| 1. |
- Dapi Nzefa, Léonie, 1971-, et al.
(author)
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"I eat to be happy, to be strong, and to live." perceptions of rural and urban adolescents in Cameroon, Africa.
- 2007
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In: Journal of nutrition education and behavior. - US : Elsevier. - 1499-4046 .- 1878-2620. ; 39:6, s. 320-326
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate factors influencing rural and urban adolescents' food perceptions during a time of nutritional transition in Cameroon, Africa.DESIGN: Qualitative in-depth interviews.SETTINGS: Yaoundé urban and Bandja rural areas.PARTICIPANTS: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.ANALYSIS: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.FINDINGS: Factors influencing adolescents' food perceptions from the rural area were "to live" "health" and "poverty." Among adolescents from the urban poor area, "health," "beauty," and "not enough money" were factors. Among adolescents from the urban rich area, "pleasure" and "beauty" were factors. Rural girls liked "to be fat," whereas girls from the urban poor wanted "to be a little bit fat," and girls from the urban rich wanted "to be normal."CONCLUSIONS AND IMPLICATIONS: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.
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| 2. |
- Dapi N., Léonie, 1971-, et al.
(author)
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Adolescents´ food habits and nutritional status in urban and rural areas in Cameroon, Africa
- 2005
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In: Scandinavian Journal of Nutrition/Næringsforskning. - : Informa UK Limited. - 1102-6480 .- 1651-2359. ; 49:4, s. 151-158
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Journal article (peer-reviewed)abstract
- Background: Food intake in Cameroon is based on three meals daily. The diet in rural areas is based on traditional staple foods, while that of the urban population incorporates more modern foods. The health and nutrition of adolescents is important as their eating behaviour and nutrition will affect their future health. Objective: To describe and compare food habits and nutritional status of adolescents in Cameroon. Design: A cross-sectional study using an unquantified food frequency questionnaire and anthropometric data, in urban and rural areas. Fifty-two adolescents, 12_/15 years old, were selected from schools. Results : Frequencies of consumption of meat, vegetables, cereals, milk products and junk food were significantly higher in urban than in rural adolescents (11.8 vs 4.5, 9.5 vs 3.9, 16.5 vs 11.9, 5.7 vs 0.8, 24.2 vs 8.7, respectively). The frequency of in-between meals was higher in urban than in rural adolescents (4.9 vs 0.9, respectively). Arm muscle area (AMA, mm2) and waist/hip ratio were significantly higher in rural than in urban adolescents (3554 vs 2802 and 0.82 vs 0.79, respectively). Body mass index (BMI, kg m_2) was higher in rural than urban adolescents, although not significant (20.6 vs 19.4, respectively). There was a positive significant correlation between BMI and AMA in urban and rural areas (r_/0.67 and r_/0. 72, respectively). Conclusions: Despite a lower frequency of food consumption, rural adolescents had higher AMA and waist/hip ratio than urban adolescents. Less junk food and more traditional food consumption, more manualactivities and walking in rural adolescents could explain these results.
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| 3. |
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| 4. |
- Dapi Nzefa, Léonie, 1971-, et al.
(author)
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Socioeconomic and gender differences in adolescents' nutritional status in urban Cameroon, Africa.
- 2009
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In: Nutrition Research. - New York : Elsevier. - 0271-5317 .- 1879-0739. ; 29:5, s. 313-319
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Journal article (peer-reviewed)abstract
- The aim of this study was to assess adolescents' nutritional status according to socioeconomic status (SES) and sex using anthropometry in urban Cameroon, Africa. Adolescent boys (n = 248) and girls (n = 333) 12 to 16 years old were recruited from randomly selected schools in a cross sectional study in Yaoundé city and grouped according to SES. Weight, height, skinfold thickness, and circumferences were measured, and body mass index, waist/hip ratio, arm muscle, and arm fat areas were calculated. Stunting, underweight, and overweight were determined using international cutoff points. Adolescents with medium and high SES were less likely to be stunted than adolescents with low SES (odds ratio [OR], 0.40; P < .01). Prevalences of stunting (12%, 6%, and 5%) and underweight (3%, 4%, and 1%) were higher among the adolescents with low and medium SES than those with high SES. Overweight prevalence was high among the adolescents with low (8%), medium (11%), and high (9%) SES. The OR for overweight was higher among girls than boys (OR, 4.13; P < .001). Girls were less likely to be stunted and underweight than boys (OR, 0.29 [P < .001] and OR, 0.20 [P < .01], respectively). Prevalences of stunting (15% and 6%) and underweight (5% and 2%) were higher among boys than girls. Pubescent adolescents were less likely to be stunted than nonpubescent (OR, 0.53; P < .05). Adolescents with low and medium SES were more underweight and stunted than adolescents with high SES. Girls were more overweight, less stunted, and underweight than boys.
