Background: Chronic pain is a major public health problem. The impact of stages of chronic pain adjusted for disease load on societal burden has not been assessed in population surveys. Methods: A cross-sectional survey with 4360 people aged ≥ 14 years representative of the German population was conducted. Measures obtained included demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (by chronic pain grade questionnaire), disease load (by self-reported comorbidity questionnaire) and societal burden (by self-reported number of doctor visits, nights spent in hospital and days of sick leave/disability in the previous 12 months, and by current unemployment). Associations between chronic pain stages with societal burden, adjusted for demographic variables and disease load, were tested by Poisson and logistic regression analyses. Results: 2508 responses were received. 19.4% (95% CI 16.8% to 22.0%) of participants met the criteria of chronic non-disabling non-malignant pain. 7.4% (95% CI 5.0% to 9.9%) met criteria for chronic disabling non-malignant pain. Compared with no chronic pain, the rate ratio (RR) of days with sick leave/disability was 1.6 for non-disabling pain and 6.4 for disabling pain. After adjusting for age and disease load, the RRs increased to 1.8 and 6.8. The RR of doctor visits was 2.5 for non-disabling pain and 4.5 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.7 and 2.6. The RR of days in hospital was 2.7 for non-disabling pain and 11.7 for disabling pain if compared with no chronic pain. After adjusting for age and disease load, the RR fell to 1.5 and 4.0. Unemployment was predicted by lower educational level (Odds Ratio OR 3.27 [95% CI 1.70-6.29]), disabling pain (OR 3.30 [95% CI 1.76-6.21]) and disease load (OR 1.70 [95% CI 1.41-2.05]). Conclusion: Chronic pain stages, but also disease load and societal inequalities contributed to societal burden. Pain measurements in epidemiology research of chronic pain should include chronic pain grades and disease load.:Background; Methods; Results; Discussion; Conclusion

Yes / Objectives. Coeliac disease (CD) is an autoimmune condition managed by a lifelong therapeutic gluten-free diet. Previous research suggests that the chronicity of CD, the limitations imposed by the gluten-free diet, and the risk of other associated diseases can have a negative impact on health-related quality of life (HRQoL) and psychological well-being. The aim of this study was to explore the illness perceptions and self-efficacy beliefs of adults with CD in the United Kingdom and to report their subjective levels of HRQoL and psychological well-being. Design. The study employed a cross-sectional postal questionnaire design. Method. Participants (n= 288) were adults with CD recruited via Coeliac UK. Measures of well-being, HRQoL, self-efficacy, illness perceptions, and dietary self-management were analysed. Preliminary descriptive and univariate procedures were employed before bivariate tests of association or difference were carried out. Backward stepwise multiple regression analysis was used to investigate the predictive strength of variables on well-being, quality of life, and self-efficacy. Logistic regression was used to look at the influence of variables on adherence. Results. Results indicate that HRQoL and psychological well-being were comparable to those found in previous related studies. Participants with weak beliefs in the serious consequences of CD and poorer emotional reactions to the condition had a greater likelihood of having enhanced HRQoL, improved psychological well-being, and higher self-efficacy. Strong beliefs in personal control and a greater perceived understanding of CD were associated with greater self-efficacy. Conclusions. Perceived self-efficacy and illness perceptions could play a role in informing psychological interventions for individuals with CD.

