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  • 1. Allard, Christina
    et al.
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Brännlund, Isabelle
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Cocq, Coppélie
    Umeå University, Faculty of Arts, Department of language studies.
    Hjortfors, Lis-Mari
    Umeå University, Faculty of Arts, Department of language studies. Umeå University, Faculty of Arts, Centre for Sami Research.
    Jacobsson, Lars
    Umeå University, Faculty of Medicine, Department of Clinical Sciences.
    Ledman, Anna-Lill
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Löf, Annette
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Johansson Lönn, Eva
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Moen, Jon
    Umeå University, Faculty of Science and Technology, Department of Ecology and Environmental Sciences.
    Nilsson, Lena Maria
    Umeå University, Arctic Research Centre at Umeå University.
    Nordin, Gabriella
    Umeå University, Arctic Research Centre at Umeå University.
    Nordlund, Christer
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Norlin, Björn
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Outakoski, Hanna
    Umeå University, Faculty of Arts, Department of language studies.
    Reimerson, Elsa
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Camilla
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Sandström, Moa
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Faculty of Arts, Department of language studies.
    Sehlin MacNeil, Kristina
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Sköld, Peter
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Stoor, Krister
    Umeå University, Faculty of Arts, Department of language studies.
    Storm Mienna, Christina
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Svonni, Charlotta
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Vinka, Mikael
    Össbo, Åsa
    Umeå University, Faculty of Arts, Department of language studies.
    Rasbiologiskt språkbruk i statens rättsprocess mot sameby2015In: Dagens Nyheter, ISSN 1101-2447Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.

  • 2.
    Axelsson, Per
    et al.
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Centre for Sami Research.
    Health and physical wellbeing of the Sámi people2019In: Routledge handbook of indigenous wellbeing / [ed] Christopher Fleming and Matthew Manning, Routledge, 2019, p. 13-22Chapter in book (Refereed)
    Abstract [en]

    This chapter describes the health and physical wellbeing of the Sámi people living in Norway, Sweden, Finland and on the Kola Peninsula in Russia. Drawing on a review of the literature, we note that cancer and cardiovascular diseases are examples of conditions that, hitherto, have been thoroughly studied in the Sámi population in relation to physical wellbeing. Generally, studies conclude that the health and living conditions of the Sámi people are good and close to the level of the non-Indigenous benchmark population. However, it is also obvious that knowledge of the Sámi health situation differs between countries, partly due to national laws and policies that circumscribe opportunities to conduct relevant research involving Sámi communities. To understand the current wellbeing of the Sámi people, it is crucial to understand the effects of colonization. As such, this chapter provides a historical background to the present situation. Finally, the chapter aims to identify future challenges that may affect the wellbeing of the Sámi people of northern Europe.

  • 3.
    Axelsson, Per
    et al.
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    The challenge of Indigenous data in Sweden2021In: Indigenous Data Sovereignty and Policy / [ed] Maggie Walter, Tahu Kukutai, Stephanie Russo Carroll, Desi Rodriguez-Lonebear, New York & Abingdon: Routledge, 2021, p. 99-111Chapter in book (Refereed)
    Abstract [en]

    Indigenous Data Sovereignty is increasingly discussed in CANZUS countries but not as much in the Nordic countries, mostly due to Nordic prohibitions of the collection of ethnicity data. This chapter reports the first study on how the Sami people in Sweden perceive Indigenous control and ownership of Sami health research data. Results show that data and data management are important with preference for Sami authorities, preferably the Sami Parliament to take responsibility of data. However, doubts were expressed on the capacity of the Sami Parliament to undertake a data repository role. The study also shows that the legacy of the Nazi regime, of racial biology and of colonization is still present in discussions on Indigenous data and adds to the lack of trust between the Sami and the Swedish nation state.

