complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), and chronic fatigue syndrome (CFS)-have emerged with human papillomavirus (HPV) vaccines, which share a similar pattern of symptomatology. Previous signal evaluations and epidemiological studies have largely relied on traditional methodologies and signals have been considered individually.

    OBJECTIVE: The aim of this study was to explore global reporting patterns for HPV vaccine for subgroups of reports with similar adverse event (AE) profiles.

    METHODS: All individual case safety reports (reports) for HPV vaccines in VigiBase(®) until 1 January 2015 were identified. A statistical cluster analysis algorithm was used to identify natural groupings based on AE profiles in a data-driven exploratory analysis. Clinical assessment of the clusters was performed to identify clusters relevant to current safety concerns.

    RESULTS: Overall, 54 clusters containing at least five reports were identified. The four largest clusters included 71 % of the analysed HPV reports and described AEs included in the product label. Four smaller clusters were identified to include case reports relevant to ongoing safety concerns (total of 694 cases). In all four of these clusters, the most commonly reported AE terms were headache and dizziness and fatigue or syncope; three of these four AE terms were reported in >50 % of the reports included in the clusters. These clusters had a higher proportion of serious cases compared with HPV reports overall (44-89 % in the clusters compared with 24 %). Furthermore, only a minority of reports included in these clusters included AE terms of diagnoses to explain these symptoms. Using proportional reporting ratios, the combination of headache and dizziness with either fatigue or syncope was found to be more commonly reported in HPV vaccine reports compared with non-HPV vaccine reports for females aged 9-25 years. This disproportionality remained when results were stratified by age and when those countries reporting the signals of CRPS (Japan) and POTS (Denmark) were excluded.

    CONCLUSIONS: Cluster analysis reveals additional reports of AEs following HPV vaccination that are serious in nature and describe symptoms that overlap those reported in cases from the recent safety signals (POTS, CRPS, and CFS), but which do not report explicit diagnoses. While the causal association between HPV vaccination and these AEs remains uncertain, more extensive analyses of spontaneous reports can better identify the relevant case series for thorough signal evaluation.

  • 59.
    Cima, Joana
    et al.
    Nova University of Lisbon, Portugal ; University of Porto, Portugal.
    Santana, R.
    Nova University of Lisbon, Portugal.
    Massof, Robert
    Johns Hopkins Wilmer Eye Institute, USA.
    Hernandez-Moreno, Laura
    University of Minho, Portugal.
    Baptista, António
    University of Minho, Portugal.
    Marques, Ana Patricia
    Nova University of Lisbon, Portugal.
    Macedo, António Filipe
    University of Minho, Portugal.
    EQ-5D and Activity Inventory: Measures of Visual Health Outcome2015Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 25, nr Suppl 3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study is to test if EQ-5D, a more generic instrument, and Activity Inventory, a more specific instrument to the visual condition, produce consistent results when considering the different levels of visual impairment. By assessing how these instruments reflect visual status in a sample of patients with visual impairment, we will help to understand how they can work in cultural context and population in which they were never tested before.Method is based on Multivariate Analysis of Variance, in which the levels of visual impairment (slightly, moderate, severe/blindness) are defined through the visual acuity values, and the utility values derived from EQ-5D and the Activity Inventory.Participants were recruited in 3 public hospitals as a part of an ongoing study of prevalence and costs of visual impairment in Portugal. Patients attending outpatient appointments in these hospitals with acuity in the better eye of 0,30logMAR or worse and/or visual field in the better eye <20 degrees were invited to take part in face-to-face interviews. Additional visual measures, as acuity was collected using standardize methods. Visual acuity was assessed using an internally illuminated ETDRS chart at 4 m with room lights extinguished.The results show that both instruments have a good explanatory power. However when considering different clinical conditions, the AI presents better results. The EQ-5D due its low sensitivity/adaptability does not capture differences in health status in patients with slightly and moderate visual impairment.Since EQ-5D is the instrument most used in the evaluation of public health programs performance, the results suggest that its use should be more cautious in a situation of different difficulty levels. The results indicate that in these cases the EQ-5D should be used with a complementary instrument more specific to the clinical condition.

    Key messages

    • The results suggest that with different difficulty levels the EQ-5D should be used with a complementary instrument more specific to the clinical condition to be produced more reliable results
    • This study is supported by the Portuguese Foundation for Science and Technology (FCT) -POCTI & FSE GRANT: PTDC/DPT-EPI/0412/2012
  • 60.
    Dahal, Pranab
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Joshi, Sunil Kumar
    Kathmandu Medical College, Nepal.
    Swahnberg, Katarina
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    'We are looked down upon and rejected socially': a qualitative study on the experiences of trafficking survivors in Nepal2015Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 8, s. 1-9, artikkel-id 29267Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The successful reintegration of sexual trafficking survivors into Nepalese society is challenging. This paper aims to explore the trafficking process, abuses faced during sexual slavery, and the challenges faced by women and girl survivors for successful reintegration. Method: This exploratory study used qualitative methods to identify that poverty, illiteracy, lack of opportunities, and varied social stigma initiate the victimization process, and continuity of this vicious circle increases the risk for (re) entrapment. Result: The reasons for sexual trafficking have also become the reasons for restricting survivors from opportunities for growth and mainstreaming. Conclusion: Non-existent support systems, detachment from familial ties, being outcast by society, and an uncertain livelihood make reintegration difficult for survivors.

  • 61.
    Dalteg, Tomas
    et al.
    Jönköping University.
    Benzein, Eva
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Sandgren, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Malm, Dan
    Jönköping University;County Hospital Ryhov.
    Årestedt, Kristofer
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Linköping University.
    Associations of Emotional Distress and Perceived Health in Persons With Atrial Fibrillation and Their Partners Using the Actor–Partner Interdependence Model2016Inngår i: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 22, nr 3, s. 368-391Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Individual behavior affects and is affected by other people. The aim of this study was to examine if emotional distress in patients with atrial fibrillation (AF) and their spouses was associated with their own and their partner’s perceived health. Participants included 91 dyads of patients and their spouses. Emotional distress was measured using the Hospital Anxiety and Depression Scale and perceived health was measured with the Short Form 36 Health Survey. The Actor–Partner Interdependence Model was used for dyad-level analyses of associations, using structural equation modeling. Higher levels of anxiety and depression were associated with lower levels of perceived health in patients and spouses. Higher levels of depression in patients were associated with lower levels of vitality in spouses and vice versa. As AF patients and their spouses influence each other, health-care interventions should consider the dyad to address dyadic dynamics. This may benefit the health of the individual patient and of the couple.

  • 62.
    Dapi Nzefa, Leonie
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    The impact of climate change on students in Yaoundé, Cameroon2011Inngår i: African Newsletter on Occupational Health and Safety, ISSN 0788-4877, Vol. 21, s. 50-51Artikkel i tidsskrift (Annet vitenskapelig)
  • 63.
    Dapi Nzefa, Leonie
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.
    Rocklöv, Joacim
    Nguefack-Tsague, Georges
    Tetanye, Ekoe
    Kjellstrom, Tord
    Heat impact on schoolchildren in Cameroon, Africa: potential health threat from climate change.2010Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Health impacts related to climate change are potentially an increasing problem in Cameroon, especially during hot seasons when there are no means for protective and adaptive actions.

    OBJECTIVE: To describe environmental conditions in schools and to evaluate the impact of heat on schoolchildren's health during school days in the Cameroon cities of Yaoundé and Douala.

    METHODS: Schoolchildren (N = 285) aged 12-16 years from public secondary schools completed a questionnaire about their background, general symptoms, and hot feelings in a cross-sectional study. In Yaoundé, 50 schoolchildren were individually interviewed during school days about hourly symptoms (fatigue, headache, and feeling very hot) and performance. Lascar dataloggers were used to measure indoor classroom temperatures and humidity.

