| 1. |
- Anttila, Sten, et al.
(författare)
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Housing programs and case management for reducing homelessness and increasing residential stability for homeless people
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The Universal Declaration of Human Rights (Article 25) states that everyone has a right to housing. Yet according to the UNHCR there are approximately 100 million homeless people worldwide. Homelessness has many negative detrimental consequences on an individual as well as on a societal level. The condition of homeless seriously affects well-being and health in general and may contribute to mental illness in particular. Once homeless, people tend to be deprived of economic, social and psychological resources that are necessary in order to get a new accommodation. If this happens the resources of some clients may be too poor and few to prevent future evictions.Case management is a collaborative process, including assessment, planning, facilitation and advocacy for options and services, intended to make sure that the client’s needs are met. Intensive case management, including assertive community treatment, is intended to ensure that the client receives sufficient services, support and treatment when and where it is needed. In this way intensive case management (case load <1:15, 24-7 availability, and the combined competence of a multidisciplinary team), may help homeless people to obtain accommodation, and once housed avoid eviction.Housing programs are more or less based on housing philosophies. According to one philosophy stable and independent housing is needed for the client to become treatment ready. Housing should neither be contingent on sobriety nor on treatment compliance, but only on rules that apply for ordinary tenants. In other words housing is parallel to and not integrated with treatment, or with other services. An alternative philosophy is based on the assumption that some clients (possibly those with a bio-chemical dependence on drugs) may need a transitional period of sobriety and treatment compliance, before they can live independently in their own apartments. Without this transitional phase the assumption is that they will soon face eviction, and return to homelessness. According to this philosophy housing is integrated with treatment. By combining housing and case management within the framework of a comprehensive program, the work to find accommodation and to prevent eviction is assumed to be facilitated.The objective was to assess the effectiveness of 9 possible combinations of housing programs and case management as means to increase residential stability and reduce homelessness. The possible combinations were based on three housing alternatives and three case management alternatives which entails 36 possible comparisons:Housing parallel to treatment, housing integrated with treatment, and no housingIntensive of case management (ICM and ACT), ordinary case management, and no case management.Electronic databases were searched by means of terms referring to population, intervention, and design (Campbell Library, Cochrane Library (including CENTRAL), PubMed, PsycINFO, Sociological Abstracts, Social Services Abstracts, ASSIA, CINAHL, ERIC, and Dissertation Abstracts International). Reference lists were hand searched, and international experts were contacted. For a study to be included the following criteria had to be met:Population: homeless or at risk of becoming homelessIntervention: housing programs with case management, housing programs without case management, or case management without a housing programComparison: any of the alternative interventions above, plus usual care, waiting lists, or no interventionOutcome: residential stability or homelessnessDesign: randomized controlled trials or observational studies (with comparison groups matched at baseline or on propensity scores)Pairs of reviewers independently screened abstracts, and read full text documents. Data was extracted and coded by two reviewers. Two reviewers also assessed risks of bias for each study and their outcomes. In several cases data had to be recalculated in order to fit the format necessary for meta-analysis based on Review Manager.After screening 1, 764 abstracts and assessing 276 documents in full text, 32 unique studies were included (26 randomized controlled trials and 6 observational studies) in this review. All studies were from the USA except three, which were undertaken in the UK (two randomized controlled trials and one observational study). The number of included studies is thus relatively high, but the body of evidence is poor, as most studies are characterized by high risk of aggregated bias (11 studies) or moderate risk of aggregated bias (15 studies and 19 comparisons). Only 6 studies were classified as having low aggregated risk of bias. In addition, most studies are rather old. The median publication year is 1998. There are 16 studies published between 2000 and 2010 (11 randomized trials and five observational studies). Since 2005 only five included studies were published (three randomized trials and two observational studies). The results can be summarized in seven points:a) Housing parallel to treatment is not superior to housing integrated with treatment or vice versa.b) Empirical results indicate that parallel housing as such is superior to no housing.c) There is not sufficient evidence to conclude that integrated housing as such is superior to no housing.d) Empirical results indicate that intensive case management as such (ACT and ICM) is superior to usual care (such as drop in centers, outpatient treatment, ordinary after care, etc.).e) Empirical results indicate that parallel housing in combination with intensive case management (ACT and ICM) is superior to usual care (such as drop in centers, outpatient treatment, ordinary after care, etc.).f)There is not sufficient evidence to conclude that integrated housing in combination with intensive case management (ACT and ICM) is superior to usual care (such as drop in centers, outpatient treatment, ordinary after care, etc.) Conclusion: Parallel housing, in combination with intensive case management (ICM and ACT), improves housing outcomes in comparison to usual care (outpatient treatment, drop in centers, ordinary after care, brokered case management, etc.). Intensive case management as well as housing contributes to this effect. However, evidence is not decisive when parallel housing is compared to integrated housing. Empirical results are highly contradictory. Studies focusing on specific subgroups such as women and persons with severe substance abuse problems are required.
