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Blomstedt, Yulia
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Blomstedt, Y., Norberg, M., Ng, N., Nyström, L., Boman, K., Lönnberg, G., . . . Weinehall, L. (2019). Flawed conclusions on the Vasterbotten Intervention Program by San Sebastian et .al [Letter to the editor]. BMC Public Health, 19(1), Article ID 1095.
Åpne denne publikasjonen i ny fane eller vindu >>Flawed conclusions on the Vasterbotten Intervention Program by San Sebastian et .al
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2019 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, nr 1, artikkel-id 1095Artikkel i tidsskrift, Letter (Fagfellevurdert) Published
Abstract [en]

An evaluation of Vasterbotten Intervention Programme (VIP) was recently conducted by San Sebastian et al. (BMC Public Health 19:202, 2019). Evaluation of health care interventions of this kind require 1) an understanding of both the design and the nature of the intervention, 2) correct definition of the target population, and 3) careful choice of the appropriate evaluation method. In this correspondence, we review the approach used by San Sebastian et al. as relates to these three criteria. Within this framework, we suggest important explanations for why the conclusions drawn by these authors contradict a large body of research on the effectiveness of the VIP.

Emneord
Prevention, Community intervention, Evaluation, CVD
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-163072 (URN)10.1186/s12889-019-7444-3 (DOI)000480751900003 ()31409308 (PubMedID)
Tilgjengelig fra: 2019-11-27 Laget: 2019-11-27 Sist oppdatert: 2019-11-27bibliografisk kontrollert
Blomstedt, Y., Bhutta, Z. A., Dahlstrand, J., Friberg, P., Gostin, L. O., Nilsson, M., . . . Alfvén, T. (2018). Partnerships for child health: capitalising on links between the sustainable development goals. BMJ. British Medical Journal, 360, Article ID k125.
Åpne denne publikasjonen i ny fane eller vindu >>Partnerships for child health: capitalising on links between the sustainable development goals
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2018 (engelsk)Inngår i: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 360, artikkel-id k125Artikkel i tidsskrift, Editorial material (Annet vitenskapelig) Published
sted, utgiver, år, opplag, sider
BMJ PUBLISHING GROUP, 2018
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-144954 (URN)10.1136/bmj.k125 (DOI)000423711300001 ()29363500 (PubMedID)
Tilgjengelig fra: 2018-02-22 Laget: 2018-02-22 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Henschke, N., Mirny, A., Haafkens, J. A., Ramroth, H., Padmawati, S., Bangha, M., . . . Kinsman, J. (2017). Strengthening capacity to research the social determinants of health in low-and middle-income countries: lessons from the INTREC programme. BMC Public Health, 17, Article ID 514.
Åpne denne publikasjonen i ny fane eller vindu >>Strengthening capacity to research the social determinants of health in low-and middle-income countries: lessons from the INTREC programme
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2017 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, artikkel-id 514Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: The INDEPTH Training & Research Centres of Excellence (INTREC) collaboration developed a training programme to strengthen social determinants of health (SDH) research in low-and middle-income countries (LMICs). It was piloted among health-and demographic researchers from 9 countries in Africa and Asia. The programme followed a blended learning approach and was split into three consecutive teaching blocks over a 12month period: 1) an online course of 7 video lectures and assignments on the theory of SDH research; 2) a 2-week qualitative and quantitative methods workshop; and 3) a 1-week data analysis workshop. This report aims to summarise the student evaluations of the pilot and to suggest key lessons for future approaches to strengthen SDH research capacity in LMICs. Methods: Semi-structured interviews and questionnaires with 24 students from 9 countries in Africa and Asia were used to evaluate each teaching block. Information was collected about the students' motivation and interest in studying SDH, any challenges they faced during the consecutive teaching blocks, and suggestions they had for future courses on SDH. Results: Of the 24 students who began the programme, 13 (54%) completed all training activities. The students recognised the need for such a course and its potential to improve their skills as health researchers. The main challenges with the online course were time management, prior knowledge and skills required to participate in the course, and the need to get feedback from teaching staff throughout the learning process. All students found the face-to-face workshops to be of high quality and value for their work, because they offered an opportunity to clarify SDH concepts taught during the online course and to gain practical research skills. After the final teaching block, students felt they had improved their data analysis skills and were better able to develop research proposals, scientific manuscripts, and policy briefs. Conclusions: The INTREC programme has trained a promising cadre of health researchers who live and work in LMICs, which is an essential component of efforts to identify and reduce national and local level health inequities. Time management and technological issues were the greatest challenges, which can inform future attempts to strengthen research capacity on SDH.