Problématique : Plusieurs expositions résidentielles ont été associées à la prévalence de l’asthme. Toutefois, peu d’études populationnelles ont examiné la relation entre ces facteurs et un asthme mal maîtrisé chez l’enfant. Objectif : Évaluer les facteurs environnementaux résidentiels associés à un asthme mal maîtrisé chez les enfants montréalais âgés de 6 mois à 12 ans. Méthodes : Les données sont tirées d’une enquête transversale menée en 2006 sur la santé respiratoire d’enfants montréalais âgés de 6 mois à 12 ans (n=7980). La maîtrise de l’asthme a été évaluée chez les enfants avec un asthme actif au cours de l’année précédent l’enquête (n=980) selon des critères recommandés par les lignes directrices canadiennes sur l’asthme. Les rapports de prévalence (RP) et les intervalles de confiance (IC) à 95 % caractérisant l’association entre les facteurs environnementaux, incluant la présence d’allergènes, d’irritants, d’humidité et de moisissures, et le risque d’un asthme mal maîtrisé ont été estimés à l’aide de modèles de régression log-binomiale. Les sujets avec une maîtrise acceptable de l’asthme ont été comparés à ceux dont la maladie était mal maîtrisée. Résultats : Des 980 enfants avec un asthme actif au cours de l’année précédant l’enquête, 36 % ont rencontré au moins un des critères des lignes directrices canadiennes suggérant un asthme mal maîtrisé. Les caractéristiques de la population associées à un asthme mal maîtrisé sont : un plus jeune âge, des antécédents d’atopie parentale, une faible scolarisation de la mère, une mère d’origine étrangère et le statut de locataire. Après ajustement pour l’âge de l’enfant, l’atopie parentale et l’exposition à la fumée de tabac au domicile, une intensité de trafic élevée à proximité du domicile (RP, 1,35; IC 95 %, 1,00-1,81) et la localisation au sous-sol de la chambre de l’enfant ou de sa résidence (RP 1,30; IC 95 %, 1,01-1,66) étaient associées à un risque accru d’asthme mal maîtrisé. Conclusions : Une maîtrise sous-optimale de l’asthme semble être associée à l’exposition au trafic routier et à des conditions d’humidité excessive et probablement de moisissures. Cette dernière exposition étant plus fréquente, elle a probablement un plus grand impact en matière de santé publique. / Background: Home environmental exposures may impede asthma control in children. However, few population-based studies have investigated this relationship. Objective: Identify environmental home exposures associated with poor asthma control among asthmatic children less than 12 years of age in Montreal. Methods: This cross-sectional population-based study used data from a respiratory health survey of Montreal children aged 6 months to 12 years conducted in 2006 (n=7,980). Asthma control was assessed among those with active asthma in the year prior to the survey (n=980) using an adaptation of the Canadian asthma consensus report clinical parameters. Using log-binomial regression models, prevalence ratios (PR) with 95 % confidence intervals (CI) were estimated to explore the relationship between inadequate control of asthma and environmental home exposures, including allergens, irritants, mold and dampness indicators. Subjects with acceptable asthma control were compared with those with inadequate disease control. Results: Of 980 children with active asthma in the year prior to the survey, 36 % met at least one of the five criteria outlined in the Canadian asthma guidelines as to poor control of their disease. The population’s characteristics found to be related with a lack of asthma control were: younger age, a history of parental atopy, low maternal education level, foreign-born mothers and tenant occupancy. After adjustments for the child’s age, parental atopy and tobacco smoke exposure at home, children living along high-traffic density streets (PR, 1.35; 95 % CI, 1.00-1.81) and those with their bedroom or residence in the basement (PR, 1.30; 95 % CI, 1.01-1.66) were found to be at increased risk of poor asthma control. Conclusions: Suboptimal asthma control appears to be mostly associated with traffic, along with mold and moisture conditions, the latter being a more frequent exposure and therefore having a greater public health impact.

Context: There are two ways that digital media may influence alcohol use. The first is commercial alcohol marketing. The second is user-created alcohol promotion, defined as content distributed through new media that promotes consumption, but independent of commercial marketing. This thesis explores how both types of content promote alcohol, what association there is between exposure and alcohol-related attitudes and behaviour, and the differences between marketing and user-created promotion. Method: A mixed method design was employed, divided into two studies. The first was a content analysis of the design features, topical references, and messages suggested about alcohol in digital marketing and user-created promotion on Facebook, Twitter, and YouTube. The second was a cross-sectional survey with young adults (n = 405). This measured awareness of, and participation with, digital marketing and user-created promotion, and the association with consumption, higher-risk drinking, brand recall, expectancies, and drinking motives. Results: The content analysis found that digital marketing had personalised designs which contained subtle and positive messages about consumption, whereas user-created promotion had simpler designs, displayed little ethical practice, and contained overt messages about higher-risk drinking. The cross-sectional survey found that young adults were aware of, and participating with, both digital marketing and user-created promotion, with exposure greater for the latter. Exposure to both types of content was positively associated with alcohol use, higher-risk consumption, and drinking intentions. User-created promotion had a stronger association with all outcomes than marketing. The association between exposure and consumption, for both types of content, was mediated through drinking motives and expectancies. Conclusion: Young adults are aware of, and participating with, a range of digital marketing and user-created promotion. That such exposure is associated with alcohol-related attitudes and behaviour highlights the potential of new media to influence alcohol consumption. Further research is required to better understand young people’s experience with digital media and the challenges of addressing online health risk messages.