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| 2. |
- Brännström, Inger, 1945-, et al.
(författare)
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Changing social patterns of risk factors for cardiovascular disease in a Swedish community intervention programme
- 1993
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Ingår i: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 22:6, s. 1026-1037
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Tidskriftsartikel (refereegranskat)abstract
- Since 1985 a small-scale community-based cardiovascular disease (CVD) preventive programme has been in operation in an inland municipality, Norsjö, in Northern Sweden. The aim of this study was to assess the development of the relationship between social position and CVD risk factors in repeated cross-sectional surveys (1985-1990) among all men and women aged 30, 40, 50 and 60 years in the study area, using an age-stratified random sample from the Northern Sweden MONICA Study of 1986 and 1990 as reference population. These multiple cross-sectional surveys comprised a self-administered questionnaire and a health examination. Of the study population 95% (n = 1499) and 80% of those in the reference area (n = 3208) participated. Subjects were classified with regard to demographic, structural and social characteristics in relation to CVD risk factors and self-reported health status. Time trends in classical risk factor occurrence were assessed in terms of age- and sex- adjusted odds ratios using Mantel-Haenszel procedures. When simultaneously adjusting for several potential confounders we used a logistic regression analysis. Initially, more than half of the study population, both males and females, had and elevated (> or = 6.5 mmol/l) serum cholesterol level. After adjustments had been made for age and social factors it was found that the relative risk of hypercholesterolaemia dropped substantially and significantly among both sexes during the 6 years of CVD intervention in the study area. However, the probability of being a smoker was significantly reduced only in highly educated groups. Among other risk factors no single statistically significant change over time could be found. In the reference area there were no changes over time for the selected CVD risk factors. People in the study area had a less favourable perception of their health than those in the reference area. Social differences were found when perceived good health was measured, especially in variables indicating emotional and social support. When sex, age and social factors had been accounted for there was not clear change over the years in perceived good health.
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| 3. |
- Brännström, Kristoffer, et al.
(författare)
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A Generic Method for Design of Oligomer-Specific Antibodies
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:3, s. e90857-
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Tidskriftsartikel (refereegranskat)abstract
- Antibodies that preferentially and specifically target pathological oligomeric protein and peptide assemblies, as opposed to their monomeric and amyloid counterparts, provide therapeutic and diagnostic opportunities for protein misfolding diseases. Unfortunately, the molecular properties associated with oligomer-specific antibodies are not well understood, and this limits targeted design and development. We present here a generic method that enables the design and optimisation of oligomer-specific antibodies. The method takes a two-step approach where discrimination between oligomers and fibrils is first accomplished through identification of cryptic epitopes exclusively buried within the structure of the fibrillar form. The second step discriminates between monomers and oligomers based on differences in avidity. We show here that a simple divalent mode of interaction, as within e. g. the IgG isotype, can increase the binding strength of the antibody up to 1500 times compared to its monovalent counterpart. We expose how the ability to bind oligomers is affected by the monovalent affinity and the turnover rate of the binding and, importantly, also how oligomer specificity is only valid within a specific concentration range. We provide an example of the method by creating and characterising a spectrum of different monoclonal antibodies against both the A beta peptide and alpha-synuclein that are associated with Alzheimer's and Parkinson's diseases, respectively. The approach is however generic, does not require identification of oligomer-specific architectures, and is, in essence, applicable to all polypeptides that form oligomeric and fibrillar assemblies.
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| 4. |
- Brännström, Lars, 1972-, et al.
