| 1. |
- Al-Emrani, Faisal, et al.
(författare)
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Pattern of Five-Year Weight Change by Age and Birth Cohorts in a Swedish Adult Population
- 2013
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Ingår i: The Open Public Health Journal. - : Bentham Science Publishers Ltd.. - 1874-9445. ; 6, s. 42-50
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Tidskriftsartikel (refereegranskat)abstract
- The driving factors behind the global epidemic of obesity have not yet been fully elucidated. Investigating the effect of age and cohort on weight change might enable us to develop effective intervention strategies. Aims To analyse the pattern of BMI change by age and birth cohort over five-year follow-up in adult Swedish sample. Methods The data was drawn from the Scania Public Health Cohort. The baseline survey was conducted between 1999 and 2000, and the follow-up in 2005. A total of 10,373 individuals responded to both surveys; all were included in the present study. The data was stratified into three-year intervals according to a respondent’s birth year and age at baseline. This was done in order to allow for age and cohort effect analysis by means of fixed effects linear mixed models. Results We observed a significant increase in BMI between baseline and follow-up for males and females (p < 0.001), as well as significant age and cohort effects resulted from age
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| 2. |
- Al-Emrani, Faisal, et al.
(författare)
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The influences of childhood and adult socioeconomic position on body mass index: A longitudinal Swedish cohort study.
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:5, s. 463-469
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low socioeconomic position (SEP) in adulthood has been associated with overweight and obesity in high-income countries. However, little is known about the contribution of childhood SEP to weight change. Using a Swedish general population sample, this study aimed to examine the association between five-year weight gain among adults and socioeconomic position in childhood and adulthood. Methods: The data was drawn from the Scania Public Health Cohort and included 4244 individuals (1816 males and 2428 females) between the ages of 29 and 60 years, stratified by sex and age (29-39 and 40-60 years). General linear and logistic regression models were used to analyse the data. Results: Adult SEP was inversely correlated to BMI at baseline in males and older females. Childhood SEP showed no clear pattern regarding current BMI or the risk of being overweight at baseline, either in males or females. However, BMI increase between baseline and follow-up was greater in the highest adult SEP groups than in lowest ones for both males and females, although with a weaker trend among females. High childhood SEP was associated with a greater BMI increase in older males, but the pattern was the opposite in older females. Conclusions: Adult as well as childhood SEP influences weight gains, but differently among males and females and in different age groups. The findings suggest two waves of socioeconomic weight gain patterns in the Swedish population: one across generations and another contemporary one.
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| 3. |
- Asamoah, Benedict O, et al.
(författare)
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Distribution of causes of maternal mortality among different socio-demographic groups in Ghana; a descriptive study
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Ghana's maternal mortality ratio remains high despite efforts made to meet Millennium Development Goal 5. A number of studies have been conducted on maternal mortality in Ghana; however, little is known about how the causes of maternal mortality are distributed in different socio-demographic subgroups. Therefore the aim of this study was to assess and analyse the causes of maternal mortality according to socio-demographic factors in Ghana.METHODS: The causes of maternal deaths were assessed with respect to age, educational level, rural/urban residence status and marital status. Data from a five year retrospective survey was used. The data was obtained from Ghana Maternal Health Survey 2007 acquired from the database of Ghana Statistical Service. A total of 605 maternal deaths within the age group 12-49 years were analysed using frequency tables, cross-tabulations and logistic regression.RESULTS: Haemorrhage was the highest cause of maternal mortality (22.8%). Married women had a significantly higher risk of dying from haemorrhage, compared with single women (adjusted OR = 2.7, 95%CI = 1.2-5.7). On the contrary, married women showed a significantly reduced risk of dying from abortion compared to single women (adjusted OR = 0.2, 95%CI = 0.1-0.4). Women aged 35-39 years had a significantly higher risk of dying from haemorrhage (aOR 2.6, 95%CI = 1.4-4.9), whereas they were at a lower risk of dying from abortion (aOR 0.3, 95% CI = 0.1-0.7) compared to their younger counterparts. The risk of maternal death from infectious diseases decreased with increasing maternal age, whereas the risk of dying from miscellaneous causes increased with increasing age.CONCLUSIONS: The study shows evidence of variations in the causes of maternal mortality among different socio-demographic subgroups in Ghana that should not be overlooked. It is therefore recommended that interventions aimed at combating the high maternal mortality in Ghana should be both cause-specific as well as target-specific.
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| 4. |
- Bisak, Adela, et al.
(författare)
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Unleashing the potential of Health Promotion in primary care-a scoping literature review
- 2024
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Ingår i: Health Promotion International. - 1460-2245. ; 39:3, s. 1-10
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Forskningsöversikt (refereegranskat)abstract
- The purpose of this study is to gain a better understanding of the role and extent of health promotion lifestyle interventions targeting adults in primary care, and especially those who are considered overall healthy, i.e. to study the outcomes of research applying salutogenesis. We performed a literature review, with three specific aims. First, to identify studies that have targeted the healthy population in intervention within the primary health care field with health promotion activities. Second, to describe these interventions in terms of which health problems they have targeted and what the interventions have entailed. Third, to assess what these programs have resulted in, in terms of health outcomes. This scoping review of 42 studies, that applied salutogenesis in primary care interventions shows that health promotion targeting healthy individuals is relevant and effective. The PRISMA-ScR guidelines for reporting on scoping review were used. Most interventions were successful in reducing disease-related risks including CVD, CVD mortality, all-cause mortality, but even more importantly success in behavioural change, sustained at follow-up. Additionally, this review shows that health promotion lifestyle interventions can improve mental health, even when having different aims.
