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  • 1. Agahi, Neda
    et al.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work. Aging Research Center.
    Carin, Lennartsson
    Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample2019In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 196, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

    Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

    Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

  • 2.
    Andersson, Eva
    et al.
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Oddsson, Kristjan
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Wahlgren, Lina
    Gymnastik- och idrottshögskolan, GIH, FoU-gruppen för rörelse, hälsa och miljö.
    Kjellman, Bengt
    Jonsson, Bo
    Taube, Jill
    Improved Physical Capacity in a Project with Guided Physical Activity for Persons with Depression or Anxiety.2010Conference paper (Refereed)
    Abstract [en]

    Background: Higher physical capacity is correlated with increased health. Knowledge in this area regarding psychiatric diseases is sparse. 

    Purpose: The aim was to study aerobic and several strength capacities in a physical activity project for persons with depression or anxiety.

    Methods: Eighty-four persons (56 women and 28 men) with depression or anxiety were recruited from psychiatric out-patient clinics in Stockholm. Their mean age and BMI was 46 (21-80) years and 26 (17-41) kg/m2, respectively. 50% were sick-listed. 50% had BMI>25. Aerobic and strength tests were chosen by each subgroup´s project leaders. Directed physical activity was given, in groups 10-15, 1 hour twice/week during 8-12 weeks.

    Results: Significant changes (p<0.05, of all n=84) between pre- and post tests were seen in submaximal cycle test (11% enhanced values, n=56) and distance of 6 minutes walk test (16%, n=15) as well as in strength tests for the back for the back (i.e. time in static horizontal belly-back, 40%, n=44), abdominal and hip flexors (i.e. number of hip flexion sit-ups, 45%, n=38), leg (i.e. standing with 90O in hips and knees, 48%, n=56) and arm with shoulder muscles (i.e. number of raising weights alternately with the arms, 46%, n=32). Hand grip tests, BMI or blood pressure values did not change significantly.

    Conclusions: Directed 8-12 weeks physical activity programs can improve physical fitness in individuals with depression or anxiety.

  • 3.
    Borg, Richard
    Dalarna University, Not School affiliated.
    Digerdöden i Skeby socken [Biblioteket testar avhandlingsfunktioner]: Vittnesmål från överlevande2025Doctoral thesis, monograph (Other academic)
    Abstract [en]

    There were different forms of the Black Death, and they were spread in different ways, though they were caused by the same organism. The Bubonic Plague was a form carried by such animals as rats and the fleas that lived on them, both of which exhibited symptoms of the disease. When a flea bit an infected rat, it would get sick; subsequently, if it bit another rat or a human being, it would vomit as it bit, infecting that animal or person. 

  • 4.
    Brun Sundblad, Gunilla
    et al.
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Mechbach, Jane
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Lundvall, Suzanne
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Orka hela vägen: Upplevd hälsa, idrotts- och träningsbakgrund bland studenter på en fysiskt inriktad yrkesutbildning.  Lärarstudenter GIH 2008 delrapport 1: 20092010Report (Other academic)
    Abstract [sv]

    Sammanfattning

    Ett sammanfattande porträtt av den nyantagna lärarstudenten vid GIH med utgångspunkt från enkätsvaren ger vid handen en bild av en person, som är ca 21 år gammal, född i Sverige och uppvuxen i en medelstor stad i Mellansverige. Studenten trivdes mycket bra i skolan och var som elev något över medel med MVG i idrott och hälsa.

    Valet av yrkesutbildning grundade sig på ett stort intresse för idrott, samt en önskan att få jobba med barn och ungdom. Studievalet hade för många påverkats av en tidigare idrotts-lärare, kompisar och familj. En bra lärare i idrott och hälsa är enligt studenten positiv, engagerad, rättvis, bestämd och kunnig.

    Lärarstudenten ser sig behärska bollspel väl. Störst kunskap och färdighet uppges i fot-boll och alpin skidåkning. Minst kunskap och färdighet skattades i softboll, baseboll, bergsklättring, långfärdsskridskoåkning och i konsten att kunna valla skidor. Många ser sig ha god kunskap om sambandet mellan hälsa, livsstil och miljö, men mindre god om hur en idrottsaktivitet har betydelse för kulturarvet, samband mellan miljö och männi-skans hälsa i ett historiskt och nutidsperspektiv samt i ergonomi.

    På sin fritid går lärarstudenten ofta på idrottsevenemang, café, tittar på TV och video eller umgås med vänner och familj. Lärarstudenten går sällan på bio och nästan aldrig på tea-ter, museum eller vernissager. "Vad är vernissage?" undrar en student.