(författare)
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Intergenerational transmission of placement in out-of-home care : Mediation and interaction by educational attainment
- 2022
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Ingår i: International Journal of Child Abuse & Neglect. - : Elsevier BV. - 0145-2134 .- 1873-7757. ; 123
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Tidskriftsartikel (refereegranskat)abstract
- Background: Persons with childhood experiences of out-of-home care (OHC) have elevated risks of having their own children taken into societal care. High educational attainment has been linked to favorable long-term outcomes in a host of previous studies on OHC alumni. This could be indicative of resilience, which may also have protective potential against intergenerational continuity of OHC placements.Objective: The present study examined the processes of mediation and interaction by educational attainment, here conceptualized as having completed upper secondary school, regarding the intergenerational transmission of placement in OHC.Participants and setting: Longitudinal data came from a Swedish cohort of parents (and their children) born in 1953 (n = 11,338).Methods: Associations between parental experience of OHC and their children's placement in OHC were analyzed by means of binary logistic regression. Four-way decomposition was used to explore mediation and interaction by parental educational attainment.Results: The odds of having at least one child being placed in OHC was more than six-fold (OR = 6.67, 95% CI = 5.28; 8.06) in the OHC group compared to majority population peers. Mediation and/or interaction by educational attainment accounted for a substantial proportion of the overall association (53%). Interaction effects appeared to be more important for the outcome than mediation.Conclusions: Having completed upper secondary school seems to reflect processes of resilience with the potential to break the intergenerational transmission of placement in OHC. These findings suggest that the impact of enhanced educational attainment of OHC populations may have potential of extending into the fate of the next generation.
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| 5. |
- S. Straatmann, Viviane, et al.
(författare)
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Associations between out-of-home care and mental health disorders within and across generations in a Swedish birth cohort
- 2022
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Ingår i: SSM - Population Health. - : Elsevier BV. - 2352-8273. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown that mental health disorders (MHD) among parents might be an important mechanism in the intergenerational transmission of out-of-home care (OHC). The current study aimed to further study this interplay by investigating the associations between OHC and MHD within and across generations. We used prospective data from the Stockholm Birth Cohort Multigenerational Study (SBC Multigen) on 9033 cohort members (Generation 1; G1) and their 15,305 sons and daughters (Generation 2; G2). By odds ratios of generalised structural equation modelling, we investigated the intergenerational transmission of OHC and MHD, respectively, as well as the association between OHC and MHD within each generation. Second, we examined the associations between OHC and MHD across the two generations. In order to explore possible sex differences, we performed the analyses stratified by the sex of G2. The results showed an intergenerational transmission of OHC, irrespective of sex. Regarding the intergenerational transmission of MHD, it was shown for both sexes although only statistically significant among G2 males. OHC was associated with MHD within both generations; in G2, this association was stronger among the males. While we found no direct association between OHC in G1 and MHD in G2, there was a significant association between MHD in G1 and OHC in G2. The latter was more evident among G2 females than G2 males. We conclude that OHC and MHD seem to be processes intertwined both within and across generations, with some variation according to sex. Although there did not seem to be any direct influences of OHC in one generation on MHD in the next generation, there was some indication of indirect paths going via parental MHD and child OHC.
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| 6. |
- Sivertsson, Fredrik, 1984-, et al.
(författare)
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Offending trajectories from childhood to retirement age : Findings from the Stockholm birth cohort study
- 2024
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Ingår i: Journal of criminal justice. - 0047-2352 .- 1873-6203. ; 91
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The current study explores heterogeneity in the aggregate age-crime curve. This is achieved by analyzing to what extent there is empirical support for the existence of pivotal typologies in developmental and life-course criminology, as well as whether there is any heterogeneity in trajectories among adult-onset offenders (first recorded for crime at age 25 or later).Methods: Data were drawn from a population-representative birth cohort of 14,608 males and females, followed prospectively in registers from age nine to 64. Trajectories of antisocial and criminal behavior were identified by means of group-based trajectory modelling.Results: A small group with a high prevalence of crime across the life course, among both males and females, was found. Furthermore, a large proportion of offenders were adult-onset offenders, and there was meaningful heterogeneity in their criminal trajectories. However, the data did not lend much support to the hypothesized phenomenon of late-blooming.Conclusion: There is meaningful heterogeneity in the aggregate age-crime curve, including trajectories that resonate fairly well with predictions derived from Moffitt's taxonomy. Nevertheless, there are firm reasons for theorizing proximate causes for the onset and continuation of crime beyond emerging adulthood.