  • 4. Balabanski, Anna H.
    et al.
    Dos Santos, Angela
    Woods, John A.
    Mutimer, Chloe A.
    Thrift, Amanda G.
    Kleinig, Timothy J.
    Suchy-Dicey, Astrid M.
    Siri, Susanna Ragnhild A.
    Boden-Albala, Bernadette
    Krishnamurthi, Rita V.
    F.
    Feigin, Valery L.
    Buchwald, Dedra
    Ranta, Annemarei
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Zavaleta-Cortijo, Carol
    Churilov, Leonid
    Burchill, Luke
    Zion, Deborah
    Longstreth, W.T.
    Tirschwell, David L.
    Anand, Sonia S.
    Parsons, Mark W.
    Brown, Alex
    Warne, Donald K.
    Harwood, Matire
    Barber, P. Alan
    Katzenellenbogen, Judith M.
    Incidence of stroke in indigenous populations of countries with a very high human development index: a systematic review2024In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 102, no 5, article id e209138Article, review/survey (Refereed)
    Abstract [en]

    Background and objectives: Cardiovascular disease contributes significantly to disease burden among many Indigenous populations. However, data on stroke incidence in Indigenous populations are sparse. We aimed to investigate what is known of stroke incidence in Indigenous populations of countries with a very high Human Development Index (HDI), locating the research in the broader context of Indigenous health.

    Methods: We identified population-based stroke incidence studies published between 1990 and 2022 among Indigenous adult populations of developed countries using PubMed, Embase, and Global Health databases, without language restriction. We excluded non-peer-reviewed sources, studies with fewer than 10 Indigenous people, or not covering a 35- to 64-year minimum age range. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. We assessed quality using "gold standard" criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and CONSIDER criteria for reporting of Indigenous health research. An Indigenous Advisory Board provided oversight for the study.

    Results: From 13,041 publications screened, 24 studies (19 full-text articles, 5 abstracts) from 7 countries met the inclusion criteria. Age-standardized stroke incidence rate ratios were greater in Aboriginal and Torres Strait Islander Australians (1.7-3.2), American Indians (1.2), Sámi of Sweden/Norway (1.08-2.14), and Singaporean Malay (1.7-1.9), compared with respective non-Indigenous populations. Studies had substantial heterogeneity in design and risk of bias. Attack rates, male-female rate ratios, and time trends are reported where available. Few investigators reported Indigenous stakeholder involvement, with few studies meeting any of the CONSIDER criteria for research among Indigenous populations.

    Discussion: In countries with a very high HDI, there are notable, albeit varying, disparities in stroke incidence between Indigenous and non-Indigenous populations, although there are gaps in data availability and quality. A greater understanding of stroke incidence is imperative for informing effective societal responses to socioeconomic and health disparities in these populations. Future studies into stroke incidence in Indigenous populations should be designed and conducted with Indigenous oversight and governance to facilitate improved outcomes and capacity building.

  • 5. Balabanski, Anna H.
    et al.
    Dos Santos, Angela
    Woods, John A.
    Thrift, Amanda G.
    Kleinig, Timothy J.
    Suchy-Dicey, Astrid
    Siri, Susanna Ragnhild
    Boden-Albala, Bernadette
    Krishnamurthi, Rita
    Feigin, Valery L.
    Buchwald, Dedra
    Ranta, Annemarei
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Zavaleta, Carol
    Churilov, Leonid
    Burchill, Luke
    Zion, Deborah
    Longstreth Jr., W.T.
    Tirschwell, David L.
    Anand, Sonia
    Parsons, Mark W.
    Brown, Alex
    Warne, Donald K.
    Harwood, Matire
    Katzenellenbogen, Judith M.
    The Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review Protocol2021In: Frontiers in Neurology, E-ISSN 1664-2295, Vol. 12, article id 661570Article, review/survey (Refereed)
    Abstract [en]

    Background and Aims: Despite known Indigenous health and socioeconomic disadvantage in countries with a Very High Human Development Index, data on the incidence of stroke in these populations are sparse. With oversight from an Indigenous Advisory Board, we will undertake a systematic review of the incidence of stroke in Indigenous populations of developed countries or regions, with comparisons between Indigenous and non-Indigenous populations of the same region, though not between different Indigenous populations.

