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  • 1.
    Abbasi, SH
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    De Leon, AP
    Division of Social Medicine, Department of Public Health Sciences, Karolinska Intitutet, Sweden.
    Kassaian, SE
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Karimi.,, AA
    Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
    Sundin, Ö
    Mittuniversitetet, Institutionen för samhällsvetenskap.
    Soares, J
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Gender Differences in the Risk of Coronary Artery Disease in Iran2012Inngår i: Iranian Journal of Public Health, ISSN 0304-4556, Vol. 41, nr 3, s. 36-47Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.

    Fulltekst (pdf)
    fulltext
  • 2.
    Eslami, Bahareh
    et al.
    Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Sundin, Örjan
    Department of Psychology, Mid Sweden University, Östersund, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim JF
    Department of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Anxiety, depressive and somatic symptoms in adults with congenital heart disease2013Inngår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 74, nr 1, s. 49-56Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective

    Despite the improvement in life-expectancy of adults with congenital heart disease, they may experience unique medical and social challenges that could impact on their psychological functioning. The aims of this study were to address the experience of anxiety, depressive and somatic symptoms among adults with congenital heart disease in comparison with that of non-heart diseased persons considering the role of various factors (e.g. socio-economic).

    Methods

    In cross-sectional case–control study, the participants consisted of 347 patients with congenital heart disease (18–64 years, 52.2% female) and 353 matched (by sex/age) non-heart diseased persons. The participants completed a questionnaire. The data were analyzed with bivariate and multivariate methods.

    Results

    In bivariate analyses, scores in anxiety and somatic symptoms were higher among patients than the healthy controls (both at p ≤ 0.001), whereas the groups did not differ in depressive symptoms. Following multiple-linear-regression-analyses, only the association between congenital heart disease and somatic symptoms was confirmed. Among the patients, perceived financial strain was significantly related to anxiety, depressive and somatic symptoms; lower perceived social support to anxiety and depression; and low annual income to somatic symptoms. Additionally, somatic symptoms were associated with anxiety and depressive symptoms, and vice versa. And no medical variables were related to anxiety, depressive and somatic symptoms.

    Conclusions

    Congenital heart disease was only independently associated with somatic symptoms. Financial strain, social support and co-existence of emotional distress with somatic symptoms should be considered in developing appropriate interventions to improve the well-being of patients with congenital heart disease. However, longitudinal research is warranted to clarify causality.

  • 3.
    Eslami, Bahareh
    et al.
    Mid Sweden University, Sundsvall, Sweden.
    Örjan, Sundin
    Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mid Sweden University, Sundsvall, Sweden.
    Khankeh, Hamid Reza
    Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J. F.
    Mid Sweden University, Sundsvall, Sweden.
    Gender differences in health conditions and socio-economic status of adults with congenital heart disease in a developing country2013Inngår i: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 23, nr 2, s. 209-218Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters.

    Materials and methods The sample consisted of 347 congenital heart disease patients in the age group of 18–64 years, including 181 women, assessed by an analytical cross-sectional study. The patients were recruited from the two major heart hospitals in Tehran. Data were collected using questionnaires.

    Results The mean age of the patients was 33.24 years. Women were more often married and more often had offspring than men (p < 0.001). Educational level and annual income were similar between women and men. Unemployment was higher among women (p < 0.001), but financial strain was higher among men (p < 0.001). Smoking, alcohol, and water-pipe use was higher among men than among women (p < 0.001). Cardiac factors, for example number of cardiac defects, were similar among women and men, except that there were more hospitalisations owing to cardiac problems, for example arrhythmia, among men. Disease was diagnosed mostly at the hospital (57.4%). Most medical care was provided by cardiologists (65.1%). Only 50.1% of patients had knowledge about their type of cardiac defect.

    Conclusion Gender differences exist in the socio-economic and lifestyle characteristics of adults with congenital heart disease, in some cases related to the disease severity. Our findings also point to the need for interventions to increase patients’ knowledge about, and use of, healthier lifestyle behaviours, irrespective of gender. Furthermore, providing appropriate jobs, vocational training, and career counselling may help patients to be more productive.

  • 4.
    Hiswåls, Anne-Sofie
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Avdelningen för statistikvetenskap, Stockholms Universitet, Department of Statistics, University of Stockholm.
    Walander, Anders
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm Sweden.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg, Community Medicine, County Council of Gävleborg.
    Öberg, Peter
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Employment Status and Inequalities in Self-Reported Health2014Inngår i: Epidemiology, Biostatistics and Public Health, ISSN 2282-2305, E-ISSN 2282-0930, Vol. 11, nr 4, s. 1-11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The aim of this study was to investigate the impact of employment status on self-reported health in gävleborg county.

