| 51. |
- Nordin, Maria, et al.
(författare)
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Sleep discontinuity and impaired sleep continuity affect transition to and from obesity over time : results from the Alameda county study.
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : Sage. - 1403-4948 .- 1651-1905. ; 38:2, s. 200-207
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate the impact of development in sleep continuity on transition to and from obesity over time. METHOD: The study used self-reported sleep and body mass index (BMI) measures from the 1965, 1974, 1983, and 1994 waves of the longitudinal Alameda County Study. Sleep continuity was assessed by a question on whether the participants had any troubles falling or staying asleep. Change in sleep and BMI were estimated from the sleep and BMI questions in 1965 and 1994 respectively. Multinomial regression analyses were used to examine the risk/chance for a transition to and from obesity (BMI >or=30 kg/m(2)) due to development in sleep continuity. RESULTS: After adjustment for confounding variables, consistent sleep discontinuity both increases the risk for a transition to obesity and reduces the chance of losing weight, whereas impaired sleep continuity lowers the chance for weight loss. Effects for obesity were non-significant for those with improved sleep continuity. CONCLUSIONS: Consistent sleep discontinuity and impaired sleep continuity increases the risk of transition to obesity or of remaining obese.
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| 52. |
- Nordyke, Katrina, et al.
(författare)
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How do children experience participating in a coeliac disease screening? A qualitative study based on childrens written narratives
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 38:4, s. 351-358
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore how 12-year-old Swedish children experienced being involved in a coeliac disease (CD) screening. Methods: A qualitative approach was used to analyse short narratives written by children who had taken part in a school-based CD screening. Narratives were written after blood sampling, but prior to learning of the test results. Through an oscillation between the texts, codes, subcategories and four categories, a theme was generated describing the childrens experience. Results: The theme "A Journey towards Confidence" captures the overall experience of the screening. It illustrates that, although some children faced fear or anxiety, overall they had or were provided tools allowing them to cope well and experience a journey towards confidence. The categories describe conditions that contributed to the experience. The first, being involved, reflects the importance of involvement in receiving information and deciding to participate. Being a "good citizen" refers to feeling a duty to help and a trust to be treated fairly. Being able to cope with the screening was influenced by the childrens ability to manage sensations and support received. The last category, being able to balance risk, illustrates that the children were able to balance the risks of screening when they had a realistic understanding of the disease and their vulnerability and had tamed their anxiety. Conclusions: This study increases the understanding of how 12-year-old Swedish children experienced participating in a CD screening and describes conditions important for a positive experience. We show that, although some children faced anxiety, they had, or were provided with, tools allowing them to cope well and gain confidence.
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| 53. |
- Nygren, Karina, 1974-, et al.
(författare)
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Norm compliance and self-reported health among Swedish adolescents
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 44-50
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study examines the relationship between norm compliance and self-reported health in adolescents, and how this differs between genders. Our specific aim was to investigate if extremely high norm compliance revealed any particular health patterns. Methods: This empirical study used a web-based survey from 2005, which was distributed to all students (n = 5,066) in years 7—9 of compulsory school within six municipalities in northern Sweden. The respondents answered questions about their general health as well as specific health problems such as headaches, stomach ache, sleeping difficulties and stress. Compliance was measured according to different norm-related behaviour, such as truancy, crime and use of tobacco, alcohol and narcotics. Results: The majority of respondents reported good health and norm-compliant behaviour. Girls reported more health problems than boys, a difference that increased with age. Those who were more norm compliant reported better health, fewer somatic complaints and less stress, which goes against our initial hypothesis that extremely high norm compliance and self-reported ill-health are related. There seemed to be a stronger relationship between self-reported health and norm compliance for girls than boys, in absolute terms. Conclusions: The results clearly show a relationship between norm compliance and health, and suggest inequalities between genders.
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| 54. |
- Omar, Faisal, et al.
(författare)
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Incentivizing deceased organ donation : A Swedish priority-setting perspective.