Problématique : Plusieurs expositions résidentielles ont été associées à la prévalence de l’asthme. Toutefois, peu d’études populationnelles ont examiné la relation entre ces facteurs et un asthme mal maîtrisé chez l’enfant. Objectif : Évaluer les facteurs environnementaux résidentiels associés à un asthme mal maîtrisé chez les enfants montréalais âgés de 6 mois à 12 ans. Méthodes : Les données sont tirées d’une enquête transversale menée en 2006 sur la santé respiratoire d’enfants montréalais âgés de 6 mois à 12 ans (n=7980). La maîtrise de l’asthme a été évaluée chez les enfants avec un asthme actif au cours de l’année précédent l’enquête (n=980) selon des critères recommandés par les lignes directrices canadiennes sur l’asthme. Les rapports de prévalence (RP) et les intervalles de confiance (IC) à 95 % caractérisant l’association entre les facteurs environnementaux, incluant la présence d’allergènes, d’irritants, d’humidité et de moisissures, et le risque d’un asthme mal maîtrisé ont été estimés à l’aide de modèles de régression log-binomiale. Les sujets avec une maîtrise acceptable de l’asthme ont été comparés à ceux dont la maladie était mal maîtrisée. Résultats : Des 980 enfants avec un asthme actif au cours de l’année précédant l’enquête, 36 % ont rencontré au moins un des critères des lignes directrices canadiennes suggérant un asthme mal maîtrisé. Les caractéristiques de la population associées à un asthme mal maîtrisé sont : un plus jeune âge, des antécédents d’atopie parentale, une faible scolarisation de la mère, une mère d’origine étrangère et le statut de locataire. Après ajustement pour l’âge de l’enfant, l’atopie parentale et l’exposition à la fumée de tabac au domicile, une intensité de trafic élevée à proximité du domicile (RP, 1,35; IC 95 %, 1,00-1,81) et la localisation au sous-sol de la chambre de l’enfant ou de sa résidence (RP 1,30; IC 95 %, 1,01-1,66) étaient associées à un risque accru d’asthme mal maîtrisé. Conclusions : Une maîtrise sous-optimale de l’asthme semble être associée à l’exposition au trafic routier et à des conditions d’humidité excessive et probablement de moisissures. Cette dernière exposition étant plus fréquente, elle a probablement un plus grand impact en matière de santé publique. / Background: Home environmental exposures may impede asthma control in children. However, few population-based studies have investigated this relationship. Objective: Identify environmental home exposures associated with poor asthma control among asthmatic children less than 12 years of age in Montreal. Methods: This cross-sectional population-based study used data from a respiratory health survey of Montreal children aged 6 months to 12 years conducted in 2006 (n=7,980). Asthma control was assessed among those with active asthma in the year prior to the survey (n=980) using an adaptation of the Canadian asthma consensus report clinical parameters. Using log-binomial regression models, prevalence ratios (PR) with 95 % confidence intervals (CI) were estimated to explore the relationship between inadequate control of asthma and environmental home exposures, including allergens, irritants, mold and dampness indicators. Subjects with acceptable asthma control were compared with those with inadequate disease control. Results: Of 980 children with active asthma in the year prior to the survey, 36 % met at least one of the five criteria outlined in the Canadian asthma guidelines as to poor control of their disease. The population’s characteristics found to be related with a lack of asthma control were: younger age, a history of parental atopy, low maternal education level, foreign-born mothers and tenant occupancy. After adjustments for the child’s age, parental atopy and tobacco smoke exposure at home, children living along high-traffic density streets (PR, 1.35; 95 % CI, 1.00-1.81) and those with their bedroom or residence in the basement (PR, 1.30; 95 % CI, 1.01-1.66) were found to be at increased risk of poor asthma control. Conclusions: Suboptimal asthma control appears to be mostly associated with traffic, along with mold and moisture conditions, the latter being a more frequent exposure and therefore having a greater public health impact.

