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  • 1001.
    Svensson, Mikael
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics. Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Adolescent Alcohol- and Illicit Drug-Use in First and Second Generation Immigrants in Sweden2010In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 38, no 2, p. 184-191Article in journal (Refereed)
  • 1002.
    Svensson, Mikael
    et al.
    Karlstad University, Faculty of Economic Sciences, Communication and IT, Department of Economics and Statistics. Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Social and Life Sciences, Centre for Research on Child and Adolescent Mental Health.
    Adolescents Alcohol-use and Economic Conditions-: A Multilevel Analysis of Data from a Period with Big Economic Changes 20092010In: European Journal of Health Economics, ISSN 1618-7598, E-ISSN 1618-7601, Vol. 11, no 6, p. 533-541Article in journal (Refereed)
  • 1003.
    Takaro, Tim K.
    et al.
    Simon Fraser Univ, Vancouver, BC, Canada..
    Scott, James A.
    Univ Toronto, Toronto, ON, Canada..
    Allen, Ryan W.
    Simon Fraser Univ, Vancouver, BC, Canada..
    Anand, Sonia S.
    McMaster Univ, Hamilton, ON, Canada..
    Becker, Allan B.
    Univ Manitoba, Winnipeg, MB, Canada..
    Befus, A. Dean
    Univ Alberta, Edmonton, AB, Canada..
    Brauer, Michael
    Univ British Columbia, Vancouver, BC V5Z 1M9, Canada..
    Duncan, Joanne
    McMaster Univ, Hamilton, ON, Canada..
    Lefebyre, Diana L.
    McMaster Univ, Hamilton, ON, Canada..
    Lou, Wendy
    Univ Toronto, Toronto, ON, Canada..
    Mandhane, Plush J.
    Univ Alberta, Edmonton, AB, Canada..
    McLean, Kathleen E.
    Simon Fraser Univ, Vancouver, BC, Canada..
    Miller, Gregory
    Northwestern Univ, Evanston, IL USA..
    Sbihi, Hind
    Univ British Columbia, Vancouver, BC V5Z 1M9, Canada..
    Shu, Huan
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Simon Fraser Univ, Vancouver, BC, Canada.;Karlstad Univ, Karlstad, Varmland, Sweden..
    Subbarao, Padmaja
    Univ Toronto, Toronto, ON, Canada.;Hosp Sick Children, Toronto, ON M5G 1X8, Canada..
    Turvey, Stuart E.
    Univ British Columbia, Vancouver, BC V5Z 1M9, Canada..
    Wheeler, Amanda J.
    Edith Cowan Univ, Joondalup, WA, Australia.;Hlth Canada, Ottawa, ON K1A 0L2, Canada..
    Zeng, Leilei
    Univ Waterloo, Waterloo, ON N2L 3G1, Canada..
    Sears, Malcolm R.
    McMaster Univ, Hamilton, ON, Canada..
    Brook, Jeffrey R.
    Univ Toronto, Toronto, ON, Canada.;Environm Canada, Toronto, ON, Canada..
    The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study: assessment of environmental exposures2015In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 25, no 6, p. 580-592Article in journal (Refereed)
    Abstract [en]

    The Canadian Healthy Infant Longitudinal Development birth cohort was designed to elucidate interactions between environment and genetics underlying development of asthma and allergy. Over 3600 pregnant mothers were recruited from the general population in four provinces with diverse environments. The child is followed to age 5 years, with prospective characterization of diverse exposures during this critical period. Key exposure domains include indoor and outdoor air pollutants, inhalation, ingestion and dermal uptake of chemicals, mold, dampness, biological allergens, pets and pests, housing structure, and living behavior, together with infections, nutrition, psychosocial environment, and medications. Assessments of early life exposures are focused on those linked to inflammatory responses driven by the acquired and innate immune systems. Mothers complete extensive environmental questionnaires including time-activity behavior at recruitment and when the child is 3, 6, 12, 24, 30, 36, 48, and 60 months old. House dust collected during a thorough home assessment at 3-4 months, and biological specimens obtained for multiple exposure-related measurements, are archived for analyses. Geo-locations of homes and daycares and land-use regression for estimating traffic-related air pollution complement time-activity-behavior data to provide comprehensive individual exposure profiles. Several analytical frameworks are proposed to address the many interacting exposure variables and potential issues of co-linearity in this complex data set.

  • 1004.
    Tang, Jiaqi
    et al.
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Yuan, Ye
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Wei, Chenxi
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Liao, Xiaomei
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Yuan, Junlin
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Nånberg, Eewa
    Zhang, Yinping
    Tsinghua Univ, Dept Bldg Sci, Beijing 100084, Peoples R China..
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Yang, Xu
    Cent China Normal Univ, Coll Life Sci, Hubei Key Lab Genet Regulat & Integrat Biol, Sect Environm Biomed, Wuhan, Peoples R China..
    Neurobehavioral changes induced by di(2-ethylhexyl) phthalate and the protective effects of vitamin E in Kunming mice2015In: Toxicology research, ISSN 2045-452X, Vol. 4, no 4, p. 1006-1015Article in journal (Refereed)
    Abstract [en]

    Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer commonly used in PVC that may leach into the environment, and has been shown to adversely affect the health of humans and animals. We undertook a study to ascertain the neurotoxicity of DEHP in Kunming mice. This study included three rounds of testing. In the first round, Kunming mice were exposed to different concentrations of DEHP (0, 5, 50, 500 mg kg(-1) per day) after which their cognitive ability was assessed using the Morris water maze (MWM) test. The reactive oxygen species (ROS) content in tissue and the malondialdehyde (MDA) content of brains were also measured. In the second round, vitamin E (50 mg kg(-1) per day) was given daily as an anti-oxidant via the intragastric route. Cognitive deficits and locomotor activity, as well as ROS and MDA contents were tested employing the same methods. In the third round, the depressive mood of mice after DEHP exposure (500 mg kg(-1) per day) was measured using the open field test, the tail suspension test, and the forced swim test. The main findings of this study include: (1) a statistical association exists between DEHP oral exposure and spatial learning (DEHP 500 mg kg(-1) per day) and memory (DEHP 50 mg kg(-1) per day) dysfunction as ascertained by an MWM test of Kunming mice. (2) A statistical association was also found between DEHP oral exposure (50 and 500 mg kg(-1) per day) and oxidative stress (ROS and MDA) of mouse brain tissue. (3) Co-administration of vitamin E (50 mg kg(-1) per day) diminishes the elevation of ROS and MDA induced by DEHP (50 mg kg(-1) per day) from significant levels to non-significant levels. (4) Co-administration of vitamin E (50 mg kg(-1) per day) protects against mouse memory dysfunction induced by DEHP (50 mg kg(-1) per day) from being significant to being not significant. (5) In the 5 mg kg(-1) per day DEHP exposure groups, oxidative stress in brain tissue, and neurobehavioral changes were not found. (6) High dose DEHP exposure (500 mg kg(-1) per day) may induce behavioral despair in mice. Conclusions: These data suggest that DEHP is neurotoxic with regard to cognitive ability and locomotor activity.