sted, utgiver, år, opplag, sider
BioMed Central, 2017
Emneord
Social determinants of health, Capacity strengthening, Education, Blended learning, Research methodology
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-137404 (URN)10.1186/s12889-017-4399-0 (DOI)000403021900005 ()28545500 (PubMedID)
Tilgjengelig fra: 2017-07-05 Laget: 2017-07-05 Sist oppdatert: 2019-05-16bibliografisk kontrollert
Preet, R., Khan, N., Blomstedt, Y., Nilsson, M. & Stewart Williams, J. (2016). Assessing dental professionals' understanding of tobacco prevention and control: a qualitative study in Västerbotten County, Sweden. BDJ Open (2), 1-6, Article ID 16009.
Åpne denne publikasjonen i ny fane eller vindu >>Assessing dental professionals' understanding of tobacco prevention and control: a qualitative study in Västerbotten County, Sweden
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2016 (engelsk)Inngår i: BDJ Open, ISSN 2056-807X, nr 2, s. 1-6, artikkel-id 16009Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Aim: To assess dental professionals’ understanding of tobacco prevention and control.

Materials and methods: In Sweden dental hygienists receive training in tobacco prevention and control. The study setting is Västerbotton County in the north of Sweden where a number of successful tobacco control initiatives have been established. A purposeful sample comprising five male and four female dental professionals and trainees was selected. Data were collected through in-depth semi-structured individual interviews and analysed using content analysis.

Results: Informants acknowledged limited adherence to tobacco prevention. They were not confident of their knowledge of tobacco and non-communicable disease prevention and had limited awareness of global oral health policies. Reasons for poor adherence included professional fragmentation, lack of training, and the absence of reimbursement for time spent on prevention activities.

Discussion: The success of efforts to reduce smoking in Västerbotton County is attributed to the network of local public health initiatives with very limited involvement by local dental professionals.

Conclusions: The findings highlight the need to more actively engage the dental workforce in tobacco control and prevention. Moreover, it is important to recognise that dental professionals can be public health advocates for tobacco control and prevention at global, national and local levels.

Emneord
Health care, Oral cancer
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-129790 (URN)10.1038/bdjopen.2016.9 (DOI)
Tilgjengelig fra: 2017-01-09 Laget: 2017-01-09 Sist oppdatert: 2019-05-16bibliografisk kontrollert
Nyagwui, A. E., Fredinah, N., Che, L. B. & Yulia, B. (2016). Motorcycle injury among secondary school students in the Tiko municipality, Cameroon. Pan African Medical Journal, 24, Article ID 116.
Åpne denne publikasjonen i ny fane eller vindu >>Motorcycle injury among secondary school students in the Tiko municipality, Cameroon
2016 (engelsk)Inngår i: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 24, artikkel-id 116Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Introduction: injury from motorcycle is a considerable cause of disability and death in the world and especially in low and middle-income countries; it is one of the most serious public health problems. In Cameroon, motorcycle is commonly used for transportation particularly among students. The aim of this paper is to study the risk-factors of the motorcycle-related accidents and injuries among secondary school students’ in the Tiko municipality, Cameroon.

Methods: a cross sectional study was conducted in January 2012 on 391 students age 16-24 from public and private schools in the Tiko Municipality. Logistic regression was used to estimate the association between risk factors and injuries. A closed-ended and few open-ended questionnaire was used to collect data.

Results: the study showed that over 70% of students used motorcycles always or often. Few had undergone any formal training for driving a motorcycle. The vast majority reported not wearing protective gear while driving or riding a motorcycle. Usage of protective gear was particularly low among girls. Over 16% reported using a motorbike always or occasionally under the influence of alcohol or drugs. Over 58% of respondents reported having an accident and over 35% were injured when driving or riding a motorcycle. Those who lived at the Tiko-Douala road have three times higher probability to sustain accidents and injuries than students residing elsewhere (OR 3.19 (1.20-8.46).