Formålet med undersøgelsen var at finde ud af, hvorvidt gravide kvinder på Færøerne fik en kost, som er i overensstemmelse med rekommandationer der foreligger gravide. 148 kvinder deltog i undersøgelsen, hvor der blev gennemført tre 24 h recall og seks selvregistreringer, samt et food frequency qeistionnaire omhandlende de sidste 12 måneder. Resultatet af den samlede energi, energifordeling, A-, C-, D- og E-vitaminer, og folsyre, jern og calcium er sammenlignet med de rekommandationer der foreligger for gravide i de nordiske lande, specielt Danmark, idet Færøerne følger de danske anbefalinger. Det gennemsnitlige energiindtag var 10,0 MJ, som i gennemsnit fordelte sig i henhold til kostanbefalingerne med 15% proteiner, 52% kulhydrater og 33% fedt. Kostfiberindtaget var lavere end anbefalet, 17,4 gram per dag. Mættede og monoumættede fedtsyrer fulgte anbefalingerne, men indtaget af polyumættede fedtsyrer var lavt, 3,6%. Indtaget af n-3 fedtsyrer var 0,6%, som er lavere end anbefalet. Indtaget at C-vitaminer og calcium var tilstrækkeligt gennem kosten. Indtaget af de andre vitaminer og mineraler var mindre end anbefalingerne. 85% tager vitamintilskud og 64% tager jerntilskud. Indtaget af fisk var 280 gram per uge, kornprodukter 323 gram per dag, kød 193 gram per dag, sødesager 128 gram per dag, frugt og grønt 193 gram per dag, frugt juice 98 gram per dag. Resultatet fra denne opgave kan sætte større fokus på kost og graviditet, samt at der er et behov for en større og mere indgående kostundersøgelse blandt den generelle befolkning, hvis resultater kan bruges i sundhedsfremmende arbejde. / The purpose of this project was to find out whether pregnant women in the Faroe Islands had a dietary intake, which were in accordance with recommendations for pregnant women. 148 women participated in the survey, which involved three 24 hour recall and six days diary, and a food frequency questionnaire for the last 12 months. The results of total energy, the energy distribution of protein, carbohydrate and fat and the micronutrients vitamin-A, -C, -D, -E, folic acid, iron and calcium are compared with recommendations for pregnant women in the Nordic countries, especially from Denmark because the Faroe Islands follow the Danish recommendations. In average the total energy consumption per day was 10,0 MJ, and the distribution was 15% protein, 52% carbohydrates and 33% fat. Dietary fibre intake was 17,4 gram per day, which is lower than recommended. The intake of saturated and monounsaturated fatty acids followed the recommendations whereas the intake of polyunsaturated fatty acids and n-3 fatty acids was lower then recommended, 3,6% and 0,6%. Supply of vitamin-C and calcium through the food was sufficient, whereas the supply of the other micronutrients was too low compare to recommendations. 85% of the women took vitamin supplements and 64% took iron supplements. Intake of fish was 280 gram per week, cereal products 323 gram per day, meat 139 gram per day, sweets 128 gram per day, fruit and vegetables 193 gram per day, fruit juice 98 gram per day. The results from this project can put a focus on the connection between diet and pregnancy as well as there is a need for a detailed dietary survey among the general population, where the results can used in further health promotion / <p>ISBN 91-7997-141-5</p>

Die vorliegende Dissertationsschrift geht der Frage nach, wie die Qualität von Haushaltsbefragungen zum Verkehrsverhalten bestimmt, bewertet und für zukünftige Erhebungen sichergestellt werden kann. Dabei spielt die Teilnahmebereitschaft als ein bedeutsamer, keinesfalls aber alleiniger Qualitätsindikator eine wichtige Rolle. Eine zentrale Forschungsfrage der Arbeit beschäftigt sich mit der Eignung gruppenspezifischer Ansprache und Befragung zur Erhöhung der Befragungsqualität. Ausgehend von grundsätzlichen Betrachtungen zu Bedeutung, wesentlichen Designelementen und insbesondere Fehlerquellen von Befragungen in der empirischen Sozialforschung, sind verschiedene Ansätze zur Einschätzung der Qualität einer Befragung Gegenstand dieses Teils der Arbeit. Darauf aufbauend werden stichtagsbezogene Haushaltsbefragungen zum Verkehrsverhalten im Alltag als Spezialfall von Befragungen eingeführt und Ansätze zur Qualitätssicherung bei derartigen Haushaltsbefragungen zusammengetragen. Eine Gegenüberstellung von Designelementen und möglichen Fehlern bei Verkehrsverhaltensbefragungen ermöglicht die Identifizierung und Beschreibung von neun Handlungsfeldern. Im Kontext von Erkenntnissen aus der Erhebungspraxis sowie Erfahrungen bei der Durchführung mehrerer Durchgänge des Forschungsprojektes „Mobilität in Städten – SrV“ wird eingeschätzt, inwieweit die jeweiligen Handlungsfelder zur Verminderung von Fehlereinflüssen und zur Qualitätssicherung beitragen können. Auf dieser Grundlage werden konkrete Handlungsoptionen