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  • 151.
    Löfmark, Sonja
    et al.
    Karolinska Institute.
    Jernberg, Cecilia
    Södertörn University, School of Life Sciences. Karolinska Institute.
    Jansson, Janet K.
    Swedish University of Agricultural Sciences.
    Edlund, Charlotta
    Karolinska Institute / Medical Products Agency.
    Clindamycin-induced enrichment and long-term persistence of resistant Bacteroides spp. and resistance genes2006In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 58, no 6, p. 1160-1167Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to study the long-term consequences of 1 week clindamycin administration regarding selection and persistence of resistance, resistance determinants and diversity of the Bacteroides spp. in the intestinal microflora. Methods: A total of 1306 Bacteroides isolates were collected from constitutively cultured faecal samples during a 2 year period from eight healthy volunteers. The strains were identified by biochemical and genotyping methods. MIC values were determined by the agar dilution method and presence of resistance genes was screened by real-time PCR. Results: Ecological changes in the intestinal microflora persisting up to 24 months were recorded after a 7 day clindamycin administration to four healthy volunteers. Compared to a control group, not exposed to clindamycin, an enrichment and stabilization of resistant Bacteroides strains and resistance determinants were discovered up to 2 years after clindamycin exposure. Conclusions: The results indicate that even a short-term antibiotic administration can cause long-term alterations in the commensal microbiota of individual subjects, detectable 2 years after dosing. The recorded selection and persistence of resistant strains and resistance genes, illustrates the importance of increasing our knowledge of the role of the abundant intestinal microbial community as a reservoir for spread of resistance.

  • 152. Mackenbach, J. P.
    et al.
    Kulhánová, I.
    Bopp, M.
    Deboosere, P.
    Eikemo, T. A.
    Hoffmann, R.
    Kulik, M. C.
    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, P.
    Menvielle, G.
    Regidor, E.
    Wojtyniak, B.
    Östergren, O.
    Lundberg, O.
    Variations in the relation between education and cause-specific mortality in 19 European populations: A test of the "fundamental causes" theory of social inequalities in health2015In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, no 127, p. 51-62Article in journal (Refereed)
    Abstract [en]

    Link and Phelan have proposed to explain the persistence of health inequalities from the fact that socioeconomic status is a "fundamental cause" which embodies an array of resources that can be used to avoid disease risks no matter what mechanisms are relevant at any given time. To test this theory we compared the magnitude of inequalities in mortality between more and less preventable causes of death in 19 European populations, and assessed whether inequalities in mortality from preventable causes are larger in countries with larger resource inequalities. We collected and harmonized mortality data by educational level on 19 national and regional populations from 16 European countries in the first decade of the 21st century. We calculated age-adjusted Relative Risks of mortality among men and women aged 30-79 for 24 causes of death, which were classified into four groups: amenable to behavior change, amenable to medical intervention, amenable to injury prevention, and non-preventable. Although an overwhelming majority of Relative Risks indicate higher mortality risks among the lower educated, the strength of the education-mortality relation is highly variable between causes of death and populations. Inequalities in mortality are generally larger for causes amenable to behavior change, medical intervention and injury prevention than for non-preventable causes. The contrast between preventable and non-preventable causes is large for causes amenable to behavior change, but absent for causes amenable to injury prevention among women. The contrast between preventable and non-preventable causes is larger in Central & Eastern Europe, where resource inequalities are substantial, than in the Nordic countries and continental Europe, where resource inequalities are relatively small, but they are absent or small in Southern Europe, where resource inequalities are also large. In conclusion, our results provide some further support for the theory of "fundamental causes". However, the absence of larger inequalities for preventable causes in Southern Europe and for injury mortality among women indicate that further empirical and theoretical analysis is necessary to understand when and why the additional resources that a higher socioeconomic status provides, do and do not protect against prevailing health risks.

  • 153. Mackenbach, Johan P.
    et al.
    Kunst, Anton E.
    Groenhof, Feikje
    Borgan, Jens-Kristian
    Costa, Giuseppe
    Faggiano, Fabrizio
    Jozan, Peter
    Leinsalu, Mall
    Södertörn University College, Avdelning 4, Sociology.
    Martikainen, Pekka
    Rychtarikova, Jitka
    Valkonen, Tapani
    Socioeconomic inequalities in mortality among women and among men: an international study1999In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 89, no 12, p. 1800-1806Article in journal (Refereed)
  • 154. Mackenbach, Johan P
    et al.
    Stirbu, Irina
    Roskam, Albert-Jan R
    Schaap, Maartje M
    Menvielle, Gwenn
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonia .
    Kunst, Anton E
    Socioeconomic inequalities in health in 22 European countries2008In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 358, no 23, p. 2468-2481Article in journal (Refereed)
    Abstract [en]

    We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

  • 155.
    Mackenbach, Johan P.
    et al.
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Valverde, Jose Rubio
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Bopp, Matthias
    University of Zürich, Zürich, Switzerland.
    Bronnum-Hansen, Henrik
    University of Copenhagen, Copenhagen, Denmark.
    Deboosere, Patrick
    rije Universiteit Brussel, Brussels, Belgium.
    Kalediene, Ramune
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Kovacs, Katalin
    Hungarian Demographic Research Institute, Budapest, Hungary.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change). ational Institute for Health Development, Tallinn, Estonia.
    Martikainen, Pekka
    University of Helsinki, Helsnki, Finland.
    Menvielle, Gwenn
    INSERM, Sorbonne Universités, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France.
    Regidor, Enrique
    niversidad Complutense de Madrid, Madrid, Spain / CIBER Epidemiologí y Salud Püblica, Madrid, Spain.
    Nusselder, Wilma J.
    University Medical Center Rotterdam, Rotterdam, Netherlands.
    Determinants of inequalities in life expectancy: an international comparative study of eight risk factors2019In: The Lancet Public Health, ISSN 2468-2667, Vol. 4, no 10, p. E529-E537Article in journal (Refereed)
    Abstract [en]

    Background Socioeconomic inequalities in longevity have been found in all European countries. We aimed to assess which determinants make the largest contribution to these inequalities. Methods We did an international comparative study of inequalities in risk factors for shorter life expectancy in Europe. We collected register-based mortality data and survey-based risk factor data from 15 European countries. We calculated partial life expectancies between the ages of 35 years and 80 years by education and gender and determined the effect on mortality of changing the prevalence of eight risk factors-father with a manual occupation, low income, few social contacts, smoking, high alcohol consumption, high bodyweight, low physical exercise, and low fruit and vegetable consumption-among people with a low level of education to that among people with a high level of education (upward levelling scenario), using population attributable fractions. Findings In all countries, a substantial gap existed in partial life expectancy between people with low and high levels of education, of 2.3-8.2 years among men and 0.6-4.5 years among women. The risk factors contributing most to the gap in life expectancy were smoking (19.8% among men and 18.9% among women), low income (9.7% and 13.4%), and high bodyweight (7.7% and 11.7%), but large differences existed between countries in the contribution of risk factors. Sensitivity analyses using the prevalence of risk factors in the most favourable country (best practice scenario) showed that the potential for reducing the gap might be considerably smaller. The results were also sensitive to varying assumptions about the mortality risks associated with each risk factor. Interpretation Smoking, low income, and high bodyweight are quantitatively important entry points for policies to reduce educational inequalities in life expectancy in most European countries, but priorities differ between countries. A substantial reduction of inequalities in life expectancy requires policy actions on a broad range of health determinants.

  • 156.
    Manhica, H.
    et al.
    Röda Korsets Högskola.
    Niemi, M.
    Karolinska Institutet.
    Gunnarsson, David
    Södertörn University, School of Historical and Contemporary Studies, Ethnology.
    Ståhle, Göran
    Södertörn University, School of Historical and Contemporary Studies, Study of Religions.
    Larsson, S.
    Röda Korsets Högskola.
    Saboonchi, F.
    Röda Korsets Högskola.
    Social participation, mental health in refugees and asylum seekers: A scoping review2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 482-482Article in journal (Other academic)
  • 157.
    Masembe, Melissa
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    The effectiveness of the Stockholm needle exchange programme: Does the Stockholm needle exchange programme control HIV, Hepatitis B, and Hepatitis C in intravenous drug users?2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND:

    The needle exchange programme (NEP) started in Sweden in 1986 in Lund and shortly after in Malmo. The first NEP in Stockholm opened in spring 2013. The NEP is a service aimed at intravenous drug users (IDU) from 18 years old, with a goal of preventing the blood borne diseases, such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV). With the on going HIV and Hepatitis epidemics, numerous countries around the world have adopted control strategies, such as the NEP to halt the spread of HIV, HBV, and HCV. The objective of this study was to examine if the needle exchange programme has decreased the incidence of HIV, HBV, and HCV in Sweden over a six-year period. 

