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  • 101.
    Ahl, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. School of Health Sciences, University Collage of Borås, SE-501, 90 Borås, Sweden.
    Nyström, Maria
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    Making up one's mind: patients' experiences of calling an ambulance2006In: Accident and Emergency Nursing, ISSN 0965-2302, E-ISSN 1532-9267, Vol. 14, no 1, p. 11-19Article in journal (Refereed)
    Abstract [en]

    The issue of the inappropriate use of ambulance transport and care has mainly been studied from the professionals' and caregivers' perspective, with few studies focusing on the patient and his/her experiences. To further understand whether patients use ambulance care in an inappropriate manner and, if so, why, it is important to obtain an overall picture of the patients' existential situation at the time they call an ambulance. The aim of this study was to analyse and describe patients' experiences related to the decision to call an ambulance and the wait for it to arrive. The design was explorative, and twenty informants aged between 34 and 82 years were interviewed. Qualitative content analyses were performed. The findings showed that calling for an ambulance is a major decision that is preceded by hesitation and attempts to handle the situation by oneself. Our conclusion is that the definition of inappropriate use of valuable health care resources should not be based solely on the professionals' point of view but also take account of the patients' reactions when they experience a threat to their life and health.

  • 102.
    Ahlberg, Camilla
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Johansson, Viola
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonalens kunskap om trycksårsprofylax: – En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Bakgrund: Att förebygga sjukdom och lindra lidande är två av sjuksköterskans huvuduppgifter. Trycksår räknas som vårdskada och är ett universellt problem med relativt konstant frekvens som innebär mycket smärta och lidande för patienten. Trycksår kan förebyggas i de flesta fall vilket är en del av vårdpersonalens ansvar.

    Syfte: Denna litteraturstudie avser att beskriva vårdpersonalens kunskap om trycksårsprofylax.

    Metod: 11 kvantitativa forskningsartiklar om vårdpersonals kunskap beträffande trycksårsprofylax har granskats och sammanställts för att få en klarare syn på kunskapen.

    Resultat: Även om vårdpersonalens kunskap om trycksårsprofylax överlag är relativt god så har man ändå kunnat identifiera stora kunskapsluckor.

    Konklusion: Dessa kunskapsluckor kan vara en av orsakerna till att undvikbara trycksår fortfarande uppstår.    

    Nyckelord: Sjuksköterska, trycksår, prevention, profylax, kunskap 

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  • 103.
    Ahlberg, Jane
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dannvik, Rebecka
    Umeå University, Faculty of Medicine, Department of Nursing.
    Omvårdnadsåtgärder: En litteraturstudie om omvårdnadsåtgärder vid Anorexia nervosa.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Anorexia nervosa är en ätstörning som debuterar i allt yngre ålder och kan yttra sig på olika sätt beroende på individen. Detta leder till att det inte finns ett enkelt svar på hur sjukdomen ska behandlas. Det ställer krav på både kunskap och erfarenhet hos sjuksköterskorna för att förstå komplexiteten av anorexia nervosa, vilket är nödvändigt för att uppnå ett lyckat behandlingsresultat.

     

    Syfte: Syftet är att beskriva sjuksköterskans omvårdnadsåtgärder vid behandling av anorexia nervosa hos unga kvinnor.

     

    Metod: En litteraturstudie grundad på åtta kvalitativa artiklar. Artiklarnas resultat har granskats, analyserats och sammanställts för att besvara syftet. Databassökningen har genomförts i Cinahl, Pubmed samt PsykInfo.

     

    Resultat: Sammanfattningen av artiklarnas resultat bildade tre kategorier som beskriver de omvårdnadsåtgärder sjuksköterskorna använder: 1) Bygga och upprätthålla en god relation till patienten, 2) Säkerställa viktökning och 3) Återställa ett normalt ätbeteende.  

     

    Slutsats: Litteraturstudien beskriver hur behandlingen påverkas av hur sjuksköterskorna genomför omvårdnaden. Att skapa en god relation till patienten är en avgörande komponent för att lyckas med viktökning och en beteendeförändring hos patienten.   

     

    Nyckelord: Anorexia nervosa, behandling, kvinnor, omvårdnad, ungdomar

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  • 104.
    Ahlgren, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Folkesson, Robert
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    The association between self-paced walking speed and cognitive function among very old people.2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning:

    I Sverige förväntas medelåldern att stiga och den äldsta åldersgruppen förutspås växa sig allt större. Nedgång i fysisk funktion och kognitiv funktion är vanligt bland människor som är äldre. Nyligen genomförda tvärsnitts- och longitudinella studier visar att det finns ett samband mellan gång och kognition. Tyvärr är forskningen begränsad då den nästintill exkluderar mycket gamla människor.Syfte:

    Utforska sambandet mellan självvald gånghastighet och kognition hos mycket gamla människor. Det specifika syftet är att analysera sambandet vid baslinjen och vid 5 års uppföljning samt sambandet i förändringen hos mycket gamla människor. Metod:

    Deltagare undersökta i Umeå 85 + / Gerontologisk regional databas-studie (GERDA), med en ålder på 85 år eller äldre, bedömdes vid baslinjen och med 5 års uppföljning. Självvald gånghastighet mättes med 2,4 meters gångtest och individernas kognitiva funktion undersöktes med hjälp av Mini-Mental State Examination.Resultat:

    Medelåldern vid baslinjen var 89,76 (SD ± 4,82). Korrelation för förändringen i självvald gånghastighet och Mini-Mental State Examination mellan baslinjen och vid uppföljningen (n = 277), r = .251, p <.001, r2 värde .063. Konklusion:

    Det finns ett samband mellan självvald gånghastighet och kognitiv funktion bland de mycket gamla, både tvärsnitt och longitudinellt. Sambandet är starkt bland de som utvecklar demens.

  • 105.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gadin, Katja Gillander
    Struggle for time to teach: Teachers' experiences of their work situation2011In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 40, no S1, p. S111-S118Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to from a gender perspective, explore elementary school teacher' experiences of their work situation, and identify conditions that could be health risks. Participants: Eighteen female teachers who work in an elementary school in Northern Sweden. Method: Thematic interviews were conducted using an interview guide. The interviews were tape-recorded and transcribed verbatim. Qualitative content analysis was used to analyse the transcribed text and interpretations were made within gender theory. Results: Four categories emerged: "Squeezed between dream and reality", "Effort to keep up with demands", "We can make it together" and "The school needs men's qualities". The categories were linked together with the theme "A struggle for time to teach". The theme describes the conflict between the teachers' ambitions to teach and create a stimulating learning environment versus the increased need for behaviour control that took time from classroom work. Beside work at the school, the teachers carried a large burden of domestic work. Conclusions: Teachers' work includes both endless demands and great joy. Their work is structured within the schools gender system in which caring duties are subordinated despite a growing demand for behaviour control. Traditional gender roles affect their domestic work load.

  • 106.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Hammarström, Anne
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Social medicine.
    Sandberg, Susanne
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Larsson, Christel
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition. Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden .
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Engagement in New Dietary Habits: Obese Women's Experiences from Participating in a 2-Year Diet Intervention2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 1, p. 84-93Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dietary weight loss interventions most often result in weight loss, but weight maintenance on a long-term basis is the main problem in obesity treatment. There is a need for an increased understanding of the behaviour patterns involved in adopting a new dietary behavior and to maintain the behaviour over time.

    PURPOSE: The purpose of this paper is to explore overweight and obese middle-aged women's experiences of the dietary change processes when participating in a 2-year-long diet intervention.

    METHODS: Qualitative semi-structured interviews with 12 overweight and obese women (54-71 years) were made after their participation in a diet intervention programme. The programme was designed as a RCT study comparing a diet according to the Nordic nutrition recommendations (NNR diet) and a Palaeolithic diet (PD). Interviews were analysed according to Grounded Theory principles.

    RESULTS: A core category "Engagement phases in the process of a diet intervention" concluded the analysis. Four categories included the informants' experiences during different stages of the process of dietary change: "Honeymoon phase", "Everyday life phase", "It's up to you phase" and "Crossroads phase". The early part of the intervention period was called "Honeymoon phase" and was characterised by positive experiences, including perceived weight loss and extensive support. The next phases, the "Everyday life phase" and "It's up to you phase", contained the largest obstacles to change. The home environment appeared as a crucial factor, which could be decisive for maintenance of the new dietary habits or relapse into old habits in the last phase called "Crossroads phase".

    CONCLUSION: We identified various phases of engagement in the process of a long-term dietary intervention among middle-aged women. A clear personal goal and support from family and friends seem to be of major importance for long-term maintenance of new dietary habits. Gender relations within the household must be considered as a possible obstacle for women engaging in diet intervention.

  • 107.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Malmgren Olsson, Eva-Britt
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gender analysis of musculoskeletal disorders and emotional exhaustion: interactive effects from physical and psychosocial work exposures and engagement in domestic work2012In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 55, no 2, p. 212-228Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to assess the relationships between physical and psychosocial work exposures, engagement in domestic work and work-home imbalance in relation to symptoms of musculoskeletal disorders and emotional exhaustion in white- and blue-collar men and women. Three thousand employees from 21 companies were asked to answer a questionnaire on family structure, household and child care tasks, work exposure, work-home imbalance and symptoms of neck/shoulder disorders, low back disorders and emotional exhaustion. Women reported more musculoskeletal disorders and engagement in domestic work. Adverse at-work exposures were highest in blue-collar women. High engagement in domestic work was not separately associated with symptoms but paid work exposure factors were associated. High engagement in domestic work interacted with adverse work exposure and increased risk estimates for low back disorders and emotional exhaustion. Reported work-home imbalance was associated with neck/shoulder disorders in women and with emotional exhaustion in both women and men.

    Practitioner Summary. The current article adds to earlier research by showing that high engagement in domestic work is not separately associated with increased symptoms, but interacts with psychosocial work exposure variables to produce emotional exhaustion in both women and men and low back disorders in women.