    RESULTS: There was a significant correlation between daily indoor temperature and the percentages of schoolchildren who felt very hot, had fatigue, and headaches in Yaoundé. A high proportion of schoolchildren felt very hot (48%), had fatigue (76%), and headaches (38%) in Yaoundé. Prevalences (%) were higher among girls than boys for headaches (58 vs 39), feeling 'very hot overall' (37 vs 21), and 'very hot in head' (21 vs 18). Up to 62% were absentminded and 45% had slow writing speed. High indoor temperatures of 32.5°C in Yaoundé and 36.6°C in Douala were observed in school.

    CONCLUSIONS: Headache, fatigue, and feeling very hot associated with high indoor air temperature were observed among schoolchildren in the present study. Longitudinal data in schools are needed to confirm these results. School environmental conditions should be improved in order to enhance learning.

  • 64.
    Dapi Nzefa, Léonie
    Umeå University.
    Socioeconomic and sex differences in adolescents’ dietary intake, anthropometry and physical activity in Cameroon, Africa2010Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: People in Cameroon are experiencing a dietary transition characterized by changing from traditional food habits to increased intake of highly processed sweet and fatty food. The rapid change in food pattern combined with an increased sedentary lifestyle has resulted in a rather high prevalence of obesity, hypertension, cardiovascular diseases and type 2 diabetes. Nutritional intake is important during adolescence for growth spurt, health, cognitive development and performance in school.

    Objective: The aim of this thesis was to assess dietary intake, anthropometry and physical activity of adolescents according to sex and socioeconomic status (SES) and to investigate food perceptions of adolescents living in urban and rural areas of Cameroon.

    Methods: Girls and boys, 12-16 years of age, were randomly selected from schools in urban and rural areas. Food frequency questionnaire, 24-hour dietary and physical activity recalls, anthropometric measurements, qualitative interviews and a background questionnaire were used for data collection.

    Results: The proportion of overweight was three times higher in girls (14%) compared to boys (4%). Stunting and underweight were more common among boys (15% and 6%) than girls (5% and 1%). The prevalence of stunting was two times higher among the urban adolescents with low SES (12%) compared to those with high SES (5%). The rural adolescents had the highest proportion of stunting but more muscle that the urban adolescents. The rural adolescents ate in order to live and to maintain health. Urban adolescents with low SES ate in order to maintain health, while those with high SES ate for pleasure. More than 30% of the adolescents skipped breakfast in the urban area. Urban adolescents with high SES and girls reported a more frequent consumption of in-between meals and most food groups compared to the rural adolescents, boys and those with low SES. Over 55% of the adolescents had a protein intake below 10% of the energy (E%). Twenty-six percent of the adolescents had fat intake below 25 E%, and 25% had fat intake above 35 E%. A large proportion of the adolescents had an intake of micronutrients below the estimated average recommendation. Boys and the adolescents with low SES reported a higher energy expenditure and physical activity level than girls and the adolescents with high SES, respectively. Both under- and over-reporting of energy intake were common among the adolescents.

    Conclusions: The present study showed that nutrient inadequacy, stunting, underweight, as well as overweight and obesity were common among the adolescents in Cameroon. Therefore an intervention program targeting both under- and overnutrition among school adolescents is needed. Sex and socioeconomic differences also need to be considered.

  • 65. De Miguel-Etayo, P.
    et al.
    Tornaritis, M.
    Bergman, Patrick
    Linnéuniversitetet, Fakultetsnämnden för hälsa, socialt arbete och beteendevetenskap, Institutionen för pedagogik, psykologi och idrottsvetenskap, PPI.
    Oja, L.
    Ahrens, W.
    Moreno, L. A.
    Consortium, IDEFICS
    Cardiorespiratory fitness levels among European children: the IDEFICS study2011Konferansepaper (Fagfellevurdert)
  • 66. De Vriendt, T.
    et al.
    Clays, E.
    Moreno, L. A.
    Bergman, Patrick
    Karolinska Inst, Unit Prevent Nutr, Dept Biosci & Nutr, S-14157 Huddinge, Sweden .
    Vicente-Rodriguez, G.
    Nagy, E.
    Dietrich, S.
    Manios, Y.
    De Henauw, S.
    Reliability and validity of the Adolescent Stress Questionnaire in a sample of European adolescents--the HELENA study2011Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, s. 717-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Since stress is hypothesized to play a role in the etiology of obesity during adolescence, research on associations between adolescent stress and obesity-related parameters and behaviours is essential. Due to lack of a well-established recent stress checklist for use in European adolescents, the study investigated the reliability and validity of the Adolescent Stress Questionnaire (ASQ) for assessing perceived stress in European adolescents. METHODS: The ASQ was translated into the languages of the participating cities (Ghent, Stockholm, Vienna, Zaragoza, Pecs and Athens) and was implemented within the HELENA cross-sectional study. A total of 1140 European adolescents provided a valid ASQ, comprising 10 component scales, used for internal reliability (Cronbach alpha) and construct validity (confirmatory factor analysis or CFA). Contributions of socio-demographic (gender, age, pubertal stage, socio-economic status) characteristics to the ASQ score variances were investigated. Two-hundred adolescents also provided valid saliva samples for cortisol analysis to compare with the ASQ scores (criterion validity). Test-retest reliability was investigated using two ASQ assessments from 37 adolescents. RESULTS: Cronbach alpha-values of the ASQ scales (0.57 to 0.88) demonstrated a moderate internal reliability of the ASQ, and intraclass correlation coefficients (0.45 to 0.84) established an insufficient test-retest reliability of the ASQ. The adolescents' gender (girls had higher stress scores than boys) and pubertal stage (those in a post-pubertal development had higher stress scores than others) significantly contributed to the variance in ASQ scores, while their age and socio-economic status did not. CFA results showed that the original scale construct fitted moderately with the data in our European adolescent population. Only in boys, four out of 10 ASQ scale scores were a significant positive predictor for baseline wake-up salivary cortisol, suggesting a rather poor criterion validity of the ASQ, especially in girls. CONCLUSIONS: In our European adolescent sample, the ASQ had an acceptable internal reliability and construct validity and the adolescents' gender and pubertal stage systematically contributed to the ASQ variance, but its test-retest reliability and criterion validity were rather poor. Overall, the utility of the ASQ for assessing perceived stress in adolescents across Europe is uncertain and some aspects require further examination.

