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  • 301. Gustafsson, Per E.
    et al.
    Janlert, Urban
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hammarström, Anne
    Social and material adversity from adolescence to adulthood and allostatic load in middle-aged women and men: results from the Northern Swedish Cohort2012In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 43, no 1, p. 117-28Article in journal (Refereed)
    Abstract [en]

    Background

    Little is known about the theoretically assumed association between adversity exposure over the life course and allostatic load in adulthood.

    Purpose

    This study aims to examine whether social and material adversity over the life course is related to allostatic load in mid-adulthood.

    Methods

    A 27-year prospective Swedish cohort (N = 822; 77% response rate) reported exposure to social and material adversities at age 16, 21, 30 and 43 years. At age 43, allostatic load was operationalized based on 12 biological parameters.

    Results

    Social adversity accumulated over the life course was related to allostatic load in both women and men, independently of cumulative socioeconomic disadvantage. Moreover, social adversity in adolescence (in women) and young adulthood (in men) was related to allostatic load, independently of cumulative socioeconomic disadvantage and also of later adversity exposure during adulthood.

    Conclusion

    Exposure to adversities involving relational threats impacts on allostatic load in adulthood and operates according to life course models of cumulative risk and a sensitive period around the transition into adulthood.

  • 302. Gustavsson, Per A.
    et al.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Bergström, Malin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berlin, Marie
    Skolans betydelse för barns och ungas psykiska hälsa – en studie baserad på den nationella totalundersökningen i årskurs 6 och 9 hösten 20092012Report (Other academic)
  • 303. Gyberg, Viveca
    et al.
    Hasson, Dan
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Tuomilehto, Jaakko
    Rydén, Lars
    Measuring risk online-Feasibility of using FINDRISC in an online workplace survey2012In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 6, no 2, p. 103-107Article in journal (Refereed)
    Abstract [en]

    AIMS: With the globally increasing prevalence of diabetes and the knowledge on how to prevent the disease there is a high demand for an effective way of identifying people at risk. The hypothesis behind this investigation was that incorporation of the FINnish Diabetes Risk SCore (FINDRISC) questionnaire in a regular workplace survey would be a feasible way to identify individuals and groups at risk for diabetes that could benefit from preventive interventions.

    METHOD: The eight FINDRISC questions were slightly modified and incorporated to Webb-QPS, an online work place survey, and distributed by e-mail to 5166 employees at Karolinska University Hospital (KUH).

    RESULTS: The total number of responders to Webb-QPS was 3581 (69%). Of those responding 3029 (84%) replied to the FINDRISC section which comprises 59% of the original population. A group of 1082 high risk individuals could be considered for intervention whereof 298 (9.8%) are expected to develop diabetes the upcoming 10 years if left without intervention.

    CONCLUSION: It is feasible to incorporate a diabetes risk score such as the FINDRISC in a workplace survey. A group that could be subject to preventive intervention programs was identified.

  • 304. Hadizadeh, Fatemeh
    et al.
    Bonfiglio, Ferdinando
    Belheouane, Meriem
    Vallier, Marie
    Sauer, Sascha
    Bang, Corinna
    Bujanda, Luis
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Agreus, Lars
    Engstrand, Lars
    Talley, Nicholas J.
    Rafter, Joseph
    Baines, John F.
    Walter, Susanna
    Franke, Andre
    D'Amato, Mauro
    Faecal microbiota composition associates with abdominal pain in the general population2018In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 67, no 4, p. 778-779Article in journal (Refereed)
  • 305. Haglund, Bo
    et al.
    Viljoen, Charles
    Tian, K
    Stockholm University, Faculty of Science, Department of Education in Arts and Professions.
    Olsson, Ulf
    Stockholm University, Faculty of Science, Department of Education in Arts and Professions. Yrkeskunnande och lärande.
    The process of development of an international research network supporting health promoting schools development between South Africa and Sweden. Paper vid konferens (WHO/EU) Health Promoting Schools Egmond aan See, Holland. September 2002.2002Other (Other (popular science, discussion, etc.))
  • 306. Hagqvist, Emma
    et al.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinberg, Stig
    The gender time gap: Time use among self-employed women and men compared to paid employees in Sweden2019In: Time & Society, ISSN 0961-463X, E-ISSN 1461-7463, Vol. 28, no 2, p. 680-696Article in journal (Refereed)
    Abstract [en]

    In this article, the authors set out to study the time use of men and women in Sweden, comparing self-employed and employed individuals. Previous studies indicate that there are reasons to believe that both gendered time use and mechanisms related to time use might differ between the self-employed and employees. Employing time use data, the aim was to study whether there are differences in gendered time use between self-employed individuals and employees in Sweden, and furthermore, which mechanism relates to gendered time use among self-employed individuals and employees. The results show that self-employed men and women distribute their time in a more gender-traditional manner than employees. In addition, relative resources are found to be an important factor related to gendered time use among the self-employed. For employees, gender relations tend to be a mechanism related to gendered time use. The conclusion is that working conditions are important for gendered time use and should be considered in future studies.

  • 307.
    Hagqvist, Emma
    et al.
    Mittuniversitetet, Sverige.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinberg, Stig
    Mittuniversitetet, Sverige.
    Time strain among self-employed women and men compared to employees in Sweden2015In: Society, Health & Vulnerability, ISSN 2002-1518, Vol. 6, no 22 decArticle in journal (Refereed)
    Abstract [en]

    Dual-earner families are common in Sweden, and most women are involved in the labour market. It has been shown that employees and self-employed individuals perceive their working conditions differently: self-employed individuals are more likely to experience an imbalance between work and family, higher job demands, and the feeling that they must be ‘‘always on.’’ Thus, there may also be a difference between employees and self-employed individuals in terms of perceived time strain. Previous studies have identified differences in time-use patterns among men and women who are employed and self-employed. This study uses time-use data to examine potential gender differences among men and women who are self-employed and those who are employees with regard to time strain effects related to time spent on paid and unpaid work in Sweden. The results show that self-employed individuals, particularly self-employed women, report the highest levels of time strain. For self-employed women, an increase in the time spent on paid work reduces perceived time strain levels, whereas the opposite is true for employees and self-employed men. It is primarily individual and family factors, and not time use, that are related to time strain. The results provide evidence that gender differences in time strain are greater among self-employed individuals than among employees.

  • 308. Hagström, Hannes
    et al.
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Carlsson, Axel C.
    Jerkeman, Mats
    Carlsten, Mattias
    Body composition measurements and risk of hematological malignancies: A population-based cohort study during 20 years of follow-up2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 8, article id e0202651Article in journal (Refereed)
    Abstract [en]

    High body mass index (BMI) is associated with development of hematological malignancies (HMs). However, although BMI is a well-established measurement of excess weight, it does not fully reflect body composition and can sometimes misclassify individuals. This study aimed at investigating what body composition measurements had highest association with development of HM. Body composition measurements on 27,557 individuals recorded by healthcare professionals as part of the Malmo Diet and Cancer study conducted in Sweden between 1991-1996 were matched with data from national registers on cancer incidence and causes of death. Cox regression models adjusted for age and sex were used to test the association between one standard deviation increments in body composition measurements and risk of HM. During a median follow-up of 20 years, 564 persons developed an HM. Several body composition measurements were associated with risk of developing an HM, but the strongest association was found for multiple myeloma (MM). Waist circumference (HR 1.31, p = 0.04) and waist-hip ratio (HR 1.61, p = 0.05) had higher risk estimates than BMI (HR 1.18, p = 0.07) for MM. In conclusion, our study shows that measurements of abdominal adiposity better predict the risk of developing HM, particularly MM, compared to BMI.