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| 7. |
- Aden, A S, et al.
(författare)
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The growth chart - a road to health chart? : Maternal comprehension of the growth chart in two Somali villages
- 1990
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 4:3, s. 340-350
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Tidskriftsartikel (refereegranskat)abstract
- Growth monitoring is so far not implemented on a large scale in the Somali health services. Available reports indicate that growth faltering is common. However, the use of growth charts as a tool for health education has been questioned. This study examines the ability of 199, predominantly illiterate, rural Somali mothers to understand the growth chart message after an intensive period of growth chart use and education. During a home-based interview the mothers were asked to combine a set of four growth curves with a set of four pictures, showing the corresponding developments of four children. The mothers managed significantly better to interpret the charts than could be expected by chance alone. Maternal age, number of children and literacy did not differ much between those who correctly and incorrectly combined pictures and charts. Almost all mothers recognised the value of the growth chart as being good for the control and promotion of their children's health and/or growth. We conclude that the growth chart may be an applicable and appropriate tool even with illiterate mothers, provided that other prerequisites for successful growth monitoring, e.g. appropriate health services, are available.
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| 8. |
- Alm, Susanne, et al.
(författare)
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Framtidstro - spelar det roll var man bor?
- 2011
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Ingår i: Utanförskap. - Stockholm : Dialogos Förlag. - 9789175042428 ; , s. 211-242
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
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| 10. |
- Almquist, Ylva B., et al.
(författare)
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A decade lost : does educational success mitigate the increased risks of premature death among children with experience of out-of-home care?
- 2018
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 72:11, s. 997-1002
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Tidskriftsartikel (refereegranskat)abstract
- Background: Past research has consistently identified children with experience of out-of-home care (OHC) as a high-risk group for premature mortality. While many have argued that educational success is a key factor in reducing these individuals’ excessive death risks, the empirical evidence has hitherto been limited. The aim of the current study was therefore to examine the potentially mitigating role of educational success for the association between OHC experience and premature mortality.Methods: Drawing on a Stockholm cohort born in 1953 (n=15,117), we analysed the associations between placement in OHC (ages 0-12), school performance (ages 13, 16, and 19), and premature all-cause mortality (ages 20-56) by means of Cox and Laplace regression analysis.Results: The Cox regression models confirmed the increased risk of premature mortality among individuals with OHC experience. Unadjusted Laplace regression models showed that these children died more than a decade, based on median survival time, before their majority population peers. However, among individuals who performed well at school, i.e. scored above-average marks at age 16 (grade 9) and age 19 (grade 12), respectively, the risks of premature mortality did not significantly differ between the two groups.Conclusion: Educational success seems to mitigate the increased risks of premature death among children with experience of OHC.
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| 11. |
- Almquist, Ylva B., et al.