  • 108.
    Ahlgren, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Waling, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Kadi, Fawzi
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Djupsjöbacka, Mats
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Centre for Musculoskeletal Research, National Institute for Working Life, Umeå , Sweden.
    Thornell, Lars-Eric
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Effects on physical performance and pain from three dynamic training programs for women with work-related trapezius myalgia2001In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, no 4, p. 162-9Article in journal (Refereed)
    Abstract [en]

    To compare training programs for women with trapezius myalgia regarding physical performance and pain, 102 women were randomized to strength, endurance, co-ordination and non-training groups. Before and after the intervention, static strength and dynamic muscular endurance in shoulder muscles were measured on a Cybex II dynamometer. Muscle activity in shoulder muscles was monitored via surface EMG. The signal amplitude ratio between the active and passive phase of repeated contractions indicated the ability to relax. Pain at present, pain in general and pain at worst were measured on visual analogue scales. After training, within group comparisons showed that the training groups rated less pain, and in the strength training group ratings of pain at worst differed from the non-training group. Using the non-training group as a reference, static strength increased in the strength and endurance training groups and muscular endurance in all training groups. The study indicates that regular exercises with strength, endurance or co-ordination training of neck/shoulder muscles might alleviate pain for women with work-related trapezius myalgia.

  • 109.
    Ahlin, Rebecca
    et al.
    Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nørskov, Natalja P.
    Department of Animal and Veterinary Sciences, Aarhus University, AU-Foulum, Tjele, Denmark.
    Nybacka, Sanna
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Landberg, Rikard
    Department of Life Sciences, Division of Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden.
    Skokic, Viktor
    Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
    Stranne, Johan
    Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Josefsson, Andreas
    Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM). Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Urology and Andrology. Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Steineck, Gunnar
    Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hedelin, Maria
    Department of Oncology, Division of Clinical Cancer Epidemiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Regional Cancer Center West, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
    Effects on serum hormone concentrations after a dietary phytoestrogen intervention in patients with prostate cancer: a randomized controlled trial2023In: Nutrients, E-ISSN 2072-6643, Vol. 15, no 7, article id 1792Article in journal (Refereed)
    Abstract [en]

    Phytoestrogens have been suggested to have an anti-proliferative role in prostate cancer, potentially by acting through estrogen receptor beta (ERβ) and modulating several hormones. We primarily aimed to investigate the effect of a phytoestrogen intervention on hormone concentrations in blood depending on the ERβ genotype. Patients with low and intermediate-risk prostate cancer, scheduled for radical prostatectomy, were randomized to an intervention group provided with soybeans and flaxseeds (∼200 mg phytoestrogens/d) added to their diet until their surgery, or a control group that was not provided with any food items. Both groups received official dietary recommendations. Blood samples were collected at baseline and endpoint and blood concentrations of different hormones and phytoestrogens were analyzed. The phytoestrogen-rich diet did not affect serum concentrations of testosterone, insulin-like growth factor 1, or sex hormone-binding globulin (SHBG). However, we found a trend of decreased risk of increased serum concentration of estradiol in the intervention group compared to the control group but only in a specific genotype of ERβ (p = 0.058). In conclusion, a high daily intake of phytoestrogen-rich foods has no major effect on hormone concentrations but may lower the concentration of estradiol in patients with prostate cancer with a specific genetic upset of ERβ.

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  • 110.
    Ahlm, Clas
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Infectious Diseases.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Vapalahti, O.
    University of Helsinki and Helsinki University Central Hospital Laboratory, Finland.
    Evander, Magnus
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology.
    Seroprevalence of Sindbis virus and associated risk factors in northern Sweden2014In: Epidemiology and Infection, ISSN 0950-2688, E-ISSN 1469-4409, Vol. 142, no 7, p. 1559-1565Article in journal (Refereed)
    Abstract [en]

    Mosquito-borne Sindbis virus (SINV) cause disease characterized by rash, fever and arthritis which often leads to long-lasting arthralgia. To determine the seroprevalence of SINV and associated risk factors in northern Sweden, a randomly selected population aged between 25 and 74 years were invited to join the MONICA study. Serum from 1611 samples were analysed for specific IgG antibodies. Overall, 2·9% had IgG against SINV. More men (3·7%) than women (2·0%) were SINV seropositive (P = 0·047) and it was more common in subjects with a lower educational level (P = 0·013) and living in small, rural communities (P < 0·001). Seropositivity was associated with higher waist circumference (P = 0·1), elevated diastolic blood pressure (P = 0·037), and history of a previous stroke (P = 0·011). In a multiple logistic regression analysis, adjusting for known risk factors for stroke, seropositivity for SINV was an independent predictor of having had a stroke (odds ratio 4·3, 95% confidence interval 1·4–13·0,P = 0·011).

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  • 111.
    Ahlm, Kristin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-20092013In: BMC Public Health, E-ISSN 1471-2458, Vol. 13, p. 216-Article in journal (Refereed)
    Abstract [en]

    Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.

    Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.

    Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.

    Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

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  • 112. Ahlqvist, Viktor H
    et al.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ortega, Francisco B
    Tynelius, Per
    Magnusson, Cecilia
    Berglind, Daniel
    Birth Weight and Cardiorespiratory Fitness Among Young Men Born at Term: The Role of Genetic and Environmental Factors2020In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 9, no 3, article id e014290Article in journal (Refereed)
    Abstract [en]

    Background: Preterm delivery and low birth weight are prospectively associated with low cardiorespiratory fitness (CRF). However, whether birth weight, within the at-term range, is associated with later CRF is largely unknown. Thus, the aim of the current study was to examine this issue and whether such association, if any, is explained by shared and/or nonshared familial factors.

    Methods and Results: We conducted a prospective cohort study, including 286 761 young male adults and a subset of 52 544 siblings born at-term. Objectively measured data were retrieved from total population registers. CRF was tested at conscription and defined as the maximal load obtained on a cycle ergometer. We used linear and nonlinear and fixed-effects regression analyses to explore associations between birth weight and CRF. Higher birth weight, within the at-term range, was strongly associated with increasing CRF in a linear fashion. Each SD increase in birth weight was associated with an increase of 7.9 (95% CI, 7.8-8.1) and 6.6 (95% CI; 5.9-7.3) Wmax in the total and sibling cohorts, respectively. The association did not vary with young adulthood body mass index.

    Conclusions: Birth weight is strongly associated with increasing CRF in young adulthood among men born at-term, across all categories of body mass index. This association appears to be mainly driven by factors that are not shared between siblings. Hence, CRF may to some extent be determined already in utero. Prevention of low birth weight, also within the at-term-range, can be a feasible mean of increasing adult CRF and health.

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  • 113. Ahlqvist, Viktor H.
    et al.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ortega, Francisco B.
    Tynelius, Per
    Magnusson, Cecilia
    Berglind, Daniel
    Birth weight and grip strength in young Swedish males: a longitudinal matched sibling analysis and across all body mass index ranges2019In: Scientific Reports, E-ISSN 2045-2322, Vol. 9, article id 9719Article in journal (Refereed)
    Abstract [en]

    Low birth weight is associated with a lower grip strength later in life. However, associations between birth weight among infants born at-term and factors driving associations between birth weight and grip strength are largely unknown. A cohort of 144,369 young men born at-term, including 10,791 individuals who had at least one male sibling/s, were followed until conscription where they performed a grip strength test. We used linear and non-linear regression analyses in the full cohort, and fixed-effects regression analyses in the sibling cohort, to address confounding by factors that are shared between siblings. After adjustment, each unit increase in birth weight z-score was associated with increases of 17.7 (95% CI, 17.2-18.2) and 13.4 (10.1-16.6) newton grip strength, which converts to approximately 1.8 and 1.4 kilogram-force in the full and within-families cohorts, respectively. The associations did not vary with young adulthood BMI. Birth weight, within the at-term range, is robustly positively associated with grip strength in young adulthood among men across all BMI categories and associations appears to be mainly driven by factors that are not shared between siblings. These findings underline the importance of recognizing the influence of low birth weight, also within the at-termrange, on young adulthood muscle strength.

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  • 114.
    Ahlström, Hanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjöstedt, Pamela
    Umeå University, Faculty of Medicine, Department of Nursing.
    Den äldre människans bästa vän: En litteraturstudie om vårdhundens positiva effekter på personer med demenssjukdom2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Många personer med demenssjukdom bor på särskilda boenden. Vårdmiljön på de särskilda boendena består både av fysiska och psykosociala faktorer, vilka påverkar hälsan. Demenssjukdom är ett kroniskt tillstånd som kan orsaka flera olika symtom. Beteendemässiga och psykiska symtom vid demenssjukdom (BPSD) är vanligt förekommande och har en negativ påverkan på livskvalitén hos personer med demenssjukdom samt personer i deras närhet. BPSD behandlas oftast med läkemedel, men det finns flera kompletterande icke- farmakologiska behandlingsmetoder och djurassisterad intervention är en av dem. Inom vården har djur visat sig ha flera positiva effekter på hälsan. Hundar är det djur som används mest och finns inom exempelvis hospice, rehabilitering och demensvård.  Syfte: Syftet var att belysa positiva effekter av att använda vårdhundar inom demensvård på särskilt boende. Metod: En litteraturstudie där resultatet baserats på nio kvantitativa studier. Först genomfördes systematiska sökningar i olika databaser med utvalda sökord. Därefter granskades, analyserades och sammanställdes de valda studierna. Resultat: Sammanställningen resulterade i fyra huvudkategorier; påverkan på BPSD, påverkan på kognition, påverkan på livskvalité samt påverkan på läkemedelsanvändning. Djurassisterad intervention kan minska BPSD, förbättra orienteringsförmågan, ökad social interaktion och förbättra livskvalitén hos personer med demenssjukdom. Inom läkemedelsanvändningen sågs inga skillnader. Konklusion: Litteraturstudiens slutsats är att vårdhundar kan ha flera positiva effekter på personer med demenssjukdom. Det krävs mer forskning om interventionens utformning och om dess potentiella förmåga att komplettera eller ersätta läkemedelsanvändning.   

