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Made available in DSpace on 2022-04-29T08:38:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-12-01 Vaccination of the population seems to be an important strategy in halting the COVID-19 pandemic in both local and global society. The aim of this study was to explore Swedish adolescents’ willingness to be vaccinated against COVID-19 and its association with sociodemographic and other possible factors. A survey was distributed in Sweden between 7 July and 8 November 2020. The main qualitative question concerned adolescents’ thoughts on vaccination against COVID-19 and evaluated whether the adolescents would like to be vaccinated when a COVID-19 vaccine is made available. In total, 702 adolescents aged between 15 and 19 responded to the questionnaire. A convergent parallel mixed-methods design was used. The results showed that nearly one in three adolescents had not decided if they wanted to get a COVID-19 vaccine, i.e. 30.5%: n = 214. Of the participants 54.3% (n = 381) were willing to be vaccinated. Girls had higher levels of anxiety about the vaccine compared to boys. In addition, high levels of anxiety impacted on the participants’ willingness to be vaccinated. One reason for being undecided about the vaccine was that participants felt they did not know enough about it. Practising social distancing increased willingness to be vaccinated, as reflected in the qualitative results which showed participants wanted to be vaccinated to protect others. The results impart important knowledge to healthcare professionals and contribute to their communication with adolescents about vaccine hesitancy. University of Gothenburg Institute of Health and Care Sciences University of Gothenburg Centre for Person-Centred Care (GPCC) Sahlgrenska Academy Red Cross University College Institute of Health Care Karolinska Institute Department of Learning Informatics Management and Ethics University West Department of Health Sciences The Queen Silvia Children's Hospital Department of Pediatrics Karolinska Institute Department of Neurobiology Care Sciences and Society Karolinska Institute Department of Biosciences and Nutrition Umeå University Department of Nursing Karolinska Institute Department of Clinical Science and Education Sachs’ Children and Youth Hospital Umeå University Institute of Epidemiology and Global Health and Institution of Care Science Botucatu Medical School - UNESP Nursing Department Botucatu Medical School - UNESP Nursing Department

The repercussions of the COVID-19 pandemic on children&rsquo, s lives deserve attention. This study aimed to assess the prevalence of anxiety among Brazilian children and its associated factors during social distancing during COVID-19. We used a cross-sectional design with an online survey from April to May 2020 in Brazil. We included children aged 6&ndash, 12 years and their guardians. The Children&rsquo, s Anxiety Questionnaire (CAQ, scores 4&ndash, 12) and the Numerical Rating Scale (NRS, scores 0&ndash, 10) were used to measure anxiety. We enrolled 157 girls and 132 boys, with a mean age of 8.84 (&plusmn, 2.05) years, 88.9% of respondents were mothers. Based on CAQ &ge, 9, the prevalence of anxiety was 19.4% (n = 56), and higher among children with parents with essential jobs and those who were social distancing without parents. In logistic regression, the following variables were associated with higher CAQ scores: social distancing without parents, more persons living together in home, and education level of guardians. Based on NRS &gt, 7, the prevalence of anxiety was 21.8% (n = 63), however, no associations with NRS scores were found with the investigated variables. These findings suggest the necessity of implementing public health actions targeting these parents and their children at the population level.

Aims: To study the prevalence of somatic and mental health comorbidity and the use of opioid medication among patients on long-term sick-leave due to chronic musculoskeletal pain (CMP); to compare an orthopaedic-based assessment of ability to work with a team assessment; to investigate the relationship between intensity of pain and psychosocial characteristics in this group. Methods: A cross-sectional study was carried out with 174 consecutive patients on sick-leave for a mean of 21 months. All were referred from the Social Insurance Office for orthopaedic evaluation and assessment of the ability to work. Of them, only 83/174 patients were referred by the Office for psychiatric evaluation. Results: Neck pain was the main cause of disability. Patients with neck pain often suffered pain in more than two sites, and greater intensity of pain. Thirty-four percent of all participants had been prescribed opioid medication before consultation. Degrees of disability, unemployment, low degree of education and to be an immigrant were related to intensity of pain. Unrecognized psychiatric disorders changed the main cause of inability to work in 69% of patients who underwent both orthopaedic and psychiatric evaluation. Conclusions: An evaluation based on biopsychosocial function is valuable in reaching an accurate assessment of the patient’s diagnosis, and ability to work in CMP. Ability to work and degree of sick-leave in patients on long-term sick-leave is determined to a large extent by undiagnosed mental health comorbidities, and not solely somatic complaints.