    Methods: The study used data from the 2010 health in equal terms survey, a cross-sectional survey carried out in gävleborg county in sweden. a total of 4,245 individuals, aged 16–65 years were included in the analyses. descriptive and logistic regression analyses were used to assess the relationship between employment status and self-reported health

    Results: Individuals outside the labour market had odds of poor health of 2.64 (cl 2.28–3.05) compared to their employed counterparts. controlling for other covariates reduced the risk slightly to 2.10 (1.69-2.60), but remained statistically significant. In addition, other variables were associated with self-reported poor health.

    Conclusions: This study found a statistically significant association between being outside the labour market and poor self-reported health. The relation was explained partially by socio-economic and demographic variables. More studies, in particular longitudinal, are needed to further investigate the observed relationships. Policy-makers within the gävleborg county need to pay attention to the health status of those out of work, especially during times of combined economic and labour market fluctuations.

    Results of the study suggest the need to pay attention to the health status of those outside the labour market, especially during times of economic hardship.

  • 5.
    Hiswåls, Anne-Sofie
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Stockholms universitet, Statistiska institutionen.
    Wijk, Katarina
    Öberg, Peter
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Soares, Joaquim
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap; Karolinska Institutet.
    Employment status and suicidal ideation during economic recession2015Inngår i: Health Science Journal, ISSN 1791-809X, Vol. 9, nr 1, artikkel-id 13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Suicide is a public health problem and an important indicator of severe mental ill-health. Thus, identifying risk factors for suicidal ideation is a public health priority. The aim of this study was to examine the relationship between employment status and suicidal ideation in Gävleborg County. Method: The study used data from the 2010 Health in Equal Terms survey, a cross-sectional survey carried out in Gävleborg County in Sweden. A total of 4,245 individuals, aged 16–65 years were included in the analyses. Descriptive and logistic regression analyses were carried out to assess the relationship between employment status and suicidal ideation Results: Individuals outside the labour market had odds of suicidal ideation of 4.21 (CI 3.14-5.64) compared to their employed counterparts. Controlling for other covariates, reduced the risk from 4.21(CI 3.14-5.64) in model I, to 1.73 (CI 1.16- 2.57) in model IV, but remained statistically significant. In addition, other variables were associated with suicidal ideation. Conclusion: There was a statistically significant association between being out of work and suicidal ideation. The association was explained partly by demographic, socio-economic and self-reported psychological variables. Results of the study suggest the need for primary prevention strategies among those out of the labour market, especially during times of economic hardship.

  • 6.
    Hiswåls, Anne-Sofie
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Avdelningen för hälsovetenskap.
    Ghilagaber, Gebrenegus
    Avdelningen för statistik, Stockholms universitet, Department of statistics, Stockholm University.
    Wijk, Katarina
    Samhällsmedicin, Landstinget Gävleborg, Community Medicine,Gävleborg County Council .
    Öberg, Peter
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science .
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Avdelningen för hälsovetenskap, Mid Sweden University, Department of Health Science .
    Inequalities and Suicide Ideation during Recession Times2014Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, nr Suppl. 2, s. 361-Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background

    Suicide behaviour is a serious public health problem as it imposes economic and human costs to individuals, families and communities. Available evidence from some European countries indicates a significant rise in suicides related to economic recession. However, the debate continues regarding the role of unemployment in the reported suicide rates. In Sweden, very few studies have investigated the relationship between suicide behaviours and employment status in the context of the recent economic crisis although unemployment increased nationally and across different counties.

    The aim of this study was to examine the relationship between employment status and suicide ideation in Gävleborg, Sweden.

    Methods

    The study used data from a cross-sectional survey, Health in Equal terms, carried out in Gävleborg County in Sweden, 2010. A total of 4245 individuals, aged 16–65 years were included in the analysis. The relationship between employment status and suicide ideation was assessed using descriptive and logistic regression analyses.

    Results

    People who were not working had odds of suicide ideation of 4.21 (95% Cl 3.14–5.64) as compared to those employed. Controlling for other covariates reduced the risk to 1.73 (95% CI 1.16-2.57) but remained statistically significant. In addition variables like anxiety, self-reported stress and young age were also associated with suicide ideation. However among the covariates, people who reported anxiety had the highest odds of suicide ideation.

    Conclusions

    This study found a statistically significant association between being out of work and suicide ideation. The association was largely explained by self-reported stress, anxiety, socioeconomic and demographic variables.

    Policy-makers within the County need to pay attention to the health status of those out of work, especially during times of combined economic and labour market fluctuations.

    Key messages

    • Suicide ideation was more common among people out of labor force in Gävleborg County, Sweden.

