Bakgrund: Inom både dam- och herrishockey är hjärnskakningar vanligt förekommande. Definitionen av hjärnskakning är att hjärnan hamnar i rörelse av direkt eller indirekt våld mot huvudet. Riktlinjer finns framtagna över hur hjärnskakningar ska hanteras och rehabiliteras och bör tas på allvar då det finns risk för blödning eller kvarstående symtom. SCAT-3 är ett värderingsverktyg vid hjärnskakningar, där ingår en symtomskattning. En hög poängsumma innebär stora symtomatiska besvär. Inga studier har påträffats över förekomst av hjärnskakningar samt hjärnskakningslikande symtom för spelare i Svenska damhockeyligan (SDHL).Syfte: Att beskriva förekomst av hjärnskakningar samt hjärnskakningsliknade symtom hos ishockeyspelare i SDHL jämfört med en kontrollgrupp.Metod: Kvantitativ, deskriptiv samt komparativ tvärsnittsdesign. Ett internetbaserat testformulär byggt på SCAT-3. Totalt 92 deltagare, n=48 hockeyspelare, n=44 kontrollgrupp.Resultat: Förekomsten av hjärnskakningar var 64,6 % bland ishockeyspelare, och signifikant högre jämfört med kontrollgruppen 38,6 % (p=0,013). Totalsumma av hjärnskakningsliknande symtom bland hockeyspelarna (17,6 poäng) jämfört med kontrollgruppen (16,4 poäng) skiljde sig inte signifikant. Vanligaste symtomen bland hockeyspelarna var känsla av trötthet/brist på energi, nackont samt irritation. Vanligaste symtomen för kontrollgruppen var känsla av trötthet/brist på energi, mer känslosam än vanligt och koncentrationssvårigheter. Konklusion: 64,6 % av spelarna i SDHL har fått minst en hjärnskakning. Hjärnskakningar var vanligare bland spelare i SDHL än i kontrollgruppen. Ingen signifikant skillnad av hjärnskakningsliknade symtom sågs mellan grupperna. Symtomen var inte tillräckligt specifika för att jämföra grupper emellan, utan bör enbart jämföras individuellt. / Background: Concussions are frequently occurring in ice hockey, both women and men hockey. A concussion appears from direct or indirect violence against the head, that will cause brain movement, and in worse case a bleeding on the brain. There are guidelines for concussion management and rehabilitation that needs to take seriously as there are risks of retaining symptoms. SCAT-3 is a concussion tool, with a symptom scale. A higher score means bigger issues of the symptoms. No studies have been done on the concussion frequency and concussion-similar symptoms for players in the Svenska damhockeyligan (SDHL).Purpose: Find out frequency of concussion and concussion-similar symptoms compared to a control group. Method: Quantitative descriptive and comparative cross-sectional design. An internet based test, based on SCAT-3, with total 92 participants, n=48 hockey players, n=44 control group.Results: Concussion frequency was 64.6 % for hockey players, and significant higher compared to the control group 38.6% (p=0.013). In total, concussion-similar symptom score for hockey players was 17.6 points and for control group 16.4 points. No significant difference between the groups. The most common symptoms among hockey players were fatigue or low energy, neck pain and irritation. In the control group, fatigue or low energy, more emotional and concentration difficulties was the most common.Conclusion: 64.6 % of the players in SDHL had received at least one concussion. Concussions are more common among players in SDHL than a control group. No significant difference of concussion-similar symptoms. The symptoms are not specific

Magister Public Health - MPH / Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of >80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence. / South Africa

The objective of this thesis was to defend an alternative approach by health policy makers for improving health outcomes through investing on social factors of peoples' lives, rather than by increasing health expenditures. In order to defend this theory, this master thesis addresses two research questions: Which are the social determinants of health with largest impact on health status of individuals? And what is the statistical correlation between those social determinants of health and self-reported health status, and psychological health, for Germany, Denmark, Spain and Ireland? The first question was answered by developing a comprehensive research among the mostrelevant literature in the field of social determinants of health and the second through the construction of a statistical multiple regression model. According this study the social determinants with largest impact on the health status of individuals are: physical activity, education level, the welfare state, emotional support, socio-economic status, living conditions, working conditions, and life balance. Regarding the results of multiple regression models all variables followed the expected trend and it was possible to proof significant statistical correlation in 7 of the 8 determinants chosen, especially in the cases of working conditions and life balance, where those having problems managing these aspects of life experienced 50% or in some cases 30% of the health status of individuals with positive experiences in these life dimensions.