  • 309. Hagström, Hannes
    et al.
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Discacciati, Andrea
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Macquarie University, Australia.
    Risk Behaviors Associated with Alcohol Consumption Predict Future Severe Liver Disease2019In: Digestive Diseases and Sciences, ISSN 0163-2116, E-ISSN 1573-2568, Vol. 64, no 7, p. 2014-2023Article in journal (Refereed)
    Abstract [en]

    Background

    Excess consumption of alcohol can lead to cirrhosis, but it is unclear whether the type of alcohol and pattern of consumption affects this risk.

    Aims

    We aimed to investigate whether type and pattern of alcohol consumption early in life could predict development of severe liver disease.

    Methods

    We examined 43,242 adolescent men conscribed to military service in Sweden in 1970. Self-reported data on total amount and type of alcohol (wine, beer, and spirits) and risk behaviors associated with heavy drinking were registered. Population-based registers were used to ascertain incident cases of severe liver disease (defined as cirrhosis, decompensated liver disease, liver failure, hepatocellular carcinoma, or liver-related mortality). Cox regression models were used to estimate hazard ratios for development of severe liver disease.

    Results

    During follow-up, 392 men developed severe liver disease. In multivariable analysis, after adjustment for BMI, smoking, use of narcotics, cardiovascular fitness, cognitive ability, and total amount of alcohol, an increased risk for severe liver disease was found in men who reported drinking alcohol to alleviate a hangover (“eye-opener”; aHR 1.47, 95% CI 1.02–2.11) and men who reported having been apprehended for being drunk (aHR 2.17, 95% CI 1.63–2.90), but not for any other risk behaviors. Wine consumption was not associated with a reduced risk for severe liver disease compared to beer and spirits.

    Conclusions

    Certain risk behaviors can identify young men with a high risk of developing severe liver disease. Wine consumption was not associated with a reduced risk for severe liver disease compared to beer and spirits.

  • 310. Hagström, Hannes
    et al.
    Stål, Per
    Hultcrantz, Rolf
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden .
    Andreasson, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden .
    Overweight in late adolescence predicts development of severe liver disease later in life: A 39 years follow-up study2016In: Journal of Hepatology, ISSN 0168-8278, E-ISSN 1600-0641, Vol. 65, no 2, p. 363-368Article in journal (Refereed)
    Abstract [en]

    BACKGROUND & AIMS: The increased prevalence of overweight has been suggested to contribute to the worldwide increase in liver diseases. We investigated if body mass index (BMI) in late adolescence predicts development of severe liver disease later in life.

    METHODS: We performed a cohort study using data from 44,248 men (18-20years) conscribed to military service in Sweden between 1969 and 1970. Outcome data were collected from national registers to identify any diagnosis of severe liver disease (i.e., diagnosis of decompensated liver disease, cirrhosis or death in liver disease) until the end of 2009. A Cox regression model was applied using BMI as independent variable. The model was adjusted for use of alcohol, use of narcotics, smoking, high blood pressure and cognitive ability at time of conscription.

    RESULTS: During a follow-up period of a mean of 37.8years, 393 men were diagnosed with severe liver disease (mean time to diagnosis 24.7years). BMI (Hazard ratio [HR]=1.05 for each unit increase in BMI, 95% confidence interval [CI]: 1.01-1.09, p=0.008) and overweight (HR=1.64 for BMI 25-30 compared to BMI 18.5-22.5, 95% CI: 1.16-2.32, p=0.006) were associated with an increased risk of development of severe liver disease.

    CONCLUSIONS: Being overweight in late adolescence is a significant predictor of severe liver disease later in life in men.

    LAY SUMMARY: We investigated close to 45,000 Swedish men in their late teens enlisted for conscription in 1969-1970. After almost 40years of follow-up, we found that being overweight was a risk factor for developing severe liver disease, independent of established risk factors such as alcohol consumption.

  • 311. Hall, A. L.
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, UK.
    Work schedule and prospective antidepressant prescriptions in the swedish workforce: a 2-year study using national drug registry data2018In: Occupational and Environmental Medicine, ISSN 1351-0711, Vol. 75, p. A482-A483Article in journal (Other academic)
    Abstract [en]

    Introduction Mood disorders affect millions of individuals worldwide and contribute to substantial morbidity and disability. A better understanding of modifiable work-related risk factors for depression could inform and advance prevention efforts in this area. This study used a large Swedish longitudinal occupational survey to prospectively examine the effect of self-reported work schedule on registry-based antidepressant prescriptions over a two-year period.

    Methods The analytic sample (n=8643) was obtained from the Swedish Longitudinal Occupational Survey of Health. Sex-stratified and unstratified analyses were conducted using logistic regression. For exposure, 8 categories were used to describe work schedule in 2008: ‘regular days’ (3 categories: night work history=none,≤3 years, or 4+years) ‘night work (regular, rostered, or rotating)’, ‘regular shift work (no nights)’, ‘rostered work (no nights)’, ‘flexible/non-regulated hours’, and ‘other’. For the outcome, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomized into ‘any’ or ‘no’ prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health, and work confounders, and for prior depressive symptoms.

    Results In unadjusted analyses, an increased odds ratio for depression was observed for ‘Other’ work hours in unstratified (OR=1.75, 95% CI: 1.21 to 2.51) and female (OR=1.62, 95% CI: 1.05 to 2.51) models; in adjusted models effects persisted but confidence intervals widened to non-significance at the p=0.05 level. In models adjusted for previous depressive symptoms, females in ‘flexible/non-regulated’ schedules showed an increased odds ratio for depression (OR=2.01, 95% CI: 1.08 to 3.76), while a decreased odds ratio was observed for the unstratified model ‘regular shift work (no nights)’ category (OR=0.61; 95% CI: 0.38 to 0.97).

    Discussion This study’s findings support prospective relationships between work schedule and antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.

