| 14731. |
- Müssener, Ulrika, et al.
(författare)
-
SMS-based smoking cessation intervention among university students: study protocol for a randomised controlled trial (NEXit trial)
- 2015
-
Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 16
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Most smoking efforts targeting young people have so far been focused on prevention of initiation, whereas smoking cessation interventions have largely been targeted towards adult populations. Thus, there is limited evidence for effective smoking cessation interventions in young people, even though many young people want to quit smoking. Mobile communication technology has the potential to reach large numbers of young people and recent text-based smoking cessation interventions using phones have shown promising results. Methods/design: The study aims to evaluate a newly developed text-based smoking cessation intervention for students in colleges and universities in Sweden. The design is a randomised controlled trial (RCT) with a delayed/waiting list intervention control condition. The trial will be performed simultaneously in all colleges and universities served by 25 student health care centres in Sweden. Outcomes will be evaluated after 4 months, with 2 cessation primary outcomes and 4 secondary outcomes. After outcome evaluation the control group will be given access to the intervention. Discussion: The study will examine the effectiveness of a stand-alone SMS text-based intervention. The intervention starts with a motivational phase in which the participants are given an opportunity to set a quit date within 4 weeks of randomisation. This first phase and the subsequent core intervention phase of 12 weeks are totally automated in order to easily integrate the intervention into the daily routines of student and other health care settings. As well as providing data for the effectiveness of the intervention, the study will also provide data for methodological analyses addressing a number issues commonly challenging in Internet-based RCTs. For example, an extensive follow-up strategy will be used in order to evaluate the use of repeated attempts in the analysis, and in particular to explore the validity of a possible missing not at random assumption that the odds ratio between the primary outcome and response is the same at every attempt.
|
|
| 14732. |
- Müssener, Ulrika, 1974-, et al.
(författare)
-
Using Mobile Devices to Deliver Lifestyle Interventions Targeting At-Risk High School Students : Protocol for a Participatory Design Study
- 2020
-
Ingår i: JMIR Research Protocols. - Toronto, Canada : J M I R Publications, Inc.. - 1929-0748. ; 1:9
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Unhealthy lifestyle behaviors such as insufficient physical activity, unhealthy diet, smoking, and harmful use of alcohol tend to cluster (ie, individuals may be at risk from more than one lifestyle behavior that can be established in early childhood and adolescence and track into adulthood). Previous research has underlined the potential of lifestyle interventions delivered via mobile phones. However, there is a need for deepened knowledge on how to design mobile health (mHealth) interventions taking end user views into consideration in order to optimize the overall usability of such interventions. Adolescents are early adopters of technology and frequent users of mobile phones, yet research on interventions that use mobile devices to deliver multiple lifestyle behavior changes targeting at-risk high school students is lacking.Objective: This protocol describes a participatory design study with the aim of developing an mHealth lifestyle behavior intervention to promote healthy lifestyles among high school students.Methods: Through an iterative process using participatory design, user requirements are investigated in terms of technical features and content. The procedures around the design and development of the intervention, including heuristic evaluations, focus group interviews, and usability tests, are described.Results: Recruitment started in May 2019. Data collection, analysis, and scientific reporting from heuristic evaluations and usability tests are expected to be completed in November 2019. Focus group interviews were being undertaken with high school students from October through December, and full results are expected to be published in Spring 2020. A planned clinical trial will commence in Summer 2020. The study was funded by a grant from the Swedish Research Council for Health, Working Life, and Welfare.Conclusions: The study is expected to add knowledge on how to design an mHealth intervention taking end users’ views into consideration in order to develop a novel, evidence-based, low-cost, and scalable intervention that high school students want to use in order to achieve a healthier lifestyle.
|
|
| 14733. |
- Mussino, Eleonora, 1981-, et al.