The determination of adiposity in adolescents is often assessed with calculations of body mass indices (BMI). Researchers often obtain these measurements from self-reported (SR) values. The purpose of this study was to determine the accuracy of SR height, weight, and calculated BMI (from height and weight). SR and actual measured (ME) BMI values were compared with standards from the FITNESSGRAM® Healthy Fitness Zone (HFZ) classifications. SR height and calculated BMI were found to be accurate while SR weight was, on average, underreported by 4.77 lbs. Because of these errors in SR height and weight, accuracy of classification into the FITNESSGRAM® HFZ was compromised. Consequently, it is important that researchers ascertain actual values of height and weight when measuring adolescents rather than use those from self-reports.

Cette thèse étudie l'influence du travail sur la qualité de l'emploi et la qualité de vie des individus. Cette dernière est approximée par la perception que les individus ont de leur santé. Le premier chapitre étudie les conséquences de la perte d'emploi liée à la fermeture d'un établissement sur l'ensemble des dimensions de la qualité de l'emploi retrouvé. Nous montrons que ce choc induit une dégradation, y compris sur le long terme, des salaires, de l'insécurité de l'emploi perçue, de la qualité de l'environnement de travail et de la satisfaction des travailleurs. Les deux derniers chapitres tentent de comprendre les déterminants des différences de santé perçue selon le genre. Dans le deuxième chapitre, nous analysons le rôle de la santé mentale dans les écarts de santé déclarée selon le genre. Le troisième chapitre étudie l'influence des normes sociales au travail, sur la santé perçue. Nous montrons que les femmes comme les hommes travaillant dans des collectifs de travail féminins déclarent davantage de problèmes de santé spécifiques que celles et ceux travaillant dans des collectifs masculins. Ce travail souligne donc, d'une part, l'effet négatif de la perte d'emploi sur la qualité de l'emploi retrouvé et la satisfaction à long terme et, d'autre part, l'importance du mal-être et des normes sociales au travail pour comprendre les différences de santé perçue entre les genres. / This thesis studies the influence of work on job and life quality, the latter being considered through the perception that individuals have of their own health. The first chapter focuses on the long-term effects of job losses due to plant closure on job quality. We show that job loss negatively affects wages, perceived job insecurity, the quality of the working environment and job satisfaction, including in the long run. The two last chapters investigate gender differences in self-reported health. The second chapter provides descriptive evidence on the relationships between self-assessed health, gender and mental health problems, i.e. depression and/or affective pains. Finally, in the last chapter, we study the influence of social norms as proxied by the gender structure of the workplace environment, on gender differences in self-reported health. We show that both women and men working in female-dominated environments report more specific health problems than those who work in male-dominated environments. The overall findings of this thesis are twofold. First, losing a job has a negative impact on several dimensions of job quality and satisfaction in the long run. Secondly, mental diseases and social norms at work are important to understand gender-related differences in health perceptions.

African American women (AAW) are at a high risk for type 2 diabetes, a debilitating and potentially fatal disease for which there is no cure. The purpose of this study was to extend the research of Mosca et al. (2012) by examining the relationship between caregiver status and self-reported health status for AAW 18 years or older diagnosed with type 2 diabetes. The chronic care model (CCM) provided the theoretical framework for this study. The CCM promoted routine care for patients with chronic illnesses to migrate from acute care to proactive, planned, and risk-based protocols. A binomial logistic regression investigated the relationship between caregiver status, categorized as paid or unpaid, and self-reported health status, which was dichotomized as either good to excellent health or poor to fair health. There was a statistically significant relationship between primary caregiver status and self-reported health status among AAW diagnosed with Type 2 diabetes after controlling for age, education, and marital status (p < .004). Based on the fitted binomial logistic regression model, there were 186 cases of AAW with type 2 diabetes; having a paid caregiver was associated with a lower odds of having good to excellent health (OR = 0.294). About 12.3% of the variance in self-report health status was attributable to caregiver status. Overall, 82.6% of predictions were accurate. Nearly all participants required frequent assistance from a caregiver in the preceding 12 months. These findings suggest a critical need for healthcare service providers to educate caregivers as a means to deliver post-acute care to AAW diagnosed with type 2 diabetes, consistent with the CCM.

