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  • 1. Aareleid, Tiiu
    et al.
    Leinsalu, Mall
    Rahu, Mati
    Baburin, Aleksei
    Lung cancer in Estonia in 1968-87: time trends and public health implications.1994In: European Journal of Cancer Prevention, ISSN 0959-8278, E-ISSN 1473-5709, Vol. 3, no 5, p. 419-425Article in journal (Refereed)
    Abstract [en]

    Changes in lung cancer incidence and mortality in Estonia were studied for 20 years (1968-87). A steady upward trend was observed for men and women. The 1983-87/1968-72 age-standardized incidence rate ratio was 1.22 (95% confidence interval (CI) 1.15-1.29) in men and 1.34 (95% CI 1.16-1.54) in women. The corresponding mortality rate ratio was 1.26 (95% CI 1.18-1.34) in men and 1.35 (95% CI 1.16-1.57) in women. The age-specific incidence and mortality rates increased clearly towards the younger birth cohorts. For men and women, the increase was most evident for the age group 45-64 years. In women there was a more rapid increase in incidence and mortality than in men. It may be a result of a substantial increase of tobacco smoking, particularly among women, after the World War II. The high and still rising occurrence of lung cancer is closely related to the high prevalence of smoking; in addition, high tar yields in domestic cigarettes could have been responsible for an elevated lung cancer risk during the past decades. There is not tobacco control programme in Estonia, and existing legislation and regulations do not defend the non-smoking population.

  • 2.
    Abdi Ali Ahmed, Yousra
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies, Development Studies.
    A Study on behavioral Health Interventions for Neglected tropical diseases: What is missing in current health interventions?2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this paper is to provide a deeper understanding of the spread of NTDs but to also determine what is missing in the health interventions that are conducted in the countries affected by NTD.

    Method and theory: The method used in this paper is the theory testing approach which is the Social Cognitive Theory. Development in the 1970s by A. Badura, it’s based on the concept of interaction between personal, environmental and social factors.

    Results: The results showed that both the previous research and today’s health interventions lack the understanding of the roll social and personal factors play in the spread of NTD. They mainly target the environmental factors and medical. Therefore, the NTDs are still endemic despite the effort during many years.

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  • 3. Adamsson, I
    et al.
    Edlund, Charlotta
    Södertörn University, Avdelning Naturvetenskap. Karolinska Institute.
    Nord, C E
    Microbial ecology and treatment of Helicobacter pylori infections: Review2000In: Journal of chemotherapy, ISSN 1120-009X, E-ISSN 1973-9478, Vol. 12, no 1, p. 5-16Article, review/survey (Refereed)
    Abstract [en]

    The aims of the present study were to investigate the ecological disturbances caused by four different anti-H. pylori regimens, to compare different methods for diagnosing H. pylori, and to study the genetic variability of H. pylori. The patients included in the study were all treated at the Center of Gastroenterology, Huddinge University Hospital, Karolinska Institute. All patients were H. pylori-positive before entering the study, confirmed by rapid urease test, histology, culture and urea breath test or PCR. Treatment regimens included in the study were omeprazole alone (OP), in combination with amoxicillin (OA), in combination with amoxicillin and metronidazole (OAM) and in combination with clarithromycin and metronidazole (OCM). Samples from the mouth (saliva and dental plaque), stomach (biopsies from the gastric mucosa in the corpus and in the antrum) and the intestine (feces) were collected before, during and after treatment. The oral microflora was challenged by the three treatment regimens including antimicrobial agents, with the emergence of resistant streptococci and staphylococci in the OCM group. Bacterial strains in the gastric mucosa increased in numbers during treatment in all treatment groups, probably due to the pH rise, which provides a better environment for the commensal microflora. This overgrowth was especially pronounced during treatment with omeprazole alone (OP), possibly due to the fact that a concomitant suppression exerted by the antimicrobial agents occurred in the other treatment groups. H. pylori was, on the other hand, suppressed during treatment in all treatment groups, possibly due to a direct effect of omeprazole and to the colonization resistance expressed by the normal microflora, An emergence of resistant commensal strains in the gastric mucosa was seen in the OCM and the OAM groups. The intestinal microflora was most altered in the OAM and the OCM groups, with persistent disturbances in the OCM group 4 weeks after treatment. The frequency of resistant Enterococcus spp, (OCM), Enterobacteriaceae spp, (OA and OAM) and Bacteroides spp, (OCM) was increased during and after treatment. Different detection methods for H. pylori were compared and PCR was shown to have higher sensitivity than other routine diagnostic tests. The patients in the present study seemed to be colonized with a single strain of H. pylori. Treatment failures in patients treated with OAM were caused by recrudescence. These four patients with relapsing H. pylori infection, were shown to be reinfected with the original H. pylori strain, indicating that H. pylori escapes treatment by a thus far unknown mechanism.

  • 4. Agvald-Öhman, C
    et al.
    Lund, B
    Edlund, Charlotta
    Södertörn University, School of Chemistry, Biology, Geography and Environmental Science.
    Multiresistant coagulase-negative staphylococci disseminate frequently between intubated patients in a multidisciplinary intensive care unit2004In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 8, no 1, p. R42-R47Article in journal (Refereed)
    Abstract [en]

    Introduction The intensive care unit is burdened with a high frequency of nosocomial infections often caused by multiresistant nosocomial pathogens. Coagulase-negative staphylococci (CoNS) are reported to be the third causative agent of nosocomial infections and the most frequent cause of nosocomial bloodstream infections. CoNS are a part of the normal microflora of skin but can also colonize the nasal mucosa, the lower airways and invasive devices. The main aim of the present study was to investigate colonization and the rate of cross-transmissions of CoNS between intubated patients in a multidisciplinary intensive care unit. Materials and methods Twenty consecutive patients, ventilated for at least 3 days, were included. Samples were collected from the upper and lower airways. All samples were cultured quantitatively and CoNS were identified by morphology and biochemical tests. A total of 199 CoNS isolates from 17 patients were genetically fingerprinted by pulsed-field gel electrophoresis in order to identify clones and to monitor dissemination within and between patients. Results An unexpected high number of transmission events were detected. Five genotypes were each isolated from two or more patients, and 14/20 patients were involved in at least one and up to eight probable transmission events. Conclusions A frequent transmission of CoNS was found between patients in the intensive care unit. Although transmission of bacteria does not necessarily lead to infection, it is nevertheless an indication that infection control measures can be improved.

  • 5.
    Ahmed, Iqra Shahzadi
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Preventing the spread of Tuberculosis via refugees, asylum seekers and immigrants entering Sweden: A study of health communication, prevention strategies, policies and recommendations2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Sweden has for many decades witnessed a decrease of the spread of tuberculosis (TB), but between the years of 2003-2012 a new pattern has emerged with refugees carrying TB entering the country and contributing to a situation where the infection has slowly begun to spread again. The communication between the refugees and the health professionals has been inefficient, which inevitably results in fewer refugees undergoing health examinations. This in turn can lead to an increase of infections and diseases.

    The purpose of this study is to examine the current health communication between Swedish health professionals and immigrants, asylum seekers and refugees, and to give an overview of what type of health care currently exist for refugees with a high risk of TB. This is done to understand what is missing in the communication process, what has been done in order to improve the situation, and how it can be further improved in order to prevent TB. In order to fulfill the purpose of this study, a qualitative method has been used combining text analysis of interviews and secondary sources.

    This study has shown based on the interviews and secondary sources that the Swedish prevention work regarding TB is developing positively in general, but the communication between newly arrived refugees, health professionals and authorities in Sweden is lacking due to the fact that most of what is written and said in this communication process is in Swedish. This makes it difficult for the refugees to understand what is communicated and is stated as one of the main reasons why many refugees do not undergo health examinations, combined with the lack of awareness. Therefore a better functioning health communication between refugees, authorities and health professionals is required to support refugees seeking health care, as well as co-operating with health professionals to prevent the spread of not only TB but other infections and diseases in Sweden.

