Slobodan Zdravkovic

Factors associated with changes in quality of life in patients undergoing allogeneic haematopoietic stem cell transplantation.

It is well known that patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) experience changes in quality of life. We investigated factors associated with quality of life changes in adult HSCT patients. The Functional Assessment of Cancer Therapy - Bone Marrow Transplantation (FACT-BMT) scale, supplemented with the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being (FACIT-Sp) subscale, was administered on three occasions, immediately before transplantation, 100 days and 12 months after transplantation. Analyses of nine selected factors were made where changes in quality of life were found. Seventy-five patients were included and 40 of these completed the study. Emotional well-being was found to improve between the baseline and 100 days, while all other dimensions deteriorated, including overall quality of life. Physical and social/family well-being deteriorated between the baseline and the 12-month follow-up, while emotional well-being improved. The main factors associated with deteriorating quality of life over time were found to be significant infections, female gender and transplantation with stem cells from a sibling donor. In our further studies we aim to focus on the relationships between patients and sibling donors in order to improve the care. Careful attention must be paid to continuous adequate information during the transplantation procedure.

Incidence of myocardial infarction among Swedish and immigrant smoking women: Can physical activity modify the risk? An epidemiological study on the Malmö Diet and Cancer study

Background: Sweden has shown a decreasing tendency in the incidence of myocardial infarction (MI), except among middle-aged women. The incidence among middle-aged immigrant women is less explored. Aim: To determine if foreign-born women have a higher risk of MI as compared to women born in Sweden. Furthermore, to examine if physical activity (PA) modifies the risk of MI regardless of immigration status and smoking habits. Methods: The Malmö Diet and Cancer Study was used for analyses. A total of 16,776 women aged 45–73 years participated. The mean follow-up time was 13.8±4 years. Results: Mean age was 57.4±7.9 years. No difference was found in incidence of MI between Swedish and immigrant women (p=0.72). For current smokers among Swedish women, the relative risk (RR) with no/low PA was 2.93 (95% CI 2.07–4.14) and with moderate/high PA, the RR was 2.21 (95% CI 1.61–3.03) with no/low PA-never smoker as the reference group. Among immigrant smoking women, the RR with no/low PA was 4.56 (95% CI 1.62–12.8) and with moderate/high PA, the RR was 3.27 (95% CI 1.21–8.84) with no/low PA-never smoker as the reference group. Conclusions: PA reduces the risk of MI in non-smokers as well as in smokers, regardless of immigration status. Furthermore, PA was even more beneficial for women born outside Sweden. Against this background, immigrant women ought to get special consideration and attention from both caregivers and public health workers.

Crowded living and its association with mental ill-health among recently-arrived migrants in Sweden: a quantitative study

ObjectiveHousing and neighbourhood conditions are widely acknowledged important social determinants of health and health inequalities that persist in developed countries despite general improvements in health outcomes across populations. Previous research has investigated what effect crowded living conditions have on mental health and concluded that women living in crowded conditions were more likely to suffer from depression. In contrast, men living in the same conditions responded with withdrawal or aggression. To the best of our knowledge, only a few studies have examined the association between recently-arrived migrants living in crowded conditions and poor mental health. The aim of this study was to investigate the association between crowded living conditions among recently-arrived migrants in Sweden and mental ill-health. The result is based on 681 migrants who completed and returned questionnaires in 2015–2016.ResultsThe analyses, independent of gender, resulted in a significant unadjusted odds ratio of 1.46 (95% CI 1.05–2.03); even after adjustments were made, the association remained significant OR 1.47 (1.05–2.07). When adding stability in housing into the adjustment-model, the OR did not remain significant OR 1.40 (0.99–1.99), P-value 0.061.