  • 312. Hallqvist, Johan
    et al.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Socialepidemiologiska metoder2012In: Den orättvisa hälsan: Om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila, Susanna Toivanen, Stockholm: Liber, 2012Chapter in book (Other academic)
  • 313. Hantikainen, Essi
    et al.
    Löf, Marie
    Grotta, Alessandra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Trolle Lagerros, Ylva
    Serafini, Mauro
    Bellocco, Rino
    Weiderpass, Elisabete
    Dietary non enzymatic antioxidant capacity and the risk of myocardial infarction in the Swedish women's lifestyle and health cohort2018In: European Journal of Epidemiology, ISSN 0393-2990, E-ISSN 1573-7284, Vol. 33, no 2, p. 213-221Article in journal (Refereed)
    Abstract [en]

    Foods rich in antioxidants have been associated with a reduced risk of myocardial infarction. However, findings from randomized clinical trials on the role of antioxidant supplementation remain controversial. It has been suggested that antioxidants interact with each other to promote cardiovascular health. We therefore investigated the association between dietary Non Enzymatic Antioxidant Capacity (NEAC), measuring the total antioxidant potential of the whole diet, and the risk of myocardial infarction. We followed 45,882 women aged 30-49 years and free from cardiovascular diseases through record linkages from 1991 until 2012. Dietary NEAC was assessed by a validated food frequency questionnaire collected at baseline. Total dietary NEAC was categorized into quintiles and multivariable Cox proportional hazard regression models were fitted to estimate hazard ratios (HR) with 95% confidence intervals (CI). During a mean follow-up time of 20.3 years we detected 657 incident cases of myocardial infarction. After adjusting for potential confounders, we found a significant 28% lower risk of myocardial infarction among women in the fourth (HR: 0.72; 95% CI 0.55-0.95) and a 40% lower risk among women in the fifth quintile (HR: 0.60, 95% CI 0.45-0.81) of dietary NEAC compared to women in the first quintile, with a significant trend (p-value < 0.001). Higher dietary NEAC is associated with a lower risk of myocardial infarction in young to middle-aged women. These findings support the hypothesis that dietary antioxidants protect from myocardial infarction and that this effect might be exerted through interactions between antioxidants.

  • 314.
    Hasson, Dan
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    von Thiele Schwarz, Ulrica
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Self-rated Health and Allostatic Load in Women Working in Two Occupational Sectors2009In: Journal of Health Psychology, ISSN 1359-1053, E-ISSN 1461-7277, Vol. 14, no 4, p. 568-577Article in journal (Refereed)
    Abstract [en]

    This study set out to investigate how biological dysregulation, in terms of allostatic load (AL), relates to selfrated health (SRH) in women. Data on SRH and 12 biomarkers used to assess AL were available for 241 employees from the health care sector and 98 employees from the IT/media sector. In line with the hypothesis, results showed that a poor SRH, along with occupational sector, age and education, were significantly associated with a high AL, particularly for those working withinthe health care sector. This association between a poor SRH and AL, suggests a link between SRH and biological dysregulation.

  • 315. Haukka, Jari
    et al.
    Suvisaari, Jaana
    Sarvimaki, Matti
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; Max Planck Institute for Demographic Research, Germany.
    The Impact of Forced Migration on Mortality A Cohort Study of 242,075 Finns from 1939-20102017In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, no 4, p. 587-593Article in journal (Refereed)
    Abstract [en]

    Background: The stresses and life changes associated with migration may have harmful long-term health effects, especially for mental health. These effects are exceedingly difficult to establish, because migrants are typically a highly selected group.

    Methods: We examined the impact of migration on health using naturally occurring historical events. In this article, we use the forced migration of 11% of the Finnish population after WWII as such a natural experiment. We observed the date and cause of death starting from 1 January 1971 and ending in 31 December 2010 for the cohort of 242,075 people. Data were obtained by linking individual-level data from the 1950 and 1970 population censuses and the register of death certificates from 1971 to 2010 (10% random sample). All-cause and cause-specific mortalities were modeled using Poisson regression.

    Results: Models with full adjustment for background variables showed that both all-cause mortality (RR 1.03, 95% CI 1.01, 1.05), and ischemic heart disease mortality (RR 1.11, 95% CI 1.08, 1.15) were higher in the displaced population than in the nondisplaced population. Suicide mortality was lower (RR 0.77, 95% CI 0.64, 0.92) in displaced than in the general population.

    Conclusions: In our long-term follow-up study, forced migration was associated with increased risk of death due to ischemic heart diseases. In contrast, lower suicide mortality was observed in association with forced migration 25 years or more.

  • 316. Head, Jenny
    et al.
    Chungkham, Holendro Singh
    Hyde, Martin
    Zaninotto, Paola
    Alexanderson, Kristina
    Stenholm, Sari
    Salo, Paula
    Kivimäki, Mika
    Goldberg, Marcel
    Zins, Marie
    Vahtera, Jussi
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 2, p. 267-272Article in journal (Refereed)
    Abstract [en]

    Background: There are striking socioeconomic differences in life expectancy, but less is known about inequalities in healthy life expectancy and disease-free life expectancy. We estimated socioeconomic differences in health expectancies in four studies in England, Finland, France and Sweden. Methods: We estimated socioeconomic differences in health expectancies using data drawn from repeated waves of the four cohorts for two indicators: (i) self-rated health and (ii) chronic diseases (cardiovascular, cancer, respiratory and diabetes). Socioeconomic position was measured by occupational position. Multistate life table models were used to estimate healthy and chronic disease-free life expectancy from ages 50 to 75. Results: In all cohorts, we found inequalities in healthy life expectancy according to socioeconomic position. In England, both women and men in the higher positions could expect 82-83% of their life between ages 50 and 75 to be in good health compared to 68% for those in lower positions. The figures were 75% compared to 47-50% for Finland; 85-87% compared to 77-79% for France and 80-83% compared to 72-75% for Sweden. Those in higher occupational positions could expect more years in good health (2.1-6.8 years) and without chronic diseases (0.5-2.3 years) from ages 50 to 75. Conclusion: There are inequalities in healthy life expectancy between ages 50 and 75 according to occupational position. These results suggest that reducing socioeconomic inequalities would make an important contribution to extending healthy life expectancy and disease-free life expectancy.

  • 317.
    Heap, Josephine
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Duration and accumulation of disadvantages in old age2015In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 123, no 2, p. 411-429Article in journal (Refereed)
    Abstract [en]

    The probability of experiencing simultaneous disadvantages in more than one life domain seems to be higher for the oldest old people than younger age groups. However, the experience of coexisting disadvantages among older adults is relatively underexplored. We set out to analyse whether coexisting disadvantages among older people are long-lasting or temporary, and whether there are patterns of an accumulation of disadvantages in old age or not. We used nationally representative, longitudinal data between 1991 and 2011. Respondents were born between 1916 and 1934. The following disadvantages were included: lack of social resources, lack of political resources, lack of financial resources, psychological health problems, physical health problems and mobility limitations. Results suggest differing experiences of disadvantage in old age. We found that reporting coexisting disadvantages in 1991 increased the probability of reporting coexisting disadvantages in 2011, but the correlation was moderate. This indicates that for some people, coexisting disadvantages in old age is relatively stable, while for others it is a temporary experience. Reporting one disadvantage in 1991 also increased the probability of reporting coexisting disadvantages in 2011, suggesting a pattern of accumulation of disadvantages. Again, this pattern may not be generalised to all people. To a large extent the observed accumulation of disadvantages in old age seemed to be driven by physical health deterioration and mobility limitations.