  • 1005.
    Tanner, Eva
    et al.
    Icahn School of Medicine at Mount Sinai, New York, NY, United State.
    Unenge Hallerbäck, Maria
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Wikström, Sverre
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Örebro Universitet.
    Lindh, Christian
    Lunds Universitet.
    Kiviranta, Hannu
    National Institute for Health and Welfare, Helsinki, Finland.
    Gennings, Chris
    Icahn School of Medicine at Mount Sinai, New York, NY, United State.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Icahn School of Medicine at Mount Sinai, New York, NY, United State.
    Early prenatal exposure to suspected endocrine disruptor mixtures is associated with lower IQ at age seven2019In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750Article in journal (Refereed)
    Abstract [en]

    Background: Endocrine disrupting chemicals (EDCs) are xenobiotics with the ability to interfere with hormone action, even at low levels. Prior environmental epidemiology studies link numerous suspected EDCs, including phthalates and bisphenol A (BPA), to adverse neurodevelopmental outcomes. However, results for some chemicals were inconsistent and most assessed one chemical at a time.

    Objectives: To evaluate the overall impact of prenatal exposure to an EDC mixture on neurodevelopment in school-aged children, and identify chemicals of concern while accounting for co-exposures.

    Methods: Among 718 mother-child pairs from the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (SELMA) study, we used Weighted Quantile Sum (WQS) regression to assess the association between 26 EDCs measured in 1st trimester urine or blood, with Wechsler Intelligence Scale for Children (IV) Intelligence Quotient (IQ) scores at age 7 years. Models were adjusted for child sex, gestational age, mother's education, mother's IQ (RAVEN), weight, and smoking status. To evaluate generalizability, we conducted repeated holdout validation, a machine learning technique.ResultsUsing repeated holdout validation, IQ scores were 1.9-points (CI = −3.6, −0.2) lower among boys for an inter-quartile-range (IQR) change in the WQS index. BPF made the largest contribution to the index with a weight of 14%. Other chemicals of concern and their weights included PBA (9%), TCP (9%), MEP (6%), MBzP (4%), PFOA (6%), PFOS (5%), PFHxS (4%), Triclosan (5%), and BPA (4%). While we did observe an inverse association between EDCs and IQ among all children when training and testing the WQS index estimate on the full dataset, these results were not robust to repeated holdout validation.

    Conclusion: Among boys, early prenatal exposure to EDCs was associated with lower intellectual functioning at age 7. We identified bisphenol F as the primary chemical of concern, suggesting that the BPA replacement compound may not be any safer for children. Future studies are needed to confirm the potential neurotoxicity of replacement analogues.

  • 1006. Tercero, F
    et al.
    Andersson, Ragnar
    Measuring traffic injuries in a developing country: an application of the capture-recapture method2004In: Accid Anal Prev. 2004 Jan;36(1):13-20Article in journal (Refereed)
  • 1007. Tercero, F
    et al.
    Andersson, Ragnar
    Peña, R
    Rocha, J
    Castro, N
    The Epidemiology of Injury in a Local Community in Nicaragua: A Household-Based Survey2006In: Public Health, 2006 Feb;120(2):106-14Article in journal (Refereed)
  • 1008. Tercero, F
    et al.
    Andersson, Ragnar
    Rocha, J
    Castro, N
    Svanström, L
    On the epidemiology of injury in developing countries: A one year emergency room based surveillance experience from León, Nicaragua1999In: International Journal for Consumer and Product Safety, 1999, Vol. 6, No. 1, pp. 33-42Article in journal (Refereed)
  • 1009.
    Tillfors, Maria
    et al.
    Univ Orebro, Sch Law Psychol & Social Work, Örebro, Sweden.
    Persson, Stefan
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Willén, Maria
    Univ Orebro, Sch Law Psychol & Social Work, Örebro, Sweden.
    Burk, William J
    Radboud Univ Nijmegen, Inst Behav Sci, Nijmegen, Netherland.
    Prospective links between social anxiety and adolescent peer relations2012In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 35, no 5, p. 1255-1263Article in journal (Refereed)
    Abstract [en]

    This study examines bi-directional links between social anxiety and multiple aspects of peer relations (peer acceptance, peer victimization, and relationship quality) in a longitudinal sample of 1528 adolescents assessed twice with one year between (754 females and 774 males; M = 14.7 years of age). Lower levels of peer acceptance predicted increases in social anxiety. Social anxiety predicted decreases in relationship support for males and increases in peer victimization for females. Collectively our findings suggest that peers seem to play a significant role for adolescent mental health and social anxiety seems to interfere with healthy peer relations. Importantly, developmental pathways for social anxiety seem to differ for adolescent females and males.

  • 1010. Trulsson, U.
    et al.
    Strandmark, Margaretha
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Klingberg, G.
    Dental health professionals' perception of treatment needs in children with disabilities2004In: Acta Odontological ScandinaviaArticle in journal (Refereed)
  • 1011. Trulsson, U.
    et al.
    Strandmark, Margaretha
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Lindälv, L.
    Mohlin, B.
    Age dependence of compliance with orthodontic treatment in children with large overjet2004In: Swedish Dental Journal 28; 101-109Article in journal (Refereed)
  • 1012. Trulsson, U.
    et al.
    Strandmark, Margaretha
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Mohlin, B.
    Berggren, U.
    A qualitive study of teenagers' decisions to undergo orthodontic treatment with fixed appliance2002In: Journal of Orthodontic 29; 197-204Article in journal (Refereed)
  • 1013.
    Unis, Brian
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Sällström, Christina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Behov av kunskap och handledning hos personal som arbetar med ensamkommande ungdomar i kunskapsområdet sex- och samlevnad samt utvärdering av en utbildningsinsats2014Report (Other academic)
  • 1014.
    Vahedi, Fatemeh
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Maksumic, Jasmina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013).
    Intagsfrekvens av kariogena produkter och munhygienvanor hos en grupp ungdomar i årskurs nio: En enkätstudie2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 1015.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Wilhelmina Children’s Hospital of the University Medical Center Utrecht, The Netherlands.
    Franssen, Gaston
    University of Amsterdam.
    Management of the self: An interdisciplinary approach toself-management in psychiatry and psychosomatic medicine2017In: Philosophy, Psychiatry, and Psychology, ISSN 1071-6076, E-ISSN 1086-3303, Vol. 24, no 2, p. 109-113Article in journal (Refereed)
  • 1016.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Univ Med Ctr Utrecht, Div Pediat, Utrecht, Netherlands..
    Fuchs, Coralie E.
    Vrije University Amsterdam, Amsterdam, Netherlands..
    van Geel, Rolf
    Open University Nijmegen, Netherlands.
    Luyten, Patrick
    University Leuven, England.
    van de Putte, Elise M.
    University Medical Centre Utrecht, Netherlands.
    The Self beyond Somatic Symptoms: A Narrative Approach to Self-Experience in Adolescent Chronic Fatigue Syndrome2015In: Psychopathology, ISSN 0254-4962, E-ISSN 1423-033X, Vol. 48, no 5, p. 278-286Article in journal (Refereed)
    Abstract [en]