    Hälsan, både fysiskt och psykiskt, skattas som tillfredsställande och man känner ofta hopp, glädje och meningsfullhet. Emellertid finner man sig även ofta stressad på grund av tidsbrist och alla krav. Många kvinnliga studenter (41%) rapporterade ryggont och många, både kvinnor och män, beskrev att de har besvär från en skadad fotled eller knä. De flesta lärarstudenterna är regelbundet fysiskt aktiva och de finner att mängden motion delvis är tillfredsställande.

    Förväntningarna är höga på utbildningen både att den är mångsidig och kommer att ge ökad kunskap inom olika områden. Under studietiden förväntar man sig att utvecklas och förbättra sin egen fysiska status och hälsa. En student uttrycker det med orden: "Mitt nya liv startar idag". Den sammanfattande bilden av lärarstudenten på GIH liknar den som tidigare har redovisats av Meckbach och Wedman i en liknande studie från maj 2005. Deras studie genomfördes på studenter efter ett års studier på GIH (Meckbach & Wed-man, 2007).

  • 5.
    Byrskog, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet; Centre for Clinical Research, Falun.
    Olsson, Pia
    Uppsala universitet.
    Essén, Birgitta
    Uppsala universitet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Being a bridge: Swedish antenatal care midwives’ encounters with Somali-born women and questions of violence; a qualitative study2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Violence against women is associated with serious health problems, including adverse maternal and child health. Antenatal care (ANC) midwives are increasingly expected to implement the routine of identifying exposure to violence. An increase of Somali born refugee women in Sweden, their reported adverse childbearing health and possible links to violence pose a challenge to the Swedish maternity health care system. Thus, the aim was to explore ways ANC midwives in Sweden work with Somali born women and the questions of exposure to violence.

    Methods: Qualitative individual interviews with 17 midwives working with Somali-born women in nine ANC clinics in Sweden were analyzed using thematic analysis.

    Results: The midwives strived to focus on the individual woman beyond ethnicity and cultural differences. In relation to the Somali born women, they navigated between different definitions of violence, ways of handling adversities in life and social contexts, guided by experience based knowledge and collegial support. Seldom was ongoing violence encountered. The Somali-born women’s’ strengths and contentment were highlighted, however, language skills were considered central for a Somali-born woman’s access to rights and support in the Swedish society. Shared language, trustful relationships, patience, and networking were important aspects in the work with violence among Somali-born women.

    Conclusion: Focus on the individual woman and skills in inter-cultural communication increases possibilities of overcoming social distances. This enhances midwives’ ability to identify Somali born woman’s resources and needs regarding violence disclosure and support. Although routine use of professional interpretation is implemented, it might not fully provide nuances and social safety needed for violence disclosure. Thus, patience and trusting relationships are fundamental in work with violence among Somali born women. In collaboration with social networks and other health care and social work professions, the midwife can be a bridge and contribute to increased awareness of rights and support for Somali-born women in a new society.

  • 6.
    Byrskog, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Centrum för klinisk forskning, Dalarna, Institutionen för kvinnors och barns hälsa, Uppsala Universitet. .
    Olsson, Pia
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Essén, Birgitta
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Perceptions and experiences of war, violence, migration and reproductive health among Somali refugee women in Sweden2013In: 19th Nordic Midwifery Congress - Nordic and Global Challenges: Book of abstracts, 2013, p. 75-Conference paper (Refereed)
    Abstract [en]

    Perceptions and experiences of war, violence and migration and related sexual and reproductive health among Somali refugee women in Sweden.

    Background and objectives: Sweden has during the latest six years experienced a twofold increase of Somali born refugees. Elevated levels of pregnancy related morbidity and perinatal complications are seen among Somali born refugee women.  Research has shown links between a mother´s prenatal stress and anxiety and the health of the child the first year. Furthermore, violence towards a mother-to-be has negative health effects and increases the neonatal mortality The specific aim in the current study was to explore perceptions and experiences of war, violence and migration among Somali refugee women in Sweden. This in order to find strategies in caring for birth giving Somali refugee women, with possible experiences of violence, which would benefit the woman and society at large.

    Material and methods: Qualitative individual audio-recorded interviews were conducted with Somali born refugee women in fertile ages. Interviews were held in three steps: 1) personal narratives by newly arrived Somali born women, 2) perceptions and views out of a depersonalized case and 3) reflections upon emerging themes by female key persons of Somali origin. Thematic analysis according to Clarke and Braun was applied.

    Preliminary results: The analysis resulted in two main themes: Lives controlled by the presence of violence and Sacrificing for the sake of a future. Access to education, livelihood opportunities and health facilities has been strictly limited by the long-lasting civil war. Escalated violations of sexual and reproductive health and rights were a common triggering factor for finalizing escape. Lives have been extensively marked by family separations. Patience created by war and a pragmatic orientation in life have made survival possible.

    Conclusions: To be presented at the congress

    Implications for practice: The results will provide increased evidence based knowledge useful to midwives when caring and supporting birth giving refugee women.