Globally, childhood obesity has increased over the last decades and is a serious public health challenge. Physical activity (PA) plays an important role in weight management; however children do not meet the recommend levels of PA. A growing number of theories address PA and motivation to engage in PA as a complex interaction between individual preferences, experiences and physical and social environments. In this study we …

INTRODUCCIÓN: El cáncer de mama desde 1992 ha sido la segunda causa de muerte femenina en Colombia (tasa promedio anual de 4,5*100.000 hab.) y se reporta una tendencia ascendente por este tipo de neoplasia, y la información sobre los potenciales factores de riesgo del cáncer de la mama en los países Latinoamericanos es escasa. Los objetivos del trabajo fueron probar la protección ofrecida por la lactancia materna, y establecer los factores reproductivos asociados al cáncer de mama en Colombia. MÉTODOS: Se realizó un estudio de casos y controles hospitalarios pareados por edad (+ 2 años) de Julio 1995 a Marzo 1996 en Bogotá. La población de estudio quedó constituída por 171 casos histopatológicamente definidos y 171 controles. La historia reproductiva y sociodemográfica fué recolectada a través de un cuestionario y se utilizó la técnica de regresión logística condicionada para el análisis estadístico de la información. RESULTADOS: Se encontraron como factores de riesgo: la nuliparidad , al contrario de las mujeres con paridades mayores de 3 hijos (OR=3,35 IC 1,4 - 8,0), la edad al primer nacimiento (>20 años vs. menores de 20. OR= 1,83 IC 0,7 - 4,8), el antecedente familiar de cáncer de mama y la lactancia al primer hijo (OR=0,09 IC 0,01-0,64 de 1-11 meses y OR= 0,01 IC 0,00-0,14 para los 12 meses) y la lactancia acumulada por encima de los 24 meses (p=0,001 prueba de tendencia) como principales factores protectores de la enfermedad. CONCLUSIONES: El estudio confirma la importancia de enfocarse en la promoción de la lactancia prolongada y ratifica que el nivel socioeconómico puede determinar los estilos de vida y los eventos reproductivos de las mujeres, explicando el aumento en la mortalidad por cáncer de mama en los países Latinoamericanos, con perfiles de fecundidad y factores de riesgo para el cáncer de mama, similares a los de los países desarrollados. INTRODUCTION: As of 1992, breast cancer has been the second cause of death in Columbian women, with a rising trend in mortality due to this type of neoplasm (average annual rate 4.5*/100.000 inhabitants). Information about potential risk factors for breast cancer in Latin American countries is scarce. The objectives of the project were to test the breastfeeding protection against breast cancer and to establish the reproductive factors associated with breast cancer in Columbia. METHODS: A hospital case-control study was carried out from July 1995 to March 1996 in Bogotá, Columbia, using paring by age groups. The study population consisted of 171 histopathologically confirmed cases and 171 controls. Reproductive history and sociodemographic data were collected through a questionnaire, and logistic regression models were used for statistical analysis of the data. RESULTS: The following associated factors were found as principal results: nuli-parousness as compared with women with over 3 children (OR=3.35 CI 1.40-8.0), age at first birth (OR=1.83 CI 0.70- 4.80), breast cancer history, breastfeeding the first child (OR=0.09 CI 0.01-0.64 for 1-11 months) and with a highly significant trend for accumulated breastfeeding above 24 months (p=0.001). CONCLUSIONS: This study indicates the importance of focusing on the promotion of prolonged breastfeeding by women identified as being at higher risk, and confirms that socio-economic level can determine life styles and reproductive events among women (such as breastfeeding time); this could explain the increase in breast cancer mortality in Latin American countries, similar to that in developed countries in terms of fertility and risk factors for breast cancer. The epidemiological information produced by this study will be useful for planning and carrying out early diagnosis and treatment of breast cancer in women identified as being at high risk of this disease. INTRODUÇÃO: O câncer de mama, desde 1992, tem sido a segunda causa de morte feminina na Colômbia (taxa média anual de 4,5*/100.000 hab.) mostrando tendência ascendente por este tipo de neoplasia, sendo poucas as informações sobre fatores de risco potenciais de câncer de mama nos países da América Latina. O estudo realizado objetivou testar a proteção da amamentação materna contra essa doença, e estabelecer fatores reprodutivos a ela associados. MÉTODOS: Realizou-se estudo de casos-controle hospitalares pareados por idade, de julho 1995 a março 1996. A população de estudo foi constituída por 171 casos histologicamente confirmados e 171 controles. A história reprodutiva e sociodemográfica foi coletada através de um questionário e adotada a técnica de regressão logística para efetuar a análise estatística dos dados. RESULTADOS: Como fatores de risco foram encontrados: nuliparidade, quando comparada com mulheres com mais de três filhos (OR=3,35 IC 1,4 - 8,0); idade do primeiro nascimento (>20 anos vs. menores de 20. OR= 1,83 IC 0,7 - 4,8); antecedente familiar de câncer mamário e amamentação do primeiro filho (OR=0,09 IC 0,01-0,64 de 1-11 meses e OR= 0,01 IC 0,00-0,14 para os 12 meses), e amamentação acumulada por mais de 24 meses (p=0,001 prova de tendência) como um dos principais fatores protetores da doença. CONCLUSÕES: O estudo confirma a importância de promover a amamentação prolongada e ratifica que o nível socioeconômico pode determinar o estilo de vida e os eventos reprodutivos das mulheres, explicando o aumento na mortalidade por câncer mamário nos países Latino-americanos, com perfil de fecundidade e fatores de risco para o câncer mamário, similares a dos países desenvolvidos.