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| 5. |
- Gustafsson, Per E., et al.
(author)
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Do peer relations in adolescence influence health in adulthood? : Peer problems in the school setting and the metabolic syndrome in middle-age
- 2012
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In: PLOS ONE. - San Francisco : Public Library of Science. - 1932-6203. ; 7:6, s. e39385-
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Journal article (peer-reviewed)abstract
- While the importance of social relations for health has been demonstrated in childhood, adolescence and adulthood, few studies have examined the prospective importance of peer relations for adult health. The aim of this study was to examine whether peer problems in the school setting in adolescence relates to the metabolic syndrome in middle-age. Participants came from the Northern Swedish Cohort, a 27-year cohort study of school leavers (effective n = 881, 82% of the original cohort). A score of peer problems was operationalized through form teachers' assessment of each student's isolation and popularity among school peers at age 16 years, and the metabolic syndrome was measured by clinical measures at age 43 according to established criteria. Additional information on health, health behaviors, achievement and social circumstances were collected from teacher interviews, school records, clinical measurements and self-administered questionnaires. Logistic regression was used as the main statistical method. Results showed a dose-response relationship between peer problems in adolescence and metabolic syndrome in middle-age, corresponding to 36% higher odds for the metabolic syndrome at age 43 for each SD higher peer problems score at age 16. The association remained significant after adjustment for health, health behaviors, school adjustment or family circumstances in adolescence, and for psychological distress, health behaviors or social circumstances in adulthood. In analyses stratified by sex, the results were significant only in women after adjustment for covariates. Peer problems were significantly related to all individual components of the metabolic syndrome. These results suggest that unsuccessful adaption to the school peer group can have enduring consequences for metabolic health.
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| 6. |
- Gustafsson, Per E., et al.
(author)
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Life-course accumulation of neighborhood disadvantage and allostatic load : empirical integration of three social determinants of health frameworks
- 2014
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In: American Journal of Public Health. - : American Public Health Association. - 0090-0036 .- 1541-0048. ; 104:5, s. 904-910
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Journal article (peer-reviewed)abstract
- OBJECTIVES: We examined if the accumulation of neighborhood disadvantages from adolescence to mid-adulthood were related to allostatic load, a measure of cumulative biological risk, in mid-adulthood, and explored whether this association was similar in women and men.METHODS: Data were from the participants in the Northern Swedish Cohort (analytical n = 818) at ages 16, 21, 30, and 43 years in 1981, 1986, 1995, and 2008. Personal living conditions were self-reported at each wave. At age 43 years, 12 biological markers were measured to operationalize allostatic load. Registered data for all residents in the cohort participants' neighborhoods at each wave were used to construct a cumulative measure of neighborhood disadvantage. Associations were examined in ordinary least-squares regression models.RESULTS: We found that cumulative neighborhood disadvantage between ages 16 and 43 years was related to higher allostatic load at age 43 years after adjusting for personal living conditions in the total sample (B = 0.11; P = .004) and in men (B = 0.16; P = .004), but not in women (B = 0.07; P = .248).CONCLUSIONS: Our findings suggested that neighborhood disadvantage acted cumulatively over the life course on biological wear and tear, and exemplified the gains of integrating social determinants of health frameworks.
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| 7. |
- Gustafsson, Per E., et al.
