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Johansson, F., Rozental, A., Edlund, K., Côté, P., Sundberg, T., Onell, C., . . . Skillgate, E. (2023). Associations between procrastination and subsequent health outcomes among university students in Sweden. JAMA Network Open, 6(1), e2249346, Article ID e2249346.
Open this publication in new window or tab >>Associations between procrastination and subsequent health outcomes among university students in Sweden
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2023 (English)In: JAMA Network Open, E-ISSN 2574-3805, Vol. 6, no 1, p. e2249346-, article id e2249346Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce.

OBJECTIVE: To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later.

EXPOSURE: Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 ("very rarely or does not represent me") to 5 ("very often or always represents me") and summed to give a total procrastination score ranging from 5 to 25.

MAIN OUTCOMES AND MEASURES: Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health.

RESULTS: The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders.

CONCLUSIONS AND RELEVANCE: This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students' health.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:shh:diva-4752 (URN)10.1001/jamanetworkopen.2022.49346 (DOI)36598789 (PubMedID)
Available from: 2023-03-10 Created: 2023-03-10 Last updated: 2024-01-16Bibliographically approved
Sundberg, T., Leach, M. J., Lilje, S., Thomson, O. P., Fryer, G., Palmgren, P. J., . . . Skillgate, E. (2023). Attitudes, skills and implementation of evidence-based practice: A national cross-sectional survey of licensed naprapaths in Sweden. Chiropractic and Manual Therapies, 31, Article ID 3.
Open this publication in new window or tab >>Attitudes, skills and implementation of evidence-based practice: A national cross-sectional survey of licensed naprapaths in Sweden
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2023 (English)In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 31, article id 3Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden.

METHODS: Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019.

RESULTS: Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths' self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake.

CONCLUSIONS: The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.

Keywords
Cross-sectional studies, Evidence-based practice, Health care surveys, Implementation science, Naprapathy
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-4761 (URN)10.1186/s12998-023-00473-5 (DOI)36670483 (PubMedID)
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2024-01-09Bibliographically approved
Onell, C., Skillgate, E., Melin, A., Källberg, H., Waldén, M., Edlund, K., . . . Asker, M. (2023). Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort. In: : . Paper presented at Scandinavian Sports Medicine Congress, Köpenhamn, Danmark, 2-4 februari 2023.
Open this publication in new window or tab >>Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort
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2023 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-5094 (URN)
Conference
Scandinavian Sports Medicine Congress, Köpenhamn, Danmark, 2-4 februari 2023
Available from: 2023-12-20 Created: 2023-12-20 Last updated: 2023-12-20Bibliographically approved
Onell, C., Skillgate, E., Melin, A., Källberg, H., Waldén, M., Edlund, K., . . . Asker, M. (2023). Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort. BMJ open sport & exercise medicine, 9(4), Article ID e001679.
Open this publication in new window or tab >>Dietary habits in adolescent male and female handball players: The Swedish Handball Cohort
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2023 (English)In: BMJ open sport & exercise medicine, ISSN 2055-7647, Vol. 9, no 4, article id e001679Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This cross-sectional study aimed to describe dietary habits in Swedish adolescent handball players and differences with respect to sex and school grade.

METHODS: Participants in the Swedish Handball Cohort answered a web-survey assessing adherence to sports nutrition recommendations for meal frequency and meal timing, and the Nordic Nutrition Recommendations (NNR) for fruits/vegetables and fish/seafood, food exclusions and use of dietary supplements. Differences with respect to sex and school grade were estimated with generalised linear models, generating prevalence ratios (PR) with 95% CIs.

RESULTS: A total of 1040 participants (16.6±0.9 years, 51% males) were included. Overall, 70% and 90%, respectively, met recommendations for meal frequency and meal timing, whereas adherence to recommended carbohydrate intake during training/game was met by 17%. Adherence to the NNR for fruits/vegetables and fish/seafood was met by 16% and 37%, respectively. Twenty-eight per cent reported using dietary supplements. Females reported lower frequency of meals, especially morning snacks (-0.6 days/week (95% CI -0.3 to -0.9)) and evening snacks (-0.8 days/week (95% CI -0.5 to -1.1)), higher prevalence of exclusions due to intolerances (PR 1.66 (95% CI 1.31 to 2.01)) and other reasons (PR 1.36 (95% CI 1.08 to 1.64)), higher adherence to the NNR for fruits/vegetables (PR 2.30 (95% CI 1.98 to 2.62)) and use of micronutrient supplements (PR 1.72 (95% CI 1.43 to 2.00)) compared with males. Only small differences were observed between school grades.