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  • 115.
    Ahlström, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Korsvall, Linda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Stärkt självledarskap genom empatisk dialog främjar hållbara förändringsprocesser: Motiverande samtal vid stressrelaterad psykisk ohälsa – en kvalitativ studie ur fysioterapeuters perspektiv2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Motiverande samtal (MI) är en klinisk samtalsmetod som används vid behandling för att understödja förändring hos patienter med sjukdomstillstånd kopplade till beteende. Stressrelaterad psykisk ohälsa innefattar ofta problem med kognition och beteende, vilket påverkar förmågan att göra hälsosamma val. Fysisk aktivitet som behandling har visat god effekt för att lindra kardinalsymtom, men följsamheten är låg. MI kan fylla en viktig funktion då motivation är av betydelse för att fullfölja behandling som syftar till beteendeförändring. Dock behövs ytterligare forskning gällande fysioterapeuters strategier och erfarenheter av att tillämpa MI som samtalsmetod.Syftet med studien var att belysa fysioterapeuters erfarenheter och användande av MI hos patienter med stressrelaterad psykisk ohälsa.

    Metod: I denna studie tillämpades kvalitativ metod. Datainsamlingen gjordes genom fyra semistrukturerade intervjuer med legitimerade fysioterapeuter. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat: Studiens resultat utmynnade i temat Stärkt självledarskap genom empatisk dialog främjar hållbara förändringsprocesser. Temat baserades på fyra kategorier (med tillhörande underkategorier): Ett stärkande och flexibelt förhållningssätt, Inkännande utifrån patientens behov, Stöd till autonomi samt Hinder och motstånd på vägen. Resultatet belyser fysioterapeuters erfarenheter och användande av MI som hjälpsamt för att främja hållbara beteendeförändringar vid stressrelaterad psykisk ohälsa.

    Slutsats: Studien har bidragit till ökad förståelse för fysioterapeuters erfarenheter och användning av MI. Huvudresultatet speglar fysioterapeuternas syn på MI som ett stödjande verktyg vid behandling rörande beteendeförändringar där en empatisk dialog utgör grund för att patientens autonomi stärks. MI upplevs hjälpsamt vid planering anpassad efter patientens individuella behov. Fortsatt forskning behövs som rör fysioterapeuters strategier att motivera patienter till hälsosamma beteendeförändringar.

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  • 116.
    Ahlström, Stina
    et al.
    Rehabilitation Unit, Luleå Primary Health Care, Luleå, Sweden.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Occupational  performance of persons who have suffered a stroke: a follow-up study2003In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 10, no 2, p. 88-94Article in journal (Refereed)
    Abstract [en]

    The main purpose of this study was to describe the progress made in terms of occupational performance during a two-year period by persons who had suffered a stroke and had been discharged to their home after their initial hospital stay. The population of the study consisted of 49 persons, 30 men and 19 women, with a mean age of 69 years. The Assessment of Motor and Process Skills (AMPS) was used to assess their occupational performance. Of the whole population at discharge, 66% showed increased effort and 29% showed decreased efficiency and independency. The results also showed that the persons who had decreased the most in their efficiency dropped out from the study. Twenty-nine persons participated in the study for 2 years. The best ADL ability was seen in the population at 3 months after discharge. A decrease was seen at 18 months after discharge in AMPS ADL process ability and at 24 months in AMPS ADL motor ability. The results suggest that persons who have suffered a stroke and live in their homes maintain their AMPS ADL ability performance for 1.5 to 2 years. A low AMPS ADL process ability measure in persons who have suffered a stroke signifies a reduced possibility of living at home.

  • 117.
    Ahlsved, Kaj
    Umeå University, Faculty of Arts, Department of culture and media studies. Åbo Akademi, Åbo, Finland.
    Velocipedmusik från stålhästens decennium - hur lät den?2023In: Toiminta soi, ISSN 2737-016XArticle in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    På 1890-talet var intresset för cykling stort i Finland. Intresset avspeglades även i musikkulturen eftersom det började komponeras musik med cykeltema. Endast en liten del av den musiken har getts ut kommersiellt i Finland. Kaj Ahlsved har grävt i arkiven och i samarbete med musiker levandegjort musiken så som den finns nertecknad i version för hornensemble i Finlands armés stämböcker. Hur lät ”cykelmusiken”, vem komponerade den och varför?  

  • 118.
    Ahmad, Irma
    et al.
    Department of Radiation Oncology, Stanford University, Stanford, CA, United States.
    Edin, Alicia
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Granvik, Christoffer
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Kumm Persson, Lowa
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Tevell, Staffan
    Department of Infectious Diseases, Karlstad Hospital, Karlstad, Sweden; Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden; School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Månsson, Emeli
    Centre for Clinical Research, Region Västmanland—Uppsala University, Västmanland Hospital Västerås, Västerås, Sweden.
    Magnuson, Anders
    Center for Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.
    Marklund, Ingela
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
    Persson, Ida-Lisa
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Kauppi, Anna
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Ahlm, Clas
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Forsell, Mattias N. E.
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    Sundh, Josefin
    Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lange, Anna
    Department of Radiation Oncology, Stanford University, Stanford, CA, United States.
    Cajander, Sara
    Department of Radiation Oncology, Stanford University, Stanford, CA, United States.
    Normark, Johan
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
    High prevalence of persistent symptoms and reduced health-related quality of life 6 months after COVID-192023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1104267Article in journal (Refereed)
    Abstract [en]

    Background: The long-term sequelae after COVID-19 constitute a challenge to public health and increased knowledge is needed. We investigated the prevalence of self-reported persistent symptoms and reduced health-related quality of life (HRQoL) in relation to functional exercise capacity, 6 months after infection, and explored risk factors for COVID-19 sequalae. Methods: This was a prospective, multicenter, cohort study including 434 patients. At 6 months, physical exercise capacity was assessed by a 1-minute sit-to-stand test (1MSTST) and persistent symptoms were reported and HRQoL was evaluated through the EuroQol 5-level 5-dimension (EQ-5D-5L) questionnaire. Patients with both persistent symptoms and reduced HRQoL were classified into a new definition of post-acute COVID syndrome, PACS+. Risk factors for developing persistent symptoms, reduced HRQoL and PACS+ were identified by multivariable Poisson regression. Results: Persistent symptoms were experienced by 79% of hospitalized, and 59% of non-hospitalized patients at 6 months. Hospitalized patients had a higher prevalence of self-assessed reduced overall health (28 vs. 12%) and PACS+ (31 vs. 11%). PACS+ was associated with reduced exercise capacity but not with abnormal pulse/desaturation during 1MSTST. Hospitalization was the most important independent risk factor for developing persistent symptoms, reduced overall health and PACS+. Conclusion: Persistent symptoms and reduced HRQoL are common among COVID-19 survivors, but abnormal pulse and peripheral saturation during exercise could not distinguish patients with PACS+. Patients with severe infection requiring hospitalization were more likely to develop PACS+, hence these patients should be prioritized for clinical follow-up after COVID-19.

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  • 119. Ahmad, S
    et al.
    Poveda, A
    Shungin, Dmitry
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Odontology. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Center, Lund University, Malmö, Sweden.
    Barroso, I
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research.
    Renström, Frida
    Umeå University, Faculty of Medicine, Department of Biobank Research. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Center, Lund University, Malmö, Sweden.
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University Diabetes Center, Lund University, Malmö, Sweden; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
    Established BMI-associated genetic variants and their prospective associations with BMI and other cardiometabolic traits: the GLACIER Study2016In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 40, no 9, p. 1346-1352Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Recent cross-sectional genome-wide scans have reported associations of 97 independent loci with body mass index (BMI). In 3541 middle-aged adult participants from the GLACIER Study, we tested whether these loci are associated with 10-year changes in BMI and other cardiometabolic traits (fasting and 2-h glucose, triglycerides, total cholesterol, and systolic and diastolic blood pressures).

    METHODS: A BMI-specific genetic risk score (GRS) was calculated by summing the BMI-associated effect alleles at each locus. Trait-specific cardiometabolic GRSs comprised only the loci that show nominal association (P⩽0.10) with the respective trait in the original cross-sectional study. In longitudinal genetic association analyses, the second visit trait measure (assessed ~10 years after baseline) was used as the dependent variable and the models were adjusted for the baseline measure of the outcome trait, age, age(2), fasting time (for glucose and lipid traits), sex, follow-up time and population substructure.

    RESULTS: The BMI-specific GRS was associated with increased BMI at follow-up (β=0.014 kg m(-2) per allele per 10-year follow-up, s.e.=0.006, P=0.019) as were three loci (PARK2 rs13191362, P=0.005; C6orf106 rs205262, P=0.043; and C9orf93 rs4740619, P=0.01). Although not withstanding Bonferroni correction, a handful of single-nucleotide polymorphisms was nominally associated with changes in blood pressure, glucose and lipid levels.

    CONCLUSIONS: Collectively, established BMI-associated loci convey modest but statistically significant time-dependent associations with long-term changes in BMI, suggesting a role for effect modification by factors that change with time in this population.

