Dygnsrytmens betydelse för ungdomars munhälsa : en-case-control studie

Syftet med studien var att jämföra dygnsrytm samt kost - och munhygienvanor mellan ungdomar som uppvisar en kariesprevalens med dem som är kariesfria. Efter ett konsekutivt urval med jämn fördelning med avseende på kariesprevalens och kön, svarade 196 ungdomar i åldern 15-16 år vid ordinarie tandvårdsbesök på en enkät. Frågeområdena var förutom bakgrundsvariabler, sömn-, kost- och munhygienvanor. Studie visade med avseende på dygnsrytm att 37% var kvällsmänniskor, 13% var morgonmänniskor och hälften var neutrala. Ett samband påvisades mellan kariesprevalens och dygnsrytm, i gruppen kvällsmänniskor fanns en större del med karies. Det var mer vanligt att äta frukost och skolmat i kategorierna morgonmänniska och neutrala än bland kvällsmänniskorna. Måltiderna frukost och skolmat samt mjölk till dessa måltider var mer vanligt att förtära i den kariesfria gruppen än i gruppen med kariesprevalens. Att borsta tänderna två gånger per dag var vanligare bland kategorierna morgonmänniska respektive de neutrala än bland kvällsmänniskorna. Det var även vanligare i den kariesfria gruppen än i gruppen med karies

'Moving On' and Transitional Bridges : Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.