    METHODS:

    Data for incidence and prevalence was extracted from the yearly reports of the Stockholm’s needle exchange programme from 2013 to 2018 and the yearly reports of the public health agency in Sweden from 2013 to 2018. The data was collected for Stockholm, and compared to Västra Götaland, and the whole of Sweden.

    RESULTS:

    The incidence of HIV was zero in 2013 and 2015 in the NEP. The incidence of HBV decreased to zero in 2013 in the NEP. There is an increased incidence of HCV in the NEP.

    CONCLUSION:

    The NEP has a protective effect through its combination of needle exchange, opiate substitute therapy, counselling, and vaccinations in reducing and stabilising incidences of the infections, in some instances to zero, as well as providing surveillance and treating infections.

  • 158.
    Melik, Wessam
    et al.
    Södertörn University, School of Life Sciences. Stockholm University.
    Nilsson, A S
    Johansson, Magnus
    Södertörn University, School of Life Sciences.
    Detection strategies of tick-borne encephalitis virus in Swedish Ixodes ricinus reveal evolutionary characteristics of emerging tick-borne flaviviruses.2007In: Archives of Virology, ISSN 0304-8608, E-ISSN 1432-8798, Vol. 152, no 5, p. 1027-1034Article in journal (Refereed)
    Abstract [en]

    The flaviviral tick-borne encephalitis virus (TBEV) is a human pathogen having significant impact on public health. The geographical distribution of TBEV and TBEV-like viruses is increasing, which makes it important to characterise the natural virus populations. Here we present four RT-PCR strategies designed for detection of broad types of tick-borne flaviviruses. Sequence information on more than 32% of a TBEV genome was generated from a small pool of ticks collected in the Stockholm archipelago on the island of Torö. The sequences were characterised and compared with those of other tick-borne flaviviruses, which classified the virus as Western European TBEV.

  • 159.
    Mengal, Muhammad Hashim
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Infectious disease control knowledge and practice among health care workers in Bolan Medical College Hospital Quetta Pakistan.2014Independent thesis Advanced level (degree of Master (One Year)), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Background Hospital-acquired infections are significant cause of morbidity and mortality among hospitalized patients worldwide. Healthcare workers during job are exposed to blood borne pathogens through contact with infected body parts, blood and body fluids. World health organization (WHO) estimated that globally about 2.5% of HIV and 40% of hepatitis viral infected cases are among health workers due to exposures. The most important mechanism of spread of these pathogens is through contaminated hands of the healthcare workers. Standard precautions measures are essential to prevent and control healthcare associated infection among healthcare workers and patients. In developing countries despite the development of detailed guideline for infection control the knowledge of standard precautions is low and not properly applied. The aim of this study is to assess the knowledge and practice of health care workers regarding standard precautions and hand hygiene to infectious disease control. 

    Aim The aim of this study was to assess the knowledge and practice of health care workers regarding hand wash and standard precautions to control infectious diseases in BMCH. In addition create awareness among participants and encourage them to practice regularly hand hygiene and standard precautions to control or reduce nosocomial infections in health care facilities

    Methods The study design is cross-sectional evaluation of healthcare worker knowledge and practices about standard precautions and hand hygiene for infectious disease control. A questionnaire administered to health care workers (doctors and nurses). The questionnaire was divided in two parts and the first part concerns demographic information, asking knowledge and practice. The second part asked opinions about risk and prevention of HAIs. The questionnaire was developed with consultation of other studies of the same kind. It has been pre tested and is finalized for survey. The ethical approval was given by hospital superintendent and informs consent from all study participants. Statistic analysis was done on Excel and statistical software SPSS version 20. Data was described in numbers, percentages and Chi Square test done for association among categorical variables, significant level was considered P= <0.05.

    Results Two hundred questionnaires were distributed to HCWs in BMCH and 169 completely fill questionnaire were returned. The male gender respondents were 42% and female respondents were 58%. The basic questions about knowledge of hand hygiene and standard precautions were answered well in both categories; about 73% were with sufficient knowledge. The practice of hand hygiene and standard precautions was not satisfactory among both categories; about 47% found with good practice. Differences found in sub groups, young age none trained doctors and nurses answered wrong and shown lack of knowledge. This study found an association of age, profession and job experience with knowledge and practice regarding hand hygiene and standard precautions. Open handed questions described well the major issue regarding HAIs and participants emphasized on risk and prevention methods. 

    Conclusions The respondents were HCWs (doctors and nurses) of both sex and this study found that majority of HCWs have good knowledge and practice about control of HAIs but difference were found in age groups, sex and profession. Above half of the HCWs were not trained for infection control in health facilities, thus getting training of infection control is important but more important is implementation of it during practice.

     

  • 160. Menvielle, Gwen
    et al.
    Stirbu, Irina
    Roskam, Albert-Jan
    Schaap, Maartje M.
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). National Institute for Health Development, Tallinn, Estonie .
    Kunst, Anton E.
    Mackenbach, Johan P.
    Les inégalités socials de mortalité en Europe: [Socioeconomic inequalities in mortality in Europe]2009In: M S.Médecine Sciences, ISSN 0767-0974, E-ISSN 1958-5381, Vol. 25, no 2, p. 192-196Article in journal (Refereed)
  • 161. Modin, Bitte
    et al.
    Vågerö, Denny
    Hallqvist, Johan
    Koupil, Ilona
    The contribution of parental and grandparental childhood social disadvantage to circulatory disease diagnosis in young Swedish men2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, p. 822-834Article in journal (Refereed)
  • 162. Modin, Bitte
    et al.
    Vågerö, Denny
    Hallqvist, Johan
    Koupil, Ilona
    The contribution of parental and grandparental childhood social disadvantage to circulatory disease diagnosis in young Swedish men2008In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 66, p. 822-834Article in journal (Refereed)
    Abstract [en]

    Men born out of wedlock in early twentieth century Sweden who never married have previously been shown to have a doubled mortality risk from ischaemic heart disease compared to the corresponding group of men born to married parents. This study further explores the question of childhood social disadvantage and its long-term consequences for cardiovascular health by examining the two subsequent generations. The question posed is whether the sons and grandsons of men and women born out of wedlock in early twentieth century Sweden have an increased risk of circulatory disease compared with the corresponding descendants of those born inside marriage. We examined this by use of military conscription data. The material used is the Uppsala Birth Cohort Multigenerational database consisting of individuals born at Uppsala University Hospital between 1915 and 1929 (UG1), their children (UG2) and grandchildren (UG3). Conscription data were available for UG2s born between 1950 and 1982 (n = 5,231) and UG3s born between 1953 and 1985 (n = 10,074) corresponding to 72.1% and 73.6%, respectively, of all males born in each time-period. Logistic regression showed that significant excess risk of circulatory disease diagnoses was present only among descendants of men born outside marriage, with sons and grandsons demonstrating odds ratios of 1.64 and 1.83, respectively, when BMI and height at the time of conscription, father's social class in mid-life and father's or grandfather's history of circulatory disease had been adjusted for. Separate analyses showed that the effect of the maternal and paternal grandfather was of approximately the same magnitude. Further analyses revealed an interaction between the father's social class and the grandfather's legitimacy status at birth on UG3-men's likelihood of having a circulatory disease, with elevated odds only among those whose fathers were either manual workers or self-employed. The results of this study suggest that social disadvantage in one generation can be linked to health disadvantage in the subsequent two generations.