  • 120. Ahmad, Shafqat
    et al.
    Rukh, Gull
    Varga, Tibor V
    Ali, Ashfaq
    Kurbasic, Azra
    Shungin, Dmitry
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Odontology. Lund University.
    Ericson, Ulrika
    Koivula, Robert W
    Chu, Audrey Y
    Rose, Lynda M
    Ganna, Andrea
    Qi, Qibin
    Stancakova, Alena
    Sandholt, Camilla H
    Elks, Cathy E
    Curhan, Gary
    Jensen, Majken K
    Tamimi, Rulla M
    Allin, Kristine H
    Jorgensen, Torben
    Brage, Soren
    Langenberg, Claudia
    Aadahl, Mette
    Grarup, Niels
    Linneberg, Allan
    Pare, Guillaume
    Magnusson, Patrik KE
    Pedersen, Nancy L
    Boehnke, Michael
    Hamsten, Anders
    Mohlke, Karen L
    Pasquale, Louis T
    Pedersen, Oluf
    Scott, Robert A
    Ridker, Paul M
    Ingelsson, Erik
    Laakso, Markku
    Hansen, Torben
    Qi, Lu
    Wareham, Nicholas J
    Chasman, Daniel I
    Hallmans, Göran
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Nutritional Research. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Hu, Frank B
    Renström, Frida
    Orho-Melander, Marju
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Lund University and Harvard University.
    Gene x physical activity interactions in obesity: combined analysis of 111,421 individuals of European ancestry2013In: PLOS Genetics, ISSN 1553-7390, E-ISSN 1553-7404, Vol. 9, no 7, p. e1003607-Article in journal (Refereed)
    Abstract [en]

    Numerous obesity loci have been identified using genome-wide association studies. A UK study indicated that physical activity may attenuate the cumulative effect of 12 of these loci, but replication studies are lacking. Therefore, we tested whether the aggregate effect of these loci is diminished in adults of European ancestry reporting high levels of physical activity. Twelve obesity-susceptibility loci were genotyped or imputed in 111,421 participants. A genetic risk score (GRS) was calculated by summing the BMI-associated alleles of each genetic variant. Physical activity was assessed using self-administered questionnaires. Multiplicative interactions between the GRS and physical activity on BMI were tested in linear and logistic regression models in each cohort, with adjustment for age, age(2), sex, study center (for multicenter studies), and the marginal terms for physical activity and the GRS. These results were combined using meta-analysis weighted by cohort sample size. The meta-analysis yielded a statistically significant GRS x physical activity interaction effect estimate (P-interaction = 0.015). However, a statistically significant interaction effect was only apparent in North American cohorts (n = 39,810, P-interaction = 0.014 vs. n = 71,611, P-interaction = 0.275 for Europeans). In secondary analyses, both the FTO rs1121980 (P-interaction = 0.003) and the SEC16B rs10913469 (P-interaction = 0.025) variants showed evidence of SNP x physical activity interactions. This meta-analysis of 111,421 individuals provides further support for an interaction between physical activity and a GRS in obesity disposition, although these findings hinge on the inclusion of cohorts from North America, indicating that these results are either population-specific or non-causal.

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  • 121.
    Ahmad, Shafqat
    et al.
    Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Zhao, Wei
    Philadelphia, PA, US.
    Renström, Frida
    Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Rasheed, Asif
    Karachi, Pakistan.
    Samuel, Maria
    Karachi, Pakistan.
    Zaidi, Mozzam
    Karachi, Pakistan.
    Shah, Nabi
    Karachi, Pakistan; Abbottabad, Pakistan.
    Mallick, Nadeem Hayyat
    Punjab Institute of Cardiology, Lahore, Pakistan.
    Zaman, Khan Shah
    Karachi, Pakistan.
    Ishaq, Mohammad
    Karachi, Pakistan.
    Rasheed, Syed Zahed
    Karachi, Pakistan.
    Memon, Fazal-ur-Rheman
    Karachi, Pakistan.
    Hanif, Bashir
    Karachi, Pakistan.
    Lakhani, Muhammad Shakir
    Karachi, Pakistan.
    Ahmed, Faisal
    Karachi, Pakistan.
    Kazmi, Shahana Urooj
    Karachi, Pakistan.
    Frossard, Philippe
    Karachi, Pakistan; Nazarbayev University, Astana, Kazakhstan.
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
    Saleheen, Danish
    Philadelphia, PA, US; Karachi, Pakistan.
    Physical activity, smoking, and genetic predisposition to obesity in people from Pakistan: the PROMIS study2015In: BMC Medical Genetics, E-ISSN 1471-2350, Vol. 16, article id 114Article in journal (Refereed)
    Abstract [en]

    Background: Multiple genetic variants have been reliably associated with obesity-related traits in Europeans, but little is known about their associations and interactions with lifestyle factors in South Asians.

    Methods: In 16,157 Pakistani adults (8232 controls; 7925 diagnosed with myocardial infarction [MI]) enrolled in the PROMIS Study, we tested whether: a) BMI-associated loci, individually or in aggregate (as a genetic risk score - GRS), are associated with BMI; b) physical activity and smoking modify the association of these loci with BMI. Analyses were adjusted for age, age(2), sex, MI (yes/no), and population substructure.

    Results: Of 95 SNPs studied here, 73 showed directionally consistent effects on BMI as reported in Europeans. Each additional BMI-raising allele of the GRS was associated with 0.04 (SE = 0.01) kg/m(2) higher BMI (P = 4.5 x 10(-14)). We observed nominal evidence of interactions of CLIP1 rs11583200 (P-interaction = 0.014), CADM2 rs13078960 (P-interaction = 0.037) and GALNT10 rs7715256 (P-interaction = 0.048) with physical activity, and PTBP2 rs11165643 (P-interaction = 0.045), HIP1 rs1167827 (P-interaction = 0.015), C6orf106 rs205262 (P-interaction = 0.032) and GRID1 rs7899106 (P-interaction = 0.043) with smoking on BMI.

    Conclusions: Most BMI-associated loci have directionally consistent effects on BMI in Pakistanis and Europeans. There were suggestive interactions of established BMI-related SNPs with smoking or physical activity.

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  • 122.
    Ahmadi, Alijoma
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gholami, Hanif
    Föräldrars erfarenheter av att leva med ett barn med diabetes typ 1: En litteraturstudie.2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes type 1 is an autoimmune disease that mainly affects children and young people, the treatment is lifelong because it is not possible to cure the disease.

    Aim: To illuminate parents' experience of living with a child with type 1 diabetes

    Methods: A qualitative literature study that compiles the existing knowledge in the subject. The search was performed in the databases Cinahl and PubMed. The results of eight empirical and qualitative studies were reviewed, analyzed and compiled. The result was analyzed according to Forsberg & Wengström five steps analysis method. 

    Results: The results were compiled into two categories: Experience of their own and others' lack of knowledge, face changes in daily life. The results showed that the child's diabetes affects the parents' daily lives in many different ways, such as physical, mental and social.

    Conclusion: The child's diabetes causes major changes in the parents' lives. The parents feel that both themselves and those in the child's environment do not have sufficient competence regarding the child's diabetes and associated diabetes care. Thus, nurses should convey knowledge and educate parents so that they can handle the child's diabetes care in a good way. School staff and relatives should be offered education so that the parents feel safe when the child is at school, with relatives or friends.

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  • 123.
    Ahmadi, Sumaiya
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Risk factors for self-perceived oral health in Northern Sweden:: a cross-sectional study2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Authors have reported socioeconomic inequalities in self-perceived oral health around the world, including Sweden. However, no study has been carried out in Northern Sweden.

    Purpose: the aim of this study is to investigate different risk factors such as age, education, civil status, occupational class, income, place of birth and smoking have an association with self- perceived oral health in Northern Sweden.

    Methods: A cross-sectional study design (N=22,975; 50% response rate), based on a survey questionnaire, Health on Equal Terms survey of 2014 in four Northern counties of Sweden. The age group was 16-84 years. The responses are linked to Statistics Sweden registry through Swedish Personal number. A multiple logistic regression while controlling for confounders, was used to analyze the differences in self-perceived oral health with respect to sex, age, educational level, civil-status, income and country of birth.

    Results: 75% of the respondents reported good self-perceived oral health. The higher odds of poor self-perceived oral health were observed among men, middle age, low education, blue-collar workers, low income, those who had their last visit to dentist in more than 5 years and those not born in Sweden.

    Conclusion: The results suggest the presence of a social gradient in Northern Sweden in self-perceived oral health. The inequity needs to be addressed by the researchers and policy makers.

  • 124.
    Ahmed, Amin
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Prevalence and socioeconomic factors associated with stress in northern Sweden2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress is worth studying because of the lack of studies in northern Sweden. The aim of studying is to estimate the prevalence of stress and to assess the socioeconomic factors associated to stress in Northern Sweden.

    Methods: Cross-sectional data from the 2018 Health on Equal Terms survey in four regions in northern Sweden was used (N = 23439). The following groups were created: region, sex, age, education, marital status, occupation, unemployment, low cash margin, and financial strain. Prevalence differences corresponding to the intersectional factor were estimated using crude and adjusted regression for outcome variables like stress.

    Results: Stress was significantly higher in females than in males (AOR=1.90, 95% CI: 1.74–2.09). Age was negatively associated with stress (30–44 and 45–64) with (AOR = 0.55, 95% CI: 0.48–0.63) and (AOR = 0.16, 95% CI: 0.14–0.19). stress was significantly higher with marital status. The unmarried, not cohabiting, and divorced were more likely to become stressed (AOR = 1.26, 95% CI: 1.12-1.41) and (AOR = 1.29, 95% CI: 1.07-1.54). stress was also significant among the unemployed (AOR = 1.43, 95% CI: 1.17–1.75) and among those with low cash and making ends meet (AOR = 2.10, 95% CI: 1.85–2.38). Occupation, both highly skilled white collars and low-skilled blue collars were significantly affected by stress (AOR = 1.49, 95% CI: 1.32–1.68) and (AOR = 1.21, 95% CI: 1.06–1.37).

    Conclusion: A series of socioeconomic risk factors were associated to stress in northern Sweden. Our findings might help policymakers develop and implement effective policies and interventions.

  • 125.
    Ahmed Hassan Ahmed, Osama
    Umeå University, Faculty of Medicine, Department of Clinical Microbiology, Virology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Rift Valley fever: challenges and new insights for prevention and control using the “One Health” approach2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Rift Valley fever (RVF) is an emerging viral zoonosis that causes frequent outbreaks in east Africa and on the Arabian Peninsula. The likelihood of RVF global expansion due to climate change and human anthropogenic factors is an important issue. The causative agent, RVF virus, is an arbovirus that is transmitted by several mosquito species and is able to infect a wide range of livestock as well as people. The infection leads to mass abortions and death in livestock and a potentially deadly hemorrhagic fever in humans. RVF has severe socio-economic consequences such as animal trade bans between countries, disruption of food security, and economic disaster for farmers and pastoralists as well as for countries. Human behavior such as direct contact with infected animals or their fluids and exposure to mosquito bites increases the risk for contracting the disease.

    To better understand the challenges associated with RVF outbreaks and to explore prevention and control strategies, we used the One Health approach. The local community had to be involved to understand the interaction between the environment, animals, and humans. We focused on Sudan, Saudi Arabia, and Kenya. First, we systematically reviewed the literature and then we performed cross sectional community-based studies using a special One Health questionnaire. Climatic and remote sensing data were used in combination with statistics to develop a sub-region predictive model for RVF.