    Background: The self and self-experience are often assumed to play an important role in adolescent patients presenting with severe somatic symptoms and bodily distress. Nonetheless, most empirical work on this subject is confined to studies of personality and patients' experience of negative emotionality. This study aims to move beyond mere descriptions of symptoms, traits and distress, and consequently adopts a narrative approach to self-experience in adolescent chronic fatigue syndrome (CFS). Sampling and Methods: The self-confrontation method (SCM) is a well-validated instrument to systematically analyze narrative self-experience. The SCM was used to study 42 adolescents with CFS, compared to 36 adolescents with juvenile idiopathic arthritis (JIA) and 25 matched healthy controls. The Child Health Questionnaire (CHQ-CF87) was used to assess mental health, self-esteem, and physical and psychosocial functioning. Results: Both patient groups reported significantly less positive self-experience of autonomy and success compared to healthy controls. Furthermore, patients with CFS described significantly more negative self-experience of powerlessness, isolation and unfulfilled longing. In the CHQ-CF87, both patient groups scored significantly lower on physical functioning than controls. Adolescents with CFS also scored significantly lower on mental health and self-esteem. Conclusions: Adolescent CFS entails a serious threat to the self, which might be inherent to the condition. Not only are patients more impaired in mental health, self-esteem, and physical and psychosocial functioning than patients with JIA, they also suffer from a distinct combination of high negative and low positive self-experience. These findings stress the need for strategies that empower patients towards a 'management of the self'. (C) 2015 S. Karger AG, Basel

  • 1017.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013). Univ Med Ctr Utrecht, Div Pediat, Lundlaan 6, NL-3584 EA Utrecht, Netherlands..
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health (from 2013).
    Are the time trends in adolescent psychosomatic problems related to functional impairment in daily life?: A 23-year study among 20,000 15-16 year olds in Sweden2016In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 87, p. 50-56Article in journal (Refereed)
    Abstract [en]

    Objective: Worldwide there are frequent reports on increasing psychosomatic problems, anxiety, emotional distress, conduct problems, and depression among adolescents. Recently, it was contended that secular studies on such aspects of adolescent mental health can only be evaluated adequately when data on symptom prevalence are analyzed together with data on functional impairment Still, this has not yet been done in epidemiological time-trend studies on any aspect of adolescent mental health. Therefore, this study aims to investigate if, and to what extent, changes in adolescents' symptoms of psychosomatic problems are affected when data on functional impairment are taken into account simultaneously. Methods: A repeated cross-sectional population study relating self-reported symptoms of psychosomatic problems to functional impairment; covering the time-period 1988-2011 and including 19.823 adolescents 15-16 years old in eight cohorts in one geographically defined population (Varmland, Sweden). Results: The proportion of adolescents with psychosomatic problems had increased significantly from 1988 to 2005/2008. In all cohorts the proportion of girls with psychosomatic problems was significantly higher than the proportion of boys reporting symptoms. Over the same period, there was a corresponding significant increase of the proportion of participants with symptoms of psychosomatic problems in combination with functional impairment Adding functional impairment to the measure of psychosomatic problems decreased the prevalence rates, while the shapes of the trend-curves stayed congruent in form. Conclusion: The long-term pattern of increasing psychosomatic problems among adolescents remains evident, even when taking functional impairment data into account. Previously observed trends of a deteriorating adolescent mental health are thus consistent with this study. 

  • 1018.
    Van Geelen, Stefan
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Rydelius, Per-Anders
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Hagquist, Curt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Centre for Research on Child and Adolescent Mental Health.
    Somatic symptoms and psychological concerns in a general adolescent population: Exploring the relevance of DSM-5 Somatic Symptom Disorder2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 79, no 4, p. 251-258Article in journal (Refereed)
    Abstract [en]

    Objective: DSM-5 somatic symptom disorder (SSD) constitutes a major change for psychosomaticmedicine and psychiatry, as well as for epidemiological research in these fields. This studyinvestigates somatic symptoms and psychological concerns among adolescents in order tosystematically explore the relevance of SSD for general adolescent populations.

    Methods: A crosssectionalpopulation-based design, with a symptoms-based strategy and a symptom-andpsychological-concerns-based strategy, was used to estimate the prevalence of somatic symptomsand psychological concerns in a general adolescent population (n=2476, mean age=16 years, 49%boys, 51% girls). Somatic symptoms and psychological concerns in relation to gender, and selfreportedmedical and psychiatric conditions were investigated. The association between somaticsymptoms, psychological concerns, and functional impairment in school-, family-, peer- and physicalactivities was studied.

    Results: Reporting 3+ persistent distressing somatic symptoms wassignificantly more common than reporting one or more persistent distressing somatic symptom(s)combined with serious psychological concern. The prevalence of such complaints was significantlyhigher in girls. The proportion of medical and psychiatric conditions was highest in the groupreporting 3+ persistent distressing somatic symptoms combined with serious psychological concern.Belonging to this group most significantly increased odds ratios for functional impairment.

    Conclusion: For large-scale studies on SSD, results suggest the use of measures based on multiplesomatic items in combination with psychological concerns, and a methodologically soundstandardized measure of functional impairment. To further enhance clinical decision-making, therelation of symptoms to functional impairment, and the substantial overlap of SSD with medical andpsychiatric conditions during adolescence should be addressed.