ausgewählt. Für die Einschätzung der Handlungsoptionen hinsichtlich ihrer Wirksamkeit bei der Sicherung und Steigerung der Erhebungsqualität können auf Basis umfangreicher Literaturauswertungen insgesamt 24 Qualitätsindikatoren zusammengestellt werden. Diese ermöglichen die systematische Bewertung der Erfassungs-, Inhalts- und Durchführungsqualität. Unter Einbeziehung der Untersuchungsgruppen und Qualitätsindikatoren wird in einer vertieften empirischen Analyse untersucht, in welchem Maße die ausgewählten Handlungsoptionen zur gruppenspezifischen Ansprache und Befragung geeignet sind und ob sich dadurch die Erhebungsqualität steigern lässt. Neben umfangreichen Gruppenvergleichen findet eine Befragungssimulation nach der Monte-Carlo-Methode statt. Die Datenbasis dieser Analysen besteht überwiegend aus den Erhebungsdurchgängen und Sondererhebungen von „Mobilität in Städten – SrV“. Im Ergebnis der Analysen lassen sich Empfehlungen für die Weiterentwicklung von Haushaltsbefragungen zur Erfassung von Verkehrsverhaltensdaten ableiten. Diese gliedern sich in einen gruppenübergreifenden Teil und einen Abschnitt für spezielle Gruppen. Noch vorangestellt ist die klare Empfehlung, bei Haushaltsbefragungen zukünftig nur noch eine Person des Haushalts zu ihren Wegen am Stichtag zu befragen. Dieses Vorgehen erleichtert die zukünftige Implementierung (sogar trennscharfer) gruppenspezifischer Ansätze deutlich. Die zusammengestellten Empfehlungen bieten eine konsistente, praktikable und auf andere Befragungen übertragbare Basis, das Erhebungsdesign bestehender und zukünftiger Haushaltsbefragungen zum Verkehrsverhalten so anzupassen, dass durch die vollständige oder zumindest teilweise Umsetzung gruppenspezifischer Ansätze eine Verbesserung der Erhebungsqualität insgesamt erzielt werden kann. / This dissertation addresses the question of how the quality of household travel surveys can be determined, evaluated, and ensured for the development of future surveys. The willingness of individuals to participate is an important, but by no means exclusive, indicator of quality. A central research question of this work deals with the concept of combining group-specific survey methods to increase survey quality. Beginning with some fundamental terminological considerations, this work then focuses on essential design elements and, in particular, sources of error in surveys in empirical social research in order to establish various approaches for assessing the quality of a survey. Building on this, household travel surveys are introduced in specific examples, and approaches for quality assurance in such household travel surveys are compiled. A comparison of design elements and possible errors in household travel surveys provides for the identification and description of nine areas of activity. In the context of findings from the surveying practice as well as experience in conducting several waves of the research project "Mobility in Cities – SrV", the extent to which the respective fields of action can contribute to the reduction of errors and to quality assurance was assessed. On this basis, concrete options for action were selected. In order to evaluate the courses for action in terms of their effectiveness in securing and increasing the quality of surveys, a total of 24 quality indicators were compiled on the basis of extensive literature review. These allowed for the systematic assessment of three areas: quality of collection, content, and of application. With the involvement of analysis groups and quality indicators, a detailed empirical analysis was carried out to examine the extent to which the selected courses for action are suitable for group-specific combinations of survey methods and whether this can increase survey quality. In addition to extensive group comparisons, a survey simulation was implemented using the Monte Carlo method. The data foundation for these analyses primarily consisted of the surveys carried out for the research project "Mobility in Cities – SrV". These analyses enabled the establishment of recommendations which further the development of household travel surveys; these were divided into a cross-group section as well as a section for specific groups. Prior to these recommendations, it became clear that for future household travel surveys, only one individual in the household should be questioned regarding their trips on specific reference days. This decision significantly facilitates the future implementation of (even more selective) group-specific approaches. The compiled recommendations provide a consistent, practical foundation that can be applied to other surveys in order to adapt the design of existing and future household travel surveys, thus providing an overall or at least partial implementation of group-specific approaches which can improve overall survey quality.