    For both Saudi Arabia and Sudan, the ecology and environment of the affected areas were similar. These areas included irrigation canals and excessive rains that provide an attractive habitat for mosquito vectors to multiply. The surveillance systems were unable to detect the virus in livestock before it spread to humans. Ideally, livestock should serve as sentinels to prevent loss of human lives, but the situation here was reversed. Differences between countries regarding further spread of RVF was mainly determined by better economic and infrastructure resources.

    In Sudan, there was a lack of knowledge and appropriate practices at the studied community regarding RVF disease symptoms and risk factors for both animals and humans. The community was hesitant in notifying the authorities about RVF suspicion in livestock due to the lack of a compensation system. The perceived role of the community in controlling RVF was fragmented, increasing the probability of RVF transmission and disease.

    In Kenya, our study found that better knowledge about RVF does not always translate to more appropriate practices that avoid exposure to the disease. However, the combination of good knowledge, attitudes, and practices may explain why certain communities were less affected. Strategies to combat RVF should consider socio-cultural and behavioral differences among communities. We also noticed that RVF outbreaks in Kenya occurred in regions with high livestock density exposed to heavy rains and wet soil fluxes, which could be measured by evapotranspiration and vegetation seasonality variables. We developed a RVF risk map on a sub-regional scale. Future outbreaks could be better managed if such relevant RVF variables are integrated into early warning systems.

    To confront RVF outbreaks, a policy is needed that better incorporates ecological factors and human interactions with livestock and environment that help the RVF pathogen spread. Early detection and notification of RVF is essential because a delay will threaten the core of International Health Regulations (IHR), which emphasizes the share of information during a transboundary disease outbreak to avoid unnecessary geographical expansion.

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  • 126.
    Ahmed, Korde
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskors erfarenhet av hur munhälsa hanteras på särskilda boenden2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 127.
    Ahmed, Lawko
    et al.
    Medical School, University of Cyprus, Nicosia, Cyprus.
    Constantinidou, Anastasia
    Medical School, University of Cyprus, Nicosia, Cyprus.
    Chatzittofis, Andreas
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry. Medical School, University of Cyprus, Nicosia, Cyprus.
    Patients' perspectives related to ethical issues and risks in precision medicine: a systematic review2023In: Frontiers in Medicine, E-ISSN 2296-858X, Vol. 10, article id 1215663Article, review/survey (Refereed)
    Abstract [en]

    Background: Precision medicine is growing due to technological advancements including next generation sequencing techniques and artificial intelligence. However, with the application of precision medicine many ethical and potential risks may emerge. Although, its benefits and potential harms are relevantly known to professional societies and practitioners, patients' attitudes toward these potential ethical risks are not well-known. The aim of this systematic review was to focus on patients' perspective on ethics and risks that may rise with the application of precision medicine.

    Methods: A systematic search was conducted on 4/1/2023 in the database of PubMed, for the period 1/1/2012 to 4/1/2023 identifying 914 articles. After initial screening, only 50 articles were found to be relevant. From these 50 articles, 24 articles were included in this systematic review, 2 articles were excluded as not in English language, 1 was a review, and 23 articles did not include enough relevant qualitative data regarding our research question to be included. All full texts were evaluated following PRISMA guidelines for reporting systematic reviews following the Joanna Briggs Institute criteria.

    Results: There were eight main themes emerging from the point of view of the patients regarding ethical concerns and risks of precision medicine: privacy and security of patient data, economic impact on the patients, possible harms of precision medicine including psychosocial harms, risk for discrimination of certain groups, risks in the process of acquiring informed consent, mistrust in the provider and in medical research, issues with the diagnostic accuracy of precision medicine and changes in the doctor-patient relationship.

    Conclusion: Ethical issues and potential risks are important for patients in relation to the applications of precision medicine and need to be addressed with patient education, dedicated research and official policies. Further research is needed for validation of the results and awareness of these findings can guide clinicians to understand and address patients concerns in clinical praxis.

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  • 128.
    Ahmed, Nazmul
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Are Hypertension and Diabetes associated with Socioeconomic inequalities in Northern Sweden?: A cross-sectional study2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background and Aims: Finding socioeconomic inequalities in health is important to creating and starting public health programs that prevent and counteract health inequality. Increasing gaps in socioeconomic inequalities are reported in Northern Sweden for some health indicators. However, less is known about inequality across the social gradient in Northern Sweden in relation to hypertension and diabetes, the two major leading causes of mortality and morbidity worldwide.To bridge this gap, this study aims to examine the association between socioeconomic determinants and two non-communicable diseases (NCD), hypertension, and diabetes in northern Sweden.

    Method: Cross-sectional data from the ‘Health on Equal Terms 2018’ survey in four regions in northern Sweden is used for this study. Birthplace, education, and household income are utilized as socioeconomic indicators. Logistic regression analyses are run to obtain the odds of association across the outcome of hypertension and diabetes separately. 23085 people, 16-84 years of age, is the available sample for hypertension, and for diabetes, the sample size is 23096.

    Result: The prevalence of hypertension is 31.26% in northern Sweden, while the prevalence of diabetes is 7.96%. The male sex, as well as chronologically higher age, lower education, and lower household income are significantly associated with a sequentially greater extent of hypertension and diabetes. Immigrants to northern Sweden who were born outside Europe/USA are also prone to these diseases. ‘Divorced’ people show 23% less vulnerability for diabetes in this study.

    Conclusion: There are two important socioeconomic barriers in front of the population of Northern Sweden; one is income equality, and another is low education. These social gradients are associated with the development of NCD, like hypertension and diabetes, which can increase the risk of mortality and morbidity in the population.

  • 129.
    Ahmed, Nazmul
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Income inequality in hypertension in Northern Sweden: An Wagstaff decomposition Analysis.2023Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 130. Ahmed, Syed Masud
    et al.
    Hadi, Abdullahel
    Razzaque, Abdur
    Ashraf, Ali
    Juvekar, Sanjay
    Ng, Nawi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Indonesia.
    Kanungsukkasem, Uraiwan
    Soonthornthada, Kusol
    Van Minh, Hoang
    Huu Bich, Tran
    Clustering of chronic non-communicable disease risk factors among selected Asian populations: levels and determinants2009In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 2, no 1, p. 68-75Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The major chronic non-communicable diseases (NCDs) operate through a cluster of common risk factors, whose presence or absence determines not only the occurrence and severity of the disease, but also informs treatment approaches. Primary prevention based on mitigation of these common risk factors through population-based programmes is the most cost-effective approach to contain the emerging epidemic of chronic NCDs.

    OBJECTIVES: This study was conducted to explore the extent of risk factors clustering for the major chronic NCDs and its determinants in nine

    INDEPTH Health and Demographic Surveillance System (HDSS) sites of five Asian countries. DESIGN: Data originated from a multi-site chronic NCD risk factor prevalence survey conducted in 2005. This cross-sectional survey used a standardised questionnaire developed by the WHO to collect core data on common risk factors such as tobacco use, intake of fruits and vegetables, physical inactivity, blood pressure levels, and body mass index. Respondents included randomly selected sample of adults (25-64 years) living in nine rural HDSS sites in Bangladesh, India, Indonesia, Thailand, and Vietnam.

    RESULTS: Findings revealed a substantial proportion (>70%) of these largely rural populations having three or more risk factors for chronic NCDs. Chronic NCD risk factors clustering was associated with increasing age, being male, and higher educational achievements. Differences were noted among the different sites, both between and within country.

    CONCLUSIONS: Since there is an extensive clustering of risk factors for the chronic NCDs in the populations studied, the interventions also need to be based on a comprehensive approach rather than on a single factor to forestall its cumulative effects which occur over time. This can work best if it is integrated within the primary health care system and the HDSS can be an invaluable epidemiological resource in this endeavor.

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  • 131.
    Ahmed, Tarig
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Delayed diagnosis of celiac disease and increased symptoms before the diagnosis2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Celiac disease is one of the diseases which are not easy to diagnose because it shares common symptoms with many other diseases. The unavailability of diagnostic facilities, the lack of updated guidelines and shortage in training for the medical staff are the factors that contribute to delay the diagnosis.

    Objectives The objective of this study is to investigate the association between the delayed diagnosis of the celiac disease and the increase in the frequency of the symptoms before the diagnosis.

    Methods The survey was conducted in collaboration with the Swedish society of celiac disease, 1560 participants selected randomly, 1031 responded. The participants were asked about the type, duration, and frequency of the symptoms before and after the diagnosis. The symptoms which the participants were asked about are fatigue, body pain, weight loss, abdominal pain, upset stomach, heartburn, nausea, vomiting, mouth ulcer, flatulence, hard stool, soft stool, skin rash, hair loss, joint pain, depression, headache and mood swinging. Furthermore, the participants were asked to report when they had symptoms that could be related to undiagnosed celiac disease and when they got their diagnosis. Also, there were other questions related to their quality of life.The analysis was done by stratifying the answers of the frequency of the symptoms into a binary outcome and the duration of delayed diagnosis into four categories of exposure. A logistic regression model reporting odds ratios was run to assess the association between the predictor and response variables.

    Result An association between delayed diagnosis of celiac disease and increasing the frequency of the symptoms before the diagnosis was found. The gastrointestinal symptoms (abdominal pain, upset stomach, mouth ulcer, flatulence, soft stool, hard stool) showed an association with delayed diagnosis with a significant result of logistic regression reporting odds ratios. Likewise, the frequency of the extra-gastrointestinal symptoms (fatigue, body pain, joint pain, skin rash, and headache) indicated a relationship with delayed diagnosis.

    Conclusion It was found that the delayed diagnosis of celiac disease increases the frequency of the symptoms before the diagnosis. It was suggested that updated guidelines for early detection and screening programs could be an effective solution.

  • 132.
    Ahnlund, Anna-Ella
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Svennberg, Elin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att främja anknytning när barnet föds för tidigt: -Barnsjuksköterskors erfarenheter2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Premature births often leads to poorer conditions for the child to develop a safe attachment. Nurses in the neonatal unit have therefore a significant role to play to enhance early attachment.