Conclusion: it is deeply alarming that every second respondent in the study reported having been in an accident and every third motorcycle user was somehow injured. We therefore call for an immediate attention and a deeper investigation into the highlighted situation, particularly at Tiko-Douala road.

Emneord
Awareness, practice, safety, accident, injury, students
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-132059 (URN)10.11604/pamj.2016.24.116.5069 (DOI)000391669700003 ()27642454 (PubMedID)
Tilgjengelig fra: 2017-03-10 Laget: 2017-03-10 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Blomstedt, Y., Norberg, M., Stenlund, H., Nyström, L., Lönnberg, G., Boman, K., . . . Weinehall, L. (2015). Impact of a combined community and primary care prevention strategy on all-cause and cardiovascular mortality: a cohort analysis based on 1 million person-years of follow-up in Västerbotten County, Sweden, during 1990-2006. BMJ Open, 5(12), Article ID e009651.
Åpne denne publikasjonen i ny fane eller vindu >>Impact of a combined community and primary care prevention strategy on all-cause and cardiovascular mortality: a cohort analysis based on 1 million person-years of follow-up in Västerbotten County, Sweden, during 1990-2006
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2015 (engelsk)Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, nr 12, artikkel-id e009651Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

OBJECTIVE: To evaluate the impact of the Västerbotten Intervention Programme (VIP) by comparing all eligible individuals (target group impact) according to the intention-to-treat principle and VIP participants with the general Swedish population.

DESIGN: Dynamic cohort study.

SETTING/PARTICIPANTS: All individuals aged 40, 50 or 60 years, residing in Västerbotten County, Sweden, between 1990 and 2006 (N=101 918) were followed from their first opportunity to participate in the VIP until age 75, study end point or prior death.

INTERVENTION: The VIP is a systematic, long-term, county-wide cardiovascular disease (CVD) intervention that is performed within the primary healthcare setting and combines individual and population approaches. The core component is a health dialogue based on a physical examination and a comprehensive questionnaire at the ages of 40, 50 and 60 years.

PRIMARY OUTCOMES: All-cause and CVD mortality.

RESULTS: For the target group, there were 5646 deaths observed over 1 054 607 person-years. Compared to Sweden at large, the standardised all-cause mortality ratio was 90.6% (95% CI 88.2% to 93.0%): for women 87.9% (95% CI 84.1% to 91.7%) and for men 92.2% (95% CI 89.2% to 95.3%). For CVD, the ratio was 95.0% (95% CI 90.7% to 99.4%): for women 90.4% (95% CI 82.6% to 98.7%) and for men 96.8% (95% CI 91.7 to 102.0). For participants, subject to further impact as well as selection, when compared to Sweden at large, the standardised all-cause mortality ratio was 66.3% (95% CI 63.7% to 69.0%), whereas the CVD ratio was 68.9% (95% CI 64.2% to 73.9%). For the target group as well as for the participants, standardised mortality ratios for all-cause mortality were reduced within all educational strata.

CONCLUSIONS: The study suggests that the VIP model of CVD prevention is able to impact on all-cause and cardiovascular mortality when evaluated according to the intention-to-treat principle.

sted, utgiver, år, opplag, sider
BMJ Publishing Group Ltd, 2015
Emneord
Primary care, Epidemiology, Public health
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-113605 (URN)10.1136/bmjopen-2015-009651 (DOI)000368839100125 ()26685034 (PubMedID)
Tilgjengelig fra: 2015-12-21 Laget: 2015-12-21 Sist oppdatert: 2018-06-07bibliografisk kontrollert
Hedlund, C., Blomstedt, Y. & Schumann, B. (2014). Association of climatic factors with infectious diseases in the Arctic and subarctic region: a systematic review. Global Health Action, 7, 1-16
Åpne denne publikasjonen i ny fane eller vindu >>Association of climatic factors with infectious diseases in the Arctic and subarctic region: a systematic review
2014 (engelsk)Inngår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 7, s. 1-16Artikkel, forskningsoversikt (Fagfellevurdert) Published
Abstract [en]

Background:

The Arctic and subarctic area are likely to be highly affected by climate change, with possible impacts on human health due to effects on food security and infectious diseases.

Objectives:

To investigate the evidence for an association between climatic factors and infectious diseases, and to identify the most climate-sensitive diseases and vulnerable populations in the Arctic and subarctic region.

