1.
Erichsén, Eva, 1959-
(författare)
Constipation in palliative care : Prevalence, definitions, symptom distress and risk-factors
2015
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background and aims: Constipation for patients in palliative care is common and described with variations in prevalence. Side -effects from opioid- treatment, is considered to be one of the main factors leading to constipation. The overall aim of the thesis was to study constipation among patients admitted to specialized palliative care- settings in Sweden. The specific aims of the thesis were 1) To describe and explore the prevalence, definition and symptom distress of constipation by applying different definitions of constipation, in patients admitted to specialized palliative care settings in Sweden. 2) To identify factors related to constipation in patients in specialized palliative care and comparing these factors for patients with different types of constipation to patients without constipation.Methods: A literature- search were conducted where prevalence of- and factors related to constipation was explored and included in a questionnaire, developed for this thesis. Data was collected in a cross- sectional design with a response rate of 50% and analysed with logistic regression.Results: A total of 485 patients from 38 specialized palliative care- units in Sweden participated. Prevalence of constipation for patients in specialized palliative care varied between 7- 43 % depending on definition used. Two different constipation- groups were identified: Medical constipation- group 23% (MCG) and Perceived constipation- group 35% (PCG). Three sub- groups was also identified: patients with i) only ≤ 3 defecations/week, 7%, ii) only perception of being constipated, 19%, and iii) patients with both ≤ 3 defecations/ week and perception of being constipated,16%. Several factors were found to be related to constipation as hospitalisation, absence of laxative- treatment, haemorrhoids, poor appetite, hard stool form and opioids.Conclusions: Prevalence of constipation may differ depending on definitions used. Distress from constipation and other factors related to constipation, than opioids, needs to be incorporated into the clinical constipation- assessment. Validated constipation assessment tool needs to be developed.
2.
Björkqvist, Susan, 1967
(författare)
Source-specific volatile organic compounds in human breath, wood smoke and biogas
1997
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Volatile biogenic compounds are often overlooked in air quality studies. This work deals with the analysis of specific organic compounds of biogenic origin and with their sources. General aspects of indoor air chemistry and measurements of volatile organic compounds in indoor air are also discussed. The determinations were based mainly on adsorbent sampling followed by gas chromatographic separations on different types of suitable columns. Identifications were made by mass spectrometry.
3.
Bonander, Carl, 1988-
(författare)
Searching for causal effects of road traffic safety interventions : applications of the interrupted time series design
2015
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Traffic-related injuries represent a global public health problem, and contribute largely to mortality and years lived with disability worldwide. Over the course of the last decades, improvements to road traffic safety and injury surveillance systems have resulted in a shift in focus from the prevention of motor vehicle accidents to the control of injury events involving vulnerable road users (VRUs), such as cyclists and moped riders. There have been calls for improvements to the evaluation of safety interventions due to methodological problems associated with the most commonly used study designs. The purpose of this licentiate thesis was to assess the strengths and limitations of the interrupted time series (ITS) design, which has gained some attention for its ability to provide valid effect estimates. Two national road safety interventions involving VRUs were selected as cases: the Swedish bicycle helmet law for children under the age 15, and the tightening of licensing rules for Class 1 mopeds. The empirical results suggest that both interventions were effective in improving the safety of VRUs. Unless other concurrent events affect the treatment population at the exact time of intervention, the effect estimates should be internally valid. One of the main limitations of the study design is the inability to identify why the interventions were successful, especially if they are complex and multifaceted. A lack of reliable exposure data can also pose a further threat to studies of interventions involving VRUs if the intervention can affect the exposure itself. It may also be difficult to generalize the exact effect estimates to other regions and populations. Future studies should consider the use of the ITS design to enhance the internal validity of before-after measurements.
4.
Cakici, Baki, 1984-
(författare)
Disease surveillance systems
2011
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Recent advances in information and communication technologies have made the development and operation of complex disease surveillance systems technically feasible, and many systems have been proposed to interpret diverse data sources for health-related signals. Implementing these systems for daily use and efficiently interpreting their output, however, remains a technical challenge. This thesis presents a method for understanding disease surveillance systems structurally, examines four existing systems, and discusses the implications of developing such systems. The discussion is followed by two papers. The first paper describes the design of a national outbreak detection system for daily disease surveillance. It is currently in use at the Swedish Institute for Communicable Disease Control. The source code has been licenced under GNU v3 and is freely available. The second paper discusses methodological issues in computational epidemiology, and presents the lessons learned from a software development project in which a spatially explicit micro-meso-macro model for the entire Swedish population was built based on registry data.
5.