  • 318.
    Heap, Josephine
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Fors, Stefan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Lennartsson, Carin
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Coexisting Disadvantages in later Life: Demographic and Socio-Economic Inequalities2017In: Journal of Population Ageing, ISSN 1874-7884, E-ISSN 1874-7876, Vol. 10, no 3, p. 247-267Article in journal (Refereed)
    Abstract [en]

    In this study, we aimed to identify which of certain demographic and socio-economic groups in the oldest part of the population that have an increased probability of experiencing simultaneous disadvantages in different life domains - here termed coexisting disadvantages. To do so, we compared analyses of coexisting disadvantages, measured as two or more simultaneous disadvantages, with analyses of single disadvantages and specific combinations of disadvantages. Indicators of physical health problems, ADL limitations, psychological health problems, limited financial resources, and limited social resources were included. We used nationally representative data from 2011 on people aged 76 and older in Sweden (n = 765). Results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups, particularly certain marital status groups. Moreover, the differences between the demographic and socio-economic groups were only found for those who reported coexisting disadvantages, and not for those who reported only one disadvantage, which suggests that demographic and social factors become more important as disadvantages compound. Further, we analysed pairwise combinations of disadvantages. We found that different combinations of disadvantages tended to be associated with different groups, information useful from a social planning perspective since different combinations of disadvantages may imply different needs for help and support.

  • 319.
    Hedlund, Ebba
    Stockholm University, Faculty of Social Sciences, Centre for Research in International Migration and Ethnic Relations (CEIFO).
    International migration and coronary heart disease2007Doctoral thesis, monograph (Other academic)
    Abstract [en]

    In today’s globalised world, with considerable international migration, knowledge about the health of immigrants is becoming increasingly important. In Sweden, about 13% of the population or over one million persons are born outside the country. Large groups have moved to Sweden from Finland, other Nordic countries, the Baltic States and other Eastern European countries, Western Europe, Turkey, Iran, Iraq, and Latin America.

    The aim of the thesis was to describe incidence of myocardial infarction (MI) among foreign-born persons compared to Sweden-born, taking into consideration gender, socio-economic status and time spent in Sweden and to evaluate if the long term trend of decreasing MI incidence in Sweden was present in immigrants to Sweden. In addi-tion, the aim was to analyse survival after a first MI among immigrants and Sweden-born. Furthermore, the aim was to investigate to what extent migration from Finland to Sweden is related to the access to welfare components including education and socio-economic status as well as social support and coronary heart disease (CHD) prevalence.

    The association between country of birth and incident MI was studied by case control methods. The study base consisted of subjects 30-74 years of age in Stockholm County during the 20 year period 1977-96. Incident cases of first acute MI were identified us-ing registers of hospital discharges and deaths and controls were selected randomly from the study base. In the sampling of controls, sampling fractions were known, which enabled estimates of person time at risk and incidence rates employed in the analyses of time trends. Information on country of birth was obtained from national censuses and from a register on immigration. The study of survival utilised all the cases in the case control study. Cases surviving 28 days were followed with regard to mortality during one year.

    In the studies of welfare components and CHD in Finnish twins, the study population consisted of twin pairs of the Finnish Twin Cohort Study where at least one twin had lived one year or more in Sweden. The study included 1,534 migrant or non-migrant subjects and 251 complete twin pairs discordant regarding residency in Sweden. Emi-grant twins were compared to non-migrant co-twins regarding welfare components and prevalence of CHD. Data on welfare components and CHD was assessed by an exten-sive questionnaire administered in 1998 including questions on social factors, health, life style factors and migration history.

    Immigrants to Sweden had a higher incidence of first MI including non-fatal as well as fatal cases compared to Sweden-born during the period 1977-96 after adjustment for age and socioeconomic group. Immigrant men had a decreasing time trend of MI inci-dence during the period 1977-96 of the same magnitude as Sweden-born but among women immigrants had a somewhat less pronounced decline compared to natives. Fur-thermore immigrants did not have an increased case fatality within 28 days after a first MI compared to Sweden-born persons when differences in socioeconomic group were accounted for. Subjects born in Finland however had an increased case fatality during the first ten years in Sweden among men and after 20 years in Sweden among women. These results suggest that differences in CHD mortality between foreign-born and Sweden-born are primarily due to a higher disease incidence rather than a lower sur-vival. Migration from Finland to Sweden did not substantially improve access to central welfare components for the migrants but a reduced prevalence of CHD in emigrants compared to non-migrants was observed, taking genetic and early childhood factors into account.

    In conclusion the results of this thesis reinforce the impression that immigrants to Swe-den, from a number of countries including Finland, are at increased risk of MI com-pared to native Swedes. Concerning immigrants from Finland this appears to be the case in spite of a certain reduction in CHD prevalence associated with migration to Sweden.

  • 320. Hedman, Annicka
    et al.
    Nygard, Louise
    Almkvist, Ove
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Karolinska Institutet, Sweden.
    Kottorp, Anders
    Amount and type of everyday technology use over time in older adults with cognitive impairment2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 3, p. 196-206Article in journal (Refereed)
    Abstract [en]

    Objectives: This two-year study examined everyday technology (ET) use in older adults with mild cognitive impairment (MCI) testing five predefined theoretical assumptions regarding factors potentially influencing the amount of ET used in everyday life. Methods: Data from 37 participants with MCI were collected at inclusion, six, 12, and 24 months, on the type and amount of ET used and how difficult this was, activity involvement, and cognitive and diagnostic status. These variables were, together with age group (55-64, 65-74, or 75-84 years) and educational level, analysed in a mixed-linear-effect model. Results: A significant decrease in the overall amount of ET used was found over time, but the number of users of specific ETs both decreased and increased. Increasing perceived difficulty in ET use, less activity involvement, decreasing cognitive status, and belonging to the oldest age group significantly decreased ET use. Two years after inclusion 42% of the participants had converted to dementia, but neither change in diagnostic status nor length of education contributed significantly to the predictive model. Conclusion: Over time, a decreasing use of ET was shown in this sample with MCI. This process was influenced by several aspects important to consider in occupational therapy intervention planning.

  • 321. Hedman, Erik
    et al.
    Andersson, Erik
    Ljótsson, Brjánn
    Axelsson, Erland
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden .
    Cost effectiveness of internet-based cognitive behaviour therapy and behavioural stress management for severe health anxiety2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 4, article id e009327Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Internet-delivered exposure-based cognitive behaviour therapy (ICBT) has been shown to be effective in the treatment of severe health anxiety. The health economic effects of the treatment have, however, been insufficiently studied and no prior study has investigated the effect of ICBT compared with an active psychological treatment. The aim of the present study was to investigate the cost effectiveness of ICBT compared with internet-delivered behavioural stress management (IBSM) for adults with severe health anxiety defined as Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) hypochondriasis. ICBT was hypothesised to be the more cost-effective treatment.

    SETTING: This was a cost-effectiveness study within the context of a randomised controlled trial conducted in a primary care/university setting. Participants from all of Sweden could apply to participate.

    PARTICIPANTS: Self-referred adults (N=158) with a principal diagnosis of DSM-IV hypochondriasis, of whom 151 (96%) provided baseline and post-treatment data.

    INTERVENTIONS: ICBT or IBSM for 12 weeks.

    PRIMARY AND SECONDARY MEASURES: The primary outcome was the Health Anxiety Inventory. The secondary outcome was the EQ-5D. Other secondary measures were used in the main outcome study but were not relevant for the present health economic analysis.

