Made available in DSpace on 2016-03-15T19:40:51Z (GMT). No. of bitstreams: 1 Karina de Roig Gatto.pdf: 419222 bytes, checksum: 6643561a2e7b4a87896292f7dfa81030 (MD5) Previous issue date: 2010-02-02 / Brazil is progressively developing a national policy that establishes people with deficiencies have access to classes within a normal school setting. This access is guaranteed through educational laws. This requires a complex system of specialized education that includes aspects of physical infrastructure, factors of human planning and capacitation of resources. For this, it is necessary to rigorously control the data that is permitted to characterize these populations of educational necessities of registered students within the normal school setting. The general objective of the present study was to characterize the sociodemographic, educational and health profiles of the students with special educational needs in the School District of Barueri. The sample was composed of 1,201 students with special educational needs (SEN) registered through December, 2008. The information was retrieved from the databank of the School District of Barueri. The principal results revealed that of the 1,201 students, 1.98% represented the percentage of SEN in 2008. Independent of the diagnosed category, the majority of the students were concentrated in a traditional school setting. In relation to the physical and mental health profile, there was an elevated percentage of students that could not be grouped with the diagnosed hypothesis. The aforementioned sociodemographic data revealed adequate indicators of human development. It was concluded that there are necessary actions of health that permit the precise formulation of diagnoses. This is necessary in that the diagnosis represents the initial step for the appropriate plan of action. It is expected that the future Centro de Atençao Integral às Pessoas com Deficiencia/Center of Integral Attention for People with Deficiencies can supply this demand within the area of Health. The study offers recommendations for clinically classifying the type of deficiency of the student, planning of materials and human resources, as well as appropriate activities within social, educational, cultural, occupational and clinical settings. / O Brasil desenvolve progressivamente uma política nacional que estabelece que pessoas com deficiências tenham acesso às classes comuns do ensino regular. Esse acesso é garantido por meio de leis educacionais. Isto exige um sistema complexo de educação especializada que abrange aspectos de infraestrutura física e de fatores humanos de planejamento e capacitação de recursos. Para tanto, é necessário o controle rigoroso de dados que permitam caracterizar estas populações com necessidades educacionais matriculados nas redes de ensino regular. O objetivo geral do presente estudo foi caracterizar o perfil sociodemográfico, educacional e de saúde dos alunos com necessidades educacionais especiais da Rede Municipal de Ensino de Barueri. A amostra foi composta por 1.201 alunos com necessidades educacionais especiais (NEE) cadastrados no banco de dados da Rede Municipal de Ensino de Barueri cujas informações foram coletadas até dezembro de 2008. Os principais resultados apontaram que os 1.201 alunos com NEE representam 1,98% do total de alunos matriculados na rede municipal de ensino em 2008. Independentemente da categoria diagnóstica, o maior número de alunos se concentrou no ensino fundamental. Em relação ao perfil de saúde física e mental houve uma porcentagem elevada de alunos que não puderam ser agrupados em hipóteses diagnósticas. Os dados sociodemográficos levantados apontaram indicadores adequados de desenvolvimento humano. Conclui-se que são necessárias ações de saúde que permitam a formulação precisa de diagnósticos. Isto é necessário já que o diagnóstico representa o passo inicial para quaisquer planejamentos de ações. Espera-se que o futuro Centro de Atenção Integral às Pessoas com Deficiência possa suprir essa demanda dentro do núcleo Saúde. O estudo formula algumas recomendações às equipes em relação à classificação clínica e ao tipo de deficiência do aluno, ao planejamento de recursos materiais e humanos e à adequação de atividades a segmentos sociais, educacionais, culturais, ocupacionais e clínicos.