Die vorliegende Dissertationsschrift geht der Frage nach, wie die Qualität von Haushaltsbefragungen zum Verkehrsverhalten bestimmt, bewertet und für zukünftige Erhebungen sichergestellt werden kann. Dabei spielt die Teilnahmebereitschaft als ein bedeutsamer, keinesfalls aber alleiniger Qualitätsindikator eine wichtige Rolle. Eine zentrale Forschungsfrage der Arbeit beschäftigt sich mit der Eignung gruppenspezifischer Ansprache und Befragung zur Erhöhung der Befragungsqualität. Ausgehend von grundsätzlichen Betrachtungen zu Bedeutung, wesentlichen Designelementen und insbesondere Fehlerquellen von Befragungen in der empirischen Sozialforschung, sind verschiedene Ansätze zur Einschätzung der Qualität einer Befragung Gegenstand dieses Teils der Arbeit. Darauf aufbauend werden stichtagsbezogene Haushaltsbefragungen zum Verkehrsverhalten im Alltag als Spezialfall von Befragungen eingeführt und Ansätze zur Qualitätssicherung bei derartigen Haushaltsbefragungen zusammengetragen. Eine Gegenüberstellung von Designelementen und möglichen Fehlern bei Verkehrsverhaltensbefragungen ermöglicht die Identifizierung und Beschreibung von neun Handlungsfeldern. Im Kontext von Erkenntnissen aus der Erhebungspraxis sowie Erfahrungen bei der Durchführung mehrerer Durchgänge des Forschungsprojektes „Mobilität in Städten – SrV“ wird eingeschätzt, inwieweit die jeweiligen Handlungsfelder zur Verminderung von Fehlereinflüssen und zur Qualitätssicherung beitragen können. Auf dieser Grundlage werden konkrete Handlungsoptionen ausgewählt. Für die Einschätzung der Handlungsoptionen hinsichtlich ihrer Wirksamkeit bei der Sicherung und Steigerung der Erhebungsqualität können auf Basis umfangreicher Literaturauswertungen insgesamt 24 Qualitätsindikatoren zusammengestellt werden. Diese ermöglichen die systematische Bewertung der Erfassungs-, Inhalts- und Durchführungsqualität. Unter Einbeziehung der Untersuchungsgruppen und Qualitätsindikatoren wird in einer vertieften empirischen Analyse untersucht, in welchem Maße die ausgewählten Handlungsoptionen zur gruppenspezifischen Ansprache und Befragung geeignet sind und ob sich dadurch die Erhebungsqualität steigern lässt. Neben umfangreichen Gruppenvergleichen findet eine Befragungssimulation nach der Monte-Carlo-Methode statt. Die Datenbasis dieser Analysen besteht überwiegend aus den Erhebungsdurchgängen und Sondererhebungen von „Mobilität in Städten – SrV“. Im Ergebnis der Analysen lassen sich Empfehlungen für die Weiterentwicklung von Haushaltsbefragungen zur Erfassung von Verkehrsverhaltensdaten ableiten. Diese gliedern sich in einen gruppenübergreifenden Teil und einen Abschnitt für spezielle Gruppen. Noch vorangestellt ist die klare Empfehlung, bei Haushaltsbefragungen zukünftig nur noch eine Person des Haushalts zu ihren Wegen am Stichtag zu befragen. Dieses Vorgehen erleichtert die zukünftige Implementierung (sogar trennscharfer) gruppenspezifischer Ansätze deutlich. Die zusammengestellten Empfehlungen bieten eine konsistente, praktikable und auf andere Befragungen übertragbare Basis, das Erhebungsdesign bestehender und zukünftiger Haushaltsbefragungen zum Verkehrsverhalten so anzupassen, dass durch die vollständige oder zumindest teilweise Umsetzung gruppenspezifischer Ansätze eine Verbesserung der Erhebungsqualität insgesamt erzielt werden kann. / This dissertation addresses the question of how the quality of household travel surveys can be determined, evaluated, and ensured for the development of future surveys. The willingness of individuals to participate is an important, but by no means exclusive, indicator of quality. A central research question of this work deals with the concept of combining group-specific survey methods to increase survey quality. Beginning with some fundamental terminological considerations, this work then focuses on essential design elements and, in particular, sources of error in surveys in empirical social research in order to establish various approaches for assessing the quality of a survey. Building on this, household travel surveys are introduced in specific examples, and approaches for quality assurance in such household travel surveys are compiled. A comparison of design elements and possible errors in household travel surveys provides for the identification and description of nine areas of activity. In the context