     

     

     

  • 7.
    Byrskog, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Centrum för klinisk forskning, Dalarna, Institutionen för kvinnors och barns hälsa, Uppsala Universitet.
    Olsson, Pia
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Essén, Birgitta
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Violence and reproductive health preceding flight from war: accounts from Somali born women in Sweden2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, article id 892Article in journal (Refereed)
    Abstract [en]

    Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden.

    Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied.

    Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war.

    Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and enhancement of well-being and sexual and reproductive health and rights in receiving countries after migration.

  • 8.
    Byrskog, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Centrum för klinisk forskning, Dalarna, Institutionen för kvinnors och barns hälsa, Uppsala Universitet. .
    Olsson, Pia
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Essén, Birgitta
    Institutionen för kvinnors och barns hälsa, Uppsala Universitet .
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Violence, sexual and reproductive health and rights in Somalia: Qualitative interviews with Somali born women in Sweden2013Conference paper (Other academic)
    Abstract [en]

    Background: Political violence is a push factors for migration and social determinants of health among migrants. The Somali migration to Sweden has increased threefold during the latest six years, now comprising refugees with more than 20 years of war experiences. Adverse childbearing health and outcomes are reported among Somali born refugees in high income countries. Health is influenced by earlier life experiences and a link between adverse sexual and reproductive health, violence and mental distress is described in research. Therefore, the aim was to explore experiences and perceptions on war, violence and sexual and reproductive health before migration among Somali born women in Sweden.

     

    Method: Qualitative semi-structured individual interviews with Somali born refugee women living in Sweden were conducted, based on personal narratives and a hypothetical case. Thematic analysis was applied.

    Results: Escalating violence and power based restrictions permeated gradually all aspect of life and limited both access to and quality of reproductive health services in pre-migration Somalia. Formal societal support for women exposed to violence was absent. This reinforced shame and stigma connected to war related and community based sexual violence and the silence surrounding sexual and intimate partner violence. Women expressed survival strategies in the context of war based on social networks, pragmatism, strength and faith.

    Conclusions: Lack of formal structures on community levels has together with collective violence negatively impacted the whole spectra of women’s lives which have undermined the sexual and reproductive and health and rights. Several factors reinforce non-disclosure of violence exposure and can thus hamper health care seeking for violence related illness in the receiving country. Survival strategies shaped by war contain resources for resilience and enhancement of mental, sexual and reproductive health in receiving country.

    Keywords: Somalia, war, violence, refugee, sexual and reproductive health and rights, qualitative method, thematic analysis

     

  • 9. Egeh, Abdi-Aziz
    et al.
    Dugsieh, Osman
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    The views of Somali religious leaders on birth spacing: A qualitative study2019In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 20, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Background

    Birth spacing is an important health intervention for women to attain good physical and mental health. In Somalia, religious leaders play a decisive role in approving or rejecting the use of family planning.

    Objective

    The study aimed to investigate Somali Islamic religious leaders’ views on birth spacing.

    Method

    Qualitative individual interviews were conducted with 17 Somali Islamic religious leaders aged 28–59 years and analysed through content analysis.

    Results

    The main category that emerged from the analysis was that the concept “birth spacing should be used and nor family planning to be in accordance with the Islamic religion. Two perspectives of views of birth spacing were identified: accepted ways and unaccepted ways. The accepted ways include breastfeeding, use of contraceptives causing no harm to the women’s health, and coitus interruptus. The preferred method should be determined by a joint agreement between the husband and wife, and that Muslim doctors should play a key role while the couples investigate their preferred method. Using contraceptives with the intention to limit the number of children was against Islamic values and practice. In addition, it was believed that using condoms promoted the temptation to engage in sex outside the marriage and was therefore prohibited.

    Conclusion

    According to the religious Islamic leaders, selected practice recommendations for contraceptive use is permitted in relation to birth spacing to promote the health of the mother and child. When providing professional contraceptive counselling to Muslim women, the word “birth spacing” is recommended to be used instead of “family planning”.

  • 10.
    Graner, Sophie
    et al.
    Karolinska Institutet, Umeå University.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Le Quyen, Duong
    Population Services/Vietnam, Hanoi, Vietnam.
    Krantz, Gunilla
    Department of Community Medicine and Public Health, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden .
    Mogren, Ingrid
    Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, .
    Pregnant women’s perception on signs and symptoms during pregnancy, and maternal health care in a rural low resource setting2013In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 92, no 9, p. 1094-1100Article in journal (Refereed)
    Abstract [en]

    Objective. Women’s understanding of pregnancy and antenatal care is influenced by their cultural context.  In low income settings women may have limited influence over their reproductive health including when to seek health care. Awareness of signs of pregnancy complications is essential to seek timely care. The use of antenatal care services in Vietnam has been studied with quantitative methods but there are few qualitative studies on the perceptions of pregnancy and maternal health care among Vietnamese women.

