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Sökning: WFRF:(Grahn Mathias) > Refereegranskat

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1.
  • Eek, Frida, et al. (författare)
  • Differences in socioeconomic and gender inequalities in tobacco smoking in Denmark and Sweden; a cross sectional comparison of the equity effect of different public health policies
  • 2010
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Denmark and Sweden are considered to be countries of rather similar socio-political type, but public health policies and smoking habits differ considerably between the two neighbours. A study comparing mechanisms behind socioeconomic inequalities in tobacco smoking, could yield information regarding the impact of health policy and -promotion in the two countries. Methods: Cross-sectional comparisons of socioeconomic and gender differences in smoking behaviour among 6 995 Danish and 13 604 Swedish persons aged 18-80 years. Results: The prevalence of smoking was higher in Denmark compared to Sweden. The total attributable fraction (TAF) of low education regarding daily smoking was 36% for Danish men and 35% for Danish women, and 32% and 46%, respectively, for Swedish men and women. TAF of low education regarding continued smoking were 16.2% and 15.8% for Danish men and women, and 11.0% and 18.8% for Swedish men and women, respectively The main finding of the study was that the socioeconomic patterning of smoking, based on level of education and expressed as the relative contribution to the total burden of smoking exposure, was rather different in Sweden and Denmark. Moreover, these differences were modified by gender and age. As a general pattern, socioeconomic differences in Sweden tended to contribute more to the total burden of this habit among women, especially in the younger age groups. In men, the patterns were much more similar between the two countries. Regarding continued smoking/unsuccessful quitting, the patterns were similar for women, but somewhat different for men. Here we found that socioeconomic differences contributed more to overall continued smoking in Danish men, especially in the middle-age and older age strata. Conclusion: The results imply that Swedish anti-smoking policy and/or implemented measures have been less effective in a health equity perspective among the younger generation of women, but more effective among men, compared to Danish policy implementation. The results also raises the more general issue regarding the possible need for a trade-off principle between overall population efficacy versus equity efficacy of anti-tobacco, as well as general public health policies and intervention strategies.
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2.
  • Grahn, Oskar, et al. (författare)
  • Postoperative non-steroidal anti-inflammatory drug use and oncological outcomes of rectal cancer
  • 2021
  • Ingår i: BJS open. - : Oxford University Press (OUP). - 2474-9842. ; 5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are known to suppress the inflammatory response after surgery and are often used for pain control. This study aimed to investigate NSAID use after radical surgical resection for rectal cancer and long-term oncological outcomes. Methods: A cohort of patients who underwent anterior resection for rectal cancer between 2007 and 2013 in 15 hospitals in Sweden was investigated retrospectively. Data were obtained from the Swedish Colorectal Cancer Registry and medical records; follow-up was undertaken until July 2019. Patients who received NSAID treatment for at least 2 days after surgery were compared with controls who did not, and the primary outcome was recurrence-free survival. Cox regression modelling with confounder adjustment, propensity score matching, and an instrumental variables approach were used; missing data were handled by multiple imputation. Results: The cohort included 1341 patients, 362 (27.0 per cent) of whom received NSAIDs after operation. In analyses using conventional regression and propensity score matching, there was no significant association between postoperative NSAID use and recurrence-free survival (adjusted hazard ratio (HR) 1.02, 0.79 to 1.33). The instrumental variables approach, including individual hospital as the instrumental variable and clinicopathological variables as co-variables, suggested a potential improvement in the NSAID group (HR 0.61, 0.38 to 0.99). Conclusion: Conventional modelling did not demonstrate an association between postoperative NSAID use and recurrence-free survival in patients with rectal cancer, although an instrumental variables approach suggested a potential benefit.
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3.