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  • 6. Akre, O
    et al.
    Ekbom, A
    Sparén, Pär
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Tretli, S
    Body size and testicular cancer2000In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 92, no 13, p. 1093-1096Article in journal (Refereed)
  • 7.
    Alam, Sadaf Sakina
    Södertörn University College, School of Life Sciences.
    Determination of gp120 & Trx80 dependent production of hydrogen peroxide in cell free & cell-dependent systems2009Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Hydrogen peroxide (H2O2), a reactive oxygen specie (ROS), is most commonly associated with oxidative stress causing cytotoxic effects on living cells. Oxidative stress has been implicated in various conditions including neurodegenerative diseases, autoimmune diseases and cancer. In addition H2O2 is produced as a defense mechanism against pathogens, as being released by activated phagocytes. In recent years, H2O2 has become established as an important regulator of signal transduction in eukaryotic cells. Hydrogen peroxide is generated both intracellularly and extracellularly in response to various stimuli including cytokines and growth factors. There are different mechanisms by which H2O2 is generated, facilitating signal transduction in cells; through NOX-system in miyochondria, via singlet oxygen, receptor/ligand interaction or by redox active metal ions. The HIV glycoprotein 120 (gp120) is associated with HIV dementia and it is known as a neurotoxin that causes neuronal damage. It has been proposed that free radicals may be involved in the pathogenesis caused by gp120. In addition the truncated form of thioredoxin (Trx80) is known to stimulate HIV replication in HIV infected cells, however, the exact mechanism is not known. A possible way both proteins may mediate their activity is by inducing H2O2 production. The aim of this study was to investigate H2O2 production induced by the proteins gp120 and Trx80. In order to detect H2O2 production an assay based on the fluorescent compound Amplex Red, was established. The assay was used to detect H2O2 released by gp120 and Trx80 in a cell-free environment, in a cell-system and in the presence of metal ions (copper ions) with a physiological reductant (ascorbate). We did not detect H2O2 production induced by gp120 and Trx80 respectively, using our assay, however, other ROS such as hydroxyl radicals may have been generated although they were not detectable with our method. Hence, further studies are needed in order to fully understand how gp120 and Trx80 mediate their activity.

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  • 8.
    Alkemar, Gunnar
    Södertörn University, School of Life Sciences. Stockholms universitet, Wenner-Grens institut.
    Ribosome and ribosomal RNA Structure: An experimental and computational analysis of expansion segments in eukaryotic ribosomal RNA2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Ribosomes are large ribonucleoprotein complexes which incorporate amino acids into peptide chains during translational process in all types of living cells. The eukaryotic ribosome is larger compared to its prokaryotic counterpart. The size differences are due to a larger protein part and that the rRNA contains eukaryote specific expansion segments (ES). Cryo-EM reconstruction has visualized many ES on the ribosomal surface which have given clues about function and structural features. However, the secondary structures of most ES are unknown or ill defined. In this thesis, the secondary and also to a certain extent the tertiary structures of several ES are determined by using computational methods and biochemical experimental techniques. The juxtaposition of ES6 close to ES3 in the Cryo-EM image of the yeast ribosome suggested that ES3 and ES6 might interact. A computational analysis of more than 2900 sequences shows that a complementary helical region of seven to nine contiguous base pairs can form between ES3 and ES6 in almost all analyzed sequences. Biochemical in situ experiments support the proposed interaction. Secondary structure models are presented for ES3 and ES6 in 18S rRNA and ES39 in 28S rRNA, where homologous structural elements could be modeled in the experimentally analyzed ribosomes from fungi, plants and mammals. The structure models were further supported by computational methods where the ES6 structure and the ES39 structure could be formed in more than 6000 and 900 sequences respectively. A tertiary structure model of ES3 and ES6 including the helical interaction is presented. An in vitro transcribed and folded ES6 sequence differed from that observed in situ, suggesting that chaperones, ribosomal proteins, and/or the tertiary rRNA interaction could be involved in the in vivo folding of ES6. An analysis of the similarities between ES39 structures suggests that it might be under selective constraint to preserve its secondary structure.

  • 9.
    Alshareef, Hanouf
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Waterborne diseases are illnesses caused by microscopic organisms, like viruses, bacteria and  parasites, that transmitted via the fecal-oral route through ingestion of contaminated water or food or by direct person to person contact. The transmission cycle can be broken through safe water supplies, maintaining standards of sanitation and proper handwashing practices. Two waterborne diseases are considered in this study: hepatitis A and amebic dysentery. The study aimed to understand the important factors for preventing waterborne diseases in order to improve public health. A descriptive cross-sectional study was conducted to assess the effect of different drinking water sources, sewage systems and different active practices of soap use for hand washing on incidence of waterborne diseases in different regions in Saudi Arabia. Data was obtained from Ministry of Health and Household Environment Survey provided by General Authority for Statistics. Statistical analysis performed by using general linear model and type II Analysis of Variance. In comparison of different drinking water sources, this study showed borderline rise in incidence of waterborne diseases with the use of private well water. Whereas different sewage systems had no clear effect on the incidence of waterborne diseases. The study also revealed that not using soap for hand washing would increase the risk for hepatitis A infection. Moreover, the study showed significant decline in waterborne diseases incidence when access to filtered water combined with regular soap use in the same linear model.

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    The Effect of Water, Sewage and Hand Hygiene on Waterborne Diseases in Saudi Arabia Hanouf Alshareef
  • 10.
    Alsterdal, Lotte
    Södertörn University, School of Culture and Communication, Centre for Studies in Practical Knowledge.
    Dilemman i omsorgsarbete: att stödja personer med funktionsnedsättningar i deras boende2010Collection (editor) (Other academic)
  • 11. Aluoja, Anu
    et al.
    Leinsalu, Mall
    Södertörn University, Department of Society and History, Sociology. Södertörn University, Department of Society and History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Symptoms of depression in the Estonian population: prevalence, sociodemographic correlates and social adjustment2004In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 78, no 1, p. 27-35Article in journal (Refereed)
  • 12. Aluoja, Anu
    et al.
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Leinsalu, Mall
    Development and psychometric properties of the Emotional State Questionnaire: a self-report questionnaire for depression and anxiety1999In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 53, no 6, p. 443-449Article in journal (Refereed)
    Abstract [en]

    Anxiety and depression are dimensions of emotional state that can be validly assessed with self-report measures. This article introduces a new self-report questionnaire for depression and anxiety (Emotional State Questionnaire (EST-Q)) and presents data on its reliability and validity. The items of the EST-Q were derived from diagnostic criteria of DSM-IV and ICD-10. Thirty-three items were rated on a five-point frequency scale. The questionnaire was administered to 194 inpatients with depressive and anxiety disorders and to a population sample of 479 subjects. According to the results of factor analysis, five subscales were formed: Depression, Anxiety, Agoraphobia-Panic, Fatigue, and Insomnia. EST-Q and subscales showed acceptable internal consistency (alpha = 0.69-0.88). Significant differences in subscales between patients and population and across diagnostic groups confirmed the discriminant validity of the instrument. Depression, Anxiety, and Agoraphobia-Panic subscales distinguished corresponding diagnostic groups. Fatigue and Insomnia appeared to assess nonspecific psychopathology dimensions characteristic of several psychiatric disorders.

  • 13. Alvarez, J. L.
    et al.
    Kunst, A. E.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Bopp, M.
    Strand, B. H.
    Menvielle, G.
    Lundberg, O.
    Martikainen, P.
    Deboosere, P.
    Kalediene, R.
    Artnik, B.
    Mackenbach, J. P.
    Richardus, J. H.
    Educational inequalities in tuberculosis mortality in sixteen European populations2011In: The International Journal of Tuberculosis and Lung Disease, ISSN 1027-3719, E-ISSN 1815-7920, Vol. 15, no 11, p. 1461-1467Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the magnitude of socioeconomic inequalities in tuberculosis (TB) mortality by level of education in male, female, urban and rural populations in several European countries. DESIGN: Data were obtained from the Eurothine Project, covering 16 populations between 1990 and 2003. Age- and sex-standardised mortality rates, the relative index of inequality and the slope index of inequality were used to assess educational inequalities. RESULTS: The number of TB deaths reported was 8530, with a death rate of 3 per 100000 per year, of which 73% were males. Educational inequalities in TB mortality were present in all European populations. Inequalities in TB mortality were greater than in total mortality. Relative and absolute inequalities were large in Eastern European and Baltic countries but relatively small in Southern European countries and in Norway, Finland and Sweden. Inequalities in mortality were observed among both men and women, and in both rural and urban populations. CONCLUSIONS: Socio-economic inequalities in TB mortality exist in all European countries. Firm political commitment is required to reduce inequalities in the social determinants of TB incidence. Targeted public health measures are called for to improve access to treatment of vulnerable groups and thereby reduce TB mortality.