No description available.

Background: The prognostic significance of chest pain is well established in patients with coronary artery disease, but still ill defined in primary prevention. Therefore, the aim of our analysis was to assess the prognostic value of different forms of chest pain in a large cohort of primary care subjects under the conditions of contemporary modalities of care in primary prevention, including measurement of serum levels of the biomarker NT-pro-BNP. Design: We carried out a post-hoc analysis of the prospective DETECT cohort study. Methods: In a total of 5570 unselected subjects, free of coronary artery disease, within the 55,518 participants of the cross-sectional DETECT study, we assessed chest pain history by a comprehensive questionnaire and measured serum NT-pro-BNP levels. Three types of chest pain, which were any chest pain, exertional chest pain and classical angina, were defined. Major adverse cardiovascular events (MACEs = cardiovascular death, myocardial infarction, coronary revascularization procedures) were assessed during a 5-year follow-up period. Results: During follow-up, 109 subjects experienced a MACE. All types of reported chest pain were associated with an approximately three-fold increased risk for the occurrence of incident MACEs, even after adjusting for cardiovascular risk factors. Any form of reported chest pain had a similar predictive value for MACEs as a one-time measurement of NT-pro-BNP. However, adding a single measurement of NT-pro-BNP and the information on chest pain resulted in reclassification of approximately 40% of subjects, when compared with risk prediction based on established cardiovascular risk factors. Conclusions: In primary prevention, self-reported chest pain and a single measurement of NT-pro-BNP substantially improve cardiovascular risk prediction and allow for risk reclassification of approximately 40% of the subjects compared with assessing classical cardiovascular risk factors alone.

An inverse relationship exists between self-reported religiousness and substance use. However, we question whether religious culture impacts the veracity of self-reported substance use. The primary aim of this study of low-income pregnant women in South Central Appalachia was to determine the accuracy of self-reported substance use in pregnant women as well as to determine whether there were differences in use rates and/or differences in the degree to which women would accurately report substance use depending on their religiousness. Self-reported use and toxicology screening results taken from a larger prospective, longitudinal, smoking cessation study were compared for five substances (cannabinoids [marijuana or other cannabinoids], benz/barb/sed [including benzodiazepines, barbiturates, or any sedative], opioids [including heroin, methadone or other medication-assisted treatment medications, or other opiates], crack/cocaine [crack or cocaine], and meth/amph [including methamphetamine or any other amphetamine]). Women who attend church frequently reported lower rates of substance use than infrequent or nonattenders, as did women who rated themselves as high in intrinsic religiosity (IR), although the difference between high and low groups is less extreme for IR as opposed to attendance. Women who attended church frequently were far less likely to report use or to have use confirmed than any of the other groups including those high in IR. Rates of positive toxicology screens did not differ statistically across religiousness groupings, but the pattern of proportionally fewer positive toxicology results was seen in frequent attenders but not in women self-reporting as high IR. Women’s tendency to underreport substance use was unrelated to religiousness variables, indicating underreporting is not necessarily driving this difference in reported substance use.

Subjective socioeconomic status (SES) has previously been shown to be correlated with a large number of health measures. In this study, the subjective SES measure is modified and translated to measure childhood SES. The subjective SES scale is examined in a participant's hometown, community, and nation. Both an immigrant Hispanic and a Caucasian sample were studied (31 Hispanic males; 42 Hispanic females; 38 Caucasian males, 40 Caucasians females). Childhood SES was the most significant predictor of self-reported health in both sample groups.