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  • 1. Bondesson, Tina
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Kjeldgård, Linnea
    Nilsson, Marie I
    A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery2016In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 10, 4141-4148 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave.

    METHODS: This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis.

    RESULTS: Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity.

    CONCLUSIONS: Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.

  • 2.
    Fossum, Bjöörn
    et al.
    Sophiahemmet University.
    Arborelius, Elisabeth
    Bremberg, Sven
    Evaluation of a counseling method for the prevention of child exposure to tobacco smoke: an example of client-centered communication2004In: Preventive Medicine, ISSN 0091-7435, E-ISSN 1096-0260, Vol. 38, no 3, 295-301 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Environmental tobacco smoke (ETS) is an important risk factor. The aim of this study is to evaluate effects of the counseling method "Smoke-free children" that focuses on protection of infants. METHODS: The counseling method, "Smoke-free children", has been developed and implemented at Swedish child health centers. The counseling method's point of departure is based upon a client-centered approach. Saliva cotinine samples from the mothers were collected when the child was 1-4 weeks and 3 months of age. Interviews regarding mothers' smoking habits and self-reported maternal smoking were also carried out. RESULTS: Forty-one mothers participated in the study, 26 in the intervention group and 15 in the control group. Cotinine was collected from 22 subjects in the intervention and 8 in the control group. Before the intervention, the mean cotinine level was 185 ng/mL in the intervention group and 245 ng/mL in the control group. After the intervention, cotinine levels were reduced in the intervention group (165 ng/mL) and increased in the control group (346 ng/mL). Yet, after the intervention, the mothers themselves reported more smoking in the intervention group than in the control group. Only weak correlations were found between self-reported smoking and cotinine. CONCLUSIONS: The statistical analysis supports the view that a client-centered intervention, aimed at increasing self-efficacy, exerts a positive effect on maternal smoking in the prevention of infant exposure to ETS, when applied in a routine clinical setting.

  • 3. Guldbrandsson, Karin
    et al.
    Fossum, Bjöörn
    Sophiahemmet University.
    An exploration of the theoretical concepts policy windows and policy entrepreneurs at the Swedish public health arena2009In: Health Promotion International, ISSN 1460-2245, Vol. 24, no 4, 434-44 p.Article in journal (Refereed)
    Abstract [en]

    In John Kingdon's Policy Streams Approach policy formation is described as the result of the flow of three 'streams', the problem stream, the policy stream and the politics stream. When these streams couple, a policy window opens which facilitate policy change. Actors who promote specific solutions are labelled policy entrepreneurs. The aim of this study was to test the applicability of the Policy Streams Approach by verifying whether the theoretical concepts 'policy windows' and 'policy entrepreneurs' could be discernable in nine specified cases. Content analyses of interviews and documents related to child health promoting measures in three Swedish municipalities were performed and nine case studies were written. The policy processes preceding the municipal measures and described in the case studies were scrutinized in order to find statements related to the concepts policy windows and policy entrepreneurs. All conditions required to open a policy window were reported to be present in eight of the nine case studies, as was the most important resource of a policy entrepreneur, sheer persistence. This study shows that empirical examples of policy windows and policy entrepreneurs could be identified in child health promoting measures in Swedish municipalities. If policy makers could learn to predict the opening of policy windows, the planning of public health measures might be more straightforward. This also applies to policy makers' ability to detect actors possessing policy entrepreneur resources.

  • 4.
    Hansson, Anna
    et al.
    Sophiahemmet University.
    Forsell, Yvonne
    Hochwälder, J
    Hillerås, Pernilla
    Sophiahemmet University.
    Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period2008In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 122, no 12, 1392-8 p.Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Mental health problems are a major issue worldwide, and there is a need to further explore factors that may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extend knowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, after controlling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change in overall well-being was also studied during the 3- year interval. STUDY DESIGN: Longitudinal design. METHODS: A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received a questionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All the respondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study. RESULTS: The overall well-being of the study sample was relatively stable. Separate analyses of the three life circumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life still affected SWB. CONCLUSIONS: Despite personality and the stability of SWB, these results indicate that changes in financial situation, social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that a negative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.

  • 5. Lager, Anton C J
    et al.
    Fossum, Bjöörn
    Sophiahemmet University.
    Rörvall, Göran
    Bremberg, Sven G
    Children's overweight and obesity: local and national monitoring using electronic health records2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 2, 201-5 p.Article in journal (Refereed)
    Abstract [en]

    AIM: To test the feasibility of a system for monitoring children's obesity and overweight based on data from electronic health records in the school health services. METHODS: Data on weight and height from electronic health records at school health services were collected for 10-year-olds in 2003-2004, 2004-2005 and 2005-2006. School health personnel extracted group-level data with a simple program installed on the computer containing the health records. Four Swedish municipalities were included in the study: Karlstad, Umeå, Västerås, and Ystad. RESULTS: The system achieved coverage of 92-96% of all children in 2005-2006. The overall prevalence rates were 4.2% (3.8-4.7%) obese and 22.0% (21.1-23.0%) overweight, including obesity. CONCLUSIONS: A system based on electronic health records from the school health services can successfully provide data. The system has practical, economical and ethical strengths.