  • 14.
    Ambagtsheer, Frederike
    et al.
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Gunnarson, Martin
    Södertörn University, School of Culture and Education, Centre for Studies in Practical Knowledge.
    de Jong, Jessica
    Central Division of the National Police, the Netherlands.
    Lundin, Susanne
    Lund University.
    van Balen, Linde
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Orr, Zvika
    The Hebrew University of Jerusalem, Israel.
    Byström, Ingela
    Lund University.
    Weimar, Willem
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Trafficking in Human Beings for the Purpose of Organ Removal: A Case Study Report2016In: Trafficking in Human Beings for the Purpose of Organ Removal: Results and Recommendations / [ed] Frederike Ambagtsheer & Willem Weimar, Lengerich: Pabst Science Publishers, 2016Chapter in book (Other academic)
  • 15.
    Ambagtsheer, Frederike
    et al.
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Gunnarson, Martin
    Södertörn University, School of Culture and Education, Centre for Studies in Practical Knowledge.
    van Balen, Linde
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Ivanovski, Ninoslav
    University of St. Cyril and Methodius, Macedonia.
    Lundin, Susanne
    Lund University.
    Byström, Ingela
    Lund University.
    Weimar, Willem
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Organ Recipients who Paid for Kidney Transplantation abroad: A Report2016In: Trafficking in Human Beings for the Purpose of Organ Removal: Results and Recommendations / [ed] Frederike Ambagtsheer & Willem Weimar, Lengerich: Pabst Science Publishers, 2016Chapter in book (Other academic)
  • 16. Andersen, Ronald
    et al.
    Smedby, Björn
    Vågerö, Denny
    Cost containment, solidarity and cautious experimentation: Swedish dilemmas2001In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 52, p. 1195-1204Article in journal (Refereed)
    Abstract [en]

    This paper uses secondary data analysis and a literature review to explore a “Swedish Dilemma”: Can Sweden continue to provide a high level of comprehensive health services for all regardless of ability to pay — a policy emphasizing “solidarity” — or must it decide to impose increasing constraints on health services spending and service delivery — a policy emphasizing “cost containment?” It examines recent policies and longer term trends including: changes in health personnel and facilities; integration of health and social services for older persons; introduction of competition among providers; cost sharing for patients; dismantling of dental insurance; decentralization of government responsibility; priority settings for treatment; and encouragement of the private sector. It is apparent that the Swedes have had considerable success in attaining cost containment — not primarily through “market mechanisms” but through government budget controls and service reduction. Further, it appears that equal access to care, or solidarity, may be adversely affected by some of the system changes.

  • 17.
    Andersson, Gustaf
    Södertörn University College, School of Discourse Studies.
    Ungdomsdiabetes: ett livslångt kontrollbehov2006Independent thesis Basic level (degree of Bachelor), 20 points / 30 hpStudent thesis
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  • 18.
    Andrén, Victoria
    et al.
    Stockholm University, Sweden; Region Västmanland, Sweden.
    Öjemyr, Torun Lindholm
    Region Västmanland, Sweden.
    Yourstone, Jenny
    Södertörn University, School of Social Sciences, Psychology.
    Damberg, Mattias
    Uppsala University, Uppsala, Sweden; Västmanland County Hospital, Sweden.
    Gender and arson: psychosocial, psychological, and somatic offender characteristics at the time of the crime2023In: Journal of Forensic Psychiatry & Psychology, ISSN 1478-9949, E-ISSN 1478-9957, Vol. 34, no 1, p. 113-130Article in journal (Refereed)
    Abstract [en]

    Deliberate fire-setting, such as the crime of arson, can have devastating, even lethal, consequences. This study compared factors at the time of arson by female and male offenders in Sweden between 2000–2010. The women (n = 100), and men (n = 100) included in this study were randomly chosen from among all individuals who had been convicted for arson during this period and who underwent forensic psychiatric investigations. Information regarding psychiatric and somatic characteristics, their psychosocial situation, and whether they were in contact with health or social services before the arsons were examined. The results showed that both women and men have complex psychiatric and somatic characteristics, as well as psychosocial situations. Women showed more self-destructive behaviour, lower Global Assessment of Functioning scores, and had been in contact with psychiatric health services to a greater extent than men. More women than men had children. These findings suggest that specific actions may be needed for preventing and treating women compared with men at risk for committing arson. 

  • 19.
    Ardila-Ardila, A.
    et al.
    University of Miami/Jackson Memorial Medical Center, USA.
    Goodkin, K.
    University of Miami/Jackson Memorial Medical Center, USA.
    Concha-Bartolini, M.
    University of Miami/Jackson Memorial Medical Center, USA.
    Lecusay-Ruiz, Robert
    University of Miami/Jackson Memorial Medical Center, USA.
    O'Mellan-Fajardo, S.
    University of Miami/Jackson Memorial Medical Center, USA.
    Suarez-Bustamante, P.
    University of Miami/Jackson Memorial Medical Center, USA.
    Molina-Vasquez, R.
    University of Miami/Jackson Memorial Medical Center, USA.
    Lee, D.
    University of Miami/Jackson Memorial Medical Center, USA.
    Chayeb, G.
    University of Miami/Jackson Memorial Medical Center, USA.
    Wilkie, F. L.
    University of Miami/Jackson Memorial Medical Center, USA.
    HUMANS: una batería neuropsicologica para la evaluación de pacientes infectados con VIH-1: [Humans: a neuropsychological battery for evaluating HIV-1 infected patients]2003In: Revista de Neurocirugía, ISSN 1514-3716, Vol. 36, no 8, p. 756-762Article, review/survey (Refereed)
    Abstract [en]

    Objective. To develop a neuropsychological test battery in Spanish for the cognitive evaluation of HIV-1 infected patients. Development. Departing from the suggestions presented by the work group of the National Institute of Mental Health (USA), a neuropsychological assessment battery was developed. It was named HUMANS (HIV/University of Miami Annotated Neuropsychological test battery in Spanish). This battery includes the following domains: 1) attention and speed of processing information, 2) memory, 3) executive function, 4) language, 5) visuospacial/visuoconstructive abilities, and 6) motor abilities. Administration takes about 3-4 hours. The English parallel version of this battery has been successfully used in English for over a decade with HIV-1 infected patients. In the paper the development and adaptation to Spanish language of the HUMANS neuropsychology section is presented Conclusions. HUMANS neuropsychological test battery fulfill the recommendations presented by the workgroup of the National Institute of Mental Health for evaluating HIV-1 infected patients. Studies regarding validity and reliability are still required.

  • 20.
    Arillo, Maria-Isabel
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Cutting the cord: a study on maternal mortality and obstetric care in disaster settings2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study examines global incentives to reduce maternal mortality, namely the fifth Millenium Developmnet Goal to reduce maternal mortality with 75% by 2015. More specifically it examines maternal mortality and obstetric care in situations of emergency. When exposed to extreme situations the risks of negative pregnancy- and delivey outcomes are increased. Data was collected from seconday sources and from interviews with health staff with experiences from humanitarian work in the field. The findings were analyzed using a theoretical framework explaining maternal mortality be referring to both direct and indirect causes. The two theoretical models used in the study are similar and reminds of each other when explaining maternal mortality. One is based on the assumption that an obstetric complication has occurred and differnt delays in recieving care is the main cause maternal mortality, whilst the other theory is more in depth and elaborates the underlying causes. The first theory is used a base tto analyze the data after which the other theory is applied in order to introdue a deeper dimension to the analysis. The findings suggest that direct causes accounts for 80 per cent of all maternal deaths, homorrhage being the largest, including in disasters. Further causes are infections, unsafe abortions, eclampsia and obstructed labor. Also, underlying socail factors such as gender inequality indirectly has a negative impact on maternal mortality. Moreover, findings suggest that obstetric care is prioritized in disaster relief response.