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| 5. |
- Bolatova, Zhanerke, et al.
(författare)
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Challenges of access to WASH in schools in low-and middle-income countries : Case study from rural central Kazakhstan
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:18
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Tidskriftsartikel (refereegranskat)abstract
- Safe water and sanitation, which give rise to appropriate hygiene, are fundamental determinants of individual and social health and well-being. Thereby, assessing and widening access to sustainable, durable water and sanitation infrastructure remains a global health issue. Rural areas are already at a disadvantage. Poor access to water, sanitation, and hygiene (WASH) can have a major negative effect on students in rural schools. Thus, the paper aims to assess the current condition and the challenge to access WASH in rural Kazakh schools. The study was conducted in three rural schools in Central Kazakhstan. Data were gathered through a survey among pupils, observations of the WASH infrastructure and maintenance, and a face-to-face interview with school administrators. The mean survey response rate was 65% across schools. Results indicated there was no alternative drinking-water source in schools, and 15% of students said they had access to water only occasionally. Half of the students reported that the water was unsafe to drink because of a poor odor, taste, or color. The toilet in school 3 was locked with a key, and a quarter of the students reported there was no access to a key. Moreover, not having gender-separated toilet facilities was a challenge because of the traditional gender norms. Despite the effective regulations and measures of handwashing taken during COVID-19, 27.7% of the students answered that soap was not offered daily in classrooms. Additionally, warm water was only provided in school 2. About 75% of students did not have access to drying materials continuously. The study shows that having the schools’ infrastructure is not enough when characteristics, such as availability, accessibility, maintenance, operation, quality of services, education, and practices, are ignored. Cooperation between local education authorities, school administration, and parents should be encouraged to the achievement of the sustainable development goals (SDGs) by 2030.
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| 6. |
- Boman, Fiffi, et al.
(författare)
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Comparing parent and teacher assessments of mental health in elementary school children
- 2016
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:2, s. 168-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: Screening instruments are often used for detecting mental health problems in children and adolescents. The Strengths and Difficulties Questionnaire (SDQ) is one instrument for screening children's mental health. The SDQ can be used for assessment by different informants, i.e. parents, teachers and by 11-16 year olds for self-reporting. Aims: The aim was to compare the precision and validity of parental and teacher SDQ assessments in elementary school children, and to analyze whether assessments were affected by the child's sex and by socio-demographic factors. Methods: A total of 512 primary school students were included in a cross-sectional study. Exploratory factor analysis, sensitivity/specificity analysis, Cronbach's alphas, and logistic regression were applied. Results: Parents rated 10.9% and teachers 8.8% of the children as high-risk individuals, but the overlap was low (32.1%). Cronbach's alphas were 0.73 and 0.71 for parents and teachers, respectively. However, factor analysis showed that the five-factor solution could be confirmed only for teacher ratings. Moreover, only the parents' ratings were affected by maternal educational level and parental country of birth when rating the same children as the teachers. Conclusions: Construct validity was only confirmed for teacher assessments. However, parental assessments might capture a dimension of a child's mental health that seems to be sensitive to socioeconomic factors, which could be important when addressing equity issues, and for the dialogue between parents and school.
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| 7. |
- Brede, Jens, et al.
(författare)
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Dynamics of molecular self-ordering in tetraphenyl porphyrin monolayers on metallic substrates
- 2009
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Ingår i: NANOTECHNOLOGY. - : IOP Publishing. - 0957-4484 .- 1361-6528. ; 20:27, s. 275602-
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Tidskriftsartikel (refereegranskat)abstract
- A molecular model system of tetraphenyl porphyrins (TPP) adsorbed on metallic substrates is systematically investigated within a joint scanning tunnelling microscopy/molecular modelling approach. The molecular conformation of TPP molecules, their adsorption on a gold surface and the growth of highly ordered TPP islands are modelled with a combination of density functional theory and dynamic force field methods. The results indicate a subtle interplay between different contributions. The molecule-substrate interaction causes a bending of the porphyrin core which also determines the relative orientations of phenyl legs attached to the core. A major consequence of this is a characteristic (and energetically most favourable) arrangement of molecules within self-assembled molecular clusters; the phenyl legs of adjacent molecules are not aligned parallel to each other (often denoted as pi-pi stacking) but perpendicularly in a T-shaped arrangement. The results of the simulations are fully consistent with the scanning tunnelling microscopy observations, in terms of the symmetries of individual molecules, orientation and relative alignment of molecules in the self-assembled clusters.
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| 8. |
- Choudhry, Vikas, et al.
(författare)
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Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students.
- 2014
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience.
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| 9. |
- Dahlman, Disa, et al.
(författare)
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Female Swedish backpackers in Vietnam: A hypotheses generating study on sexual health risks while travelling.
