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  • 1.
    Berthelsen, Hanne
    et al.
    Malmö University, Centre for Work Life and Evaluation Studies (CTA). Malmö University, Faculty of Odontology (OD).
    Owen, Mikaela
    University of South Australia.
    Westerlund, Hugo
    Stockholm University.
    Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1320Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics.

    METHODS: The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested.

    RESULTS: High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level.

    CONCLUSIONS: Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.

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  • 2.
    Fredricson, Adrian Salinas
    et al.
    Folktandvarden Stockholm, Publ Dent Serv, Eastmaninst, Dept Oral & Maxillofacial Surg, Stockholm, Sweden.;Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden..
    Weiner, Carina Kruger
    Folktandvarden Stockholm, Publ Dent Serv, Eastmaninst, Dept Oral & Maxillofacial Surg, Stockholm, Sweden.;Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden..
    Adami, Johanna
    Sophiahemmet Univ, Stockholm, Sweden..
    Rosen, Annika
    Univ Bergen, Dept Clin Dent, Div Oral & Maxillofacial Surg, Bergen, Norway.;Haukeland Hosp, Dept Oral & Maxillofacial Surg, Bergen, Norway..
    Lund, Bodil
    Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden.;Karolinska Univ Hosp, Med Unit Reconstruct Plast & Craniofacial Surg, Stockholm, Sweden..
    Hedenberg-Magnusson, Britt
    Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden.;Folktandvarden Stockholm, Publ Dent Serv, Eastmaninst, Dept Orofacial Pain & Jaw Funct, Stockholm, Sweden..
    Fredriksson, Lars
    Karolinska Inst, Dept Dent Med, Div Oral Diagnost & Rehabil, Stockholm, Sweden.;Folktandvarden Stockholm, Publ Dent Serv, Eastmaninst, Dept Orofacial Pain & Jaw Funct, Stockholm, Sweden..
    Svedberg, Pia
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden..
    Naimi-Akbar, Aron
    Malmö University, Faculty of Odontology (OD).
    Sick leave and disability pension in a cohort of TMD-patients - The Swedish National Registry Studies for Surgically Treated TMD (SWEREG-TMD)2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 916Article in journal (Refereed)
    Abstract [en]

    Background Temporomandibular disorders (TMD) are common and affect approximately 10% of the adult population. TMD is usually associated with headache, pain in the masticatory muscles and/or the temporomandibular joint, clicking or crepitations during mandibular movement as well as painful and/or reduced mouth opening. This study aimed to investigate the level TMD-patients use social insurance benefits before and after their first time of diagnosis or first surgical event, compared to the general population. Furthermore, the aim was to investigate the differences in the use of social insurance benefits between surgically and non-surgically treated TMD-patients that were diagnosed in a hospital setting. Methods All Swedish citizens aged 23-59 diagnosed with TMD in a hospital setting and/or surgically treated for the condition during 1998-2016 were identified via the Swedish National Board of Health and Welfare. A non-exposed comparison cohort was collected via the Total Population Registry. Outcome and sociodemographic data were collected via Statistics Sweden. Main outcome was annual net days on sick leave and disability pension five years before (-T5) and five years after (T5) diagnosis and/or surgical treatment (T0). Regression analysis was conducted with generalized estimated equations. Results The study included 219 255 individuals (73% female) - 19 934 in the exposed cohort and 199 321 in the comparison cohort. The exposed group was classified into three subgroups: non-surgical, surgically treated once, and surgically treated twice or more. The mean annual net days of sick leave and disability pension combined during the ten-year follow-up was 61 days in the non-surgical group, 76 days in the surgically treated once group, and 104 days in the surgically treated twice or more subgroup. The corresponding number for the non-exposed comparison cohort was 32 days. Conclusion Patients diagnosed with TMD in a hospital setting are 2-3 times more dependent on the use of social benefits than the general population. The reliance on sick leave and disability pension is seen as early as five years before diagnosis, and the reliance remains after surgical treatment. The reliance is stronger in patients with several surgical interventions. These findings indicate that patients diagnosed with TMD constitute a patient group with a high burden of health issues causing long-term dependence on social security benefits.