(författare)
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Association of Child Placement in Out-of-Home Care With Trajectories of Hospitalization Because of Suicide Attempts From Early to Late Adulthood
- 2020
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 3:6
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Tidskriftsartikel (refereegranskat)abstract
- Importance Children placed in out-of-home care (OHC) have higher rates of suicidal behaviors, including suicide attempts, compared with those who grow up in their family of origin. Several studies have shown that this elevated risk persists into young adulthood. Yet, our knowledge about any longer-term associations of OHC with suicide attempts is limited. Objective To examine how childhood experiences of placement in OHC are associated with trajectories of hospitalization because of suicide attempts (HSA) from early into late adulthood. Design, Setting, and Participants This prospective birth cohort study that was conducted in Stockholm, Sweden, and analyzed in March 2020 included 14559 individuals born in 1953 who were living in the greater metropolitan of Stockholm in November 1963 and followed through registers up until December 2016. Exposures Childhood experiences of OHC based on information from the Social Register (age 0-19 years). Main Outcomes and Measures Hospitalization because of suicide attempts based on in-patient care data from the National Patient Register. Group-based trajectory modeling was used to cluster individuals according to their probabilities of HSA across adulthood (age 20-63 years). Results In this cohort of 14559 individuals (7146 women [49.1%]), 1320 individuals (9.1%) had childhood experiences of OHC, whereas 525 individuals ( 3.6%) had HSA. A Cox regression analysis showed a substantially higher risk of HSA among those with childhood experiences of OHC (hazard ratio, 3.58; 95% CI, 2.93-4.36) and after adjusting for a range of adverse childhood living conditions (hazard ratio, 2.51; 95% CI, 2.00-3.15). Those with at least 1 HSA were grouped into 4 trajectories: (1) peak in middle adulthood (66 [12.6%]), (2) stable low across adulthood (167 [31.8%]), (3) peak in early adulthood (210 [40.0%]), and (4) peak in emerging adulthood (82 [15.6%]). A multinomial regression analysis suggested that those with experiences of OHC had higher risks of following any of these trajectories (trajectory 1: relative risk ratio [RRR], 2.91; 95% CI, 1.61-5.26; trajectory 2: RRR, 3.18; 95% CI, 2.21-4.59; trajectory 3: RRR, 4.32; 95% CI, 3.18-5.86; trajectory 4: RRR, 3.26; 95% CI, 1.94-5.46). The estimates were reduced after adjusting for adverse childhood living conditions. Conclusions and Relevance The findings suggest that the elevated risk of suicide attempts among former child welfare clients does not cease after young adulthood, indicating the necessity for clinical attention to childhood experiences of OHC as a risk marker for suicidal behavior across the life span. Question How are childhood experiences of placement in out-of-home care associated with trajectories of hospitalization because of suicide attempts from early into late adulthood? Findings In this cohort study of 14559 individuals, individuals were grouped into 4 trajectories with differential onset of suicide attempts across adulthood. Childhood experiences of placement in out-of-home care were associated with increased risks of following each of these trajectories. Meaning The elevated risk of suicide attempts among former child welfare clients persists into young adulthood, indicating the necessity for clinical attention to childhood experiences of out-of-home care as a risk marker for suicidal behavior across the life span. This cohort study examines the association between childhood experiences of placement in out-of-home care and trajectories of hospitalization because of suicide attempts from early into late adulthood in Sweden.
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| 12. |
- Almquist, Ylva B., et al.
(författare)
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Childhood Adversity and Trajectories of Disadvantage Through Adulthood : Findings from the Stockholm Birth Cohort Study
- 2018
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Ingår i: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 136:1, s. 225-245
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Tidskriftsartikel (refereegranskat)abstract
- Children whose parents experience adverse social, economic, or health-related living conditions are more likely to face similar types of disadvantage in their adult life. However, a limitation of many earlier studies is that they do not account for the multidimensionality of the concept of living conditions, and that the child generation’s life courses are targeted as static and independent from the societal context in which they are imbedded. The current investigation addressed these aspects by focusing on the complexity, duration, and timing of disadvantage with regard to how adverse circumstances in the family of origin are associated with trajectories of social, economic, and health-related living conditions across adulthood. We also examined the role of educational attainment for these associations. Analyses were based a Swedish cohort born in 1953 (n = 14,294). We first conducted sequence analysis, followed by hierarchical cluster analysis, to generate ‘outcome profiles’, i.e. trajectories of adult disadvantage. Second, several indicators of adverse circumstances in childhood were analysed by means of multinominal regression analysis, showing the odds of ending up in the different trajectories. The results indicated that individuals who grew up under adverse conditions were more likely to experience disadvantaged social, economic, and health-related trajectories. This was particularly the case for trajectories characterised by a high degree of complexity, i.e. coexisting disadvantages, and—among men only—by a longer duration of disadvantage. Educational attainment was identified as a powerful mediator, suggesting that efforts to increase equal educational opportunity may be a way of reducing the intergenerational transmission of disadvantage.
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| 13. |
- Almquist, Ylva B., et al.