    RESULTS: Both treatments led to significant reductions in gross total costs, costs of healthcare visits, direct non-medical costs and costs of domestic work cutback (p=0.000-0.035). The incremental cost-effectiveness ratio (ICER) indicated that the cost of one additional case of clinically significant improvement in ICBT compared with IBSM was $2214. The cost-utility ICER, that is, the cost of one additional quality-adjusted life year, was estimated to be $10 000.

    CONCLUSIONS: ICBT is a cost-effective treatment compared with IBSM and treatment costs are offset by societal net cost reductions in a short time. A cost-benefit analysis speaks for ICBT to play an important role in increasing access to effective treatment for severe health anxiety.

    TRIAL REGISTRATION NUMBER: NCT01673035; Results.

  • 322. Hedman, Erik
    et al.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Ljótsson, Brjánn
    Lindefors, Nils
    Rück, Christian
    Andersson, Gerhard
    Andersson, Erik
    Optimal cut-off points on the health anxiety inventory, illness attitude scales and whiteley index to identify severe health anxiety2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 4, article id e0123412Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health anxiety can be viewed as a dimensional phenomenon where severe health anxiety in form of DSM-IV hypochondriasis represents a cut-off where the health anxiety becomes clinically significant. Three of the most reliable and used self-report measures of health anxiety are the Health Anxiety Inventory (HAI), the Illness Attitude Scales (IAS) and the Whiteley Index (WI). Identifying the optimal cut-offs for classification of presence of a diagnosis of severe health anxiety on these measures has several advantages in clinical and research settings. The aim of this study was therefore to investigate the HAI, IAS and WI as proximal diagnostic instruments for severe health anxiety defined as DSM-IV hypochondriasis.

    METHODS: We investigated sensitivity, specificity and predictive value on the HAI, IAS and WI using a total of 347 adult participants of whom 158 had a diagnosis of severe health anxiety, 97 had obsessive-compulsive disorder and 92 were healthy non-clinical controls. Diagnostic assessments were conducted using the Anxiety Disorder Interview Schedule.

    RESULTS: Optimal cut-offs for identifying a diagnosis of severe health anxiety was 67 on the HAI, 47 on the IAS, and 5 on the WI. Sensitivity and specificity were high, ranging from 92.6 to 99.4%. Positive and negative predictive values ranged from 91.6 to 99.4% using unadjusted prevalence rates.

    CONCLUSIONS: The HAI, IAS and WI have very good properties as diagnostic indicators of severe health anxiety and can be used as cost-efficient proximal estimates of the diagnosis.

  • 323. Hedström, Anna Karin
    et al.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Klareskog, Lars
    Alfredsson, Lars
    Relationship between shift work and the onset of rheumatoid arthritis2017In: RMD Open, E-ISSN 2056-5933, Vol. 3, no 2, article id e000475Article in journal (Refereed)
    Abstract [en]

    Background Environmental factors play a prominent role in rheumatoid arthritis (RA) aetiology. Shift work has previously been associated with increased RA risk in females. The aim of this study was to investigate the potential association, including a dose-response association, between permanent night shift work, rotating shift work and day-oriented shift work and risk of developing anticitrullinated peptide antibodies (ACPA)-positive and ACPA-negative RA.

    Methods The present report is based on a population-based, case-control study with incident cases of RA (1951 cases and 2225 controls matched by age, gender and residential area). Using logistic regression, occurrence of RA among subjects who have been exposed to different kinds of shift work was compared with that among those who have never been exposed by calculating the OR with a 95% CI.

    Results Rotating shift work and day-oriented shift work increased the risk of developing ACPA-positive RA (OR 1.3, 95% CI 1.0 to 1.7 and OR 1.3, 95% CI 1.0 to 1.6), but not ACPA-negative RA. Permanent night shift work appeared to be a protective factor both against ACPA-positive RA (OR 0.7, 95% CI 0.6 to 0.9) and ACPA-negative RA (OR 0.8, 95% CI 0.6 to 1.0). For both subsets of RA, significant trends showed a lower risk of developing RA with increasing duration of permanent night shift work (p value for trend 0.002 vs 0.04).

    Conclusions Sleep restriction as a consequence of shift work is associated with several biological effects among which changes in melatonin production may be involved. The present epidemiological findings of a complex relationship between sleep patterns and different forms of RA may be of importance for increasing the understanding of the pathophysiology of RA.

  • 324.
    Hedén, Mikaela
    et al.
    Stockholm University, The Stockholm Institute of Education, Department of Human Development, Learning and Special Education(LHS).
    Olsson, Jan
    Stockholm University, The Stockholm Institute of Education, Department of Human Development, Learning and Special Education(LHS).
    Thörne, Leif
    Stockholm University, The Stockholm Institute of Education, Department of Human Development, Learning and Special Education(LHS).
    Gymnasieungdomars kost och motionsvanor: En studie i årskurs 1 på hotell - och restaurangprogrammet, Dackeskolan och energiprogrammet, Tullängsskolan2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Målet med vår studie är att försöka ta reda på hur det ligger till med våra ungdomars kost och motionsvanor. Man läser ofta i tidningar om den växande ohälsan bland våra ungdomar, så vi vill med denna uppsats försöka belysa detta problem genom denna undersökning. Vi har sett en tendens på våra respektive skolor att eleverna verkar dricka mycket läsk och äter ofta godis innan första lektionen. Vi undrar därför om eleverna äter frukost? Vi har även studerat om eleverna är fysiskt aktiva eller inte, samt hur mycket tid de lägger ner på tv tittande och datoranvändning. En av våra frågor som vi vill ha svar på är om eleverna blir informerade av skolan och föräldrarna om betydelsen av att äta rätt kost och om hur de äter beror på deras identitetsbegrepp. Genom att studera aktuell forskningslitteratur och undersökningar på området så hoppas vi få svar på hur förhållandet kost och motion i relation till våra ungdomars vanor ser ut. Vi har valt att jobba med två klasser från Tullängsskolan i Örebro där eleverna går på Energiprogrammet och Elprogrammet vilket representeras till stor del av killar och en klass från Dackeskolan i Mjölby där eleverna tillhör Hotell och restaurangprogrammet och representeras av tjejer. Samtliga elever är årskurs 1 elever. Det är totalt 46 elever med i vår studie.

    Vår undersökning är av kvalitativ karaktär men vi tar hjälp av en enkätundersökning som oftast betraktas som en kvantitativ undersökningsmetod.

  • 325. Heikkilä, Katriina
    et al.
    Nyberg, Solja T.
    Fransson, Eleonor I.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob B.
    Bonenfant, Sebastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hooftman, Wendela E.
    Houtman, Irene L.
    Joensuu, Matti
    Joeckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, Thorsten
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, Michael G.
    Nielsen, Martin L.
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Vaananen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, United Kingdom.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hamer, Mark
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Job Strain and Alcohol Intake: A Collaborative Meta-Analysis of Individual-Participant Data from 140 000 Men and Women2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, p. e40101-Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. Methodology and Principal Findings: We analysed cross-sectional data from 12 European studies (n = 142 140) and longitudinal data from four studies (n = 48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1-14, men: 1-21 drinks/week), intermediate (women: 15-20, men: 22-27 drinks/week) and heavy (women: > 20, men: > 27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake. Conclusions: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.