  • Grahn, Oskar, et al. (författare)
  • Postoperative non-steroidal anti-inflammatory drugs in relation to recurrence, survival and anastomotic leakage after surgery for colorectal cancer
  • 2022
  • Ingår i: Colorectal Disease. - : Blackwell Publishing. - 1462-8910 .- 1463-1318. ; 24:8, s. 933-942
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To investigate whether non-steroidal anti-inflammatory drugs (NSAIDs) could be beneficial or harmful when used perioperatively for colorectal cancer patients, as inflammation may affect occult disease and anastomotic healing.METHODS: This is a protocol-based retrospective cohort study on colorectal cancer patients operated between 2007 and 2012 at 21 hospitals in Sweden. The NSAID exposure was retrieved from postoperative analgesia protocols, while outcomes and patient data were retrieved from the Swedish Colorectal Cancer Registry. Older or severely comorbid patients, as well as those with disseminated or non-radically operated tumours were excluded. Multivariable regression with adjustment for confounders was performed, estimating hazard ratios (HRs) for long-term and odds ratios (ORs) for short-term outcomes, including 95% confidence intervals (CIs).RESULTS: Some 6945 patients remained after exclusion, of which 3996 were treated at hospitals where an NSAID protocol was in place. No association was seen between NSAIDs and recurrence-free survival (HR 0.97; 95% CI 0.87-1.09). However, a reduction in cancer recurrence was detected (HR 0.83; 95% 0.72-0.95), which remained significant when stratifying into locoregional (HR 0.68; 95% CI 0.48-0.97) and distant recurrences (HR 0.85; 95% CI 0.74-0.98). Anastomotic leakage was less frequent (HR 0.69%; 95% CI 0.51-0.94) in the NSAID-exposed, mainly due to a risk reduction in colo- and ileo-rectal anastomoses (HR 0.47; 95% CI 0.33-0.68).CONCLUSION: There was no association between NSAID exposure and recurrence-free survival, but an association with improved cancer recurrence and the rate of anastomotic leakage was detected, which may depend on tumour site and anastomotic location.
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4.
  • Mangrio, Elisabeth, 1978-, et al. (författare)
  • Risk for mental illness and family composition after migration to Sweden
  • 2021
  • Ingår i: PLOS ONE. - : PLOS. - 1932-6203. ; 16:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim of the present study is to determine how marital status and certain post-migration family structures are associated with the risk of mental illness among recently arrived Arabic- speaking refugees in Sweden. Methods: A cross-sectional study was conducted during 2015 and 2016. The study population was recruited by inviting all adult refugees who participated in the mandatory public integration support programme. All refugees that participated had received refugee status. A total of 681 of the invited participants returned the GHQ-12 questionnaires, through which the risk for mental illness was measured and only Arabic- speaking refugees (N=638) were included in the analyses. Results: Marital status per se was not associated with a risk for mental illness. However, for the whole study sample there was a statistical significant odds ratio of 1.72 (95% CI 1.03–2.86). For male Arabic-speaking refugees with a spouse or child left behind in the home country there was a borderline significant increased risk for mental illness, odds ratio = 1. 87 (95% CI 0.99–3.56). The risk for female Arabic-speaking refugees was non-significant, odds ratio = 1.35 (95% CI 0.55–3.33). Conclusions: Arabic- speaking refugees who were separated from family members reported an increased risk for mental illness after arriving in the host country. Actions to facilitate family reunion after arriving as a refugee (in Sweden) seems to be an important factor to promote mental health among refugees. 
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5.
