Syfte och frågeställningar | Undersöka sambandet mellan kardiovaskulär kondition och skärmtid, samt undersöka skillnader i kardiovaskulär kondition samt skärmtid hos ungdomar med Attention Deficit Hyperactivity Disorder (ADHD) och hur det skiljer sig från ungdomar utan ADHD. Frågeställningar: 1. Hur skiljer sig kondition (beräknad VO2max) hos ungdomar med och utan ADHD? 2. Hur skiljer sig skärmtid hos ungdomar med ADHD från ungdomar utan ADHD? 3. Hur ser sambandet ut mellan skärmtid och kondition hos ungdomar med samt utan ADHD diagnos?  Metod | Studien inkluderar 1139 ungdomar från 34 skolor i åldersspannet 13–14 år. Studien är en tvärsnittsstudie som är en del av en större studie ”Physical Activity for Healthy Brain Functions in School Youth” genomförd 2019 baserad på kvantitativ data där kardiovaskulär kondition uppskattades i ml/kg/min efter utfört Ekblom-Bak submaximala cykel ergometer test. Skärmtid samt allmän beskrivande data (kön, ålder, vikt och längd) baserades på enkätfrågor och inhämtad data från SCB kring socioekonomisk bakgrund.  Resultat | Resultaten visade ingen signifikant skillnad i VO2max (ml/kg/min) mellan ungdomar med ADHD och utan ADHD (p = 0.333). Vid kontroll av kön, föräldrautbildning och BMI kunde en signifikant skillnad visas (β = -3.398 ml/kg/min, p = 0.014). Vid analys av skillnader i skärmtid under en vanlig vardag och en vanlig helgdag var inte skillnaden signifikant mellan ungdomar med ADHD och utan ADHD (vardag p = 0.269, helgdag p =0.275). Det fanns ett signifikant samband hos ungdomar utan ADHD vid uppskattad VO2maxoch skärmtid vardag 3–4 timmar (β = -1.993 ml/kg/min, p &lt;0.001), vardag ≥5 timmar (β = -2.066 ml/kg/min, p = 0.004), helgdag ≥5 timmar (β = -2.244 ml/kg/min, p = 0.003) jämfört med referens 0–2 timmar. För ungdomar med ADHD kunde inget signifikant samband för samtliga kategorier av skärmtid utläsas (p = 0.786, p = 0.060, p = 0.392, p = 0.806).  Slutsats | Denna studie påvisar en signifikant skillnad i VO2max mellan ungdomar med och utan ADHD, medan ingen signifikant skillnad i skärmtid observerades. Uppmätt signifikant samband mellan kardiorespiratorisk kondition och skärmtid en vanlig vardag ≥3, samt skärmtid en vanlig helgdag ≥5 timmar hos ungdomar utan ADHD kunde tydas. Däremot sågs inget sådant samband hos ungdomar med ADHD. Ytterligare forskning föreslås med större stickprov på ungdomar med ADHD samt kontroll av diagnos och medicinering. / Aim | To investigate the associations between cardiorespiratory fitness and screen time, also investigate the differences in cardiorespiratory fitness as well as screen time for adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and how it differs from adolescents without ADHD. Questions posed: 1. How does cardiorespiratory fitness (calculated VO2max) differ in adolescents with and without ADHD? 2. How does screen time differ for adolescents with ADHD compared to adolescents without ADHD? 3. What are the associations between screen time and cardiorespiratory fitness based on adolescents with and without ADHD diagnosis? Method | The study included 1139 adolescents from 34 schools in the age range 13–14. This is a cross- sectional study as a part of the larger study ”Physical Activity for Healthy Brain Functions in School Youth” conducted 2019 based on quantitative data where cardiorespiratory fitness was estimated in ml/ kg/ min after performing the Ekblom-Bak cycle ergometertest. Screen time and general descriptive data (gender, age, weight and height) were based on survey questions and obtained data from SCB concerning socioeconomic background.  