  • 67. DeHenauw, Stefaan
    et al.
    Gottrand, Fredreique
    DeBourdeaudhuij, Ilse
    Gonzalez-Gross, Marcela
    Leclercq, Cathrine
    Kafatos, Antony
    Molnar, Denes
    Marcos, Acenscion
    Castillo, Manuel J
    Dallongeville, Jean
    Gilbert, Chantal
    Bergman, Patrick
    Karolinska Institutet, Huddinge, Sweden.
    Widhalm, Kurt
    Manios, Yannis
    Breidenassel, Christina
    Kersting, Matilde
    Moreno, Luis A
    Nutritional status and lifestyle of adolescents from a public health perspective. The HELENA Project - Healthy Lifestyle in Europe by Nutrition in Adolescence.2007Inngår i: Journal of Public Health, Vol. 15, nr 3, s. 187-197Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The HELENA Project—Healthy Lifestyle in Europe by Nutrition in Adolescence—is a European, collaborative research project financed by the EU Sixth Framework Programme in the area of nutrition-related adolescent health. The basic objective of the HELENA project is to obtain reliable and comparable data from a random sample of European adolescents (boys and girls aged 13–16 years) on a broad battery of relevant nutrition and health-related parameters: dietary intake, food choices and preferences, anthropometry, serum indicators of lipid metabolism and glucose metabolism, vitamin and mineral status, immunological markers, physical activity, fitness and genetic markers. The HELENA project is conceived as a scientific construction with four complementary sub-studies that are elaborated through 14 well-defined work packages. Sub-studies are focused, respectively, on “a cross-sectional description of lifestyles and indicators of nutritional status (HELENA-CSS)”, “a lifestyle education intervention programme (HELENA-LSEI), “a metabolic study with cross-over design (HELENA-COMS)” and a “study on behaviour, food preferences and food development” (HELENA-BEFO). The project unites 20 research centres from 10 European countries. In addition, the consortium comprises five SMEs (small and medium-sized enterprises) that are actively involved in the research activities. The core of the HELENA project study material is an overall European cohort of 3,000 adolescents, equally recruited in ten cities from nine countries. Standardization of methods among partners is a key issue in the project and is obtained through the development of standard protocols, training sessions, validation sub-studies and pilot projects. Health-related problems have a tendency to evolve in cycles, with ever new problems emerging in ever new contexts that call for appropriate and tailored actions. The HELENA project is expected to offer essential elements for use in the overall machinery of required public health nutrition cycles. It is of the greatest importance for its results to prove useful that it can communicate with other initiatives on the level of science and society.

  • 68.
    Ding, Ding
    et al.
    University of California San Diego, USA ; San Diego State University, USA ; University of Sydney, USA.
    Adams, Marc A.
    University of California San Diego, USA ; Arizona State University, USA.
    Sallis, James F.
    University of California San Diego, USA.
    Norman, Gregory J.
    University of California San Diego, USA.
    Hovell, Melbourn F.
    San Diego State University, USA.
    Chambers, Christina D.
    University of California San Diego, USA.
    Hofstetter, C. Richard
    San Diego State University, USA.
    Bowles, Heather R.
    National Cancer Institute, USA.
    Hagströmer, Maria
    Karolinska Institutet.
    Craig, Cora L.
    Canadian Fitness and Lifestyle Research Institute, Canada.
    Fernando Gomez, Luis
    De Bourdeaudhuij, Ilse
    Macfarlane, Duncan J.
    Ainsworth, Barbara E.
    Bergman, Patrick
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    Bull, Fiona C.
    Carr, Harriette
    Klasson-Heggebo, Lena
    Inoue, Shigeru
    Murase, Norio
    Matsudo, Sandra
    Matsudo, Victor
    McLean, Grant
    Sjostrom, Michael
    Tomten, Heidi
    Lefevre, Johan
    Volbekiene, Vida
    Bauman, Adrian E.
    Perceived neighborhood environment and physical activity in 11 countries: Do associations differ by country?2013Inngår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 10, nr 1, artikkel-id 57Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Increasing empirical evidence supports associations between neighborhood environments and physical activity. However, since most studies were conducted in a single country, particularly western countries, the generalizability of associations in an international setting is not well understood. The current study examined whether associations between perceived attributes of neighborhood environments and physical activity differed by country. Methods: Population representative samples from 11 countries on five continents were surveyed using comparable methodologies and measurement instruments. Neighborhood environment x country interactions were tested in logistic regression models with meeting physical activity recommendations as the outcome, adjusted for demographic characteristics. Country-specific associations were reported. Results: Significant neighborhood environment attribute x country interactions implied some differences across countries in the association of each neighborhood attribute with meeting physical activity recommendations. Across the 11 countries, land-use mix and sidewalks had the most consistent associations with physical activity. Access to public transit, bicycle facilities, and low-cost recreation facilities had some associations with physical activity, but with less consistency across countries. There was little evidence supporting the associations of residential density and crime-related safety with physical activity in most countries. Conclusion: There is evidence of generalizability for the associations of land use mix, and presence of sidewalks with physical activity. Associations of other neighborhood characteristics with physical activity tended to differ by country. Future studies should include objective measures of neighborhood environments, compare psychometric properties of reports across countries, and use better specified models to further understand the similarities and differences in associations across countries.

  • 69.
    Djukanovic, Ingrid
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Peterson, Ulla
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Experiences of the transition intoretirement: An interview study2016Inngår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, nr 4, s. 224-232Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Retirement is one of the most important transitions in a person's life, which also might affect health and well-being. Adjustment to a life as retiree does not follow a uniform pattern, which emphasizes the importance of an individual perspective. This article uses transition theory as a theoretical perspective. In-depth interviews were conducted with 13 individuals newly retired, focusing on experiences from the last year of work and the time after retirement. Content analysis was used to analyze data. Two themes emerged: ‘become aware of’ and ‘become adapted to’. Nine subthemes describe the individual experiences reflecting positive expectations and outcomes but also feelings of grief and disconnectedness and fears about loss of social network and identity. Transition into retirement should receive more attention from a nursing perspective since experiences such as, for example, grief, disconnectedness and loss of identity if unaddressed could lead to an unhealthy transition.

  • 70. Eklöf, Motzi
    et al.
    Petersson, MargaretaLinnéuniversitetet, Fakulteten för konst och humaniora (FKH), Institutionen för film och litteratur (IFL).
    Livsberättelser, kultur & hälsa2015Collection/Antologi (Annet vitenskapelig)
  • 71.
    Ekstedt, Mirjam
    et al.
    Ersta Sköndal University College ; Karolinska Institutet.
    Kenttä, Göran
    Swedish School of Sport and Health Sciences.
    Återhämtning självklart för elitidrottare …men inte för yrkesarbetare2011Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, nr 36, s. 1684-1687Artikkel, forskningsoversikt (Fagfellevurdert)
  • 72.
    Ekstedt, Mirjam
    et al.
    Karolinska Institutet;KTH Royal Institute of Technology.
    Nyberg, Gisela
    Karolinska Institutet.
    Ingre, Mikael
    Stockholm University.
    Ekblom, Örjan
    Karolinska Institutet;Swedish School of Sport and Health Sciences.
    Marcus, Claude
    Karolinska Institutet.
    Sleep, physical activity and BMI in six to ten-year-old children measured by accelerometry: a cross-sectional study2013Inngår i: International Journal of Behavioral Nutrition and Physical Activity, ISSN 1479-5868, E-ISSN 1479-5868, Vol. 10, artikkel-id 82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND:

    The aim of this study is to describe the relationship between objective measures of sleep, physical activity and BMI in Swedish pre-adolescents. The day-to-day association between physical activity and sleep quality as well as week-day and weekend pattern of sleep is also described.

    METHOD:

    We conducted a cross sectional study consisted of a cohort of 1.231 children aged six to ten years within the Stockholm county area. Sleep and physical activity were measured by accelerometry during seven consecutive days. Outcome measures are total sleep time, sleep efficiency, sleep start and sleep end; physical activity intensity divided into: sedentary (<1.5 METS), light (1.5 to 3 METS) and moderate-to-vigorous (> 3 METS); and Body Mass Index standard deviations score, BMIsds.

    RESULTS:

    Total sleep time decreased with increasing age, and was shorter in boys than girls on both weekdays and weekends. Late bedtime but consistent wake-up time during weekends made total sleep time shorter on weekends than on weekdays. Day-to-day within-subject analysis revealed that moderate-to-vigorous intense physical activity promoted an increased sleep efficiency the following night (CI < 0.001 to 0.047), while total sleep time was not affected (CI -0.003 to 0.043). Neither sleep duration (CI -0.024 to 0.022) nor sleep efficiency (CI -0.019 to 0.028) affected mean physical activity level the subsequent day. The between-subject analysis indicates that the sleep of children characterized by high moderate-to-vigorous physical activity during the day was frequently interrupted (SE = -.23, P < .01). A negative association between BMIsds and sleep duration was found (-.10, p < .01).