(författare)
-
Lives saved, lives lost, and under-reported COVID-19 deaths : Excess and non-excess mortality in relation to cause-specific mortality during the first year of the COVID-19 pandemic in Sweden
- 2024
-
Ingår i: Demographic Research. - 1435-9871. ; 50
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The number of confirmed COVID-19 deaths differed across countries and across waves of the pandemic. Patterns also differed between groups within a country.Objective: We combine data on excess mortality with data on cause-of-death-specific mortality in the case of Sweden to identify which groups had excess mortality beyond what can be captured by analyses of COVID-19-specific deaths. We also explore the possibility that some groups may have benefited in terms of reduced all-cause mortality, potentially due to home-centered living conditions during the pandemic.Methods: We produced and compared three sets of group-specific incidence rates: deaths from (1) any cause in 2020, (2) any cause in 2019, (3) any cause excluding COVID-19 in 2020. We compared rates across different socioeconomic profiles based on combinations of sex, age, marital status, education, and country of birth.Contribution: We show that many of those who died during 2020 would not have done so in the absence of the pandemic. We find some evidence of COVID-19 mortality underestimation, mainly among individuals with a migration background. We also found groups for which mortality decreased during the pandemic, even when including COVID-19 mortality. Progression across the first and second waves of the pandemic shows that more groups appeared to become protected over time and that there was less underestimation of COVID-19 mortality in the second part of 2020.
|
|
| 14734. |
- Mustafa, Nida, et al.
(författare)
-
The lived experiences of chronic pain among immigrant Indian-Canadian women : A phenomenological analysis
- 2020
-
Ingår i: Canadian Journal of Pain. - : Taylor & Francis. - 2474-0527. ; 4:3, s. 40-50
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Chronic pain is a growing public health concern affecting 1.5 million people in Canada. In particular, it is a concern among the expanding immigrant population, as immigrant groups report higher pain intensity than non-immigrants. In 2011, the Indian population became the largest visible minority group, and continues to be the fastest growing. While the prevalence of chronic pain among Canadian-Indians is unknown, research has found a higher prevalence among Indian women than men in India, Malaysia, Singapore and the United Kingdom, with women reporting more severe pain. An understanding of how pain is experienced by this particular group is, therefore, important for providing culturally-sensitive care. Aims. This study explores the lived experiences of chronic pain among immigrant Indian women in Canada. Methods. Thirteen immigrant Indian women participated in a one-on-one interview exploring daily experiences of chronic pain. Results. Using thematic analysis informed by van Manen’s phenomenology of practice, four themes emerged: (1) the body in pain, (2) pain in the context of lived and felt space, (3) pain and relationships and (4) pain and time. Women revealed their experiences were shaped by gender roles and expectations enforced through culture. Specifically, a ‘dual gender-role’ was identified after immigration, in which women had to balance traditional household responsibilities of family labour and care, alongside employment outside the home, exacerbating pain. Conclusions. This research uncovers the multifaceted nature of chronic pain and identifies factors within the socio-cultural context which may place particular groups of women more at risk of living with pain.
|
|
| 14735. |
- Mustelin, L., et al.
(författare)
-
Risk of eating disorders in immigrant populations
- 2017
-
Ingår i: Acta Psychiatrica Scandinavica. - Stockholm : Wiley. - 0001-690X .- 1600-0447. ; 136:2, s. 156-165
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The risk of certain psychiatric disorders is elevated among immigrants. To date, no population studies on immigrant health have addressed eating disorders. We examined whether risk of eating disorders in first- and second-generation immigrants differs from native-born Danes and Swedes. Method: All individuals born 1984–2002 (Danish cohort) and 1989–1999 (Swedish cohort) and residing in the respective country on their 10th birthday were included. They were followed up for the development of eating disorders based on out-patient and in-patient data. Results: The risks of all eating disorder types were lower among first-generation immigrants compared to the native populations: Incidence-rate ratio (95% confidence interval) was 0.39 (0.29, 0.51) for anorexia nervosa, 0.60 (0.42, 0.83) for bulimia nervosa, and 0.62 (0.47, 0.79) for other eating disorders in Denmark and 0.27 (0.21, 0.34) for anorexia nervosa, 0.30 (0.18, 0.51) for bulimia nervosa, and 0.39 (0.32, 0.47) for other eating disorders in Sweden. Likewise, second-generation immigrants by both parents were at lower risk, whereas those with only one foreign-born parent were not. Conclusion: The decreased risk of eating disorders among immigrants is opposite to what has been observed for other psychiatric disorders, particularly schizophrenia. Possible explanations include buffering sociocultural factors and underdetection in health care.
|
|
| 14736. |
- Mustonen, Ulla, et al.