    Design. Four focus group discussions (FGD) with pregnant women were performed.

    SettingThe study was conducted in a rural district in northern Vietnam.

    PopulationPregnant women in the last trimester living in Bavi district, Vietnam.

    MethodThe data were analysed using manifest and latent content analysis.

    ResultThe latent theme ‘Securing pregnancy during normal course and at deviation’, consisting of the main categories ‘Ensuring a healthy pregnancy’ and ‘Separating the normal from the abnormal’ emerged.

    ConclusionThis qualitative study of pregnant women in rural Vietnam indicates how women create a strategy to promote a healthy pregnancy through lifestyle adjustments, gathering of information, and seeking timely medical care. Insight in pregnancy-related conditions were sought from various sources and influenced both by Vietnamese traditions and modern medical knowledge. Public knowledge about deviating symptoms during pregnancy and high confidence in maternal health care are most likely contributing factors to the relative good maternal health status in Vietnam.

     

     

     

  • 11.
    Graner, Sophie
    et al.
    Umeå University.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Phuc, Ho Dang
    Huong, Dao Lan
    Krantz, Gunilla
    Mogren, Ingrid
    Adverse perinatal and neonatal outcomes and their determinants in rural Vietnam 1999-20052010In: Paediatric and Perinatal Epidemiology, ISSN 0269-5022, E-ISSN 1365-3016, Vol. 24, no 6, p. 535-545Article in journal (Refereed)
    Abstract [en]

    Population-based estimations of perinatal and neonatal outcomes are sparse in Vietnam. There are no previously published data on small for gestational age (SGA) infants. A rural population in northern Vietnam was investigated from 1999 to 2005 (n = 5521). Based on the birthweight distributions within the population under study, reference curves for intrauterine growth for Vietnamese infants were constructed and the prevalence and distribution of SGA was calculated for each sex. Neonatal mortality was estimated as 11.6 per 1000 live births and the perinatal mortality as 25.0 per 1000 births during the study period. The mean birthweight was 3112 g and the prevalence of low birthweight was 5.0%. The overall prevalence of SGA was 6.4%. SGA increased with gestational age and was 2.2%, 4.5% and 27.1% for preterm, term and post-term infants, respectively. Risk factors for SGA were post-term birth: adjusted odds ratio (AOR) 7.75 [95% CI 6.02, 9.98], mothers in farming occupations AOR 1.72 [95% CI 1.21, 2.45] and female infant AOR 1.61 [95% CI 1.27, 2.03]. There was a pronounced decrease in neonatal mortality after 33 weeks of gestation. Suggested interventions are improved prenatal identification of SGA infants by ultrasound investigation for fetal growth among infants who do not follow their expected clinical growth curve at the antenatal clinic. Other suggestions include allocating a higher proportion of preterm deliveries to health facilities with surgical capacity and neonatal care.

  • 12. Grooten, Wilhelmus Johannes Andreas
    et al.
    Hansson, Amanda
    Forsman, Mikael
    Kjellberg, Katarina
    Toomingas, Allan
    Müller, Mira
    Svartengren, Magnus
    Äng, Björn
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet; Uppsala University.
    Non-participation in initial and repeated health risk appraisals: a drop-out analysis based on a health project2019In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, article id 130Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health risk assessment (HRAs) are commonly used by occupational health services (OHS) to aid workplaces in keeping their employees healthy, but for unknown reasons, many employees choose not to participate in the HRAs. The aim of the study was to explore whether demographic, lifestyle and health-related factors in employees are associated with non-participation in initial and repeated HRAs.

    METHODS: In an OHS-based health project, 2022 municipal employees were asked to participate in three repeated HRAs. Multiple logistic regression analyses were used so as to determine associations between non-participating and demographic, lifestyle and health-related factors (e.g. biomarkers).

    RESULTS: Among the employees who were asked to participate in the health project, more than half did not participate in any HRA and among those who did, more than one third did not participate in repeated HRAs. Young age, male sex and being employed in the Technical department or Health and Social Care department in comparison with being employed in the department for Childcare and Education were factors significantly associated with non-participation in the initial HRA. These factors, together with being on sick leave and having unhealthy dietary habits, were factors associated with non-participation in repeated HRAs.

    CONCLUSIONS: Among the non-participators in initial HRAs and in repeated HRAs younger men and those already related to ill-health were overrepresented. This implicates that health care providers to a higher extent should focus on "those most needed" and that employers should be more engaged in results of repeated HRA's. Future studies should focus on modifiable variables that could make the HRAs more attractive and inclusive.