Abstract Over 90% of addicts start substance use during adolescence. There are few studies focusing on the comorbidity and temporality of substance dependence among adolescents. The aim of this study was to investigate the comorbidity and temporality of substance use disorders, to identify the factors leading to intravenous drug dependence and to evaluate the psychotropic medication history among adolescents. The study population comprised a sample of 508 (300 girls) 12- to 17-year-old hospitalized inpatients during a defined 5-year period. Substance use and other psychiatric disorders were identified according to DSM-IV criteria and adolescents’ socio-demographic and substance use background was examined. The main findings of the present study include the following: The most common comorbidities of alcohol and drug dependence are behavioral, depressive and phobic disorders; Phobic and behavioral disorders develop generally prior to the onset of alcohol and drug dependence; Drug dependent boys are more likely to have depression than girls (IV); In adolescence, phobic disorders may influence the development of secondary substance dependence within a few years from the onset of phobia (I); Behavioral disorders are associated with earlier initiation of daily smoking, and earlier age of onset of daily smoking is associated with an increased risk for alcohol and drug dependence (III); Adolescents with intravenous drug dependence start experiment with drugs at young age, often before the age of 10 years, and present more commonly with parental absence and troubled school background (II); Prescribed benzodiazepine medication is associated with an increased risk of sedative dependence (V). These findings imply that psychiatric comorbidity plays a pivotal role in the development of substance use disorders in adolescence. Those adolescents who experiment with substances at a young age are at greatest risk of substance dependence and intravenous drug use before the age of 18. Family dynamics seem to play an important role in this development. The psychotropic medication history of substance-using adolescents often differs greatly from current evidence-based guidelines and is dominated by those medications that are frequently abused. / Tiivistelmä Yli 90 % päihdeongelmaisista aloittaa päihteidenkäytön nuoruusiällä. Silti päihdehäiriöiden ja niihin liittyvän psykiatrisen sairastavuuden – komorbiditeetin ja tämän ajallisen ilmenemisen – temporaliteetin - tutkimus nuorisoväestössä on suppeaa. Väitöskirjatutkimuksen tarkoituksena oli kartoittaa nuoruusiän päihdehäiriöiden komorbiditeetin ja temporaliteetin ominaispiirteitä, selventää taustalla olevia sosiodemografisia tekijöitä, sekä arvioida päihdehäiriöisten nuorten reseptilääkehistoriaa päihdehäiriöiden synnyn ymmärtämiseksi. Tutkimusaineisto koostui 508 (300 tyttöä) 12-17-vuotiaasta akuuttia psykiatrista sairaalahoitoa tarvitsevasta potilaista. Nuorten psykiatrinen- ja päihdesairastavuus selvitettiin DSM-IV diagnoosijärjestelmän mukaisesti, sekä sosiodemografinen tausta kartoitettiin kattavasti. Alkoholi- ja huumeriippuvaisilla nuorilla yleisimpiä komorbideja häiriöitä olivat käytös-, masennus- ja pelkohäiriöt. Pelko- ja käytöshäiriöt ilmenivät yleensä ajallisesti ennen alkoholi- ja huumeriippuvuutta. Huumeriippuvaisilla pojilla oli tyttöjä useammin masennusta (IV). Pelkohäiriöt vaikuttivat sekundaarisen päihderiippuvuuden kehittymiseen mahdollisesti jo muutamien vuosien kuluessa pelkohäiriöiden ilmenemisestä (I). Käytöshäiriöt liittyivät aikaisempaan päivittäisen tupakoinnin aloittamiseen joka liittyy edelleen sekä alkoholi- että huumeriippuvuuteen (III). Suonensisäisen huumeidenkäytön aloittaminen nuorella iällä liittyi selkeästi vanhemmattomaan kotiin, sekä jo ala-asteella alkaneisiin koulunkäyntiongelmiin. Vaikeimmin päihderiippuvaisten nuorten päihteidenkäyttökokeilut alkoivat merkittävän nuorena, jo onnen 10 ikävuotta ala-asteella (II). Bentsodiatsepiinien reseptilääkkekäyttö sairaalahoitoa aiemmin liittyi merkittävästi sedatiiviriippuvuuteen (V). Löydösten perusteella psykiatrisella sairastavuudella on merkittävää rooli päihdehäiriön kehittymisessä jo nuoruusiällä. Nuoret, joiden päihdekokeilut alkavat varhain, ovat suurimmassa riskissä riippuvuuteen ja ajautumiseen suonensisäiseen käyttöön. Päihderiippuvaisilla nuorilla on lisäksi taipumus sekä reseptilääkkeiden väärinkäyttöön, että kykyä näiden hankkimiseen - myös lääkärin määräämänä.

