| 1. |
|
|
| 2. |
- Carlerby, Heidi, 1967-
(författare)
-
Health and Social Determinants Among Boys and Girls in Sweden : Focusing on Parental Background
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The majority of Swedish boys and girls have good psychosomatic health. Despite that the risk of mental health problems such as nervousness, feeling low and sleeping difficulties has increased steadily in recent decades. Moreover, previous surveys on health and well-being indicate that boys and girls of foreign extraction in Sweden are at increased risk of ill health compared to boys and girls of Swedish background. The main aim of this thesis was to analyse health and social determinants among boys and girls of foreign extraction in Sweden. The factors explored in papers I–IV include parental background, family affluence and gender and their associations with subjective health complaints, psychosomatic problems or health risk behaviours. Other included risk factors for ill health were involvement in bullying, low participation and discrimination at school. This thesis takes an intersectional perspective, with ambitions to be able to emphasize the interplay between different power relations (i.e. gender, social class and parental background). Two sets of cross-sectional data were used. Three papers were based on the Swedish part of the World Health Organization’s Health Behaviour in School-Aged Children. The sample consisted of 11,972 children (boys n = 6054; girls n = 5918) in grades five, seven and nine from the measurement years 1997/98, 2001/02 and 2005/06. The response rate varied between 85 and 90%. About one fifth of the included children were of foreign extraction. For the fourth paper regional data from Northern Sweden were used. Boys (n = 729) and girls (n = 798) in grades six to nine answered a questionnaire in 2011 and the response rate was 80%. About 14% of the included children were of foreign extraction. Statistical methods used were chi-square test, correlation analyses, logistic regression analyses, cluster analyses and test of mediating factor. The results showed that girls of foreign background were at increased risk of subjective health complaints (SHC) and boys of mixed background were at increased risk of psychosomatic problems (PSP). Increased risk of allocation to the cluster profile of multiple risk behaviour was shown in boys and girls of mixed background, in girls of foreign background and in girls of low family affluence. Increased risk of allocation to the cluster profile of inadequate tooth brushing was shown in boys and girls of foreign background and in girls of low family affluence. General risk factors for increased risk of ill health for boys and girls in Sweden were: any form of bullying involvement, low family affluence, low participation and discrimination at school, of which the latter also was a mediating factor for ill health. Living with a single parent was a risk factor for ill health among girls. The results can function as a basis for developing health promotion programmes at schools that focus on social consequences of foreign extraction, family affluence, participation as well as health risk behaviours and gender.
|
|
| 3. |
- Carlerby, Heidi, 1967-, et al.
(författare)
-
How Bullying Involvement is Associated with the Distribution of Parental Background and With Subjective Health Complaints Among Swedish Boys and Girls
- 2013
-
Ingår i: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 111:3, s. 775-783
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to analyze how bullying involvement is associated with the distribution of parental background and with subjective health complaints (SHC) among Swedish boys and girls. Data were collected from the World Health Organization, Health Behavior in School-aged Children (WHO/HBSC) survey, measurement years 1997/1998, 2001/2002 and 2005/2006. A total of 11,972 boys (50.6 %) and girls (49.4 %) in grades five, seven and nine participated in the study. The adolescents were categorized in subgroups according to parental background: Swedish (80.1 %), mixed (10.5 %) and foreign(9.7 %). Multivariate logistic regressions were used to estimate remaining risk of SHC in the categories of bullying involvement. The frequencies of bullying involvement once or more were: none involved (74.8 %), victims (10.6 %), bullies (10.3 %) and bully/victims (4.4 %). Six out of ten involved in bullying were boys. Boys of foreign background were more involved as bullies compared to boys of mixed or Swedish background. Girls of foreign background were more involved in all three categories of bullying than girls of mixed or Swedish background. Increased risk of SHC was estimated among all adolescents involved in bullying, with highest OR in the category of bully/victims, OR 3.95 (CI 3.13–4.97) for the boys and OR 4.51 (CI 4.51–6.40) for the girls. The multivariate models were stable even after adjustment for socio-demographics. There are some associations between bullying involvement and parental background. Regardless of parental background, family affluence, family structure and gender, all adolescents involved in bullying are at increased risk of SHC.
|
|
| 4. |
- Carlerby, Heidi, 1967-, et al.