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  • 3.
    Johansson, Nina
    et al.
    Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Sarkadi, Anna
    Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Feldman, Inna
    Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Price, Anna M H
    Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia.
    Goldfeld, Sharon
    Centre for Community Child Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, VIC, Australia.
    Salonen, Tapio
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Wijk, Katarina
    Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Isaksson, David
    Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden.
    Kolic, Emir
    Konsument Gästrikland Budget and Debt Counselling Service, Gävle, Sweden.
    Stenquist, Sara
    Konsument Gästrikland Budget and Debt Counselling Service, Gävle, Sweden.
    Elg, Maria
    Sandviken Municipality, Sandviken, Sweden.
    Lönn, Ewa
    Sandviken Municipality, Sandviken, Sweden.
    Wennelin, Josefine
    Gävle Municipality, Gävle, Sweden.
    Lindström, Linda
    Helsingborg Municipality, Helsingborg, Sweden.
    Medina, Mirelle
    Public Contributor, Sandviken, Sweden.
    Åberg, Sofie
    Public Contributor, Sandviken, Sweden.
    Viklund, Jessica
    Public Contributor, Sandviken, Sweden.
    Warner, Georgina
    Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Ameliorating Child poverty through Connecting Economic Services with child health Services (ACCESS): study protocol for a randomised controlled trial of the healthier wealthier families model in Sweden.2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, p. 1-12, article id 2181Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sweden is often held up as an example of a country with low child deprivation; yet, rates of relative deprivation are rising. Every municipality in Sweden is required to provide free, timely and accessible budget and debt counselling under the Social Services Act. The services have been encouraged to perform preventative practice with families; however, this has not been realised. The Healthier Wealthier Families (HWF) model embeds universal screening for economic hardship into child health services and creates a referral pathway to economic support services. Given the universal child health system in Sweden, which is freely available and has excellent coverage of the child population, implementation of the HWF model has potential to support families to access the freely available municipal budget and debt counselling and ultimately improve rates of child deprivation in Sweden.

    METHODS/DESIGN: We will conduct a two-arm randomised waitlist-control superiority trial to examine the effectiveness and cost-effectiveness of the HWF model in the Sweden. A longitudinal follow-up with the cohort will explore whether any effects are maintained in the longer-term.

    DISCUSSION: HWF is a collaborative and sustainable model that could maximise the effectiveness of current services to address child deprivation in Sweden. The study outlined in this protocol is the first effectiveness evaluation of the HWF model in Sweden and is a crucial step before HWF can be recommended for national implementation within the child health services.

    TRIAL REGISTRATION: Clinicaltrials.gov; NCT05511961. Prospectively registered on 23 August 2022. https://clinicaltrials.gov/ct2/show/NCT05511961.

  • 4.
    Lerdal, Anners
    et al.
    Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
    Gay, Caryl
    Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Family Health Care Nursing, University of California, San Francisco, USA.
    Bonsaksen, Tore
    Department of Health and Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway.
    Ekeberg, Øivind
    Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
    Grimholt, Trine
    Department of Health, Faculty of Health Studies, VID Specialized University, Oslo, Norway; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
    Heir, Trond
    Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lee, Kathryn A
    Department of Family Health Care Nursing, University of California, San Francisco, USA.
    Skogstad, Laila
    Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Schou-Bredal, Inger
    Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
    Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 2132Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population.

    METHODS: This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model.

    RESULTS: Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents' fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items.

    CONCLUSIONS: The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.

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  • 5. Nohler, Eva
    et al.
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Tillgren, Per
    Johansson, Pia
    Rosenblad, Andreas
    Helgason, Ásgeir R
    Comparison of a high and a low intensity smoking cessation intervention in a dentistry setting in Sweden: a randomized trial2009In: BMC Public Health, E-ISSN 1471-2458, Vol. 9, p. 121-131Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Tobacco is still the number one life style risk factor for ill health and premature death and also one of the major contributors to oral problems and diseases. Dentistry may be a potential setting for several aspects of clinical public health interventions and there is a growing interest in several countries to develop tobacco cessation support in dentistry setting. The aim of the present study was to assess the relative effectiveness of a high intensity intervention compared with a low intensity intervention for smoking cessation support in a dental clinic setting. METHODS: 300 smokers attending dental or general health care were randomly assigned to two arms and referred to the local dental clinic for smoking cessation support. One arm received support with low intensity treatment (LIT), whereas the other group was assigned to high intensity treatment (HIT) support. The main outcome measures included self-reported point prevalence and continuous abstinence (> or = 183 days) at the 12-month follow-up. RESULTS: Follow-up questionnaires were returned from 86% of the participants. People in the HIT-arm were twice as likely to report continuous abstinence compared with the LIT-arm (18% vs. 9%, p = 0.02). There was a difference (not significant) between the arms in point prevalence abstinence in favour of the HIT-protocol (23% vs. 16%). However, point prevalence cessation rates in the LIT-arm reporting additional support were relatively high (23%) compared with available data assessing abstinence in smokers trying to quit without professional support. CONCLUSION: Screening for willingness to quit smoking within the health care system and offering smoking cessation support within dentistry may be an effective model for smoking cessation support in Sweden. The LIT approach is less expensive and time consuming and may be appropriate as a first treatment option, but should be integrated with other forms of available support in the community. The more extensive and expensive HIT-protocol should be offered to those who are unable to quit with the LIT approach in combination with other support. TRIAL REGISTRATION: Trial registration number: NCT00670514.