Results | No significant difference in VO2max (ml/kg/min) between adolescents with ADHD and without ADHD (p = 0.333). When controlled for gender, parental education and BMI, a significant difference could be established (β = -3.398 ml/kg/min, p = 0.014).Analysis of differences in screen time during a normal weekday and weekend day was not significant between adolescents with ADHD and without ADHD (weekday p = 0.269, weekend day p = 0.275). There were a significant association in adolescents without ADHD with estimated VO2max and screen time weekdays 3–4 hours (β = -1.993 ml/kg/min, p &lt;0.001), weekday ≥5 hours (β = - 2.066 ml/kg/min, p = 0.004), weekend day ≥5 hours (β = -2.244 ml/kg/min, p = 0.003) from the reference 0–2 hours. For adolescents with ADHD, no significant association was seen for any category of screentime (p = 0.786, p = 0.060, p = 0.392, p=0.806). Conclusions | This study showed significant difference in VO2max between adolescents with and without ADHD, however no significant difference in screen time was observed. Significant measured association between cardiorespiratory fitness and screen time on an iiiordinary weekday ≥3, such as screen time on an ordinary weekend day ≥5 h in adolescents without ADHD was shown. However, no such association was seen for adolescents with ADHD. Further research with a larger population in adolescents with ADHD and controlling for diagnosis and medication is necessary. / <p>Uppsatsen tilldelades stipendiemedel ur Överste och Fru Adolf Johnssons fond 2023.</p>

Female Genital Mutilation/Cutting (FGM/C) is a universal concern, with more than 200 million girls and women alive today who have undergone the practice primarily concentrated in Africa. The Maasai, a semi-nomadic ethnic group inhabiting the Northern Central part of Tanzania, have the highest rate of FGM/C in the whole country. Researchers have emphasised the importance of local context-based studies in the field to help abandon the practice. This study aimed to explore what challenges lies in combating FGM/C within Maasai communities in the Northern Central part of Tanzania as well as how strategies for ending the practice can be put in place, using local context-based information. Twelve qualitative semi-open interviews were conducted in Arusha, Tanzania, with people who had experience with FGM/C, either personal or professional. The interviews were analysed by using a thematic analytical approach and by using different theoretical frameworks relating to the social and cultural aspects of FGM/C. The results of this study shows that FGM/C is a social convention, deeply rooted in cultural traditions and beliefs connected with marriage and adulthood, whereby the norm and expectations itself are the driving force behind the practice rather than any specific group in the community. Our findings indicate that boys and mens role are bigger than initially acknowledged, suggesting a higher degree of their inclusion in all interventions on FGM/C. In the work of eliminating the practice, the most efficient strategies are those on individual and community level to build up awareness: Training sessions involving community leaders, religious leaders and health care professionals. Important strategies on the individual level include education and economic empowerment. One key finding in this study is that visual proof and information such as videos and drama has been very fruitful in changing perceptions on FGM/C. Further, we suggest that all interventions aiming to achieve sustainable change need to happen from within, using Maasai themselves. Hence, capacity building within communities is crucial. Another key finding in this study is the existing communication gap between advocators against FGM/C and practicing communities, indicating a need of higher degree of understanding in relation to the complexity surrounding FGM/C, especially in relation to cultural sensitivity.