CONCLUSIONS: Swedish adolescent handball players' dietary habits are fairly in accordance with sports nutrition recommendations but not the NNR. Females appear to display more restrictive habits than males.

Keywords
Adolescent, Athlete, Epidemiology, Handball, Sports and nutrition
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:shh:diva-5107 (URN)10.1136/bmjsem-2023-001679 (DOI)38143719 (PubMedID)
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-12Bibliographically approved
Sundberg, T., Skillgate, E., Gustavsson, P. & Rudman, A. (2023). Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study. Scandinavian Journal of Public Health, Article ID 14034948231151992.
Open this publication in new window or tab >>Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study
2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, article id 14034948231151992Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

Keywords
Work environment, Back pain, Neck pain, Nursing
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-4904 (URN)10.1177/14034948231151992 (DOI)36814114 (PubMedID)
Available from: 2023-05-17 Created: 2023-05-17 Last updated: 2023-05-17Bibliographically approved
Berglöf, M., Skillgate, E., Hägglund, M. & Asker, M. (2023). Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons. In: : . Paper presented at Scandinavian Sports Medicine Congress, Köpenhamn, Danmark, 2-4 februari 2023.
Open this publication in new window or tab >>Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons
2023 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-5118 (URN)
Conference
Scandinavian Sports Medicine Congress, Köpenhamn, Danmark, 2-4 februari 2023
Available from: 2024-01-18 Created: 2024-01-18 Last updated: 2024-01-18Bibliographically approved
Berglöf, M., Skillgate, E., Hägglund, M. & Asker, M. (2023). Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons. In: : . Paper presented at Idrottsmedicinskt vårmöte, Norrköping, 20-21 april 2023.
Open this publication in new window or tab >>Increased adherence to injury prevention exercise programs in adolescent handball: Cohort study of 3219 player seasons
2023 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-5119 (URN)
Conference
Idrottsmedicinskt vårmöte, Norrköping, 20-21 april 2023
Available from: 2024-01-18 Created: 2024-01-18 Last updated: 2024-01-18Bibliographically approved
Onell, C., Skillgate, E., Melin, A., Källberg, H., Waldén, M., Edlund, K., . . . Asker, M. (2023). Matvanor inom svensk ungdomshandboll. In: : . Paper presented at Idrottsmedicinskt vårmöte, Norrköping, 20-21 april 2023.
Open this publication in new window or tab >>Matvanor inom svensk ungdomshandboll
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2023 (Swedish)Conference paper, Oral presentation only (Other academic)
National Category
Physiotherapy
Identifiers
urn:nbn:se:shh:diva-5095 (URN)
Conference
Idrottsmedicinskt vårmöte, Norrköping, 20-21 april 2023
Available from: 2023-12-20 Created: 2023-12-20 Last updated: 2023-12-20Bibliographically approved
Weiss, N., Skillgate, E. & Axén, I. (2023). Psychological distress and musculoskeletal pain in manual therapists during the second wave of the COVID-19 pandemic in Sweden: A cross-sectional study. Chiropractic and Manual Therapies, 31, Article ID 34.
Open this publication in new window or tab >>Psychological distress and musculoskeletal pain in manual therapists during the second wave of the COVID-19 pandemic in Sweden: A cross-sectional study
2023 (English)In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 31, article id 34Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The COVID-19 pandemic had an unprecedented impact on healthcare, and the health of healthcare workers has been subject of much research. However, studies of health-related factors in manual therapists during the COVID-19 pandemic are scarce. Research in this field can provide valuable insights for future crises policy and guidelines, including in regions where the public health response to COVID-19 contrasts with that of most other international jurisdictions. The aim was to describe the prevalence of psychological distress and musculoskeletal pain, and to investigate factors potentially associated with high psychological distress and activity-limiting musculoskeletal pain in clinically active chiropractors and naprapaths during the second wave of the COVID-19 pandemic in Sweden.