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  • 21.
    Azad, Azadé
    et al.
    Stockholm University, Sweden.
    Sernbo, Elisabet
    University of Gothenburg, Sweden.
    Svärd, Veronica
    Södertörn University, School of Social Sciences, Social Work. Karolinska Institutet, Sweden.
    Holmlund, Lisa
    Karolinska Institutet, Sweden.
    Björk Brämberg, Elisabeth
    Karolinska Institutet, Sweden.
    Conducting In-Depth Interviews via Mobile Phone with Persons with Common Mental Disorders and Multimorbidity: The Challenges and Advantages as Experienced by Participants and Researchers2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 22, p. 11828-11828Article in journal (Refereed)
    Abstract [en]

    Qualitative interviews are generally conducted in person. As the coronavirus pandemic (COVID-19) prevents in-person interviews, methodological studies which investigate the use of the telephone for persons with different illness experiences are needed. The aim was to explore experiences of the use of telephone during semi-structured research interviews, from the perspective of participants and researchers. Data were collected from mobile phone interviews with 32 individuals who had common mental disorders or multimorbidity which were analyzed thematically, as well as field notes reflecting researchers’ experiences. The findings reveal several advantages of conducting interviews using mobile phones: flexibility, balanced anonymity and power relations, as well as a positive effect on self-disclosure and emotional display (leading to less emotional work and social responsibility). Challenges included the loss of human encounter, intense listening, and worries about technology, as well as sounds or disturbances in the environment. However, the positive aspects of not seeing each other were regarded as more important. In addition, we present some strategies before, during, and after conducting telephone interviews. Telephone interviews can be a valuable first option for data collection, allowing more individuals to be given a fair opportunity to share their experiences.

  • 22.
    Azad, Azadé
    et al.
    Karolinska Institutet, Sweden; Stockholm University, Sweden.
    Svärd, Veronica
    Södertörn University, School of Social Sciences, Social Work. Karolinska Institutet, Sweden.
    Patients’ with Multimorbidity and Psychosocial Difficulties and Their Views on Important Professional Competence for Rehabilitation Coordinators in the Return-to-Work Process2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 19, article id 10280Article in journal (Refereed)
    Abstract [en]

    Coordinators may play a key role during the return-to-work (RTW) process for people on sickness absence. There are still few studies on the newly implemented rehabilitation coordinators (RECO) within Swedish healthcare, and none focus on their competence. The aim of this study was to explore how persons with multimorbidity and psychosocial difficulties describe the professional competence of the RECO they encountered during their RTW process. The study takes a relational and practical approach in defining professional competence, including both what professionals do and what they possess. Interviews with 12 people with multimorbidity and psychosocial difficulties who had encountered a RECO during their RTW process were analysed using thematic analysis. Six different themes were found: communicative and coordinating skills; advisory and guidance skills; engagement and advocacy skills; being persistent and flexible; being empathic and therapeutic; being professional and trustworthy. Most of these are found in research on RTW coordinators, but being persistent, and having advisory, guidance, advocacy and therapeutic skills have not been recognised as important competences previously. This study adds patients’ views on important professional competence that support the RTW process, which should be regarded in further developments of RECOs’ functions and their competence descriptions.

  • 23.
    Baars, Adája E
    et al.
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Rubio-Valverde, Jose R
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Hu, Yannan
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Bopp, Matthias
    University of Zürich, Zurich, Switzerland.
    Brønnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsinki, Finland.
    Regidor, Enrique
    Universidad Complutense de Madrid, and CIBER Epidemiología y Salud Pública, Madrid, Spain.
    White, Chris
    Office for National Statistics, London, United Kingdom.
    Wojtyniak, Bogdan
    National Institute of Public Health, Warsaw, Poland.
    Mackenbach, Johan P
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Nusselder, Wilma J
    Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
    Fruit and vegetable consumption and its contribution to inequalities in life expectancy and disability-free life expectancy in ten European countries2019In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 64, no 6, p. 861-872Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess to what extent educational differences in total life expectancy (TLE) and disability-free life expectancy (DFLE) could be reduced by improving fruit and vegetable consumption in ten European countries.

    METHODS: Data from national census or registries with mortality follow-up, EU-SILC, and ESS were used in two scenarios to calculate the impact: the upward levelling scenario (exposure in low educated equals exposure in high educated) and the elimination scenario (no exposure in both groups). Results are estimated for men and women between ages 35 and 79 years.

    RESULTS: Varying by country, upward levelling reduced inequalities in DFLE by 0.1-1.1 years (1-10%) in males, and by 0.0-1.3 years (0-18%) in females. Eliminating exposure reduced inequalities in DFLE between 0.6 and 1.7 years for males (6-15%), and between 0.1 years and 1.8 years for females (3-20%).

    CONCLUSIONS: Upward levelling of fruit and vegetable consumption would have a small, positive effect on both TLE and DFLE, and could potentially reduce inequalities in TLE and DFLE.

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  • 24.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia / University of Tampere, Tampere, Finland.
    Lai, Taavi
    University of Tartu, Tartu, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Avoidable mortality in Estonia: Exploring the differences in life expectancy between Estonians and non-Estonians in 2005-2007.2011In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 125, no 11, p. 754-762Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: A considerable increase in social inequalities in mortality was observed in Eastern Europe during the post-communist transition. This study evaluated the contribution of avoidable causes of death to the difference in life expectancy between Estonians and non-Estonians in Estonia.

    STUDY DESIGN: Descriptive study.

    METHODS: Temporary life expectancy (TLE) was calculated for Estonian and non-Estonian men and women aged 0-74 years in 2005-2007. The ethnic TLE gap was decomposed by age and cause of death (classified as preventable or treatable).

    RESULTS: The TLE of non-Estonian men was 3.53 years less than that of Estonian men, and the TLE of non-Estonian women was 1.36 years less than that of Estonian women. Preventable causes of death contributed 2.19 years to the gap for men and 0.78 years to the gap for women, while treatable causes contributed 0.67 and 0.33 years, respectively. Cardiorespiratory conditions were the major treatable causes of death, with ischaemic heart disease alone contributing 0.29 and 0.08 years to the gap for men and women, respectively. Conditions related to alcohol and substance use represented the largest proportion of preventable causes of death.

    CONCLUSIONS: Inequalities in health behaviours underlie the ethnic TLE gap in Estonia, rather than inequalities in access to health care or the quality of health care. Public health interventions should prioritize primary prevention aimed at alcohol and substance use, and should be implemented in conjunction with wider social policy measures.

  • 25.
    Baburin, Aleksei
    et al.
    National Institute for Health Development, Tallinn, Estonia.
    Reile, Rainer
    National Institute for Health Development, Tallinn, Estonia; University of Tartu, Tartu, Estonia.
    Veideman, Tatjana
    National Institute for Health Development, Tallinn, Estonia.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). National Institute for Health Development, Tallinn, Estonia.
    Age, Period and Cohort Effects On Alcohol Consumption In Estonia, 1996-20182021In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 56, no 4, p. 451-459Article in journal (Refereed)
    Abstract [en]

    AIMS: To analyse the independent effects of age, period and cohort on estimated daily alcohol consumption in Estonia.

    METHODS: This study used data from nationally representative repeated cross-sectional surveys from 1996 to 2018 and included 11,717 men and 16,513 women aged 16-64 years in total. The dependent variables were consumption of total alcohol and consumption by types of beverages (beer, wine and strong liquor) presented as average daily consumption in grams of absolute alcohol. Mixed-effects negative binomial models stratified by sex were used for age-period-cohort analysis.

    RESULTS: Alcohol consumption was highest at ages 20-29 years for both men and women and declined in older ages. Significant period effects were found indicating that total alcohol consumption and consumption of different types of beverages had increased significantly since the 1990s for both men and women. Cohort trends differed for men and women. Men born in the 1990-2000s had significantly lower daily consumption compared to earlier cohorts, whereas the opposite was found for women.

    CONCLUSION: While age-related patterns of alcohol consumption are aligned with life course stages, alcohol use has increased over the study period. Although the total daily consumption among men is nearly four times higher than among women, the cohort trends suggest convergence of alcohol consumption patterns for men and women.

  • 26.
    Bangah, Ramesh
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies, Environmental Science.
    The State of Needle Exchange Programs in Sweden and Hepatitis C Virus Incidence2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hepatitis C virus (HCV) affects up to 45,000 people in Sweden today. Although it is a very treatable disease, the prevalence of HCV is extremely high within the population of people who inject drugs (PWID). This study examines the direct effect of needle exchange programs (NEPs) on HCV rates in Sweden. Previous research has shown that NEPs reduce the transmission of other blood-borne diseases among PWID. Using an interrupted time series (ITS) analysis, this study investigates if there are statistically significant differences between HCV rates in Swedish counties before and after the implementation of NEPs. The study also investigates via linear regression to see if there is a relationship between sterile injecting equipment (needles and syringes) dispensed and HCV rates in the counties where NEPs exist. While there has been a steady decrease in HCV rates across the country as a whole, the ITS analyses show no statistically significant differences in HCV rates due to the opening of NEPs. Because of the relatively recent introduction of NEPs in Sweden, more data points post-intervention may be needed before we can truly see the effect they have on regional HCV rates. There is also no relationship between the number of needles and syringes dispensed and county HCV rates. However, Sweden falls far short of the 300 syringes/needles per user per year recommendation of the World Health Organization at this time. Standardized data collection and further research can help answer these questions more clearly. 