(författare)
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Childhood friendships and the clustering of adverse circumstances in adulthood - a longitudinal study of a Stockholm cohort
- 2013
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Ingår i: Longitudinal and Life Course Studies. - : Bristol University Press. - 1757-9597. ; 4:3, s. 180-195
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Tidskriftsartikel (refereegranskat)abstract
- Friendships constitute a central feature of childhood, yet little is known about the developmental significance extending beyond childhood and adolescence. The aim of the present study was therefore to investigate the association between childhood friendships and adult outcomes. Since many outcomes in adulthood go hand in hand, the outcome pattern as a whole was targeted. Based on a longitudinal data material consisting of more than 14,000 individuals born in Stockholm in 1953, a cluster analysis of adult circumstances (1992-2007) was first conducted. Second, the association between three indicators of childhood friendships (1966) and the outcome profiles was analysed by means of multinomial regression analysis. The results indicated that children who lacked leisure time friends and a best friend in the school class had increased risks of ending up in the more adverse clusters as adults, whereas the opposite association was found for those who reported being solitary. The effect of childhood friendships was rather consistent across both single and multiple problems, suggesting that the disadvantages of being without friends in childhood do not accumulate over the life course to any large extent. Generally, the results were the same for males and females. It is concluded that childhood friendships are important for adverse circumstances in adulthood, for both genders. As far as the long-lasting effects of children's friendships involve varying access to social support, school-based interventions should compensate for the scarcity of support following the lack of childhood friends.
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| 14. |
- Almquist, Ylva B., et al.
(författare)
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Childhood Peer Status and the Clustering of Adverse Living Conditions in Adulthood
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Within the context of the school class, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Several studies have shown that children’s peer status is associated with a wide range of social and health-related outcomes. These studies commonly target separate outcomes, paying little attention to the fact that such circumstances are likely to go hand in hand. The overarching aim of the present study was therefore to examine the impact of childhood peer status on the clustering of living conditions in adulthood. Based on a 1953 cohort born in Stockholm, Sweden, multinomial regression analysis demonstrated that children who had lower peer status also had exceedingly high risks of ending up in more problem-burdened clusters as adults. Moreover, these associations remained after adjusting for a variety of family-related circumstances. We conclude that peer status constitutes a central aspect of children’s upbringing with important consequences for subsequent life chances, over and above the influences originating from the family.
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| 15. |
- Almquist, Ylva B., et al.
(författare)
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Childhood Peer Status and the Clustering of Social, Economic, and Health-related Circumstances in Adulthood
- 2014
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 105, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- Within the school-class context, children attain a social position in the peer hierarchy to which varying amounts of status are attached. Studies have shown that peer status – i.e. the degree of acceptance and likeability among classmates – is associated with adult health. However, these studies have generally paid little attention to the fact that health problems are likely to coincide with other adverse circumstances within the individual. The overarching aim of the current study was therefore to examine the impact of childhood peer status on the clustering of social, economic, and health-related circumstances in adulthood. Using a 1953 cohort born in Stockholm, Sweden (n = 14,294), four outcome profiles in adulthood were identified by means of latent class analysis: ‘Average’, ‘Low education’, ‘Unemployment’, and ‘Social assistance recipiency and mental health problems’. Multinomial regression analysis demonstrated that those with lower peer status had exceedingly higher risks of later ending up in the more adverse clusters. This association remained after adjusting for a variety of family-related and individual factors. We conclude that peer status constitutes a central aspect of children's upbringing with important consequences for life chances.
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| 16. |
- Almquist, Ylva B., 1983-, et al.
(författare)
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Do trajectories of economic, work- and health-related disadvantages explain child welfare clients’ increased mortality risk? A prospective cohort study
- 2019
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPast research has shown that individuals who have had experiences of out-of-home care (OHC) in childhood have increased risks of premature mortality. Prior studies also suggest that these individuals are more likely to follow long-term trajectories that are characterised by economic, work-, and health-related disadvantages, compared to majority population peers. Yet, we do not know the extent to which such trajectories may explain their elevated mortality risks. The aim of this study is therefore to examine whether trajectories of economic, work-, and health-related disadvantages in midlife mediate the association between OHC experience in childhood and subsequent all-cause mortality.MethodsUtilising longitudinal Swedish data from a 1953 cohort (n = 14,294), followed from birth up until 2008 (age 55), this study applies gender-specific logistic regression analysis to analyse the association between OHC experience in childhood (ages 0–19; 1953–1972) and all-cause mortality (ages 47–55; 2000–2008). A decomposition method developed for non-linear regression models is used to estimate mediation by trajectories of economic, work-, and health-related disadvantages (ages 39–46; 1992–1999), as indicated by social welfare receipt, unemployment, and mental health problems. To account for selection processes underlying placement in OHC, an alternative comparison group of children who were investigated by the child welfare committee but not placed, is included.ResultsThe results confirm that individuals with experience of OHC have more than a two-fold increased risk of all-cause mortality, for men (OR: 2.10, 95% CI: 1.42–3.11) and women (OR: 2.23, 95% CI: 1.39–3.59) alike. Approximately one-third (31.1%) of the association among men, and one-fourth (27.4%) of the association among women, is mediated by the long-term trajectories of economic, work-, and health-related disadvantages. The group who were investigated but not placed shows similar, yet overall weaker, associations.ConclusionsIndividuals who come to the attention of the child welfare services, regardless of whether they are placed in out-of-home care or not, continue to be at risk of adverse outcomes across the life course. Preventing them from following trajectories of economic, work-, and health-related disadvantages could potentially reduce their risk of premature death.
