| 1. |
- Chrapkowska, Cecilia, et al.
(författare)
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Validation of the new Swedish vaccination register – Accuracy and completeness of register data
- 2020
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Ingår i: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 38:25, s. 4104-4110
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aims of this study are to validate infant vaccination data in the Swedish Vaccination Register (SVR) to the Swedish administrative coverage reports, and to assess differences in register-based vaccination coverage estimates between providers using different data reporting methods. Methods: The study population included all infants born in Sweden with a Swedish Personal Identity Number during 2014 and 2015 (n = 230,220). Data on all National Immunisation Programme vaccinations administered before 24 months of age were collected from the SVR and from administrative coverage reports. Information regarding data registration methods in the SVR were collected from national and regional authorities. Coverage from health care providers using single registration methods, where vaccination data were transferred automatically from the electronic health care record to the SVR, was compared to that from providers using double registration methods where data had to be added into the SVR in a separate process. Results: For 98,4% of the study population at least one vaccination was recorded in the SVR. The coverage of 3-dose DTP-containing (87,1%) and 1 dose MMR (91,1%) in the register did not reach administrative data coverage (97,4% for 3-dose DTP-containing and 97,0% for MMR). Single registration procedures yielded significantly higher coverage than double registration procedures (92,24% vs 87,10%, p < 0,0001). A regional switch from double to single registration increased coverage from 80,0 to 95,2%. Conclusions: The SVR is a valuable data source for vaccination coverage monitoring. For research purposes, the SVR provides valuable data, since every health care provider is obliged to register all vaccine doses given within the national immunisation program. The SVR shows a high completeness validated by comparison to a very well-functioning administrative data system. Single-registration procedures give more complete data and should be supported by health systems while creating health care registers.
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| 2. |
- Kark, Malin
(författare)
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Population-based studies of body mass index, overweight and systolic blood pressure among Swedish young men
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Overweight and obesity has increased in Sweden and worldwide in recent decades. Lifestyle and environmental changes, genetic susceptibility and interactions between these factors are believed to be important. A theoretical framework often referred to, as the fetal origins hypothesis has been extensively debated over the last 15 years. According to this controversial hypothesis, overweight and other components of the metabolic syndrome - such as high blood pressure - might be long-term consequences of impaired fetal growth. The overall objectives of the studies were to investigate the epidemiology of body mass index and overweight among young men in Sweden and to explore relationships between growth in fetal life on the one hand and overweight and systolic blood pressure in young adulthood on the other. Specific aims were to: 1) study time trends and socio-economic differences in body mass index and overweight among young men over the last decades; 2) study the occurrence of overweight among male international adoptees; and, 3) test the fetal origins hypothesis by analyzing relationships between aspects of fetal growth and overweight, and also between fetal growth and systolic blood pressure among singletons and twins in young adulthood. This thesis is based on nationwide data sets created by record linkages between the Medical Birth Register, the Military Service Conscription Register and several other national registers. The twin studies include additional information collected by a mailed questionnaire. The prevalence of overweight among 18-year-old men increased two-fold over a 25-year period. The results show large socio-economic differentials in overweight, with higher prevalence among young men from low-educated families. Socio- economic differentials did not change over time. The prevalence of overweight was 2-3 times higher among young men adopted from Latin America in early childhood than among non-adopted individuals of the same ages. By contrast, the risk of overweight was not higher among adoptees from the Indian subcontinent or the Far East than among non-adopted individuals. The results show a positive relationship between gestational-age-adjusted birthweight and overweight at 18 years of age among singletons. Clearly, this finding does not support the fetal origins hypothesis. However, the hypothesis was further tested in a population-based twin study. A weak positive association was uncovered for the within-pair effects of birthweight on body mass index at the age of 18 among monozygotic twin pairs. The twin brother with the highest birthweight had a slightly higher risk of overweight at age 18 than his co-twin. No between-pairs effect of birthweight on body mass index was observed for monozygotic pairs of twins. And no relationships were observed among dizygotic twin pairs. Neither of these findings supports the fetal origins hypothesis. When studying fetal growth and systolic blood pressure among singletons, a clear inverse association was found between gestational-age-adjusted birthweight and systolic blood pressure at 18 years of age. That there was an independent inverse association between gestational age per se and systolic blood pressure is a novel finding. For monozygotic twins the results show an inverse between-pairs effect of birthweight on systolic blood pressure at age 18. There was an inverse within-pair effect of birthweight on systolic blood pressure among monozygotic twins, although the effect was not significant. No relationships were found among dizygotic twins. Although the results of the singleton study are in accordance with the fetal origins hypothesis, the twin study does not provide substantial support. In sum, the results show a strong increase in overweight over the last decades among young men, and also demonstrate large socio-economic differentials in overweight. Large and unexplained differences in over-weight among international adoptees compared with non-adopted young men were found. The studies addressing the fetal origins hypothesis showed mixed results with clear support for an inverse association between birthweight and blood pressure in the singleton study, weak support in the twin study, and no clear-cut support in either of the two other studies.
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| 3. |
- Rehn, Moa, et al.