  • 13.
    Hogmark, Sara
    et al.
    Falu County Hospital, Obstetrics and Gynaecology, Department of Women's and Children's Health (IMCH), Uppsala University, Uppsala, Sweden.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Women's and Children's Health, Karolinska Institutet, School of Social and Health Science, Dalarna University, Falun, Sweden.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet, Womens and Childrens Health.
    Ohlsson, Hannes
    Uppsala University, Womens and Childrens Health.
    Essén, Birgitta
    Uppsala University, Womens and Childrens Health.
    Medical students’ knowledge, attitudes, and perceptions on contraceptive use and counselling: a cross-sectional survey in Maharashtra, India2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 12, article id e003739Article in journal (Refereed)
    Abstract [en]

    Objectives. This study aimed to investigate the knowledge, attitudes and perceptionstowards contraceptive use and counselling among medical students in Maharashtra, India.

    Setting. Considerable global maternal mortality and morbidity could be avoided through theuse of effective contraception. In India, contraception services are frequently unavailable or there are obstacles to obtaining modern, reversible contraceptives.

    Participants. A cross-sectional descriptive study using a self-administered questionnaire was conducted among 1996 medical students in their fifth year of study at 27 medical colleges in the state of Maharashtra, India. Descriptive and analytical statistics interpreted the survey instrument and significant results were presented with 95% CI.

    Results. Respondents expressed a desire to provide contraceptive services. A few studentshad experienced training in abortion care. There were misconceptions about moderncontraceptive methods and the impact of sex education. Attitudes towards contraceptionwere mainly positive, premarital counselling was supported and the influence of traditional values and negative provider attitudes on services was recognised. Gender, area of upbringing and type of medical college did not change the results.

    Conclusions. Despite mostly positive attitudes towards modern contraceptives, sex education and family planning counselling, medical students in Maharashtra have misconceptions about modern methods of contraception. Preservice and in-service training in contraceptive counselling should be implemented in order to increase women's access to evidence-based maternal healthcare services.

  • 14.
    Iyengar, Kirti
    et al.
    Karolinska Institutet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Iyengar, Sharad
    Action for Reserach in Health (ARTH).
    Paul, Mandira
    Uppsala Universitet.
    Essen, Birgitta
    Uppsala Universitet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Home use of misoprostol for early medical abortion in a low resource setting: secondary analysis of a randomized controlled trial2016In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 2, p. 173-181Article in journal (Refereed)
  • 15.
    Iyengar, Kirti
    et al.
    Karolinska institutet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Iyengar, Sharad
    Action for Reserach in Health (ARTH).
    Paul, Mandira
    Uppsala Universitet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Essen, Birgitta
    Uppsala Universitet.
    “Who wants to go repeatedly to the hospital?”: Perceptions and experiences of simplified medical abortion in Rajasthan, India2016In: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 3Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to explore women's experiences and perceptions of home use of misoprostol and of the self-assessment of the outcome of early medical abortion in a low-resource setting in India. In-depth interviews were conducted with 20 women seeking early medical abortion, who administered misoprostol at home and assessed their own outcome of abortion using a low-sensitivity pregnancy test. With home use of misoprostol, women were able to avoid inconvenience of travel, child care, and housework, and maintain confidentiality. The use of a low-sensitivity pregnancy test alleviated women's anxieties about retained products. Majority said they would prefer medical abortion involving a single visit in future. This study provides nuanced understanding of how women manage a simplified medical abortion in the context of low literacy and limited communication facilities. Service delivery guidelines should be revised to allow women to have medical abortion with fewer visits.

  • 16.
    Klingberg-Allvin, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Amanda, Cleeve
    Karolinska Institutet.
    Susan, Atuhairwe
    Makerere Universititet.
    Nazaarius Mbona, Tumwesigye
    Makerere Universitetet.
    Elisabeth, Faxelid
    Karolinska Institutet.
    Josaphat, Byamugisha
    Makerere Universitetet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Is treatment of incomplete abortion with misoprostol by midwives safe and effective?: Randomized controlled equivalence trial to compare physicians and midwives at district level in Uganda2015In: Abstracts: XXI FIGO World Congress of Gynaecology and Obstetrics, Vancouver, 4-9 October 2015, 2015Conference paper (Refereed)
  • 17.
    Klingberg-Allvin, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hatakka, Mathias
    Dalarna University, School of Technology and Business Studies, Information Systems.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Byrskog, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Egal, Jama
    "Change-makers in midwifery care": Exploring the differences between expectations and outcomes - a qualitative study of a midwifery net-based education programme in the Somali region2019In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 69, p. 135-142Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to explore midwifery educators’ expected outcomes in the net-based master's programme, the programmes’ realised outcomes and the reported difference regarding the increased choices for the graduates and the effect on their agency.