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  • 27.
    Bellander, Theres
    et al.
    Stockholms universitet, Sverige.
    Karlsson, Anna-Malin
    Stockholms universitet, Sverige.
    Landqvist, Mats
    Södertörn University, School of Culture and Education, Swedish Language.
    Melander Marttala, Ulla
    Uppsala univrsitet, Sverige.
    Nikolaidou, Zoe
    Södertörn University, School of Culture and Education, Swedish Language.
    Att bygga hälsokunskap från konsultationsrum till onlineforum2021In: Tala om kroppen: språkliga perspektiv på hälsa och sjukdom i den digitala eran / [ed] Inga-Lill Grahn; Camilla Lindholm, Stockholm: Morfem , 2021, p. 109-137Chapter in book (Other academic)
  • 28. Bergander, L
    et al.
    Wahlström, Niklas
    Södertörn University, Avdelning Naturvetenskap. Karolinska Institutet.
    Alsberg, T
    Bergman, Jan
    Södertörn University, Avdelning Naturvetenskap. Karolinska Institutet.
    Rannug, A
    Rannug, U
    Characterization of in vitro metabolites of the aryl hydrocarbon receptor ligand 6-formylindolo[3,2-b] carbazole by liquid chromatography-mass spectrometry and NMR.2003In: Drug Metabolism And Disposition, ISSN 0090-9556, E-ISSN 1521-009X, Vol. 31, no 2, p. 233-241Article in journal (Refereed)
    Abstract [en]

    The tryptophan photoproduct 6-formylindolo[3,2-b] carbazole (FICZ) exhibits the highest aryl hydrocarbon receptor (AhR) binding affinity reported so far. In different cells, in vitro, both extracts of UV-irradiated tryptophan and the synthesized pure compound FICZ induce a rapid and transient expression of AhR-regulated genes. The transient induction suggests that the biotransformation gene battery induced by AhR activation takes part in a metabolic degradation of the ligand, whereby a low steady-state level is regained. The down-regulation of AhR-regulated gene expression was previously shown to be dependent on cytochrome P450 1A1 (CYP1A1). Metabolism of FICZ generates five major metabolites, which appeared as three peaks (M1-M3) in the high performance liquid chromatography. The aim of the present study was to use rat liver S9 from Aroclor-pretreated rats to produce large enough quantities of FICZ metabolites for structure characterization and to determine their product precursor relationship. NMR analysis of large combined fractions of the metabolites indicated that M3 and M2 contained 2 isomers, respectively. By means of liquid chromatography-mass spectrometry (negative ion electrospray mode) and NMR spectroscopy (by H-1-NMR, correlation spectroscopy, and nuclear Overhauser effect spectroscopy techniques) five metabolites of FICZ were identified, and their structures were elucidated. The molecular weights of the two M3 isomers were 300 and both M2 and M1 compounds demonstrated molecular weights of 316, corresponding to addition of one (M3) and of two oxygen (M2 and M1), respectively. The structures were assigned as 2- and 8-hydroxy (M3), 2,10- and 4,8-dihydroxy (M2) and 2,8-dihydroxy derivatives of indolo[3,2-b] carbazole-6-carboxaldehyde (6-formylindolo[ 3,2-b] carbazole).

  • 29.
    Bergfeldt, Vendela
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Microbes that never sleep: A multidisciplinary study of the antibiotic resistance management in Sweden2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The hypotheses of this study are that reduction and rational usage of antibiotics reduces development of antibiotic resistance. In Sweden, the trends do not follow this pattern. Despite a decrease in prescriptions of antibiotics, there is an increase in the number of patients infected with Methicillin-resistant Staphylococcus Aureus (MRSA), Extended Spectrum Beta-Lactamases (ESBL) and ESBL selecting for carbapenem-resistance (ESBLCARBA). This study aims to study factors affecting antibiotic resistance management. An additional aim is to use a multidisciplinary approach for a subject that has mostly been studied with quantitative methods. First, linear regressions investigated any possible significant changes of prescription rates in outpatient care, hospital usage of antibiotic groups and antibiotic resistance. After this, nine interviews were conducted with physicians in outpatient care, hospital care and with representatives from the Swedish Strategic Programme for the Rational Use of Antimicrobial Agents and Surveillance of Resistance (Strama), a network working for Swedish prevention against antibiotics resistance. There was a significant decrease in the number of prescriptions of antibiotics in outpatient care among all Swedish counties and a small, but significant increase of antibiotics used in hospitals. The number of patients infected with multidrug resistant bacteria also show a significant increase. The interviews revealed that health care workers in all counties follow the same guidelines and try to be as specific as possible in choosing antibiotics to hit specific bacteria. The respondents suggested migration and extended travelling as explanations to the growing number of cases of multidrug resistant bacteria. Further, two major factors emerged as important for an efficient antibiotic resistance management; Education/knowledge and Discussion. The results indicate a need for further research on rational usage of antibiotics and the use of broad-spectrum antibiotics in hospital care, rather than the reduction through prescriptions. The results indicate that rational usage has a bigger impact than reduction. Using a multidisciplinary approach gave a broader perspective on the issue and future studies should see the possibilities of mixing quantitative and qualitative studies.

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  • 30.
    Berglund, Erik
    et al.
    Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Friberg, Emilie
    Karolinska Institutet, Sweden.
    Engblom, Monika
    Karolinska Institutet, Sweden.
    Andersén, Åsa
    Uppsala University, Sweden.
    Svärd, Veronica
    Södertörn University, School of Social Sciences, Social Work. Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Coordination and Perceived Support for Return to Work: A Cross-Sectional Study among Patients in Swedish Healthcare2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 7, article id 4040Article in journal (Refereed)
    Abstract [en]

    Background: Receiving support from a return-to-work (RTW) coordinator (RTWC) may be beneficial for people on long-term sick leave. The aim of this study was to investigate whether the number of contacts with an RTWC and their involvement in designing rehabilitation plans for the patients were associated with perceiving support for RTW, emotional response to the RTWC, and healthcare utilization. Methods: In this cross-sectional study, 274 patients who had recently been in contact with an RTWC in Swedish primary or psychiatric care answered questions regarding their interaction with an RTWC, perceived support for RTW, and emotional response to the RTWC. Results: Having more contact with an RTWC was associated with perceiving more support in the RTW process (adjusted OR 4.14, 95% CI 1.49–11.47). RTWC involvement in designing a rehabilitation plan for the patient was associated with perceiving more support in the RTW process from an RTWC and having a more positive emotional response to the RTWC. Conclusions: From the patient’s perspective, this study indicates that the involvement of an RTWC and receiving a rehabilitation plan that an RTWC has helped to design might be perceived as important in the RTW process.

  • 31.
    Berglund, Erik
    et al.
    Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Friberg, Emilie
    Karolinska Institutet, Sweden.
    Engblom, Monika
    Karolinska Institutet, Sweden.
    Svärd, Veronica
    Södertörn University, School of Social Sciences, Social Work. Karolinska Institutet, Sweden; Karolinska University Hospital, Sweden.
    Physicians’ experience of and collaboration with return-to-work coordinators in healthcare: a cross-sectional study in Sweden2023In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Purpose: Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians.  The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics.

    Materials and methods: Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs.

    Results: Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RtWcs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification.

    Conclusions: Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RtW stakeholders and improvements in the sickness certification process may be of importance for physicians.