- 2013
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Ingår i: Travel Medicine and Infectious Disease. - : Elsevier BV. - 1873-0442 .- 1477-8939. ; 11:4, s. 243-249
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: According to previous studies, foreign travellers and backpackers are at increased risk of sexually transmitted infections (STI). Concurrently, STI incidence, especially Chlamydia, is increasing among young Swedes. Our objective was to investigate Swedish backpackers' own view of sexual health and risks while travelling, with the purpose to identify hypotheses for further, more extensive research. METHOD: In-depth semi-structured interviews were carried out in Vietnam with four Swedish women in their early twenties. The interviewees had been travelling throughout South East Asia for a period of at least two weeks. RESULTS: There were large differences between the respondents regarding perceived health risks in relation to food safety, STI, and alcohol and drug use; and to what extent their behaviour while travelling deviated from their normal one. In contrast, the interviewees shared a perceived lack of knowledge about sexual health abroad. CONCLUSIONS: The study identified six hypotheses and suggestions for preventive measures that could be analysed in future research. The study demonstrated that sexual behaviour as well as attitudes and norms were strongly linked to the individual level, rather than to the group of backpackers.
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| 10. |
- Hayes-Mejia, Rebecca, et al.
(författare)
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Psychosocial work environment and mental health among the global workforce of seafarers in the wake of the COVID-19 pandemic
- 2023
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Ingår i: BMC Public Health. - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to investigate the impact of the COVID-19 pandemic on the mental health outcomes of international seafarers, who played a crucial role in maintaining global trade during the pandemic. The study examined how changes in psychosocial work environment and policies affected mental health outcomes among seafarers. Methods: We analyzed a survey including answers from 17,861 seafarers, serving on 44 different international commercial vessels with 154 different nationalities. Stress, anxiety, and depression were applied as outcome measures in this study. Three sets of independent variables were included; work-related consequences of the COVID-19 pandemic, general psychosocial work environment onboard, and socioeconomic variables. First, we applied binary linear regression, followed by a multivariate linear regression analysis. Results: The study found that changes in safety consciousness and clear communication from employers were associated with better mental health outcomes among seafarers. Eroded policies related to crew changes had a significant negative effect on mental wellbeing due to delays caused by national quarantine guidelines and travel restrictions. The results also showed a discrepancy in mental health outcomes between those onboard and those onshore, with stress being present in both groups. Conclusions: The findings suggest that crisis management within shipping companies played an important role in mitigating adverse mental health outcomes during the pandemic. Clear communication from employers and emphasizing safety issues onboard were effective strategies for promoting better mental wellbeing among seafarers. However, delays in crew changes had a significant negative impact on mental health outcomes, highlighting the need for global cooperation and overarching agreements to protect international seafarers during times of crises.
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| 11. |
- Hayes-Mejia, Rebecca, et al.
(författare)
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Wellbeing and Happiness and Their Association With Working Conditions at Sea : A Cross-sectional Study Among the Global Workforce of Seafarers
- 2024
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Ingår i: Inquiry: The Journal of Health Care Organization, Provision and Financing. - 0046-9580. ; 61
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether seafarers' self-reported work experiences were associated with wellbeing and happiness while onboard. The study also examined which indicators of the work experiences had an effect in what direction. We analyzed the survey responses from 13 008 seafarers onboard, from 154 different nationalities, serving in 44 different international shipping companies. The outcome measures were wellbeing and happiness, and the exposure variables were work environment factors: satisfaction, expectations, ideal, skills and training, challenges, and workload. General psychosocial work environment onboard and socioeconomic independent variables were also included. We conducted different logistic regression analyses, and presented the results as odds ratios (OR) and 95% confidence intervals (CIs). The study found that most seafarers reported high levels of wellbeing and happiness and that these were significantly associated to the work environment factors, except for workload. A stratified analysis, showed that workload modified the effect of the other work environment factors. The study found that there were independently significant associations between work related factors and wellbeing and happiness among seafarers at sea. The findings suggest that a greater emphasis on these outcomes could have a positive impact both on crew retention and safety at sea.
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| 12. |
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| 13. |
- Holmer, Hampus, et al.
(författare)
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Nu ses en ljusnande framtid för socialmedicinen
- 2020
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 117:46-47, s. 1508-1509
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 14. |
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| 15. |
- Kjeldsted, Eva, et al.
(författare)
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Association between human papillomavirus status and health-related quality of life in oropharyngeal and oral cavity cancer survivors
- 2020
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Ingår i: Oral Oncology. - : Elsevier BV. - 1368-8375. ; 109
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The human papillomavirus (HPV) is a risk factor for a subgroup of head and neck cancers (HNC). HPV-positive and HPV-negative HNC patients encompass heterogeneous groups regarding risk factors, sociodemographic and clinical characteristics, which may influence health-related quality of life (HRQL) differently. Since this has been sparsely studied, our study investigated the association between HPV status and HRQL in HNC survivors in Denmark. Materials and methods: This cross-sectional study included 179 recurrence-free oropharyngeal and oral cavity squamous cell carcinoma (OSCC) survivors. HRQL was assessed on the EORTC QLQ-C30 and QLQ-H&N35 questionnaires. Linear and logistic regression models were adjusted for sociodemographic, clinical and lifestyle factors. Results: Most unadjusted results showed better HRQL among HPV-positive (n = 119) compared to HPV-negative (n = 60) OSCC survivors (average 18 months since diagnosis). After adjustments, the HPV-positive survivors reported higher role functioning (mean difference [MD] 9.2, 95% confidence interval [CI] 0.1 to –18.4), and fewer problems with speech (MD −9.0, 95% CI −18.0 to −0.1), sexuality (MD −21.9, 95% CI −38.0 to −5.9) and opening mouth (MD −13.7, 95% CI −26.6 to −0.8) compared to HPV-negative survivors. Conclusion: Our findings support that HPV-positive OSCC survivors experience better HRQL than HPV-negative survivors. However, results indicate that sociodemographic, clinical and lifestyle factors explain most of the association between HPV status and HRQL. Findings suggest increased focus on the HPV-negative OSCC survivors with deteriorated HRQL in rehabilitation programs and future research to investigate the long-term effects of treatment among HPV-positive OSCC survivors who may develop symptoms later in survivorship.