(författare)
-
How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden
- 2012
-
Ingår i: Health. - : Scientific Research Publishing, Inc.. - 1949-5005 .- 1949-4998. ; 4:10, s. 866-872
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at school, participation and psychosomatic problems. Methods: Pupils in grades 6–9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex; culture or ethnicity; disability; religion beliefs; sexual preferences; and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z=d/s (d)was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z=d/s (d) was > + 2 SD, –2.59 for boys and –39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effectwas stronger in girls than in boys. There is a need for school health promotion programsfocusing on participation in terms of democratic processes, communication and cooperation in the classroom.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Carlerby, Heidi, 1967-, et al.
(författare)
-
Risk behaviour, parental background, and wealth: a cluster analysis among Swedish boys and girls in the HBSC study
- 2012
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 40:4, s. 368-376
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse how health risk behaviours (HRB) are clustered and associated with parental background and family wealth among Swedish boys and girls.Methods: Data were collected from Health Behaviour in School-aged Children (HBSC),a global cross-sectional survey for 1997/98, 2001/02, and 2005/06. A total of 11,972 boys and girls in grades 5, 7, and 9 participated in the study. The pupils were categorised in subgroups according to parental background: Swedish (80.0%), mixed (10.6%), and foreign (9.4%). Cluster analyses were used to identify HRB profiles. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, parental background, and family affluence.Results: In total 11,232 pupils were identified and allocated to five cluster profiles, half of them in the cluster profile of low-risk behaviour. The most disadvantaged cluster was multiple HRB, which was characterised by high prevalence of smoking, drunkenness, low physical activity, and high soft-drink consumption. The cluster profile of multiple HRB was associated with both mixed background and foreign background in girls and with mixed background in boys.. The cluster profile of inadequate tooth brushing was associated with foreign background in both boys and girls. The cluster profiles of multiple HRB and inadequate tooth brushing were associated with low family affluence in girls.Conclusions: The cluster profiles of multiple HRB and inadequate tooth brushing were associated with parental foreign extraction in boys and girls and with low family affluence in girls. Prevention programmes based on identified clusters of HRB, including consideration of impact of socio-demographic indicators, are needed.
|
|
| 8. |
- Forsberg, Hanna, et al.
(författare)
-
Positive self-reported health might be an important determinant of student's experiences of high school in northern Sweden
- 2019
-
Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 78:1
-
Tidskriftsartikel (refereegranskat)abstract
- There is a need for more knowledge about positive health determinants in the school setting. The overall aim of this study was to analyse if positive self-reported health is associated with experiences of school among high-school students. Data originated from the health dialogue questionnaire answered by students in grade 1 of high school. A total of 5035 students participated from the academic years 2013 to 2016. Logistic regression with positive odds ratio (POR) was used to analyse associations between positive self-reported health and school experiences. There was an association between positive self-reported health and school experiences among students. Positive mental health was the strongest predictor for positive school experiences. To frequently participate in Physical Education, have a positive body image and satisfactory sleep nearly doubled the students' odds for positive school experiences. The results also revealed gender differences; boys more often reported positive experiences of school and positive health than girls. Positive self-reported health is associated with positive experiences of school, particularly mental health. Moreover, these findings have significant implications for how students experience school and demonstrate the importance of including health-promoting interventions in systemic school improvement, meeting both girls' and boys' needs.
|
|
| 9. |
- Mosleh, Marwan, et al.
(författare)
-
Barriers to managing and delivery of care to war-injured survivors or patients with non-communicable disease : a qualitative study of Palestinian patients' and policy-makers' perspectives
- 2020
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundImproving access to optimal quality of care is a core priority and ambitious health policy goal in spite of impediments, threats and challenges in Palestine. Understanding the factors that may impede quality of care is essential in developing an effective healthcare intervention for patient with non-communicable disease (NCD) or war-injured survivors.MethodsQualitative interviews were performed using a purposive sampling strategy of 18 political-key informants, 10 patients with NCD and 7 war-injured survivors from different health facilities in Gaza Strip. A semi-structured interview guide was developed for data collection. The interviews were audio recorded and transcribed verbatim. Important field notes of the individual interviews were also reported. Thematic-driven analytic approach was used to identify key themes and patterns.ResultsFrom the policy maker’s perspective, the following important barriers to accessing optimal healthcare for patients with NCD or war-injured survivors’ treatment were identified; 1) organizational/structural 2) availability 3) communication 4) personnel/lack of staff 5) financial and political barriers. Patient with NCD or war-injury had similar experiences of barriers as the policy makers. In addition, they also identified socioeconomic, physical and psychological barriers for accessing optimal healthcare and treatment.ConclusionsThe main perceived barriers explored through this study will be very interesting and useful if they are considered seriously and handled carefully, in order to ensure efficient, productive, cost-effective intervention and delivery of a high-standard quality of care and better disease management.