Methods:

A systematic review was conducted. A search was made in PubMed, with the last update in May 2013. Inclusion criteria included human cases of infectious disease as outcome, climate or weather factor as exposure, and Arctic or subarctic areas as study origin. Narrative reviews, case reports, and projection studies were excluded. Abstracts and selected full texts were read and evaluated by two independent readers. A data collection sheet and an adjusted version of the SIGN methodology checklist were used to assess the quality grade of each article.

Results:

In total, 1953 abstracts were initially found, of which finally 29 articles were included. Almost half of the studies were carried out in Canada (n = 14), the rest from Sweden (n = 6), Finland (n = 4), Norway (n = 2), Russia (n = 2), and Alaska, US (n = 1). Articles were analyzed by disease group: food-and waterborne diseases, vector-borne diseases, airborne viral-and airborne bacterial diseases. Strong evidence was found in our review for an association between climatic factors and food-and waterborne diseases. The scientific evidence for a link between climate and specific vector-and rodent-borne diseases was weak due to that only a few diseases being addressed in more than one publication, although several articles were of very high quality. Air temperature and humidity seem to be important climatic factors to investigate further for viral-and bacterial airborne diseases, but from our results no conclusion about a causal relationship could be drawn.

Conclusions:

More studies of high quality are needed to investigate the adverse health impacts of weather and climatic factors in the Arctic and subarctic region. No studies from Greenland or Iceland were found, and only a few from Siberia and Alaska. Disease and syndromic surveillance should be part of climate change adaptation measures in the Arctic and subarctic regions, with monitoring of extreme weather events known to pose a risk for certain infectious diseases implemented at the community level.

sted, utgiver, år, opplag, sider
Global Health Action, 2014
Emneord
infectious diseases, climatic factors, Arctic, subarctic region, systematic reviews
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-91394 (URN)10.3402/gha.v7.24161 (DOI)000338438200001 ()24990685 (PubMedID)
Tilgjengelig fra: 2014-08-06 Laget: 2014-08-04 Sist oppdatert: 2018-06-07bibliografisk kontrollert
Hirve, S., Verdes, E., Lele, P., Juvekar, S., Blomstedt, Y., Tollman, S., . . . Ng, N. (2014). Evaluating Reporting Heterogeneity in Self-Rated Health Among Adults Aged 50 Years and Above in India: An Anchoring Vignettes Analytic Approach. Journal of Aging and Health, 26(6), 1015-1031
Åpne denne publikasjonen i ny fane eller vindu >>Evaluating Reporting Heterogeneity in Self-Rated Health Among Adults Aged 50 Years and Above in India: An Anchoring Vignettes Analytic Approach
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2014 (engelsk)Inngår i: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 26, nr 6, s. 1015-1031Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: To use anchoring vignettes to evaluate reporting heterogeneity (RH) in self-rated mobility and cognition in older adults. Method: We analyzed vignettes and self-rated mobility and cognition in 2,558 individuals aged 50 years and above. We tested for assumptions of vignette equivalence (VE) and response consistency (RC). We used a joint hierarchical ordered probit (HOPIT) model to evaluate self-rating responses for RH. Results: The assumption of VE was met except for "learning" vignettes. Higher socioeconomic status (SES) and education significantly lowered thresholds for cognition ratings. After correction for RH, women, lower SES, and older respondents were significantly more likely to report greater difficulty in mobility. The influence of age, SES, and education on thresholds was less apparent for cognition. Discussion: Our study provides strong evidence of RH in self-rated mobility and cognition. We highlight the need to formally test basic assumptions before using vignettes to adjust self-rating responses for RH.

Emneord
reporting heterogeneity; differential item functioning; mobility; cognition; self-rating; anchoring vignettes; India
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-90527 (URN)10.1177/0898264314535634 (DOI)000340728600007 ()24925690 (PubMedID)
Tilgjengelig fra: 2014-06-24 Laget: 2014-06-24 Sist oppdatert: 2018-06-07bibliografisk kontrollert
Nahar, N., Blomstedt, Y., Wu, B., Kandarina, I., Trisnantoro, L. & Kinsman, J. (2014). Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh. BMC Public Health, 14(1), 708
Åpne denne publikasjonen i ny fane eller vindu >>Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh
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2014 (engelsk)Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, nr 1, s. 708-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Bangladesh has the highest natural disaster mortality rate in the world, with over half a million people lost to disaster events since 1970. Most of these people have died during floods or cyclones, both of which are likely to become more frequent due to global climate change. To date, the government's post-disaster response strategy has focused, increasingly effectively, on the physical needs of survivors, through the provision of shelter, food and medical care. However, the serious and widespread mental health consequences of natural disasters in Bangladesh have not yet received the attention that they deserve. This Debate article proposes a practical model that will facilitate the provision of comprehensive and effective post-disaster mental health services for vulnerable Bangladeshis on a sustainable basis.