  • 6. Lager, Anton
    et al.
    Fossum, Bjöörn
    Sophiahemmet University.
    Bremberg, Sven
    Övervikt bland barn: nytt system för nationell uppföljning2005Report (Other academic)
    Abstract [en]

    Rapporten visar att det är praktiskt genomförbart att basera ett nationellt uppföljningssystem av barns övervikt och fetma på statistiken från skolhälsovården. Fyra kommuner med datoriserade journalsystem lämnade uppgifter: Västerås, Umeå, Karlstad och Ystad. Övervikt och fetma är ett stort folkhälsoproblem och antalet barn och ungdomar med övervikt har fördubblas på femton år. För att värdera de samlade effekterna av förebyggande insatser är det angeläget att följa utvecklingen över tid.Uppgifter från skolhälsovården kan enkelt sammanställas för att följa utvecklingen i Sverige.

  • 7. Lager, Anton
    et al.
    Guldbrandsson, Karin
    Fossum, Bjöörn
    Sophiahemmet University.
    The chance of Sweden's public health targets making a difference2007In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 80, no 3, 413-21 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is a trend in health policy towards more focus on determinants and societal interventions and less on individuals. The Swedish public health targets are in line with this trend. The value of public health targets lies in their ability to function as a tool in governing with targets. This paper examines the possibility of the Swedish targets functioning as such a tool. METHOD: Document analyses were performed to examine three prerequisites of governing with targets: (1) the influence of the administration in the target setting process, (2) the explicitness of targets and (3) the follow-up system. The material consisted of the documents from the committee drafting the targets, the written opinions on the drafts, and the governmental bill with the adopted public health targets. RESULTS: The administration influenced the target setting process. Further, the government invests in a follow-up system that makes indicators on health determinants visible. However, although there existed explicit targets earlier in the process, the final targets in the bill are not explicit enough. CONCLUSION: The Swedish public health targets are not explicit enough to function in governing with targets. The reasons for this were political rather than technical. This suggests that policy makers focusing health determinants should not put time and resources in technical target formulating. Instead they could make indicators visible, thereby drawing attention to trends that are political by nature.

  • 8. Larsson, Sam
    et al.
    Lilja, John
    Fossum, Bjöörn
    Sophiahemmet University.
    Vem får man vara i vårt samhälle?: en kort introduktion till rapporten Om transpersoners psykosociala situation och psykiska hälsa2008Report (Other academic)
  • 9. Larsson, Sam
    et al.
    Lilja, John
    Fossum, Bjöörn
    Sophiahemmet University.
    Vem får man vara i vårt samhälle?: om transpersoners psykosociala situation och psykiska hälsa2008Report (Other academic)
    Abstract [sv]

    Det här är den första svenska kunskapssammanställningen om transpersoners psykiska och psykosociala hälsa. Särskilt fokus ligger på grupperna manliga transvestiter och transsexuella – de grupper som det i nuläget finns mest forskning om. Några viktiga frågor som rapporten försöker ge svar på är: Vad syftar begreppet transperson på? Hur kan transpersoners livssituation beskrivas i relevanta avseenden,som bakgrund, utveckling, identitetsupplevelse, social situation och sociala relationer? Vilka psykiska eller psykosociala påfrestningar kan finnas för transpersoner i samhället kopplat till att de är just transpersoner? Hur kan transpersoner förstås kopplat till samhällets identitets- och genusnormer samt i relation till heteronormen? Hur kan transpersoner förstås i ett historiskt och kulturellt sammanhang? Hur beskriver transpersoner sin situation med egna ord? Vilka förslag till insatser skulle kunna förbättra den psykosociala hälsosituationen för transpersoner?Vi vet att psykisk ohälsa har samband med utanförskap och diskriminering – något som drabbar många transpersoner. Denna rapport är ett viktigt bidrag till hur vi alla ska kunna skapa ett samhälle som visar större förståelse och acceptans för skilda sätt att vara och leva. Kunskapsunderlaget är angelägen läsning för politiker och beslutsfattare. Det riktar sig också till studerande och personal inom skola och högskola samt olika kategorier av vårdpersonal som läkare, sjuksköterskor, psykologer, socionomer och socialpedagoger. Givetvis vänder sig rapporten också till en intresserad allmänhet.