    • Further studies are needed to investigate suicide ideation among unemployed persons during times of economic and labor market insecurity.

  • 7. Innocent, M
    et al.
    Ndonko, F
    Ngo’o, G
    Soares, Joaquim J. F.
    Mid Sweden University, Sundsvall, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mid Sweden University, Sundsvall, Sweden.
    Breaking the Silence: Understanding the practice of Breast ironing in Cameroon2012Inngår i: African Journal of Health Sciences, ISSN 1022-9272, E-ISSN 2306-1987, Vol. 23, nr 4, s. 232-237Artikkel i tidsskrift (Fagfellevurdert)
  • 8. Lindert, Jutta
    et al.
    Soares, Joaquim JF
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Csöff, RM
    Barros, H
    Torres-Gonzalez, F
    Ioannidi-Kapolou, E
    Lamura, G
    de Dios Luna, J
    Macassa, G
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Melchiorre, MG
    Stankunas, M
    Gewalt und Gesundheit bei älteren Menschen in Europa2013Bok (Annet vitenskapelig)
  • 9.
    Macassa, Gloria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap.
    Ahmadi, Nader
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Hiswåls, Anne-Sofie
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap.
    Alfredsson, J.
    Samhällsmedicin, Landstinget Gävleborg.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Stankunas, M.
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Differences in health care-seeking behavior during economic recession2014Inngår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 24, nr Suppl. 2Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    Background

    In Europe, equitable access to high-quality healthcare constitutes a key challenge for health systems across the continent. However, the recent economic recession left many outside the labour market, causing many to fall in poverty and social exclusion. Unemployment is probably the main factor leading to social exclusion. Studies which analysed health seeking behaviour among unemployed people have reported a variety of results, from low to high utilization of health services. However, some researchers argue that during stressful economic and social circumstances can cause high utilization of the health care system due to increased psychological disorders masked by physical complaints. This study examined differences in health seeking behaviour in Gävleborg County, which at the pick of the economic recession had high levels of unemployment as compared to the national average.

    Methods

    The data for the study come from the 2010 Survey of Health in Equal terms carried out in Gävleborg County, Sweden. The sample included 4245 persons aged 16-65 years. Descriptive and binary logistic analysis was used to assess differences in health seeking behavior by employment status.

    Results

    There was a statistical significant relationship between employment status and health-seeking behavior. Compared to employed persons, people who were out of the labor market had odds ratio of 1.42 (1.12-1.62) for contact with health care services; of 1.30 (1.12-1.50) for contact with a doctor in a health care facility and 1.67 (1.42-1.97) for contact with a doctor in a hospital. Controlling for age, sex, marital status, education, income, smoking habits, physical activity, self-rated health, and long standing illness removed the statistical significance of the observed relationships. Thus, the odds for contact with health care services went from.

    Conclusions

    At the pic of the recent economic recession, people who were outside the labor market had more contact with health care services, with doctor in hospitals as well as primary health care services as compared to employed counterparts. The differences in health seeking behavior were explained by demographic, socioeconomic and health variables.

    Key Words: Employment status, Health care, Gävleborg, economic recession.

    Key messages

    • People who were out of labor market in Gävleborg County in 2010 had more contact with health care services, with a doctor in hospital and primary health care respectively.

    • Future studies are warranted that can assess trends in health-seeking behavior among people outside Gävleborgs labor market.

  • 10.
    Macassa, Gloria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Ghilagaber, Gebreneus
    Stockholm university.
    Charsmar, Harry
    Stockholm university.
    Walander, A
    Sundin, Örjan
    Mittuniversitetet, Institutionen för samhällsvetenskap.
    Soares, Joaquim
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Geographic differentials in mortality of children in Mozambique: their implications for achievement of millenium development goal 42012Inngår i: Journal of Health, Population and Nutrition, ISSN 1606-0997, E-ISSN 2072-1315, Vol. 30, nr 3, s. 331-345Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In the light of Mozambique's progress towards the achievement of Millennium Development Goal 4 of reducing mortality of children aged less than five years (under-five mortality) by two-thirds within 2015, this study investigated the relationship between the province of mother's residence and under-five mortality in Mozambique, using data from the 2003 Mozambican Demographic and Health Survey. The analyses included 10,326 children born within 10 years before the survey. Results of univariate and multivariate analyses showed a significant association between under-five mortality and province (region) of mother's residence. Children of mothers living in the North provinces (Niassa, Cabo Delgado, and Nampula) and the Central provinces (Zambezia, Sofala, Manica, and Tete) had higher risks of mortality than children whose mothers lived in the South provinces, especially Maputo province and Maputo city. However, controlling for the demographic, socioeconomic and environmental variables, the significance found between the place of mother's residence and under-five mortality reduced slightly. This suggests that other variables (income distribution and trade, density of population, distribution of the basic infrastructure, including healthcare services, climatic and ecologic factors), which were not included in the study, may have confounding effects. This study supports the thought that interventions aimed at reducing under-five mortality should be tailored to take into account the subnational/regional variation in economic development. However, research is warranted to further investigate the potential determinants behind the observed differences in under-five mortality.