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| 16. |
- Lecerof, Susanne Sundell, et al.
(författare)
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Findings from a prospective cohort study evaluating the effects of International Health Advisors’ work on recently settled migrants’ health
- 2017
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. Methods: The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results: The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions: Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and deteriorated or unchanged health needs is that participation was limited to one’s own social group, and therefore had limited positive influence on health seeking behaviour. The lack of measurable improvements in health status could be explained by limitations in the study, in the theoretical assumptions underlying the intervention, and in the implementation of the intervention. Further research is needed to understand success factors in health promoting interventions among recently settled migrants better.
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| 17. |
- Löthberg, Katarina, et al.
(författare)
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Hälsokommunikation på modersmål – gör den någon skillnad? Etablering, utveckling och utvärdering
- 2012
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Ingår i: Socialmedicinsk tidskrift. - 0037-833X. ; 89:2, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- Invandrares hälsa är sämre än totalbefolkningens. Jämlik hälsa är en nationell målsättning. Kan en hälsokommunikativ intervention påverka nyanlända flyktingars och invandrares hälsa? Denna artikel beskriver hur hälsokommunikatörsverksamheten etablerats, utvärderats och spridits. Forskningsprojektet IMHAd – Impact of Multicultural Health Advisors – har med hjälp av en longitudinell kohortstudie försökt ta reda på om verksamheten har effekt på målgrupperna. Resultatet av studiens folkhälsodata presenterassummariskt och artikeln avslutas med en reflektion kring hälsokommunikatörernas möjligheter att få genomslag på målgruppernas hälsoutveckling.
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| 18. |
- Manieri, Marco, et al.
(författare)
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Sex tourist risk behaviour - An on-site survey among Swedish men buying sex in Thailand.
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:4, s. 392-397
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Tidskriftsartikel (refereegranskat)abstract
- Background: Thailand is not only a popular destination for Swedish tourists, it is also the foreign country where the largest numbers of Swedish males contract HIV. This study investigated sexual risk-behaviour of Swedish men who have sex with commercial sex workers (CSW) in Thailand. Method: Eligible men were approached on location in red-light districts of Pattaya and Bangkok with a self-administered multiple-choice questionnaire in December 2010. The data collected was analysed using SPSS version 18 generating cross-tabs, independent sample t-test, univariate and multivariate logistic regression. Results: In total, 158 questionnaires were included in the analyses. The results indicated that 63% of the study sample had lifetime experience of sexual intercourse with CSWs, while 48% of the respondents indicated that they were likely to pay for sex during their present trip. 71% of the lifetime sex-buyers reported consistent use of condoms in the past. Out of the men that were planning to have sex with a CSW in the near future, 80% reported that they would use condoms consistently. While most of these men always use, and plan on always using a condom when having sex with a CSW, some do so inconsistently or not at all. The study found that those reporting inconsistent condom use when engaging in sexual intercourse with Thai CSWs assessed the risk of becoming infected with HIV to be significantly lower than those who used condoms consistently (p < 0.005). Conclusions: Inconsistent condom use by Swedish male tourists to Thailand when having sex with CSWs puts them at risk of contracting HIV and other STIs, and seems to be associated with a lower assessment of the risk of becoming infected with HIV.
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| 19. |
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| 20. |
- Rubens-Augustson, Taylor, et al.
(författare)
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Healthcare provider perspectives on the uptake of the human papillomavirus vaccine among newcomers to Canada : a qualitative study
- 2019
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Ingår i: Human Vaccines and Immunotherapeutics. - : Informa UK Limited. - 2164-5515 .- 2164-554X. ; 15:7-8, s. 1697-1707
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Tidskriftsartikel (refereegranskat)abstract
- Human papillomavirus is among the most common sexually transmitted infections in the world. Newcomers, defined in Canada as foreign-born individuals who are either immigrants or refugees, but may also include students and undocumented migrants, face numerous barriers to HPV vaccination. This study sought to understand, from the perspective of healthcare providers, barriers and facilitators to HPV vaccination, and recommendations to improve HPV vaccine uptake among newcomers. Semi-structured interviews were conducted with 10 healthcare providers between March and April 2018. Data were analyzed at the manifest level using a Qualitative Content Analysis approach. Categories of barriers to vaccination included: access, communication, knowledge, culture, and provider-related factors. Facilitators included targeted health promotion; understanding the relevance of HPV vaccination; trusting the healthcare system; and cultural sensitivity. Two overarching recommendations were to publicly fund the HPV vaccine, and enhance language- and culturally-appropriate health promotion activities. Further research should explore informational desires and needs from the perspective of newcomers to inform strategies to promote equitable HPV vaccine coverage.
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| 21. |
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| 22. |
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| 23. |
- Stafström, Martin, et al.
(författare)
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A community-based intervention to reduce alcohol-related accidents and violence in 9th grade students in southern Sweden: The example of the Trelleborg Project.