    Design

    In this case study, we focused on a net-based master's programme in sexual and reproductive health in Somalia. Somalia suffers from a shortage of skilled birth attendants and there is a need for building up the capacity of midwifery educators.

    Setting and participants

    Data was collected in focus group discussions at the start of the programme and eight months after the students graduated. The data were analysed through the lens of the choice framework, which is based on the capability approach.

    Findings

    Findings show that many of the graduates’ expectations were met, while some were more difficult to fulfil. While the midwives’ choices and resource portfolios had improved because of their role as educators, the social structure prevented them from acting on their agency, specifically in regards to making changes at the social level. Several of the positive developments can be attributed to the pedagogy and structure of the programme.

    Conclusion

    The flexibility of net-based education gave the midwifery educators a new educational opportunity that they previously did not have. Students gained increased power and influence on some levels. However, they still lack power in government organisations where, in addition to their role as educators, they could use their skills and knowledge to change policies at the social level.

  • 18.
    Larsson, Elin
    et al.
    Karolinska institutet.
    Friedh, Sara
    Karolinska institutet.
    Essen, Birgitta
    Uppsala Universitet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Is equality in abortion care achievable care? Health care workers perspectives of providing abortion care to foreign-born women in Sweden2015Conference paper (Refereed)
  • 19.
    Oddsson, Kristjan
    et al.
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Danielsson, Evelina
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Björn Ekbloms och Mats Börjessons forskningsgrupp.
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH.
    Wahlgren, Lina
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Andersson, Eva
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Development of physical tests and ratings scales of perceived health in a project with supervised physical activity for elderly.2010Conference paper (Refereed)
    Abstract [en]

    Background: Valid and reliable field tests for measuring physical fitness and different health parameters is an important matter for evaluating effects of exercise interventions.

    Purpose: The aim was to study different test parameters such as aerobic capacity, strength, perceived health and life style habits, such as physical activity, in a physical activity intervention for elderly people.

    Method: 117 old-age pensioners (99 women and 18 men). Their mean age (yrs) and BMI (kg/m2 ) was 74 and 26 for the women and 73 and 25 for the men, respectively. Different aerobic, strength and balance tests were measured. Guided physical activity (nordic walking, strength training, aqua gymnastics), were given 45-60 min, 2 times/week for 8-12 weeks. Perceived exertion ratings during the exercises were moderate and/or strong.

    Results: Significant changes (p< 0,05) were seen between pre- and post tests regarding all physical tests except the balance test for men. Even the perceived physical and mental health significantly improved. The mean values for questions concerning self reported inactive/active life style, including sedentary time, were changed to a more active life style.

    Conclusion: 8-12 weeks of guided physical activity can improve several physiological parameters which are positively correlated to decreased risk of numerous diseases. More research is needed to develop reliable and valid field tests for physical capacity and different health parameters.

  • 20.
    Osman, Fatumo
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Ladnaan - att må bra: En utvärdering av ett riktat stöd till somaliska föräldrar i Borlänge Kommun2015Report (Other academic)
    Abstract [sv]

    Folkhälsomyndigheten har finansierat ett samarbetsprojekt mellan Borlänge kommun och Högskolan Dalarna för att anpassa och implementera ett föräldrastödsprogram till somaliska föräldrar, samt att mäta effekten av denna intervention avseende föräldrars och barns psykiska hälsa. Studien började med en explorativ delstudie med syfte att samla kunskap om vad somaliska föräldrar upplever som utmanande i sitt föräldraskap i Sverige, vilket behov av föräldrastöd de behöver samt hur ett sådant stöd ska vara utformat. Studien genomfördes med hjälp av fokusgruppsintervjuer med 23 föräldrar (15 mammor och 8 pappor) boende i Borlänge. Resultatet visade att föräldrarna upplevde en rad utmaningar i sin nya livssituation och i sitt föräldraskap i nya landet. De beskrev skillnader i synsätt på barnuppfostran och föräldraskap mellan hemlandet och Sverige och eftersträvade därför att kulturanpassa sitt föräldraskap.

    Resultaten från denna studie samt en genomgång av forskning kring föräldrastöd låg till grund för valet av föräldrastödsprogram samt ett samhällsorienterande tillägg till programmet.

     

    Målgrupp för studien var föräldrar med barn i åldrarna 11-16 år och som upplevde stress i sitt föräldraskap. Föräldrarna erbjöds sammanlagt 16 timmars utbildning fördelat på 12 träffar (10 timmar Connect föräldrastöd + 6 timmar samhällsorienterande tillägg). Effekten av föräldrastödet undersöktes genom en randomiserad kontrollerad studie där totalt 120 föräldrar ingick. De preliminära resultaten visar att deltagande föräldrars barn har förbättrats signifikant i subskalorna ”socialt” och ”skola”. Dessutom minskade barnens oro, somatiska problem, sociala problem och brytande av regler.