    CONCLUSIONS:

    Short sleep duration was associated with high BMI in six to ten year old children. This study underscores the importance of consistent bedtimes throughout the week for promoting sleep duration in preadolescents. Furthermore, this study suggests that a large proportion of intensive physical activity during the day might promote good sleep quality.

  • 73.
    Ekstedt, Mirjam
    et al.
    Oslo University Hospital, Norway ; Stockholm University ; Karolinska Institutet.
    Söderström, Marie
    Stockholm University ; Karolinska Institutet.
    Åkerstedt, Torbjörn
    Stockholm University ; Karolinska Institutet.
    Sleep physiology in recovery from burnout2009Inngår i: Biological Psychology, ISSN 0301-0511, E-ISSN 1873-6246, Vol. 82, nr 3, s. 267-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study aimed to investigate the role of sleep physiology in recovery from burnout, in particular the relation between sleep and changes in fatigue and whether those changes would be related to return to work. 23 white-collar workers on long-term sick leave (>3 months) due to a burnout related diagnosis and 16 healthy controls were subjected to polysomnographic recordings at baseline and after 6-12 months' rehabilitation. Occupational status, subjective sleep quality, fatigue, anxiety and depression were assessed. Recovery from burnout was accompanied by improved sleep continuity. Significant interaction effects were seen for number of arousals, sleep fragmentation, sleep latency, sleep efficiency and time of rising. The burnout group improved significantly on all symptom variables although the post-treatment levels did not reach the levels of the controls. Recovery from fatigue was related to a reduction of the arousal from sleep and was the best predictor of return to work.

  • 74.
    Ekstedt, Mirjam
    et al.
    Karolinska Institutet ; National Institute for Psychosocial Factors and Health.
    Åkerstedt, Torbjörn
    Karolinska Institutet ; National Institute for Psychosocial Factors and Health.
    Söderström, Marie
    Karolinska Institutet ; National Institute for Psychosocial Factors and Health.
    Microarousals during sleep are associated with increased levels of lipids, cortisol, and blood pressure2004Inngår i: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 66, nr 6, s. 925-931Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Previous work has demonstrated a link between restricted sleep and risk indicators for cardiovascular and metabolic disease, such as levels of cortisol, lipids, and glucose. The present study sought to identify relations between polysomnographic measures of disturbed sleep (frequency of arousals from sleep, total sleep time, and sleep efficiency) and a number of such indicators. A second purpose was to relate the number of arousals to mood, stress, work characteristics, and other possible predictors in daily life.

    Methods: Twenty-four people (10 men, 14 women; mean age 30 years), high vs. low on burnout, were recruited from a Swedish IT company. Polysomnographically recorded sleep was measured at home before a workday. Blood pressure, heart rate, morning blood sample, and saliva samples of cortisol were measured the subsequent working day. They were also recorded for diary ratings of sleep and stress, and a questionnaire with ratings of sleep, stress, work conditions, and mood was completed.

    Results: A stepwise regression analysis using sleep parameters as predictors brought out number of arousals as the best predictor of morning cortisol (serum and saliva), heart rate, systolic and diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL)-, low-density lipoprotein (LDL)-cholesterol, and LDL/HDL-ratio. Work stress/unclear boundaries between work and leisure time was the best predictor of arousals among the stress variables.

    Conclusion: Consistent with sleep restriction experiments, sleep fragmentation was associated with elevated levels of metabolic and cardiovascular risk indicators of stress-related disorders. Number of arousals also seems to be related to workload/stress.

  • 75. Elmerstig, Eva
    et al.
    Wijma, Barbro
    Swahnberg, Katarina
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Linköping Univ, Fac Hlth Sci, Dept Clin & Expt Med, Unit Gender & Med, S-58183 Linköping.
    Prioritizing the partner's enjoyment: a population-based study on young Swedish women with experience of pain during vaginal intercourse2013Inngår i: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, nr 2, s. 82-89Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present study examines the prevalence of women who continue to have vaginal intercourse (VIC) despite pain, avoid telling the partner, and feign enjoyment. It also considers the reasons for this behavior. A sample of 1566 female senior high school students (aged 18-22 years) completed a questionnaire concerning their experiences and attitudes toward their body and sexuality. Forty-seven percent (270/576) of those women who reported pain during VIC continued to have VIC despite the pain. The most common reasons were that they did not want to spoil sex for or hurt the partner by interrupting VIC. Feigning enjoyment and not telling the partner about their pain were reported by 22 and 33%, respectively. Continuing to have VIC despite pain was associated with feelings of being inferior to the partner during sex, dissatisfaction with their own sex lives and feigning enjoyment while having pain. Pain during VIC is reported by every third young Swedish woman, and almost half of those still continue to have VIC. The major reason given is noteworthy - prioritizing the partner's enjoyment before their own - and indicates that young women who continue to have VIC despite pain take a subordinate position in sexual interactions.

  • 76.
    Ericson, Lisa
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Hovstadius, Bo
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Carlsson, Martin
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO). Kalmar County Hospital.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Wanby, Pär
    Kalmar County Hospital.
    A cost analysis of systematic vitamin D supplementation in the elderly versus supplementation based on assessed requirements2017Inngår i: Journal of Aging Research and Healthcare, ISSN 2474-7785, Vol. 2, nr 2, s. 13-22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Hypovitaminosis D is common among older people and treatment with vitamin D is associated with reduced risk of falls and fractures. This paper provides a cost analysis of assessing the vitamin D status of and providing the pharmaceuticals for elderly citizens in Kalmar County, Sweden (population approximately 230,000). Four hypothetical interventions were analyzed: (a) systematic vitamin D/calcium supplementation to all elderly (≥75 years), (b) assessment of vitamin D status in elderly and supplementation to those with insufficient levels, (c) systematic vitamin D/calcium supplementation to all nursing-home residents, and (d) assessment of vitamin D status in nursing-home residents and supplementation to those with insufficient levels. The calculations were based on an estimated reduction in overall costs due to the assessed number of hip fractures after vitamin D/calcium supplementation. The annual net economic benefit of vitamin D/calcium supplementation was estimated at (a) €304,000, (b) €860,000, (c) €755,000, and (d) €740,000. The provision of systematic vitamin D supplementation to nursing-home residents would provide a substantial net economic benefit to society and assessment of the vitamin D status before starting supplementation does not seem to be necessary. Although assessment of all elderly citizens would be more comprehensive, the true proportion with insufficient vitamin D levels in the general population is uncertain and to reaching consensus on the most advantageous daily vitamin D intake, vitamin D blood levels are necessary. Also, systematic supplementation to all elderly would result in other outcomes that could be worth the cost, but that remains to be evaluated.

  • 77.
    Fagerström, Cecilia
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Blekinge Centre of Competence.
    Wranker, Lena Sandin
    Lund University.
    Kabir, Zarina Nahar
    Karolinska Institutet.
    Sternäng, Ola
    Jönköping University;Södertörn University.
    Everyday health among older people: a comparison between two countries with variant life conditions2017Inngår i: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, artikkel-id 2720942Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study described health factors of importance for everyday health, such as pain, tiredness, and sleeping problems, in a cross-national context. Data for persons 60+ years were obtained from the Poverty and Health in Aging study, Bangladesh, and the Swedish National Study on Aging and Care-Blekinge. The strongest associations with everyday health in Sweden were found for pain and tiredness, while in Bangladesh they were financial status, tiredness, and sleeping problems. As similarities were found regarding the associations of tiredness on everyday health, tiredness may be a universal predictor of everyday health in older adults irrespective of country context.