|
|
| 10. |
- Mosleh, Marwan, PhD researcher, 1975-
(författare)
-
Non-communicable diseases and war injuries in Palestine : burden, incidence and management in the health system
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The epidemics of non-communicable diseases (NCDs) and war-related injuries are a significant health concerns, and are rapidly emerging as major causes of mortality and disability globally, particularly in low and middle-income countries (LMICs) such as Palestine. Health research on the epidemiology and management of NCDs and war injuries is scarce and largely neglected. Therefore, this research responds to epidemiologic and public health concerns due to the increasing incidences of NCDs and war-injuries. The objective of this thesis was to describe, characterize and analyze the burden, incidence and management of NCDs and war-related injuries in the Palestinian health system (PHS).Methods: A combination of methods was employed in the research, including quantitative (study I and II), and qualitative approaches (study III and IV) in order to achieve the study aims and to gain a better understanding of NCDs and war injuries related issues in the PHS. For study I, the Disability-Adjusted Life Years (DALYs) framework was employed using available registry data of NCDs from 2010 to quantify the burden of NCDs, whereas, for study II a registry injuries data of the 2014 Gaza war was used to analyze the incidence and patterns of war injuries in the PHS. For study III, a qualitative focus group strategy was used to explore healthcare providers’ perspectives on NCDs and war injuries management and for study IV, a qualitative interview strategy was applied, using study topic guides to explore patients and policy makers’ perspectives of barriers to managing and delivering of care to war injured survivors or patients with NCDs. The participants were purposely selected and invited to be involved in the focus group discussions and interviews. The qualitative data were transcribed verbatim and analyzed using manifest content and thematic analysis in study III and IV respectively.Results: The research concludes that the total burden of reported NCDs was estimated at 57/1000 and 60/1000 DALYs in the Gaza Strip and the West Bank in 2010 respectively, with each DALY being thought of as one lost year of optimal healthy life. Heart diseases were found to be the leading causes of NCDs related burden among the population (study I). Study II showed that males experienced more war injury than females with a male: female ratio of 3.1:1. Almost half of victims were of age 20-39, followed by children and individuals younger than 20 years (31.4%). The overall incidence of war injuries was 6.4/1000 of the population, but it varied among regions. Explosion or blast injuries were the major causes of war-related injuries (72.9%) in the Gaza Strip. The largest percentage of injuries were reported to be in the upper body (study II). In study III, the qualitative analysis resulted in four main themes, resulting from the accounts of the key healthcare providers. The informants frequently expressed feeling that despite some positive aspects in the health system, there were, however, fundamental changes and significant improvements are necessary to make care work better than they do now. Some expressed serious concerns about the healthcare system, suggesting that it needs complete rebuilding in order to make it work better. In study IV, important barriers were explored by patients and key-policy makers, relating to managing and delivery care to war injured survivors or patients with NCDs, including organizational/structural, availability, communication, personal/shortage of staff, and financial and political barriers. Patients had similar experiences of barriers to those of the policy makers. In addition, patients experienced socioeconomic, physical, and psychological barriers.Conclusion: The epidemic of NCDs, especially heart disease, and the high influx of war-associated injuries, impose a substantial and heavy burden on the PHS. The health system has many deficiencies and public hospitals do not work as they should, because of many challenges and the burden of diseases in the health system. Given this evidence, immediate actions and effective interventions should be initiated to tackle the burden of NCDs and war injuries in Palestine. A clear cost-effective health policy with a focus on preventive measures should be implemented. Further research using recent data on large scale populations are important to provide further insights on the magnitude and trend of NCDs and war injuries in this problematic context. Using research evidence to develop health policy-making is vital.
|
|