    Methods: Using PubMed, OVID-EMBASE, and Global Health databases, we will examine population-based incidence studies of stroke in Indigenous adult populations of developed countries published 1990-current, without language restriction. Non-peer-reviewed sources, studies including <10 Indigenous People, or with insufficient data to determine incidence, will be excluded. Two reviewers will independently validate the search strategies, screen titles and abstracts, and record reasons for rejection. Relevant articles will undergo full-text screening, with standard data extracted for all studies included. Quality assessment will include Sudlow and Warlow's criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and the CONSIDER checklist for Indigenous research.

    Results: Primary outcomes include crude, age-specific and/or age-standardized incidence of stroke. Secondary outcomes include overall stroke rates, incidence rate ratio and case-fatality. Results will be synthesized in figures and tables, describing data sources, populations, methodology, and findings. Within-population meta-analysis will be performed if, and where, methodologically sound and comparable studies allow this.

    Conclusion: We will undertake the first systematic review assessing disparities in stroke incidence in Indigenous populations of developed countries. Data outputs will be disseminated to relevant Indigenous stakeholders to inform public health and policy research.

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  • 6. Madden, Richard
    et al.
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research.
    Kukutai, Tahu
    Griffiths, Kalinda
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Brown, Ngiare
    Coleman, Claire
    Ring, Ian
    Statistics on Indigenous Peoples: International effort needed2016In: Statistical Journal of the IAOS, ISSN 1874-7655, E-ISSN 1875-9254, Vol. 32, no 1, p. 37-41Article in journal (Refereed)
    Abstract [en]

    In 2007, the UN General Assembly endorsed the United Nations Declaration on the Rights of Indigenous Peoples. In the following years, there has been a strong call from a range United Nations agencies and spokespersons for countries to act to improve their statistics relating to Indigenous peoples as part of their response to the Declaration. These calls have emphasised the need for a holistic approach, describing strengths and resilience of Indigenous peoples and not just a focus on gaps and disadvantage. National responses have been mixed and overall statistics remain inadequate. Significantly, there has been no international statistical effort through the United Nations statistical structures to respond to the Declaration and the increasing array of calls for improved statistics. The United Nations Statistical Commission in particular has an array of mechanisms to study statistical needs and develop solutions across a broad international statistical agenda. It is time for countries to make a concerted effort to improve their own statistics on Indigenous peoples, and to insist that the Statistical Commission work in partnership with the Permanent Forum on Indigenous Issues and other stakeholders to lead a major international drive to improve statistics on and for Indigenous peoples.

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  • 7.
    Marklund, Susanna
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Wahlström, Jens
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Englund, Erling
    Department of Research and Development, Sundsvall, Sweden.
    Wiesinger, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Research and Development, Sundsvall, Sweden.
    Work ability and productivity among dentists: associations with musculoskeletal pain, stress, and sleep2020In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, no 2, p. 271-278Article in journal (Refereed)
    Abstract [en]

    Purpose: Work ability can be measured by the work ability index (WAI), and work-related questions measuring productivity loss in terms of quality and quantity of work. Dentists have high occupational risk of musculoskeletal pain and the exposure of ergonomic strain is already high during dental education. The aim was to evaluate work ability and productivity among dentists, and to identify gender differences and associations with sleep, stress, and reported frequent pain.

    Methods: The study population comprised 187 dentists (123 women and 64 men) who had been working as dentists between 5 and 12 years. Participants completed a questionnaire regarding sleep, stress, presence of pain at different sites, work ability assessed by WAI, and productivity in terms of quality and quantity of work.

    Results: Poor sleep quality and high level of stress were reported by 31% and 48.1% of participants, respectively, with no gender differences and no association with age. The prevalence of frequent pain ranged 6.4–46.5% with shoulders being the most prevalent site. Thirty-three percent reported reduced work ability. Poor sleep, high amount of stress, and multi-site pain were associated with decreased work ability.

    Conclusions: A high prevalence of pain was shown among dentists. Decreased work ability in terms of productivity loss was associated with poor sleep quality, high amount of stress, and multi-site pain. Preventive actions at the workplace should promote good musculoskeletal health, and measures taken, both individual and organizational, to minimize the risk of high, persistent stress and work-related pain.