    Fulltekst (pdf)
    fulltext
  • 11.
    Macassa, Gloria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Department of Health Science, Section of Public Sci ence, Mid-Sweden University, Sundsvall, Sweden; Department of Public Health Sciences, Karolinska In stitute, Stockholm, Sweden .
    Hiswåls, Anne-Sofie
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap.
    Ahmadi, Nader
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för socialt arbete och psykologi, Socialt arbete.
    Alfredsson, Johanna
    Department of Community Medicine, Gävleborg County Council, Gävle, Sweden .
    Soares, Joaquim F. J.
    Mittuniversitetet, Avdelningen för Folkhälsovetenskap.
    Stankunas, Mindaugas
    University of Health Sciences, Kaunas, Lithuania.
    Employment status and health care utilization in a context of economic recession: Results of a population based survey in East Central Sweden2014Inngår i: Science Journal of Public Health, ISSN 2328-7942, Vol. 2, nr 6, s. 610-616Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: The most recent economic recession left many people outside the labour market world-wide, causing widespread poverty and social exclusion. Gävleborg County in East Central Sweden experienced massive layoffs caused by closure of various industries. Objective: The objective of this study was to investigate differences in health-care use according to employment status at the pick of the recent economic recession. Methods: The study used data from a cross-sectional survey “Health in Equal Terms” carried out in Gävleborg County in 2010. The sample included 4245 persons aged 16-65 years. Descriptive and logistic regression analyses were used to assess differences in health-care seeking behaviour by employment status. Results: Employment status was statistically significantly associated with health-care use in Gävleborg County. In the bivariate analysis people who were not employed had odds ratio of 1.62 (CI 1.18-1.72) for health care use as compared to their employed counterparts. Controlling for other variables in Model II to IV removed the statistical significance and reduced the odds to 0.44(CI 0.20-1.00). Conclusions: This study found that at the pick of the most recent economic recession, people who were out of work used more often health services as compared with their employed counterparts. The observed differences in health-care use were explained by demographic, socio-economic and health-related variables. Further studies are needed to analyze trends of healthcare utilization according to employment nationally, particularly at the county level.

  • 12.
    Macassa, Gloria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Sundin, Örjan
    Mittuniversitetet, Avdelningen för psykologi.
    Viitasara, Eija
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Barros, H
    Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
    Torres Gonzales, F
    Departmental Section of Psychiatry and Psychological Medicine, University of Granada, Granada, Spain.
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health, Athens, Greece.
    Melchiorre, MG
    Italian National Institute of Health and Science on Aging (INRCA), Ancona, Italy.
    Lindert, J
    Protestant University of Applied Sciences, Ludwigsburg, Germany.
    Stankunas, M
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Psychological abuse among older persons in Europe: A cross-sectional study2013Inngår i: Journal of Aggression, Conflict and Peace Research, ISSN 1759-6599, Vol. 5, nr 1, s. 16-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose – Elder abuse is an issue of great concern world-wide, not least in Europe. Older people are increasingly vulnerable to physical, psychological, financial maltreatment and sexual coercion. However, due to complexities of measurement, psychological abuse may be underestimated. The purpose of this study is to investigate the prevalence of psychological abuse toward older persons within a 12 month period.

    Design/methodology/approach – The study design was cross-sectional and data were collected during January-July 2009 in the survey “Elder abuse: a multinational prevalence survey, ABUEL”. The participants were 4,467 randomly selected persons aged 60-84 years (2,559 women, 57.3 per cent) from seven EU countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden). The sample size was adapted to each city according to their population of women and men aged 60-84 years (albeit representative and proportional to sex-age). The participants answered a structured questionnaire either through a face-to-face interview or a mix of interview/self-response. The data were analysed using descriptive statistics and regression methods.