Flyborg, Johan
(författare)
The use of the intelligent powered toothbrush in health technology
2022
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
BackgroundApplied health technology is a research field that ties together several disciplines to improve and preserve the health and quality of life of individuals and society. Helping especially elderly to meet the above goals is an important and necessary task and assistive technology and collection of health data are part of this work.AimsPaper I aims to investigate whether the use of a powered toothbrush could maintain oral health in a group of individuals with MCI and if changes in oral health affect various aspects of quality of life. Paper II and III aims to examine the capacity of a powered toothbrush as a carrier and mediator of health-related data.MethodsFor papers I and II, the participants were recruited from the Swedish site of the multicenter project Support Monitoring And Reminder Technology for Mild Dementia and for paper III from the Department of Health at Blekinge Institute of Technology. In all three papers, a powered toothbrush has been used as a tool, sensor carrier and transmitter of data. For Quality-of-life assessment two instruments are used, The QoL-AD and OHIP 14.ResultsBy introducing an intelligent powered toothbrush in the group of older individuals with mild cognitive impairment we have showed that they, regardless of cognitive level,improved their scores for plaque index, bleeding index and deepened periodontal pockets ≥ 4mm, over 12 months. The quality-of-life instrument related to oral health improved in parallel with the improvement in oral health. Furthermore, it is possible to use the intelligent powered toothbrush both as a carrier for healt related sensors and to transfer user data via Bluetooth technology to a single-core processor that stores or forwards the data via Wifi to an external computer for processing, analysis and storage. A fesibility study regarding temperature sensor for measuring body temperature during toothbrushing have been evaluated and found to be comparable to traditional oral temperature measurement. ConclusionsAn intelligent powered toothbrush is a well-functioning tool for maintaining oral health in older people with mild cognitive impairment as well as for collecting and transferring brush and health data to external units for storage and analysis.
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8.
Hermann, Veronica, 1972-
(författare)
Psykisk hälsa, psykisk ohälsa och relaterat stigma : En kvalitativ studie utifrån ungdomars perspektiv
2022
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Adolescent mental health problems are a well-recognized and frequently discussed societal problem in Sweden. However, few studies concerning adolescents’ own views on mental health concepts and associated stigma have been conducted. This thesis, including two sub-studies, investigated Swedish adolescents’ views of mental health concepts, mental health problems and perceptions about stigma. A total of 32 adolescents on the Swedish island Gotland were interviewed either in focus groups or individually.In sub-study I on mental health concepts, adolescents described mental well-being as a condition with emotional well-being and good psychological and social function, which they termed to feel well. Mental health problems were described as a spectrum of conditions, caused by several factors. All kinds of mental health problems were termed to feel unwell or to not feel well. Both the presence of mental well-being and symptoms of mental health problems were suggested to be considered when assessing young peoples’ mental health.Sub-study II explored adolescents’ perceptions of the prevalence of mental health problems and related stigma among young people. The adolescents perceived mental health problems as a natural part of their lives and explained the increase by current living condition factors, e.g. pressure related to school or social media and improved openness about mental health problems. Stigmatisation of young people with mental health problems were recognised to be caused by prejudice, triggered by lack of knowledge. The adolescents wished for a future without stereotypic gender norms and stigma of mental health problems.In conclusion, findings of the thesis suggest that adolescents’ descriptions of mental health concepts encompass a broad range of conditions, from normal challenges that can cause distress to severe disabling mental health problems. Furthermore, adolescents acknowledge the simultaneous presence of mental wellbeing and mental health problems, as well as stigma consisting of negative preconceptions, stereotyping and discrimination. The results highlight that adolescents have a complex contextual understanding of mental health problems, but use the terms to feel well or unwell, of which adults need to be aware. Additionally, taking rumour spreading seriously and actively addressing stereotypic gender norms could be important to improve adolescents’ mental health.
9.