Abstract The aim of this study was to investigate the status of erosive tooth wear (ETW) in Finnish middle-aged adults and its association with dental caries and sociodemographic and intrinsic factors. In addition, we performed a genome-wide association study (GWAS) to identify whether genetic polymorphism (single nucleotide polymorphism) could explain some of the individual variance in the ETW status. Another aim of the study was to validate the use of the erosion index, the Basic Erosive Wear Examination (BEWE), on 3D models. Of the total Northern Finland Birth Cohort (NFBC1966), a convenience sample of 3,181 people was invited for an oral health examination in 2012–2013, of whom 1,962 participated, thus comprising the study group for the present study. ETW was assessed by sextants using the BEWE index. The clinical data was supplemented by information collected by means of postal questionnaires in 1997–1998 and 2012–2013, blood samples, and 3D models of the dentition. Of those clinically examined, 586 participants were randomly selected for the validation study of the BEWE index on 3D models. ETW was a common finding among the Finnish adult population, and almost half of the population needed at least preventive measures against the condition, and almost one in ten had severe ETW. Male gender and restorative treatment need due to dental caries were associated with ETW, unlike sociodemographic factors. Of the intrinsic factors, daily reflux symptoms and hyposalivation were the most significantly associated with severe ETW. According to the results from the GWAS, susceptibility to ETW could be partly explained by genetic polymorphism. The BEWE index was found reliable for recording ETW clinically and on 3D models, and 3D models were especially sensitive in detecting initial ETW. In conclusion, ETW seems to be common among Finnish adults, especially among males. In addition to risk factors, individual susceptibility should be kept in mind when assessing the risk for the condition. Early diagnosis of ETW is important in maintaining good oral health, and the BEWE seems to be a reliable index for that purpose both clinically and on 3D models. / Tiivistelmä Tutkimuksen tavoitteena oli selvittää hampaiden erosiivisen kulumisen yleisyyttä ja vakavuutta suomalaisilla keski-ikäisillä aikuisilla, sekä erosiivisen kulumisen yhteyttä hampaiden reikiintymiseen sekä sosiodemografisiin ja sisäisiin tekijöihin. Lisäksi selvitettiin koko genomin kartoitusta hyödyntäen, voidaanko geneettisellä polymorfismilla (yksittäisillä emäsparin vaihdoksilla) selittää yksilön alttiutta erosiiviselle kulumiselle. Tutkimuksen tavoitteena oli myös validoida erosiivista kulumista arvioiva indeksi (The Basic Erosive Wear Examination, BEWE) 3D-malleilla. Koko Pohjois-Suomen vuoden 1966 syntymäkohortista kutsuttiin 3 181 henkilöä suun terveystarkastukseen vuosina 2012–2013. Kutsutuista 1 962 osallistui tutkimukseen muodostaen lopullisen tutkimusjoukon. Erosiivista kulumista arvioitiin käyttäen BEWE-indeksiä. Kliinistä tutkimusta täydensivät vuosina 1997–1998 ja 2012–2013 tehdyt postikyselyt, verinäytteet ja hampaiston 3D-mallit. Kliinisesti tutkituista osallistujista yhteensä 586 henkilöä valittiin satunnaisesti BEWE-indeksin validointitutkimukseen 3D-malleilla. Erosiivinen kuluminen oli yleistä suomalaisilla aikuisilla, ja lähes puolella oli erosiivista kulumista, joka vaatisi vähintään ennaltaehkäiseviä toimia. Vakavaa erosiivista kulumista on lähes joka kymmenennellä. Miessukupuoli ja korjaavan hoidon tarve hampaiden karioitumisen vuoksi olivat yhteydessä erosiiviseen kulumiseen, toisin kuin sosiodemografiset tekijät. Sisäisistä tekijöistä päivittäiset reflux-oireet ja vähäinen syljeneritys olivat vahvimmin yhteydessä vakavaan erosiiviseen kulumiseen. Koko genomikartoituksen perusteella vaikuttaa siltä, että alttius erosiiviselle kulumiselle saattaa selittyä osittain geneettisellä polymorfismilla. BEWE-indeksi näyttää olevan luotettava menetelmä niin kliinisessä arvioinnissa kuin arvioitaessa erosiivista kulumista 3D-malleilla. Alkava erosiivinen kuluminen oli helpommin havaittavissa 3D-malleilta kliiniseen arviointiin verrattuna. Tutkimuksen perusteella voidaan sanoa, että erosiivinen kuluminen on yleistä suomalaisilla aikuisilla, etenkin miehillä. Jo tiedettyjen riskitekijöiden lisäksi yksilöllinen alttius erosiiviselle kulumiselle tulisi pitää mielessä riskikartoitusta tehdessä. Erosiivisen kulumisen aikainen diagnosointi on tärkeää hyvän suun terveyden ylläpitämiseksi, ja BEWE-indeksi vaikuttaa soveltuvan diagnosointiin niin kliinisesti kuin 3D malleillakin.