of findings from the surveying practice as well as experience in conducting several waves of the research project 'Mobility in Cities – SrV', the extent to which the respective fields of action can contribute to the reduction of errors and to quality assurance was assessed. On this basis, concrete options for action were selected. In order to evaluate the courses for action in terms of their effectiveness in securing and increasing the quality of surveys, a total of 24 quality indicators were compiled on the basis of extensive literature review. These allowed for the systematic assessment of three areas: quality of collection, content, and of application. With the involvement of analysis groups and quality indicators, a detailed empirical analysis was carried out to examine the extent to which the selected courses for action are suitable for group-specific combinations of survey methods and whether this can increase survey quality. In addition to extensive group comparisons, a survey simulation was implemented using the Monte Carlo method. The data foundation for these analyses primarily consisted of the surveys carried out for the research project 'Mobility in Cities – SrV'. These analyses enabled the establishment of recommendations which further the development of household travel surveys; these were divided into a cross-group section as well as a section for specific groups. Prior to these recommendations, it became clear that for future household travel surveys, only one individual in the household should be questioned regarding their trips on specific reference days. This decision significantly facilitates the future implementation of (even more selective) group-specific approaches. The compiled recommendations provide a consistent, practical foundation that can be applied to other surveys in order to adapt the design of existing and future household travel surveys, thus providing an overall or at least partial implementation of group-specific approaches which can improve overall survey quality.

Cardiovascular diseases are the leading cause of death in most industrialised countries and in developing countries the trend in cardiovascular-related deaths is increasing. World-wide, type 2 diabetes mellitus (T2DM) is an emerging cause of disability and premature death. Both these conditions are closely associated with the consumption of energy-dense foods and food products that are poor in nutrients, as well as with a sedentary lifestyle. Pharmacological and surgical interventions can improve the outcome and delay the progression of the disease, but in terms of population-level prevention there is no substitute for the adoption of a healthy lifestyle. SETTING The underlying studies were conducted in Västerbotten (the VIP study), and in Norrbotten and Västerbotten combined (the MONICA Project). Norrbotten andVästerbotten are the two northernmost counties in Sweden. Since the mid-1980sthe prevalence of cardiovascular disease has decreased and diabetes rates haveremained stable in this region, despite of an unbroken trend of increasing body weight. OBJECTIVE The aim of this thesis is to describe changes in reported dietary habits, estimatetheir relative importance as risk factors for diabetes and cardiovascular disease, and finally to identify lifestyle components as potential targets for intervention. RESULTS The first paper describes changes in self-reported food consumption between 1986 and 1999. During this period, the population in question switched from products with high saturated fatty acid content (e.g. milk containing 3% fat, butter) to foods containing less saturated fat (e.g. milk containing 1.5% fat, vegetable oil, low-fat margarine); pasta and rice were consumed more often, and potatoes were consumed less. Convenience foods (e.g. hamburgers, snacks, sweets) became more popular, whilst traditional dishes (e.g. potato dumplings, black pudding, blöta) decreased in popularity. Fruit and vegetable intake remained low. In paper two we study the effects of these changes in food intake on the risk of developing T2DM using body fat distribution as an early indicator. Increased consumption of convenience foods was associated with unfavourable changes (smaller hip circumference and larger waist circumference), whereas the increased consumption of vegetable oil and pasta