  • 1019.
    Vandenberg, Laura N.
    et al.
    Univ Massachusetts, Amherst Sch Publ Hlth & Hlth Sci, Dept Environm Hlth Sci, Amherst, MA USA..
    Agerstrand, Marlene
    Stockholm Univ, Dept Environm Sci & Analyt Chem, Stockholm, Sweden..
    Beronius, Anna
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden..
    Beausoleil, Claire
    ANSES French Agcy Food Environm & Occupat Hlth Sa, Maisons Alfort, France..
    Bergman, Ake
    Stockholm Univ, Dept Environm Sci & Analyt Chem, Stockholm, Sweden.;Swedish Toxicol Sci Res Ctr, Sodertalje, Sweden..
    Bero, Lisa A.
    Univ Sydney, Charles Perkins Ctr, Sydney, NSW, Australia..
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Icahn Sch Med Mt Sinai, New York, NY USA..
    Boyer, C. Scott
    Swedish Toxicol Sci Res Ctr, Sodertalje, Sweden..
    Cooper, Glinda S.
    US EPA, Washington, DC USA..
    Cotgreave, Ian
    Karolinska Inst, Swedish Toxicol Sci Res Ctr Swetox, Sodertalje, Sweden..
    Gee, David
    Brunel Univ London, Inst Environm Hlth & Societies, Uxbridge, Middx, England..
    Grandjean, Philippe
    Univ Southern Denmark, Dept Environm Med, Odense, Denmark. Int Agcy Res Canc, Lyon, France. Tech Univ Denmark, Natl Food Inst, Soborg, Denmark..
    Guyton, Kathryn Z.
    Hass, Ulla
    Heindel, Jerrold J.
    Natl Inst Environm Hlth Sci, Div Extramural Res & Training, Res Triangle Pk, NC USA..
    Jobling, Susan
    Brunel Univ London, Inst Environm Hlth & Societies, Uxbridge, Middx, England..
    Kidd, Karen A.
    Univ New Brunswick, Dept Biol, St John, NB, Canada.;Univ New Brunswick, Canadian Rivers Inst, St John, NB, Canada..
    Kortenkamp, Andreas
    Brunel Univ London, Inst Environm Hlth & Societies, Uxbridge, Middx, England..
    Macleod, Malcolm R.
    Univ Edinburgh, Ctr Clin Brain Sci, Edinburgh, Midlothian, Scotland..
    Martin, Olwenn V.
    Brunel Univ London, Inst Environm Hlth & Societies, Uxbridge, Middx, England..
    Norinder, Ulf
    Swedish Toxicol Sci Res Ctr, Sodertalje, Sweden..
    Scheringer, Martin
    ETH, Inst Chem & Bioengn, Zurich, Switzerland..
    Thayer, Kristina A.
    Natl Inst Environm Hlth Sci, Dept Hlth & Human Serv, Div Natl Toxicol Program, NIH, Res Triangle Pk, NC USA..
    Toppari, Jorma
    Univ Turku, Turku Univ Hosp, Turku, Finland..
    Whaley, Paul
    Univ Lancaster, Lancaster Environm Ctr, Lancaster, England..
    Woodruff, Tracey J.
    Univ Calif San Francisco, Sch Med, Program Reprod Hlth & Environm, Oakland, CA USA..
    Ruden, Christina
    Stockholm Univ, Dept Environm Sci & Analyt Chem, Stockholm, Sweden..
    A proposed framework for the systematic review and integrated assessment (SYRINA) of endocrine disrupting chemicals2016In: Environmental health, ISSN 1476-069X, E-ISSN 1476-069X, Vol. 15, article id 74Article in journal (Refereed)
    Abstract [en]

    Background: The issue of endocrine disrupting chemicals (EDCs) is receiving wide attention from both the scientific and regulatory communities. Recent analyses of the EDC literature have been criticized for failing to use transparent and objective approaches to draw conclusions about the strength of evidence linking EDC exposures to adverse health or environmental outcomes. Systematic review methodologies are ideal for addressing this issue as they provide transparent and consistent approaches to study selection and evaluation. Objective methods are needed for integrating the multiple streams of evidence (epidemiology, wildlife, laboratory animal, in vitro, and in silico data) that are relevant in assessing EDCs. Methods: We have developed a framework for the systematic review and integrated assessment (SYRINA) of EDC studies. The framework was designed for use with the International Program on Chemical Safety (IPCS) and World Health Organization (WHO) definition of an EDC, which requires appraisal of evidence regarding 1) association between exposure and an adverse effect, 2) association between exposure and endocrine disrupting activity, and 3) a plausible link between the adverse effect and the endocrine disrupting activity. Results: Building from existing methodologies for evaluating and synthesizing evidence, the SYRINA framework includes seven steps: 1) Formulate the problem; 2) Develop the review protocol; 3) Identify relevant evidence; 4) Evaluate evidence from individual studies; 5) Summarize and evaluate each stream of evidence; 6) Integrate evidence across all streams; 7) Draw conclusions, make recommendations, and evaluate uncertainties. The proposed method is tailored to the IPCS/WHO definition of an EDC but offers flexibility for use in the context of other definitions of EDCs. Conclusions: When using the SYRINA framework, the overall objective is to provide the evidence base needed to support decision making, including any action to avoid/minimise potential adverse effects of exposures. This framework allows for the evaluation and synthesis of evidence from multiple evidence streams. Finally, a decision regarding regulatory action is not only dependent on the strength of evidence, but also the consequences of action/inaction, e.g. limited or weak evidence may be sufficient to justify action if consequences are serious or irreversible.

  • 1020.
    Vichayanrat, Tippanart
    et al.
    Department of Community Dentistry, Faculty of Dentistry, Mahidol University.
    Steckler, Allan
    Department of Health Behavior and Health Education, School of Public Health, the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
    Tanasugarn, Chanuantong
    3Department of Health Education and Behavioral Science, Faculty of Public Health, Mahidol University, Bangkok, Thailand.
    Lexomboon, Duangjai
    1Department of Community Dentistry, Faculty of Dentistry, Mahidol University.
    The evaluation of a multi-level oral health intervention to improve oral health practices among caregivers of preschool children2012In: Southeast Asian Journal of Tropical Medicine and Public Health, ISSN 0125-1562, Vol. 43, no 2, p. 526-539Article in journal (Refereed)
    Abstract [en]

    This study reports the effects of a pilot multi-level oral health interventionon caregivers’ oral health practices and their determinants. Quasi-experimental,pretest-posttest evaluations using a comparison group design were employedto evaluate the effectiveness of a proposed intervention for promoting caregiveroral health behavior. The intervention consisted of three components: home visitsby lay health workers (LHWs), enhancing oral health education and services athealth centers, and community mobilization. These components were designedto target factors at intrapersonal, interpersonal, organizational and communitylevels based on a Social Ecological Model (SEM). Four oral health behaviors associatedwith early childhood caries (infant bottle feeding, tooth brushing, snackconsumption and fluoride use), and multi-level determinants were assessed duringpre- and post-tests. The one-year intervention demonstrated a positive effect ontooth brushing, using toothpaste, and fluoride supplements, but did not have asignificant effect on bottle feeding and snack consumption among children. Theintervention also had no effect on dental caries; in fact caries increased in bothcontrol and experimental groups. The caregiver knowledge, attitudes, outcomeexpectations, and self-efficacy towards these behaviors were significantly increasedin the experimental group after intervention. Caregivers in the experimentalgroup received greater social support by LHWs and health center staff than thosein the control group (p<0.001). The program had an impact on integrating oralhealth services at health centers and community participation in children’s oralhealth. These findings confirm multi-level factors influence reported oral healthbehavior, but not outcomes in terms of caries. Process evaluation is needed todetermine actual implementation levels, barriers and suggests for modificationof the program in the future to improve outcomes in terms of caries.