The aim of this thesis is to propose new ways of communication of the self-help group focused on people suffering from social phobia. The theoretical part deals with perspectives of self- help groups and participation model taking into account socio-demographic profile, barriers to participation and motivation to participate as factors influencing participation. In the empirical part the reasons for the selection of questionnaires and interviews as data collection methods are described. In the part "results and discussion" I present the results of the analysis of external communication, the characteristics of the target group, the motivation to participate in the self-help group, barriers to participation in the self-help group and I propose new ways of communication adapted to the target group.

Introduktion: Det finns allt fler studier inom området “Aktivitetsbalans” inom Arbetsterapin. Studier lyfter associationer till aktivitetsbalans inom olika livsområden men än finns få studier som sammanställer Forskningsläget kring dessa associationer. Samlad kunskap behövs kring arbetsterapeutens förebyggande, återställande och bibehållande insatser gentemot sina klienter. Syfte: Syftet var att beskriva forskningsläget kring vad som är associerat till aktivitetsbalans i kvantitativa studier. Metod: Designen för examensarbete var scoping review. Datainsamling genomfördes i databaserna Cinahl och Medline. Tjugo artiklar inkluderades och analyserades med numerisk och tematisk analys. Resultat: Examensarbetet resulterade i teman och underteman som beskriver associationer till aktivitetsbalans. Följande fem teman skapades: Hälsa och välbefinnande, Sociodemografi, Aktivitet, Interpersonella faktorer och Omgivningsfaktorer. Dessa utmynnade i elva underteman som associerar till aktivitetsbalans: Hälsa, livskvalitet och livstillfredsställelse, personfaktorer, variabla personfaktorer, sysselsättning, tillfredsställelse med aktivitetsutförande, problematiskt internetanvändande, familj och sociala relationer, barn med särskilda behov, samhällsinformation och isolering. Slutsats: En persons hälsa, relationer och dagliga aktiviteter har genom arbetet visat sig ha ett samband med aktivitetsbalans. Även personliga egenskaper och delar av den omgivningen där personen befinner sig i förefaller vara associerat till aktivitetsbalansen. Aktivitetsbalans har i examensarbetet visat sig ha associationer till flera olika delar av en människas tillvaro. / Introduction: More research is getting produced regarding ”occupational balance” (OB) in the field of occupational therapy. Studies lifts associations to occupational balance in different areas of life but there’s still few studies that conclude these associations. Congregated knowledge is needed in the occupational therapist daily preventive, restorative and maintaining work. Aim: To describe the current research about associations to OB in quantitative studies. Method: The study design was a scoping review. Data was collected from Cinahl and Medline. Twenty articles were included and analysed through numerical and thematical analysis. Results: The thesis resulted in five themes and eleven sub-themes describing associations to OB. Following five themes were created: Health and wellbeing, sociodemographic, activity, interpersonal factors, environmental factors. These themes resulted in eleven sub-themes with associations to OB: Health, life quality and life satisfaction, personal factors, variating personfactors, employment, family and social relationships, children with special needs, problematic internet use, social information, isolation, and satisfaction with occupational performance. Conclusions: A persons health, relations and daily activities have shown a relationship to occupational balance. Personal characteristics and surrounding environment of which the person belongs seems to relate to occupational balance. Occupational balance has shown associations to many parts of the human life.

Despite advances in health promotion through efforts to reduce tobacco smoking, tobacco-related health conditions have continued to be significant. Exposure to secondhand smoke has been identified as a health risk also in addition to infant health risks related to maternal smoking. In contrast, breastfeeding has been found to promote infant health and is strongly encouraged. Despite literature supporting both of these statements, the combined effects of both breastfeeding and maternal smoking on infant wellbeing have not been delineated. Otitis media represents a common health problem among infants and young children. Tobacco exposure has been shown to increase its incidence while breastfeeding has been shown to reduce its occurrence. In the current study, a consecutive sample of all infants less than 5 years of age with otitis media and breastfed for at least 6 months was collected from a busy urban clinic for analysis. A survey tool was administered to those meeting study criteria. Primary analysis examined the odds ratio of developing otitis media among breastfed infants between those whose mothers smoked tobacco and those whose mothers did not. As a result, the association between the protective effects of breastfeeding and the detrimental effects of maternal smoking was evaluated in relation to the development of otitis media. Secondary variables including demographics, family history, past medical and birth history, and secondhand smoke exposure were also assessed. Results failed to demonstrate a significant difference in otitis media between the 2 cohorts in this study, and of the secondary variables, only cranio-facial deformities and/or a family history of these conditions resulted in higher otitis media occurrence. Further study with larger populations with higher tobacco use rates may offer additional insights into this matter.