Hultman, Barbro
(författare)
Self-rated quality of life among unemployed people and people in work in northern Sweden
2007
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Self-assessed quality of life (QoL) is analysed using a QoL questionnaire (Hörnquist’s QLcs)covering the life spheres: somatic health, mental well-being, cognitive ability, social and family life,activity, financial situation, meaning in life and a global score for ‘entire life’. In all, 487unemployed and 2917 employed subjects aged 25-64; and 651 unemployed subjects and 2802 inwork (including employment, studying and military service) in the 18-24 age group, wereinvestigated in a population-based cross-sectional study on life and health in northern Sweden in1997.In line with previous findings, results showed that unemployed people exhibited poorer QoL. Thegreatest difference between unemployed people and those in work was in the financial domain (18-24, 25-64). Unemployed women (aged 25-64) rated the final values of QoL – ‘entire life’ andmeaning in life – higher than unemployed men did. In the young group (aged 18-24), unemployedwomen did not rate any of the domains higher. The young unemployed men rated somatic health andmental well-being higher. Interaction effects were interpreted in the following way: a) unemployedmen (aged 25-64) were worst off in the global domain ‘entire life’; b) employed respondents, havinga university/college education was beneficial for QoL, while for unemployed respondents (25-64) itwas not; c) in the young group (aged 18-24), people in work rated their activity higher thanunemployed people, and the effect was strengthened when they were regularly active during leisure.Close friends and cash reserve were important for all participants, no matter whether they wereemployed or not. The risk of being young and unemployed was greater if the person had a shortereducation, worse economy (according to their own ratings) and was in the upper half of the agegroup (aged 21-24). Finally, the conclusion that QoL is poorer when in unemployment – both for theyoung and those who are older (aged 25-64) – is in line with earlier findings; however, in contrast tothree previous studies, we conclude that psychological well-being is even poorer for young peoplethan for those who are older.Intervention, in terms of steadily improved labour market conditions to counteract the negativeeffects of exclusion from the labour market, is of great importance from a public health perspective.
10.
Islam, Mohammad Redwanul, 1986-
(författare)
Limited dietary diversity and consumption of ultra-processed and deep-fried foods among adolescents in rural Bangladesh : uncovering the two faces of suboptimal diet
2021
Licentiatavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background: With an estimated number of 1.2 billion in the world, adolescents represent a major transformative force in global health. Optimum adolescent nutrition is increasingly important for scaling up population health gains in low- and middle-income countries (LMICs) of South Asia. Nevertheless, little is known about the gender and socio-economic stratification of diets consumed by rural adolescents in these countries. The aim of this project was to understand the gender and socio-economic stratification of their diet with a dual, descriptive-analytic focus on dietary diversity (DD) and consumption of ultra-processed and deep-fried foods.Methods: This thesis builds upon cross-sectional analyses of data collected during 15-year follow-up of the MINIMat (Maternal and Infant Nutrition Interventions in Matlab) trial, from September 2017 to June 2019. Data on dietary and socio-demographic variables were collected through household survey; using a pre-tested, structured questionnaire. A single, 24-hour recall was employed to assess consumption of staples and non-staples arranged in 10 groups, ultra-processed foods (UPF) in four groups, and of one group of deep-fried foods. Data were analyzed using logistic regression models. The analytic sample comprised 2463 adolescents.Results: The prevalence of inadequate DD was 42.3% (40.3-44.2). Consumption of dark green leafy vegetables, vitamin A-rich fruits and vegetables, and animal-source foods–except fish–appeared low. The proportions of adolescents consuming meat, egg and dairy were higher among those from the richest households than those from the poorest households, and among boys than girls. Belonging to the poorest households (adjusted odds ratio (aOR): 1.59; 95% confidence interval (CI): 1.27-2.00) and the food insecure households (aOR: 1.34; 95% CI: 1.13-1.59), and attaining secondary education (aOR: 1.38; 95% CI: 1.11-1.71) were positively associated with inadequate DD. Adolescents having mothers with secondary education or above had lower odds of inadequate DD (aOR: 0.76; 95% CI: 0.60-0.96). Gender was not an independent predictor of inadequate DD.Approximately 83% (81.5-84.4) adolescents reportedly consumed at least one ultra-processed or deep-fried food in the 24 hours preceding the survey. Packaged confectioneries were the most consumed and sugar-sweetened beverages (SSB) the least consumed UPF group. Boys had greater odds of consumption than girls for all UPF groups and deep-fried foods. The association was strongest for SSB (aOR: 2.57; 95% CI: 1.97, 3.37), followed by deep-fried foods (aOR 1.96; 95% CI: 1.66, 2.32). Belonging to the richest households was associated with consumption of ready-to-eat foods (aOR 1.55; 95% CI: 1.12-2.16) and of SSB (aOR: 1.44; 95% CI: 1.02-2.03). Adolescents with higher educational attainment had lower odds of consuming SSB (aOR 0.73; 95% CI: 0.54-0.98).Conclusion: The studies presented compelling evidence of limited DD concurrent with emergent consumption of ultra-processed and deep-fried foods in a rural cohort of adolescents. Inadequate DD was more likely among those from the poorest and the food insecure households. For ultra-processed and deep-fried foods, gender association persisted across the food groups with boys having a greater likelihood of consumption than girls. Wealth status influenced consumption of “instant” foods and SSB only. This suboptimal dietary pattern may place the adolescents at heightened risk of different forms of malnutrition.