(författare)
-
Elämänkulku, mielenterveys ja hyvinvointi. Seurantatutkimus 16-vuotiaista tamperelaisnuorista 22-, 32- ja 42-vuotiaina (TAM-projekti)
- 2013
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The development of children and young people and the conditions in which they are brought up lay the foundation for future well-being. People's educational and lifestyle choices in adolescence and early adulthood influence their health and social status far into their adult years. Adulthood and adult well-being are defined by roles at work, in interpersonal relationship, in family, and in other communities as well as by individual needs for change and development. This research report describes the life cycle and well-being from youth to early middle-age of one age group of pupils in Tampere, totalling some 2200 persons. The report summarises key results from a 25-year-long longitudinal study. The survey examines different kinds of risk factors in family backgrounds, adolescence, early adulthood and adult life and their links with mental health and psychosocial well-being. It also studies factors that protect against problems in mental health and well-being in young people's development and in their life cycle. The target group consisted of all Finnish-speaking pupils in the 9th grade of comprehensive school in the city of Tampere in spring 1983 (n = 2269). The research data was collected with a survey questionnaire, which a total of 2194 pupils (96.7%) filled in during one lesson at school. The first follow-up was carried out as a postal questionnaire when the respondents were 22 years old (n = 1656), and the second when the respondents were 32 years old (n =1471). The most recent followup was carried out in 2009 when the respondents were 42 years old (n = 1334). Key topics in all the follow-up surveys have been physical and mental health, health behaviour, social relationships, life situation, and psychosocial resources. The research findings indicate so far that most of the respondents have fared well at the developmental tasks and challenges they have faced in the different stages of their life. It seems, however, that there are risk factors associated with young people's growth and development and the environment in which they grow up, and that these risk factors may have negative effects on well-being in adolescence and far into adulthood. For example, the results indicate that a family's low socio-economic THL – Raportti 17/2013 9 Elämänkulku, mielenterveys ja hyvinvointi status is linked with unhealthy lifestyles in adolescence and a lower level of educational attainment in adulthood. Childhood experience of parents' divorce foretold a higher risk of problems in mental health, interpersonal relationships, and other relationships, as well as a lower socio-economic status in later life. It was also discovered that multiple social deprivation in adolescence is associated with higher mortality in adulthood. Adult depression was linked with depressive symptoms and low self-esteem especially in adolescence. Also, a link was discovered between long-term diseases and mental health. Young people with a long-term disease reported psychosomatic symptoms more often than their peers. In adulthood, a long-term disease was linked with depression among men, but not among women. Men with a long-term disease made more use of emotional means of coping than healthy men, and they had a lower sense of control over their own lives. The most important factors associated with a high level of alcohol consumption were male gender, childhood experience of divorce, depressive symptoms in adolescence, as well as regular binge drinking already at young age. With regard to binge drinking, different kinds of development paths were identified from adolescence to early middle-age. Two kinds of development paths were identified to be associated with various dimensions of social deprivation in early middle-age. These were regular binge drinking from adolescence to early middle among women and men and increasing regular binge drinking during the life-cycle among men. However, no similar link was observed when binge drinking decreased from early adulthood and adulthood. When studying factors that protect against problems of mental health and wellbeing, it was discovered, for example, that good relationship with parents, high selfesteem, and an intimate relationship protected young people against depression in later life. These factors had also an indirect link with the quality of intimate relationships in adult life. In the group of people with a long-term disease, factors protecting against depression included active problem-solving perspective to coping among men and experienced access to social support among women. Changes in individual resources, such as self-esteem, sense of control, and experiencing life as meaningful, were associated with the development of socio-economic inequalities in health in early adulthood. If these resources remained unchanged, also the socio-economic inequalities in health remained unchanged, while an increase in the resources signified a narrowing of the socio-economic inequalities in health. The analysing and reporting of the longitudinal study continue still, and two related dissertations are under way. A number of articles on the study have been published in distinguished scientific journals both in Finland and abroad. The research material has been used in several thesis studies, and the findings have been reported extensively both nationally and internationally. This report includes a list of these THL – Raportti 17/2013 10 Elämänkulku, mielenterveys ja hyvinvointi publications. Those interested in learning more about the research and its themes can study the original publications. The research material forms an internationally valuable follow-up material, and the research results can be utilised especially in social welfare and health care services that aim to promote the mental health and wellbeing of young people and adults. The result can also be used in education services and youth services. The research project and individual researchers have received funding from various sources. We are grateful for all the financial support to our research project. We would like to thank especially the Academy of Finland, the Signe and Ane Gyllenberg Foundation and the Yrjö Jahnsson Foundation for their significant support in enabling the data collection in different stages of the research, as well as the Tampere University School of Health Sciences and the National Public Health Institute/National Institute for Health and Welfare for providing the premises for conducting the research. We extend our warmest thanks to those who took part in this longitudinal study for their long-term interest in the study and for the valuable information they gave about their own lives.