    Motive: Research shows that nurses in neonatal care often experience difficulties in the work of supporting the parents in the process of attaching with their premature child. Few studies shed light on the subject from the perspective of the nurse, which may be of importance for future work. It is therefore of interest to seek more knowledge about nurses’ experiences of promoting the attachment.

    Aim: To shed light on nurses' experiences of enhanceing early attachment between the parents and their premature born child in neonatal units.

    Methods: A semi-structured interview study with eight pediatric nurses in neonatal units in southeastern Sweden. Data is analyzed using content analysis. Result: The analysis resulted in four categories: Enabling closeness between the child and the parents, Supporting the parents to participation, Strengthening the parents' sense of parenthood, Obstacles in the work of enhancing attachment.

    Discussion: The result is strengthened and discussed in relation to previous research showing that the attachment is promoted between parents and children when they experience closeness to each other, when parents are involved in the child's nursing care and when parents feel secure in their parenting role. The result shows that nurses often find that they lack enough skills to support the parents who end up in crisis, something that has also been shown in previous research. It also emerged that nurses often lack formal competence in, enhancing early attachment which, however, does not appear in previous research.

    Conclusion: The nurses' experience shows that when responsibility for the child is safely transferred to the parents, the attachment is promoted. Increased knowledge of how the nurse can support parents in crisis can lead to improvements in the work of enhanceing early attachment. Organizational changes that enable cooperation between clinics can also lead to changes that facilitate the work of enhanceing early attachment

  • 133.
    Ait Zaid, Melissa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gunnesson, Michaela
    Umeå University, Faculty of Medicine, Department of Nursing.
    Skolsköterskors erfarenheter av att arbeta med barn med övervikt och obesitas: En kvalitativ intervjustudie2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 134.
    Aiyash, Asoom
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Susanne, Långhed
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskors/distriktssköterskors erfarenheter av utmaningar i psykosocial och fysisk arbetsmiljö i vården av personer med funktionsvariationer på LSS-boende2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 135. Ajeani, Judith
    et al.
    Ayiasi, Richard Mangwi
    Tetui, Moses
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Makerere University School of Public Health (MakSPH), Makerere University College of Health Sciences, Kampala, Uganda.
    Ekirapa-Kiracho, Elizabeth
    Namazzi, Gertrude
    Kananura, Rornald Muhumuza
    Kiwanuka, Suzanne Namusoke
    Beyeza-Kashesya, Jolly
    A cascade model of mentorship for frontline health workers in rural health facilities in Eastern Uganda: processes, achievements and lessons2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1345497Article in journal (Refereed)
    Abstract [en]

    Background: There is increasing demand for trainers to shift from traditional didactic training to innovative approaches that are more results-oriented. Mentorship is one such approach that could bridge the clinical knowledge gap among health workers.

    Objectives: This paper describes the experiences of an attempt to improve health-worker performance in maternal and newborn health in three rural districts through a mentoring process using the cascade model. The paper further highlights achievements and lessons learnt during implementation of the cascade model.

    Methods: The cascade model started with initial training of health workers from three districts of Pallisa, Kibuku and Kamuli from where potential local mentors were selected for further training and mentorship by central mentors. These local mentors then went on to conduct mentorship visits supported by the external mentors. The mentorship process concentrated on partograph use, newborn resuscitation, prevention and management of Post-Partum Haemorrhage (PPH), including active management of third stage of labour, preeclampsia management and management of the sick newborn. Data for this paper was obtained from key informant interviews with district-level managers and local mentors.

    Results: Mentorship improved several aspects of health-care delivery, ranging from improved competencies and responsiveness to emergencies and health-worker professionalism. In addition, due to better district leadership for Maternal and Newborn Health (MNH), there were improved supplies/medicine availability, team work and innovative local problem-solving approaches. Health workers were ultimately empowered to perform better.

    Conclusions: The study demonstrated that it is possible to improve the competencies of frontline health workers through performance enhancement for MNH services using locally built capacity in clinical mentorship for Emergency Obstetric and Newborn Care (EmONC). The cascade mentoring process needed strong external mentorship support at the start to ensure improved capacity among local mentors to provide mentorship among local district staff.

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  • 136.
    Ajiko, Mary Margaret
    et al.
    Surgery, Soroti Regional Referral Hospital, Kampala, Uganda; Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
    Kressner, Julia
    Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
    Matovu, Alphonsus
    Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Surgery, Mubende Regional Referral Hospital, Kampala, Uganda.
    Nordin, Pär
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Department of Surgery, Östersunds Sjukhus, Ostersund, Sweden.
    Wladis, Andreas
    Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Löfgren, Jenny
    Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
    Surgical procedures for children in the public healthcare sector: A nationwide, facility-based study in Uganda2021In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 7, article id e048540Article in journal (Refereed)
    Abstract [en]

    Objective: This study investigated the surgical services for children at the highest levels of the public healthcare sector in Uganda. The aim was to determine volumes and types of procedure performed and the patients and the human resource involved.

    Design: The study was a facility-based, record review.

    Setting: The study was carried out at the National Referral Hospital, all 14 regional referral hospitals and 14 general hospitals in Uganda, representing the highest levels of hospital in the public healthcare sector.

    Participants: The subjects were children <18 years who underwent major surgery in the study hospitals during 2013 and 2014.

    Results: The study hospitals contribute with an average annual rate of paediatric surgery at 22.0 per 100 000 paediatric population. This is a fraction of the estimated need. Most of the procedures were performed for congenital anomalies (n=3111, 39.4%), inflammation and infection (n=2264, 28.7%) and trauma (n=1210, 15.3%). Specialist surgeons performed 60.3% (n=4758) of the procedures, and anaesthesia was administered by specialist physician anaesthetists in 11.6% (n=917) of the cases.

    Conclusions: A variety of paediatric surgical procedures are performed in a relatively decentralised system throughout Uganda. Task shifting and task sharing of surgery and anaesthesia are widespread: a large proportion of surgical procedures was carried out by non-specialist physicians, with anaesthesia mostly delivered by non-physician anaesthetists. Reinforcing the capacity and promoting the expansion of the health facilities studied, in particular the general hospitals and regional referral hospitals, could help reduce the immense unmet need for surgical services for children in Uganda.

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  • 137. Ajroud-Driss, Senda
    et al.
    Adams, David
    Coelho, Teresa
    Polydefkis, Michael
    Gonzalez-Duarte, Alejandra
    Quan, Dianna
    Kristen, Arnt
    Berk, John L.
    Partisano, Angela M.
    Gollob, Jared
    Sweetser, Marianne T.
    Chen, Jihong
    Agarwal, Sonalee
    Suhr, Ole B.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Impact of Patisiran on Overall Health Status in hATTR Amyloidosis: Results from the APOLLO Trial2019In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 92, no 15Article in journal (Other academic)
  • 138. Akesson, Agneta
    et al.
    Barregard, Lars
    Bergdahl, Ingvar A.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Biobank Research.
    Nordberg, Gunnar F.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordberg, Monica
    Skerfving, Staffan
    Non-Renal Effects and the Risk Assessment of Environmental Cadmium Exposure2014In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 122, no 5, p. 431-438Article in journal (Refereed)
    Abstract [en]

    Background: Exposure to cadmium (Cd) has long been recognized as a health hazard, both in industry and in general populations with high exposure. Under the currently prevailing health risk assessment, the relationship between urinary Cd (U-Cd) concentrations and tubular proteinuria is used. However, doubts have recently been raised regarding the justification of basing the risk assessment on this relationship at very low exposure. Objectives: Our objective was to review available information on health effects of Cd exposure with respect to human health risk assessment. Discussion: The associations between U-Cd and urinary proteins at very low exposure may not be due to Cd toxicity, and the clinical significance of slight proteinuria may also be limited. More importantly, other effects have been reported at very low Cd exposure. There is reason to challenge the basis of the existing health risk assessment for Cd. Our review of the literature found that exposure to low concentrations of Cd is associated with effects on bone, including increased risk of osteoporosis and fractures, and that this observation has implications for the health risk assessment of Cd. Other effects associated with Cd should also be considered, in particular cancer, although the information is still too limited for appropriate use in quantitative risk assessment. Conclusion: Non-renal effects should be considered critical effects in the health risk assessment of Cd.

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  • 139.
    Akhtar, Zubair
    et al.
    Biosecurity Program, The Kirby Institute, UNSW Medicine, University of New South Wales, NSW, Sydney, Australia; Programme on Emerging Infections, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh.
    Götberg, Matthias
    Department of Cardiology, Skane University Hospital, Clinical Sciences, Lund University, Lund, Sweden.
    Erlinge, David
    Department of Cardiology, Skane University Hospital, Clinical Sciences, Lund University, Lund, Sweden.
    Christiansen, Evald H.
    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
    Oldroyd, Keith G.
    Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom.
    Motovska, Zuzana
    Cardiocenter, Third Faculty of Medicine, Charles University, Prague and University Hospital Kralovske Vinohrady, Prague, Czech Republic.
    Erglis, Andrejs
    Pauls Stradins Clinical University Hospital, University of Latvia, Riga, Latvia.
    Hlinomaz, Ota
    International Clinical Research Center, St. Anne University Hospital and Masaryk University, Brno, Czech Republic.
    Jakobsen, Lars
    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
    Engstrøm, Thomas
    Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
    Jensen, Lisette O.
    Department of Cardiology, Odense University Hospital, Odense, Denmark.
    Fallesen, Christian O.
    Department of Cardiology, Odense University Hospital, Odense, Denmark.
    Jensen, Svend E.
    Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
    Angerås, Oskar
    Sahlgrenska University Hospital, Gothenburg, Sweden and Institute of Medicine, Department of molecular and clinical medicine, Gothenburg University, Gothenburg, Sweden.
    Calais, Fredrik
    Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden.
    Kåregren, Amra
    Västmanlands sjukhus Västerås, Västerås, Sweden.
    Lauermann, Jörg
    Department of Cardiology, Jönköping, Region Jönköping County, Department of Health, Medicine and Caring, Linköping University, Linköping, Sweden.
    Mokhtari, Arash
    Department of Cardiology, Skane University Hospital, Clinical Sciences, Lund University, Lund, Sweden.
    Nilsson, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Persson, Jonas
    Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
    Islam, Abu K.M.M.
    National Institute of Cardiovascular Diseases, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
    Rahman, Afzalur
    National Institute of Cardiovascular Diseases, Sher-e-Bangla Nagar, Dhaka, Bangladesh.
    Malik, Fazila
    National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh.
    Choudhury, Sohel
    National Heart Foundation Hospital & Research Institute, Dhaka, Bangladesh.
    Collier, Timothy
    Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Pocock, Stuart J.
    Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Pernow, John
    Cardiology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    MacIntyre, Chandini R.
    Biosecurity Program, The Kirby Institute, UNSW Medicine, University of New South Wales, NSW, Sydney, Australia; Cardiology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
    Fröbert, Ole
    Örebro University, Faculty of Health, Department of Cardiology, Örebro, Sweden; College of Public Service & Community Solutions, Arizona State University, AZ, Tempe, United States; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Clinical Pharmacology, Aarhus University Hospital, Arhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
    Optimal timing of influenza vaccination among patients with acute myocardial infarction: findings from the IAMI trial2023In: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 41, no 48, p. 7159-7165Article in journal (Refereed)
    Abstract [en]

