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- Fossum, Bjöörn, et al.
(författare)
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Evaluation of a counseling method for the prevention of child exposure to tobacco smoke : an example of client-centered communication
- 2004
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Ingår i: Preventive Medicine. - : Elsevier BV. - 0091-7435 .- 1096-0260. ; 38:3, s. 295-301
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Environmental tobacco smoke (ETS) is an important risk factor. The aim of this study is to evaluate effects of the counseling method "Smoke-free children" that focuses on protection of infants. METHODS: The counseling method, "Smoke-free children", has been developed and implemented at Swedish child health centers. The counseling method's point of departure is based upon a client-centered approach. Saliva cotinine samples from the mothers were collected when the child was 1-4 weeks and 3 months of age. Interviews regarding mothers' smoking habits and self-reported maternal smoking were also carried out. RESULTS: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine. CONCLUSIONS: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.
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3. |
- Sellström, Eva, et al.
(författare)
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Association between childhood community safety interventions and hospital injury records: a multilevel study.
- 2003
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 57, s. 724-
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: To study municipal variations in children's injury risk and to assess the impact of safety promotion measures in general municipal, preschool, school, and leisure activity settings, on injury outcome.Design: A cohort study based on individual data on children's consumption of hospital care as a result of injury, the age and sex of each child, and socioeconomic data on each child's mother. Municipal characteristics-that is, population density and municipal safety measures-were also used. Connections between individual and community level determinants were analysed with multilevel logistic regression.Setting: Twenty five municipalities in Stockholm County in Sweden were studied.Participants: Children between 1 and 15 years old in 25 municipalities in Stockholm County, identified in the Total Population Register in Sweden. The study base included 1 055 179 person years.Main results: Municipality injury rates varied between 3.84-7.69 per 1000 person years among 1-6 year olds and, between 0.86-6.18 among 7-15 year olds. Implementation of multiple safety measures in a municipality had a significant effect on the risk of injury for preschool children. In municipalities that implemented few safety measures, the risk of injury was 33% higher than in municipalities that implemented many. A similar effect, though insignificant, was observed in the school aged children.Conclusions: This study shows that how municipalities organise their safety activities affect injury rates. Sweden has a comparatively low injury rate and thus, in a European perspective, there is an obvious potential for municipal safety efforts.
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- Sellström, Eva, et al.
(författare)
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Injuries in Swedish Day-Care Centers
- 1994
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Ingår i: Pediatrics. - 0031-4005. ; 84:6, s. 1033-1036
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Tidskriftsartikel (refereegranskat)abstract
- In the developed countries, an increasing number of children are enrolled in day-care centers. When parents leave their child in a day-care center they expect high standards of health and safety. Accidental injuries are a major threat in this age group. In a comparable institution that serves children, the school, the risk of injury is higher than in the home environment.1-2 Thus, safety in day-care centers cannot be taken for granted. A few studies of injuries in day-care centers have been reported, from the Nordic countries2,3-5 and from the US.6-10 Most of these studies, however, have been small and most lack information on time of exposure. Information about the risk of injury in Swedish day-care centers might be of interest as enrollment has been high for a long time. In Sweden, within the frame of a national injury program,11 a number of local hospital- and health center-based injury report systems have been set up. All have a basic common coding. These systems enable compilation of injuries in day-care centers on a national basis. The aim of our study was to analyze child injuries in day-care centers as reported in 10 local injury registry systems in Sweden regarding incidence, type, and mechanism of injury. METHOD Data were compiled from 10 local injury registry systems, covering 1- to 2-year periods. The earliest registers were from the years 1983 to 1984 and the latest from 1991. These systems were set up in all medical institutions at a predefined level, covering all individuals in a total or a part of a county.
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6. |
- Sellström, Eva, et al.