(author)
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The association between long-term accumulation of temporary employment, the cortisol awakening response and circadian cortisol levels
- 2012
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In: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 37:6, s. 789-800
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Journal article (peer-reviewed)abstract
- Temporary employment is an increasingly common contract type, which has not been investigated in a psychoneuroendocrinological context despite previous observations of associations between adverse work and employment conditions and hypothalamic-pituitary-adrenal (HPA) axis dysregulations. The present study aims to examine whether the 12-year accumulation of temporary employment is related to circadian cortisol levels, and if any association is independent of current employment conditions. Participants were drawn from the prospective Northern Swedish Cohort (n = 791, 74% of the original cohort). At age 43 years, retrospective reports of employments over the last 12 years and of current social conditions were collected by questionnaire, and one-day salivary cortisol profile was measured (at awakening, +15 min post-awakening, pre-lunch, bedtime). Results indicated a gradually higher magnitude of the cortisol awakening response (CAR) in subjects with no (0 months in temporary employment; mean CAR = 34%), moderate (1-25 months in temporary employment; mean CAR = 41%) and heavy (>25 months in temporary employment; mean CAR = 51%) exposure (p = .020), remaining after adjustment for potential confounders and for current employment conditions (p = .028). The higher CAR was explained by lower awakening rather than higher post-awakening cortisol levels. Cortisol levels at all times of the day except post-awakening displayed tendencies to negative relations to temporary employment; as indicated by a lower Area Under of Curve (regression coefficient = 5.0%, p = .038 after adjustment). This study thus suggests that the long-term exposure to temporary employment might confer HPA dysregulations in the form of increased dynamics of the CAR and circadian suppression. (C) 2011 Elsevier Ltd. All rights reserved.
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| 8. |
- Hassler, Sven, 1963-, et al.
(author)
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Northern Fennoscandia
- 2008
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In: Health Transitions in Arctic Populations. - Toronto, Kanada : University of Toronto Press. - 9780802091093 - 9780802094018 ; , s. 103-116
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Book chapter (other academic/artistic)
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| 9. |
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| 10. |
- Hult, Carl, 1953-, et al.
(author)
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Timing of retirement and mortality : A cohort study of Swedish construction workers
- 2010
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In: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 70:10, s. 1480-1486
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Journal article (peer-reviewed)abstract
- Recent studies indicate that early retirement per se may have a negative effect on health to such an extent that it increases mortality risk. One type of early retirement often referred to in these studies is retirement with disability pension/benefit. Given the overall objective of disability benefit programmes - to help the disabled live socially and economically satisfactory lives, freed from exposure to employment health hazards and thus avoid further declines in health - the finding is challenging. This paper examined the relationship between timing of retirement and mortality using a cohort of Swedish construction workers. The mortality risk of disability pensioners - excluding those with diagnoses normally connected to increased mortality - was compared with the risk of those continuing to work. Although initial indications were in line with earlier results, it became obvious that the increased mortality risk of disability pensioners did not depend on early retirement per se but on poor health before early retirement not explicitly recognized in the diagnosis on which the disability pension rested. The results indicate that there are no general differences in mortality depending on timing of retirement. Future studies of mortality differences arising from working or not working must sufficiently control for health selection effects into the studied retirement paths.
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| 11. |
- Norström, Fredrik, 1974-, et al.
(author)
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How does unemployment affect self-assessed health? : A systematic review focusing on subgroup effects
- 2014
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 14:1
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Research review (peer-reviewed)abstract
- BACKGROUND: Almost all studies on the effect on health from unemployment have concluded that unemployment is bad for your health. However, only a few review articles have dealt with this relation in recent years, and none of them have focused on the analysis of subgroups such as age, gender, and marital status. The objective of our article is to review how unemployment relates to self-assessed health with a focus on its effect on subgroups.METHODS: A search was performed in Web of Science to find articles that measured the effect on health from unemployment. The selection of articles was limited to those written in English, consisting of original data, and published in 2003 or later. Our definition of health was restricted to self-assessed health. Mortality- and morbidity-related measurements were therefore not included in our analysis. For the 41 articles included, information about health measurements, employment status definitions, other factors included in the statistical analysis, study design (including study population), and statistical method were collected with the aim of analysing the results on both the population and factor level.RESULTS: Most of the studies in our review showed a negative effect on health from unemployment on a population basis. Results at the factor levels were most common for gender (25 articles), age (11 articles), geographic location (8 articles), and education level (5 articles). The analysis showed that there was a health effect for gender, age, education level, household income, and geographic location. However, this effect differed between studies and no clear pattern on who benefits or suffers more among these groups could be determined. The result instead seemed to depend on the study context. The only clear patterns of association found were for socioeconomic status (manual workers suffer more), reason for unemployment (being unemployed due to health reasons is worse), and social network (a strong network is beneficial).CONCLUSIONS: Unemployment affects groups of individuals differently. We believe that a greater effort should be spent on specific groups of individuals, such as men or women, instead of the population as a whole when analysing the effect of unemployment on health.