  • 163. Modin, Bitte
    et al.
    Vågerö, Denny
    Koupil, Ilona
    The impact of early twentieth century illegitimacy across three generations: Longevity and intergenerational health correlates.2009In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 68, no 9, p. 1633-1640Article in journal (Refereed)
    Abstract [en]

    This study contributes to the understanding of how social mortality patterns are reproduced across generations by documenting associations of women's marital status at childbirth in the beginning of last century with selected health indicators across three subsequent generations of their offspring, and by highlighting a special set of plausible mechanisms linked to this particular event in history. We use the Multigenerational Uppsala Birth Cohort Study (UBCoS) database consisting of 12,168 individuals born at Uppsala University Hospital in 1915-1929 (UG1), their children (UG2) and grandchildren (UG3). Results showed that men and women born outside wedlock (BOW) in early twentieth century Sweden were at an increased risk of adult mortality compared to those who were born in wedlock (BIW), and the men were also significantly less likely to reach their 80th birthday. The question of childhood social disadvantage and its long-term consequences for health is then taken one step further by examining their offspring in two subsequent generations in terms of four specific anthropometric and psychological outcomes at the time of military conscription, all known to predict disease and mortality later in life. Results showed that sons of men BOW as well as sons and grandsons of women BOW had significantly lower psychological functioning and cognitive ability. Regarding body mass index and height, however, significant associations were found only among descendants of men BOW. The anthropometric and psychological disadvantages found among descendents of individuals BOW were partly mediated by their social class background. The four outcomes observed early in the lives of UG2s and UG3s do in fact constitute early health determinants, each potentially influencing longevity and mortality risk in these generations. We conclude that the social disadvantage imposed on those BOW in early twentieth century Sweden appears to be reproduced as a health disadvantage in their children and grandchildren, with likely consequences for mortality among these.

  • 164.
    Molin, Jenny
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    From Policy to Action: A study on the implementation of gender policies and a gender perspective in Swedish humanitarian assistance work2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    More than a decade has now passed since the concept of “gender mainstreaming” and polices addressing a gender perspective first appeared on the international agenda, yet evaluations on these policies’ implementation show that progress has been slow in the field of humanitarian assistance. As executive workers, the humanitarian field staff have in policy documents been identified as crucial actors in the “gender mainstreaming” work, however, no previous research have been found evaluating their achievements in the field.

    This study examines if formulated gender policies, within Swedish humanitarian organisations and agencies, are implemented and translated into action in the field. This was carried out by investigating Swedish humanitarian fieldworkers’ gender sensitiveness and experiences of working with a gender perspective in the field. The empirical material was collected from qualitative deep interviews with ten fieldworkers from four different humanitarian organisations/agencies. The interview data was then analysed by using a theoretical framework based on Gender theory, Postcolonial feminist theory and Policy implementation theory.

    The results show that even though most of the interviewed fieldworkers mean that they are aware of gender issues and the importance of using a gender perspective in the field, they have a general low understanding of the gender concept. An emerging “cultural sensitivity versus gender policy implementation” dilemma was valid and possibly affecting the informants’ attempts to act on formulated policies. Moreover, the method that the organisations/agencies use when educating staff on gender issues seem to have an impact on this dilemma. It became apparent that the fieldworkers underestimate their own responsibility in using a gender perspective in the field; at the same time the organisations/agencies overestimate their workers’ capacity to implement their gender policies. Much also indicate on how a still old-fashioned gender discourse is produced, and reproduced, in gender policy formulations and among the fieldworkers. In conclusion, it seems like a gap occur between the initial intention of a policy, its formulation, interpretation and the final intervention result.

  • 165.
    Nid, Nora
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Water quality in southwest rural areas of Morocco: A field-study2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Former studies of water quality in southwest Morocco shows that some water sources in the rural region of Agadir are affected by intrusion bringing chemical values above normal in drinking water of the villagers. In this study, I want to investigate if the intrusion also creates increasing exposure of microorganisms and water borne diseases among the villagers. In a field- study, face to face interviews following a questionnaire were used to gather socioeconomic, clinical and water use information about the subjects living in the study area. Water sampling was made in 10 rural areas around Agadir. PH, conductivity and temperature were measured directly at the water locations. These parameters were re-measured at the chemical laboratory of Ibn Zohr University using traditional analytical methods. Additional chemical analysis (Bicarbonate, Calcium, Magnesium, Potassium, Sodium, Sulfate, Nitrate, and Chlorine) were also made at the university.

    The bacterial analysis (microorganisms at 22 ºC and 37 ºC, Coliform bacteria, Echerichia coli, Intestinal enterococci and Clostridium perfingens) was made with the same water sampling approach as the chemical analysis adding 1 random urban district for comparison. Water samples for bacterial analysis were analyzed within 24 hours at Veto lab using ISO methods according to NM 7899-2, 6461-2, 9308-1, and 6222. The results show that all rural water samples according to the guidelines for drinking water are classified as non- drinkable and the urban water sample is classified as drinkable. The rural respondents state that they do not collect their drinking water from the sample sources but this does not exclude increased exposure to contaminated water and the increased risk of getting infected by microorganisms through the use of contaminated sources for bathing, washing, swimming, cleaning, and cleaning feeding utensils. My conclusion is that further investigation must be made on different sources of contamination and existing factors that generates the growth of microorganisms in the rural wells along with recommendations for policy makers, surveillance managers, clinicians and laboratory staff to prevent any potential waterborne outbreaks among rural villagers in southwest Morocco.

  • 166.
    Niemi, Maria
    et al.
    Karolinska Institutet.
    Manhica, Hélio
    Karolinska Institutet.
    Gunnarsson, David
    Södertörn University, School of Historical and Contemporary Studies, Ethnology.
    Ståhle, Göran
    Södertörn University, School of Historical and Contemporary Studies, Study of Religions.
    Larsson, Sofia
    Swedish Red Cross University College.
    Saboonchi, Fredrik
    Swedish Red Cross University College / Karolinska Institutet.
    A Scoping Review and Conceptual Model of Social Participation and Mental Health among Refugees and Asylum Seekers2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 20, article id E4027Article, review/survey (Refereed)
    Abstract [en]

    Social participation plays a key role in the integration of refugees and asylum seekers into their host societies, and is also closely tied to the mental health of those populations. The aim of this scoping review was to study how the concept of social participation is described in empirical research, and how it is associated with mental health outcomes.

    METHODS: In total, 64 studies were identified through searches in PubMed, PsycInfo, and Sociological Abstracts. These studies describe various forms of social participation among refugees and asylum seekers, and 33 of them also addressed various forms of mental health outcomes.

    RESULTS: The identified studies described forms and conditions of social participation-both in the host country and transnationally-that could be synthesized into three broad dimensions: (1) Regulatory frameworks, conditions and initiatives; (2) Established societal organizations and social structures; and (3) Community organized groups. Each of these consisted of several sub-domains. The identified dimensions of social participation were also associated with psychosocial well-being and decreased psychological distress.

    CONCLUSIONS: There is a need for policies to enable and support the participation of refugees and asylum seekers in various dimensions of social structures in host societies. Social participation enhances resilience, re-establishes social lives, and acts as a protective factor against poor mental health outcomes.

  • 167.
    Niemi, Maria
    et al.
    Karolinska Institutet, Department of Public Health Science / Integrative Care Science Center, Järna.
    Ståhle, Göran
    Södertörn University, School of Historical and Contemporary Studies, Study of Religions. Integrative Care Science Center, Järna.
    The use of ayurvedic medicine in the context of health promotion: A mixed methods case study of an Ayurvedic centre in Sweden2016In: BMC Complementary and Alternative Medicine, ISSN 1472-6882, E-ISSN 1472-6882, Vol. 16, no 1, article id 62Article in journal (Refereed)
    Abstract [en]

    Background

    Ayurveda has its historical roots in India, but has also been internationalised, partly via migration and partly through an increased interest in alternative medicine in the West, where studies point toward increased use. However, there is to date scarce knowledge about the use and experiences of ayurveda in Sweden.

    Methods

    We have conducted a case study of a center for ayurvedic healthcare in Sweden. We have collected information on client background data from the center’s documentation, and compiled data from all clients who visited the centre for ayurvedic consultation during spring 2014. In total, 55 individuals were included in the study, and 18 of them were chosen for individual semi-structured interviews, to gain a deeper understanding of their motives for seeking, and experiences of ayurvedic health care. The material was analysed and compiled through a mix of qualitative and quantitative methods.

    Results

    Among the 55 clients, 91 % were female the mean age was 47 years, and 64 % gave a specific illness as a reason for seeking ayurveda. The most common illnesses were respiratory, musculoskeletal, circulatory, tumor, and cutaneous illnesses. The qualitative results showed that ayurveda was being used in combination with other methods, including various diets, other alternative medicine methods and conventional medicine. Some participants recounted having sought ayurveda as a complement to conventional medicine, or in cases when conventional medicine had been experienced as insufficient in terms of diagnosis or treatment. However, some participants experienced it as difficult to follow the ayurvedic life-style advice in the midst of their everyday life. Many participants reported positive experiences of pulse diagnostics, which was the main diagnostic method used in ayurvedic consultation. Some reported concrete, physical improvement of their symptoms.

    Conclusions

    This study points towards important aspects of participant experience of ayurveda, that may be subject to further research. The positive effects experienced by some clients should be studied more systematically in order to discern whether they are specific or non-specific.