(författare)
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Is there a ‘‘school effect’’ on pupil outcomes? : A review of multilevel studies
- 2006
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 60:2, s. 149-155
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Forskningsöversikt (refereegranskat)abstract
- Study objective: The school environment is of importance for child outcomes. Multilevel analyses can separate determinants operating at an individual level from those operating at a contextual level. This paper aims to systematically review multilevel studies of school contextual effects on pupil outcomes. Design: Key word searching of five databases yielded 17 cross-sectional or longitudinal studies meeting the inclusion criteria. Results are summarized with reference to type of school contextual determinant. Main results: Four main school effects on pupil outcomes were identified. Having a health or anti-smoking policy, a good school climate, high average socio-economic status [SES], and urban localization had a positive effect on pupil outcomes. Outcomes under study were smoking habits, well-being, problem behaviour and school achievement. Conclusions: Despite the different pupil outcomes and the variety of determinants used in the included papers, a school effect was evident. However, in order to improve our understanding of school effects, presentations of results from multilevel studies need to be standardized. Intra-class correlation (ICC) and explained between-school variance give relevant information on factors in the school environment influencing pupil outcomes, and should be included in all multilevel studies. Inclusion of pupil-level predictors in the multilevel models should be based on theoretical considerations on how schools and communities are interconnected and through which paths pupils and their families are influenced by school contextual factors.
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- Sellström, Eva, et al.
(författare)
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Närmiljöns betydelse för barns och ungdomars hälsa och välbefinnande : en systematisk kunskapsöversikt
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Barn påverkas inte bara av sina föräldrar utan även av den miljö de växer upp i. Barn tillbringar ofta en stor del av alla sin tid i bostadsområdet där de går i förskola och skola, tar del av fritidsverksamhet och träffar andra barn och vuxna. Flera äldre undersökningar tyder på att barn som växer upp i resursrika områden också gynnas hälsomässigt. Studierna har dock varit så utformade att det är möjligt att den påvisade effekten helt kan förklaras av de enskilda familjernas situation. Under det senaste decenniet har ny säkrare statistik metodik börjat användas för att klargöra frågor av denna typ. Avsikten har därför varit att analysera studier genomförda med modern flernivåteknik för att klargöra om närmiljöns karaktär kan påverka barns och ungdomars hälsa. Totalt identifierades 16 studier som uppfyllde uppställda kvalitetskrav. Studier som enbart behandlade skolmiljö exkluderades för att presenteras i en särskild genomgång. Översikten visar att en resursrik närmiljön både minskar risken för att barn ska födas med låg födelsevikt och minskar risken för att barn ska utveckla beteendeproblem. Det är redan känt att en risken för låg födelsevikt och risken för beteendeproblem är lägre i socialt gynnade familjer. Vad denna genomgång tillför är att bostadsområdets karaktär förefaller ha en självständig effekt, oberoende av den enskilda familjens situation. Flera analyser tyder vidare på att effekter av bostadsområdet inte bara adderas till den enskilda familjens risk utan även förstärker denna.
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9. |
- Sellström, Eva, et al.
(författare)
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Risk of childhood injury : Predictors of mothers' perceptions
- 2000
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 28:3, s. 188-193
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVES: Safety education often targets parental risk perception. Predictors of risk perception, however, are not well known, thus limiting the feasibility of effective safety education. Accordingly, in this study, a range of predictors of maternal risk perception were examined. METHODS: A random sample of 870 mothers in northern Sweden was included in the study. Three different questionnaires, with scenarios of a burn injury, a bicycle injury in the home environment, and a bicycle injury in traffic, were completed by the subjects. Multiple linear regression models tested the possible influence of causal attributions, normative beliefs, and sociodemographic and behaviour-related variables on mothers' risk perception. RESULTS: Only 14-23% of the variance in mothers' risk perception could be explained by the multivariate models. Causal attribution to the child was found to be the most important predictor of maternal risk perception. CONCLUSION: Present theoretical models give few clues about how to design educational models that might influence risk perception. To make safety education more effective, other modifiable factors that influence parental safety behaviour, such as subjective norms and self-efficacy, might be better targets.
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10. |
- Sellström, Eva, et al.
(författare)
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The neighbourhood they live in : Does it matter to women's smoking habits during pregnancy?
- 2008
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Ingår i: Health and Place. - Oxford : Elsevier BV. - 1353-8292 .- 1873-2054. ; 14:2, s. 155-166
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Socioeconomic factors in the neighbourhood are associated with smoking habits in various populations. We studied a 10-year-cohort to determine whether women�s smoking behaviour during pregnancy can similarly be determined by neighbourhood economic and ethnic factors. The cohort included 297,526 pregnant women in 594 Swedish neighbourhoods during the years 1992-2001. Multilevel technique was used to regress pregnancy smoking on socioeconomic individual-level variables and neighbourhood characteristics. Seven per cent of the variation in pregnancy smoking was at the neighbourhood level and the odds of smoking during pregnancy were doubled in poorer areas. Health education and smoking cessation interventions should be directed at maternity care units in deprived neighbourhoods.
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