DISCUSSION: A series of socially determined factors render the women and the poor of Bangladesh particularly vulnerable to dying in natural disasters; and, for those who survive, to suffering from some sort of disaster-related mental health illness. For women, this is largely due to the enforced gender separation, or purdah, that they endure; while for the poor, it is the fact that they are, by definition, only able to afford to live in the most climatically dangerous, and under-served parts of the country. Although the disasters themselves are brought by nature, therefore, social determinants increase the vulnerability of particular groups to mental illness as a result of them. While deeply entrenched, these determinants are at least partially amenable to change through policy and action.

SUMMARY: In response to the 2004 Indian Ocean tsunami, the World Health Organisation developed a framework for providing mental health and psychosocial support after major disasters, which, we argue, could be adapted to Bangladeshi post-cyclone and post-flood contexts. The framework is community-based, it includes both medical and non-clinical components, and it could be adapted so that women and the poor are actively sought out and provided for. After training, these services could be run by Bangladesh's pre-existing 50,000-strong Cyclone Preparedness Programme workforce, alongside the country's extensive network of community-based health workers.

Emneord
Bangladesh. cyclone. flood. disaster. mental health. vulnerability. gender. poverty. social determinants of health
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-91942 (URN)10.1186/1471-2458-14-708 (DOI)000339075400001 ()25011931 (PubMedID)
Tilgjengelig fra: 2014-08-18 Laget: 2014-08-18 Sist oppdatert: 2018-06-07bibliografisk kontrollert
Padyab, M., Blomstedt, Y. & Norberg, M. (2014). No association found between cardiovascular mortality, and job demands and decision latitude: experience from the Västerbotten Intervention Programme in Sweden. Social Science and Medicine, 117, 58-66
Åpne denne publikasjonen i ny fane eller vindu >>No association found between cardiovascular mortality, and job demands and decision latitude: experience from the Västerbotten Intervention Programme in Sweden
2014 (engelsk)Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 117, s. 58-66Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

The current prospective study with the longest follow-up period in Northern Sweden aims to investigate the association between job demands and decision latitude and cardiovascular disease (CVD) mortality. Further, we aim to assess the effect of conventional risk factors (i.e., body mass index, alcohol consumption, physical activity, marital status, education and smoking) on the association between job demands and decision latitude and CVD mortality. The data originated from the Linnaeus database, available at the Center for Population Studies, Umeå University, Sweden. A cohort of men and women aged 40, 50 and 60 years were recruited from the Västerbotten Intervention Programme. Deaths due to stroke and myocardial infarction at the end of the follow up are considered the outcome. Baseline job characteristics were defined by the Swedish version of the Karasek demand/control model. Statistical methods include proportional Cox hazard modeling and Relative Excess Risk due to Interaction (RERI) to assess interactions. The findings from this study did not support the association between job demands and decision latitude and CVD mortality. Instead, conventional risk factors were found stronger predictors, most evidently education differentials were associated with CVD mortality. We know from previous research that the greater the attenuation of the gradient after adjustment for a given risk factor, the greater the potential to reduce educational inequality via interventions that target this factor. Based on the present findings of the experience in Västerbotten, further research is needed to identify other risk factors besides job strain and its components that would reduce the socioeconomic gradient in CVD mortality.

sted, utgiver, år, opplag, sider
Elsevier, 2014
Emneord
Sweden, job demands, decision latitude, CVD mortality, longitudinal, conventional risk factors
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-91237 (URN)10.1016/j.socscimed.2014.07.033 (DOI)000341481100008 ()
Tilgjengelig fra: 2014-07-21 Laget: 2014-07-21 Sist oppdatert: 2018-06-07bibliografisk kontrollert
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