  • 10. Nilsen, Bente B
    et al.
    Yngve, Agneta
    Sophiahemmet University.
    Sjöberg, Agneta
    Moraeus, Lotta
    Lissner, Lauren
    Werner, Bo
    Using different growth references to measure thinness and overweight among Swedish primary school children showed considerable variations2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 10, 1158-65 p.Article in journal (Refereed)
    Abstract [en]

    AIM: The study compared how four different growth references determined the prevalence of thinness and overweight, based on height and weight measurements from a nationally representative sample of Swedish children from seven to nine years of age.

    METHODS: The height and weight measurements of 4,518 Swedish schoolchildren aged seven to nine years were carried out in 2008 using a standardised protocol. The prevalence of different degrees of thinness and overweight were calculated using international growth references from the World Health Organization, the International Obesity Task Force and two Swedish growth references from Werner and Karlberg.

    RESULTS: Depending on which growth reference we used, the prevalence of different degrees of thinness varied from 7.5%-16.9% for the boys and 6.9%-13.7% for the girls, while for the prevalence of overweight, including obesity and severe obesity, varied from 16.5%-25.7% for the boys and 18.2-25.2% for the girls. There were also significant gender differences depending on the growth reference we used.

    CONCLUSION: Using four different growth references, two international and two Swedish, produced wide variations in the prevalence of thinness and overweight, together with significant gender differences. In the absence of a global definition, we need both national and international growth references. This article is protected by copyright. All rights reserved.

  • 11. Olsson, M
    et al.
    Nilsson, M
    Fugl-Meyer, K
    Petersson, LM
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Kjeldgård, L
    Alexanderson, K
    Life satisfaction of women of working age shortly after breast cancer surgery2017In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, no 3, 673-684 p.Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    To explore, among women of working age, satisfaction with life as a whole and with different life domains, and its associations with social and health variables, shortly after breast cancer surgery.

    METHODS:

    This cross-sectional study included 605 women, aged 20-63 years, who had had breast cancer surgery with no distant metastasis, pre-surgical chemotherapy, or previous breast cancer. Associations between LiSat-11 and demographic and social factors as well as health- and treatment-related variables were analysed by multivariable logistic regression.

    RESULTS:

    Compared with Swedish reference levels, the women were, after breast cancer surgery, less satisfied with life, particularly sexual life. Women working shortly after breast cancer surgery were more often satisfied with life in provision domains compared with the reference population. Although most included variables showed associations with satisfaction, after adjustment for all significantly associated variables, only six variables-having children, being in work, having emotional and informational social support, and having good physical and emotional functioning-were positively associated with satisfaction with life as a whole. The odds ratios for satisfaction were higher in most life domains if the woman had social support and good emotional and cognitive functioning.

    CONCLUSIONS:

    One month after breast cancer surgery, satisfaction with different life domains was associated primarily with social support and health-related functioning. However, this soon after surgery, treatment-related variables showed no significant associations with life satisfaction. These results are useful for planning interventions to enhance e.g. social support and emotional as well as cognitive functioning.

  • 12. Saboonchi, Fredrik
    et al.
    Petersson, Lena-Marie
    Wennman-Larsen, Agneta
    Sophiahemmet University.
    Alexanderson, Kristina
    Vaez, Marjan
    Trajectories of anxiety among women with breast cancer: A proxy for adjustment from acute to transitional survivorship2015In: Journal of psychosocial oncology, ISSN 0734-7332, E-ISSN 1540-7586, Vol. 33, no 6, 603-619 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Anxiety is one of the main components of distress among women with breast cancer (BC), particularly in the early stages of the disease. Changes in anxiety over time may reflect the process of adjustment or lack thereof. The process of adjustment in the traverse of acute to transitional stages of survivorship warrants further examination.

    AIM: To examine the trajectory of anxiety and the specific patterns that may indicate a lack of adjustment within two years following BC surgery.

    METHODS: Survey data from a two-year prospective cohort study of 725 women with BC were analyzed by Mixture Growth Modelling and logistic regression and analysis of variance.

    RESULTS: A piece wise growth curve displayed the best fit to the data, indicating a significant decrease in anxiety in the first year, followed by a slower rate of change during the second year. Four classes of trajectories were identified of which a High Stable anxiety class showed the most substantive indications of lack of adjustment. This subgroup was predominantly characterized by sociodemographic variables such as financial difficulties.

    CONCLUSION: Our results support an emphasize on the transitional nature of the stage that follows the end of primary active treatment, and imply a need for supportive follow up care for those who display lack of adjustment at this stage.

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