- 2008
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 1879-2057 .- 0001-4575. ; 40:3, s. 920-925
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was to analyse if a community-based intervention has led to a decrease in alcohol-related accidents and violence, and whether this was mediated by a reduction in excessive drinking and frequency of distilled spirits consumption. We applied logistic regression analyses on cross-sectional, non-repeated data, which was collected from a questionnaire distributed in classrooms to all 9th graders from 1999 to 2001, and in 2003 (n=1376, 724 boys and 652 girls; response rate=92.3%). All alcohol abstainers (n=330) were excluded from the analyses, making the sample 1046 individuals. The odds ratio for alcohol-related accidents was significantly lower, comparing the baseline year (1999) with 2003 (OR 0.5, 95% CI 0.27-0.76). There was also an indication that self-reported alcohol-related violence had decreased between 1999 and 2003 (OR 0.7, 95% CI 0.43-1.01). When controlling these estimates for excessive drinking and frequency of distilled spirits consumption, the differences between survey years were substantially reduced or even deleted. In conclusion, the decrease in alcohol-related accidents and violence among 15-16-year-olds in Trelleborg, between 1999 and 2002, is likely to be attributed to the identified reduction in excessive drinking and frequency of distilled spirits consumption.
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| 24. |
- Stafström, Martin
(författare)
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Influence of Parental Alcohol-Related Attitudes, Behavior and Parenting Styles on Alcohol Use in Late and Very Late Adolescence.
- 2014
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Ingår i: European Addiction Research. - : S. Karger AG. - 1421-9891 .- 1022-6877. ; 20:5, s. 233-240
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Tidskriftsartikel (refereegranskat)abstract
- Parents influence adolescent drinking behavior, but to what extent does this association diminish with age, however? The cross-sectional data was drawn from the Scania drug use survey 2007, consisting of 4,828 secondary education students in the 9th and 11th grade. The age- and gender-adjusted findings indicate that having parents who are consenting to alcohol use (OR 1.4), having been provided with alcohol by one's parents (OR 1.8), having parents with an authoritarian (OR 1.5) or neglectful (OR 2.1) parenting style, and having parents who both have a university degree (OR 1.3) were factors significantly associated with monthly heavy episodic drinking. These findings lead to the conclusion that parenting styles as well as parental attitudes and behaviors are important throughout the high school years. Thus, prevention targeting parents should emphasize both these domains. © 2014 S. Karger AG, Basel.
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| 25. |
- Stafström, Martin
(författare)
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Kick back and destroy the ride: Alcohol-related violence and associations with drinking patterns and delinquency in adolescence
- 2007
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Ingår i: Substance Abuse Treatment, Prevention, and Policy. - 1747-597X. ; 2, s. 18-18
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess how drinking patterns and delinquency are associated with self-reported experiences of alcohol-related violence in an adolescent population. POPULATION AND RESEARCH DESIGN: Cross-sectional data were acquired from the Scania drug use survey 2005, consisting of 3847 students in 9th grade. Abstainers were omitted and 1873 responses analyzed, with binary and multi-variable logistic regression modeling. RESULTS: All drinking pattern indicators were statistically significantly associated with alcohol-related violence, high usual volume of distilled spirits consumed (OR 2.2, CI 95 % 1.7-2.9) being the strongest. Delinquency had, when included in the analysis, a significant effect (OR 2.5, CI 95 % 1.8-3.6); however, the drinking pattern indicators also remained statistically significant. An analysis of the effect moderation between usual volume of distilled spirits consumed and delinquency showed that there was a synergetic effect between them (SI 1.6, CI 95 % 1.1-2.4). A separate analysis for non-delinquent students, those with little experience of delinquency, and those who engaged regularly in delinquent activities, showed that the effects of different drinking patterns, especially use of distilled spirits, were significant in both groups, however, differently distributed. CONCLUSION: The results show that alcohol consumption pattern, with usual volume of distilled spirits being the most prominent one, had an effect on alcohol-related violence, and that this effect was amplified by delinquent behavior. The analyses also showed that there are similarities, regarding risk factors for alcohol-related violence, between delinquent and non-delinquent youth. This, indicating that consumption pattern cannot be discarded as a key factor in alcohol-related violence in adolescence. POLICY IMPLICATIONS: The study shows that alcohol-related violence in adolescence is related to both alcohol consumption patterns, e.g. usual volume of distilled spirits consumed, and delinquency. In order to prevent the harm outcome, both phenomenons have to be targeted, either by alcohol or broader social policy initiatives.