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  • 6. Nohlert, Eva
    et al.
    Öhrvik, John
    Tegelberg, Åke
    Malmö högskola, Faculty of Odontology (OD).
    Tillgren, Per
    Helgason, Ásgeir R
    Long-term follow-up of a high- and a low-intensity smoking cessation intervention in a dental setting: a randomized trial2013In: BMC Public Health, E-ISSN 1471-2458, Vol. 13, article id 592Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols.The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence. METHODS: 300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (>=6 months), and sustained abstinence. The study was a follow-up after 5--8 years of a previously performed 12-month follow-up, both by postal questionnaires. RESULTS: Response rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up. CONCLUSIONS: Abstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5--8 years after the intervention.Trial registration number: NCT00670514.

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  • 7.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Awad, Eman
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Development and evaluation of a physical activity intervention informed by participatory research: a feasibility study2020In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, article id 112Article in journal (Refereed)
    Abstract [en]

    Background: Despite numerous interventions aiming to improve physical activity in socially disadvantagedpopulations, physical inactivity remains to be a rising challenge to public health globally, as well as, in Sweden. Inan effort to address this challenge, a community-based participatory intervention was developed through activecommunity engagement and implemented in a socially disadvantaged neighborhood in Sweden. The current studyaims to present the development and initial evaluation of a participatory research driven physical activityintervention.Methods: Fifteen participants (11 females and 4 males) aged 17–59 years volunteered to participate in the physicalactivity intervention program. The intervention program was evaluated using a longitudinal mixed methods designmeasuring health impact changes over time through focus group discussions and quality of life surveys. Furtheradditional biomedical health parameters such as levels of glycosylated hemoglobin, blood pressure, levels ofoxygen saturation and body mass index were monitored before and after the intervention. Focus group data wereanalyzed using content analysis with an inductive approach. The pre-and post-test scores from the survey-basedquality of life domains, as well as the health parameters were compared using non-parametric and parametricstatistics.Results: Four themes emerged from the analysis of the focus group discussions including sense of fellowship,striving for inclusion and equity, changing the learner perspective and health beyond illness. The scores for thedomains Physical Health, Psychological Health, Social Relationships and Health Satisfaction where significantlyhigher after participation in the physical activity intervention program compared to the pre-test scores (p < .05)s.There were however, no significant changes in the scores for the environmental domain and overall quality of lifeafter intervention compared to that prior to intervention start. Overall, the biomedical health parameters remainedstable within the normal ranges during intervention.Conclusion: The focus group discussions and results from the surveys and biomedical measures reveal importantfindings to understand and further develop the intervention program to promote health equity among citizens indisadvantaged areas. Evaluating the feasibility of such an intervention using multiple approaches contributes toeffective implementation of it for larger communities in need.

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  • 8.
    Rämgård, Margareta
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmo Univ, Fac Hlth & Soc, Dept Care Sci, Jan Waldenstroms Gata 25, SE-20506 Malmo, Sweden..
    Ramji, Rathi
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjögren Forss, Katarina
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    'No one size fits all' - community trust-building as a strategy to reduce COVID-19-related health disparities2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 18Article in journal (Refereed)
    Abstract [en]