  • 32. Bergström, R.
    et al.
    Sparén, Pär
    Södertörn University, Avdelning 4, SCOHOST (Stockholm Centre on Health of Societies in Transition). Karolinska Institute.
    Adami, H. -O
    Trends in cancer of the cervix uteri in Sweden following cytological screening1999In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 81, no 1, p. 159-166Article in journal (Refereed)
    Abstract [en]

    Trends in cervical cancer incidence following the introduction of screening have mostly been studied using cross-sectional data and not analysed separately for squamous cell cancer and adenocarcinomas. Using Swedish nationwide data on incidence and mortality, we analysed trends during more than 3 decades and fitted Poisson-based age-period-cohort models, and also investigated whether screening has reduced the incidence of adenocarcinomas of the cervix. The incidence of reported cancer in situ increased rapidly during 1958-1967. Incidence rates of squamous cell cancer, fairly stable before 1968, decreased thereafter by 4-6% yearly in women aged 40-64, with a much smaller magnitude in younger and older women. An age-cohort model indicated a stable 70-75% reduction in incidence for women born 1940 and later compared with those born around 1923. The incidence of adenocarcinomas doubled during the 35-year study period. The mortality rate increased by 3.6% before 1968 and decreased by 4.0% yearly thereafter. Although a combination of organized and opportunistic screening can reduce the incidence of squamous cell cancer substantially, the incidence of adenocarcinomas appears uninfluenced by screening.

  • 33.
    Björk, Ragnar
    Södertörn University College, School of Gender, Culture and History, History.
    Nobelsystemet: Karolinska institutet och Nobelpriset i medicin till Hugo Theorell 19552007In: Lychnos, ISSN 0076-1648, p. 43-62Article in journal (Refereed)
  • 34.
    Björkehag, Jonathan
    et al.
    Södertörn University College, School of Business Studies.
    Seglare, Kristin
    Södertörn University College, School of Business Studies.
    Innovationssystem för medicinsk teknik i Stockholm: En undersökning av centrala omständigheter för organisatorisk samverkan2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction In order to foster innovation of medical devices within the healthcare sector, a collaboration project, PUSH, has been initiated including the hospitals managed by the Stockholm County Council. The collaboration aims to capture ideas from employees and turn them into so called “high-practice” products as well as facilitate the possibilities for medical device companies to try out their products in the settings of healthcare. Collaborations for innovation, comparable to the PUSH project, can be found in both Swedish and foreign regions, but some of them fail to survive due to obstacles affecting the progress of each collaboration. Avoiding the same destiny will be a challenge to the PUSH project.

    Purpose The purpose is to search for factors affecting organizational collaboration concerning innovation systems for medical device development. The study is focusing on ”high-practice” products within the PUSH project.

    Theoretical approach In order to emphasize factors affecting innovation, theories regarding innovation systems, clusters and networks has been studied hence they  all concern organizational collaboration.

    Method The study’s qualitative approach is based on a semi deductive method. The analysis derives from a deductive outlook consistent with chosen theories, whereas collected data is used inductively to stress and enlarge part of the theoretical framework. Semi structured interviews, earlier research and evaluations constitutes most of the collected data.

    Results and analysis Experience from collaborations for innovation shows that some affecting factors can’t be influenced by collaborators, as political decisions and medical device directives. Collaborators can however affect circumstances such as connections and networking, which is significant to manage the innovation process; from idea to commercialization. An explicit focus on commercialization is important to the collaboration project’s surviving opportunities. A central cause why innovation projects don’t last is lack of funding, both for commercializing certain products as well as for retaining and developing existing innovation structures.

    Conclusion Collaborating projects should utilize existing structures and complement their networks to involve extensive competency. Decision makers need to decide whether innovation ventures shall be part of the County Council’s assignment. To fulfil the visions of the collaboration project, a policy common to all participants in the forthcoming innovation project needs to be stated, regarding ownership relations, risk sharing, funding and sharing of profits.

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  • 35.
    Björkehag, Jonathan
    et al.
    Södertörn University College, School of Business Studies.
    Seglare, Kristin
    Södertörn University College, School of Business Studies.
    Karolinska Testbädd för Telemedicin och eHälsa: En analys av medicintekniska företags behov och krav på en samverkansmiljö för produktutveckling på Karolinska Universitetssjukhuset2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The purpose is to study the demand for a testbed for telemedicine and to analyze the medical device-developing companies’ requirements on the testbed’s facilities when collaborating with the healthcare sector in their product development. The study’s aim is to result in a commercialization plan for Karolinska Testbed for telemedicine and eHealth, at the department of Biomedical Engineering at Karolinska University Hospital. During the study, 19 interviews and 6 telephone-interviews has been held with people from the medical device industry, hospitals, potential funders and collaboration structures which foster medical device development. A web-survey has been sent to 279 companies within the fields of medical technologies, IT and telecom, to quantify the results from the interviews.

    The study describes how the clinical research on medical technologies has changed over the last decades and what the situation is like today. Present and forthcoming challenges to the Swedish health care system is presented, like demographic changes, increasing healthcare-costs, expensive treatments and the scarcity of medical device innovations being commercialized. Obstacles affecting the medical device development are studied, including the regulatory differences between IT and medical devices. An analysis of the research on product and service development is also looked at from the perspectives on how the medical device companies develop their products, which is derived from both interviews and the web-survey.

    The result shows that medical device companies rely upon the ability to collaborate with the hospitals in different phases of their product development process and that there is an extensive need for a testbed structure amongst companies. The companies that collaborate with hospitals do it primarily because it makes their products more adaptive to functioning in the settings of healthcare, time to market and development costs can be decreased and it facilitates the process when validating the functionality of their products. Several companies have their ways of collaborating with hospital wards whilst others explicitly lack indispensable collaboration structures. The study has identified some companies which have shown interest in collaborating with Testbed Karolinska for telemedicine and eHealth and other ones whom wish to receive more information on what the testbed can offer them. In the commercialization plan it is suggested that Karolinska Testbed for telemedicine and eHealth shall focus on their niche and elaborate the competency which the companies doesn’t have. It is also suggested that the Testbed continues the work with developing the internal organization within Karolinska to enable efficient, flexible and qualitative collaboration between companies and the clinics at Karolinska University Hospital.

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    Karolinska Testbädd för Telemedicin och eHälsa : J Björkehag, K Seglare
  • 36.
    Blomqvist Mickelsson, Tony
    Södertörn University, School of Police Studies.
    Sports clubs’ role in community capacity development: illustrations from the Swedish sports movement2024In: Community Development Journal, ISSN 0010-3802, E-ISSN 1468-2656Article in journal (Refereed)
    Abstract [en]

    Strong political neoliberal currents in Sweden are directing attention toward communities’ responsibility to address local issues, particularly in disadvantaged areas. In parallel, community sports clubs in Sweden have gained strong traction as being sites where social issues can be addressed. In Swedish disadvantaged areas, where infrastructure is of poor quality, these clubs can be an important addition to statutory interventions, but they need to be further explored in terms of strategic pathways and conditions. Community sports have only recently been conceptualized with Chaskin’s capacity-building concept. In this paper, I seek to further stimulate this line of inquiry. By using material from two interrelated projects with informants in the sports movement, I show how sports clubs use multiple strategies according to three of Chaskin’s proposed strategies: leadership development, organizational development, and inter-organizational collaboration. By outlining an empirically dense illustration, this paper contributes to the research on sports clubs and their role in the community and provides suggestions on how strategical assessments must include how associations develop strategies online.

  • 37.
    Blomqvist Mickelsson, Tony
    Södertörn University, School of Social Sciences, Social Work.
    Towards Understanding Post-Socialist Migrants’ Access to Physical Activity in the Nordic Region: A Critical Realist Integrative Review2021In: Social Sciences, E-ISSN 2076-0760, Vol. 10, no 12, article id 452Article, review/survey (Refereed)
    Abstract [en]

    Experiences of, and access and barriers to, physical activity (PA) differ between individuals. This becomes perpetuated in a migration context. Although there is super-diversity between migrant groups, health research rarely accounts for this cultural diversity. More concerningly, the matter of context is rarely scrutinized or juxtaposed with the specifics of certain ethnic groups. This integrative review assessed the evidence on post-socialist migrants’ PA levels, constraints, and enablers for PA in the Nordic region. The results show that post-socialist female migrants have an especially high risk of being physically inactive. The qualitative work elucidates socio-cultural factors that impose specific constraints on females when attempting to engage in PA. Furthermore, in scrutinizing the context, Nordic nature (Friluftsliv) is a viable way for migrants to access PA with additional health benefits (e.g., mental). However, the Nordic environment also poses specific PA challenges, such as harsh winters. This can be understood by considering post-socialist migrants’ prior use of, and attitude to, nature. The review highlights the importance of understanding specifics about both migrant groups and contexts through a critical-realist lens in the pursuit of providing PA opportunities. Future PA programs need to understand the contextual, sociohistorical, and cultural settings in which they and migrants are embedded.