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Bakgrund: Familjeband är en av de anhörigutbildningar som erbjuds för att stötta och stärka närstående i sin situation. Familjeband syftar till att ge närstående verktyg och strategier för att möta den suicidnära personen mer konstruktivt samt erbjuda ett forum för närstående att möta andra i liknande situationer. Syfte: Att kvalitativt utvärdera Familjeband: ett utbildningsprogram för närstående till suicidnära personer för att nå fördjupad kunskap om de närståendes upplevelser av utbildningsprogrammet och deras upplevda effekter av programmet. Metod: Semistrukturerade intervjuer med åtta närstående till suicidnära personer som gått utbildningsprogrammet Familjeband vid Region Gotland. Materialet analyserades induktivt med kvalitativ innehållsanalys. Resultat: Tre teman framkom ur analysen: (1) att vara del av en grupp; (2) förbättrat bemötande och fördjupade relationer; och (3) ett uppskattat och framgångsrikt utbildningsprogram möter målgruppens behov. Närstående upplevde erfarenhetsutbytet och möjligheterna att träffa andra i liknande situationer som några av de bästa komponenterna med Familjeband. Familjeband bidrog till att närståendes eget måendet förbättrades samt att kommunikationen och relationen till den suicidnära personen stärktes. Slutsats: Utbildningsprogrammet Familjeband har haft positiv inverkan på de närståendes mående, kommunikationen och relationen till den suicidnära personen har stärkts. Familjeband är en lovande intervention för att stärka närstående till suicidnära personer och rekommenderas av samtliga närstående. / Background: Family Connections (FC) is an educational program offered to support and empower relatives in their situation. FC aims to provide tools and strategies for relatives to interact with the person at risk of suicide in a more constructive manner, as well as offer a forum for relatives to connect with others in similar situations. Objective: To qualitatively evaluate Family Connections: an educational program for relatives of individuals at risk of suicide, to gain in-depth knowledge about the experiences of the relatives and the perceived effects of the program. Method: Semi structured interviews were conducted with eight relatives who had participated in the FC program in the Gotland Region. Data was analyzed using inductive qualitative content analysis. Results: Three themes emerged from the analysis: (1) being part of a group; (2) improved interactions and deeper relationships; and (3) an appreciated and successful educational program meets the needs of the target group. The relatives reported that exchange of experiences and the opportunity to meet others in similar situations were among the best components of FC. FC contributed to an improvement in well-being of relatives themselves, as well as strengthened communication and relationships with the individual at risk of suicide. Conclusion: The FC program has had a positive impact on well-being of the relatives, communication, and relationships with the person at risk of suicide have been strengthened. FC is a promising intervention for empowering relatives of individuals at risk of suicide and is recommended by all participants.

Bakgrund: Andelen av den svenska befolkningen som rapporterade psykiska problem har ökat under de senaste decennierna och särskilt de senaste åren, vilket bekräftar betydelsen av att monitorera den psykiska hälsan i befolkningen. Syfte: Att undersöka förekomsten av psykiska problem i en population av svenska vuxna, och att analysera de oberoende sambanden mellan de demografiska och socioekonomiska förhållandena och mellan självskattat psykiskt välbefinnande och psykisk påfrestning. Metod: Studien baseras på den senaste undersökningen Liv och Hälsa (2022) som hade 35 169 deltagare av båda könen och från 55 kommuner i Mellansverige. Deskriptiv statistik användes för att besvara den första forskningsfrågan. Binära logistiska regressionsanalyser gjordes för att besvara den andra forskningsfrågan. Resultat: Kvinnor rapporterade sämre resultat för alla mentala variabler. Unga deltagare (18–29) inom varje kön rapporterade de högsta andelarna för de diagnostiserade problemen, för att ha psykisk påfrestning och inte ha bra psykiskt välbefinnande och för de allvarliga symtomen av nästan alla psykiska problem. Faktorer som var starkt och oberoende associerade med psykisk påfrestning och psykiskt välbefinnande var: Att ha blivit förringad under de senaste tre månaderna, att sakna socialt stöd och att sakna ett förvärvsarbete. Slutsats: Intressenter bör ägna mer uppmärksamhet åt kvinnors och ungas psykiska hälsa och åt de demografiska och socioekonomiska förhållandena som potentiella områden för intervention och förebyggande insatser. Mer forskning rekommenderas för att förbättra kvinnors och ungas psykiska hälsa och för att få en bättre förståelse av faktorerna som associeras med psykisk hälsa. / Background: The proportion of the Swedish population that reported mental problems has increased during the last decades and especially the last few years, which confirms the importance of keeping track of mental health in the population. Aim: To investigate the prevalence of mental problems in a population of Swedish adults, and to disentangle the independent associations between the demographic and socio-economic conditions and self-rated mental wellbeing and psychological distress. Method: The study is based on the most recent Life and Health survey (2022) which had 35 169 responders from both genders and from 55 municipalities in central Sweden. Descriptive statistics was used to answer the first research question. Binary logistic regression analyses were done to answer the second research question.   Results: Women reported worse results for all of the mental variables. Young participants (18-29) within each gender reported the highest proportions for the diagnosed problems, for having psychological distress and not having good mental wellbeing and for the severe symptoms of almost all of the mental problems. Factors that were strongly and independently associated with psychological distress and with mental wellbeing were: Being belittled in the last three months, lacking social support and lacking a paid job. Conclusion: Stake-holders should pay more attention to women's and youth's mental health, and to the demographic and socio-economic conditions as potential areas for intervention and prevention. Further research is recommended to enhance the mental health of women and youths, and to get a better understanding of the factors that are associated with mental health.