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| 26. |
- Stafström, Martin
(författare)
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Preventing Adolescent Alcohol Use: Processes and Outcomes of a Community-Based Intervention in Trelleborg
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to investigate the potential of applying a community-based intervention, implemented in the Swedish city of Trelleborg 1999-2002, to reduce adolescent alcohol use. In order to do so, we had four specific aims. First, we studied the processes, both in terms of action and institu-tionalization, within the intervention. This would improve our understanding of the quantitative analyses. Second, we investigated the effects of the intervention, based on a number of indicators related to the interven-tion objectives. Third, we investigated which risk factors were significant for adolescent alcohol use in Trelleborg. Fourth, we exam-ined whether the changes of the intervention's target indicators resulted in less alcohol-related accidents and violence among the Trelleborg youth. In the process evaluation (Paper I), we carried out a qualitative data analysis, apply-ing an iterative explanation-building process, using interviews, public records, meeting minutes and evaluation seminars. In Papers II-IV, we analyzed school survey data, apply-ing logistic regression modelling and other statistical analyses. The process evaluation showed that the community intervention did not adequately institutionalize alcohol and drug prevention within the city administration, mainly due to numerous un-planned events and that the structure was individual oriented. Neverthe-less, the community mobilization and the raise in public awareness regarding the alcohol issue are factors which could have contributed to the impact of the project. The effect evaluation (Papers II-IV) showed that the community-based interven-tion in Trelleborg is likely to have contributed to a reduction in adolescent alcohol consump-tion. When comparing the data, for a popula-tion 15 and 16 years old, from the first school survey in 1999 with the one carried out in 2003, there is a decrease in the proportion of alcohol consumers (decreased by 21.8%), monthly heavy episodic drinking (38.2%), excessive drinking (36.3%), alcohol-related accidents (38.5%), and alcohol-related vio-lence (50.0%). The data analyses show that these changes are independent of significant factors on community, group and individual level. Availability of alcohol was also reduced in the target group during the intervention, but this change was not sustained after the project completion. In addition, the analyses supported the hypothesis that the decrease in alcohol-related accidents and violence was related to the reduction in adolescent alcohol consumption. The findings in the thesis support the as-sumption that by implementing a city policy program, including a plan of action, a mu-nicipality can reduce adolescent alcohol use, and subsequently alcohol-related harm. How-ever, in order to institutionalize the interven-tions and the alcohol issue there has to be a balance of internal and external input throughout the project. It seems that the implementation process in terms of institu-tionalization and the effects of the interven-tion do not have to be correlated, i.e., a weak institutionalization does not necessarily result in weak effects.
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| 27. |
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| 28. |
- Stafström, Martin, et al.
(författare)
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Socio-economic determinants for alcohol consumption and heavy episodic drinking in a Ugandan student population
- 2012
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Ingår i: The International Journal of Alcohol and Drug Research. - : International Journal of Alcohol and Drug Research. - 1925-7066. ; 1:1, s. 57-67
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To examine whether the socio-economic determinants of alcohol use found in high-income university student settings are also true of Uganda. Design: Two cross-sectional surveys, conducted in 2005 and 2010, combined into a single dataset. Setting: Mbarara University of Science and Technology (MUST) in southwestern Uganda. Participants: 2,934 students (N in 2005 = 980; N in 2010 = 1,954). Total response rate = 76.8%. Results: Multivariate logistic regression showed the following socio-economic determinants to be positively associated with alcohol consumption: having attended boarding school (for males only); being Catholic; religion not playing a big role while growing up; head of household having had secondary education or higher (for females only); being a student of development studies, tropical forest conservation or computer science (the latter two for males only). Being Muslim or, for males, being a non-Anglican Protestant were negatively related to alcohol use. Different patterns were found for heavy episodic drinking. Being a male Muslim or a male student of development studies was positively related to heavy episodic drinking; while among females, being of a non-classified faith, having had a head of the household with a secondary education, not being raised by both parents, or being a student of development studies or science were positively related to heavy episodic drinking. Conclusion: Alcohol consumption and heavy episodic drinking on a monthly basis among the students at MUST seem linked to a student’s socio-economic background, with varying patterns for male and female students.
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| 29. |
- Stafström, Martin, et al.
(författare)
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The Impact of Policy Changes on Consumer Behaviour and Alcohol Consumption in Scania, Sweden 1999-2005.
- 2014
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Ingår i: Alcohol and Alcoholism. - : Oxford University Press (OUP). - 1464-3502 .- 0735-0414. ; 49:5, s. 572-578
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Tidskriftsartikel (refereegranskat)abstract
- To analyse the hypothesis that a gradual deregulation of traveller allowances, starting in 2001 and ending in 2004, on alcoholic beverages changed consumer behaviours that ultimately led to an increase in alcohol consumption in southern Sweden between in 2005 compared with 1999.
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| 30. |
- Stafström, Martin
(författare)
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The impact of relaxed traveller allowances: Fixed-effects analyses of the associations between consumer behaviour and alcohol use
- 2018
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Ingår i: NAD Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1458-6126 .- 1455-0725. ; 35:4, s. 275-287
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse to what extent the gradual relaxation of traveller allowances for alcoholic beverages 2001–2004 changed consumer behaviours and subsequent alcohol consumption patterns within a longitudinal panel data population study in Southern Sweden. Methods: General population random sample panel data study with repeated measurements were collected in 1999, in 2005, and in 2010 in the county of Scania. The study analyses answers from 9770 individuals, who in 1999 were 18–80 years old. A fixed-effects modelling was applied to assess the association between consumer behaviour and change in alcohol use across the study period. Results: Cross-border shopping for alcoholic beverages was associated, on average, with a 3.1% (p < 0.001) increase in alcohol use. Buying imported alcohol from a private person was associated with a mean increase of 2.6% (p < 0.001), with a total additive effect of 5.7%. Furthermore, when stratified for gender, age, and location, significant fixed effects were found. The magnitude was greater among women, younger and older ages, and in particular in the Northeast and Central regions. Both consumer behaviours – cross-border trading (OR 1.6, CI 95% 1.28–1.92) and buying alcohol from a private person (OR 1.4, CI 95% 1.12–1.73) – were significantly associated with heavy alcohol use. Conclusion: The fixed-effects analyses identified significant associations between consumer behaviours and alcohol consumption. The uptake of behaviours that developed because of a relaxation of the Swedish alcohol policy has contributed to an overall long-term increase in alcohol use and higher prevalence of heavy alcohol use within this general population study sample.