was associated with low-risk fat distribution. In the third paper we report studies on the association between fat consumption and T2DM. We used the pattern of fatty acids in the membranes of red blood cells as a marker of fat intake. In addition to confirming earlier findings (markers of the intake of saturated fat are associated with increased risk of T2DM and markers of unsaturated fat are associated with reduced T2DM risk), we also identified associations between two markers of milk-derived saturated fat intake and enterolactone, a biomarker of dietary fibre intake, and the risk of developing myocardial infarction. Our results indicate that moderately high levels of enterolactone intake in men are associated with lower risk of experiencing myocardial infarction. Manuscript 5 ranks education level, physical activity, smoking status, and self-reported intake of dietary fibre and fatty acids according to their effects on body fat distribution. Increased levels of physical activity, a higher education level and a reduced intake of saturated fat from meat were ranked as the most strongly associated factors in both men and women. Increased intake of dietary fibre from grains in women, and increased intake of dietary fibre from fruits and vegetables in men, was also inversely associated with average waist circumference. CONCLUSION Both questionnaire-based and biological markers of the risk of developing diabetes or cardiovascular disease have been identified. Based on available population level measurements, reduced consumption of convenience foods, increased consumption of whole-grain products, fruits and vegetables, vegetable oil and pasta as well as increased physical activity are potential goals for interventions in northern Sweden.

Text in English / This study investigates the nature of spiritual intelligence and its link to ethnic identity, and gauges the difference across the main ethnic groups in Mauritius. A new scale, the Multicultural Spiritual Intelligence Scale (MSIS) was proposed, using the following six dimensions: self-awareness, transcendental awareness, levels of consciousness, the quest for meaning, sensitivity, and resilience. The MSIS was developed and tested using a cross-sectional survey research design with the option of completing a paper or online version, administered to a sample of 1,177 adult participants in Mauritius. This research looked at the three major ethnic groups in Mauritius: Hindu-Mauritians, Creole-Mauritians, and Muslim-Mauritians, and examined their conceptions of spiritual intelligence and ethnic identification. A factor analysis was conducted on the scale and five specific factors: self-mastery, transcendental awareness, spiritual sensitivity, resilience, and the existential quest. These factors emerged with factor loadings greater than 0.35. The MSIS’s construct validity was tested with other similar scales, particularly Meaning in Life (MLQ) (Steger et al., 2006), the Connor-Davison Resilience Scale (CD-RISC) (Connor & Davidson, 2011), Private Self-Consciousness (PSC) (Scheir & Carver, 1985), and New Indices of Religious Orientation (NIRO) (Francis, 2007). The Balanced Inventory of Desirable Responding (BIDR) (Paulhus, 1991) was also included to check for social desirable responses and MSIS’s divergent validity. A Welch ANOVA revealed a statistical difference in spiritual intelligence among the ethnic groups: Welch’s F (2, 639.98) = 3.923. Spearman’s rank order correlation revealed that ethnic identification was connected to spiritual intelligence: rs (98) = 0.52, p < 0.0005. A Games-Howell post-hoc analysis indicated a statistically significant mean difference between Muslim-Mauritians and Hindu Mauritians (0.27, 95% CI [0.083, 0.45]) and between Muslim-Mauritians and Creole Mauritians (0.44, 95% CI [0.25, 0.62]). The Muslim-Mauritians obtained the highest score in both ethnic exploration and ethnic commitment. Ethnic identification implied a prior quest for identity, which was connected with spiritual development. A second study was conducted on a sample of 303 participants using a shorter version of MSIS to confirm the five-factor model. Implications for further research include analysing the MSIS in terms of other constructs and using the MSIS with other minority groups in Mauritius. / Psychology / D.Litt et Phil. (Psychology)