    Findings – The prevalence of overall psychological abuse was 29.7 per cent in Sweden, followed by 27.1 per cent in Germany; 24.6 per cent in Lithuania and 21.9 per cent in Portugal. The lowest prevalence was reported in Greece, Spain and Italy with 13.2 per cent, 11.5 per cent and 10.4 per cent, respectively. Similar tendencies were observed concerning minor/severe abuse. The Northern countries (Germany, Lithuania, Sweden) compared to Southern countries (Greece, Italy, Portugal, Spain) reported a higher mean prevalence (across countries) of minor/severe abuse (26.3 per cent/11.5 per cent and 12.9 per cent/5.9 per cent, respectively). Most perpetrators (71.2 per cent) were spouses/partners and other relatives (e.g. children). The regression analysis indicated that being from Greece, Italy, Portugal and Spain was associated with less risk of psychological abuse. Low social support, living in rented housing, alcohol use, frequent health care use, and high scores in anxiety and somatic complaints were associated with increased risk of psychological abuse.

    Social implications – Psychological abuse was more prevalent in Northern than Southern countries and factors such as low social support and high anxiety levels played an important role. Further studies are warranted to investigate the prevalence of psychological abuse and risk factors among older persons in other EU countries. Particular attention should be paid to severe abuse. Such research may help policy makers and health planers/providers in tailoring interventions to tackle the ever growing problem of elder abuse.

    Originality/value – The paper reports data from the ABUEL Survey, which collected population based data on elderly abuse.

  • 13.
    Macassa, Gloria
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Walander, A
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden .
    Soares, Joaquim JF
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Violence against women in Stockholm County: Does marital status matter?2013Inngår i: Journal of Aggression, Conflict and Peace Research, ISSN 1759-6599, Vol. 5, nr 2, s. 101-111Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this paper is to investigate differences in victimization among single and married mothers using data (n=6,388 women) from the 2006 Stockholm County Public Health Survey (SCPHS), a cross-sectional survey based on a self-administered postal questionnaire. Design/methodology/approach: Results showed higher odds of victimization among lone mothers compared to married ones. Additionally, the greatest odds of victimization were observed among those with low education, low income, and decreased social and practical support. Findings: In Sweden, particularly in Stockholm, there is a need for future population-based surveys regarding the prevalence of violence and to identify high risk groups. Furthermore, it is crucial that these surveys include items that will enable investigation of direct links between violence and health effects, and the utilization of health care for these women. Originality/value: This paper is original and it addresses for the first time violence among single mothers within a social epidemiology perspective.

  • 14.
    Melchiorre, Maria Gabriella
    et al.
    Centre of Socio-Economic Research on Ageing, Italian National Institute of Health and Science on Aging, I.N.R.C.A., Ancona, Italy.
    Chiatti, Carlos
    Italian National Institute of Health and Science on Aging, I.N.R.C.A., Ancona, Italy.
    Lamura, Giovanni
    Centre of Socio-Economic Research on Ageing, Italian National Institute of Health and Science on Aging, I.N.R.C.A., Ancona, Italy.
    Torres-Gonzales, Francisco
    Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), University of Granada, Granada, Spain.
    Stankunas, Mindaugas
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Lindert, Jutta
    Department of Public Health Science, Protestant University of Applied Sciences, Ludwigsburg, Germany.
    Ioannidi-Kapolou, Elisabeth
    Department of Sociology, National School of Public Health, Athens, Greece.
    Barros, Henrique
    Department of Hygiene and Epidemiology, Medical School, University of Porto, Porto, Portugal.
    Macassa, Gloria
    Mid Sweden University and Karolinska Institute.
    Soares, Joaquim
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Social Support, Socio-Economic Status, Health and Abuse among Older People in Seven European Countries: Social support and elder abuse in Europe2013Inngår i: PLOS ONE, E-ISSN 1932-6203, Vol. 8, nr 1, s. e54856-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Social support has a strong impact on individuals, not least on older individuals with health problems. A lack of support network and poor family or social relations may be crucial in later life, and represent risk factors for elder abuse. This study focused on the associations between social support, demographics/socio-economics, health variables and elder mistreatment.

    Methods

    The cross-sectional data was collected by means of interviews or interviews/self-response during January-July 2009, among a sample of 4,467 not demented individuals aged 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden).

    Results

    Multivariate analyses showed that women and persons living in large households and with a spouse/partner or other persons were more likely to experience high levels of social support. Moreover, frequent use of health care services and low scores on depression or discomfort due to physical complaints were indicators of high social support. Low levels of social support were related to older age and abuse, particularly psychological abuse.

    Conclusions

    High levels of social support may represent a protective factor in reducing both the vulnerability of older people and risk of elder mistreatment. On the basis of these results, policy makers, clinicians and researchers could act by developing intervention programmes that facilitate friendships and social activities in old age.