    Influenza vaccination reduces the risk of adverse cardiovascular events. The IAMI trial randomly assigned 2571 patients with acute myocardial infarction (AMI) to receive influenza vaccine or saline placebo during their index hospital admission. It was conducted at 30 centers in 8 countries from October 1, 2016 to March 1, 2020. In this post-hoc exploratory sub-study, we compare the trial outcomes in patients receiving early season vaccination (n = 1188) and late season vaccination (n = 1344). The primary endpoint was the composite of all-cause death, myocardial infarction (MI), or stent thrombosis at 12 months. The cumulative incidence of the primary and key secondary endpoints by randomized treatment and early or late vaccination was estimated using the Kaplan-Meier method. In the early vaccinated group, the primary composite endpoint occurred in 36 participants (6.0%) assigned to influenza vaccine and 49 (8.4%) assigned to placebo (HR 0.69; 95% CI 0.45 to 1.07), compared to 31 participants (4.7%) assigned to influenza vaccine and 42 (6.2%) assigned to placebo (HR 0.74; 95% CI 0.47 to 1.18) in the late vaccinated group (P = 0.848 for interaction on HR scale at 1 year). We observed similar estimates for the key secondary endpoints of all-cause death and CV death. There was no statistically significant difference in vaccine effectiveness against adverse cardiovascular events by timing of vaccination. The effect of vaccination on all-cause death at one year was more pronounced in the group receiving early vaccination (HR 0.50; 95% CI, 0.29 to 0.86) compared late vaccination group (HR 0.75; 35% CI, 0.40 to 1.40) but there was no statistically significant difference between these groups (Interaction P = 0.335). In conclusion, there is insufficient evidence from the trial to establish whether there is a difference in efficacy between early and late vaccination but regardless of vaccination timing we strongly recommended influenza vaccination in all patients with cardiovascular diseases.

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  • 140.
    Akhter Urmi, Sharmeen
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Parental attitude towards their autistic child and the underlying factors regulating parental attitude in Bangladesh: A Study Protocol2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Autism is a global health crisis. Among other developing countries, Bangladesh has the highest rate on prevalence of autism which ranges from 0.15%-0.84%. Several factors have been found to influence parent’s attitude towards autistic child such as lack of knowledge and understanding of autism, societal stigma, cultural belief in karma, parent’s expectations, parent’s uncertainty about child’s future, worry about child’s educational development, parent’s guilt as caregivers, hampering family relationship. Bangladesh is still lacking in knowledge and awareness of autism, thus, giving rise to negative attitude among parents towards their autistic child. The aim of the study is to understand parental attitude towards their autistic child comparing both the father and mother’s attitude and to explore the underlying factors regulating their attitude.

    Methods This will be a qualitative study protocol with abductive approach following emergent design conducted with semi-structured interviews with open-ended questions among both the parents having an autistic child diagnosed for minimum 6 months, living together in Dhakaand registered on files of Center for Neurodevelopment and Autism in Children (CNAC) in Bangabandhu Sheikh Mujib Medical University (BSMMU).

    Conclusion This study is expected to bring out deeper understanding of parental attitude towards their autistic child providing a baseline for interventions and evaluations of support programs for autistic child and their parents in Bangladesh. This study will influence for having autism support groups, autistic child-family support group, social support groups and trained social workers in public sector workers for reducing stigma of autism.

  • 141.
    Akner, Gunnar
    et al.
    Institutionen för hälsovetenskap och medicin, Örebro universitet, Personalized geriatric medicine, Sweden.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Geriatriken behöver skifta fokus – från sjukdom till person2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 29-31, article id CYICArticle in journal (Other (popular science, discussion, etc.))
  • 142.
    Akour, Amal
    et al.
    Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan; Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah Univeristy of Jordan, Amman, Jordan.
    Abuloha, Sumaya
    Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
    Mulakhudair, Ali R.
    Department of Food Health and Nutrition, College of Food Science, Al-Qasim Green University, Babylon, Iraq.
    Kasabri, Violet
    Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan.
    Al-Tammemi, Ala'a B.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.
    Complementary and alternative medicine for urinary tract illnesses: a cross-sectional survey in Jordan2021In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 43, article id 101321Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess the extent of Complementary and Alternative Medicine (CAM) usage, especially herbal preparations, in treating urinary tract illnesses, and their perceived efficacy. This was a cross-sectional survey that used a convenience sample of 278 adults who reported having any form of urinary tract illness. During the last 3 months, 105 (37.8%) of participants had used CAM for various urinary tract conditions, of which, 87 (82.9%) used herbal remedies. Urinary tract infections (UTIs) were the most reported urinary condition (n = 77, 73.3%) among CAM users. The most commonly used herbs were, parsley (n = 54, 19.2%), followed by chamomile (n = 29, 10.4%), barley (n = 20, 7.4%) and ginger (n = 18, 6.7%).The study provides an overview of various CAM remedies used to treat urinary tract illnesses in the Jordanian society, which would draw attention to the necessity of conducting interventional studies to evaluate the efficacy and safety of CAMs in treating urinary tract illnesses, either as stand-alone or adjuvant treatment.

  • 143. Akour, Amal
    et al.
    Al-Tammemi, Ala'a B.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary.
    Barakat, Muna
    Kanj, Rama
    Fakhouri, Hussam
    Malkawi, Ahmad
    Musleh, Ghadeer
    The Impact of the COVID-19 Pandemic and Emergency Distance Teaching on the Psychological Status of University Teachers: A Cross-Sectional Study in Jordan2020In: American Journal of Tropical Medicine and Hygiene, ISSN 0002-9637, E-ISSN 1476-1645, Vol. 103, no 6, p. 2391-2399Article in journal (Refereed)
    Abstract [en]

    The COVID-19 pandemic has struck many countries globally. Jordan has implemented strict nationwide control measures to halt the viral spread, one of which was the closure of universities and shifting to remote teaching. The impact of this pandemic could extend beyond the risk of physical harm to substantial psychological consequences. Our study aimed at assessing 1) psychological status, 2) challenges of distance teaching, and 3) coping activities and pandemic-related concerns among university teachers in Jordan in the midst of COVID-19–related quarantine and control measures. We conducted a cross-sectional study using an anonymous online survey. The measure of psychological distress was obtained using a validated Arabic version of the Kessler Distress Scale (K10). Other information collected included sociodemographic profile, methods used to handle distress, motivation to participate in distance teaching, and challenges of distance teaching as well as the most worrisome issues during this pandemic. Three hundred eighty-two university teachers returned completed surveys. Results of K10 showed that 31.4% of respondents had severe distress and 38.2% had mild to moderate distress. Whereas gender was not associated with distress severity, age had a weak negative correlation (Rho = −0.19, P < 0.0001). Interestingly, most teachers had moderate to high motivation for distance teaching. Engagement with family was the most reported self-coping activity. More than half of the participants were most concerned and fearful about SARS-CoV-2 infection. In conclusion, university teachers have shown to exhibit various levels of psychological distress and challenges during the implementation of precautionary national measures in the battle against COVID-19 in Jordan.

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  • 144.
    Aktell, Carolina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Magnusson, Malin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Upplevelser av urininkontinens bland äldre kvinnor2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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  • 145.
    Akuamoah-Boateng, Henrietta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Self-reported vision health status among older people in the Kassena-Nankana District, Ghana2013In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 6, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background: If current trends continue, Ghana's aged population will increase in the coming decades. Currently, there is little knowledge on the health of the aged in Ghana. Research on vision problems among this group is virtually non-existent. This research gap needs to be filled immediately in order to promote the general health among older people in Ghana.

    Objective: The objective of the study was to analyse vision health and its determinants among the older adult population in a district in one of the poorest regions in Ghana - the Kassena-Nankana district.

    Methods: Data were obtained from the WHO multi-country studies unit (SAGE). A total of 4,294 people over the age of 50 responded to the survey. Data analysis was conducted using Stata statistical package. The aim of the analysis was to identify the prevalence of self-reported vision problems and assistive device use. Age, level of education, marital status, living arrangement, socio-economic status and proportion of people aged 50 and over in a household were used as determinants of vision health.

    Results: In total, 54 and 63% (p-value, 0.00) of men and women reported having far-sightedness, while 35% of men and 40.6% of women reported having near-sightedness (p-value, 0.00). In total, 33.5% of men and 38.6% of women reported having both near-sightedness and far-sightedness (p-value, 0.00). Of those who reported having either vision problems, 2.9% reported the use of visual assistive devices. Men had a higher assistive device use of 4.5% compared to 2.1% among women (p = 0.002). Age and household socio-economic status was positively associated with reporting vision problems and assistive device use, respectively.

    Conclusions: The results from this analysis showed that despite the high reporting of vision problems, only 2.9% reported using assistive devices. This outcome shows that there is a need to prevent vision problems and increase access to assistive devices among older people in the Kassena-Nankana district in Ghana.