METHODS: A cross-sectional survey was distributed to a representative sample of Swedish manual therapists, between November 2020 and January 2021. High psychological distress and activity-limiting musculoskeletal pain were investigated regarding associations with residing in a municipality with a high spread of infection, a previous/ongoing SARS-CoV-2 infection, clinical interferences and economic consequences associated with the pandemic. Generalized Linear Models with log link and binomial distribution were used, computing prevalence ratios (PR) with 95% confidence intervals (95% CI).

RESULTS: A total of 762 participants were included, representing 46% of the source population. The prevalence of depressive, anxiety, and stress symptoms was 17%, 7%, and 12%, respectively. Neck (50%), low back (46%), upper back (40%), and shoulders (39%) were the most prevalent musculoskeletal pain areas. Economic consequences due to the pandemic were associated with high psychological distress (PR = 2.30, 95% CI: 1.48-3.53).

CONCLUSIONS: During the second wave of the COVID-19 pandemic in Sweden, manual therapists primarily suffered from musculoskeletal pain related to the back and shoulders, while depressive symptoms were the most common symptom of psychological distress. Owners of businesses that suffered economic consequences had a higher prevalence of high psychological distress, which may call for targeted support of this group in future similar contexts. Future longitudinal studies during the pandemic are warranted to assess these associations further.

Keywords
Anxiety, Chiropractors, Depression, Naprapaths, SARS-CoV-2, Stress
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:shh:diva-5032 (URN)10.1186/s12998-023-00511-2 (DOI)37700309 (PubMedID)
Available from: 2023-10-13 Created: 2023-10-13 Last updated: 2024-01-09Bibliographically approved
Johansson, F., Côté, P., Onell, C., Källberg, H., Sundberg, T., Edlund, K. & Skillgate, E. (2023). Strengths of associations between depressive symptoms and loneliness, perfectionistic concerns, risky alcohol use and physical activity across levels of sleep quality in Swedish university students: A cross-sectional study. Journal of Sleep Research, 32(2), Article ID e13745.
Open this publication in new window or tab >>Strengths of associations between depressive symptoms and loneliness, perfectionistic concerns, risky alcohol use and physical activity across levels of sleep quality in Swedish university students: A cross-sectional study
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2023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 2, article id e13745Article in journal (Refereed) Published
Abstract [en]

Previous research shows that sleep quality may interact with some other predictors of depression, such that poor sleep could strengthen the association between these factors and depression. We aimed to determine the presence of statistical interactions between sleep quality and loneliness, risky alcohol use, perfectionistic concerns and/or physical inactivity in relation to depressive symptoms. Further, we aimed to describe the functional form of the statistical interactions and associations. We used a cross-sectional design and included 4262 Swedish university students. All measures were self-reported, sleep quality was measured with the Pittsburgh Sleep Quality Index, and depressive symptoms with the short-form Depression, Anxiety and Stress Scale. Regression models of increasing complexity (linear and non-linear, with and without interactions) were compared to determine the presence of associations and statistical interactions, and to explore the best functional form for these associations and interactions. Out-of-sample R2 from repeated cross-validation was used to select the final models. We found that sleep quality was associated with depressive symptoms in all final models. Sleep quality showed a linear interaction with perfectionistic concerns in relation to depressive symptoms, such that perfectionistic concerns were more strongly associated with depressive symptoms when sleep quality was poor. Loneliness, risky alcohol use and physical inactivity were non-linearly associated with depressive symptoms but did not interact with sleep quality. We concluded that out of the four examined variables, only perfectionistic concerns interacted with sleep quality in relation to depressive symptoms. This interaction was weak and explained little of the overall variance in depressive symptoms.

Keywords
Alcohol use, Depression, Interaction, Loneliness, Perfectionism, Sleep quality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:shh:diva-4667 (URN)10.1111/jsr.13745 (DOI)36217878 (PubMedID)
Available from: 2022-12-08 Created: 2022-12-08 Last updated: 2024-01-16Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2096-1530

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