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| 12. |
- Nygren, Karina, et al.
(author)
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Adolescent self-reported health in relation to school factors : a multilevel analysis
- 2014
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In: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 30:2, s. 114-122
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Journal article (peer-reviewed)abstract
- The aim of the study was to examine school-related determinants of self-reported health among adolescents. Questionnaire survey data comprising 4,972 students, Grades 7 through 9, from 20 schools in northern Sweden were used. Also, complimentary data about each school were collected from the Swedish National Agency for Education. Using multilevel logistic regression analyses, results showed that most variation in self-reported health was explained by individual-level differences. Truancy, bullying, and poor relations with teachers significantly increased the odds ratio of reporting poor general health, for boys and for girls. Most variables at the school level, for example, school size and student-teacher ratio, did not render significant associations with students' self-reported health. In conclusion, this study indicates that health promotion at school, including school health services, may benefit from focusing primarily on individual-level determinants of health, that is, students' relations to peers and teachers, without ignoring that bullying and weak student-teacher relationships also may induce school-level interventions.
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| 13. |
- Nygren, Karina, 1974-, et al.
(author)
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Norm compliance and self-reported health among Swedish adolescents
- 2011
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In: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39:1, s. 44-50
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Journal article (peer-reviewed)abstract
- Aims: This study examines the relationship between norm compliance and self-reported health in adolescents, and how this differs between genders. Our specific aim was to investigate if extremely high norm compliance revealed any particular health patterns. Methods: This empirical study used a web-based survey from 2005, which was distributed to all students (n = 5,066) in years 7—9 of compulsory school within six municipalities in northern Sweden. The respondents answered questions about their general health as well as specific health problems such as headaches, stomach ache, sleeping difficulties and stress. Compliance was measured according to different norm-related behaviour, such as truancy, crime and use of tobacco, alcohol and narcotics. Results: The majority of respondents reported good health and norm-compliant behaviour. Girls reported more health problems than boys, a difference that increased with age. Those who were more norm compliant reported better health, fewer somatic complaints and less stress, which goes against our initial hypothesis that extremely high norm compliance and self-reported ill-health are related. There seemed to be a stronger relationship between self-reported health and norm compliance for girls than boys, in absolute terms. Conclusions: The results clearly show a relationship between norm compliance and health, and suggest inequalities between genders.
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| 14. |
- Nygren, Karina, 1974-, et al.
(author)
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Parents matter : but relations to parents do not explain gender differences in self-reported health in adolescents
- 2012
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:4, s. 643-653
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Journal article (peer-reviewed)abstract
- The aim of the study was to explore whether parent-adolescent relations are associated to self-reported health of adolescents. Logistic regression analyses were performed on a cross-sectional data set consisting of 5060 adolescents, grades 7-9, from six municipalities in the northern part of Sweden. The study was approved by the Regional Ethical Review Board in Umeå, Sweden. Results showed that, in both boys and girls, experiencing low parental demands as well as perceiving the relationship quality and the communication with parents as poor were significantly associated with having poor general health, somatic complaints and feelings of stress. In general, girls scored lower on self-reported health than boys, but our findings indicate that these gender differences could not be explained by relations to parents. In conclusion, relations to parents play an important role for self-reported health of adolescents. Although no causal-effect statements can be determined in this study, it is implied that there is a need for health professionals, such as school nurses, school welfare officers, etc., to pay special attention to parent-adolescent relations in their work with adolescents.
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| 15. |
- Nygren, Karina, 1974-, et al.
