Metabolite profiling paradoxically reveals favorable levels of lipids, markers of oxidative stress and unsaturated fatty acids in a diabetes susceptible group of Middle Eastern immigrants.

AIMS: The population of immigrants from the Middle East in Sweden show a higher prevalence of type 2 diabetes (T2D) compared to native Swedes. The exact reason for this is unknown. Here, we have performed metabolite profiling to investigate these differences. METHODS: Metabolite profiling was conducted in Iraqi immigrants (n = 93) and native Swedes (n = 77) using two complementary mass spectrometry-based platforms. Differences in metabolite levels were compared after adjustment for confounding anthropometric, diet and clinical variables. RESULTS: The Iraqi immigrant population were more obese (44.1 vs 24.7%, p < 0.05), but had a lower prevalence of hypertension (32.3 vs 54.8%, p < 0.01) than the native Swedish population. We detected 140 metabolites, 26 of which showed different levels between populations (q < 0.05,) after adjustment for age, sex, BMI, T2D and use of metformin. Twenty-two metabolites remained significant after further adjustment for HOMA-IR, HOMA-beta or insulin sensitivity index. Levels of polyunsaturated acylcarnitines (14:2 and 18:2) and fatty acid (18:2) were higher, whereas those of saturated and monounsaturated acylcarnitines (14:0, 18:1, and 8:1), fatty acids (12:0, 14:0, 16:0, and 18:1), uremic solutes (urate and quinate) and ketone bodies (beta-hydroxybutyrate) were lower in Iraqi immigrants. Further, levels of phospholipids were generally lower in the Iraqi immigrant population. CONCLUSIONS: Our result suggests an overall beneficial lipid profile in Iraqi immigrants, despite a higher risk to develop T2D. Higher levels of polyunsaturated fatty acids may suggest differences in dietary pattern, which in turn may reduce the risk of hypertension.

Conceptions of transgender parenthood in fertility care and family planning in Sweden: from reproductive rights to concrete practices.

It is an oft-repeated trope that the recent medical advances in the field of assisted reproduction have radically transformed the ways in which we can achieve, practice and imagine parenthood. This development has enabled new forms of non-heterosexual family constellations, including same-sex nuclear families and solo-parents by choice, and as a result an increasing number of groups are mobilising politically for access to fertility treatments. Swedish transgender patients are one of these groups; after many years of political mobilisation, they are no longer required by law to go through sterilisation as a compulsory part of gender corrective surgery, and instead today, all transgender patients are offered fertility preservation through gamete freezing. This, in turn, has meant not only that Swedish fertility clinics have faced an entirely new patient group - the transgender fertility patient - but also that the cultural imagination of who can become a parent and what a family might look like is becoming further destabilised. Building on interviews with medical staff, LGBTQ-advocates and complementing qualitative data, this paper seeks to shed light on the very process by which these new rights are translated in the practical context of the fertility clinic, and also what it means, more generally, for cultural imaginations of parenting when a group whose reproductive futures were previously considered either impossible or undesirable are now 'anticipating infertility' and engaging in 'family planning' as central parts of their lifecourse and medical engagements.

Traditional folk beliefs on epilepsy in Norway and Sweden.

In Norway and Sweden, epilepsy has for many centuries been considered a strange and mysterious disease. The explanations of its causes have been many and imaginative. One being that epilepsy was caused by the hidden people inhabiting the woods and the mountains. To avoid the disease, these hidden people should not be annoyed. One commonly used treatment principle was to try to place the disease back to the ground, or passing the diseased through a hole or an opening in the nature. Fresh blood from criminals was also considered to have strong antiepileptic properties. In the Scandinavian countries, some of these folk beliefs have been very tenacious.

Long-term adherence and effects on grip strength and upper leg performance of prescribed supplemental vitamin D in pregnant and recently pregnant women of Somali and Swedish birth with 25-hydroxyvitamin D deficiency: a before-and-after treatment study.