  • 78.
    Furenbäck, Ingela
    Kristianstad University.
    Utveckling av samverkan: ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård2012Doktoravhandling, monografi (Annet vitenskapelig)
    Abstract [sv]

    Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.

    Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.

    Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.

    Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte  på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.

  • 79.
    Grandahl, Maria
    et al.
    Uppsala universitet.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Uppsala universitet.
    Stenhammar, Christina
    Uppsala universitet.
    Nevéus, Tryggve
    Uppsala universitet.
    Westerling, Ragnar
    Uppsala universitet.
    Tydén, Tanja
    Uppsala universitet.
    Not the right time: Why parents refuse to let their daughters have the human papillomavirus vaccination2014Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, nr 4, s. 436-441Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To explore why parents refused to allow their ten to 12-year-old daughters to

    receive the human papillomavirus (HPV) vaccination from the Swedish schoolbased

    vaccination programme.

    Methods: Individual interviews with 25 parents who had been offered, but not

    consented to, their daughters receiving the HPV vaccination.

    Results: Five themes emerged through the interviews: 1) she is just a little girl, 2)

    inadequate information, 3) not compatible with our way of life, 4) scepticism about

    the vaccination and 5) who can you trust? The parents made their decisions with

    their child’s best interests in mind. This was not considered the right time and the

    vaccine was perceived as unnecessary and different from other vaccines. Mistrust in

    Government recommendations and a lack of evidence or information were other

    reasons to decline.

    Conclusion: The decision-making process was complex. These parents preferred

    to wait until their daughter was older and believed the information they received from

    the school health system was insufficient. The results indicate that a more flexible

    HPV vaccination schedule may improve vaccine uptake. This includes more

    transparent information about the virus and the vaccine and information about who

    to contact to get the daughter vaccinated at a later date.

  • 80.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Uppsala University.
    Stenhammar, Christina
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Uppsala university.
    Andrén, Bengt
    Uppsala University.
    Dalianis, Tina
    Karolinska Institutet.
    Neveus, Tryggve
    Uppsala University.
    School-based intervention for the prevention of HPV among adolescents: a cluster randomised controlled study2016Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, nr 1, artikkel-id e009875Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To improve primary prevention of human papillomavirus (HPV) infection by promoting vaccination and increased condom use among upper secondary school students. Design: Cluster randomised controlled trial. Setting: 18 upper secondary schools in Sweden. Participants: Schools were first randomised to the intervention or the control group, after which individual classes were randomised so as to be included or not. Of the 832 students aged 16 years invited to participate during the regular individual health interview with the school nurse, 751 (90.2%) agreed to participate and 741 (89.1%) students completed the study. Interventions: The intervention was based on the Health Belief Model (HBM). According to HBM, a person’s health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 min face-to-face structured information about HPV, including cancer risks and HPV prevention, by propagating condom use and HPV vaccination. Students in the intervention and the control groups completed questionnaires at baseline and after 3 months. Main outcome measures: Intention to use condom with a new partner and beliefs about primary prevention of HPV, and also specifically vaccinationstatus and increased condom use. Results: All statistical analyses were performed at the individual level. The intervention had a significant effect on the intention to use condom (p=0.004). There was also a significant effect on HBM total score ( p=0.003), with a 2.559 points higher score for the intervention group compared to the controls. The influence on the HBM parameters susceptibility and severity was also significant (p<0.001 for both variables). The intervention also influenced behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls ( p=0.02). No harms were reported. Conclusions: The school-based intervention had favourable effects on the beliefs about primary prevention of HPV, and increased the HPV vaccination rates in a diverse population of adolescents.

  • 81.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Centre for Clinical Research Västerås ; Uppsala university ; Västerås Central Hospital.
    Stenhammar, Christina
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Dalianis, Tina
    Karolinska University Hospital.
    Nevéus, Tryggve
    Uppsala university.
    School-based intervention for the prevention of HPV among adolescents: a randomised controlled study2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: Vaccination against human papillomavirus (HPV) is one important factor for preconception health and care. In Sweden a national vaccination programme for girls was implemented in 2012.

    Aim: To improve primary prevention of HPV infection by promoting vaccination and increased condom use among upper secondary school students at time for the general health interview with the school nurse.

    Methods: Randomised controlled trial among upper secondary schools (n=18). Participant schools were first randomised to the intervention or the control group, after which individual classes were randomised to be included or not. 832 students, both boys and girls aged 16 were invited to participate and in the end, 741 (89.1%) students completed the study. The intervention was based on the Health Belief Model (HBM). According to HBM a person’s health behaviour can be explained by individual beliefs regarding health actions. School nurses delivered 30 minute face-to-face structured information about HPV, including cancer risks and HPV prevention, i.e. condom use and HPV vaccination. Students in both groups completed questionnaires at baseline and after three months.

    Results: The intervention had positive effect on behaviour: girls in the intervention group chose to have themselves vaccinated to a significantly higher degree than the controls (p=0.02). There was also a significant effect on HBM total score (p=0.003), students in the intervention group had more favourable beliefs compared to the controls. The influence on the HBM parameters susceptibility and severity were also significant (p<0.001 for both variables). In addition, the intervention had significant effect on the intention to use condom (p=0.004).

    Conclusion: The school-based intervention increased HPV vaccination rates and had favourable effects on beliefs towards primary prevention of HPV in a diverse population of adolescents. These resultss provide the scientific support for the implication of nation-wide educational interventions with the potential to improve preconception health.

  • 82.
    Grandahl, Maria
    et al.
    Uppsala university.
    Rosenblad, Andreas
    Centre for Clinical Research Västerås ; Uppsala university ; Västerås Central Hospital.
    Stenhammar, Christina
    Uppsala university.
    Westerling, Ragnar
    Uppsala university.
    Larsson, Margareta
    Uppsala university.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Andrae, Bengt
    Uppsala University ; Region of Gävleborg.
    Dalianis, Tina
    Karolinska University Hospital.
    Nevéus, Tryggve
    Uppsala university.
    A school-based educational intervention can increase adolescents’ knowledge and awareness about HPV2016Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background / Objectives

    Background: In Sweden HPV vaccination is offered to girls aged 10-12 years within the school-based vaccination program, while older girls (13-26 years) are offered the vaccine through the primary care. The vaccination rates are substantially lower (59%) among the catch-up group compared to the younger age group (82%). Adolescents have low awareness and knowledge about HPV, especially regarding cancer risks. The providers - school nurses - play a key role in providing such information. Upper secondary school students, aged 16 years, are by the school nurse offered a health interview, which includes a dialogue regarding their health, including sexual health. The health interview does however not include systematic information about HPV.

    Objectives: To improve adolescents’ knowledge and awareness about primary prevention of high risk HPV infection.

    Methods

    Methods: A cluster-randomised controlled trial among upper secondary schools (n=18) was performed. Schools were first randomised to an intervention or control group, after which individual classes were randomised. In total, 832 students, boys and girls aged 16 years attending theoretical or vocational programs were invited to participate. In the end, 741 (89.1%) students completed the256study. The intervention was based on the Health Belief Model (HBM). School nurses delivered 30 minutes of face-to-face structured information about HPV, including cancer risks and HPV prevention (i.e. condom use and HPV vaccination) to the intervention group. Students in both groups completed questionnaires at baseline and at follow-up after three months. The control group received standard treatment, i.e. the regular health interview with the school nurse. Generalized estimating equation analyses were used for examining the results of the intervention.

    Results

    Results: The intervention had positive effects on the adolescents’ knowledge (p<0.001), with a 0.582 higher score for the intervention group compared to the control group. There were no differences in knowledge due to sex (p=0.093) or immigrant background (p=0.592). The intervention also increased awareness (p<0.001), with a 0.590 higher score for the intervention compared to the control. Again, there were no differences in awareness due to sex (p=0.183) or immigrant background (p=0.319).