  • 326. Heikkilä, Katriina
    et al.
    Nyberg, Solja T.
    Fransson, Eleonor I.
    Alfredsson, Lars
    De Bacquer, Dirk
    Bjorner, Jakob B.
    Bonenfant, Sebastien
    Borritz, Marianne
    Burr, Hermann
    Clays, Els
    Casini, Annalisa
    Dragano, Nico
    Erbel, Raimund
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hooftman, Wendela E.
    Houtman, Irene L.
    Joensuu, Matti
    Jöckel, Karl-Heinz
    Kittel, France
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lunau, Thorsten
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, Michael G.
    Nielsen, Martin L.
    Nordin, Maria
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Siegrist, Johannes
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Vaananen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University College London, UK.
    Zins, Marie
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hamer, Mark
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, article id e35463Article in journal (Refereed)
    Abstract [en]

    Background: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults. Methodology and Principal Findings: We analysed cross-sectional data from 15 European studies comprising 166 130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166 130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking. Conclusions: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.

  • 327. Heikkilä, Katriina
    et al.
    Nyberg, Solja T.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Alfredsson, Lars
    Bjorner, Jakob B.
    Bonenfant, Sebastien
    Borritz, Marianne
    Bouillon, Kim
    Burr, Herman
    Dragano, Nico
    Geuskens, Goedele A.
    Goldberg, Marcel
    Hamer, Mark
    Hooftman, Wendela E.
    Houtman, Irene L.
    Joensuu, Matti
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Marmot, Michael G.
    Nielsen, Martin L.
    Nordin, Maria
    Oksanen, Tuula
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Väänänen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Zins, Marie
    Ferrie, Jane E.
    Singh-Manoux, Archana
    Batty, G. David
    Kivimäki, Mika
    Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women2013In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 346, article id f165Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intake Results A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer. Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.

  • 328. Heim, Derek
    et al.
    Blomqvist, Jan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Edman, Johan
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Room, Robin
    University of Melbourne, Australia.
    Storbjörk, Jesisca
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD).
    Addiction: Not just brain malfunction2014In: Nature, ISSN 0028-0836, Vol. 507, p. 40-40Article in journal (Other (popular science, discussion, etc.))
  • 329. Hellman, Matilda
    et al.
    Room, Robin
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). University of Melbourne, Australia; Turning Point Alcohol & Drug Centre, Australia.
    What’s the story on addiction? Popular myths in the USA and Finland2015In: Critical Public Health, ISSN 0958-1596, E-ISSN 1469-3682, Vol. 25, no 5, p. 582-598Article in journal (Refereed)
    Abstract [en]

    The study inquires into popular myths on addiction in two countries: Finland and the USA. It provides evidence of the manners in which the typical media narratives incorporate basic value traits from their context of origin. We distinguish some main features in the narrative set-ups that support different solution repertoires for dealing with addiction. Belief and hope are crucial story elements associated with the US emphasis on group formation and local empowerment. The individual is assigned obligations and can be morally condemned. In the Finnish journalistic prose, there seems to be an inherent belief that the agenda-setting in itself will propel the question into the institutionalised welfare state solution machinery. The occurrence of a story resolution was customary in the US stories, whereas the Finnish stories were typically left pending. The evidence produced has implications for the ongoing debate regarding the mainstreaming of both definitions of and solutions to addiction problems.

  • 330.
    Hemmingsson, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Special Education. Linköping University, Sweden.
    Ahlsten, Gunnar
    Wandin, Helena
    Rytterström, Patrik
    Borgestig, Maria
    Eye-Gaze Control Technology as Early Intervention for a Non-Verbal Young Child with High Spinal Cord Injury: A Case Report2018In: Technologies, ISSN 2227-7080, Vol. 6, no 1, article id 12Article in journal (Refereed)
    Abstract [en]

    Assistive technology (AT) can be used as early intervention in order to reduce activity limitations in play and communication. This longitudinal case study examines eye-gaze control technology as early intervention for a young child with high spinal cord injury without the ability to make sounds. The young child was followed by repeated measures concerning performance and communication from baseline at 9 months to 26 months, and finalized at 36 months by field observations in the home setting. The results showed eye-gaze performance and frequency of use of eye-gaze control technology increased over time. Goals set at 15 months concerning learning and using the AT; naming objects and interactions with family was successfully completed at 26 months. Communicative functions regarding obtaining objects and social interaction increased from unintentional actions to purposeful choices and interactions. At 36 months, the toddler was partly independent in eye gazing, used all activities provided, and made independent choices. In conclusion, the results show that a 9-month-old child with profound motor disabilities can benefit from eye-gaze control technology in order to gradually perform activities, socially interact with family members, and make choices.

  • 331.
    Hemmingsson, Tomas
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Danielsson, Anna-Karin
    Falkstedt, Daniel
    Fathers' alcohol consumption and risk of alcohol-related hospitalization in offspring before 60 years of age2017In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 24, no 1, p. 3-8Article in journal (Refereed)
    Abstract [en]

    Introduction: The aim of the present study was to investigate the association between exposure to fathers' alcohol consumption and offspring's own risk of alcohol-related hospitalization. Methods: Data on circumstances in childhood and adolescence, e.g. fathers' alcohol consumption at different levels (never, rarely, occasionally, often), parental divorce, as well as offspring's own risky use of alcohol, smoking and mental health were collected among 49,321 men (sons), born in 1949-51, during conscription for compulsory military training in 1969/70, i.e. at ages 18-20. Data on alcohol-related diagnoses were collected from the Swedish In-patient Care register 1973-2009. Results: The relative risk of alcohol-related diagnoses among sons after the age of 20 increased with increasing level of alcohol consumption in the fathers. Compared with sons whose fathers never drank alcohol, those with fathers who drank alcohol occasionally or often had an increased hazard ratio (HR) of later hospitalization with alcohol-related diagnoses of 1.77 (95% confidence interval (CI)=1.57-1.99) and 3.69 (CI 95% = 3.16-4.32), respectively. The associations were markedly stronger when the men were followed from age 40 and onwards compared with follow-up between 20 and 40 years of age. Conclusion: Father's alcohol consumption was associated with an increased relative risk of alcohol-related hospitalization in offspring in adulthood.