    Background Citizens with low levels of social capital and social status, and relative poverty, seem to have been disproportionally exposed to COVID-19 and are at greater risk of experiencing poor health. Notably, the incidence of COVID-19 was nearly three times higher among citizens living in socially vulnerable areas. Experiences from the African Ebola epidemic show that in an environment based on trust, community partners can help to improve understanding of disease control without compromising safety. Such an approach is often driven by the civil society and local lay health promoters. However, little is known about the role of lay health promoters during a pandemic with communicable diseases in the European Union. This study had its point of departure in an already established Community Based Participatory Research health promotion programme in a socially disadvantaged area in southern Sweden. The aim of this study was to explore how citizens and local lay health promoters living in vulnerable neighbourhoods responded to the COVID-19 pandemic a year from the start of the pandemic.Method In-depth interviews with the 5 lay health promoters and focus group discussions with 34 citizens from the neighbourhood who were involved in the activities within the programme were conducted in autumn 2020. The interviews and focus group discussions were transcribed verbatim and analysed using qualitative content analysis following an inductive approach.Results Four themes emerged including, 'balancing between different kinds of information', 'balancing between place-based activities and activities on social media', 'bridging between local authorities and the communities and community members', and 'balancing ambivalence through participatory dialogues'.Conclusion The study highlights that a Community Based Participatory Research programme with lay health promoters as community trust builders had a potential to work with communicable diseases during the pandemic. The lay health promoters played a key role in promoting health during the pandemic by deepening the knowledge and understanding of the role that marginalised citizens have in building resilience and sustainability in their community in preparation for future crises. Public health authorities need to take the local context into consideration within their pandemic strategies to reach out to vulnerable groups.

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  • 9.
    Salinas Fredricson, Adrian
    et al.
    Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi; Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Krüger Weiner, Carina
    Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi; Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm ; Department of Oral and Maxillofacial Surgery, Gävle County Hospital, Gävle;.
    Adami, Johanna
    Sophiahemmet University, Stockholm.
    Rosén, Annika
    Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi; Department of Clinical Dentistry, Division of Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway; Department of Oral and Maxil‑ lofacial Surgery, Haukeland University Hospital, Bergen, Norway.
    Lund, Bodil
    Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm; Medical Unit for Reconstructive Plastic‑ and Craniofacial Surgery, Karolinska University Hospital, Stockholm.
    Hedenberg-Magnusson, Britt
    Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm; Department of Orofacial Pain and Jaw Func‑ tion, Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet‑ Stockholm.
    Fredriksson, Lars
    Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Svedberg, Pia
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm.
    Naimi-Akbar, Aron
    Malmö University, Faculty of Odontology (OD). Public Dental Services, Folktandvården Stockholm, Eastmaninstitutet, Department of Oral and Maxillofacial Surgery, Eastmaninstitutet Käkkirurgi; Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Stockholm.
    Sick leave and disability pension among TMD patients with musculoskeletal diseases, mental and behavioural disorders - a SWEREG-TMD population-based cohort study.2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, p. 1-17, article id 852Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2-3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated.

    METHODS: All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23-59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations.

    RESULTS: TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2-3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect.

    CONCLUSION: TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients' impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.

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  • 10.
    Schindele, Anna ChuChu
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA). Malmö University, Centre for Sexology and Sexuality Studies (CSS).
    Areskoug Josefsson, Kristina
    Faculty of Health Studies, VID Specialized University, Sandnes, Norway. Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway..
    Lindroth, Malin
    Malmö University, Centre for Sexology and Sexuality Studies (CSS). Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Analysing intersecting social resources in young people’s ability to suggest safer sex - results from a national population-based survey in Sweden2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1285Article in journal (Refereed)
    Abstract [en]

    Background

    Safer sex is one of the most crucial areas in sexual and reproductive health and rights (SRHR). Drawingon the theory of health promotion where social life generates resources for health our hypothesis is that having controlover one’s life situation, affects the ability for safer sex and thereby sexual health. The aim is to explore the associationbetween having control over one’s life and the ability to suggest safer sex among young people aged 16–29, andhow this plays out in relation to membership of six constructed social groups based on: gender, transgender experience,sexual identity, economy, being foreign-born, and social welfare recipiency followed by an in-depth analysis ofthe intersection of gender and sexual identity.