    Conclusion

    Conclusions: The school-based intervention delivered by school nurses, had favourable effects on knowledge and awareness about primary prevention of HPV among adolescents aged 16 years.

  • 83.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Gottvall, Maria
    Uppsala University.
    Westerling, Ragnar
    Uppsala University.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Uppsala University.
    Immigrant women's experiences and views on prevention of cervical cancer: A qualitative study2015Inngår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, nr 3, s. 344-354Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Many Western countries have cervical cancer screening programmes and have implemented nation-wide human papillomavirus (HPV) vaccination programmes for preventing cervical cancer.

    Objective

    To explore immigrant women’s experiences and views on the prevention of cervical cancer, screening, HPV vaccination and condom use.

    Design

    An exploratory qualitative study. The Health Belief Model (HBM) was used as a theoretical framework.

    Setting and participants

    Eight focus group interviews, 5–8 women in each group (average number 6,5), were conducted with 50 women aged 18–54, who studied Swedish for immigrants. Data were analysed by latent content analysis.

    Results

    Four themes emerged: (i) deprioritization of women’s health in home countries, (ii) positive attitude towards the availability of women’s health care in Sweden, (iii) positive and negative attitudes towards HPV vaccination, and (iv) communication barriers limit health care access. Even though the women were positive to the prevention of cervical cancer, several barriers were identified: difficulties in contacting health care due to language problems, limited knowledge regarding the relation between sexual transmission of HPV and cervical cancer, culturally determined gender roles and the fact that many of the women were not used to regular health check-ups.

    Conclusion

    The women wanted to participate in cervical cancer prevention programmes and would accept HPV vaccination for their daughters, but expressed difficulties in understanding information from health-care providers. Therefore, information needs to be in different languages and provided through different sources. Health-care professionals should also consider immigrant women’s difficulties concerning cultural norms and pay attention to their experiences.

     

  • 84.
    Grandahl, Maria
    et al.
    Uppsala university.
    Tydén, Tanja
    Uppsala university.
    Rosenblad, A.
    Uppsala university.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Nevéus, Tryggve
    Uppsala university.
    Stenhammar, C.
    Uppsala university.
    A population based survey of school nurses' attitudes to the implemented HPV vaccination programme in Sweden2015Inngår i: Eurogin 2015: abstracts part 2, 2015, s. 168-168Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Objective: To investigate school nurses’ attitudes to, and experiences of the school-based HPV vaccination programme,one year after its implementation in Sweden.

    Methods: Data were collected using a web-based questionnaire in spring 2013, and 83.1% (851/1024) of the nursesanswered the questionnaire.

    Results: The majority (88.9%, n=756) agreed that HPV vaccinations should be the school nurses’ responsibility, and mostalso agreed (81.5%, n=693) that boys also should be offered the vaccine. Two thirds, 66.9% (n=570), stated that they hadexperienced difficulties with the vaccination and of these 59.1% (n=337) considered the task time-consuming. Three outof four nurses, 76.1% (n=648), had been contacted by parents who raised questions regarding the vaccine. The most commonquestions were related to side effects. There were strong associations between the nurses’ received education aboutthe HPV vaccine and perceived knowledge about the HPV vaccine and a favourable attitude towards vaccination (both p<0.001). A school nurse with a high level of received education was 9.8 times more likely to have a positive attitude to HPVvaccination compared to a nurse with a low level of received education (p<0.001). Nurses with high perceived knowledgewere 2.5 times more likely to have a positive attitude compared to those with a low level of perceived knowledge(p=0.006).

    Conclusions: HPV vaccination is a complex and time-consuming task and the school nurses need adequate knowledge,education, skills and time in order to address questions and concerns from parents, as well as informing about HPV.

  • 85.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Rosenblad, Andreas
    Uppsala University.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Uppsala University.
    Nevéus, Tryggve
    Uppsala University.
    Stenhammar, Christina
    Uppsala University.
    School nurses' attitudes and experiences regarding the human papillomavirus vaccination programme in Sweden: a population-based survey2014Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, artikkel-id 540Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Sweden introduced a school-based human papillomavirus (HPV) vaccination programme in 2012, and school nurses are responsible for managing the vaccinations. The aim of the present study was to investigate the attitudes and experiences of school nurses regarding the school-based HPV vaccination programme 1 year after its implementation. Methods: Data were collected using a web-based questionnaire in the spring of 2013, and 83.1% (851/1024) of nurses responded. Results: There were strong associations between the nurses' education about the HPV vaccine and their perceived knowledge about the vaccine and a favourable attitude towards vaccination (both p < 0.001). School nurses who received a high level of education were more likely to have a positive attitude to HPV vaccination compared with nurses with little education about HPV vaccination (adjusted odds ratio [OR] = 9.8; 95% confidence interval [CI]: 3.797-25.132). Nurses with high perceived knowledge were more likely to have a positive attitude compared with those with a low level of perceived knowledge (OR = 2.5; 95% CI: 1.299-4.955). If financial support from the government was used to fund an additional school nurse, nurses were more likely to have a positive attitude than if thefinancial support was not used to cover the extra expenses incurred by the HPV vaccination (OR = 2.1; 95% CI: 1.051-4.010). The majority, 648 (76.1%), had been contacted by parents with questions aboutthe vaccine, mostly related to adverse effects. In addition, 570 (66.9%) stated that they had experienced difficulties with the vaccinations, and 337 (59.1%) of these considered the task to be time-consuming. Conclusions: A high level of education and perceived good knowledge about HPV are associated with a positive attitude of school nurses to the HPV vaccination programme. Thus, nurses require adequate knowledge, education, skills and time to address the questions and concerns of parents, as well as providing information about HPV. Strategic financial support is required because HPV vaccination is a complex and time-consuming task.

  • 86.
    Grandahl, Maria
    et al.
    Uppsala University.
    Tydén, Tanja
    Uppsala University.
    Westerling, Ragnar
    Uppsala University.
    Nevéus, Tryggve
    Uppsala University.
    Rosenblad, Andreas
    Uppsala University.
    Hedin, EriK
    Uppsala University.
    Oscarsson, Marie
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Uppsala University.
    To consent or decline HPV vaccination: a pilot study at the start of the national school-based vaccination program in Sweden2017Inngår i: Journal of School Health, ISSN 0022-4391, E-ISSN 1746-1561, Vol. 87, nr 1, s. 62-70Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND

    Parents' beliefs about human papillomavirus (HPV) vaccination influence whether they allow their daughters to be vaccinated. We examined the association between parents' refusal and sociodemographic background, knowledge and beliefs about HPV, and the HPV vaccination in relation to the Health Belief Model.

    METHODS

    The sample consisted of 200 (55%) parents of children aged 11-12 years in the Swedish national vaccination program. Data were collected using a self-reported questionnaire. Most parents (N = 186) agreed to the vaccination. Pearson's chi-square, Fisher's exact test, and the Mann-Whitney U test were used to analyze data.

    RESULTS

    Declining parents saw more risks and fewer benefits of HPV vaccination but no differences in beliefs regarding the severity or young girls' susceptibility to HPV were found. There was an association between refusing the HPV vaccine and lower acceptance of previous childhood vaccinations, and their main source of information was the Internet. Parents who declined the vaccine believed it could adversely affect condom use, the age of their daughter's sexual debut, and the number of sexual partners.

    CONCLUSION

    Parents should have the possibility to discuss HPV and HPV vaccine with a school nurse or other health care professionals, and should have access to evidence-based information on the Internet.