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| 17. |
- Andershed, Henrik, 1975-, et al.
(författare)
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Bokens bakgrund, syfte, innehåll och målgrupp
- 2010. - 1
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Ingår i: Ungdomar som begår brott. - Stockholm : Gothia Förlag AB. - 9789172056664 ; , s. 13-24
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Andrée Löfholm, Cecilia, et al.
(författare)
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Treatment as usual in effectiveness studies : what is it and does it matter?
- 2013
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Ingår i: International Journal of Social Welfare. - Oxford : Blackwell Publishing. - 1369-6866 .- 1468-2397. ; 22:1, s. 25-34
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Tidskriftsartikel (refereegranskat)abstract
- A hallmark of an evidence-based practice (EBP) is the systematic appraisal of research related to the effectiveness of interventions. This study addressed the issue of interpreting results from effectiveness studies that use treatment-as-usual (TAU) as a comparator. Using randomised controlled studies that evaluate the effectiveness of multisystemic therapy as an illustrative example, we show that TAU includes a wide variety of treatment alternatives. Estimated treatment effects on recidivism suggest that TAU seems to contain a greater variation in underlying risk than experimental conditions, supporting the hypothesis that the content of TAU could affect outcomes. Implications for the realisation of an EBP are discussed.
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| 19. |
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| 20. |
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| 21. |
- Beck, Alexander, et al.
(författare)
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Akut brist på lärare i ekonomi på universiteten
- 2016
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Ingår i: Svenska Dagbladet.
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Recension (populärvet., debatt m.m.)abstract
- Redovisningen spelar en central roll i samhället genom att skapa transparens i näringsliv och offentlig sektor. Kraven på transparens ökar och redovisningen vidareutvecklas och anpassas till en global marknad. Bland studenter i företagsekonomi är det populärt att läsa redovisning. Men det råder stor brist på kompetenta universitetslärare i redovisning i Sverige
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| 22. |
- Berg, Lisa, et al.
(författare)
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Evicted children and subsequent placement in out-of-home care : A cohort study
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundEvictions may have serious consequences for individuals’ health and wellbeing. Even though an eviction may be experienced as a significant crisis for the family, there is little previous knowledge on consequences for evicted children. This study represents the first attempt to examine to what extent children from evicted households were separated from their parents and placed in out-of-home care (foster family or residential care) using population-based data, net of observed confounding factors related to the socioeconomic and psychosocial circumstances of their parents.MethodsThis study takes advantage of information from a Swedish national database, consisting of about 8 000 evicted individuals and a random sample of 770 000 individuals from the national population, linked to individual-level, longitudinal data from Swedish national registers. Our analytical sample consists of information for more than 250 000 children born in 1995–2008, including 2 224 children from evicted households. We used binary logistic regression based on the Karlson/Holm/Breen method to account for observed imbalances at baseline between evicted and non-evicted children.ResultsCompared to non-evicted children, the crude odds ratio for placement in out-of-home care in evicted children was 12.10 (95% CI 8.54–17.14). Net of observed confounding factors related to the socioeconomic and psychosocial circumstances of the parents, evicted children had a twofold elevated risk of being placed in out-of-home care (odds ratio 2.26, 95% CI 1.55–3.27). Crude OR for evicted children in comparison with children under threat of eviction (eviction not formally executed) was 1.71 (95% CI 1.17–2.49) and adjusted OR 1.58 (95% CI 1.06–2.35).ConclusionChildren who experience eviction constitute a disadvantaged group and are at significant risk of being separated from their parents and placed in out-of-home care. These results demonstrate the importance of providing support for these children and their parents. Strategies to prevent households with children from being evicted seem to be an important and viable intervention path.