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE. - 1403-4948 .- 1651-1905. ; 39:2, s. 156-163
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The established deceased organ donation models in many countries, relying chiefly on altruism, have failed to motivate a sufficient number of donors. As a consequence organs that could save lives are routinely missed leading to a growing gap between demand and supply. The aim of this paper is twofold; firstly to develop a proposal for compensated deceased organ donation that could potentially address the organ shortage; secondly to examine the compatibility of the proposal with the ethical values of the Swedish healthcare system. METHODS: The proposal for compensating deceased donation is grounded in behavioural agency theory and combines extrinsic, intrinsic and signalling incentives in order to increase prosocial behaviour. Furthermore the compatibility of our proposal with the values of the Swedish healthcare system is evaluated in reference to the principles of human dignity, needs and solidarity, and cost effectiveness. RESULTS: Extrinsic incentives in the form of a €5,000 compensation towards funeral expenses paid to the estate of the deceased or family is proposed. Intrinsic and signalling incentives are incorporated by allowing all or part of the compensation to be diverted as a donation to a reputable charity. The decision for organ donation must not be against the explicit will of the donor. CONCLUSIONS: We find that our proposal for compensated deceased donation is compatible with the values of the Swedish healthcare system, and therefore merits serious consideration. It is however important to acknowledge issues relating to coercion, commodification and loss of public trust and the ethical challenges that they might pose.
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| 55. |
- Osman, Fatumo, et al.
(författare)
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Perceptions of the use of khat among Somali immigrants living in Swedish society
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to gain a better understanding of Somali immigrants’ perceptions of the use of khat living in Swedish society. Using khat is illegal in SwedenMethods: A phenomenographic design was used to capture different perception of using khat. Fourteen interviews were conducted with both men and women. The information was subjected to phenomenographic analysis.Findings: Perceptions of the habit of chewing khat among Somalis living in Sweden vary. The use of khat is perceived as a kind of food or as a drug. To use khat is perceived as having a physical impact on individual health, as well as an impact on social and family life. Using khat also has an impact on people’s time, because time is needed to indulge the habit. Furthermore, using khat is perceived as a medium for cultural and community cohesiveness. The Somalis prefered preventive measures in place to counter the use of khat in SwedenConclusions: The use of a phenomenographic design which captured the variation in perceptions of the habit of using khat among Somali immigrants’ living in Swedish society is helpful in guiding individual strategies in health promotion activities.
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| 56. |
- Ostberg, Anna-Lena, et al.
(författare)
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Group treatment of obesity in primary care practice : A qualitative study of patients' perspectives
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 98-105
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore patients' experiences of very low calorie diet (VLCD) and subsequent corset treatment of obesity in a primary care setting, and to explore their perceptions of factors influencing weight control. Methods: In western Sweden, five focus group sessions were carried out. The main themes for the discussions were the informants' perceptions of the treatment they had received and their experiences of living with obesity. The analysis was based on the Grounded Theory methodology. Results: The outcomes reflect obese individuals' struggle to handle the demands of their life situation and to recognize their own resources. The core category generated was labelled "Achieving a balance in life and adjusting one's identity". Three categories related to the process of weight reduction were identified: living with obesity, reducing weight and developing self-management. The group treatment with VLCD was positively perceived by the participants, but the corset treatment was considered to be of less value. Conclusions: Maintenance after weight reduction was demanding and the findings indicate a need for extended support. For some individuals the corset treatment could be a psychological support. Follow-up after weight reduction programmes should focus on long-term self-help strategies.
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| 57. |
- Reine, Ieva, 1972-, et al.
(författare)
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Is participation in labour market programmes related to mental health? : results from a 14-year follow-up of the Northern Swedish cohort
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 26-34
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Tidskriftsartikel (refereegranskat)abstract
- Aims: There is a lack of empirical studies assessing the possible impact of active labour market programmes (ALMP) on health. The aim of this study was to analyze whether participation in ALMP, in contrast to being unemployed and not participating in ALMP (UNALMP), was related to mental health at different ages. Methods: The study was carried out in a medium-sized industrial town in the north of Sweden. The cohort, consisting of all 1,083 pupils who attended or should have attended the last year of compulsory school in 1981, was followed up at the ages of 16, 18, 21 and 30. Data on 381 individuals at age 21, and 281 at age 30 were used in the study. The main health measurement was psychological symptoms among participants of ALMP in contrast to UNALMP at ages 21 and 30, and was analyzed by propensity score matching method (PSM) and multivariate logistic regression. Results: Generally, ALMP had higher scores of psychological symptoms than UNALMP. Nevertheless, participation in ALMP was not related to mental health. Due to methodological shortages our results have to be interpreted with caution. Adjustment for either all background selection variables or the propensity score in multivariate logistic regression showed similar associations, suggesting that propensity score could be used to adjust for background selection variables. Conclusions: There is a need for more well-designed studies, using a theoretical framework, within the field, that are based on larger samples.
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| 58. |
- Romé, Åsa, et al.
(författare)
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Willingness to pay for health improvements of physical activity on prescription.