Le sommeil est essentiel à la santé et au bien-être. La littérature suggère que le sommeil s’est prolongé et sa qualité a diminué durant la première vague de COVID-19. Ce phénomène fut associé à divers prédicteurs de la santé. Dû au manque d'études longitudinales et d'échantillons représentatifs, celle-ci visait à (1) examiner les trajectoires de sommeil en début de COVID-19, (2) identifier les prédicteurs de ces trajectoires, et (3) déterminer les associations intertrajectoires. Un échantillon canadien représentatif (N=2246) fut interrogé 6 fois d’avril-juillet 2020. Les participants ont rapporté la durée et qualité de leur sommeil et des prédicteurs de santé. Premièrement, un modèle de croissance à classes latentes a identifié les trajectoires. Deuxièmement, une régression logistique a examiné les relations prédicteurs-trajectoires. Troisièmement, une analyse de trajectoires conjointes multiniveaux a testé les associations entre trajectoires. Quatre trajectoires constantes de qualité du sommeil furent identifiées (M=2,48/10, 6,7 %; M=5,44/10, 37,1%; M=7,83/10, 45,5 %; M=10/10, 10,7%). Deux trajectoires de durée de sommeil furent identifiées, une courte, mais constante (M=369 min, 33.9%), et une longue, mais décroissante (M=486 min, 66.1%, -2.32min/semaine). Le troisième âge, le genre masculin et le respect des recommandations gouvernementales prédisaient une qualité de sommeil élevée. Être plus vieux prédisait un sommeil court, mais constant, tandis que vivre avec un ménage prédisait un sommeil long, mais décroissant. Le sommeil des Canadiens n'a pas significativement changé comme suggéré par la littérature, possiblement due à la méthodologie de l’étude, déterminant les trajectoires de sommeil d’un échantillon pancanadien durant la première vague de COVID-19. / Sleep plays a critical role in maintaining overall health and well-being. During the early days of the COVID-19 pandemic, reports showed a high prevalence of short sleep and poor sleep quality. This was associated with various health predictors. Given the lack of Canadian longitudinal studies and representative samples, our study aimed to (1) examine trajectories of sleep duration and quality during COVID-19, (2) identify predictors associated with these trajectories, and (3) determine inter-trajectory associations. A representative Canadian sample (N=2,246) was surveyed 6 times between April and July 2020. Participants self-reported their sleep duration, sleep quality, and health predictors. First, a Latent Class Growth Analysis identified sleep trajectories. Second, multinomial logistic regression models were used to examine relationships between predictors and trajectory groups. Third, a multilevel joint trajectory analysis tested the associations between trajectories. Four constant sleep quality trajectories were identified (M=2.48/10, 6.7%; M=5.44/10, 37.1%; M=7.83/10, 45.5%; M=10/10, 10.7%). Two sleep duration trajectories were identified, one shorter but constant (M=369min, 33.9%), and one longer but decreasing (M=486min, 66.1%, -2.32 min/week). Being older than 25 years old predicted short but constant sleep duration, while living with a household predicted long but decreasing sleep duration. The sleep of Canadians during early COVID-19 did not meaningfully change, which contradicts earlier reports. Sleep may not be immediately impacted by health crises. This may be explained by the study’s design as the first to provide evidence of trajectories of sleep in a representative pan-Canadian sample during the first COVID-19 wave.