  • 168.
    Nilsson, Erika
    Södertörn University College, School of Discourse Studies.
    Vem ska laga dina tänder?2006Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Polska tandläkare i Sverige och svenska tandläkare i England. Gränserna i Europa öppnas alltmer. I den här artikelserien om framtidens tandvård berättar en polsk tandläkare om sin flytt till Sverige. Du möter en tandläkarstudent som blivit av med sin tandläkarskräck och en klinikchef som inte tycker att han är särskilt bra. Vi börjar på lågpriskliniken City Dental, som satt igång debatten.

  • 169.
    Nilsson, Mikael
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    The Hidden Victims of Disasters: Avoiding Stress-Related Disorders among Swedish Relief Workers through Preparedness2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Since September 11, 2001, the focus on health among relief workers has become an important issue. The focus on mental health has caught the attention of researchers and as a fairly new research area, there are still many issues that need to be answered. This study evaluates the preparation of relief workers in two Swedish organizations (Swedish Civil Contingency Agency and Swedish Red Cross) by investigating how these preparations contribute in avoiding stress-related disorders among relief workers. The organizations were evaluated by comparing data of preparations, collected from interviews and documents, with a criteria mostly based on Walsh (2009) and scholars from the Antares Foundation Guidelines (2012). Compared to the criteria the organizations' strengths are found in information of the operation with the score 9 out of 10 (which is the fulfillment of the criteria). SRC's weakness is the education of relief workers with the score 6 out of 10. MSB is relatively strong in that category, but weaker in requirements for employment with 2 out of 4 points. However, these weaknesses must not obscure the overall good results for both MSB and SRC. This study establishes that the preparation of relief workers, in two of the most important relief organizations in Sweden, is good. However, further research is necessary to facilitate the creation of generally recognized guidelines for how to prepare relief workers.

  • 170.
    Nilsson, Torbjörn
    Södertörn University College, Avdelning 3, Institute of Contemporary History.
    Hundra år med idrottsfolk i rörelse2003In: Idrott, historia och samhälle, ISSN 0280-2775, p. 128-132Article in journal (Other academic)
  • 171.
    Nilsson, Torbjörn
    Södertörn University College, School of Sociology and Contemporary History, Institute of Contemporary History.
    Staten och idrotten: politiskt inflytande eller aktiv neutralitet?2004In: Idrott, historia och samhälle, ISSN 0280-2775, p. 132-137Article in journal (Other academic)
  • 172.
    Nugent, Rebecca L.
    et al.
    University of Southern California.
    Johnsson, Anna
    Södertörn University, School of Life Sciences, Molecular biology. Karolinska Intitutet.
    Fleharty, Brian
    Stowers Institute for Medical Research.
    Gogol, Madelaine
    Stowers Institute for Medical Research.
    Xue-Franzen, Yongtao
    Södertörn University, School of Life Sciences, Molecular biology. Karolinska Institutet.
    Seidel, Chris
    Stowers Institute for Medical Research.
    Wright, Anthony P. H.
    Södertörn University, School of Life Sciences, Molecular biology. Karolinska Institutet.
    Forsburg, Susan L.
    University of Southern California.
    Expression profiling of S. pombe acetyltransferase mutants identifies redundant pathways of gene regulation2010In: BMC Genomics, ISSN 1471-2164, E-ISSN 1471-2164, Vol. 11, article id 59Article in journal (Refereed)
    Abstract [en]

    Background: Histone acetyltransferase enzymes (HATs) are implicated in egulation of transcription. HATs from different families may overlap in arget and substrate specificity. esults: We isolated the elp3(+) gene encoding the histone cetyltransferase subunit of the Elongator complex in fission yeast and haracterized the phenotype of an Delta elp3 mutant. We examined genetic nteractions between Delta elp3 and two other HAT mutants, Delta mst2 nd Delta gcn5 and used whole genome microarray analysis to analyze heir effects on gene expression. onclusions: Comparison of phenotypes and expression profiles in single, ouble and triple mutants indicate that these HAT enzymes have verlapping functions. Consistent with this, overlapping specificity in istone H3 acetylation is observed. However, there is no evidence for verlap with another HAT enzyme, encoded by the essential mst1(+) gene.

  • 173. Oh, H
    et al.
    Nord, C E
    Barkholt, L
    Hedberg, M
    Edlund, Charlotta
    Södertörn University, Avdelning Naturvetenskap.
    Ecological disturbances in intestinal microflora caused by clinafloxacin, an extended-spectrum quinolone2000In: Infection. Zeitschrift für Klinik und Therapie der Infektionen, ISSN 0300-8126, E-ISSN 1439-0973, Vol. 28, no 5, p. 272-277Article in journal (Refereed)
    Abstract [en]

    Background: The quinolones developed over the past few years have enhanced in vitro activity and a broader spectrum of antimicrobial activity compared to ma ny other antimicrobial agents including the older quinolones. The present study focuses on the effect of clinafloxacin, a member of the new broad-spectrum quinolone class of antibiotics, on the normal intestinal microflora. Subjects and Methods: A total of it healthy volunteers received clinafloxacin orally, zoo mg twice daily for 7 days. Fecal specimens were collected at defined intervals before, during and after the administration in order to study the effect of clinafloxacin on the intestinal microflora and to correlate this effect with fecal clinafloxacin concentrations. Intestinal microorganisms isolated before, during and 2 weeks after clinafloxacin administration were tested for their suseptibility to clinafloxacin. Results: Oral administration of clinafloxacin resulted in high drug levels in feces (mean value 176.2 mg/kg on day 7) and pronounced ecological disturbances. The aerobic microflora was eradicated in 11 of the 12 subjects and the anaerobic microflora was strongly suppressed during administration. There was a significant emergence of clinafloxacin-resistant Bacteroides spp, strains (MIC greater than or equal to 4 mg/ml) during administration. The elevated MIC values still remained 2 weeks after discontinuation of the antibiotic (p < 0.001). Conclusion: The emergence of clinafloxacin-resistant Bacteroides spp. demonstrates the necessity of restricting prescription for particular indications in order to preserve the efficacy of the highly active broad-spectrum quinolones.

  • 174.
    Oh, Hans
    et al.
    University of Southern California , Los Angeles , CA , USA.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre for Health and Social Change).
    Lincoln, Karen D
    University of Southern California , Los Angeles , CA , USA.
    Koyanagi, Ai
    Universitat de Barcelona, Fundació Sant Joan de Deu , Barcelona , Spain / CIBERSAM , Madrid , Spain.
    Allergies, infections, and psychiatric disorders among Black Americans: findings from the National Survey of American Life2019In: Ethnicity and Health, ISSN 1355-7858, E-ISSN 1465-3419, p. 1-9Article in journal (Refereed)
    Abstract [en]

    Objectives: An emerging body of literature shows that allergies and infections are associated with psychiatric disorders, though there is little research to confirm these associations among Black Americans in the United States. Design: We analyzed data from the National Survey of American Life, and used multivariable logistic regression models to examine the associations between past 12-month allergies/infections and past 12-month psychiatric disorders, adjusting for socio-demographic characteristics, tobacco use, lifetime diabetes, and body mass index. Results: We found that allergies/infections were associated with mood, anxiety, and eating disorders, but not alcohol or substance use disorders. We detected effect modification by ethnicity, with stronger odds for mood, anxiety disorders, and alcohol use disorders, with no significant associations for substance use or eating disorders among Caribbean Blacks. Conclusions: Our findings underscore the importance of screening for psychiatric disorders among Black individuals complaining of allergies/infections, and the need to also treat allergies/infections among people with psychiatric disorders.