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| 31. |
- Stafström, Martin, et al.
(författare)
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The Trelleborg project: a process evaluation of a multi-sector community intervention to reduce alcohol consumption and related harm.
- 2007
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Ingår i: Substance Use & Misuse. - : Informa UK Limited. - 1532-2491 .- 1082-6084. ; 42:12-13, s. 2041-2051
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Tidskriftsartikel (refereegranskat)abstract
- The Trelleborg project ran between 1999 and 2002. This article describes and analyzes the processes relating to institutionalization and social change, and their consequences, within the project. The research, funded by the Swedish National Institute of Public Health, was based on qualitative data collected during the project, including focused interviews with 12 key individuals, five focus group interviews, two evaluation seminars, and a large number of meeting minutes. The article concludes that positive interaction between organization elites is a prerequisite for institutionalization. However, the elites within an organization also have to take external pressures into account when transforming an ad hoc initiation into sustained activity.
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| 32. |
- Stafström, Martin, et al.
(författare)
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Trends in alcohol-related harm among Swedish youth : Do in-patient care registry data match drinking trends?
- 2024
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Ingår i: Drug and Alcohol Review. - 0959-5236. ; 43:3, s. 625-632
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionYouth drinking has been declining in Sweden since the year 2000. There is a paucity of studies examining trends in alcohol-related harm during this period. The overall aim of the present study is to examine how trends in alcohol-related harm match trends in drinking among Swedish youths during 2000–2021.MethodsMeasures of alcohol use were obtained from national school surveys. Prevalence rates of any alcohol use and heavy episodic drinking were used. Alcohol-related harm indicators were obtained from registry information from the National Board of Health and Welfare. Annual trends in harm indicators were tested with linear regression models and correlations between alcohol use and alcohol-related harm indicators were assessed using Pearson's correlation on annual data.ResultsStatistically significant negative trends were observed for all alcohol-related harm indicators for the period 2000–2021. Significant correlations were found for both measures of alcohol use and all alcohol-related harm indicators.Discussion and ConclusionsThe levels of alcohol-related harm have declined among youths in Sweden during the period 2000–2021. The trends in harm seem to reflect the decline in youth drinking that has occurred during the same period.
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| 33. |
- Sundell, Susanne, et al.
(författare)
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Does social capital protect mental health among migrants in Sweden?
- 2016
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Ingår i: Health Promotion International. - : Oxford University Press (OUP). - 0957-4824 .- 1460-2245. ; 31:3, s. 644-652
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Tidskriftsartikel (refereegranskat)abstract
- Poor mental health is common among migrants. This has been explained by migration-related and socio-economic factors. Weak social capital has also been related to poor mental health. Few studies have explored factors that protect mental health of migrants in the post-migration phase. Such knowledge could be useful for health promotion purposes. Therefore, this study aimed to analyse associations between financial difficulties, housing problems and experience of discrimination and poor mental health; and to detect possible effect modification by social capital, among recently settled Iraqi migrants in Sweden. A postal questionnaire in Arabic was sent to recently settled Iraqi citizens. The response rate was 51% (n = 617). Mental health was measured by the GHQ-12 instrument and social capital was defined as social participation and trust in others. Data were analysed by means of logistic regression. Poor mental health was associated with experience of discrimination (OR 2.88, 95% CI 1.73-4.79), housing problems (OR 2.79, 95% CI 1.84-4.22), and financial difficulties (OR 2.14, 95% CI 1.44-3.19), after adjustments. Trust in others seemed to have a protective effect for mental health when exposed to these factors. Social participation had a protective effect when exposed to experience of discrimination. Social determinants and social capital in the host country play important roles in the mental health of migrants. Social capital modifies the effect of risk factors and might be a fruitful way to promote resilience to factors harmful to mental health among migrants, but must be combined with policy efforts to reduce social inequities.
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| 34. |
- Svensson, Pia, et al.
(författare)
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A meta-analysis and systematic literature review of factors associated with sexual risk-taking during international travel
- 2018
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Ingår i: Travel Medicine and Infectious Disease. - : Elsevier BV. - 1477-8939 .- 1873-0442. ; 24, s. 65-88
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Tidskriftsartikel (refereegranskat)abstract
- Background: International travel facilitates global spread of sexually transmitted infections (STI). Travellers could contribute to onward transmission of pathogens rarely encountered at home and export new strains to the destination. The aim was to systematically examine evidence regarding determinants of travel-related sexual risk-taking and identify knowledge gaps and areas for targeted interventions. Method: Articles published in peer-reviewed journals from 2000 to 2017 were screened in 6 databases and assessed for relevance against criteria. Data was extracted for factors associated with travel-related STI or proxies. Meta-analyses estimated pooled prevalence of casual sex and non-condom use. Adjusted odds ratios of predictors were pooled to generate a combined estimate. Result: Forty-nine articles qualified for inclusion. A heterogeneity test indicated variation across studies. The pooled prevalence of casual travel sex was 35% and prevalence of non-condom use 17%. Expectations of casual sex strongly predicted sex with a new partner when travelling abroad. Planning to have sex indicated condom use. Conclusion: The studies largely represented sub-groups of risk-taking populations from a European context, indicating substantial knowledge gaps. Studies investigating migrants travelling to visit friends and relatives, older travellers, and female travelers are needed. Post–travel harm reduction activities may serve as a focus for future interventions.