  • 332. Herr, Raphael M.
    et al.
    Bosch, Jos A.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Loerbroks, Adrian
    Bidirectional associations between psychological distress and hearing problems: an 18-year longitudinal analysis of the British Household Panel Survey2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 11, p. 816-824Article in journal (Refereed)
    Abstract [en]

    Objective: Hearing problems are a significant public health concern. It has been suggested that psychological distress may represent both a cause and a consequence of hearing problems. Prospective data that allow testing such potential bi-directionality have thus far been lacking. The present study aimed to address this knowledge gap. Random (RE) and fixed effects (FE) panel regression models estimated the association of psychological distress (GHQ-12) and participant-reported hearing problems. Data from 18 annual waves of the British Household Panel Survey were used (n = 10,008). Psychological distress was prospectively associated with self-reported hearing problems in women (multivariable odds ratios (ORs) >= 1.44; one-year time lag >= 1.16) and men (ORs >= 1.15; time lag >= 1.17). Conversely, self-reported hearing problems were associated with increases in psychological distress in both sexes (OR >= 1.26; time lag >= 1.08). These associations were independent of the analytical strategy and of adjustment for sociodemographic variables, lifestyle factors, and measurement period. We present first evidence of a bidirectional association between psychological distress and self-reported hearing problems. These findings suggest that stress management interventions may contribute to the prevention of self-reported hearing problems, and, in turn, alleviating self-reported hearing problems may reduce psychological distress.

  • 333. Herttua, Kimmo
    et al.
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; The Max Planck Institute for Demographic Research, Germany.
    Batty, G. David
    Kivimäki, Mika
    Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke2016In: Journal of the American College of Cardiology, ISSN 0735-1097, E-ISSN 1558-3597, Vol. 67, no 13, p. 1507-1515Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Poor adherence to medication regimens is common, potentially contributing to the occurrence of related disease. OBJECTIVES The authors sought to assess the risk of fatal stroke associated with nonadherence to statin and/ or antihypertensive therapy. METHODS We conducted a population-based study using electronic medical and prescription records from Finnish national registers in 1995 to 2007. Of the 58,266 hypercholesterolemia patients age 30+ years without pre-existing stroke or cardiovascular disease, 532 patients died of stroke (cases), and 57,734 remained free of incident stroke (controls) during the mean follow-up of 5.5 years. We captured year-by-year adherence to statin and antihypertensive therapy in both study groups and estimated the excess risk of stroke death associated with nonadherence. RESULTS In all hypercholesterolemia patients, the adjusted odds ratio for stroke death for nonadherent compared with adherent statin users was 1.35 (95% confidence interval [CI] 1.04 to 1.74) 4 years before and 2.04 (95% CI: 1.72 to 2.43) at the year of stroke death or the end of the follow-up. In hypercholesterolemia patients with hypertension, relative to those who adhered to statins and antihypertensive therapy, the odds ratio at the year of stroke death was 7.43 (95% CI: 5.22 to 10.59) for those nonadherent both to statin and antihypertensive therapy, 1.82 (95% CI: 1.43 to 2.33) for those non-adherent to statin but adherent to antihypertensive therapy, and 1.30 (95% CI: 0.53 to 3.20) for those adherent to statin, but nonadherent to antihypertensive, therapy. CONCLUSIONS Individuals with hypercholesterolemia and hypertension who fail to take their prescribed statin and antihypertensive medication experience a substantially increased risk of fatal stroke. The risk is lower if the patient is adherent to either one of these therapies.

  • 334. Herttua, Kimmo
    et al.
    Östergren, Olof
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Lundberg, Olle
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Martikainen, Pekka
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). University of Helsinki, Finland; The Max Planck Institute for Demographic Research, Germany.
    Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: a time series analysis2017In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 71, no 12, p. 1168-1176Article in journal (Refereed)
    Abstract [en]

    Background: Prices of alcohol and income tend to influence how much people buy and consume alcohol. Price and income may be combined into one measure, affordability of alcohol. Research on the association between affordability of alcohol and alcohol-related harm is scarce. Furthermore, no research exists on how this association varies across different subpopulations. We estimated the effects of affordability of alcohol on alcohol-related mortality according to gender and education in Finland and Sweden.

    Methods: Vector-autoregressive time series modelling was applied to the quarter-annual aggregations of alcohol-related deaths and affordability of alcohol in Finland in 1988–2007 and in Sweden in 1991–2008. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. We calculated affordability of alcohol index using information on personal taxable income and prices of various types of alcohol.

    Results: Among Finnish men with secondary education,an increase of 1% in the affordability of total alcohol was associated with an increase of 0.028% (95% CI 0.004 to 0.053) in alcohol-related mortality. Similar associations were also found for affordability for various types of alcohol and for beer only in the lowest education group. We found few other significant positive associations for other subpopulations in Finland or Sweden. However, reverse associations were found among secondary-educated Swedish women.

    Conclusions: Overall, the associations between affordability of alcohol and alcohol-related mortality were relatively weak. Increased affordability of total alcoholic beverages was associated with higher rates of alcohol-related mortality only among Finnish men with secondary education.

  • 335.
    Heshmati, Amy
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Chaparro, M. Pia
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Tulane University, USA.
    Goodman, Anna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). London School of Hygiene and Tropical Medicine, UK.
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Early life characteristics, social mobility during childhood and risk of stroke in later life: findings from a Swedish cohort2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 4, p. 419-427Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate if early life characteristics and social mobility during childhood are associated with incident thrombotic stroke (TS), haemorrhagic stroke (HS) and other stroke (OS). Methods: Our study population consists of all live births at Uppsala University Hospital in 1915-1929 (Uppsala Birth Cohort; n = 14,192), of whom 5532 males and 5061 females were singleton births and lived in Sweden in 1964. We followed them from 1 January 1964 until first diagnosis of stroke (in the National Patient Register or Causes of Death Register), emigration, death, or until 31 December 2008. Data were analysed using Cox regression, stratifying by gender. Results: Gestational age was negatively associated with TS and OS in women only. Women had increased risk of TS if they were born early preterm (<35 weeks) (HR 1.54 (95% CI 1.02-2.31)) or preterm (35-36 weeks) (HR 1.37 (95% CI 1.03-1.83)) compared to women born at term. By contrast, only women who were early preterm (HR 1.98 (95% CI 1.27-3.10) had an increased risk of OS. Men who were born post-term (42 weeks) had increased risk of HS (HR 1.45 (95% CI 1.04-2.01)) compared with men born at term, with no association for women. TS was associated with social mobility during childhood in women: women whose families were upwardly or downwardly mobile had increased risk of TS compared to women who were always advantaged during childhood. Conclusions: Gestational age and social mobility during childhood were associated with increased risk of stroke later in life, particularly among women, but there was some heterogeneity between stroke subtypes.

  • 336.
    Heshmati, Amy
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Chaparro, Pia
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Illona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Maternal pelvic size, fetal growth and risk of stroke in adult offspring in a large Swedish cohort2016In: Journal of Developmental Origins of Health and Disease, ISSN 2040-1744, E-ISSN 2040-1752, Vol. 7, no 1, p. 108-113Article in journal (Refereed)
    Abstract [en]

    Earlier research suggests that maternal pelvic size is associated with offspring's stroke risk in later life. We followed 6362 men and women from Uppsala, Sweden, born between 1915 and 1929 from 1964 to 2008 to assess whether maternal pelvic size was associated with incidence of thrombotic stroke (TS), haemorrhagic stroke (HS) and other stroke (OS). Offspring whose mothers had a flat pelvis had lower birth weight and birth-weight-for-gestational-age compared with those who did not. Inverse linear associations of birth-weight-for-gestational-age were observed with TS and OS. Female offspring whose mothers had a flat pelvis had increased risk of TS, but flat pelvis was not associated with other types of stroke. A smaller difference between intercristal and interspinous diameters and a smaller external conjugate diameter were independently associated with HS, whereas no pelvic measurements were associated with OS. We conclude that a smaller pelvis in women may impact the health of their offspring in adulthood.