  • 1021.
    von Kobyletzki, L. B.
    et al.
    Lund Univ, Dept Dermatol, Inst Clin Res Malmo, Skne Univ Hosp, Malmo, Sweden.;Cty Council Varmland, Primary Care Res Unit, Karlstad, Sweden..
    Bornehag, C. G.
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Lundin, F.
    Cty Council Varmland, Clin Res Ctr, Karlstad, Sweden..
    Hasselgren, M.
    Cty Council Varmland, Primary Care Res Unit, Karlstad, Sweden..
    Svensson, K.
    Lund Univ, Dept Dermatol, Inst Clin Res Malmo, Skne Univ Hosp, Malmo, Sweden..
    Eczema in children and development of asthma and rhinitis: prospective longitudinal population-based Swedish cohort2011In: Experimental dermatology, ISSN 0906-6705, E-ISSN 1600-0625, Vol. 20, no 2, p. 170-170Article in journal (Other academic)
  • 1022.
    von Kobyletzki, Laura B.
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lunds universitet.
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smeeth, Liam
    London Sch Hyg & Trop Med, London, England.
    McKee, Martin
    London Sch Hyg & Trop Med, London, England; .
    Quint, Jennifer K.
    Imperial Coll London, Resp Epidemiol Occupat Med & Publ Hlth, London.
    Abuabara, Katrina
    Univ Calif San Francisco, Dept Dermatol, Program Clin Res, San Francisco.
    Langan, Sinead
    London Sch Hyg & Trop Med, London, England; St Johns Inst Dermatol, Dept Dermatol, London, England.
    Association between childhood allergic diseases, educational attainment and occupational status in later life: systematic review protocol2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 10, article id e017245Article in journal (Refereed)
    Abstract [en]

    Introduction Childhood allergic diseases may prevent affected children from achieving their academic potential. Potential mechanisms include absence from school due to illness and medical appointments. Experience of symptoms in classes or leisure time, and stigma associated with visible signs and symptoms, including skin disease, requirements for medication during school time or the need for specific diets, may also contribute to reduced educational attainment. Studies have investigated the association between specific allergic diseases and educational attainment. The aim of this study is to systematically review the literature on allergic diseases, educational attainment and occupational status, and if possible, calculate meta-analytic summary estimates for the associations. Methods Systematic electronic searches in Medline, EMBASE, Cochrane, Cumulative Index to Nursing & Allied Health Literature (CINAHL), PsycINFO and education Resources Information Center (ERIC); hand search in reference lists of included papers and conference reports; search for unpublished studies in clinical trial registers and the New York Academy of Medicine Grey Literature Report; data extraction; and study quality assessment (Newcastle-Ottawa Scale) will be performed. Analysis Data will be summarised descriptively, and meta-analysis including meta-regression to explore sources of heterogeneities will be performed if possible. Ethics and dissemination Dissemination in a peer-reviewed, open-access, international scientific journal is planned.

  • 1023.
    von Kobyletzki, Laura B.
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Beckman, Linda
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smirnova, J
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Smeeth, L
    London School of Hygiene and Tropical Medicine.
    Williams, H C
    Centre of Evidence Based Dermatology, University of Nottingham.
    McKee, M
    London School of Hygiene and Tropical Medicine.
    Abuabara, K
    University of California, San Francisco, USA.
    Langan, S M
    London School of Hygiene and Tropical Medicine, UK.
    Eczema and educational attainment: A systematic review2017In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 177, no 3, p. e47-e49Article, review/survey (Refereed)
    Abstract [en]

    Eczema (syn. atopic dermatitis or atopic eczema) accounts for the largest global burden of disability due to skin disease (1) . Eczema affects up to 20% of children (1) , and is associated with impaired quality of life (QoL) of a similar magnitude to cancer and epilepsy. Yet, although eczema is common in children, little is known about long-term outcomes such as educational attainment (EA) of those affected. This article is protected by copyright. All rights reserved.

  • 1024.
    von Kobyletzki, Laura B.
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skane Univ Hosp, Dept Dermatol, SE-20502 Malmo, Sweden.
    Berner, A.
    Cty Council Varmland, Primary Care Res Unit, Karlstad, Sweden.
    Carlstedt, F.
    Cty Council Varmland, Primary Care Res Unit, Karlstad Sweden.
    Hasselgren, M.
    Cty Council Varmland, Primary Care Res Unit, Karlstad, Sweden.;Univ Orebro, Sch Med, Orebro, Sweden.
    Bornehag, Carl Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. SP Tech Res Inst Sweden, Boras, Sweden.
    Svensson, A.
    Lund Univ, Skane Univ Hosp, Dept Dermatol, SE-20502 Malmo, Sweden.
    Validation of a Parental Questionnaire to Identify Atopic Dermatitis in a Population-Based Sample of Children up to 2 Years of Age2013In: Dermatology, ISSN 1018-8665, E-ISSN 1421-9832, Vol. 226, no 3, p. 222-226Article in journal (Refereed)
    Abstract [en]

    Background: Validated eczema questionnaires have been available for schoolchildren only, but the incidence of atopic dermatitis (AD) is highest during infancy. Objective: To validate a parental questionnaire to identify AD in children up to 2 years of age. Methods: Parents of 476 children answered a written questionnaire prior to an examination by a physician. Sensitivity, specificity, predictive values and test-retest reliability of the questionnaire were assessed. Results: A total of 245 (51%) girls and 231 (49%) boys, aged 1-24 months, with and without physician-diagnosed AD participated. Seventy-one children (15%) had physician-diagnosed AD. Validation of the questionnaire by comparisons with physicians' diagnoses showed a sensitivity of 0.87 (95% confidence interval, CI, 0.77-0.94) and a specificity of 0.98 (95% CI, 0.96-0.99). The positive predictive value was 0.90 (95% CI, 0.80-0.96) and the negative predictive value was 0.98 (95% CI, 0.96-0.99). Conclusion: The questionnaire identified AD in children aged 0-2 years with high accuracy.