BACKGROUND & OBJECTIVES: This study aimed to assess levels of physical activity (PA) and sedentary behaviours among Danish and Colombian adolescents, and to compare relevant environmental and psychosocial factors associated with physical inactivity (PI) between both student groups. Further, we aimed to compare PI between Danish students born in Denmark and those with immigrant background living in Denmark, but born in another country.METHODS: The comparative study was performed with 1.374 Danish adolescents (among them 152 born outside the country) who participated in the Danish Youth Cohort and 452 Colombian students who completed the ISCOLE questionnaire, both from the most disadvantaged socioeconomic strata.RESULTS: The prevalence of physical inactivity (PI) was much higher among Colombian students (74.6%) compared with Danish (25.2%) and with students with a non-Danish background living in Denmark (21.1%). Both groups of Danish adolescents participated more often in organized sports, spent more time on sports after school, were more likely to actively commute to school compared to Colombians and spent less time on screen viewing than Colombians did. In both Columbian and Danish students, low time spent on sports after school, and poorer self-perceived health, were associated with PI. Sedentary behaviours (time in front of screen) were also positively associated with PI.CONCLUSION: Most Colombian adolescents were not meeting the recommendation of accumulating at least 60 minutes per day of moderate-to-vigorous intensity PA for positive health outcomes as most Danish adolescents did independently of their ethnic background. We assume that the physical and social environment in the neighbourhoods where adolescents live may explain the differences in levels of PA between the countries.

Objective: The main objective of this study was to investigate different psychometric properties of the Swedish version of the Depression, Anxiety, and Positive Outlook Scale (DAPOS) in patients with chronic musculoskeletal pain in an orthopedic setting. Methods: A total of 449 participants took part in the study, including 288 patients with chronic musculoskeletal pain and 161 participants in a reference group. Internal consistency, convergent validity, and measurement invariance of the constructs of DAPOS were investigated across sex and diagnostic groups. The Beck Depression Inventory and the Spielberger Anxiety Inventory were used for measures of convergent validity. Multigroup confirmatory factor analysis was performed to test measurement invariance of the theoretical constructs of DAPOS. Results: Internal consistency was good for all 3 constructs, and correlations concerned with convergent validity were found to be acceptable to good. With regard to cross-validation, the 3 constructs of DAPOS were strictly measurement invariant with respect to sex. Across diagnostic groups, the constructs of anxiety and positive outlook were almost strictly measurement invariant, although there were some restrictions of measurement invariance for the construct of depression. Discussion: To be able to rely on an instrument with as few items as DAPOS, the cross-validation of its constructs for sex and diagnostic groups is a valuable information, particularly when investigated in patients with musculoskeletal pain. Based on these results, we recommend that DAPOS could replace longer and more time-consuming screening tests in clinical settings.