  • 175. Oja, Leila
    et al.
    Matsi, Ardo
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Estonian Health Interview Survey 2006: Methodological report2008Report (Other academic)
  • 176. Olin Lauritzen, Sonja
    et al.
    Svenaeus, FredrikSödertörn University, Institutionen för medier, konst och filosofi, Centre for Studies in Practical Knowledge.Jonsson, Ann-Christin
    När människan möter medicinen: livsvärldens och berättelsens betydelse för förståelsen av sjukdom och medicinsk teknologi2004Collection (editor) (Other academic)
  • 177.
    Olsson, Ida
    et al.
    Södertörn University, School of Life Sciences.
    Berrez, Jean-Marc
    Södertörn University, School of Life Sciences.
    Leipus, Arunas
    CHORI, Children's Hospital Oakland Research Institute, Oakland, USA / Umeå University.
    Östlund, Cecilia
    Columbia University, New York, USA.
    Mutvei, Ann
    Södertörn University, School of Life Sciences.
    The arginine methyltransferase Rmt2 is enriched in the nucleus and co-purifies with the nuclear porins Nup49, Nup57 and Nup1002007In: Experimental Cell Research, ISSN 0014-4827, E-ISSN 1090-2422, Vol. 313, no 9, p. 1778-1789Article in journal (Refereed)
    Abstract [en]

    Arginine methylation is a post-translational modification of proteins implicated in RNA processing, protein compartmentalization, signal transduction, transcriptional regulation and DNA repair. In a screen for proteins associated with the nuclear envelope in the yeast Saccharomyces cerevisiae, we have identified the arginine methyltransferase Rmt2, previously shown to methylate the ribosomal protein L12. By indirect immunofluorescence and subcellular fractionations we demonstrate here that Rmt2 has nuclear and cytoplasmic localizations. Biochemical analysis of a fraction enriched in nuclei reveals that nuclear Rmt2 is resistant to extractions with salt and detergent, indicating an association with structural components. This was supported by affinity purification experiments with TAP-tagged Rmt2. Rmt2 was found to co-purify with the nucleoporins Nup49, Nup57 and Nup100, revealing a novel link between arginine methyltransferases and the nuclear pore complex. In addition, a genome-wide transcription study of the rmt2 Delta mutant shows significant downregulation of the transcription of MYO1, encoding the Type II myosin heavy chain required for cytokinesis and cell separation.

  • 178.
    Onischenko, Evgeny A.
    et al.
    Södertörn University, School of Life Sciences. Karolinska Institute.
    Crafoord, Ellinor
    Södertörn University, School of Life Sciences. Karolinska Institute.
    Hallberg, Einar
    Södertörn University, School of Life Sciences.
    Phosphomimetic mutation of the mitotically phosphorylated serine 1880 compromises the interaction of the transmembrane nucleoporin gp210 with the nuclear pore complex2007In: Experimental Cell Research, ISSN 0014-4827, E-ISSN 1090-2422, Vol. 313, no 12, p. 2744-2751Article in journal (Refereed)
    Abstract [en]

    The nuclear pore complexes (NPCs) reversibly disassemble and reassemble during mitosis. Disassembly of the NPC is accompanied by phosphorylation of many nucleoporins although the function of this is not clear. It was previously shown that in the transmembrane nucleoporin gp210 a single serine residue at position 1880 is specifically phosphorylated during mitosis. Using amino acid substitution combined with live cell imaging, time-lapse microscopy and FRAP, we investigated the role of serine 1880 in binding of gp210 to the NPC in vivo An alanine subtitutions mutant (S1880A) was significantly more dynamic at the NPC compared to the wild-type protein, suggesting that serine 1880 is important for binding of gp210 to the NPC. Moreover a glutamate substitution (S1880E) closely mimicking phosphorylated serine specifically interfered with incorporation of gp210 into the NPC and compromised its post-mitotic recruitment to the nuclear envelope of daughter nuclei. our findings are consistent with the idea that mitotic phosphorylation acts to dissociate gp210 from the structural elements of the NPC.

  • 179. Osby, U
    et al.
    Correia, N
    Brandt, L
    Ekbom, A
    Sparén, Pär
    Södertörn University.
    Mortality and causes of death in schizophrenia in Stockholm County, Sweden2000In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 45, no 1-2, p. 21-28Article in journal (Refereed)
    Abstract [en]

    A study of mortality for all patients with a first hospital diagnosis of schizophrenia in Stockholm County, Sweden, during 1973 to 1995 was performed, by linking the in-patient register with the national cause-of-death register. Overall and cause-specific standardized mortality ratios (SMR) were calculated by 5-year age classes and 5-year calendar time periods. The number of excess deaths was calculated by reducing the observed number of deaths by those expected. Our results confirmed a marked increase in mortality in schizophrenia both in males and females. Natural (somatic) causes of death was the main cause of excess deaths, with more than half of the excess deaths in females, and almost half of the excess deaths in males. Suicide was the specific cause of the largest number of excess deaths in males, while in females it was cardiovascular disease. SMRs were increased in both natural and unnatural causes of death, with 2.8 for males and 2.4 for females for all deaths, but were highest in suicide with 15.7 for males and 19.7 for females, and in unspecified violence with 11.7 for males and 9.9 for females. SMRs in suicide were especially high in young patients in the first year after the first diagnosis.

  • 180. Osby, U
    et al.
    Hammar, N
    Brandt, L
    Wicks, S
    Thinsz, Z
    Ekbom, A
    Sparén, Pär
    Södertörn University.
    Time trends in first admissions for schizophrenia and paranoid psychosis in Stockholm County, Sweden2001In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 47, no 2-3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Several studies have reported decreasing time trends in first diagnosed schizophrenia patients. The aim of this: study was to analyze time trends for first admissions with a diagnosis of schizophrenia or a diagnosis of either schizophrenia or paranoid psychosis during 1978-1994 in Stockholm County, Sweden, with a population of around 1.8 million. Information about first psychiatric admission with the diagnosis schizophrenia or paranoid psychosis for residents of Stockholm County was obtained from the Swedish population-based psychiatric inpatient register. Age-adjusted average yearly changes in first hospitalization rates were estimated in a Poisson regression model. Time trends in first admission rates were calculated from 1978 to 1994, while admissions during 1971 to 1977 were observed only to eliminate later re-admissions. First admissions for schizophrenia declined by 1.9% annually for females and by 1.3% for males, while first admissions for schizophrenia and paranoid psychosis together were unchanged over the study period for both genders. Our results indicate that the incidence of schizophrenia and paranoid psychosis taken together was essentially the same over the studied time period in Stockholm County, and that the apparent decline in first admission rates for schizophrenia may be an effect of changes in clinical diagnosis over time.

  • 181.
    Pascalev, Assya
    et al.
    Bulgarian Center for Bioethics.
    de Jong, Jessica
    Central Division of the National Police, the Netherlands.
    Ambagtsheer, Frederike
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Lundin, Susanne
    Lund University.
    Ivanovski, Ninoslav
    University of St. Cyril and Methodius, Macedonia.
    Codreanu, Natalia
    Renal Foundation, Moldova.
    Gunnarson, Martin
    Södertörn University, School of Culture and Education, Centre for Studies in Practical Knowledge.
    Yankov, Jordan
    Bulgarian Center for Bioethics, Bulgaria.
    Frunza, Mihaela
    Academic Society for the Research of Religions and Ideologies, Romania.
    Byström, Ingela
    Lund University.
    Bos, Michael
    Eurotransplant International Foundation, the Netherlands.
    Weimar, Willem
    Erasmus MC University Hospital Rotterdam, the Netherlands.
    Trafficking in Human Beings for the Purpose of Organ Removal: A Comprehensive Literature Review2016In: 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)
  • 182.
    Pascalev, Assya
    et al.
    Bulgarian Center for Bioethics, Bulgaria.
    Van Assche, Kristof
    Bioethics Institute Ghent, Ghent University, Belgium.
    Sándor, Judit
    Center for Ethics and Law in Biomedicine, Central European University, Hungary.
    Codreanu, Natalia
    Renal Foundation, Moldova.
    Naqvi, Anwar
    Department of Urology and Centre of Biomedical Ethics and Culture, Sindh Institute of Urology and Transplantation, Pakistan.
    Gunnarson, Martin
    Avdelningen för etnologi, Institutionen för kulturvetenskaper, Lunds universitet.
    Frunza, Mihaela
    Academic Society for the Research of Religions and Ideologies, Romania.
    Yankov, Jordan
    Bulgarian Center for Bioethics, Bulgaria.
    Protection of Human Beings Trafficked for the Purpose of Organ Removal: Recommendations2016In: Transplantation Direct, ISSN 2373-8731, Vol. 2, no 2, p. 1-4, article id e59Article in journal (Refereed)
    Abstract [en]

    This report presents a comprehensive set of recommendations for protection of human beings who are trafficked for the purpose of organ removal or are targeted for such trafficking. Developed by an interdisciplinary group of international experts under the auspices of the project Trafficking in Human Beings for the Purpose of Organ Removal (also known as the HOTT project), these recommendations are grounded in the view that an individual who parts with an organ for money within an illegal scheme is ipso facto a victim and that the crime of trafficking in human beings for the purpose of organ removal (THBOR) intersects with the crime of trafficking in organs. Consequently, the protection of victims should be a priority for all actors involved in antitrafficking activities: those combating organ-related crimes, such as health organizations and survivor support services, and those combating trafficking in human beings, such as the criminal justice sectors. Taking into account the special characteristics of THBOR, the authors identify 5 key stakeholders in the protection of human beings trafficked for organ removal or targeted for such trafficking: states, law enforcement agencies and judiciary, nongovernmental organizations working in the areas of human rights and antitrafficking, transplant centers and health professionals involved in transplant medicine, and oversight bodies. For each stakeholder, the authors identify key areas of concern and concrete measures to identify and protect the victims of THBOR. The aim of the recommendations is to contribute to the development of a nonlegislative response to THBOR, to promote the exchange of knowledge and best practices in the area of victim protection, and to facilitate the development of a policy-driven action plan for the protection of THBOR victims in the European Union and worldwide.