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  • 146.
    Akyol, Dilba
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Granberg, Frida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Barn och ungdomar med cerebral pares och deras upplevelser av smärta och delaktighet i aktivitet: En litteraturöversikt2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Cerebral pares är den vanligaste orsaken till rörelsehinder hos barn och ungdomar. Funktionsnedsättningen cerebral pares kan orsaka begränsad fysisk förmåga och utlösa smärta. Samhällets attityder och utformning av miljö kan påverka barn och ungdomars möjligheter till delaktighet i aktivitet. Meningsfulla aktiviteter kan bidra till en känsla av tillfredsställelse och en känsla av samhörighet. Dagens forskning är begränsad vad gäller barn och ungdomars subjektiva upplevelser av smärta och delaktighet i aktivitet. En litteraturöversikt med systematiska inslag genomfördes och syftet var att beskriva upplevelser av smärta och delaktighet i aktivitet hos barn och ungdomar med cerebral pares. Huvudsökningar har utförts i PubMed, Cinahl och APA PsycInfo. De inkluderade artiklarna är av kvalitativ metod för att besvara syftet med barns subjektiva upplevelser. De inkluderade artiklarna i studien resulterade i tre kategorier och nio underkategorier. Kategorierna var följande: 1) Smärtan begränsar mitt dagliga liv. 2) Kroppen kan hindra och motivera mig i aktivitet. 3) Samhället och omgivningen påverkar min vardag. Resultatet visar barn och ungdomars individuella upplevelser av sin smärta och hur smärtan tar sig i uttryck både fysiskt och psykiskt. De flesta barn och ungdomar upplever smärtan som ett hinder för delaktighet i aktivitet, men även samhället och omgivningens attityder sågs som hinder. Resultatet kan underlätta för intresserade individer inom området samt arbetsterapeuter som i sitt yrkesliv ofta möter barn och ungdomar med cerebral pares.

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  • 147.
    Al Bitar, Ghiath
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Diabetes and Edentulism: Analysis of WHO Study on global AGEing and adult health (SAGE) Wave 12015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 148.
    Al Hindosh, Sali
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gashi, Fiona
    Umeå University, Faculty of Medicine, Department of Nursing.
    Specialistsjuksköterskors erfarenheter av att kommunicera med patienter som behandlas i tryckkammare.2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt  

    Bakgrund: Omvårdnad baseras och stärks av en effektiv kommunikation mellan vårdpersonal och patienter. Det finns olika sätt att kommunicera på, men det finns hinder som kan försämra en effektiv kommunikation. Bristande kommunikation inom vården är en av de vanligaste orsakerna till vårdskador och lidande för patienterna. Kommunikationen är ett av sjuksköterskans viktigaste verktyg inom vården men det brister forskning om kommunikation med patienter under tryckkammarbehandling.   

    Motiv: Aktuell forskning om specialistsjuksköterskornas erfarenheter av kommunikation med patienter under tryckkammarbehandling är viktig. Studien kommer att bidra med fördjupad förståelse om kommunikationen under tryckkammarbehandling.   

    Syfte: Syftet med studien var att beskriva specialistsjuksköterskor erfarenheter av att kommunicera med patienter som behandlas i tryckkammare.  

    Metod: En kvalitativ studie genomfördes med hjälp av semistrukturerade intervjuer med specialistsjuksköterskor (n=7) som arbetade på centraloperation samt en intensivvårdsavdelning i en medelstor stad i södra Sverige. En intervjuguide utformades med lämpliga frågor som stöd under intervjuerna, som spelades in. De semistrukturerade intervjuerna transkriberades ordagrant. Transkripten bearbetades med kvalitativ innehållsanalys och resulterade i två huvudkategorier och sex underkategorier.   

    Resultat: Specialistsjuksköterskornas erfarenheter av att kommunicera med patienter under tryckkammarbehandling handlade om att identifiera hinder i kommunikationen samt att skapa goda förutsättningar för en god kommunikation. Den avgränsande miljön under behandlingen, avsaknad återkoppling och brist på tid var hinder som visade sig i intervjuerna. Förutsättningarna för god kommunikation inkluderade att skapa förtroende och ge stöd, förbereda patienten samt nyttjandet av både verbal och icke-verbal kommunikation.    

    Konklusion: Studien redovisar hinder i kommunikationen under tryckkammarbehandling samt belyser specialistsjuksköterskors förmågor att skapa förutsättningar för att motverka dessa hinder.   

  • 149.
    Al Mamun, Mohammad Feroz
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Pokharel, Arpan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Reasons behind the use of tanning beds:: A Scoping Review2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Tanning beds emit short, energetic and harmful rays, UV-A and UV-B which leads to various ocular and skin diseases; moreover, DNA damage and the initiation of carcinogenic changes are associated with regular use of it. Basal cell carcinoma and melanoma incidence rate have been rapidly increasing over a few decades due to unregulated consumption of solar bed. It has been classified as carcinogenic device and different organizations regularly advice for the prohibition of it. Despite the proven association of ocular and skin diseases and cancer from the large epidemiological data solar bed consumption is not degraded; furthermore, tanning bed has been developed as a culture in the modern western world. The exploration of tanning bed displayed that it is interconnected with the ancient sun worshippers, an advent of vitamin D and carbon arc lamps with quartz lens, heliotherapy clinics and to the modern sun stimulated indoor tanning. This scoping review provides a broad understanding of the reasons behind the popularity and the current consumption of indoor tanning bed.

    Aim:

    The aim of our study is to analyse and summarize the factors that contribute to the practice of indoor tanning beds in an overall population; furthermore, attitudes, perception, belief, behaviour and motivation factors of indoor tanners were undertaken to explore and find gaps in the existing literatures.

     Method:

    By using a scoping review twenty articles both qualitative and quantitative were identified and selected from the Umeå University Library website by using only one database, “Web of Science TM Core Collection Studies (v.5.21)” during the months of March and April 2016.  Boolean logic was used to identify both qualitative and quantitative studies with keywords such as “Indoor tanning”, “Tanning bed”, “Qualitative Study”, “attitude”, “belief”, “behaviour”, “motivation” and “perception”. The relevant articles that were published and written only in English language and free to download a full copy of the articles through the Umeå University Library website and without any financial transactions and contacts with organizations and authors were included. In terms of population, our target study group is broad which includes both male and female population who are active and passive users of the tanning beds. The age of the participants in our study range from 11 years to 94 years.

    Results:

    Seven themes are reported to be the main reasons behind the consumption of carcinogenic tanning bed. These are: - (1) Modern Healthism, (2) Influence from family and friends, (3) Social occasions and holidays, (4) Physical and Mental Gain, (5) Complex cognition, (6) Addiction and (7) Tactful marketing.  Modern healthism, tanning industries and salon’s tactful marketing help to set up image-based modern norms, attractive, healthy golden brown skin, in societal level influencing families and friends, which further develops indoor tanning as a culture and beautifying practice during special events like social occasions and holidays. The cognition regarding physical and mental gain perceived from an individual and societal perspective and contradictory findings from ongoing researches with respect to the hazards of solar beds create complex cognition among active and passive tanners, like ambivalence, cognitive dissonance, temporal discounting, rationalization and optimistic bias. However, in the adolescent phase, there is increasing consumption of the tanning beds which can be further explained by complex cognitive, the adolescent egocentrism. The complex cognition enhances the regular use of addictive tanning bed which further leads to dependence and skin cancers or the diseases of the eyes and the skin.

    Conclusions: Consumption of risky tanning bed has been developed as a culture or beauty norms that are still ingrained in the mind of tanners, i.e., golden brown tanned skin is attractive, which is created under the influence of modern healthism. The reasons behind the use of carcinogenic solar bed can be well explained by the concepts of cognitive science and psychology, i.e., ambivalence, adolescent egocentrism, cognitive dissonance, temporal discounting, rationalization, optimistic bias, and addiction. In order to tackle with solar bed dependence and its health related hazards, health workers should develop and implement promotive and preventive health programs which incorporate social norms and factors, tanner’s cognition and psychology. Policy makers and health actors should ban solar beds or avoid the use of it in the minors, i.e., under 18 years through embracing the evidence suggested by epidemiological studies.

  • 150.
    Al- Rubaye, Ali Kadhim Qasim
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Health Behavioral Risk Factors Associated to Quality of Life: A Cross-Sectional Study in Northern Sweden2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Obesity, smoking, low level of physical activity, lack of fruit and vegetable intake, and harmful consumption of alcohol, are all established risk factors that have undesirable effects on health. These behavioural risk factors have a joint adverse effect on both morbidity and mortality. This thesis aims to explore the relationship between these risk factors and the quality of life among adults population with an age range between 16 to 84 year old livings in Northern Sweden.

    Methodology: This cross-sectional study is based on data from Sweden‘s national public health survey Hälsa på lika villkor – HLV (Health on Equal Terms) that was conducted between February and May 2014 in the four Northern counties in Sweden: Norrbotten, Västerbotten, Västernorrland, and Jämtland. With a response rate of 50%, the final sample consisted of 25.667 individuals. In this study, individuals with missing data from any of the study variables were dropped to assure complete analysis. The final study population was 17,138 (67% of those who responded to the HET 2014 survey) Multivariable linear regression was used to statistically analyze the relationship between the outcome variable, the EQ5D utility score which is a standardized instrument widely used for measuring the generic health status, and the following independent variables: BMI, physical activity, smoking status, fruit and vegetable intake, and alcohol consumption. The association was presented in terms of coefficient factor and CI 95%.

    Results: The findings showed that risk factors namely obesity, less than the recommended daily level of physical activity, low daily consumption of fruits and vegetables, daily use of tobacco and the heavy episodic drinking of alcohol had significantly associated with Low EQ5D.

    Conclusion: The results of the study suggest that HRQoL measured by EQ5D-3L might have a significant relation with lifestyle behaviours. This finding would emphasize the role of public health interventions for better overall health to the population. More research is needed to fully understand and explore the determinants of the relationship between the lifestyle behaviours and the HRQol.

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