  • Mangrio, Elisabeth, 1978-, et al. (författare)
  • Social relations and mental ill-health among newly arrived refugees in Sweden : a cross-sectional study
  • 2022
  • Ingår i: PLOS Global Public Health. - : PLoS. - 2767-3375. ; 2:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Previous research indicates that social relations have an impact on the well-being of refugees and that well-being is important for effective integration into the host country. Few studies in Sweden have, to the best of our knowledge, looked at the association between social relations and mental ill-health among newly arrived refugees. The aim is to investigate what effect social relations have on the mental health of newly arrived refugees in the south of Sweden. Methods: A cross-sectional study was conducted in Scania, the southernmost county of Sweden, between February 2015 and February 2016. The study population consisted of newly arrived adult refugees speaking Dari or Arabic, who received the civic and health information that is part of an introduction course for all newly arrived refugees. Results: Individuals who rarely met with friends had higher odds of experiencing mental ill-health (OR=1.70, 95% CI, 1.03-2.82) than individuals who frequently spent time with friends. Furthermore, individuals who seldom attended social/community meetings or activities in an organisation or group, such as a sports association or another kind of association, a church, a mosque, or women’s or men’s meetings, had higher odds of mental ill-health (OR=1.58, 1.1-2.28), compared to those who frequently did so. Conclusions: The study suggests a link between spending time with friends, as well as engaging in social/community activities, and the mental health of newly arrived refugees in the southernmost county of Sweden, which is one of the counties in Sweden that received the highest number of refugees. The results are in line with a previous study on the same subject in Sweden.
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6.
  • Moussa, Kontie, et al. (författare)
  • Socioeconomic differences in smoking trends among pregnant women at first antenatal visit in Sweden 1982-2001 : increasing importance of educational level for the total burden of smoking
  • 2009
  • Ingår i: Tobacco Control. - : BMJ. - 0964-4563 .- 1468-3318. ; 18:2, s. 92-97
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: There was a decrease in smoking during early pregnancy in Swedish women between 1982 and 2001. We sought to determine whether there was a parallel decrease in socioeconomic inequality in smoking. METHODS: Registry data indicating educational level and smoking status at first antenatal visit in all 2,022,469 pregnancies in Sweden 1982-2001 were analysed. Prevalence differences, odds ratios based on prevalences and total attributable fractions were compared for five-year intervals. RESULTS: The prevalence differences of smoking showed a greater decrease at the lowest and middle educational level compared with the highest educational level (14.5%, 15.7% and 10.2%, respectively) indicating reduced inequality in absolute terms. However, odds ratios regarding low educational attainment versus high, increased from 5.6 to 14.2, signifying increased inequality in relative terms. Moreover, the total attributable fraction of low and intermediate educational level regarding smoking at first antenatal visit increased from 61% to 76% during the period studied. CONCLUSIONS: Smoking at first antenatal visit in Sweden between 1982 to 2001 decreased in a way that conclusions regarding trends in inequalities in smoking at first antenatal visit depend on the type of measure applied. However, using the measure of total attributable fraction, which takes into consideration the impact of the exposure on the individual as well as the effect of the varying size of the group of exposed, the growing importance of educational level for the behaviour in the population was demonstrated.
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7.
  • Sjögren Forss, Katarina, et al. (författare)
  • Physical Activity in Relation to Wellbeing Among Newly Arrived Refugees in Sweden : A Quantitative Study
  • 2021
  • Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 8
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Little is known about physical activity among newly arrived refugees and what impact physical activity might have on their health, as measured by mental wellbeing, vitality, stress and sleep quality. Thus, this study sought to investigate the relationship between physical activity and wellbeing among refugees who were newly arrived in Sweden. Methods: The present study was based on the results from a survey, conducted in 2015-2016 among newly arrived adult refugees who spoke Arabic, Pashto, Somali or Dari, participated in a mandatory public integration support programme in the Scania region of Sweden and agreed to participate in the survey. Ultimately 681 participants completed the survey (a response rate of 39.5%). Results: We found a significant association between physical activity and mental wellbeing, vitality, stress and sleep quality among newly arrived refugees. Conclusions: Newly arrived refugees need to be informed about the importance of prioritizing physical activity for their health and wellbeing, regardless of their external circumstances, and supported in their attempts to do so.
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8.
  • Sundbeck, Mats, et al. (författare)
  • Snuff use associated with abdominal obesity in former smokers.
  • 2009
  • Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 37:5, s. 487-93
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and METHODS: Tobacco use was explored in 834 men aged 30-75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. RESULTS: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08-3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08-2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05-2.36) (p = 0.041) waist circumference and 0.01 (0.00-0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. CONCLUSIONS: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
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