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  • 38.
    Blomqvist Mickelsson, Tony
    Södertörn University, School of Social Sciences, Social Work.
    Ukrainian refugees and the Swedish sports movement: new opportunities and challenges2023In: European Sport Management Quarterly, ISSN 1618-4742, E-ISSN 1746-031XArticle in journal (Refereed)
    Abstract [en]

    Research Question: The war in Ukraine has forced approximately eight million people into neighboring European countries. As part of sports clubs’ societal commitment, many have received Ukrainian refugees. However, compared to previous so-called ‘refugee waves’, forced migration from Ukraine is different in terms of demographics, culture, and (sports) traditions. This paper aimed to assess these ‘new’ nuances and their implications for the European sports movement. Research Methods: Data were gathered through 17 semi-structured interviews with Swedish sports club representatives, analyzed with a critical realist-inspired thematic analysis, and interpreted with Bronfenbrenner’s process-person-context-time framework. Results and Findings: The representatives expressed that Ukrainian refugees are more in-tune with organized sports compared to other refugee populations; however, there are also culturally discrepant ideas about sports. Specifically, there seems to be an influx of skilled (youth) refugees, who approach sports in ways incompatible with Swedish conventions about youth sports. While the sporting capital often enables easier inclusion, it also presents challenges in extreme cases. Implications: The findings show that the European sports movement must be attentive to new challenges and opportunities associated with the current humanitarian crisis. Sports representatives need to balance culturally sensitive approaches with ethical considerations regarding youth sports. 

  • 39.
    Blomqvist Mickelsson, Tony
    et al.
    Södertörn University, School of Social Sciences, Social Work.
    Stylin, Pilo
    Swedish Budo and Martial Arts Confederation, Stockholm, Sweden.
    Integrating Rough-and-Tumble Play in Martial Arts: A Practitioner's Model2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 731000Article in journal (Refereed)
    Abstract [en]

    This paper introduces a model that explains psychosocial development by embedding the developmental concept of rough-and-tumble play (RTP) into the contextual settings of martial arts (MA). Current sport-for-change literature relies on theories that address contextual factors surrounding sport but agrees that sport in itself does not facilitate developmental outcomes. In contemporary times where western societies invest substantial resources in sport programs for their psychosocial contribution, this becomes problematic. If the contextual factors surrounding sport are exclusively what produce developmental outcomes, what is the rationale for investing resources in sport specifically? We challenge this idea and argue that although contextual factors are important to any social phenomena, the developmental outcomes from sport can also be traced to the corporeal domain in sport. To date, we have lacked the theoretical lenses to articulate this. The developmental concept of RTP emphasizes how "play fighting" between consenting parties stimulates psychosocial growth through its demand for self-regulation and control when "play fighting" with peers. In short, RTP demands that individuals maintain a self-regulated mode of fighting and is contingent on a give-and-take relationship to maintain enjoyment. RTP can thus foster empathy and prosocial behavior and has strong social bonding implications. However, such play can also escalate. A fitting setting to be considered as moderated RTP is MA because of its resemblance to RTP, and its inherent philosophical features, which emphasizes self-regulation, empathy, and prosocial behavior. This paper outlines what constitutes high-quality RTP in a MA context and how this relates to developmental outcomes. By doing so, we present a practitioner's framework in which practitioners, social workers, and physical educators can explain how MA, and not merely contextual factors, contributes toward developmental outcomes. In a time where sport is becoming increasingly politicized and used as a social intervention, it too becomes imperative to account for why sport, and in this case, MA, is suitable to such ends.

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  • 40.
    Bonds, Olivia
    Södertörn University College, School of Discourse Studies.
    Mobbning: ur flera perspektiv2007Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Det finns elever som trycker ner andra i sin omgivning. När det är dags för rast finns det de som säger ”vad äcklig du är” och skrattar åt sin jämnåriga skolkamrat. Samtidigt sprider sig nya tekniker som gör skolan ännu mer försvarslös mot mobbning än tidigare. Inte ens i det egna hemmet kan ett barn vara garanterad att få slippa sin plågoande. Vad är egentligen mobbning? Hur tänker en mobbare? Och hur ser en vanlig skolmiljö ut år 2007?

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  • 41. Brooks, Andrew J
    et al.
    Johansson, Magnus
    Södertörn University College, Avdelning Naturvetenskap.
    Criswell, Erin
    Jans, David A
    Vasudevan, Subhash G
    The Interdomain Region of Dengue NS5 ProteinInteracts with NS3 and Host Proteins2002In: Dengue Bulletin, ISSN 1020-895X, Vol. 26, p. 155-161Article in journal (Other academic)
    Abstract [en]

    Although dengue virus genome replication occurs in the cytoplasm of infected cells, it has been shown that the NS5 protein (RNA-dependent RNA polymerase) is hyperphosphorylated at a late stage in infection and localized to the cell nucleus. A 37 amino acid sequence of NS5 (residues 369-405) was shown to contain a functional nuclear localization signal (NLS) that interacted with the cellular nuclear transport factor, importin α/β heterodimer. Further studies using the yeast two-hybrid system revealed that the NS5 region (residues 320-368) immediately adjacent to the NLS contained an importin β-binding site that abuts or overlaps the binding site for the NS3 protein (protease/helicase). The importin β-binding site has also been shown to be a functional NLS (bNLS). Intriguingly, when both bNLS and NLS (residues 320-405) were present, the fused β -galactosidase protein did not accumulate in the nucleus. Here we provide a review of our studies on the NS5 interdomain region and compare it to other members of the Flavivirus genus in order to highlight the importance of this region as a possible target for developing broad-acting antiviral agent against dengue and other mechanistically-related viruses.

  • 42. Brooks, Andrew J
    et al.
    Johansson, Magnus
    James Cook University.
    John, Anna V
    Xu, Yibin
    Jans, David A
    Vasudevan, Subhash G
    The interdomain region of dengue NS5 protein that binds to the viral helicase NS3 contains independently functional importin beta 1 and importin alpha/beta-recognized nuclear localization signals.2002In: Journal of Biological Chemistry, ISSN 0021-9258, E-ISSN 1083-351X, Vol. 277, no 39, p. 36399-36407Article in journal (Refereed)
    Abstract [en]

    Dengue virus NS5 protein is a multifunctional RNA-dependent RNA polymerase that is essential for virus replication. We have shown previously that the 37- amino acid interdomain spacer sequence (residues (369)X(2)KKX(14)KKKX(11)RKX(3)405) of Dengue2 NS5 contains a functional nuclear localization signal (NLS). In this study, beta-galactosidase fusion proteins carrying point mutations of the positively charged residues or truncations of the interdomain linker region (residues 369-389 or residues 386-405) were analyzed for nuclear import and importin binding activities to show that the N-terminal part of the linker region (residues 369-389, a/bNLS) is critical for nuclear localization and is recognized with high affinity by the conventional NLS-binding importin alpha/beta heterodimeric nuclear import receptor. We also show that the importin beta-binding site (residues 320-368, bNLS) adjacent to the a/bNLS, previously identified by yeast two-hybrid analysis, is functional as an NLS, recognized with high affinity by importin beta, and able to target beta-galactosidase to the nucleus. Intriguingly, the bNLS is highly conserved among Dengue and related flaviviruses, implying a general role for the region and importin beta in the infectious cycle.