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  • 8.
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Temporomandibular disorders among Sami women: perspectives based on an epidemiological survey with mixed methods2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction The aim of the research project was to examine prevalence, co-morbidity, and impact on daily life of pain and dysfunction in the jaw-face, head, and neck-shoulder regions among adult Sami women in northern Sweden. The aim of the qualitative part of the study was to explore, thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD, to gain insights into their health care experiences.

    Methods The research project used a mixed methods approach including questionnaire analysis, a case-control study, and thematic interviews. The study population (Papers I and III) included 487 women living in the Arctic region of northern Sweden and enrolled in the register of the Swedish Sami Parliament or registered as reindeer owners or reindeer herders in the Swedish Board of Agriculture. Two years after the questionnaire study, 22 women (cases) with longstanding, intense, and frequent symptoms indicative of TMD, together with 46 age-matched women (controls) without any symptoms in the jaw–face region, underwent a clinical examination of the function of the temporomandibular joint, jaw- and neck muscles, mandibular mobility, and dental occlusion. The examiner was blind to the women’s affiliation (Paper II). Thematic interviews with a strategic subsample of 17 Sami women (Paper IV) were thereafter conducted and analyzed with a grounded theory approach.

    Results The prevalence of frequent symptoms indicative of TMD was 17%, of headaches 19%, and of neck-shoulder pain (NSP) 30%. Seventeen percent reported that their TMD affected daily life. Duration of jaw pain, troublesome impaired jaw opening, and neck pain, together with a low education level, affected the statement of whether TMD influenced daily life or not. Factors related to pain had the greatest influence when these Sami women rated the related impairment. There was a statistically significant relationship between TMD, frequent headaches, and frequent NSP (P <0.0001). Longstanding, intense, and frequent symptoms indicative of TMD remained essentially unchanged over the two-year follow-up period. Cases reported impaired general health and awareness of clenching teeth significantly more frequently than did controls. Variations in dental occlusion did not distinguish cases from controls. In the qualitative part of the project the core category, “Grin(d) and bear it,” summarizes the participants’ various ways and stages of processing and handling the interacting categories: (1) triggers, (2) strains, (3) distrust, and (4) reconciliation with pain and/or difficulties in life. Perpetuating factors were described as mental-physical strain and stress, and also a tooth clenching behavior. Women without TMD expressed factors that helped them to handle strains, reconcile, and stay healthy. They relied on helpful social support.

    Conclusion Disabling TMD, headaches, and NSP are common in Sami women. Women with TMD commonly expressed that tooth clenching was a familiar habit related to strains in life; they described an impaired general state of health and distrust in the care providers’ competence and ability to manage their problems. Women without TMD expressed confidence in their self-efficacy and were generally less concerned with strains in their lives. Rehabilitation strategies aiming at empowerment and improved self-efficacy may be a successful approach in women with disabling TMD.

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  • 9.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Axelsson, PerUmeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Hälsa i Sápmi2021Collection (editor) (Refereed)
    Abstract [sv]

    Forskningen rörande samisk hälsa har de senaste två decennierna ökat avsevärt och bit för bit börjat förbättra ett fragmentariskt kunskapsläge. Det kan också sägas om det internationella forskningsområdet urfolkshälsa (Indigenous Health), där samisk hälsoforskning ofta hämtar jämförelser och inspiration. Vi önskar med detta temanummer väcka intresse för den samiska befolkningens hälsa och sätta ljus på den pågående samiska hälsoforskningen. Temanummret innehåller sammanlagt fem peer-review granskade originalartiklar, två översiktsartiklar och tre recensioner. Välkomna till det första temanumret om samisk hälsoforskning!

  • 10.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Axelsson, Per
    Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Samisk hälsoforskning - framsteg och utmaningar2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 5-6, p. 751-757Article, review/survey (Other academic)
    Abstract [sv]

    Forskningen rörande samisk hälsa har de senaste två decennierna ökat avsevärt och bit för bit börjat förbättra ett fragmentariskt kunskapsläge. Det kan också sägas om det internationella forskningsområdet urfolkshälsa (Indigenous Health), där samisk hälsoforskning ofta hämtar jämförelser och inspiration. Vi önskar med detta temanummer väcka intresse för den samiska befolkningens hälsa och sätta ljus på den pågående samiska hälsoforskningen. Temanumret innehåller sammanlagt fem peer-review granskade originalartiklar, två översiktsartiklar och tre recensioner. Välkomna till det första temanumret om samisk hälsoforskning!