|
|
| 14737. |
- Mutebi, Aloysius, et al.
(författare)
-
Characteristics of community savings groups in rural Eastern Uganda : opportunities for improving access to maternal health services
- 2017
-
Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 10
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Rural populations in Uganda have limited access to formal financial Institutions, but a growing majority belong to saving groups. These saving groups could have the potential to improve household income and access to health services.Objective: To understand organizational characteristics, benefits and challenges, of savings groups in rural Uganda.Methods: This was a cross-sectional descriptive study that employed both quantitative and qualitative data collection techniques. Data on the characteristics of community-based savings groups (CBSGs) were collected from 247 CBSG leaders in the districts of Kamuli, Kibukuand Pallisa using self-administered open-ended questionnaires. To triangulate the findings, we conducted in-depth interviews with seven CBSG leaders. Descriptive quantitative and content analysis for qualitative data was undertaken respectively.Results: Almost a quarter of the savings groups had 5-14 members and slightly more than half of the saving groups had 15-30 members. Ninety-three percent of the CBSGs indicated electing their management committees democratically to select the group leaders and held meetings at least once a week. Eighty-nine percent of the CBSGs had used metallic boxes to keep their money, while 10% of the CBSGs kept their money using mobile money and banks, respectively. The main reasons for the formation of CBSGs were to increase household income, developing the community and saving for emergencies. The most common challenges associated with CBSG management included high illiteracy (35%) among the leaders, irregular attendance of meetings (22%), and lack of training on management and leadership (19%). The qualitative findings agreed with the quantitative findings and served to triangulate the main results.Conclusions: Saving groups in Uganda have the basic required structures; however, challenges exist in relation to training and management of the groups and their assets. The government and development partners should work together to provide technical support to the groups.
|
|
| 14738. |
- Mutie, Pascal
(författare)
-
Elucidating causal relationships between energy homeostasis and cardiometabolic outcomes
- 2022
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Energy metabolism dyshomeostasis is associated with multiple health problems. For example, abundant epidemiological data show that obesity and overweight increase the risk of cardiometabolic diseases and early mortality. Type 2 diabetes (T2D), characterized by chronically elevated blood glucose, is also associated with debilitating complications, high healthcare costs and mortality, with cardiovascular complications accounting for more than half of T2D-related deaths. Prediabetes, which is defined as elevated blood glucose below the diagnostic threshold for T2D, affects approximately 350M people worldwide, with about 35-50% developing T2D within 5 years. Further, non-alcoholic fatty liver disease, a form of ectopic fat deposition as a result of energy imbalance, is associated with increased risk of T2D, CVD and hepatocellular carcinoma. Determination of causal relationships between phenotypes related to positive energy balance and disease outcomes, as well as elucidation of the nature of these relationships, may help inform public health intervention policies. In addition, utilizing big data and machine learning (ML) approaches can improve prediction of outcomes related to excess adiposity both for research purposes and eventual validation and clinical translation. AimsIn paper 1, I set out to summarize observational evidence and further determine the causal relationships between prediabetes and common vascular complications associated with T2D i.e., coronary artery disease (CAD), stroke and renal disease. In paper 2, I studied the association between LRIG1 genetic variants and BMI, T2D and lipid biomarkers. In paper 3, we used ML to identify novel molecular features associated with non-alcoholic fatty liver disease (NAFLD). In paper 4, I elucidate the nature of causal relationships between BMI and cardiometabolic traits and investigate sex differences within the causal framework.ResultsPrediabetes was associated with CAD and stroke but not renal disease in observational analyses, whilst