    Methods

    The data set comprises cross-sectional survey responses from a stratified random sample of 7755 in thetotal Swedish population of young people. The SRHR-focused questionnaire was developed within the HIV-monitoringprogram at the Public Health Agency of Sweden. Data collection was conducted by Statistics Sweden betweenApril 15 and June 8 in 2015. The survey had a response rate of 26%, which was in line with the study design. Statisticalanalysis was used to explore the self-reported outcome variable ability for safer sex and the exposure variable controlover one’s life. The methods used comprise multivariate logistic regression and an intersecting multivariate regressionexploring 12 intersecting social positions by gender and sexual identity.

    Results

    The results show that young people’s control over their lives is associated with their ability for safer sex. Dueto this, control over one’s life can be seen as a resource for safer sex. The associations in the 12 intersecting social positionsshowed complex patterns.Conclusions: The intersections of resources show the complexity and that gender cannot account for all differencesin the resources for young people’s ability to suggest safer sex. Implications for policy and practitioners involve bothaddressing and strengthening the sexual rights of young people from sexual minorities and tailoring interventions ina way that takes the intersections between gender and sexual identity into consideration.

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  • 11.
    Sjögren, Katarina
    et al.
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University, CRC entrance 72:28:11, Malmö University Hospital, 205 02, Malmö, Sweden; School of Health Science, Blekinge Institute of Technology, 371 79, Karlskrona, Sweden.
    Hansson, Eva Ekvall
    Faculty of Medicine, Department of Clinical Sciences in Malmö, General Practice, Lund University, CRC entrance 72:28:11, Malmö University Hospital, 205 02, Malmö, Sweden.
    Stjernberg, Louise
    School of Health Science, Blekinge Institute of Technology, 371 79, Karlskrona, Sweden.
    Parenthood and factors that influence outdoor recreational physical activity from a gender perspective2011In: BMC Public Health, E-ISSN 1471-2458, Vol. 11, no 93Article in journal (Refereed)
    Abstract [en]

    Background: A physically active life promotes both physical and mental health, increasing well-being and quality of life. Physical activity (PA) performed outdoors has been found to be particularly good for promoting well-being. However, participation in PA can change during the course of a lifetime. Parenthood has been found to be a life event associated with decreased PA, especially among women, although studies in the field are sparse. The aim of this study was to investigate participation in outdoor recreational PA, and factors influencing participation among parents-to-be, with and without previous children, from a gender perspective. Methods: This study included baseline data from parents-to-be, 224 women and 208 men, from the municipality of Karlskrona in south-east Sweden. Data collection was carried out during 2008-2009. We measured the self-reported amount of outdoor recreational PA undertaken during the last year and analysed the probability of participating in this PA using 25 variables covering individual and socioeconomic factors. Results: Seventy-six per cent of the women and 65% of the men had participated in outdoor recreational PA, varying from several times per month to every day, over a 12-month period prior to one month before pregnancy. Participation in PA indoors and owning a dog or a horse emerged as the most important factors associated with the probability of participation in outdoor recreational PA. Men were affected by a greater number of factors than women, for example men who had a family situation that permitted outdoor recreational PA participated in activities to a greater extent than men without such a family situation. The physical aspect, i.e. improved physical condition, staying power and vigour, also played a significant role with regard to participation among men. Conclusions: Becoming a parent is a life-changing event that affects participation in PA. By offering family-oriented PA choices that involve both parents and children, midwives and health promoters can encourage parents to be active and to support each other. The promotion of outdoor recreational PA, which also has restorative effects on well-being, needs to focus on activities which are attractive and affordable for the majority of both women and men.

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  • 12.
    Svensson, Pia
    et al.
    Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Agardh, Anette
    Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Zdravkovic, Slobodan
    Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM). Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Asamoah, Benedict Oppong
    Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
    Investigating pathways for predisposing, enabling and need factors in predicting the use of STI/HIV-testing services among Syrian and Iraqi migrants in Scania, Sweden - a cross-sectional study with directed acyclic graphs for modelling pathways to testing2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, p. 2177-, article id 2177Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Some groups of migrants have increased vulnerability to Sexually Transmitted Infections (STI) and Human Immunodeficiency Virus (HIV) transmission partly due to a lower uptake of disease preventive activities targeting the general population in receiving country. Limited access to economic and social resources and poor language skills may exacerbate exposure to sexual risks and utilization of health services.

    AIM: To explore general and migrant specific predictors for STI/HIV-testing among Syrian and Iraqi migrants in Sweden and to investigate potential pathways that link predisposing, enabling and need- factors to STI/HIV-testing.