  • 183.
    Pelto-Piri, V.
    et al.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    Engström, Karin
    Stockholm University.
    Engström, I.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    Paternalism, autonomy and reciprocity: Ethical perspectives in encounters with patients in psychiatric in-patient care2013In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 14, no 1, article id 49Article in journal (Refereed)
    Abstract [en]

    Background

    Psychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.

    Methods

    All staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.

    Results

    The majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.

    • Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.

    • Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.

    • Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.

    Conclusions

    Paternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision.

  • 184.
    Pelto-Piri, V.
    et al.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    Engström, Karin
    Stockholm University.
    Engström, I.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    Staffs' perceptions of the ethical landscape in psychiatric inpatient care: A qualitative content analysis of ethical diaries2014In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 9, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    This study presents a qualitative description of situations at work that staff members perceive as giving rise to ethical issues. All staff members working with patients across seven wards were given the opportunity to freely describe ethical considerations in an ethical diary over the course of one week. One hundred and five staff members kept a diary. The diaries were analysed with qualitative content analysis where four dominant themes emerged: good care, order and clarity, loyalty, and inadequacy. These results contain statements in which patients are respected and listened to, as well as statements that express a desire for relatively strict, routine-based care. Relatively few statements were of a reflective or discussing nature which highlights the need for clinical ethical support. There is a need of a visible and supportive leadership which encourages ethical reflection. Reflections on real cases could provide an opportunity to challenge existing practices and thereby promote ethical awareness.

  • 185.
    Pelto-Piri, V.
    et al.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    Engström, Karin
    Örebro University.
    Engström, I.
    Psychiatric Research Centre, Örebro County Council / Örebro University.
    The ethical landscape of professional care in everyday practice as perceived by staff: A qualitative content analysis of ethical diaries written by staff in child and adolescent psychiatric in-patient care2012In: Child and Adolescent Psychiatry and Mental Health, ISSN 1753-2000, E-ISSN 1753-2000, Vol. 6, article id 18Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Although there has been some empirical research on ethics concerning the attitudes and approaches of staff in relation to adult patients, there is very little to be found on child and adolescent psychiatric care. In most cases researchers have defined which issues are important, for instance, coercive care. The aim of this study was to provide a qualitative description of situations and experiences that gave rise to ethical problems and considerations as reported by staff members on child and adolescent psychiatric wards, although they were not provided with a definition of the concept.

    METHODS:

    The study took place in six child and adolescent psychiatric wards in Sweden. All staff members involved with patients on these wards were invited to participate. The staff members were asked to keep an ethical diary over the course of one week, and data collection comprised the diaries handed in by 68 persons. Qualitative content analysis was used in order to analyse the diaries.

    RESULTS:

    In the analysis three themes emerged; 1) good care 2) loyalty and 3) powerlessness. The theme 'good care' contains statements about the ideal of commitment but also about problems living up to the ideal. Staff members emphasized the importance of involving patients and parents in the care, but also of the need for professional distance. Participants seldom perceived decisions about coercive measures as problematic, in contrast to those about pressure and restrictions, especially in the case of patients admitted for voluntary care. The theme 'loyalty' contains statements in which staff members perceived contradictory expectations from different interested parties, mainly parents but also their supervisor, doctors, colleagues and the social services. The theme 'powerlessness' contains statements about situations that create frustration, in which freedom of action is perceived as limited and can concern inadequacy in relation to patients and violations in the workplace.

    CONCLUSIONS:

    The ethical considerations described by child and adolescent psychiatric care staff are multifaceted and remarkably often concern problems of loyalty and organization. These problems frequently had a considerable influence on the care provided. It seems that staff members lack a language of ethics and require both an ethical education and a forum for discussion of ethical issues.

  • 186.
    Petrov, Kristian
    Södertörn University, School of Culture and Communication, History of ideas. Södertörn University, Centre for Baltic and East European Studies (CBEES).
    Från blodbesudlat kolonialsocker till livsviktigt blodsocker: Svensk-europeiska teman i sockrets globala kulturhistoria2012In: RIG: Kulturhistorisk tidskrift, ISSN 0035-5267, E-ISSN 2002-3863, Vol. 95, no 3, p. 129-154Article in journal (Refereed)
    Abstract [en]

    "From Blood-Stained Colonial Sugar to Life-Essential Blood Sugar: Swedish-European Themes in the Global Cultural History of Sugar"

    Drawing on material cultural studies and classical intellectual history, a cultural history of sugar in Sweden and Europe is reconstructed. The aim is to identify the modern conceptualisations of sugar and historically analyse their dialectical sympathies and antipathies. What are the historical reasons for eating—or not eating—sugar, and how are these actualised today? Sugar’s history is followed from antiquity, the middle ages and the Enlightenment up till the present. Sugar was spread in wider European circles only from the 1600s onwards, which triggered various conflicts that in many respects are still current. Was sugar a medicine or a poison, essential or fatal? Sugar played a powerful role in the creation of European wealth and has become intrinsically connected to Western modernity. With a contrastive departure in Mintz (1986) it is shown how the conceptualisations of sugar have changed from signifying an exclusive medicine, spice and sweetener to an omnipresent food (more recently, it might also be referred to as a drug). Cookbooks indicate that sugar in Sweden was transformed into a mass-consumed food during the 1830s. One hundred years later sugar was among Swedish bureaucrats elevated into the utmost important foodstuff of the future, to which the country had committed itself. Increasing the prevalence and consumption of cheap, energy-rich and chemically pure sugar was considered modern, rational and ethical. By eating sugar a Swede could literally eat happiness, freedom and modernity. Even critics of sugar consumption have since the 18th century associated modernity with sugar. Sugar crystals embodied civilization’s inequality and degeneration. When scientists in the 1840s enthusiastically discovered that sugar in humans was transformed into ‘blood sugar’, a poetical motive from 1700s slavery criticism was ironically recycled, in which ‘sugar’ had been attributed with ‘blood’ in order to discourage people’s consumption. The medical identification of sugar (sucrose) and blood sugar (glucose) meant that sucrose increasingly was regarded as essential, which gradually helped to consolidate the prevailing idea of ​​carbohydrates as the primary energy source. Although preference for sweetness is genetic, cultural circumstances determine the forms and scope of sugar consumption. If sugar previously was a status marker of the aristocracy, it has accompanied by new medical discoveries increasingly become emblematic for the junk food of the underprivileged. Sugar’s white colour, purity, status of ‘blood sugar’, ethereal lightness and historic significance for national growth and autarky, are, however, examples of cultural factors which still legitimise sugar’s omnipresence in society. In today’s polarised debate about possible threshold values or penalty taxes, many opinions ventilated even in commercial, medical and public health discourses implicitly relate to older religious and cultural ideas and practices.

  • 187.
    Pettersson, Sara
    Södertörn University College, School of Life Sciences.
    Development of siRNA against the CYP1A1 gene for trap of endogenous Ah-receptor ligand2006Independent thesis Basic level (professional degree), 20 points / 30 hpStudent thesis
    Abstract [en]

    The aryl hydrocarbon receptor (Ah-receptor) is a member of the bHLH-PAS protein family. The Ah-receptor is a ligand dependent transcription factor, which activates a wide range of genes, most notably the xenobiotica metabolising genes, CYP1A1 and CYP1A2. The biological function of the Ah-receptor is still unknown and an endogenous ligand has yet not been identified. A possible Ah-receptor ligand is 6-formylindolo[3,2-b]carbazole (FICZ). FICZ has a high affinity for the Ah-receptor and is rapidly metabolised by CYP1A1, CYP1A2 and aldehydeoxidase (AOX). To try to trap FICZ or other possible endogenous Ah-receptor ligands, the metabolising enzymes CYP1A1, CYP1A2 and AOX were blocked. This was achieved through chemical blockage of CYP1A1 and CYP1A2 by ellepticin and through silencing with siRNA directed against CYP1A1 and CYP1A2. Successful blockage would be seen as an increase in Ah-receptor dependent XRE-luciferase activity. Chemical blockage of AOX with tungstate did not affect FICZ-dependent XRE-luciferase activation which could indicate that HepG2 cells lack AOX. The chemical blockage of CYP1A1 and CYP1A2 with ellepticin modified the XRE-luciferase response, but did not completely block Ah-receptor activation. In addition it is possible that ellepticin is a ligand for the Ah-receptor. The blockage of CYP1A1 by siRNA was successful; a silencing of CYP1A1 mRNA by at least 50 percent was detected. However due to lack of time it was not tested if the blockage of CYP1A1 and CYP1A2 was sufficient to trap Ah-receptor ligands.