<p><strong>Do women’s sociodemographic characteristics or type of prenatal care provider influence quality of prenatal care?</strong></p> <p><strong>Objective: </strong>This study examined whether sociodemographic characteristics or type of prenatal care provider influenced the quality of prenatal care received by women in Canada. The main predictors of high quality prenatal care received by Canadian women were identified.</p> <p><strong>Methods: </strong>A secondary analysis of data collected for a primary study that developed and tested the Quality of Prenatal Care Questionnaire (QPCQ) was conducted. Women (n=422), recruited from five cities, completed a background questionnaire and the QPCQ. Data analysis involved examining nine sociodemographic variables and one prenatal care provider variable using independent samples t‐ tests, one‐way analysis of variance, and analysis of covariance.</p> <p><strong>Results: </strong>Statistically significant differences in prenatal care quality were noted among women based on language spoken at home, racial background, marital status, family income, and education level. Women receiving midwifery care reported the highest quality of prenatal care, compared to women receiving care from obstetricians who reported lower quality prenatal care. The strongest predictors of high quality prenatal care were type of prenatal care provider and total family income.</p> <p><strong>Conclusions: </strong>Efforts to universally improve quality of prenatal care in Canada require practice, policy, and research initiatives. Incorporating alternative/ancillary prenatal care services has the potential to improve access, psychosocial supports, appropriate referrals, education, and interventions for women receiving lower quality prenatal care. Systemic practice and policy changes to increase midwifery care capacity would enable midwives to provide high quality prenatal care to a larger portion of low risk Canadian women. Shared care models could reduce the burden on obstetricians, enabling them to provide higher quality prenatal care to high risk Canadian women. Future research needs to focus on identifying the efficacy of each prenatal care component and examining their specific effects on birth outcomes.</p> / Master of Science (MSc)

BAKGRUND: Hypertoni, högt blodtryck, är den folksjukdom som är förknippad med högst dödlighet i världen. Det kan leda till allvarliga hälsoproblem, såsom stroke och hjärtinfarkt. Risken ökar med stigande ålder och sociodemografisk utsatthet. SYFTE: Syftet med denna studie är att öka kunskapen om sambanden mellan sociodemografiska förutsättningar och hypertoni i Kalmar län. METOD: Detta är en retrospektiv registerbaserad tvärsnittsstudie. Kvantitativ metod används för att beräkna sociodemografisk utsatthet och prevalens av blodtrycksmätning och hypertoni per demografiskt statistikområde (DeSO, n=157). Det är geografiska områden som är mindre än en kommun. De oberoende sociodemografiska variablerna består av femgradiga skalor (Q1–Q5) där områden med Q1 har lägst sociodemografisk utsatthet och Q5 har högst. Respektive vuxen individ (18+ år, n=196 993) tilldelas sitt områdes värden. Därefter analyseras sambanden mellan sociodemografiska förutsättningar och blodtryck genom logistisk regression efter kontroll för ålder och kön. RESULTAT: I Kalmar län är det 29,1 procent av den vuxna befolkningen 18+ år som har hypertoni. Andelen ökar med åldern upp till 90–94-åringar där 79,2 procent har diagnosen. I områden med störst andel förgymnasialt utbildade (Q5) är oddset 34 procent högre (OR = 1,34, 95% KI 1,24–1,43) att ha hypertoni. Oddset är även 14 procent högre (OR=1,14, 95% KI 1,07–1,21) i områden med lägst valdeltagande (Q5) jämfört med områden med högst valdeltagande (Q1). SLUTSATSER: Det finns stora sociodemografiska skillnader mellan DeSO-områden i Kalmar län. Sociodemografiska faktorer som ålder, förgymnasial utbildning och lågt valdeltagande kan ha samband med andelen av befolkningen som har hypertoni. Ett ojämlikt blodtryck får negativa individuella, folkhälsomässiga och ekonomiska konsekvenser. Det är viktigt att beslutsfattare och personal i vården är medvetna om att de sociodemografiska skillnaderna existerar. Åtgärder behövs för att öka jämlikheten mellan invånare i olika DeSO-områden. Här har hälso- och sjukvården en särskilt viktig uppgift att göra målgruppsanpassade insatser för ett normalt och jämlikt blodtryck. / BACKGROUND: Hypertension, high blood pressure, is the deadliest public health issue worldwide. It can lead to serious health problems such as stroke and heart attack. The risk increases with age and sociodemographic vulnerability. OBJECTIVE: The aim of this study is to increase knowledge about the relationships between sociodemographic conditions and hypertension in Kalmar County. METHOD: This is a retrospective register-based cross-sectional study. A quantitative method is used to calculate sociodemographic vulnerability and the prevalence of blood pressure measurement and primary hypertension per demographic statistical area (DeSO, n=157). These are geographical areas smaller than a municipality. The independent sociodemographic variables consist of five-level scales (Q1–Q5) where areas with Q1 have the lowest socio-demographic vulnerability and Q5 have the highest. Each adult individual (18+ years, n=196,993) is assigned their area’s values. The correlations between sociodemographic conditions and blood pressure are then analysed through logistic regression after controlling for age and gender. RESULTS: In Kalmar County, 29.1 percent of the adult population aged 18 and over have hypertension. The proportion increases with age, reaching 79.2 percent among those aged 90–94. In areas with the highest proportion of people with only primary education (Q5), the odds of having hypertension are 34 percent higher (OR = 1.34, 95% CI 1.24–1.43). The odds are also 14 percent higher (OR = 1.14, 95% CI 1.07–1.21) in areas with the lowest voter turnout (Q5) compared to areas with the highest voter turnout (Q1). CONCLUSIONS: There are significant sociodemographic differences between DeSO areas in Kalmar County. Sociodemographic factors such as age, primary education, and low voter turnout may be associated with the proportion of the population that has hypertension. Unequal blood pressure has negative individual, public health, and economic consequences. It is important that decision-makers and healthcare personnel are aware of these sociodemographic differences. Measures are needed to increase equity among residents in different DeSO areas. Here, healthcare has a particularly important task to implement targeted interventions for normal and equitable blood pressure.