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  • 11.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Centre for Sami Research.
    Axelsson, Per
    Umeå University, Faculty of Arts, Centre for Sami Research. Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies.
    Somatic health in the Indigenous Sami population - a systematic review2019In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 78, no 1, article id 1638195Article in journal (Refereed)
    Abstract [en]

    The objective of this systematic review was to survey the current scientific knowledge regarding the state of somatic health among situation of the Indigenous Sami people in Norway, Finland, Sweden and the Kola Peninsula in Russia; and assess the quality of the identified studies. A systematic search in the databases Pubmed, EBSCOhost (AMED, Medline, Cinahl) and Svemed was conducted from January 2000, through December 2017. This systematic search identified 399 articles. After screening abstracts, 93 articles were reviewed in full text, 32 of which met the inclusion criteria. The scientific quality of the evidence was rated according to the Newcastle–Ottawa scale. Based on the studies with moderate to high scientific quality, there is evidence for stating that the majority of the Sami included in this review experience good health. Mortality and life expectancy are similar, with only minor differences, to those of a non-Sami population. The cancer risk rate among Sami was lower than that of the general population of Norway, Sweden and Finland. Self-reported myocardial infarction prevalence was similar between Sami and non-Sami, but Angina pectoris was more prevalent among Sami. In Sweden, cardiovascular disease rates were similar between Sami and non-Sami. Musculoskeletal pain symptoms are common among the Sami population, as are obesity and overweight. To conclude, there are knowledge gaps in regard to the somatic health situation of the Indigenous Sami in the circumpolar area, especially in Russia, Finland and Sweden; as current knowledge is mainly based on publications from the SAMINOR study in Norway. No study obtained the highest quality score, suggesting a need to implement longitudinal prospective studies.

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  • 12.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Glas, Linnéa
    Umeå University, Faculty of Medicine, Department of Odontology.
    Magnusson, My
    Umeå University, Faculty of Medicine, Department of Odontology.
    Ilgunas, Aurelija
    Umeå University, Faculty of Medicine, Department of Odontology.
    Häggman-Henrikson, Birgitta
    Umeå University, Faculty of Medicine, Department of Odontology. Department of Orofacial pain and Jaw function, Malmö Universiy, Malmö, Sweden.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Patients' experiences of supervised jaw-neck exercise among patients with localized TMD pain or TMD pain associated with generalized pain2019In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 77, no 7, p. 495-501Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate temporomandibular disorder (TMD) patients’ experiences of a supervised jaw-neck exercise programme.

    Materials and methods: The study used a mixed method design. All patients were diagnosed with myalgia according to the Research Diagnostic Criteria for TMD and divided into local myalgia (n = 50; 38 women, mean age 43 yrs, SD 14), and myalgia with generalized pain (n = 28; 27 women, mean age 43 yrs, SD 13). Patients participated in a ten-session supervised exercise programme that included relaxation, coordination and resistance training of the jaw, neck and shoulders. After the 10 sessions an evaluation form was filled out including both open- and closed-ended questions. The quantitative analysis was based on closed-ended questions concerned experience, adaptation and side-effects from the exercise programme. The qualitative analysis was employing inductive content analysis of open-ended questions.

    Results: Patients reported similar positive overall experiences of exercise regardless of diagnosis, although more individuals in the general pain group experienced pain during training (57%) compared to the local pain group (26%; p = .015). Patients in both groups shared similar experiences and acknowledged the possibility to participate in an individualized and demanding exercise programme. They expressed feelings of being noticed, taken seriously and respectful care management to be key factors for successful treatment outcome. The exercise programme was acknowledged as a valuable part of treatment.