  • 188.
    Petäjävaara, Ida
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    Sustainability and Health in Disaster Waste Management2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In order to see if, and how, future aid efforts can be improved and better contribute to a more sustainable and resilient society this essay is about how management of solid waste generated in emergency situations work and what effects the waste have on public health. This is investigated using information collected from secondary sources and interviews with three persons who have knowledge and experience in the subject. Health and sustainability are of importance in the guidelines that deal with management of waste in disaster situations. However, there are no documentations of real experiences of disaster waste impacts on human health. Even so the waste might contaminate drinking water and increase the amount of disease-carrying vectors in the area. Previous conditions in the country, low priority of waste and information to the public are some of the main features preventing optimal function of a sustainable and healthy waste management.

  • 189. Plug, Iris
    et al.
    Hoffmann, Rasmus
    Artnik, Barbara
    Bopp, Matthias
    Borrell, Carme
    Costa, Giuseppe
    Deboosere, Patrick
    Esnaola, Santi
    Kalediene, Ramune
    Leinsalu, Mall
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Lundberg, Olle
    Martikainen, Pekka
    Regidor, Enrique
    Rychtarikova, Jitka
    Strand, Bjorn Heine
    Wojtyniak, Bogdan
    Mackenbach, Johan P
    Socioeconomic inequalities in mortality from conditions amenable to medical interventions: do they reflect inequalities in access or quality of health care?2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, article id 346Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: BACKGROUND: Previous studies have reported large socioeconomic inequalities in mortality from conditions amenable to medical intervention, but it is unclear whether these can be attributed to inequalities in access or quality of health care, or to confounding influences such as inequalities in background risk of diseases. We therefore studied whether inequalities in mortality from conditions amenable to medical intervention vary between countries in patterns which differ from those observed for other (non-amenable) causes of death. More specifically, we hypothesized that, as compared to non-amenable causes, inequalities in mortality from amenable causes are more strongly associated with inequalities in health care use and less strongly with inequalities in common risk factors for disease such as smoking. Data and methods Cause-specific mortality data for people aged 30-74 years were obtained for 14 countries, and were analysed by calculating age-standardized mortality rates and relative risks comparing a lower with a higher educational group. Survey data on health care use and behavioural risk factors for people aged 30-74 years were obtained for 12 countries, and were analysed by calculating age-and sex-adjusted odds ratios comparing a low with a higher educational group. Patterns of association were explored by calculating correlation coefficients. RESULTS: In most countries and for most amenable causes of death substantial inequalities in mortality were observed, but inequalities in mortality from amenable causes did not vary between countries in patterns that are different from those seen for inequalities in non-amenable mortality. As compared to non-amenable causes, inequalities in mortality from amenable causes are not more strongly associated with inequalities in health care use. Inequalities in mortality from amenable causes are also not less strongly associated with common risk factors such as smoking. CONCLUSIONS: We did not find evidence that inequalities in mortality from amenable conditions are related to inequalities in access or quality of health care. Further research is needed to find the causes of socio-economic inequalities in mortality from amenable conditions, and caution should be exercised in interpreting these inequalities as indicating health care deficiencies.

  • 190. Podar, T
    et al.
    Solntsev, A
    Rahu, M
    Leinsalu, Mall
    Tuomilehto, J
    LaPorte, R E
    Mortality of childhood-onset IDDM patients in Estonia1996In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 39, no 10, p. 1238-1239Article in journal (Refereed)
  • 191. Pray, Leslie
    et al.
    Cohen, ClaraMäkinen, Ilkka HenrikSödertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).Värnik, AiriMacKellar, F. Landis
    Suicide in Eastern Europe, the CIS, and the Baltic Countries: Social and Public Health Determinants. A Foundation for Designing Interventions. Summary of a Conference2013Conference proceedings (editor) (Other academic)
  • 192.
    Rajput, Abdul Mateen
    Södertörn University College, School of Life Sciences.
    Histone modifications after DNA damage affect survival in Schizosaccharomyces pombe2010Independent thesis Advanced level (degree of Master (One Year)), 60 credits / 90 HE creditsStudent thesis
    Abstract [en]

    S. cerevisiae Ada2 and Bre1 has a role in histone post-translational modifications. Deletion of these genes causes deficiency in acetylation (Ada2) or ubiquitination (Bre1) of histones. Further, mutants lacking these genes or homologous genes showed different phenotypes in human and S. cerevisiae while treated with DNA damaging agents 4-NQO and MMS. Bre1 deficient cells showed 4-NQO sensitivity in S. cerevisiae and resistance in human cells. Since it has been shown that S. pombe is more close to mammals in chromatin regulation we wanted to examine S. pombe response against MMS and 4-NQO. By homologous recombination, genes were deleted and mutants were treated with different concentration of both the genotoxins. In accordance with a previous study, Ada2Δ showed sensitivity to MMS while Brl1Δ & Brl2Δ grew as wild type. Surprisingly, unlike S. cerevisiae, S. pombe showed resistance to 4-NQO and has a phenotype similar to the one found in human cells.

  • 193.
    Rashed, Ismail Ismail Ibrahim
    Södertörn University, School of Natural Sciences, Technology and Environmental Studies.
    The association between vitamin D deficiency and tuberculosis: Effects of different levels of vitamin D deficiency - A meta-analysis2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To conduct a systematic review and meta-analysis of all published studies studying the risk of vitamin D deficiency in tuberculosis patients and in healthy controls. Additionally, subgroup meta-analysis was performed based on the level of vitamin D to test the risk in TB groups and in healthy groups.

    Methods: Pubmed was searched for observational studies in human and English that discussed the association between risk of low serum vitamin D and TB. Meta-analysis was performed on all relevant studies combined and for subgroups of each vitamin D level.

    Results: 22 studies were selected and pooled in the analysis. The results were consistent with previous studies examining the same risk. The overall log risk ratio (log RR) of low vitamin D was significantly higher in TB patients 1.68 times than healthy controls. In 4 subgroup meta- analyses based on vitamin D level below (20 nmol/L, 30 nmol/L, 50 nmol/L, and 75 nmol/L), the risk of having low vitamin D in TB patients was (1.82, 2.89, 1.38, 1.32) respectively. That subgroup analysis showed more clearly the higher RR were below 20 and 30 nmol/L. The smallest RR was at 75 nmol/L level.

    Conclusion: This study verified the association between risk of low vitamin D level and TB development. It also clarified that, the risk increased by decreasing vitamin D level.

  • 194.
    Reile, R
    et al.
    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). The National Institute for Health Development, Tallinn, Estonia.
    Differentiating positive and negative self-rated health: results from a cross-sectional study in Estonia2013In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 58, no 4, p. 555-564Article in journal (Refereed)
  • 195.
    Reile, Rainer
    et al.
    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.
    Factors associated with improving diet and physical activity among persons with excess body weight2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, article id ckz170Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As overweight and obesity are highly prevalent in Eastern Europe, the study examined the trends and factors associated with self-reported weight reducing behaviours among individuals with excess body weight in Estonia.

    METHODS: Study used nationally representative cross-sectional data from 2006 to 2016 including 4302 men and 3627 women aged 20-64 years with excess body weight (BMI ≥ 25). Trends in the prevalence of changing eating habits and physical activity and their sociodemographic and health-related correlates were studied using descriptive statistics and multivariable logistic regression.

    RESULTS: Among overweight or obese respondents, 41% of men and 48% of women reported improvements in dietary habits and 19% of men and women reported increase in physical activity during the past 12 months in 2016. Positive trend for 2006-2016 regarding both outcomes was observed for men whereas no statistically significant differences were found for women. Women and those with lower than tertiary education had higher odds for reporting change in eating habits whereas older age and smoking or excessive alcohol consumption reduced the odds. Improvement in physical activity was more likely among younger respondents, women, ethnic Estonians and those with tertiary education, whereas poorer health and smoking reduced the odds. Weight-related advice from health professionals or family had strong effect on both outcomes.