  • 87. Grjibovski, Andrej M
    et al.
    Bergman, Patrick
    Hagströmer, Maria
    Hurtig-Wennlof, Anita
    Meusel, Dirk
    Ortega, Francisco B
    Patterson, Emma
    Poortvliet, Eric
    Rizzo, Nico
    Ruiz, Jonatan R
    Wärnberg, Julia
    Sjöström, Michael
    A dropout analysis of the second phase of the Swedish part of the European Youth Heart Study2006Inngår i: Journal of Public Health, Vol. 14, nr 5, s. 261-268Artikkel i tidsskrift (Fagfellevurdert)
  • 88.
    Grossi, Giorgio
    et al.
    National Institute for Psychosocial Factors and Health, Stockholm.
    Perski, Aleksander
    National Institute for Psychosocial Factors and Health, Stockholm.
    Ekstedt, Mirjam
    National Institute for Psychosocial Factors and Health, Stockholm.
    Johansson, Thorbjörn
    National Institute for Psychosocial Factors and Health, Stockholm.
    Lindström, Morie
    Uppsala University.
    Holm, Karin
    Uppsala University.
    The morning salivary cortisol response in burnout.2005Inngår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 59, nr 2, s. 103-111Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The results of the present study indicate a dysregulation in hypothalamic-pituitary-adrenocortical axis (HPA axis) activity, characterised by elevated morning salivary cortisol levels, among female burnout patients. Among males, increased cortisol levels were observed among participants with moderate levels of burnout, but not among patients or healthy controls.

  • 89.
    Hadziabdic, Emina
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Albin, Björn
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Hjelm, Katarina
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Arabic-speaking migrants’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey2014Inngår i: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, artikkel-id 71Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Good communication is an important prerequisite for equal treatment in a healthcare encounter. One way to overcome language barriers when patients and healthcare staff do not share the same language is to use a professional interpreter. Few previous studies have been found investigating the use of interpreters, and just one previous study from the perspective of European migrants, which showed that they perceived interpreters as a communication aid and a guide in the healthcare system as regards information and practical matters. No previous study has gathered quantitative information to focus on non-European migrants’ attitudes to the use of interpreters in healthcare encounters. Thus, the aim of this study was to investigate Arabic-speaking individuals’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare in order to: (i) understand how persons’ expectations and concerns regarding interpreters may vary, both within and across cultural/linguistic populations; (ii) understand the consequences of diverse opinions/expectations for planning responsive services; and (iii) confirm findings from previous qualitative studies.

    Method

    A postal cross-sectional study using a structured self-administered 51-item questionnaire was used to describe and document aspects of Arabic-speaking individuals’ attitudes to the use of interpreters in healthcare. The sample of 53 Arabic-speaking migrants was recruited from three different places. Participants were mostly born in Iraq and had a high level of education and were almost equally divided between genders. Data were analysed with descriptive statistics.

    Results

    The main findings were that most of the participants perceived the interpreter’s role as being a communication aid and a practical aid, interpreting literally and objectively. Trust in the professional interpreter was related to qualification as an interpreter and personal contact with face-to-face interaction. The qualities of the desired professional interpreter were: a good knowledge of languages and medical terminology, translation ability, and sharing the same origin, dialect and gender as the patient.

    Conclusion

    This study confirmed previous qualitative findings from European migrant groups with a different cultural and linguistic background. The study supports the importance of planning a good interpretation situation in accordance with individuals’ desire, irrespective of the migrant’s linguistic and cultural background, and using interpreters who interpret literally and objectively, who are highly trained with language skills in medical terminology, and with a professional attitude to promote communication, thus increasing cost-effective, high-quality individualized healthcare.

  • 90.
    Hagell, Peter
    et al.
    Kristianstad University.
    Westergren, Albert
    Kristianstad University.
    Årestedt, Kristofer
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV). Kalmar Cty Hospital ; Linköping University.
    Beware of the origin of numbers: Standard scoring of the SF-12 and SF-36 summary measures distorts measurement and score interpretations2017Inngår i: Research in Nursing & Health, ISSN 0160-6891, E-ISSN 1098-240X, Vol. 40, nr 4, s. 378-386Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The 12-item Short Form Health Survey (SF-12) is a generic health rating scale developed to reproduce the Physical and Mental Component Summary scores (PCS and MCS, respectively) of a longer survey, the SF-36. The standard PCS/MCS scoring algorithm has been criticized because its expected dimensionality often lacks empirical support, scoring is based on the assumption that physical and mental health are uncorrelated, and because scores on physical health items influence MCS scores, and vice versa. In this paper, we review the standard PCS/MCS scoring algorithm for the SF-12 and consider alternative scoring procedures: the RAND-12 Health Status Inventory (HSI) and raw sum scores. We corroborate that the SF-12 reproduces SF-36 scores but also inherits its problems. In simulations, good physical health scores reduce mental health scores, and vice versa. This may explain results of clinical studies in which, for example, poor physical health scores result in good MCS scores despite compromised mental health. When applied to empirical data from people with Parkinson's disease (PD) and stroke, standard SF-12 scores suggest a weak correlation between physical and mental health (r(s). 16), whereas RAND-12 HSI and raw sum scores show a much stronger correlation (r(s). 67-.68). Furthermore, standard PCS scores yield a different statistical conclusion regarding the association between physical health and age than do RAND-12 HSI and raw sum scores. We recommend that the standard SF-12 scoring algorithm be abandoned in favor of alternatives that provide more valid representations of physical and mental health, of which raw sum scores appear the simplest.

  • 91.
    Hagman, Jan
    et al.
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för pedagogik (PED).
    Hagman, Theresia
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för pedagogik (PED).
    Ett livslångt tränande: Elevers syn på idrottsundervisning i skolan och fortsatt fysisk aktivitet2013Independent thesis Basic level (university diploma), 210 hpOppgave
    Abstract [sv]

    Abstrakt

     

    Huvudsyftet med elevers skolgång är att förbereda barn och ungdomar för livets fortsatta utmaningar. Med ämnet idrott och hälsa vill man enligt styrdokumenten hjälpa elever in på en hälsosam livsstil och få dem att bry sig om sin och andras hälsa livet ut (Skolverket, 2011). ”Skolan går ut på att barn och ungdomar skall lära sig saker och ting som är nödvändiga för att klara sig i livet och alla ämnen bidrar till elevers lärande, eller med ett annat uttryck, bildning” (Annerstedt, 2007, s. 25). Läraren i idrott och hälsa har naturligtvis en central roll i uppdraget att väcka elevers intresse för ett fysiskt aktivt liv.

     

    Det övergripande syftet med denna rapport är att undersöka med hjälp av en kvantitativ metod hur elever i årskurs 7 respektive årskurs 9 ser på ämnet idrott och hälsa.  

    Studien som genomförts visar att majoriteten av eleverna som deltagit i undersökningen gillar ämnet idrott och hälsa. Man kan dock se vissa skillnader mellan de olika årskurserna och mellan pojkars och flickors syn på ämnet idrott och hälsa.

     

    Huvudsyftet med elevers skolgång är att förbereda barn och ungdomar för livets fortsatta utmaningar. Med ämnet idrott och hälsa vill man enligt styrdokumenten hjälpa elever in på en hälsosam livsstil och få dem att bry sig om sin och andras hälsa livet ut (Skolverket, 2011). ”Skolan går ut på att barn och ungdomar skall lära sig saker och ting som är nödvändiga för att klara sig i livet och alla ämnen bidrar till elevers lärande, eller med ett annat uttryck, bildning” (Annerstedt, 2007, s. 25). Läraren i idrott och hälsa har naturligtvis en central roll i uppdraget att väcka elevers intresse för ett fysiskt aktivt liv.