     

    Föräldrarna var nöjda med interventionen. De upplevde att de fått en ökad kunskap om hur socialtjänstens arbete fungerar och fått förtroende för deras arbete kring barn och unga. Över hälften av föräldrarna upplevde sig mer säkra i sin föräldraroll och att deras relation med barnen hade förbättrats.

     

    Genom en processutvärdering av implementeringen av föräldrastödet har framgångsfaktorer för genomförandet avföräldrastödsprogrammet studerats. Resultatet visade att de olika strategier som vidtagits vid rekrytering av föräldrar och implementering av interventionen har varit lyckade. Exempel på sådana strategier har varit att projektmedarbetarna som rekryterat till föräldrastödet har varit av Somaliskt ursprung, kursen har getts på somaliska men framförallt att föräldrastödet utgick ifrån föräldrarnas upplevda behov.

  • 21.
    Paul, Mandira
    et al.
    Uppsala Universitet.
    Iyengar, Kirti
    Karolinska institutet.
    Iyengar, Sharad
    Action for Reserach in Health (ARTH).
    Essen, Birgitta
    Uppsala Universitet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Simplified Follow-up after Medical Abortion using a Low-sensitivity Urinary Pregnancy Test and a Checklist in Rajasthan, India – Study Protocol and Intervention adaptation of a Randomised Control Trial2014Conference paper (Refereed)
    Abstract [en]

    Background

    The WHO suggests that simplification of the medical abortion regime will contribute to an

    increased acceptability of medical abortion, among women as well as providers. It is expected

    that a home-based follow-up after a medical abortion will increase the willingness to opt for

    medical abortion as well as decrease the workload and service costs in the clinic. This study

    protocol describes an RCT that aims to evaluate the efficacy of home-based self-assessment

    after a medical abortion and the acceptability and feasibility of the intervention in a lowresource

    setting.

    Method/Design

    The study is a randomised, controlled, non-superiority trial that will evaluate the effectiveness

    and acceptability of self-assessment using a low-sensitivity pregnancy test and a checklist two

    weeks after medical abortion. Women screened to participate in the study are those with

    unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women

    randomised to the self-assessment group will use the low-sensitivity pregnancy test and the

    checklist at home, while the women in the clinic follow-up group will return to the clinic for

    routine follow-up carried out by a doctor. To ensure feasibility of the self-assessment

    intervention an adaption phase took place at the selected study sites before study initiation.

    This was to optimise and tailor-make the intervention and the study procedures and resulted

    in the development of a pictorial instruction sheet for how to use the low-sensitivity

    pregnancy test and the checklist of danger signs after a medical abortion.

    Discussion

    In this paper, we will describe the study protocol for a randomised control trial investigating

    the efficacy of simplified follow-up in terms of home-based self-assessment, two weeks after

    a medical abortion. Moreover, a description of the adaptation phase is included for a better

    understanding of the implementation of the intervention in a setting where literacy is low and

    the road-connections are poor.

    Trial registration

    Clinicaltrials.gov (No. NCT01827995)

  • 22.
    Paul, Mandira
    et al.
    Uppsala Universitet.
    Iyengar, Kirti
    Karolinska Institutet.
    Iyengar, Sharad
    Actiona for Reserach in Health (ARTH), India.
    Essen, Birgitta
    Uppsala Universitet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Simplified follow-up after medical abortion using a low-sensitivity urinary pregnancy test and a pictorial instruction sheet in Rajasthan, India: study protocol and intervention adaptation of a randomised control trial2014In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 14, article id 98Article in journal (Refereed)
    Abstract [en]

    The World Health Organisation suggests that simplification of the medical abortion regime will contribute to an increased acceptability of medical abortion, among women as well as providers. It is expected that a home-based follow-up after a medical abortion will increase the willingness to opt for medical abortion as well as decrease the workload and service costs in the clinic.

    Trial design

    The study is a randomised, controlled, non-superiority trial .

    Methods

    Women screened to participate in the study are those with unwanted pregnancies and gestational ages equal to or less than nine weeks. Eligible women randomised to the home-based assessment group will use a low-sensitivity pregnancy test and a pictorial instruction sheet at home, while the women in the clinic follow-up group will return to the clinic for routine follow-up carried out by a doctor. The primary objective of the study is to evaluate the effectiveness of home-based assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet 10-14 days after an early medical abortion. Providers or research assistants will not be blinded during outcome assessment. To ensure feasibility of the self-assessment intervention an adaption phase took place at the selected study sites before study initiation. This was to optimise and tailor-make the intervention and the study procedures and resulted in the development of the pictorial instruction sheet for how to use the low-sensitivity pregnancy test and the danger signs after a medical abortion.