La problématique des réfugiés fait partie du cadre plus large des politiques migratoires et de la migration internationale en général. Étant un pays d’immigration, le Canada a dû composer avec plusieurs vagues migratoires et s’y adapter en changeant sa politique d’immigration (au niveau fédéral et provincial) en définissant, en termes numériques, les objectifs annuels d’admission des immigrants (le nombre souhaité d’immigrants), ainsi que les objectifs politiques, humanitaires, économiques et démographiques à long terme. Le groupe visé par le présent rapport (les demandeurs d’asile et les réfugiés) se distingue de toute autre catégorie d’immigration par la spécificité de sa condition - une fuite involontaire et une absence de protection des autorités nationales de leur pays. Au plan international et dans le cadre de la politique canadienne, un réfugié: « l’individu qui fuit la persécution » devient un «demandeur d’asile » au moment de faire face à un processus de reconnaissance du statut de réfugié, conforme aux définitions, aux lois et à la politique d’immigration canadiennes. Les étapes de ce processus sont importantes, parce qu’elles établissent une continuité de la demande d’asile, mais aussi parce qu’elles influencent la comptabilisation et les statistiques sur les demandeurs d’asile et les réfugiés. Les données de Citoyenneté et Immigration Canada figurent parmi les rares sources disponibles donnant à la fois des informations sur les demandeurs d’asile et les réfugiés. Cette population au Canada est mal connue et assez difficile à décrire à cause de la faiblesse des statistiques. Du point de vue démographique, une meilleure connaissance du nombre et de l’évolution des immigrants de la catégorie « demandeur d’asile » ou « réfugié », ainsi que de leurs caractéristiques sociodémographiques (sexe, âge, scolarité, connaissances linguistiques, pays d’origine, etc.) aide à cerner leurs besoins en services et à leur fournir des politiques adéquates d’intégration à la culture et à la vie canadiennes. / The problem of refugees is part of the broader framework of migration policies and international migration in general. As a country of immigration, Canada has had to deal with several waves of migration and to adapt its immigration policy (at the federal and provincial level) by defining, in numerical terms, the annual targets for the admission of immigrants (the desired number of immigrants), as well as its political, humanitarian, economic and demographic objectives. The target group for this report (the asylum seekers and refugees) differs from any other category of immigration by a specific condition – an inadvertent leak and a lack of protection from the national authorities of their country. At the international level and in the context of Canadian politics, a refugee: “the individual who is fleeing persecution” becomes an “asylum seeker” when engaging a process of recognition of refugee status, consistent with the Canadian immigration policy. The steps involved in this process are important because they establish continuity in the application process for asylum, but also because they influence the accounting and statistics on asylum seekers and refugees. The data from Citizenship and Immigration Canada are among the few sources available that provides indication on both asylum seekers and refugees. From a demographic point of view, a better knowledge of the number and the evolution of the immigrants of the category “asylum seeker” or “refugee”, as well as of their sociodemographic characteristics (sex, age, education, language skills, country of origin, etc.) help to identify their needs in services and to provide them with adequate policies of integration to Canada.