    Fulltekst (pdf)
    fulltext
  • 15.
    Soares, Joaquim
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Grossi, Giorgio
    Stockholm University.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap.
    Örjan, Sundin
    Mittuniversitetet, Institutionen för samhällsvetenskap.
    Psychological distress in a sample of Swedish women: a longitudinal study2014Manuskript (preprint) (Annet vitenskapelig)
  • 16.
    Soares, Joaquim J. F.
    et al.
    Stockholm Centre for Public Health, Stockholm, Sweden, and Karolinska Institutet , Stockholm, Sweden .
    Macassa, Gloria
    Karolinska Institutet , Stockholm, Sweden .
    Grossi, Giorgio
    National Institute for Psychosocial Factors and Health , Stockholm, Sweden .
    Viitasara, Eija
    Mittuniversitetet, Mid Sweden University, Department of Health Sciences, Sundsvall, Sweden .
    Psychosocial Correlates of Hopelessness Among Men2008Inngår i: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 37, nr 1, s. 50-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study examined overall hopelessness, explored differences in various variables (e.g. burnout) between men reporting no/mild hopelessness and moderate/severe hopelessness, and scrutinized factors associated with hopelessness. The study design was cross-sectional, and the participants were 517 men randomly selected from the general population. About 12% of men reported moderate/severe hopelessness, and men with moderate/severe hopelessness were more often older, divorced/widowed, low educated, employed in blue-collar positions, on sick leave/other/unemployment/retirement, and financially strained. They also reported more depression, posttraumatic symptoms, and burnout. Only unemployment/retirement, depression, and posttraumatic symptoms were independently associated with an increased risk for moderate/severe hopelessness in the regression analysis, with unemployment and retirement as the most important factors. In conclusion, this study seems to corroborate previous findings and may provide new insights into men's experiences and predictors of hopelessness. More research into the predictors of hopelessness in men is warranted.

  • 17. Soares, Joaquim J.F
    et al.
    Viitasara, Eija
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Macassa, Gloria
    Karolinska Institutet.
    Quality of life among lifetime victimized men2007Inngår i: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 22, nr 2, s. 289-204Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Quality of life was compared for lifetime victimized (n = 353) and nonvictimized men (n = 167) for demographic and quality of life variables by a cross-sectional design. The univariate analyses showed that victims compared to nonvictims had a lower quality of life, were younger, more often had upper secondary school education, and were more often blue-collar/low white-collar workers, on student allowances, on unemployment, financially strained, and smokers. The regressions revealed that unemployment, financial strain, smoking, depression, and home/public abuse were associated with reduced quality of life among victimized men. Being a blue-collar/low/intermediate white-collar worker and social support were related to increased quality of life. This study may have provided new insights into the experiences of quality of life of victimized men.

  • 18.
    Soares, Joaquim
    et al.
    Karolinska Inst, Stockholm, Sweden.
    Macassa, Gloria
    Karolinska Inst, Stockholm, Sweden.
    Miranda, Jamilette
    Viitasara, Eija
    Mid Sweden Univ, Dept Hlth Sci, Sundsvall, Sweden.
    Health among lifetime victimized men2007Inngår i: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 66, nr 4, s. 351-364Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives. We examined differences in demographics/socio-economics, lifestyles and mental/physical health between victimized/non-victimized men, and identified/quantified factors associated with mental/physical health.Study design. The study design was cross-sectional.Methods. The men were assessed in various areas (e.g., depression) by means of a questionnaire.Results. The univariate analyses showed that victims compared with non-victims were younger. They also had higher intermediate education levels, were more often blue-collar/low white-collar workers, were on student allowances and financially strained, smoked more, had a lower BMI, and reported headaches, depression, tension and cognitive difficulties more frequently. The regression analyses showed that financial strain rather than violence was a more important factor for ill-health. Only headaches and cognitive difficulties were associated with violence.Conclusions. Quite an number of men were in a poor physical/mental state, but there were few differences between victims/non-victims. Financial strain was determined to be a more important factor for ill-health than violence. Our data indicate that violence had little effect on men's health. Our findings do not generally support a relationship between poor health and the abuse of men.

  • 19.
    Yahaya, Ismael
    et al.
    Mid Sweden University, Sundsvall, Sweden, and London School of Hygiene and Tropical Medicine, London, UK .
    Uthman, Olalekan A
    Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, United Kingdom, and Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK .
    Soares, Joaquim
    Mid Sweden University, Sundsvall, Sweden, and Karolinska Institute, Stockholm, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mid Sweden University, Sundsvall, Sweden, and Karolinska Institute, Stockholm, Sweden.
    Social disorganization and history of child sexual abuse against girls in Sub-Saharan Africa: A multilevel analysis2013Inngår i: BMC International Health and Human Rights, E-ISSN 1472-698X, Vol. 13, nr 33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Child sexual abuse (CSA) is a considerable public health problem. Less focus has been paid to the role of community level factors associated with CSA. The aim of this study was to examine the association between neighbourhood-level measures of social disorganization and child sexual abuse CSA.