BACKGROUND: Muscular weakness and severe vitamin D deficiency is prevalent in Somali (veiled) pregnant women, Sweden. The study aims here were to explore adherence to prescribed supplemental vitamin D in new mothers with vitamin D deficiency and its effects on grip strength and upper leg performance in Somali (target group TG) and Swedish women (reference group RG) from spring through winter. METHODS: A before- and after study was designed. A cross-sectional sample of women in antenatal care with serum 25-OHD ≤50 nmol/L were prescribed one or two tablets daily (800 or 1600 IU vitamin D3 with calcium) for 10 months. Reminders were made by Somali nurses (TG) or Swedish doctors (RG). Baseline and 10 month measurements of plasma nmol/L 25-OHD, maximal grip strength held for 10 s (Newton, N) and ability to squat (yes;no) were done. Total tablet intake (n) was calculated. Outcome variables were changes from baseline in grip strength and ability to squat. Predicting variables for change in grip strength and ability to squat were calculated using linear and binary regression in final models. Undetectable 25-OHD values (<10 nmol/L) were replaced with '9' in statistic calculations. RESULTS: Seventy-one women (46 TG, 1/3 with undetectable baseline 25-OHD; 25 RG) participated. At the 10-month follow up, 17% TG and 8% RG women reported having refrained from supplement. Mean 25-OHD increased 16 to 49 nmol/L (TG) and 39 nmol/L to 67 nmol/L (RG), (both p < 0.001). Grip strength had improved from 153 to 188 N (TG) (p < 0.001) and from 257 to 297 N (RG) (p = 0.003) and inability to squat had decreased in TG (35 to 9, p < 0.001). Intake of number of tablets predicted increased grip strength (B 0.067, 95%CI 0.008-0.127, p = 0.027). One tablet daily (>300 in total) predicted improved ability to squat (OR 16; 95% CI 1.8-144.6). CONCLUSIONS: Adherence to supplemental vitamin D and calcium should be encouraged as an even moderate intake was associated to improved grip strength and upper leg performance, which was particularly useful for the women with severe 25-OHD deficiency and poor physical performance at baseline. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02922803 . Date of registration: September 28, 2016.

The first historical movements of kinesiology: scientification in the borderline between physical culture and medicine around 1850.

The kinesiology concept is used worldwide and by many different professional groups with scientific aspirations. Yet nobody seems to know much about where it comes from and why it came into existence. This article traces the origins of the concept back to one of Sweden's greatest cultural exports of the nineteenth century - Swedish gymnastics - and the efforts of especially Swedish physiotherapists and physical educators to spread its scientific doctrines throughout the world. Primarily their goal was to convert the representatives of conventional medicine (pharmacology) into a more mechanical mode of understanding and curing illness (physiotherapy). While following in the footsteps of one physiotherapist/physical educator -'the father of kinesiology'- and examining the ideological and historical conditions his so-called 'mission' was ruled by, the social construction of knowledge and science is made visible in a way seldom highlighted in the history of medicine and physical education.

Use of complementary, non-pharmacological pain reduction methods during childbirth among foreign-born and Swedish-born women.

OBJECTIVE: to investigate the association between country of origin of women and their use of complementary pain reduction methods (i.e. non-pharmacological) during childbirth in Sweden. DESIGN: cross-sectional design. SETTING: a national register-based study. PARTICIPANTS: 215,497 singleton deliveries (including the first birth of each woman during the period) of women aged 18-47 years in Sweden between 1996 and 1998, divided into 12 subgroups of countries or regions. MEASUREMENTS: the use of complementary pain reduction methods during childbirth was analysed by logistic regression, adjusting for parity, level of education, number of antenatal care visits, complications in pregnancy, complications during childbirth, use of any pharmacological methods and use of epidural/spinal analgesia during childbirth. FINDINGS: all subgroups of foreign-born women, except those from Finland, had lower odds of complementary pain reduction methods during childbirth than Swedish-born women. Women from Bosnia, Arab countries, Sub-Saharan Africa, Turkey, Iran and Asia had about 40% lower odds for use of complementary pain reduction methods during childbirth than Swedish-born women. Women who used epidural analgesia had higher odds for use of complementary pain reduction methods during childbirth than women who did not use any pharmacological methods. KEY CONCLUSION: most subgroups of foreign-born women showed lower odds for and a different pattern in the use of complementary pain reduction methods during childbirth than Swedish-born women. These findings raise questions of whether the Swedish health-care system and care providers have sufficient awareness of and insight into the socio-cultural context of giving birth.