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| 35. |
- Toleubekov, Berik, et al.
(författare)
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Assessing Access to WASH in Urban Schools during COVID-19 in Kazakhstan : Case Study of Central Kazakhstan
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:11
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Tidskriftsartikel (refereegranskat)abstract
- The WHO/UNICEF Joint Monitoring Program (JMP) for Water Supply, Sanitation and Hygiene (WASH) produces global estimates of the real situation of access to water, sanitation and hygiene services, and sanitation and hygiene in households, educational institutes and health care facilities; however it is lacking data on schools in Kazakhstan. Thus, the aim of this research was to assess access to WASH in schools of urban area in Kazakhstan. The study was conducted in seven schools of Central Kazakhstan during the COVID-19 pandemic and restrictive measures. Three data collection methods were used: a questionnaire for administrative staff, a questionnaire for parents and observation. Parents of offline study pupils (only second and third grades due to the pandemic) were included in the survey. Students had access to in-building toilets in all schools connected to the centralized sewer. The number of school toilets varied from 7 (KAZ200085) to 61 (KAZ200089). The average amount of toilets was 28.08 ± 16.97. Only two out of seven schools complied with the requirements of Kazakhstan national sanitary standards for the ratio of school toilets to the number of students. From the questionnaire with the school administrations, it was defined that the primary source of drinking water was the public water supply. All schools regularly disinfect and check the water supply system. At the same time, the results also revealed discrepancies in the answers between administration and parents (2.6% of parents showed that their children have rare access to drinking water), and insufficient monitoring of implementation of WASH services. This study also confirmed that the full provision of access to water and water services in the structure of educational institutions solves several SDG targets.
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| 36. |
- Vincens, Natalia, et al.
(författare)
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Constructing social identity through multiple "us and them": a grounded theory study of how contextual factors are manifested in the lives of residents of a vulnerable district in Brazil
- 2020
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Ingår i: International Journal for Equity in Health. - : Springer Science and Business Media LLC. - 1475-9276. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- The association between contextual factors and health inequalities is well documented, also in Brazil. However, questions about how contextual factors actually affect health and well-being persist. The aim of this qualitative study was to explore how contextual factors-i.e., social stratification and neighborhood opportunity structures-are manifested in the lives of the residents of a vulnerable district in Brazil. We used a Constructivist Grounded Theory approach based on 12 in-depth interviews. The core category constructing social identity through multiple "us and them" is supported by eight main categories that characterize different pairs of "us and them", based on internal and external aspects of the social processes involved. Our findings strengthen and support the links between contextual factors and health inequalities, highlighting the relevance of downward social comparison, territorial segregation and stigmatization and erosion of social capital in the construction of social identities and the manifestation of social hierarchies and neighborhood structures in the Brazilian context. Ultimately, these create shame and stress but also pride and empowerment, which are recognized determinants of health inequities.
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| 37. |
- Vincens, Natalia, et al.
(författare)
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Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009.
- 2015
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:9
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Tidskriftsartikel (refereegranskat)abstract
- Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC). Income inequality and gross domestic product (GDP) per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association.
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| 38. |
- Vincens, Natalia, et al.
(författare)
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Social capital, income inequality and the social gradient in self-rated health in Latin America : A fixed effects analysis
- 2018
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536. ; 196, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- Latin America is the most unequal region in the world. The current sustainable development agenda increased attention to health inequity and its determinants in the region. Our aim is to investigate the social gradient in health in Latin America and assess the effects of social capital and income inequality on it. We used cross-sectional data from the World Values Survey and the World Bank. Our sample included 10,426 respondents in eight Latin American countries. Self-rated health was used as the outcome. Education level was the socioeconomic position indicator. We measured social capital by associational membership, civic participation, generalized trust, and neighborhood trust indicators at both individual and country levels. Income inequality was operationalized using the Gini index at country-level. We employed fixed effects logistic regressions and cross-level interactions to assess the impact of social capital and income inequality on the heath gradient, controlling for country heterogeneity. Education level was independently associated with self-rated health, representing a clear social gradient in health, favoring individuals in higher socioeconomic positions. Generalized and neighborhood trust at country-level moderated the effect on the association between socioeconomic position and health, yet favoring individuals in lower socioeconomic positions, especially in lower inequality countries, despite their lower individual social capital. Our findings suggest that collective rather than individual social capital can impact the social gradient in health in Latin America, explaining health inequalities.
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| 39. |
- Vincens, Natalia, et al.
(författare)
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The interplay of contextual layers : A multilevel analysis of income distribution, neighborhood infrastructure, socioeconomic position and self-rated health in Brazil
- 2018
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Ingår i: Health and Place. - : Elsevier BV. - 1353-8292. ; 52, s. 155-162
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Tidskriftsartikel (refereegranskat)abstract
- Our hypothesis is that neighborhood infrastructure modifies the association between state-level income distribution and self-rated health. In our findings neighborhood infrastructure amplifies the association between income equality and self-rated health, yet with a differential impact on health according to sex, race and education level favoring individuals at higher socioeconomic positions. Most of the individual health variation attributed to context happens at neighborhood level, based on random effects analyses. Our findings contribute to a further understanding of health inequalities in Brazil. The demonstrated synergism between state, neighborhood and individual level determinants of health supports inter-sectoral policies and interventions in a clearly multileveled way.
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