    Conclusion: The hypothesis generated was that individualized and gradually demanding exercise in the rehabilitation process of TMD stimulates self-efficacy and confidence in chronic TMD patients regardless of whether the pain was localized or combined with wide-spread pain.

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  • 13.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Johansson, Eva E
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    "Grin(d) and bear it": narratives from Sami women with and without temporomandibular disorders. A qualitative study.2014In: Journal of oral & facial pain and headache, ISSN 2333-0384, Vol. 28, no 3, p. 243-251Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore thoughts, experiences, and beliefs regarding temporomandibular disorders (TMD) among Sami women with and without TMD in order to gain insights into their health care experiences and to generate a hypothesis regarding factors associated with long-standing TMD.

    METHODS: Qualitative thematic interviews were conducted with a strategic sample of 17 Sami women, of whom 10 had a TMD diagnosis according to the Research Diagnostic Criteria for TMD and 7 age-matched women who had no signs or symptoms of TMD. Their ages were between 23 and 58 years. The thematic interviews were audiotaped, transcribed verbatim, and analyzed based on Grounded Theory, a qualitative methodology aiming to generate hypotheses grounded in the gathered data.

    RESULTS: The core category that evolved was "Grin(d) and bear it," which summarizes the Sami participants' various ways and stages of processing and handling the interacting categories (triggers, strains, distrust, and reconciliation with pain and/or difficulties in life). They described divergent as well as similar understandings of triggering factors. Maintaining factors were described as mental-physical strain and stress, and also a jaw-clenching behavior. Women without TMD contributed with factors that helped them to handle strains, reconcile, and stay healthy. They relied on strong social support.

    CONCLUSION: Based on the analysis, the following hypothesis was generated: Women with TMD, associated headaches, and neck-shoulder pain may benefit from efforts aimed at empowering them to use their own abilities to reduce stress behavior, strain, and disuse of the jaw. Rehabilitation strategies in groups might increase their sense of coherence and increase social support, which seems to be more limited than in women with no symptoms of TMD.

  • 14.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Omma, Lotta
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Axelsson, Per
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Arts, Department of historical, philosophical and religious studies. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Fokus på hälsa och hälsoforskning i Sápmi: resultat från elva samiska fokusgrupper2021Report (Other academic)
    Abstract [sv]

    En sammanfattning av rapporten finns på svenska, nord- och lulesamiska. En sydsamisk översättning utgår på grund av återbud med kort varsel där ingen ersättare kunnat hittas inom tidsfristen. 

    Syfte: Fokusgruppstudiens syfte var att möjliggöra för samer att delta i öppna samtal om hälsotillstånd och hur levnadsvillkor och livsstil kan påverka hälsan och att låta denna kunskap berika utformningen av en enkät och en klinisk studie om hälsotillstånd som nästa steg av HALDI-studien.

    Metod: Elva fokusgrupper med samiska deltagare geografiskt fördelade från södra delarna till norra delarna av Sápmi genomfördes under hösten 2018-våren 2019. Deltagarnas ålder sträcker sig från 23-77 år, med en medelålder på 53 år. Två över-gripande frågeområden avhandlades vid fokusgruppdiskussionerna; samisk hälsa och hälsoforskning med fokus på samernas hälsa. Samtalen ljudinspelades och transkriberades till text. Texterna analyserades av tre oberoende forskare med hjälp av kvalitativ innehållsanalys.