    CONCLUSION: Socio-demographic and health profiles differentiate the self-reported behavioural change among persons with excess body weight. Advice from either health professionals or family may have a potential to facilitate positive changes in eating habits and physical activity among those individuals.

  • 196. Rissler, P.
    et al.
    Söderdahl, G.
    Nordman, Tomas
    Södertörn University, School of Life Sciences. Karolinska Institute.
    Xia, L.
    Torndal, U. -B
    Björnstedt, M.
    Ericzon, B. -G
    Olsson, J. M.
    Eriksson, L. C.
    Adriamycin cytotoxicity may stimulate growth of hepatocellular tumours in an experimental model for adjuvant systemic chemotherapy in liver transplantation2005In: Transplant International, ISSN 0934-0874, E-ISSN 1432-2277, Vol. 18, no 8, p. 992-1000Article in journal (Refereed)
    Abstract [en]

    Adjuvant treatment with adriamycin has been suggested to improve results after liver transplantation for hepatocellular cancer. Here we have applied an animal model for evaluation of treatment with adriamycin and/or cyclosporine A on liver tumour growth. Three chemically induced rat liver tumours with various degree of differentiation were transferred to the spleens of syngenic rats. Each recipient group was divided into four subgroups, treated with adriamycin and/or cyclosporine A or none of the drugs. When the tumour was well differentiated no proliferation was found in any of the subgroups. When the tumour exhibited a more pronounced dysplasia, adriamycin stimulated tumour growth. This effect was further increased by cyclosporine. In the animals transplanted with the most aggressive tumour, adriamycin inhibited tumour growth. When given together with cyclosporine this inhibition was counteracted. These data suggest that adriamycin, especially when given together with cyclosporine, may have a stimulatory effect on liver tumour cell growth.

  • 197.
    Roberts, Bayard
    et al.
    London School of Hygiene and Tropical Medicine, London, UK.
    Gilmore, Anna
    University of Bath, Bath, UK.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). London School of Hygiene and Tropical Medicine, London, UK / University of Tokyo, Tokyo, Japan.
    Rotman, David
    Belarussian State University, Minsk, Belarus.
    Prohoda, Vladimir
    Lomonosov Moscow State University, Moscow, Russia.
    Haerpfer, Christian
    Aberdeen University, Aberdeen, Scotland.
    McKee, Martin
    London School of Hygiene and Tropical Medicine, London, UK.
    Changes in Smoking Prevalence in 8 Countries of the Former Soviet Union Between 2001 and 20102012In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 102, no 7, p. 1320-1328Article in journal (Refereed)
    Abstract [en]

    Objectives. We sought to present new data on smoking prevalence in 8 countries, analyze prevalence changes between 2001 and 2010, and examine trend variance by age, location, education level, and household economic status. Methods. We conducted cross-sectional household surveys in 2010 in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. We compared smoking prevalence with a related 2001 study for the different countries and population subgroups, and also calculated the adjusted prevalence rate ratios of smoking. Results. All-age 2010 smoking prevalence among men ranged from 39% (Moldova) to 59% (Armenia), and among women from 2% (Armenia) to 16% (Russia). There was a significantly lower smoking prevalence among men in 2010 compared with 2001 in Belarus, Kazakhstan, Kyrgyzstan, and Russia, but not for women in any country. For all countries combined, there was a significantly lower smoking prevalence in 2010 than in 2001 for men aged 18 to 39 years and men with a good or average economic situation. Conclusions. Smoking prevalence appears to have stabilized and may be declining in younger groups, but remains extremely high among men, especially those in lower socioeconomic groups. (Am J Public Health. 2012;102:1320-1328. doi:10.2105/AJPH.2011.300547)

  • 198. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    Haerpfer, Christian
    McKee, Martin
    The persistence of irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 11, p. 1079-1082Article in journal (Refereed)
    Abstract [en]

    Background Hypertension is one of the leading causes of avoidable mortality in the former Soviet Union (fSU). In previous work, the authors described patterns of irregular hypertension treatment in eight countries of the fSU in 2001. This paper presents new data on changes in the use of hypertension treatment in the same countries. Methods Using household survey data from 18 420 (2001) and 17 914 (2010) respondents from Armenia, Azerbaijan (2010 only), Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine, the authors describe changes in rates of irregular treatment use (less than daily) between 2001 and 2010. Multivariate logistic regression was also used to analyse the characteristics associated with irregular treatment. Results Irregular treatment was extremely high at 74% in 2001 and only fell to 68% in 2010 (all countries combined). Irregular treatment remained particularly high in 2010 in Armenia (79%), Kazakhstan (73%) and Moldova (73%). Recurring characteristics associated with irregular treatment included gender (men), younger age, higher fitness levels, and consuming alcohol and tobacco. Conclusions Irregular hypertension treatment continues to be a major problem in the countries of the fSU and requires an urgent response.

  • 199. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition).
    Balabanova, Dina
    McKee, Martin
    Irregular treatment of hypertension in the former Soviet Union2012In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 66, no 6, p. 482-488Article in journal (Refereed)
    Abstract [en]

    Background The USSR failed to establish a modern pharmaceutical industry and lacked the capacity for reliable distribution of drugs. Patients were required to pay for outpatient drugs and the successor states have inherited this legacy, so that those requiring long-term treatment face considerable barriers in receiving it. It was hypothesised that citizens of former Soviet republics requiring treatment for hypertension may not be receiving regular treatment. Aims To describe the regularity of treatment among those diagnosed with hypertension and prescribed treatment in eight countries of the former Soviet Union, and explore which factors are associated with not taking medication regularly. Methods Using data from over 18 000 respondents from eight former Soviet countries, individuals who had been told that they had hypertension by a health professional and prescribed treatment were identified. By means of multivariate logistic analysis the characteristics of those taking treatment daily and less than daily were compared. Results Only 26% of those prescribed treatment took it daily. The probability of doing so varied among countries and was highest in Russia, Belarus and Georgia, and lowest in Armenia ( although Georgia's apparent advantage may reflect low rates of diagnosis). Women, older people, those living in urban areas, and nonsmokers and non-drinkers were more likely to take treatment daily. Conclusions A high proportion of those who have been identified by health professionals as requiring hypertension treatment are not taking it daily. These findings suggest that irregular hypertension treatment is a major problem in this region and will require an urgent response.

  • 200. Roberts, Bayard
    et al.
    Stickley, Andrew
    Södertörn University, School of Social Sciences, Sociology. Södertörn University, School of Social Sciences, SCOHOST (Stockholm Centre on Health of Societies in Transition). University of London & Univesity of Tokyo.
    Gilmore, Anna B.
    Danishevski, Kirill
    Kizilova, Kseniya
    Bryden, Anna
    Rotman, David
    Haerpfer, Christian
    McKee, Martin
    Knowledge of the health impacts of smoking and public attitudes towards tobacco control in the former Soviet Union2013In: Tobacco Control, ISSN 0964-4563, E-ISSN 1468-3318, Vol. 22, no 6, p. e12-Article in journal (Refereed)
    Abstract [en]

    Aims To describe levels of knowledge on the harmful effects of tobacco and public support for tobacco control measures in nine countries of the former Soviet Union and to examine the characteristics associated with this knowledge and support.

    Methods Standardised, cross-sectional nationally representative surveys conducted in 2010/2011 with 18?000 men and women aged 18years and older in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Respondents were asked a range of questions on their knowledge of the health effects of tobacco and their support for a variety of tobacco control measures. Descriptive analysis was conducted on levels of knowledge and support, along with multivariate logistic regression analysis of characteristics associated with overall knowledge and support scores.

    Results Large gaps exist in public understanding of the negative health effects of tobacco use, particularly in Azerbaijan, Kazakhstan, Kyrgyzstan and Moldova. There are also extremely high levels of misunderstanding about the potential effects of light' cigarettes. However, there is popular support for tobacco control measures. Over three quarters of the respondents felt that their governments could be more effective in pursuing tobacco control. Higher levels of education, social capital (membership of an organisation) and being a former or never-smoker were associated with higher knowledge on the health effects of tobacco and/or being more supportive of tobacco control measures.

    Conclusions Increasing public awareness of tobacco's health effects is essential for informed decision-making by individuals and for further increasing public support for tobacco control measures.

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