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38, s. 151-159
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To estimate the willingness to pay for health improvements among participants in the programme "Physical Activity on Prescription". The objective was also to examine predictors such as income, education level, health status, activity level and BMI, differences for long- and short-term health effects of physical activity and differences between a high- and low-intensity activity group. METHODS: Willingness to pay (WTP) data were collected alongside a randomized, controlled trial in Sweden 2007, and 128 sedentary individuals, 20-80 years old (intervention/high-intensity group n = 71, control/low-intensity group n = 57), with lifestyle-related health problems answered open-ended questions in this contingent valuation study. RESULTS: The highest mean WTP (euro59/SEK 552) was stated for an immediate health improvement, but no significant differences compared with long-term health improvements. The high-intensity group showed higher WTP-values for all health improvements, but without significant differences compared with a low-intensity group. Regression analyses show strong associations between a higher level of education and the WTP for improved well-being and improved health, and also between income and the WTP for improved well-being. There are significant correlations between the WTP and the variables BMI, income and education level, as expected from economic theories. CONCLUSIONS: The willingness to pay for the health improvements of exercise is influenced by a higher education level, income and BMI. The highest WTP for a health outcome of physical activity is for an immediate health improvement. The results of this randomized controlled trial in primary health care may be of interest to decision makers when evaluating different approaches to promoting physical activity among people who are sedentary.
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| 59. |
- Ropponen, A, et al.
(författare)
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Association between hand grip/body weight ratio and disability pension due to musculoskeletal disorders: a population-based cohort study of 1 million Swedish men
- 2011
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 830-838
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate the predictive value of hand grip/body weight ratio and hand grip strength in early adulthood for obtaining a disability pension (DP) due to musculoskeletal disorders in later life. Methods: A nationwide population-based sample of men born 1951–76 ( n = 1,387,166) in Sweden and anthropometric and strength indicators from their conscription examination. Register data on the date and diagnoses of granted DP between the years 1971–2006. Cox proportional hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (95% CI). Results: The lowest quintile of hand grip/body weight ratio predicted a greatly increased risk (HR 2.51, 95% CI 2.40–2.63) for DP due to musculoskeletal disorders compared to the mid-quintile. The highest quintile of hand grip/body weight ratio predicted a decreased risk (HR 0.80, 95% CI 0.75–0.84). Stratification of the hand grip/body weight ratio with body mass index confirmed the results. However, the highest quintiles of hand grip strength adjusted for height and weight predicted a somewhat increased risk for DP due to musculoskeletal disorders (HR 1.25, 95% CI 1.18–1.32). Conclusions: This study indicates that the hand grip/body weight ratio in young adulthood is strongly and inversely associated with men's risk of obtaining a disability pension due to musculoskeletal disorders in later life. However, the risk seems to be mediated through the body weight. The properties of hand grip/body weight ratio should be further evaluated before it can be recommended for use in clinical and epidemiological studies.
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| 60. |
- Ropponen, A, et al.
(författare)
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Health-related risk factors for disability pensions due to musculoskeletal diagnoses: a 30-year Finnish twin cohort study
- 2011
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 39:8, s. 839-848
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Tidskriftsartikel (refereegranskat)abstract
- Aims: There is a need to better understand work incapacity due to musculoskeletal disorders (MSD) and the factors that contribute to being granted disability pension (DP) with such disorders. A twin cohort study would serve a powerful tool responding to this knowledge gap by providing information on factors affecting DP when controlling for family background. The purpose was to investigate the incidence of and risk factors for DP due to any MSD ( n = 1,819) and specifically due to osteoarthritis (OA, n = 677) in a twin cohort of 24,043 people over a 30-year follow-up. Methods: Data on twin pairs from a mailed questionnaire during the baseline year of 1975 were followed up with register data regarding DP, emigration, old-age pension, and death. For statistical analysis, univariate and multivariate Cox proportional hazard ratios were estimated. Results: Baseline musculoskeletal pain, frequency of use of analgesics, body mass index, and chronic diseases, as well as education and social class were significant risk factors for DP due to MSD at follow-up in both sexes. These factors were also the significant predictors of DP due to OA in men. In women, DP due to OA was best predicted by baseline musculoskeletal pain and lower social class. Conclusions: The risk of DP due to MSD and OA seemed to be influenced by comorbidities, educational level and social class. Analyses of twin pairs discordant for DP confirmed the results. Accumulated health problems and chronic conditions during the life course may lead to permanent work incapacity.
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