    Discussion

    In this paper, we will describe the study protocol for a randomised control trial investigating the efficacy of simplified follow-up in terms of home-based assessment, 10-14 days after a medical abortion. Moreover, a description of the adaptation phase is included for a better understanding of the implementation of the intervention in a setting where literacy is low and the road-connections are poor. Trial registration: Clinicaltrials.gov NCT01827995. Registered 04 May 2013

  • 23.
    Paul, Mandira
    et al.
    Uppsala Universitet.
    Josaphat, Byamugisha
    Makerere Universitetet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Elin
    karolinska institutet.
    Health care providers balancing norms and practice: Challenges and opportunities in contraceptive counselling to young people in Uganda2015Conference paper (Refereed)
  • 24.
    Råssjö, Eva-Britta
    et al.
    Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden; Clin Res Ctr, Dalarna, Sweden.
    Byrskog, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden; Dalarna Univ, Sch Hlth & Social Sci, Falun, Sweden.
    Samir, Raghad
    Falun Cent Hosp, Dept Obstet & Gynaecol, Falun, Sweden ; Clin Res Ctr, Dalarna, Sweden.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Inst, Dept Womens & Childrens Hlth, S-10401 Stockholm, Sweden.
    Somali women’s use of maternity health services and the outcome of their pregnancies: a descriptive study comparing Somali migrants with inborn Swedish Women2013In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 4, no 3, p. 99-106Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe how Somali immigrant women in a Swedish county access and use the antenatal care and health services, their reported and observed health problems and the outcome of their pregnancies.

    Study design: Retrospective, descriptive study, comparing data obtained from the records of antenatal and obstetric care for Somali born women with the same data for parity matched women born in Sweden giving birth between 2001 and 2009.

    Main outcome measures: Utilisation of antenatal health care (timing and number of visits), pregnancy complications (severe hyperemesis, anaemia, preeclampsia, urinary tract infections), mode of birth (normal vaginal, operative vaginal, caesarean), and infant outcomes (preterm birth, birth weight, and perinatal mortality)

    Results: Compared to the 523 Swedish-born women the 262 Somali women booked later and made less visits for antenatal care. They were more likely to have anaemia, severe hyperemesis and recurrent urinary tract infection. Emergency caesarean section (OR 9.90, CI 1.16-3.10), especially before start of labour (OR 4.96, CI 1.73-14.22), high perinatal mortality  with seven versus one perinatal deaths and small for date infants (OR 2.95, CI 1.49-5.82) was also more prevalent.

    Conclusion: Pregnant Somali immigrant women constitutes a vulnerable group that needs targeted attention. There is an increased risk for intrauterine foetal death, small for date and low birth weight infants as well as serious maternal morbidity.

     

     

     

  • 25.
    Sjöström, Susanne
    et al.
    Karolinska Institutet.
    Essen, Birgitta
    Uppsala Universitet.
    Syden, Filip
    Uppsala Universitet.
    Gemzell-Danielsson, Kristina
    Karolinska Institutet.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet; Karolinska Institutet.
    Medical students' attitudes and perceptions on abortion: a cross-sectional survey among medical interns in Maharastra, India2014In: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 90, no 1, p. 42-46Article in journal (Refereed)
    Abstract [en]

    Introduction: Although abortion care has been an established routine since decades in India, 8% of maternal mortality is attributed to unsafe abortion. Increased knowledge and improved attitudes among health care providers have a potential to reduce barriers to safe abortion care by reducing stigma and reluctance to provide abortion. Previous research has shown that medical students' attitudes can predict whether they will perform abortions. The objective of our study was to explore attitudes toward abortion among medical interns in Maharastra, India.

    Study Design: A cross-sectional survey was carried out among 1996 medical interns in Maharastra, India. Descriptive and analytical statistics were used to interpret the study instrument.

    Results: Almost one quarter of the respondents considered abortion to be morally wrong, one fifth did not find abortions for unmarried women acceptable and one quarter falsely believed that a woman needs her partner or spouse's approval to have an abortion. Most participants agreed that unsafe abortion is a serious health problem in India. A majority of the respondents rated their knowledge of sexual and reproductive health as good, but only 13% had any clinical practice in abortion care services.

    Conclusion: Disallowing attitudes toward abortion and misconceptions about the legal regulations were common among the surveyed medical students. Knowledge and attitudes toward abortion among future physicians could be improved by amendments to the medical education, potentially increasing the number of future providers delivering safe and legal abortion services.

  • 26.
    Vinberg, Stig
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Sandberg, Karl W
    Mittuniversitetet, Institutionen för informationsteknologi och medier.
    Hydén, Katarina
    Schönbäck, Catharina
    Förbättringsprocesser: vägar till arbetsglädje, hälsa och effektivitet2006Book (Other academic)
1 - 26 of 26
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