  • 43.
    Bräutigam, Lars
    et al.
    Södertörn University, School of Life Sciences, Molecular biology.
    Hillmer, Janine M.
    Södertörn University, School of Life Sciences, Molecular biology.
    Söll, Iris
    Södertörn University, School of Life Sciences, Molecular biology.
    Hauptmann, Giselbert
    Södertörn University, School of Life Sciences, Molecular biology.
    Localized Expression of Urocortin Genes in the Developing Zebrafish rain2010In: Journal of Comparative Neurology, ISSN 0021-9967, E-ISSN 1096-9861, Vol. 518, no 15, p. 2978-2995Article in journal (Refereed)
    Abstract [en]

    The corticotropin-releasing hormone (CRH) family consists of four aralogous genes, CRH and urocortins (UCNs) 1, 2, and 3. In a previous tudy, we analyzed CRH in the teleost model organism zebrafish and its ranscript distribution in the embryonic brain. Here, we describe ull-length cDNAs encoding urotensin 1 (UTS1), the teleost UCN1 rtholog, and UCN3 of zebrafish. Major expression sites of uts1 in adult ebrafish are the caudal neurosecretory system and brain. By using T-PCR analysis, we show that uts1 mRNA is also present in ovary, aternally contributed to the embryo, and expressed throughout embryonic evelopment. Expression of ucn3 mRNA was detected in a range of adult issues and during developmental stages from 24 hours post fertilization nward. Analysis of spatial transcript distributions by whole-mount in itu hybridization revealed limited forebrain expression of uts1 and cn3 during early development. Small numbers of uts1-synthesizing eurons were found in subpallium, hypothalamus, and posterior iencephalon, whereas ucn3-positive cells were restricted to elencephalon and retina. The brainstem was the main site of uts1 and cn3 synthesis in the embryonic brain. uts1 Expression was confined to he midbrain tegmentum; distinct hindbrain cell groups, including locus oeruleus and Mauthner neurons; and the spinal cord. ucn3 Expression was ocalized to the optic tectum, serotonergic raphe, and distinct hombomeric cell clusters. The prominent expression of uts1 and ucn3 in rainstem is consistent with proposed roles of CRH-related peptides in tress-induced modulation of locomotor activity through monoaminergic rainstem neuromodulatory systems. J. Comp. Neurol. 518:2978-2995, 2010.

  • 44.
    Burbano, X.
    et al.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Miguez, M. J.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Lecusay, Robert
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Rodriguez, A.
    University of Miami School of Medicine, Department of Medicine, Miami, FL, United States.
    Ruiz, P.
    University of Miami School of Medicine, Department of Medicine, Miami, FL, United States.
    Morales, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Castillo, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Baum, M.
    Florida International University, College of Health Dietetics and Nutrition, Miami, FL, United States.
    Shor-Posner, G.
    University of Miami School of Medicine, Division of Disease Prevention, Department of Psychiatry and Behavioral Sciences, Miami, FL, United States.
    Thrombocytopenia in HIV-infected drug users in the HAART era2001In: Platelets, ISSN 0953-7104, E-ISSN 1369-1635, Vol. 12, no 8, p. 456-461Article in journal (Refereed)
    Abstract [en]

    The present case-control study compared 26 HIV+ drug users having persistent thrombocytopenia (TCP< 150 000/mm(3)) with 54 available age, gender and HIV CDC classification matched controls with normal platelet counts. Participants were followed longitudinally over a 2-year period (1998-2000), and hematological alterations evaluated in relationship to antiretroviral treatment, drug use and nutritional (selenium) status. Demographic information and medical history, including antiretroviral treatment were obtained. Blood was drawn for complete cell blood count, T lymphocytes and viral load. Sixty-nine percent of the individuals with persistent TCP and 49% of the controls were receiving antiretrovirals. At baseline, no significant differences in CD4 existed between the two groups. Over time, CD4 cell count declined in the cases (P = 0.05) and a significantly higher proportion of the cases (38%) developed AIDS (CD4< 200 cell/mm(3)), as compared to the controls (18%, P = 0.004). A high risk for development of thrombocytopenia was observed with specific drug use (heroin 2.96 times, P = 0.0007), selenium levels below 145 mug/l (6 times, P = 0.008), and abnormal liver enzyme (SGOT) levels (2 times, P = 0.002). Together, these results indicate a number of factors that may be sensitive predictors of thrombocytopenia, which, despite antiretroviral treatment, appears to be related to more rapid disease progression in drug users.

  • 45. Burström, Bo
    et al.
    Macassa, Gloria
    Öberg, Lisa
    Södertörn University, Avdelning 1, Centre for Studies in Practical Knowledge.
    Bernhardt, Eva
    Smedman, Lars
    Barnadödlighet, fattigdom och sanitära reformer: Stockholm 1878-19252003In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 80, no 3, p. 209-215Article in journal (Refereed)
  • 46. Burström, Bo
    et al.
    Macassa, Gloria
    Öberg, Lisa
    Södertörn University, Institutionen för medier, konst och filosofi.
    Bernhardt, Eva
    Smedman, Lars
    Equitable child health interventions: the impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925.2005In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 95, no 2, p. 208-216Article in journal (Refereed)
    Abstract [en]

    Today, many of the 10 million childhood deaths each year are caused by diseases of poverty--diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality. In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.

  • 47. Burström, Bo
    et al.
    Öberg, Lisa
    Södertörn University, School of Culture and Communication.
    The dialectics of childhood diarrhea mortality2006In: International Journal of Health Services, ISSN 0020-7314, E-ISSN 1541-4469, Vol. 36, no 3, p. 481-501Article in journal (Refereed)
    Abstract [en]

    As in European countries a century ago, diarrhea is a major cause of child mortality in poor countries today. In Stockholm at the turn of the 19th century, political commitment, infrastructural investments in water and sanitation, and enforcement of sanitary improvements by a strong implementing organization helped eliminate diarrhea as a principal cause of death among children. These interventions also had an equitable impact on social class differences in diarrhea mortality, but not on overall mortality; overall mortality declined, but class differences remained. General infrastructural improvement and health education coupled with targeted interventions to vulnerable children may be successful in improving child health and reducing social differentials in mortality. Specific health care interventions may need to be complemented by infrastructural investments to improve water and sanitation if diarrhea mortality is to be further reduced in poor countries today.

  • 48. Burström, Bo
    et al.
    Öberg, Lisa
    Södertörn University, Lärarutbildningen.
    Smedman, Lars
    Policy measures and the survival of foster infants in Stockholm 1878-19252012In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 22, no 1, p. 56-60Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: At the end of the 19th century, infant mortality was high in urban and rural areas in Sweden. In Stockholm, the mortality rate was particularly high among foster children. This study addresses the importance for health of targeted public policies and their local implementation in the reduction of excess mortality among foster children in Stockholm at the turn of the 19th century. In response to public concern, a law was passed in 1902 on inspections of foster homes. Stockholm city employed a handful of inspectors who visited foster homes and advised parents on child care and feeding. METHODS: Analysis of historical records from the City of Stockholm was combined with epidemiological analysis of mortality rates and hazard ratios on individual-level data for 112 746 children aged <1 year residing in one part of Stockholm between 1878 and 1925. Hazard ratios of mortality were calculated using Cox' regression analysis. RESULTS: Mortality rates of foster infants exceeded 300/1000 before 1903. Ten years later the mortality rates among foster children had declined and were similar to other children born in and out of wedlock. Historical accounts and epidemiological analysis of individual-level data over a longer time period showed similar results. CONCLUSIONS: Targeted policy measures to foster children may have potentiated the positive health effects of other universal policies, such as improved living conditions, clean water and sanitation for the whole population in the city, contributing to an equalization of mortality rates between different groups.

  • 49.
    Carlson, Per
    Södertörn University, School of Sociology and Contemporary History, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Relatively poor, absolutely ill?: A study of regional income inequality in Russia and its possible health consequences2005In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 59, no 5, p. 389-394Article in journal (Refereed)
    Abstract [en]

    Study objective: To investigate whether the income distribution in a Russian region has a "contextual" effect on individuals' self rated health, and whether the regional income distributions are related to regional health differences. Methods: The Russia longitudinal monitoring survey (RLMS) is a survey (n = 7696) that is representative of the Russian population. With multilevel regressions both individual as well as contextual effects on self rated health were estimated. Main results: The effect of income inequality is not negative on men's self rated health as long as the level of inequality is not very great. When inequality levels are high, however, there is a tendency for men's health to be negatively affected. Regional health differences among men are in part explained by regional income differences. On the other hand, women do not seem to be affected in the same way, and individual characteristics like age and educational level seem to be more important. Conclusions: It seems that a rise in income inequality has no negative effect on men's self rated health as long as the level of inequality is not very great. On the other hand, when inequality levels are higher a rise tends to affect men's health negatively. A curvilinear relation between self rated health and income distribution is an interesting hypothesis. It could help to explain the confusing results that arise when you look at countries with a high degree of income inequality (USA) and those with lower income inequality (for example, Japan and New Zealand).

  • 50.
    Carlson, Per
    Stockholms universitet.
    Self-rated health in East and West Europe: Another European health divide?2000In: Self-rated health in a European perspective / [ed] Nilsson P, Orth-Gomér K, Stockholm: Forskningsrådsnämnden , 2000, p. 77-84Chapter in book (Other academic)
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