  • 337.
    Heshmati, Amy
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Koupil, Ilona
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Placental weight and foetal growth rate as predictors of ischaemic heart disease in a Swedish cohort2014In: Journal of Developmental Origins of Health and Disease, ISSN 2040-1744, E-ISSN 2040-1752, Vol. 5, no 3, p. 164-170Article in journal (Refereed)
    Abstract [en]

    Studies on placental size and cardiovascular disease have shown inconsistent results. We followed 10,503 men and women born in Uppsala, Sweden, 1915-1929 from 1964 to 2008 to assess whether birth characteristics, including placental weight and placenta/birth weight ratio, were predictive of future ischaemic heart disease (IHD). Adjustments were made for birth cohort, age, sex, mother's parity, birth weight, gestational age and social class at birth. Placental weight and birth weight were negatively associated with IHD. The effect of placental weight on IHD was stronger in individuals from medium social class at birth and in those with low education. Men and women from non-manual social class at birth had the lowest risk for IHD as adults. We conclude that low foetal growth rate rather than placental weight was more predictive of IHD in the Swedish cohort. However, the strong effect of social class at birth on risk for IHD did not appear to be mediated by foetal growth rate.

  • 338. Hillgren, Kristina
    et al.
    Sarkar, Kamalesh
    Elofsson, Stig
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Britton, Sven
    Utbrett riskbeteende bland injektionsnarkomaner2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 25, p. 1221-1225Article in journal (Refereed)
  • 339. Hiswåls, Anne-Sofie
    et al.
    Ghilagaber, Gebrenegus
    Stockholm University, Faculty of Social Sciences, Department of Statistics.
    Walander, Anders
    Wijk, Katarina
    Öberg, Peter
    Soares, Joaquim
    Macassa, Gloria
    Employment status and inequalities in self-reported health2014In: Epidemiology, Biostatistics and Public Health, ISSN 2282-2305, E-ISSN 2282-0930, Vol. 11, no 4, p. e10006-1-e1006-11Article in journal (Refereed)
  • 340.
    Hiyoshi, Ayako
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Örebro University, Sweden.
    Kondo, Naoki
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Increasing income-based inequality in suicide mortality among working-age women and men, Sweden, 1990-2007: is there a point of trend change?2018In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 72, no 11, p. 1009-1015Article in journal (Refereed)
    Abstract [en]

    Background Income inequalities have risen from the 1990s to 2000s, following the economic recession in 1994, but little research has investigated socioeconomic inequalities in suicide mortality for working-age men and women (aged between 30 and 64 years) over the time using longitudinal data in Sweden. Methods Using Swedish national register data between 1990 and 2007 as a series of repeated cohort studies with a 3-year follow-up (sample sizes were approximately 3.7 to 4.0million in each year), relative and slope indices of inequality (RII and SII respectively) based on quintiles of individual disposable income were calculated and tested for temporal trends. Results SII for the risk of suicide mortality ranged from 27.6 (95% CI 19.5 to 35.8) to 44.5 (36.3 to 52.6) in men and 5.2 (0.2 to 10.4) to 16.6 (10.7 to 22.4) in women (per 100000 population). In men, temporal trends in suicide inequalities were stable in SII but increasing in RII by 3% each year (p=0.002). In women, inequalities tended to increase in both RII and SII, especially after the late-1990s, with 10% increment in RII per year (p<0.001). Conclusions Despite universal social security and generous welfare provision, income inequalities in suicide were considerable and have widened, especially in women. The steeper rise in women may be partially related to higher job insecurity and poorer working conditions in the female dominated public sector after the recession. To reduce health consequences following an economic crisis and widened income inequalities, additional measures may be necessary in proportion to the levels of financial vulnerability.

  • 341.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Att förebygga uppgivenhetssymptom och annan allvarlig psykisk ohälsa hos asylsökande och gömda barn2013In: Från apati till aktivitet: teori och behandling av flyktingbarn med svår psykisk ohälsa / [ed] Henry Ascher, Anders Hjern, Lund: Studentlitteratur AB, 2013, p. 99-116Chapter in book (Other academic)
  • 342.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Children's health: Health in Sweden: The National Public Health Report 2012. Chapter 22012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no Suppl. 9, p. 23-41Article in journal (Refereed)
  • 343.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Migration and public health: Health in Sweden: The National Public Health Report 2012. Chapter 13.2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 9 suppl, p. 255-267Article in journal (Refereed)
  • 344.
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Refugee children in exile – a Swedish public health perspective2012In: For the sake of children: social paediatrics in action : a festschrift in honour of Staffan Janson / [ed] Martin McKee, Karlstad: Karlstad University , 2012, p. 87-99Chapter in book (Other academic)
  • 345.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Ascher, Henry
    För nyanlända barn2012In: Barnmedicin / [ed] Katarina Hanséus, Hugo Lagercrantz, Tor Lindberg, Lund, 2012, 4, p. 121-130Chapter in book (Other academic)
  • 346.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). institutionen för medicin, Karolinska institutet, Stockholm, Sweden.
    Ascher, Henry
    Svårt att säkert fastställa ålder hos asylsökande barn - Medicinska metoder håller inte måttet - psykosocialbedömning bör prövas2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 112, article id DRFZArticle in journal (Refereed)
    Abstract [en]

    Many unaccompanied asylum seeking young people in Europe lack documents proving their age. X rays of the wrist and wisdom teeth are often used by European migration authorities to assess age in this situation. The large inter-individual differences in physical maturation during adolescence create such large margins of error for these methods that their informative value is very limited. The Swedish National Board of Health and Welfare should reconsider its previous position on these methods and examine the possibility to include psychosocial methods in these age assessment procedures. 

  • 347.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Ascher, Henry
    Vervliet, Marianne
    Derluyn, Ilse
    Identification: Age and identity assessment2018In: Research Handbook on Child Migration / [ed] Jacqueline Bhabha, Jyothi Kanics, Daniel Senovilla Hernández, Cheltenhamn, UK: Edward Elgar Publishing, 2018, p. 281-293Chapter in book (Other academic)
  • 348.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.
    Berg, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Arat, Arzu
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Klöfvermark, Josefin
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Manhica, Hélio
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Children as next of kin in Sweden2017Report (Other academic)
  • 349.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berg, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Barn som anhöriga: hur går det i skolan?2015In: Att se barn som anhöriga: om relationer, interventioner och omsorgsansvar / [ed] Ulrika Järkestig Berggren, Lennart Magnusson, Elizabeth Hanson, Kalmar: NKA och Linnéuniversitetet , 2015, p. 117-132Chapter in book (Other academic)
  • 350.
    Hjern, Anders
    et al.
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Berg, Lisa
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Vinnerljung, Bo
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Barn som anhöriga: hur går det i skolan?2013Report (Other academic)
45678910 301 - 350 of 1061
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