     

    Det övergripande syftet med denna rapport är att undersöka med hjälp av en kvantitativ metod hur elever i årskurs 7 respektive årskurs 9 ser på ämnet idrott och hälsa.  

    Studien som genomförts visar att majoriteten av eleverna som deltagit i undersökningen gillar ämnet idrott och hälsa. Man kan dock se vissa skillnader mellan de olika årskurserna och mellan pojkars och flickors syn på ämnet idrott och hälsa.

  • 92. Hagströmer, Maria
    et al.
    Bergman, Patrick
    DeBourdeaudhuij, Ilse
    Ortega, Francisco B
    Ruiz, Jonatan R
    Manios, Yannis
    Rey, Pablo
    Phillipp, Katharina
    Von Berlepsch, Juliana
    Sjöström, Michael
    Concurrent validity of a modified version of the International Physical Activity Questionnaire (IPAQ-A) in European adolescents - The HELENA study2008Inngår i: Int J Obes (Lond), Vol. 32, s. S42-S48Artikkel i tidsskrift (Fagfellevurdert)
  • 93. Hagströmer, Maria
    et al.
    Bergman, Patrick
    Oja, Pekka
    Sjöström, Michael
    Are over weight adults less physically active than normal weight adults?2006Inngår i: 2nd annual meeting of HEPA Europe, Tampere Finland, 2006Konferansepaper (Fagfellevurdert)
  • 94. Hagströmer, Maria
    et al.
    Bergman, Patrick
    Sjöstrom, Michael
    Är överviktiga mindre aktiva än normalviktiga?2005Inngår i: Läkarstämman, Stockholm, 2005Konferansepaper (Fagfellevurdert)
  • 95. Hagströmer, Maria
    et al.
    Bergman, Patrick
    Sjöström, Michael
    Experiences of the use accelerometers to assess physical activity on a national sample – The ALPHA project2008Inngår i: International Conference on Physical Activity and Health, Amsterdam, 2008Konferansepaper (Fagfellevurdert)
  • 96. Hagströmer, Maria
    et al.
    Bergman, Patrick
    Sjöström, Michael
    The International Prevalence Study; Health Enhancing Physical Activity in Sweden.2006Inngår i: Journal of Public Health, Vol. 14, nr 2Artikkel i tidsskrift (Fagfellevurdert)
  • 97.
    Hagströmer, Maria
    et al.
    Karolinska Institutet.
    Kwak, Lydia
    Karolinska Institutet.
    Hallman, David
    University of Gävle.
    Grooten, Wim
    Karolinska Institutet.
    Bergman, Patrick
    Linnéuniversitetet, Fakulteten för samhällsvetenskap (FSV), Institutionen för idrottsvetenskap (ID).
    A holistic approach in measuring occupational physical activity: challenges and potentials2015Konferansepaper (Fagfellevurdert)
  • 98.
    Hammar, Tora
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Lidström, Bodil
    Swedish eHealth Agency.
    Petersson, Göran
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för medicin och optometri (MEO).
    Gustafson, Yngve
    Umeå University.
    Eiermann, Birgit
    Karolinska Institutet ; Swedish eHealth Agency.
    Potential drug-related problems detected by electronic expert support system: physicians’ views on clinical relevance2015Inngår i: International Journal of Clinical Pharmacy, ISSN 2210-7703, E-ISSN 2210-7711, Vol. 37, nr 5, s. 941-948Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Drug-related problems cause suffering for patients and substantial costs. Multi-dose drug dispensing is a service in which patients receive their medication packed in bags with one unit for each dose occasion. The electronic expert support system (EES) is a clinical decision support system that provides alerts if potential drug-related problems are detected among a patients’ current prescriptions, including drug–drug interactions, therapy duplications, high doses, drug-disease interactions, drug gender warnings, and inappropriate drugs and doses for geriatric or pediatric patients. Objective The aim of the study was to explore physicians’ views on the clinical relevance of alerts provided by EES. Furthermore we investigated if physicians performed any changes in drug treatment following the alerts and if there were any differences in perceived relevance and performed changes between different types of alerts and drugs. Setting Two geriatric clinics and three primary care units in Sweden. Method Prescribed medications for patients (n = 254) with multi-dose drug dispensing were analyzed for potential drug-related problems using EES. For each alert, a physician assessed clinical relevance and indicated any intended action. A total of 15 physicians took part in the study. Changes in drug treatment following the alerts were later measured. The relationship between variables was analyzed using Chi square test. Main outcome measure Physicians’ perceived clinical relevance of each alert, and changes in drug treatment following the alerts. ResultsPhysicians perceived 68 % (502/740) of EES alerts as clinically relevant and 11 % of all alerts were followed by a change in drug treatment. Clinical relevance and likelihood to make changes in drug treatment was related to the alert category and substances involved in the alert. Conclusion In most patients with multi-dose drug dispensing, EES detected potential drug-related problems, with the majority of the alerts regarded as clinically relevant and some followed by measurable changes in drug treatment.

  • 99.
    Hellman, Alicia
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Törn, Fanny
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Motiverande samtal i förebyggandet av livsstilsrelaterade sjukdomar: En intervjustudie ur sjuksköterskans perspektiv2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Livsstilsrelaterade sjukdomar är idag de mest förekommande sjukdomarna i Sverige. Sjukdomar som orsakas av ohälsosamma levnadsvanor kan förebyggas genom att leva mer hälsosamt. Motiverande samtal är en samtalsmetod som sjuksköterskan kan använda sig av i arbetet med att hjälpa patienter hitta motivation till livsstilsförändring med mål att förebygga livsstilsrelaterade sjukdomar.

    Syfte: Syftet med studien var att beskriva sjuksköterskans upplevelser av Motiverande samtal i förebyggandet av livsstilsrelaterade sjukdomar

    Metod: En kvalitativ intervjustudie med semistrukturerade frågor där sex intervjuer genomfördes med sjuksköterskor som arbetade på vårdcentraler, strålenhet, tobakavvänjning, inom företagshälsovård och hemsjukvård i södra Sverige. En manifest innehållsanalys användes för att analysera materialet från intervjuerna.

    Resultat: Sjuksköterskornas upplevelser sammanställdes i fyra kategorier och nio underkategorier. De fyra kategorierna som framkom var Olika strategier i förändringsprocessen, Patienten som en del i vårdteamet, Faktorer som har betydelse för livsstilsförändring och Styrkor och svagheter med MI.  

    Slutsats: Sjuksköterskorna upplever MI som ett hjälpmedel i arbetet med att förebygga livsstilsrelaterade sjukdomar. MI upplevs också främja patienters delaktighet och egenvård. Att arbeta förebyggande mot livsstilsrelaterade sjukdomar genom MI upplevs kunna främja kostnadseffektivitet i samhället, minska belastning på sjukvården och förbättra folkhälsan. Svårigheter som upplevs i tillämpningen av MI är vid situationer med språk- och kulturskillnader och kan därför vara ett ämne för vidare forskning.

  • 100.
    Herlitz, Johan
    et al.
    University of Borås, Sweden.
    Axelsson, Christer
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Hagiwara, Magnus
    University of Borås, Sweden.
    Englund, Lotta
    University of Borås, Sweden.
    Så skapas världens bästa ambulanssjukvård2011Inngår i: Göteborgsposten, ISSN 1103-9345, nr 2011-05-14Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Tiden från larm till dess att ambulans kommer har ökat dramatiskt de senaste tio åren i Västra Götaland. Samtidigt bedöms allt fler i behov av snabb utryckning. Kompetens finns att råda bot på detta – om den tillåts styra utvecklingen, skriver bland andra professor Johan Herlitz.

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