Patricia Olaya-Contreras1, Torgny Persson2, Jorma Styf11Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy at The University of Gothenburg, Sweden; 2The Lundby Hospital, Gothenburg, SwedenBackground: Chronic musculoskeletal pain (CMP) is associated with psychological distress and long-term disability. Underlying diagnoses causing long-term sickness absence due to CMP have not been explored enough. In a somatic health care setting, it is important to identify mental health comorbidity to facilitate the selection of appropriate treatment. The objectives of this study were to compare the scores of depressed mood obtained on the Beck Depression Inventory (BDI) with the diagnosis of depression made by a psychiatrist, and to study the prevalence of undiagnosed mental health comorbidity in these patients.Methods and patients: 83 consecutive patients on sick leave (mean duration 21 months) due to CMP who had been referred by the Social Insurance Office to an orthopedist and a psychiatrist for assessment of the patient’s diagnoses and capacity to work. The mean age was 45 (23–61) years, 58% were women and 52% were immigrants. The accuracy of measurements was calculated using the Diagnostic Statistical Manual of Mental Disorders IV as the Gold standard.Results: Psychiatric illness was diagnosed in 87% of the patients. The diagnosis was depression in 56%, other psychiatric illnesses in 31%, whereas 13% were mentally healthy. Of all the patients, only 10% had a previous psychiatric diagnosis. The median value of the BDI score was 26 points in depressed patients, whereas it was 23 in patients with other psychiatric diagnoses. The sensitivity of the BDI to detect depression was 87.5%. We found good agreement between the BDI score and a diagnosis of depression.Conclusion: Undiagnosed psychiatric disorders were commonly seen in patients with CMP. The high sensitivity of the BDI scores enables the screening of mental health comorbidity in patients with a somatic dysfunction. The test is a useful tool for detecting distress in patients who are on long-term sick leave due to CMP and who need additional treatment.Keywords: agreement, disability, underlying diagnoses

Background and purpose Methods for identification of patients with illness behavior in orthopedic settings are still being debated. The purpose of this study was to test the association between illness behavior, depressed mood, pain intensity, self-rated disability, and clinical status in patients with chronic musculoskeletal pain (CMP). Methods We examined 174 consecutive sick-listed patients (90 women). Musculoskeletal function was estimated by range of motion, muscle strength, and motor and sensory function. The degree of illness behavior was measured by Waddell signs (WS). Results WS were observed in 47/174 (27%) of the patients, 16% of whom manifested excessive illness behaviour. In general, more patients with WS were depressed (OR = 4.4; 95% CI: 1.8–11) and experienced greater pain (OR = 2.9; CI: 1.1–7.7). No abnormal physical function could be observed in two-thirds of the patients. Other predictive factors for manifesting WS at the clinical examinations were longer sick leave and previous full sick leave (p < 0.05). Interpretation Excessive illness behavior is related to psychological distress in patients with CMP and long-term disability. Thus, some patients may also require psychological assessment. Looking for WS during consultation is useful for targeting other factors that may be important in the diagnostic process.

Low back pain (LBP) is described as highly recurrent and frequently persistent public health worldwide. The “stay active” concept has been regarded as the most appropriate treatment recommendation for patients with acute LBP. The objective of this study was to evaluate the influence of distress on disability, physical activity and pain intensity in subjects with severe acute LBP. Methods A Randomised Control Trial (RCT) was conducted, 99 employed subjects (mean age 45 years, 20–63), 61% white- and 39% blue-collar workers with acute LBP were examined within 48 h after the onset of pain. All patients were initially assessed using the Depression Anxiety and Positive Outlook Scale (DAPOS) and the Tampa Scale of Kinesiophobia (TSK) questionnaires. Thereafter, the patients documented the following in a diary over a 7-day period: pain intensity, disability rating index (DRI) and step count (pedometer). Linear Mixed Models (LMM) for repeated measures were employed for the statistical analyses. All results were adjusted for age, gender, treatment, number of days and for the interaction term (treatment *DAPOS-D). Results Prospectively, DRI and pain intensity responses were differentially mediated by the treatment, in interaction with the scores of DAPOS (p 38) had a lower step count over time (p Conclusion Depressed mood and fear of movement affect the outcomes of disability, the level of physical activity and the pain intensity in patients with acute LBP.