(författare)
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Post-infection symptoms following two large waterborne outbreaks of Cryptosporidium hominis in Northern Sweden, 2010-2011
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 2010-2011, two large waterborne outbreaks caused by Cryptosporidium hominis affected two cities in Sweden, Ostersund and Skelleftea. We investigated potential post-infection health consequences in people who had reported symptoms compatible with cryptosporidiosis during the outbreaks using questionnaires. Methods: We compared cases linked to these outbreaks with non-cases in terms of symptoms present up to eleven months after the initial infection. We examined if cases were more likely to report a list of symptoms at follow-up than non-cases, calculating odds ratios (OR) and 95 % confidence intervals (CI) obtained through logistic regression. Results: A total of 872 (310 cases) and 743 (149 cases) individuals responded to the follow-up questionnaires in Ostersund and Skelleftea respectively. Outbreak cases were more likely to report diarrhea (Ostersund OR: 3.3, CI: 2.0-5.3. Skelleftea OR: 3.6, CI: 2.0-6.6), watery diarrhea (Ostersund OR: 3.4, CI: 1.9-6.3. Skelleftea OR: 2.8, CI: 1.5-5.1) abdominal pain (Ostersund OR: 2.1, CI: 1.4-3.3, Skelleftea OR: 2.7, CI: 1.5-4.6) and joint pain (Ostersund OR: 2.0, CI: 1.2-3.3, Skelleftea OR: 2.0, CI: 1.1-3.6) at follow-up compared to non-cases. Conclusions: Our findings suggest that gastrointestinal-and joint symptoms can persist several months after the initial infection with Cryptosporidium and should be regarded as a potential cause of unexplained symptoms in people who have suffered from the infection.
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| 4. |
- Stoor, Jon Petter A., et al.
(författare)
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Hur mår samer i Sverige? : Resultat från en enkätundersökning om hälsa, livsvillkor och levnadsvanor bland samer
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I den här rapporten presenterar vi resultat från enkätundersökningen Samisk hälsapå lika villkor. Den genomfördes under våren 2021 och besvarades av 3 658 sameri åldern 18–84 år i Sverige. Syftet med rapporten är att översiktligt beskriva hälsa,livsvillkor och levnadsvanor bland samer. Resultaten har även jämförts medbefolkningen i övrigt genom data från den nationella folkhälsoenkäten Hälsa pålika villkor, också den genomförd under våren 2021.Resultaten i korthetDe flesta samer i den här studien, 73 procent, uppger att de har en god allmänhälsa. Nästan alla, 87 procent, har ett gott psykiskt välbefinnande. Totalt 41 procentav samerna uppger att de har en långvarig sjukdom eller funktionsnedsättning.Andelen som uppger att de röker dagligen är 4 procent, och andelen som snusar 23procent.Jämförelsen mellan samer och befolkningen i övrigt visar följande:• En lika stor andel samer som befolkningen i övrigt uppger en god allmänhälsa. Även andelen samer som uppger sjukdomar som högt blodtryck ochdiabetes eller psykiska besvär som ängslan, oro eller ångest är lika stor som ibefolkningen i övrigt.• En mindre andel samer än befolkningen i övrigt uppger sömnsvårigheter,trötthet och psykisk påfrestning. Det är också en mindre andel samer somuppger att de är stillasittande mer än tio timmar per dag, har en riskkonsumtionav alkohol, uppger att de röker dagligen eller att de någon gång har använtcannabis.• En mindre andel samer jämfört med befolkningen i övrigt uppger bra tandhälsaoch att de äter frukt och grönsaker minst en gång per dag.• En större andel samer än befolkningen i övrigt har ett gott psykisktvälbefinnande. Däremot uppger en större andel samer att de har en långvarigsjukdom eller funktionsnedsättning, värk i olika delar av kroppen, astma,allergi, övervikt och fetma. Även andelen samer som uppger att de snusardagligen är större än i befolkningen i övrigt.• En större andel samer än befolkningen i övrigt uppger att de någon gångallvarligt övervägt att ta sitt liv eller att de någon gång försökt att ta sitt liv.Vidare är det en större andel samer som uppger att de har haft svårt att klara delöpande utgifterna under de senaste 12 månaderna. Andelen samer som uppgeratt de någon gång under de senaste 3 månaderna blivit behandlade ellerbemötta så att de har känt sig kränkta är större än i befolkningen i övrigt.Vad gäller covid-19-pandemin, uppger en mindre andel samer än befolkningen iövrigt att de har testat positivt för covid-19. Däremot uppger en större andel sameratt de har varit oroliga för att de själva eller någon närstående ska bli allvarligt sjuk. 8Samers hälsa behöver fortsatt följasDen här kartläggningen är ett första viktigt steg för att följa hälsosituationen blandsamer i Sverige och är en av de mest omfattande enkätundersökningar som hargenomförts hittills. Studien bidrar till viktig kunskap om samers hälsa, livsvillkoroch levnadsvanor och kan ligga till grund både för fortsatt kunskapsutveckling ochutformning av hälsofrämjande och förebyggande insatser på lokal, regional ochnationell nivå. Det behövs även fortsatta och fördjupade analyser med särskiltfokus på olika grupper bland samer som kan ha sämre hälsa eller sämreförutsättningar för en god hälsa.
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