    Methods

    We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 adolescents from six countries in sub-Saharan Africa between 2006 and 2008.

    Results

    The percentage of adolescents that had experienced CSA ranged from 1.04% to 5.84%. There was a significant variation in the odds of reporting CSA across the communities, suggesting 18% of the variation in CSA could be attributed to community level factors. Respondents currently employed were more likely to have reported CSA than those who were unemployed (odds ratio [OR] = 2.05, 95% confidence interval [CI] 1.48 to 2.83). Respondents from communities with a high family disruption rate were 57% more likely to have reported CSA (OR=1.57, 95% CI 1.14 to 2.16).

    Conclusion

    We found that exposure to CSA was associated with high community level of family disruption, thus suggesting that neighbourhoods may indeed have significant important effects on exposure to CSA. Further studies are needed to explore pathways that connect the individual and neighbourhood levels, that is, means through which deleterious neighbourhood effects are transmitted to individuals.

    Fulltekst (pdf)
    fulltext
  • 20.
    Yahaya, Ismail
    et al.
    Department of Public Health Sciences, Midsweden University, Sweden, and Centre for Evidence-Based Global Health, Nigeria.
    Ponce de Leon, Antonio
    Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Sweden.
    A. Uthman, Olalekan
    Warwick - Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, The University of Warwick, Coven try, CV4 7AL, United Kingdom.
    Soares, Joaquim
    Department of Public Health Sciences, Midsweden University, Sweden, and Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Department of Public Health Sciences, Midsweden University, Sweden, and Division of Social Medicine, Department of Public Health Sciences, Karolinska Institute, Sweden.
    Individual and community-level socioeconomic position and its association with adolescents experience of childhood sexual abuse: a multilevel analysis of sixcountries in Sub-Saharan Africa2013Inngår i: Journal of Injury and Violence Research, ISSN 2008-2053, E-ISSN 2008-4072, Vol. 6, nr 1, s. 21-30Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Childhood sexual abuse (CSA) is a substantial global health and human rights problem and consequently a growing concern in sub-Saharan Africa. We examined the association between individual and community-level socioeconomic status (SES) and the likelihood of reporting CSA.

    METHODS: We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351female adolescents between the ages of 15 and 18 years from six countries in sub-Saharan Africa, between 2006 and 2008.

    RESULTS: About 70% of the reported cases of CSA were between 14 and 17 years. Zambia had the highest proportion of reported cases of CSA (5.8%). At the individual and community level, we found that there was no association between CSA and socioeconomic position. This study provides evidence that the likelihood of reporting CSA cut across all individual SES as well as all community socioeconomic strata.

    CONCLUSIONS: We found no evidence of socioeconomic differentials in adolescents’ experience of CSA, suggesting that adolescents from the six countries studied experienced CSA regardless of their individual- and community-level socioeconomic position. However, we found some evidence of geographical clustering, adolescents in the same community are subject to common contextual influences. Further studies are needed to explore possible effects of countries’ political, social, economic, legal, and cultural impact on Childhood sexual abuse.

    Fulltekst (pdf)
    fulltext
  • 21.
    Yahaya, Ismail
    et al.
    Mid-Sweden University, Sweden.
    Soares, Joaquim
    Mid-Sweden University, Sweden.
    De Leon, Antonio Ponce
    Mid-Sweden University, Sweden.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mid-Sweden University, Sweden.
    A comparative study of the socioeconomic factors associated with childhood sexual abuse in sub-Saharan Africa2012Inngår i: Pan African Medical Journal, E-ISSN 1937-8688, Vol. 11, nr 51, s. 1-8Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Childhood sexual abuse (CSA) is a problem of considerable proportion in Africa where up to one-third of adolescent girls report their first sexual experience as being forced. The impact of child hood sexual abuse resonates in all areas of health. The aim of this study was to describe the prevalence of childhood sexual abuse and variations across socioeconomic status in six sub-Saharan countries. Methods: Datasets from Demographic and Health Surveys (DHS) in six sub-Saharan African countries conducted between 2003 and 2007 were used to access the relationship between CSA and socio economic status using multiple logistic regression models. Results: There was no association between CSA and education, wealth and area of settlement. However, there was contrasting association between CSA and working status of women. Conclusion: This study concurs with other western studies which indicate that CSA transcends across all socio economic group. It is therefore important that effective preventive strategies are developed and implemented that will cross across all socio-economic groups. © Ismail Yahaya et al.