  • 1025.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Breeze, E.
    London Sch Hyg & Trop Med, London WC1, England..
    Larsson, M.
    Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Engman, L. Hagerhed
    SP Tech Res Inst Sweden, Dept Bldg Phys & Indoor Environm, Bors, Sweden..
    Lindstrom, C. Boman
    Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Svensson, A.
    Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden..
    Remission of eczema in children and influencing factors: a prospective population-based Swedish study2012In: Experimental dermatology, ISSN 0906-6705, E-ISSN 1600-0625, Vol. 21, no 3, p. e21-e22Article in journal (Refereed)
  • 1026.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Lund University.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Breeze, Elizabeth
    London School of Hygiene and Tropical Medicine, United Kingdom.
    Larsson, Malin
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Boman Lindström, Cecilia
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Svensson, Ake
    Lund University.
    Factors Associated with Remission of Eczema in Children: A Population-based Follow-up Study2014In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 90, no 2, p. 179-184Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remission were: milder eczema (adjusted odds ratio (aOR), 1.43; 95% confidence interval (95% CI) 1.16-1.77); later onset of eczema (aOR 1.40; 95% CI 1.08-1.80); non-flexural eczema (aOR 2.57; 95% CI 1.62-4.09); no food allergy (aOR 1.51; 95% CI 1.11-2.04), and rural living (aOR 1.48; 95% CI 1.07-2.05). Certain aspects of AD and rural living were important for remission, but despite the initial hypotheses to the contrary, the environmental factors examined in this paper were not substantial predictors of remission.

  • 1027.
    von Kobyletzki, Laura B.
    et al.
    Lund Univ, Skane Univ Hosp, Dept Dermatol, SE-20502 Malmo, Sweden.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Hasselgren, Mikael
    School of Medicine, Örebro University.
    Larsson, Malin
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Boman Lindström, Cecilia
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Svensson, Åke
    und Univ, Skane Univ Hosp, Dept Dermatol, SE-20502 Malmo, Sweden.
    Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort.2012In: BMC Dermatology, ISSN 1471-5945, E-ISSN 1471-5945, Vol. 12, p. 11-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This study aimed to estimate the association between eczema in early childhood and the onset of asthma and rhinitis later in life in children.

    METHODS: A total of 3,124 children aged 1-2 years were included in the Dampness in Building and Health (DBH) study in the year 2000, and followed up 5 years later by a parental questionnaire based on an International Study of Asthma and Allergies in Childhood protocol. The association between eczema in early childhood and the incidence of asthma and rhinitis later in life was estimated by univariable and multivariable logistic regression modelling.

    RESULTS: The prevalence of eczema in children aged 1-2 years was 17.6% at baseline. Children with eczema had a 3-fold increased odds of developing asthma (adjusted odds ratio [aOR], 3.07; 95% confidence interval (CI) 1.79-5.27), and a nearly 3-fold increased odds of developing rhinitis (aOR, 2.63; 1.85-3.73) at follow-up compared with children without eczema, adjusted for age, sex, parental allergic disease, parental smoking, length of breastfeeding, site of living, polyvinylchloride flooring material, and concomitant allergic disease. When eczema was divided into subgroups, moderate to severe eczema (aOR, 3.56; 1.62-7.83 and aOR, 3.87; 2.37-6.33, respectively), early onset of eczema (aOR, 3.44; 1.94-6.09 and aOR, 4.05; 2.82-5.81; respectively), and persistence of eczema (aOR, 5.16; 2.62-10.18 and aOR, 4.00; 2.53-6.22, respectively) further increased the odds of developing asthma and rhinitis. Further independent risk factors increasing the odds of developing asthma were a parental history of allergic disease (aOR, 1.83; 1.29-2.60) and a period of breast feeding shorter than 6 months (aOR, 1.57; 1.03-2.39). The incidence of rhinitis was increased for parental history of allergic disease (aOR, 2.00; 1.59-2.51) and polyvinylchloride flooring (aOR, 1.60; 1.02-2.51).

    CONCLUSION: Eczema in infancy is associated with development of asthma and rhinitis during the following 5-year period, and eczema is one of the strongest risk factors. Early identification is valuable for prediction of the atopic march.