[A description of a Swedish midwifery work environment in an assistance project in West africa]. / En beskrivning av en svensk barnmorskas arbetsmiljö inom ett biståndsprojekt i västafrika.

PIP: The routine daily consultation in the health post of 1 of 10 project villages for pregnant women and children under age 5 is interrupted by a call to an emergency delivery which ends up with the birth of a baby girl weighing 2100 g who is named after the author. Under the project funded by SIDA, Stockholm, a local village committee was elected to open a dispensary which became well-attended. Due to visits to another nearby village, the number of children checked increased to 263 instead of the previous number of 147 per month. The weight status of children was worsening despite vaccination and nutritional advice, because women worked in the fields without taking a meal break for their children. After advising that several meals a day were needed, the children gained weight in the following months. A lecture by the project doctor to representatives of surrounding villages about the safety of delivery in the dispensary or the hospital elicited a positive response to send pregnant women there for delivery. The number of institutional deliveries had already increased from 249 in 1986 to 433 in 1989. Working in a developing country required preliminary preparations, French and English language study, a 4-week cultural orientation course organized by the International Child Health Unit, and reading professional books on obstetrics and gynecology in such countries.^ieng

Population studies in northern Sweden. XVII. Estimates of Finnish and Saamish influence.

The North-Swedish population is a mixture of Finnish, Saamish and Central-Swedish ethnic groups. We have studied the Finnish and Saamish admixture by means of genetic markers in 23 North-Swedish subpopulations. The Finnish influence was estimated using the transferrin genes B0-1, DCHI and C3 and the enzyme gene SOD1*2, and markers for Saamish influence were the blood group gene ABO*A2, the serum group gene GC*1F and the enzyme gene 6PGD*C. In the subpopulations the Finnish influence (admixture) varied between 0 and 84% and the Saamish influence between 0 and 34%. The Saamish influence was strongest in the western and northern parts of the area. In the northern part of the area, between 1/4 and 1/3 of the gene pool of the present-day population may be Saamish in origin. The Finnish influence was strongest in the northern and northeastern parts of the area. In the subpopulations along the Finnish border, between 60 and 80% of the gene pool may be Finnish in origin. Significant correlations were found between the Saamish marker genes and between the Finnish marker genes. Due to geographical overlapping of Finnish and Saamish influence, significant correlations were also found between Finnish and Saamish marker genes. The geographical pictures of Saamish and Finnish influence in northern Sweden showed a fair agreement with the expectations derived from historical knowledge. Although a substantial part of the genetic heterogeneity of the North-Swedish population is ethnic in origin, it is obvious that founder effect and genetic drift also have played an important role.

[A community project in India]. / Ett byprojekt i Indien.

PIP: A report is given of a visit to an Indian village community project which is supported by a small Swedish foundation. The project was started about 40 years ago by a female relative of Mahatma Gandhi. The community is a small village of about 2000 inhabitants and consists of an irrigated agricultural project, a school through 10th grade, a small hospital, a home for 140 poor or orphan girls and a nursery. The program employs 12 community health workers who have some healthcare training. Each worker cares for 200-250 households and usually knows his/her families well. Primary emphasis is on care of children which includes help with nutrition and a vaccination program. For every 4 community health workers there is an auxiliary nurse midwife who has 3 years special training following 10th grade. The midwives check up on pregnant women once a month through the 7th month, 2 visits in the 8th month and once/week in the 9th month. Undernourishment and anemia are the most common problems of pregnancy. Children are often born in the parents' home without any trained obstetric help. In spite of this, maternal mortality is very low. Even infection from childbirth is extremely rare. The visitor was particularly impressed by the respect and affection everyone in the village showed for children and for each other.^ieng