    Resultat: Deltagarna beskriver en holistisk syn på hälsa, det vill säga att allt hänger samman. De lägger stor vikt vid upplevelser/tillstånd av andlighet, vistelsei naturen, fysisk aktivitet och harmoni för att uppnå en god hälsa. Andligheten kopplas inte samman med religion utan förknippas starkt med naturen. Det framkom att en kulturell norm ”ieš birget” kan påverka benägenheten att söka vård. Denna norm innebär en strävan efter att klara sig själv, att vara stark, inte visa sig svag och att inte belasta andra med problem. I fokusgruppdiskussionerna framkom även att det både är svårt och ovanligt att öppet prata om psykisk ohälsa och missbruksproblematik. Detta kan på sikt påverka hälsan och benägenhet att söka vård negativt. Deltagarna har negativa erfarenheter av bristfällig kulturförståelse och okunskap om samiska livsvillkor i mötet med hälso- och sjukvården. Utsatthet i form av diskriminering, rasism och okunskap om samisk historia och samiska livsvillkor framkommer som vanligt förekommande och beskrevs vara en risk för ohälsa och ansågs ha en negativ inverkan på hälsotillståndet. Det uttrycktes skepsis och misstroende mot forskning generellt. Detta grundades på upplevelse av brist på delaktighet, bristfällig information och utebliven återkoppling av resultat men även på historiska erfarenheter kopplade till bland annat rasbiologi. Samtidigt påtalades att ökad kunskap avseende samernas hälsa behövs och därför ansåg deltagarna att det ändå var viktigt att delta i forskningsstudier. Vikten av att tydliggöra forskningens syfte och dess nytta betonades särskilt.

    Slutsatser: Fokusgruppstudien har gett värdefulla bidrag om viktiga forskningsområden och hur kommande hälsostudier som involverar samisk befolkning bör utformas och genomföras. Det går att konstatera att inom samisk hälsoforskning i Sverige finns många områden som går att förbättra och tydlig-göra exempelvis kring etik, information, återkoppling, datahantering och utformning av studier 

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  • 15.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    A two-year follow-up study of temporomandibular disorders in a female Sami population: validation of cases and controls as predicted by questionnaire2007In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 65, no 6, p. 341-347Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The first aim of this study was to validate persistent, severe symptoms of temporomandibular disorders (TMD) among Sami females, as predicted by questionnaire. The second aim was to establish diagnoses according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis 1 among predicted cases and controls. The third aim was to compare subjects with severe TMD to controls in regard to dental occlusion, general health, and parafunctions.

    MATERIAL AND METHODS: The subjects, Sami females living in the Arctic region of northern Sweden, all with long-standing (>or=1 year), intense (>or=5 on NS), and frequent (>or=once a week) symptoms of pain and dysfunction in the jaw-face region, were invited for clinical examination; 22 (63%) agreed to participate. Forty-six subjects with no symptoms in the jaw-face region were matched to these cases in accordance with five age groups. The examiner was blind to subject affiliation.

    RESULTS: The positive predictive value of presenting with signs and symptoms of TMD at follow-up was 0.82; the negative value was 0.87. Cases reported impaired general health and awareness of parafunctions significantly more frequently than did controls. Registered dental occlusion factors did not distinguish cases from controls.

    CONCLUSIONS: Long-standing, intense, and frequent TMD symptoms remained essentially unchanged over the 2-year follow-up of females in a Sami population. Presence of severe TMD was related to impaired general health and awareness of oral parafunctions.

  • 16.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Self-reported impact on daily life activities related to temporomandibular disorders, headaches, and neck-shoulder pain among women in a Sami population living in Northern Sweden2012In: Journal of Orofacial Pain, ISSN 1064-6655, E-ISSN 1945-3396, Vol. 26, no 3, p. 215-224Article in journal (Refereed)
    Abstract [en]

    Aims: To analyze the influence of frequency, intensity, and duration of temporomandibular disorders (TMD), headaches, and neck-shoulder pain (NSP) on Sami women's daily life. A further aim was to analyze the relationship between these symptoms and age.

    Methods: All 751 Sami women 21 to 70 years old registered in either the Swedish Sami Parliament's electoral register or registered as reindeer owners or herders and living north of the Arctic Circle in Sweden were sent a questionnaire regarding TMD symptoms, NSP, and headaches. In total, 487 women (65%) participated. The questionnaire focused on symptom frequency, duration, and intensity and whether these symptoms influenced activities of daily life. The symptom's interference with daily life activities was measured, respectively, with a numerical rating scale (NRS). The statistical analyses included multiple logistic regression analysis and Chi-square test. A P value < .05 was considered statistically significant.

