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Povlsen L.,Nordic School of Public Health
Scandinavian Journal of Public Health

Aims: To gain a deeper understanding of the conditions for and perceived benefits of regular participation in an immigrant women's club, with special focus on the women's wellbeing and the club's potential for health promotion. Methods: A qualitative research approach was applied, including semi-structured interviews, which were analysed using the constructivist Grounded Theory method. Individual interviews of 15 women aged 40-59 years and from various ethnic backgrounds were conducted in 2010/2011. Findings: Four categories were identified during the analysis. These were labelled "Forming a place for coping with loneliness" (core category), "Learning the rules", "Social bonding and support", and "A space for wellbeing and health". The categories describe how the members deal with the club's status as a municipal association, the structure of the meetings, and the informants' perceptions of being members of a club, as well as the effects of the membership. Conclusions: Immigrant women may find support and perceive increased wellbeing from gathering in clubs with women from a similar background. In addition, the clubs may provide society an opportunity and a space for adapted health-promotion initiatives. © 2012 the Nordic Societies of Public Health. Source

Ahgren B.,Nordic School of Public Health
Health Policy

Despite of an insignificant track record of quasi-market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as " choice of care" This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is " local health care" , which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This article reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible. The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals. © 2010 Elsevier Ireland Ltd. Source

Forsman A.K.,Nordic School of Public Health
Scandinavian journal of public health

To determine the associations between the cognitive aspects of social capital and mental health status in older adults. Data on older people (65 years of age or older, n = 1,102) were retrieved from a general population mental health survey conducted in Finland in 2008. The response rate was 61%. The associations between self-reported depression (measured by the Composite International Diagnostic Interview Short Form, CIDI-SF) or psychological distress (measured by the General Health Questionnaire, GHQ-12) and perceived social support, sense of belonging, and trust were tested by logistic regression analyses. For the cognitive social capital indicators, difficult access to help from neighbours showed a significant association with depression. Furthermore, not having people to count on, experiencing a lack of concern from other people, and feeling mistrust towards other people were all significantly associated with psychological distress. Links between mental health and cognitive social capital indicate that social support and trust may be important factors to consider when developing interventions to promote mental health and prevent mental disorders among older adults. Source

Objective: to increase our understanding of how pregnant women experience early ultrasound examination that includes a risk assessment for chromosomal anomalies and how such women perceive the test results. Design/setting: qualitative study at St. Olavs Hospital in Norway. Both pre- and post-examination interviews were conducted with ten pregnant women who underwent risk assessment for chromosomal anomalies. Grounded theory was used to analyse the results. Findings: the study generated a core category (I want a choice, but I don't want to decide), which related to the conflict between choice and decision making. There were also five main categories (existential choices, search for knowledge, anxiety, feeling of guilt and counselling and care). The main categories describe the complex feelings experienced by the women regarding the risk assessment. Factors contributing to the difficulty of choice included loss of control and coping, emotional connection to the fetus and social pressure. As the women sought independent choices without any external influence, they also felt greater responsibility. The women's understanding of the actual risk varied, and they used different types of logic and methods to evaluate the risk and reach a decision. Conclusions: the pregnant women in this study wanted prenatal diagnostic information and easy access to specialty services. Stress-related feelings and non-transparent information about the actual and perceived risks as well as personal moral judgments made the decision-making process complicated. Improved distribution of information and frequent contact with health professionals may help such women to make informed choices in accordance with their values and beliefs. © 2010 Elsevier Ltd. Source

Laursen T.M.,University of Aarhus | Laursen T.M.,Nordic School of Public Health
Schizophrenia Research

The objective was to estimate life-expectancy (average age at death) among these persons and make a comparison to people in the general population. Methods: Life-expectancy was calculated by means of survival analysis techniques using the entire Danish population as a cohort. Results: Life-expectancy was 18.7. years shorter for schizophrenic men compared to men in the general population. Corresponding numbers for schizophrenic women was 16.3. years, for bipolar men 13.6. years, and for bipolar women 12.1. years. Conclusions: Life-expectancy was much shorter in persons with schizophrenia or bipolar disorder. Excess mortality from physical diseases and medical conditions exerts a far greater influence on the curtailed life-expectancy, when compared against the impact of death by external causes. © 2011 Elsevier B.V. Source

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