    METHOD: Cross-sectional study design based on a migration specific framework for health care utilization. Directed acyclic graphs (DAGs) were used to model assumptions about factors associated with the uptake of STI/HIV-testing services. Bi-variable and multivariable logistic regression analyses assessed individual predictors while adjusting for covariates. The magnitude of the indirect effect of mediating variables were estimated with bootstrap analyses and a method for decomposing the total effect.

    RESULT: The pathways between younger age, unmarried, and self-identifying as bi- or homosexual and testing were mainly indirect, mediated by experiences of sexual coercion and other risk behaviours. One third of the indirect mediating effect of the pathway between higher education and testing could be attributed to Swedish language skills.

    CONCLUSION: Utilization of STI/HIV-testing services among Syrian and Iraqi migrants seemed to be motivated by sexual risk exposure and risk awareness. Interventions should focus on language-adapted information about available screening services and where to go for advice on sexual wellbeing and sexual rights. Such activities should be implemented within an integration promoting framework, addressing structures that increase STI/HIV risk exposure, specifically targeting vulnerable subgroups of migrants.

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  • 13.
    Svensson, Robert
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Johnson, Björn
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA). Malmö University, Faculty of Health and Society (HS), People, Places and Prevention.
    Kronkvist, Karl
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    A community intervention to reduce alcohol consumption and drunkenness among adolescents in Sweden: a quasi-experiment2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 764Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Several studies have examined the effect of community interventions on youth alcohol consumption, and the results have often been mixed. The aim of this study is to evaluate the effectiveness of a community intervention known as the Öckerö Method on adolescent alcohol consumption and perceived parental attitudes towards adolescent drinking.

    METHOD: The study is based on a quasi-experimental design, using matched controls. Self-report studies were conducted among adolescents in grades 7-9 of compulsory education in four control and four intervention communities in the south of Sweden in 2016-2018. Baseline measures were collected in autumn 2016 before the intervention was implemented in the intervention communities. Outcomes were the adolescents' alcohol consumption, past-year drunkenness, past-month drunkenness and perceived parental attitudes towards alcohol.

    RESULTS: Estimating Difference-in-Difference models using Linear Probability Models, we found no empirical evidence that the intervention has any effect on adolescents' drinking habits, or on their perceptions of their parents' attitudes towards adolescent drinking.

    CONCLUSION: This is the first evaluation of this method, and we found no evidence that the intervention had any effect on the level of either young people's alcohol consumption or their past-year or past-month drunkenness, nor on their parents' perceived attitudes toward adolescent drinking. A further improvement would be to employ a follow-up period that is longer than the three-year period employed in this study.

    TRIAL REGISTRATION: ISRCTN registry: Study ID: 51635778 , 31th March 2021 (Retrospectively registered).

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  • 14.
    Svensson, Robert
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Johnson, Björn
    Malmö University, Faculty of Health and Society (HS), Department of Social Work (SA).
    Olsson, Andreas
    Karolinska Institutet.
    Does gender matter? The association between different digital media activities and adolescent well-being2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, p. 1-10, article id 273Article in journal (Refereed)
    Abstract [en]

    Background:

    Previous research on the relationship between social media use and well-being in adolescents has yielded inconsistent results. We addressed this issue by examining the association between various digital media activities, including a new and differentiated measure of social media use, and well-being (internalizing symptoms) in adolescent boys and girls.

    Method:

    The sample was drawn from the four cross-sectional surveys from the Öckerö project (2016–2019) in eight municipalities in southern Sweden, consisting of 3957 adolescents in year 7 of compulsory education, aged 12–13. We measured the following digital media activities: playing games and three different activities of social media use (chatting, online sociability, and self-presentation). Our outcome measure was internalizing symptoms. Hypotheses were tested with linear regression analysis.

    Results:

    Social media use and playing games were positively associated with internalizing symptoms. The effect of social media use was conditional on gender, indicating that social media use was only associated with internalizing symptoms for girls. Of the social media activities, only chatting and self-presentation (posting information about themselves) were positively associated with internalizing symptoms. Self-presentation was associated with internalizing symptoms only for girls.

    Conclusion:

    Our study shows the importance of research going beyond studying the time spent on social media to examine how different kinds of social media activities are associated with well-being. Consistent with research in psychology, our results suggest that young girls posting information about themselves (i.e. self-presentation) might be especially vulnerable to display internalizing symptoms.

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