    Results: Seventeen percent of the women reported that symptoms in the jaw-face region to some degree disturbed their daily life, and for 6%, the interference was significant (>= 5 on NRS). Duration of jaw pain, troublesome impaired jaw opening, and neck pain, together with a low education level, affected reports of whether symptoms of TMD influenced daily life. Almost half of the study population reported that headaches had a negative impact on their life. A similar pattern was reported for NSP. The prevalence of frequent and troublesome symptoms of TMD and headaches, but not NSP, showed a declining trend with age.

    Conclusion: TMD symptoms, headaches, and NSP negatively influence many Sami women's daily life. Factors related to pain had the greatest influence when these Sami women rated the related impairment.

  • 17.
    Storm Mienna, Christina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Wänman, Anders
    Umeå University, Faculty of Medicine, Department of Odontology, Clinical Oral Physiology.
    Temporomandiular disorders, headaches, and cervical pain among females in a Sami population2006In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 64, no 5, p. 319-325Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of this study was to examine the prevalence and co-morbidity of long-standing, intense, and frequent symptoms of pain and dysfunction in the jaw-face, head, and cervical region among adult females drawn from the Sami population in northern Sweden.

    Methods. A total of 487 females, taken from the register of the Swedish Sami Parliament or registered as reindeer owners or reindeer herders in the Swedish Board of Agriculture and living in the Arctic region of northern Sweden, participated in a questionnaire study.

    Results. The prevalence of pain and/or dysfunction in the jaw-face region was 32%, of headaches 61%, and of pain in the cervical region 56%. When the criterion of frequent symptoms (once a week or more often) was used, prevalence dropped to 17%, 19%, and 30%, respectively, and when that of intense symptoms, defined as 5 or more on an 11-point numerical rating scale, was added, prevalence dropped further to 8%, 11%, and 20%, respectively. The majority reported long-standing symptoms (67-98% depending on symptom). A high statistically significant relationship was found between frequent symptoms of pain and/or dysfunction in the jaw-face, frequent headaches, and frequent cervical pain (p <0.0001).

    Conclusions. Symptoms in the jaw-face, headaches, and cervical pain were frequently reported among a sample of Sami females living in the Swedish Arctic region. The prevalence of symptoms was strongly dependent on criteria of frequency and intensity.

  • 18.
    Yekkalam, Negin
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Storm Mienna, Christina
    Umeå University, Faculty of Medicine, Department of Odontology. Umeå University, Faculty of Arts, Várdduo – Centre for Sámi Research.
    Stoor, Jon Petter Anders
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Social determinants of self-reported oral health among Sámi in Sweden2023In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 51, no 6, p. 1258-1265Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the prevalence of poor self-reported oral health and to identify socio-demographic, socio-economic and cultural-related risk factors associated with poor oral health among Sámi in Sweden.

    Methods: A Sámi sample frame was constructed drawing from three pre-existing registers. All identified persons aged 18–84 were invited to participate in the study during February–May 2021. Among the 9249 invitations, 3779 answered the survey. The frequencies of the independent variables in terms of socio-economic, socio-demographic and cultural-related factors as well as the outcome, self-reported oral health, were calculated first. Prevalence ratios (PRs) and their 95% confidence interval (95% CI) were estimated to assess the relationship between the independent variables and the outcome.

    Results: Overall, 32.5% of the participants reported a poor oral health with a higher prevalence among men compared to women. Among the socio-demographic factors, being old (PR: 1.99; 95% CI: 1.59–2.51), unmarried (PR: 1.17; 95% CI: 1.03–1.33) and divorced or widow-er (PR: 1.27; 95% CI: 1.09–1.46) were statistically associated to poor self-reported oral health. Among the socio-economic factors, a low education level (PR: 1.56; 95% CI: 1.29–1.89), belonging to the poorest quintile (PR: 1.63; 95% CI: 1.35–1.96), and experiencing difficulties to make ends meet several times during the last 12 months (PR: 1.74; 95% CI: 1.51–1.99) were statistically significant related to poor oral health.

    Conclusions: The self-reported oral health among Sámi in Sweden appears to be worse than that of the general Swedish population. Several socio-economic and socio-demographic factors were found to be strongly associated with poor self-reported oral health. Targeted interventions addressing these social determinants are needed to reduce inequalities in oral health among the Sámi population.

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