  • 22.
    Zacarias, AE
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Macassa, Gloria
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Soares, Joaquim
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Interpersonal violence against women in Mozambique2011Konferansepaper (Fagfellevurdert)
  • 23.
    Zacarias, Antonio Eugenio
    et al.
    Eduardo Mondlane University, Faculty of Medicine, Maputo, Mozambique.
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Soares, Joaquim J. F
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Svanström, Leif
    Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden.
    Antai, Diddy
    Division of Global Health and Inequalities, The Angels Trust - Nigeria, Abuja, Nigeria.
    Symptoms of depression, anxiety, and somatization in female victims and perpetrators of intimate partner violence in Maputo City, Mozambique2012Inngår i: International Journal of Women's Health, E-ISSN 1179-1411, Vol. 4, s. 491-503Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Little knowledge exists in Mozambique and sub-Saharan Africa about the mental health (symptoms of depression, anxiety, and somatization) of women victims and perpetrators of intimate partner violence (IPV) by type of abuse (psychological aggression, physical assault without/with injury, and sexual coercion). This study scrutinizes factors associated with mental health among women victims and perpetrators of IPV over the 12 months prior to the study.

    Methods and materials: Mental health data were analyzed with bivariate and multiple regression methods for 1442 women aged 15–49 years who contacted Forensic Services at Maputo Central Hospital (Maputo City, Mozambique) for IPV victimization between April 1, 2007 and March 31, 2008.

    Results: In bivariate analyses, victims and perpetrators of IPVs scored higher on symptoms of mental health than their unaffected counterparts. Multiple regressions revealed that controlling behaviors, mental health comorbidity, social support, smoking, childhood abuse, sleep difficulties, age, and lack of education were more important in explaining symptoms of mental health than demographics/socioeconomics or life-style factors. Victimization and perpetration across all types of IPV were not associated with symptoms of mental health.

    Conclusion: In our sample, victimization and perpetration were not important factors in explaining mental ill health, contrary to previous findings. More research into the relationship between women’s IPV victimization and perpetration and mental health is warranted as well as the influence of controlling behaviors on mental health.

  • 24.
    Zacarias, Antonio Eugenio
    et al.
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden, and do Mondlane University, Faculty of Medicine, Maputo City, Mozambique .
    Macassa, Gloria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för arbets- och folkhälsovetenskap, Folkhälsovetenskap. Mittuniversitetet, Institutionen för hälsovetenskap.
    Svanström, Leif
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
    Soares, Joaquim JF
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden, and Department of Health Sciences, Division of Public Health Sciences, Mid Sweden University, Sundsvall, Sweden .
    Antai, Diddy
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden, and Center for Global & Population Health, The Angels Trust Nigeria, Abuja, Nigeria .
    Intimate partner violence against women in Maputo city, Mozambique2012Inngår i: BMC International Health and Human Rights, E-ISSN 1472-698X, Vol. 12, nr 1, artikkel-id 35Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    There is limited research about IPV against women and associated factors in Sub-Saharan Africa, not least Mozambique. The objective of this study was to examine the occurrence, severity, chronicity and "predictors" of IPV against women in Maputo City (Mozambique).

    Methods

    Data were collected during a 12 month-period (consecutive cases, with each woman seen only once) from 1,442 women aged 15--49 years old seeking help for abuse by an intimate partner at the Forensic Services at the Maputo Central Hospital, Maputo City, Mozambique. Interviews were conducted by trained female interviewers, and data collected included demographics and lifestyle variables, violence (using the previously validated Revised Conflict Tactics Scale (CTS2), and control (using the Controlling Behaviour Scale Revised (CBS-R). The data were analysed using bivariate and multivariate methods.

    Results

    The overall experienced IPV during the past 12 months across severity (one or more types, minor and severe) was 70.2% (chronicity, 85.8 +/- 120.9).a Severe IPV varied between 26.3-45.9% and chronicity between 3.1 +/- 9.1-12.8 +/- 26.9, depending on IPV type. Severity and chronicity figures were higher in psychological aggression than in the other IPV types. Further, 26.8% (chronicity, 55.3 +/- 117.6) of women experienced all IPV types across severity. The experience of other composite IPV types across severity (4 combinations of 3 types of IPV) varied between 27.1-42.6% and chronicity between 35.7 +/- 80.3-64.9 +/- 110.9, depending on the type of combination. The combination psychological aggression, physical assault and sexual coercion had the highest figures compared with the other combinations.. The multiple regressions showed that controlling behaviours, own perpetration and co-occurring victimization were more important in "explaining" the experience of IPV than other variables (e.g. abuse as a child).

    Conclusions

    In our study, controlling behaviours over/by partner, own perpetration, co-occurring victimization and childhood abuse were more important factors in "explaining" sustained IPV. More investigation into women's IPV exposure and its "predictors" is warranted in Sub-Saharan Africa, particularly Mozambique.

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