  • 1028.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Mischo, M.
    Ruhr Univ Bochum, Bochum, Germany..
    Schmidt, D. A.
    N Carolina Agr & Tech State Univ, Dept Phys, Greensboro, NC 27411 USA..
    Bruendermann, E.
    Ruhr Univ Bochum, Bochum, Germany..
    Brockmeyer, N. H.
    Ruhr Univ Bochum, Dept Dermatol, Bochum, Germany..
    Potthoff, A.
    Ruhr Univ Bochum, Dept Dermatol, Bochum, Germany..
    Havenith, M.
    Ruhr Univ Bochum, Bochum, Germany..
    Changes in Antioxidant and Lipid Network in HIV patients compared to young and old patients: Probing Epidermis and Dermis by Raman Spectroscopy2012In: Journal der Deutschen Dermatologischen Gesellschaft, ISSN 1610-0379, E-ISSN 1610-0387, Vol. 10, p. 15-15Article in journal (Refereed)
  • 1029.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Mischo, Meike
    Schmidt, Diedrich A.
    N Carolina Agr & Tech State Univ, Dept Phys, Greensboro, NC USA..
    Brundermann, Erik
    Brockmeyer, Norbert H.
    Ruhr Univ Bochum, Dept Dermatol, Bochum, Germany..
    Potthoff, Anja
    Ruhr Univ Bochum, Dept Dermatol, Bochum, Germany..
    Havenith, Martina
    Probing epidermis and dermis by Raman spectroscopy: changes in antioxidant and lipid network with age and disease2012In: International Journal of Cosmetic Science, ISSN 0142-5463, E-ISSN 1468-2494, Vol. 34, no 4, p. 372-373Article in journal (Refereed)
  • 1030.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Svensson, A.
    Lund Univ, Skane Univ Hosp, Dept Dermatol, D-93053 Lund, Sweden..
    Apfelbacher, C.
    Univ Regensburg, Inst Epidemiol & Prevent Med, Regensburg, Germany..
    Schmitt, J.
    Tech Univ Dresden, Ctr Evidence Based Healthcare, Univ Klinikum Carl Gustav Carus, Dresden, Germany..
    Which factors predict remission of infant atopic dermatitis?: A systematic review2014In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 170, no 6, p. E52-E53Article in journal (Other academic)
  • 1031.
    von Kobyletzki, Laura B
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Lund Univ, Skne Univ Hosp, Dept Dermatol, Inst Clin Res Malmo, Malmo, Sweden.;Karlstad Univ, Dept Publ Hlth Sci, Karlstad, Sweden..
    Thomas, K.
    Univ Nottingham, Ctr Evidence Based Dermatol, Nottingham NG7 2RD, England..
    Schmitt, J.
    Tech Univ Dresden, Univ Klinikum Carl Gustav Carus, Ctr Evidence Based Healthcare, Dresden, Germany..
    Chalmers, J.
    Univ Nottingham, Ctr Evidence Based Dermatol, Nottingham NG7 2RD, England..
    Deckert, S.
    Tech Univ Dresden, Univ Klinikum Carl Gustav Carus, Ctr Evidence Based Healthcare, Dresden, Germany..
    Aoki, V.
    Univ Sao Paulo, Sch Med, Dept Dermatol, Sao Paulo, Brazil..
    Svensson, A.
    Lund Univ, Skane Univ Hosp, Dept Dermatol, S-22100 Lund, Sweden..
    Eczema signs and symptoms: what is important to patients?2014In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, Vol. 170, no 6, p. E11-E11Article in journal (Other academic)
  • 1032.
    Väisänen, Lina
    et al.
    Karlstad University.
    Hedlund, Marika
    Karlstad University.
    Motivation till fysisk aktivitet: En studie bland seniorer2013Student paper second term, 5 credits / 7,5 HE creditsStudent thesis
  • 1033. Wargocki, P.
    et al.
    Wyon, D.
    Lynge Jensen, K.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    The effect of electrostatic particle filtration and supply air filter condition in classrooms on the performance of schoolwork by children. ASHRAE IAQ Applications. HVAC&R Research (In press)2008In: ASHRAE IAQ Applications. HVAC&R Research 2008 (In press)Article in journal (Refereed)
  • 1034.
    Wold, Caroliine
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Den viktiga kampen: En kvalitativ intervjustudie kring motiverande respektive hindrande faktorer för viktnedgång2014Independent thesis Basic level (university diploma), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Övervikt är ett starkt hot mot folkhälsan. Många överviktiga vill minska i vikt, men många lyckas trots det inte med att uppnå den önskade viktnedgången. Syftet med studien var att ta reda på vilka faktorer som upplevs motivera till att gå ner i vikt respektive vilka faktorer som upplevdes hindra att lyckas med den önskade viktnedgången. Sex överviktiga personer intervjuades och delgav sina tankar och erfarenheter om problematiken. Intervjuerna bearbetades genom kvalitativ innehållsanalys. Resultatet visade att det fanns ett flertal faktorer som upplevdes motivera till att minska i vikt respektive hindra att uppnå viktnedgång. Dessa faktorer var i första hand inre faktorer som personens målsättning, resultat av viktminskningsförsök, förväntade effekter av viktnedgång, förhållningssätt, förmåga att övervinna hinder, tron på den egna förmågan att lyckas, upplevd kunskap samt upplevd kontroll över viktutvecklingen. Även yttre faktorer som fysisk hälsa och kapacitet, socialt stöd, socialt liv samt miljö- och omgivningsmässiga faktorer var betydande faktorer som kunde upplevas motivera till att minska i vikt eller hindra framgång i viktminskningen. Slutsatsen utifrån studiens resultat är att det finns en stor komplexitet gällande problematiken att önska minska i vikt samt att lyckas med den önskade viktnedgången.

  • 1035.
    Wolfe, Ingrid
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
    Child Health, Health Services and Systems in UK and other European countries2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    This work in child population medicine describes child health problems, increases knowledge of health services, systems, and wider determinants, and makes recommendations for improvements.

    Aims

    To explore trends in UK child health and health service quality and highlight policy lessons from the UK and other European countries

    To study child health and health services in western Europe and derive lessons from different approaches to common challenges

    To enhance knowledge on child to adult transition care

    To describe trends in UK and EU15+ child and adolescent mortality and seek explanations for deteriorating UK health system performance, and make recommendations for improving survival

    Methods

    Population level measures of health status and system performance; primary and secondary research on policies and practice for health system assessments. Quantitative: mortality rate trends, excess deaths, DALYs, healthcare processes Qualitative: case reports, system descriptions, analyses 

    Results

    European child survival has improved, but variably between countries. The UK has not matched recent EU mortality gains. There are 6,000 excess deaths annually in children under 15 years in EU14 countries.

    There are child survival inequities; countries investing in social protection have lower mortality. Children in the UK, compared with other EU countries, are more likely to be poor than adults.

    Non-communicable diseases are now dominant causes of child death, disease, and disability.

    Mortality, processes, and outcomes of healthcare amenable conditions varies between countries. Better outcomes seem to be associated with flexible health care models promoting cooperation, team working, and transition.

    Conclusions

    Child health in Europe is improving, but unevenly. Child health systems are not adapting sufficiently to meet needs. Recommendations are made for improving health systems and services.

  • 1036.
    Wolfe, Ingrid
    et al.
    London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
    Donkin, Angela
    Marmot, Michael
    McFarlane, Alison
    Cass, Hilary
    Viner, Russel
    UK child survival in a European context: Recommendations for a national Countdown Collaboration2015In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 100, no 10, p. 907-914Article in journal (Other academic)
  • 1037.
    Wolfe, Ingrid
    et al.
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    Thompson, Matthew
    European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
    Gill, Peter
    Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    Tamburlini, Giorgio
    Centro per la Salute del Bambino, Trieste, Italy.
    Blair, Mitch
    Division of Paediatrics, Imperial College, London, UK.
    van den Bruel, Ann
    Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
    Ehrich, Jochen
    Medizinische Hochschule, Hannover, Hanover, Germany.
    Pettoello-Mantovani, Massimo
    School of Medicine, University of Foggia, Foggia, Italy.
    Janson, Staffan
    Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.
    Karanikolos, Marina
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    McKee, Martin
    European Centre on Health of Societies in Transition, London School of Hygiene & Tropical Medicine, London, UK.
    Health services for children in western Europe2013In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 381, no 9873, p. 1224-1234Article in journal (Refereed)
    Abstract [en]