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| 23. |
- Berlin, Marie, et al.
(författare)
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Educational outcomes of children from long-term foster care : Does foster parents’ educational attainment matter?
- 2019
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Ingår i: Developmental Child Welfare. - : SAGE Publications. - 2516-1032 .- 2516-1040. ; 1:4, s. 344-359
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Tidskriftsartikel (refereegranskat)abstract
- Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2,167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.
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| 24. |
- Berlin, Marie, et al.
(författare)
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Long-term NEET among young adults with experience of out-of-home care : A comparative study of three Nordic countries
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study compares the risk of long-term NEET (Not in Employment, Education or Training) among young adults with out-of-home care (OHC) experience across Denmark, Finland, and Sweden, using register data for an entire cohort of domestic born in 1987. The Nordic countries share many features, but there are differences in the provision of after-care support and in the linkage between the educational system and the labour market. The results show that about one-fourth in Denmark and Sweden, and about one-third in Finland, of young adults with OHC experience were NEET. The high prevalence of poor school performance in the OHC population was associated with their excess risk of NEET, and the findings suggest that the current measures aimed at improving young adults’ school-to-work transition are not sufficient for youth from OHC. Implications for research, policy and practice are discussed.
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| 25. |
- Berlin, Marie, 1965-
(författare)
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Out-of-Home Care and Educational Outcomes : Prevalence, Patterns and Consequences
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to examine educational stratification in the context of out-of-home care (OHC; foster family care, residential care) and to place one of society’s most vulnerable groups in the fields of social stratification and family complexity research. About 5% of the Swedish population experience OHC during childhood or adolescence. OHC is not only a matter of protecting children and youth; it is also intended to improve future opportunities and compensate for adverse childhood factors. However, a vast body of international research, including Swedish studies, shows that a substantial proportion of young people from OHC have poor school performance and low educational attainment as adults. Furthermore, this is strongly associated with their high risk of other adverse outcomes in life. To date there are no signs of improvement in this regard, and the disadvantage of having a low education is increasing in today’s knowledge-based society.Many previous OHC studies have relied on small, local samples, and longitudinal data are often lacking. In this respect, Swedish researchers are well positioned to contribute to the field through research based on our high-quality population registers. The main data source in this thesis – the Child Welfare Intervention Register – covers half a century of OHC data. Based on these data, an overview of OHC prevalence in Sweden and patterns of educational outcomes are presented in the introductory chapter. The thesis further consists of five individual studies investigating different aspects of the transition through the educational system to adult life among children and youth from OHC. Two of the five studies focus on children who spent most of their childhood in OHC and for whom society has assumed a long-term commitment of parental responsibilities.The descriptive data show that patterns of poor educational outcomes in the OHC population have remained stable as long as they can be followed in the registers. Study I shows that youth who exited long-term care were disadvantaged as compared to youth without OHC experience, both in terms of educational attainment and regarding the strong association between poor school performance and other adverse outcomes in young adulthood. Up to 55% of their excess risks of later psychosocial problems were statistically attributable to dismal school performance. Study II shows that 54% of clients in substance-misuse treatment in the 1980s had been in OHC, half before their teen years and half as teenagers. In this group, OHC was associated with excess mortality during the 30-year follow-up from exit from treatment, with statistical significance mainly for females who had entered OHC before their teens. School failure was more common in the OHC population than for misuse clients without OHC experience, and was strongly associated with the excess mortality of females. Two Nordic comparative studies (Studies III and IV) show that the OHC population had a substantially higher risk of not completing upper-secondary education across countries, and that poor performance in primary school inflicted a greater risk in OHC youth of being NEET in young adulthood than for their peers without OHC experience. Study V shows that the intergenerational transmission of education was weak and inconsistent in the foster care setting, and that living in a highly educated foster family did not have a robust positive effect on foster children’s educational outcomes.
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