(author)
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What happens with local survey findings? : a study of how adolescent school surveys are disseminated and utilized in Swedish schools
- 2013
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In: Scandinavian Journal of Educational Research. - : Taylor & Francis Group. - 0031-3831 .- 1470-1170. ; 57:5, s. 526-543
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Journal article (peer-reviewed)abstract
- This paper aimed at examining the barriers to and facilitators of disseminating and utilizing the results of a local Swedish school survey. Interviews with 21 school district managers/principals were performed. Results showed that dissemination and utilization of local survey data appeared as two interrelated processes. With those processes, various barriers and facilitators were mentioned. The barriers and facilitators were not merely the opposites of each other; instead they qualitatively differed from each other depending on what phase in the process the manager/principal referred to. The results also showed that the dissemination phase was both a prerequisite for and interwoven with the utilization phase, e.g. dissemination efforts were important for how the survey results were utilized.
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| 16. |
- Virtanen, P., et al.
(author)
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Health status and health behaviour as predictors of the occurrence of unemployment and prolonged unemployment
- 2013
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In: Public Health. - : Elsevier. - 0033-3506 .- 1476-5616. ; 127:1, s. 46-52
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Journal article (peer-reviewed)abstract
- Objectives: Earlier research on health-related selection into unemployment has been based on relatively severe health problems, leaves questions unanswered about particular problems, follow-up times have been short and the measurement of unemployment utilised has been crude. The present study explores the effects of suboptimal health on employment in the long term, with statistics that enable assessment of the occurrence and extent of unemployment. Study design: Employment status of a population cohort (n = 1083) was measured half-yearly from 18 to 42 years of age with four follow-up surveys. Methods: Health status at 30 years of age was assessed with nine indicators. Their associations with the occurrence of a period of unemployment during the subsequent 12 years were analysed with Cox proportional hazard models, and generalized linear models were applied in assessing their associations with prolonged unemployment. Results: Suboptimal self-rated health and suboptimal mood were the most robust predictors of both occurrence of unemployment {hazard rates 1.48 [95% confidence interval (CI) 1.13-1.94] and 1.59 (95% CI 1.19-2.12), respectively} and prolonged unemployment [risk ratios 1.95 (95% CI 1.66-2.29) and 1.44 (95% CI 1.24-1.67), respectively]. Significant associations, particularly with prolonged unemployment, were also seen for musculoskeletal pain, suboptimal sense functions and sleep quality, and smoking and risky alcohol intake. Conclusions: There is health-related selection into unemployment in early middle age, irrespective of unemployment earlier in the life course. High risk ratios for prolonged unemployment suggest that selection takes place, in particular, at re-employment. The findings indicate the need for policies to prevent those with a history of health problems being at a disadvantage in terms of future employment. (C) 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
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| 17. |
- Waller, Göran, et al.
(author)
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A cross-sectional and semantic investigation of self-rated health in the northern Sweden MONICA-study
- 2012
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In: BMC Medical Research Methodology. - London : BioMed Central. - 1471-2288. ; 12
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Journal article (peer-reviewed)abstract
- Background: Self-Rated Health (SRH) correlates with risk of illness and death. But how are different questions of SRH to be interpreted? Does it matter whether one asks: “How would you assess your general state of health?”(General SRH) or “How would you assess your general state of health compared to persons of your own age?”(Comparative SRH)? Does the context in a questionnaire affect the answers? The aim of this paper is to examine the meaning of two questions on self-rated health, the statistical distribution of the answers, and whether the context of the question in a questionnaire affects the answers.Methods: Statistical and semantic methodologies were used to analyse the answers of two different SRH questions in a cross-sectional survey, the MONICA-project of northern Sweden.Results: The answers from 3504 persons were analysed. The statistical distributions of answers differed. The most common answer to the General SRH was “good”, while the most common answer to the Comparative SRH was “similar”. The semantic analysis showed that what is assessed in SRH is not health in a medical and lexical sense but fields of association connected to health, for example health behaviour, functional ability, youth, looks, way of life. The meaning and function of the two questions differ – mainly due to the comparing reference in Comparative SRH. The context in the questionnaire may have affected the statistics.Conclusions: Health is primarily assessed in terms of its sense-relations (associations) and Comparative SRH and General SRH contain different information on SRH. Comparative SRH is semantically more distinct. The context of the questions in a questionnaire may affect the way self-rated health questions are answered. Comparative SRH should not be eliminated from use in questionnaires. Its usefulness in clinical encounters should be investigated.
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