    Western European health systems are not keeping pace with changes in child health needs. Non-communicable diseases are increasingly common causes of childhood illness and death. Countries are responding to changing needs by adapting child health services in different ways and useful insights can be gained through comparison, especially because some have better outcomes, or have made more progress, than others. Although overall child health has improved throughout Europe, wide inequities remain. Health services and social and cultural determinants contribute to differences in health outcomes. Improvement of child health and reduction of suffering are achievable goals. Development of systems more responsive to evolving child health needs is likely to necessitate reconfiguring of health services as part of a whole-systems approach to improvement of health. Chronic care services and first-contact care systems are important aspects. The Swedish and Dutch experiences of development of integrated systems emphasise the importance of supportive policies backed by adequate funding. France, the UK, Italy, and Germany offer further insights into chronic care services in different health systems. First-contact care models and the outcomes they deliver are highly variable. Comparisons between systems are challenging. Important issues emerging include the organisation of first-contact models, professional training, arrangements for provision of out-of-hours services, and task-sharing between doctors and nurses. Flexible first-contact models in which child health professionals work closely together could offer a way to balance the need to provide expertise with ready access. Strategies to improve child health and health services in Europe necessitate a whole-systems approach in three interdependent systems—practice (chronic care models, first-contact care, competency standards for child health professionals), plans (child health indicator sets, reliable systems for capture and analysis of data, scale-up of child health research, anticipation of future child health needs), and policy (translation of high-level goals into actionable policies, open and transparent accountability structures, political commitment to delivery of improvements in child health and equity throughout Europe).

  • 1038.
    YinPing, Zhang
    et al.
    China.
    BaiZhan, Li
    China.
    Chen, Huang
    China.
    Xu, Yang
    China.
    Hua, Qian
    China.
    QiHong, Deng
    China.
    ZhuoHui, Zhao
    China.
    AnGui, Li
    China.
    JiaNing, Zhao
    China.
    Xin, Zhang
    China.
    Fang, Qu
    China.
    Yu, Hu
    China.
    Qin, Yang
    China.
    Juan, Wang
    China.
    Ming, Zhang
    China.
    Fang, Wang
    China.
    XiaoHong, Zheng
    China.
    Chan, Lu
    China.
    ZhiJian, Liu
    China.
    YueXia, Sun
    China.
    JinHan, Mo
    China.
    YiLi, Zhao
    China.
    Wei, Liu
    China.
    TingTing, Wang
    China.
    Norback, Dan
    Uppsala University Hospital, Sweden.
    Bornehag, Carl-Gustaf
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Sundell, Jan
    China.
    Ten cities cross-sectional questionnaire survey of children asthma and other allergies in China2013In: Chinese Science Bulletin, ISSN 1001-6538, E-ISSN 1861-9541, Vol. 58, no 34, p. 4182-4189Article in journal (Refereed)
    Abstract [en]

    Asthma, rhinitis and eczema (allergic or non-allergic) have increased throughout the world during the last decades, especially among children. Changes in the indoor environment are suspected to be important causes. China has experienced a dramatic change in indoor environmental exposures during the past two decades. However, such changes and their associations with children's asthma and other health aspects have not been thoroughly studied. China, Children, Homes, Health (CCHH), Phase I, was a cross-sectional questionnaire survey of 48219 children 1-8 years old in 10 Chinese cities during 2010-2012. The questionnaire includes the International Study of Asthma and Allergies in Childhood (ISAAC) core health questions and additional questions regarding housing, life habits and outdoor environment. In health analyses, children aged 3-6 years old were included. The prevalences of doctor diagnosed asthma varied from 1.7% to 9.8% (mean 6.8%), a large increase from 0.91% in 1999 and 1.50% in 2000. The prevalence of wheeze, rhinitis and atopic eczema (last 12 months) varied from 13.9% to 23.7%, 24.0% to 50.8% and 4.8% to 15.8%, respectively. Taiyuan had the lowest prevalences of all illnesses and Shanghai the highest, except for wheeze-where the highest value was for Urumqi. We found (1) no obvious association between disease prevalences and ambient PM10 concentrations and (2) higher prevalences of disease in humid climates with hot summers and cold winters, but with no centrally heated buildings. Associations between the diseases and economic status as indexed by Gross Domestic Product (GDP) requires further study.

  • 1039.
    Ängeby, Karin
    et al.
    Women’s Department, Central Hospital, Karlstad, Sweden.
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013). Inland Norway Univ Appl Sci, Fac Publ Hlth, Dept Nursing, Elverum, Norway.
    Hildingsson, Ingegerd
    Department of Health Sciences, Mid Sweden University, Sundsvall, .
    Sandin-Bojö, Ann-Kristin
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Prevalence of Prolonged Latent Phase and Labor Outcome: Review of Birth Records in a Swedish Population2018In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 63, no 1, p. 33-44, article id JMWH12704Article in journal (Refereed)
    Abstract [en]

    The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase.

    METHODS:

    A descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013-2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables.

    A prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26).

    Based on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

  • 1040.
    Åslund, Cecilia
    et al.
    Uppsala Univ, Vastmanland Cty Hosp Vasteras, Ctr Clin Res Vasteras, Vasteras, Sweden..
    Larm, Peter
    Uppsala Univ, Vastmanland Cty Hosp Vasteras, Ctr Clin Res Vasteras, Vasteras, Sweden.;Malardalen Univ, Sch Hlth Care & Social Welf, Vasteras, Sweden..
    Starrin, Bengt
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies.
    Nilsson, Kent W.
    Uppsala Univ, Vastmanland Cty Hosp Vasteras, Ctr Clin Res Vasteras, Vasteras, Sweden..
    The buffering effect of tangible social support on financial stress: Influence on psychological well-being and psychosomatic symptoms in a large sample of the adult general population2014In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, article id 85Article in journal (Refereed)
    Abstract [en]

    Introduction: Financial stress is an important source of distress and is related to poor mental and physical health outcomes. The present study investigated whether tangible social support could buffer the effect of financial stress on psychological and psychosomatic health. Methods: Two separate postal surveys were sent to random samples in five counties in Sweden in 2004 and 2008, with a total of 84 263 respondents. The questionnaires included questions about financial stress, tangible social support, psychosomatic symptoms, and psychological well-being (General Health Questionnaire-12). Results: Individuals with high financial stress and low tangible social support had six to seven times increased odds ratios for low psychological well-being and many psychosomatic symptoms. By contrast, individuals with high financial stress and high tangible social support had only two to three times increased odds ratios for low psychological well-being and three to four times increased odds ratios for many psychosomatic symptoms, suggesting a buffering effect of tangible social support. Consistent with the buffering hypothesis, there were significant interactions between financial stress and social support, particularly in relation to low psychological well-being. Conclusions: Social support had its strongest effect at high levels of financial stress. The question whether the altering of our social networks may improve physical health is important for the prevention of ill health in people experiencing financial stress. Strengthening social networks may have the potential to influence health-care costs and improve quality of life.

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