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Background: Celiac disease, a permanent gluten sensitive enteropathy, is the most common genetic disorder, although largely underestimated public health problem worldwide. The wide spectrum of its multifaceted manifestations is a continuum representing the outcome of a complex interplay of genetic and environmental factors with immunological processes suggesting its multifactorial etiopathogenesis and also involves the risk of malignancy. Despite of the new insights gained by recent advances in knowledge, etiopathogenesis still remains to be elucidated completely. Investigating the Swedish epidemic of CD by epidemiological approach has revealed the possible associations of CD with some environmental factors. Emphasizing the significance of events in early infancy in view of current CD aetiopathogenesis concepts and with relevance to the unique pattern of CD incidence trends in Swedish children, early infectious episodes emerge as seemingly important clue in etiology of CD. This study investigates the possible contribution to the risk from early infectious episodes to development of Celiac disease. Objectives: This study aims to investigate possible contribution by early infectious episodes to the risk of development of celiac disease and discusses the findings in view of current concepts of CD aetiopathogenesis. Methods: Literature-review. A review of available knowledge from studies in the aetiopathogenesis of celiac disease was done to understand the possible association with environmental factors, in particular role of infectious episodes. Study-design and data-analysis: Data from a Swedish population-based incident case-referent study with 627 confirmed cases of celiac disease and 1254 referents was analyzed to investigate a possible predisposition caused by early infections to celiac disease. Results: Current literature suggests that infections may induce, trigger the development of CD (Gl infectious episodes to the major extent) or may activate already latent CD by different mechanisms. However, our study concludes statistically significant risk associated with early infectious episodes of all types to the development of celiac disease. Besides, findings suggest higher risk associated with the combined effect of consumption of larger amounts of gluten and frequent infectious episodes. Conclusion: This study presents the first epidemiological findings concluding increased risk to development of celiac disease associated with occurrence of infectious episodes during early infancy (before the age of 6 months), and suggests possible involvement of molecular mimicry or other mechanism. The findings also suggest focusing on early infancy and to the events that precede immunopathogenetic processes. Thus, it provides implication for the further exploration of complete immunolopathogenetic mechanisms involved in pathogenesis of celiac disease and it may prove rewarding in designing innovative preventive, immunomodulatory and antigen-centered therapeutic strategies. / digitalisering@umu

Working to strengthen the health of individuals with a state of dependence can, eventually, strengthen their independence, which can result in a life without drugs or alcohol. The purpose of the present study is to investigate the perception of social supporters of the work to strengthen the health of individuals with a addiction.  In the present study, a qualitative method was used with semi-structured interviews. Through a purposeful sampling, five people with the professional term social supporter who works in the social services of a municipality in the Mälardalen region could be interviewed. The material from the interviews was analyzed using a manifest content analysis. The results show that it is important to focus on motivational conversations, improved collaboration between social administration and other agencies, and to strengthen individuals' independence by enabling various factors such as employment can provide good health. The conclusion from the study is that social supporters' perceptions of their working methods were that they mainly work with motivational interviews and support in everyday tasks. Social supporters work from client focus and administrative work method, and that improved collaboration can benefit clients' health development. Increased education and resources from the social services and the municipality can strengthen health promotion work.   Keywords: Addiction, Empowerment, Health promotion, Motivational Interview, Participation, Social supporter

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