in the causal inference analyses, prediabetes was only associated with CAD. Common LRIG1 variant (rs4856886) was associated with increased BMI and lipid hyperplasia but a decreased risk of T2D. In paper 3, models using common clinical variables showed strong NAFLD prediction ability (ROCAUC = 0.73, p < 0.001); addition of hepatic and glycemic biomarkers and omics data to these models strengthened predictive power (ROCAUC = 0.84, p < 0.001). Finally, there was evidence of non-linearity in the causal effect of BMI on T2D and CAD, biomarkers and blood pressure. The causal effects BMI on CAD were different in men and women, though this difference did no hold after Bonferroni correction. ConclusionWe show that derangements in energy homeostasis are causally associated with increased risk of cardiometabolic outcomes and that early intervention on perturbed glucose control and excess adiposity may help prevent these adverse health outcomes. In addition, effects of novel LRIG1 genetic variants on BMI and T2D might enrich our understanding of lipid metabolism and T2D and thus warrant further investigations. Finally, application of ML to multidimensional data improves prediction of NAFLD; similar approaches could be used in other disease research.
|
|
| 14739. |
- Mutie, Pascal M., et al.
(författare)
-
Different domains of self-reported physical activity and risk of type 2 diabetes in a population-based Swedish cohort : the Malmö diet and Cancer study
- 2020
-
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: While a dose-response relationship between physical activity and risk of diabetes has been demonstrated, few studies have assessed the relative importance of different measures of physical activity on diabetes risk. The aim was to examine the association between different self-reported measures of physical activity and risk of type 2 diabetes in a prospective cohort study. METHODS: Out of 26,615 adults (45-74 years, 60% women) in the population-based Swedish Malmö Diet and Cancer Study cohort, 3791 type 2 diabetes cases were identified from registers during 17 years of follow-up. Leisure-time (17 activities), occupational and domestic physical activity were assessed through a questionnaire, and these and total physical activity were investigated in relation to type 2 diabetes risk. RESULTS: All physical activity measures showed weak to modest associations with type 2 diabetes risk. The strongest association was found in the lower end of leisure-time physical activity in dose-response analysis at levels approximately below 22 MET-hrs/week (300 min/week) representing around 40% of the population. Compared with the lowest quintile, the moderate leisure-time physical activity category had a 28% (95% CI: 0.71, 0.87) decreased risk of type 2 diabetes. Total physical activity showed a similar, but weaker, association with diabetes risk as to that of leisure-time physical activity. Domestic physical activity was positively and linearly related to diabetes risk, HR = 1.11 (95% CI: 0.99, 1.25) comparing highest to lowest quintile. There was no association between occupational physical activity and diabetes risk. CONCLUSION: A curvilinear association was observed between leisure-time physical activity and risk of diabetes. Beyond a threshold level of approximately 22 MET-hrs/week or 300 min/week, no additional risk reduction was observed with increase in physical activity.
|
|
| 14740. |
- Mutola, Sianga, et al.
(författare)
-
The Fight against Female Genital Mutilation/Cutting among the Ejaghams of Cameroon: Kinks in the Legal Approach and Implications for Public Health Practice
- 2022
-
Ingår i: International Journal of Sexual Health. - : Informa UK Limited. - 1931-7611 .- 1931-762X. ; 34:1, s. 160-168
-
Tidskriftsartikel (refereegranskat)abstract
- Female genital mutilation/cutting (FGM/C) is one of the most prevalent harmful cultural practices against women and girls in many African countries. We identified reasons for the failure of the legal approach to stop FGC practice in the Ejagham region Southwest of Cameroon through multi-locale ethnographic fieldwork. The reasons revolve around the belief that FGM is useful for the reduction of sexual immorality among women, removal of sexual ambiguity and improving genital esthetics, a feministic symbol and cultural identity, and the government's socio-economic neglect of the Ejagham communities; the basis for resistance. Non-legal approaches involving community development and women empowerment have been proposed for fighting FGC.
|
|
