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Macassa, Gloria
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Abbasi, S. H., Sundin, Ö., Jalali, A., Soares, J. & Macassa, G. (2018). Ethnic differences in the risk factors and severity of coronary artery disease: a patient-based study in Iran. Journal of Racial and Ethnic Health Disparities, 5(3), 623-631
Open this publication in new window or tab >>Ethnic differences in the risk factors and severity of coronary artery disease: a patient-based study in Iran
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2018 (English)In: Journal of Racial and Ethnic Health Disparities, ISSN 2197-3792, Vol. 5, no 3, p. 623-631Article in journal (Refereed) Published
Abstract [en]

Background Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.

Methods In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.

Results The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).

Conclusions This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2018
Keywords
Health status disparities, Ethnicity, Coronary heart disease, Iran
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-31406 (URN)10.1007/s40615-017-0408-3 (DOI)000439352900021 ()28776137 (PubMedID)2-s2.0-85026809542 (Scopus ID)
Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2019-03-25Bibliographically approved
Begum, A., Viitasara, E., Soares, J., Rahman, A. F. & Macassa, G. (2018). Parental socio-economic position and suicidal ideation among adolescents in Rural Bangladesh. Journal of Psychiatry and Behavioral Sciences (4), Article ID 1018.
Open this publication in new window or tab >>Parental socio-economic position and suicidal ideation among adolescents in Rural Bangladesh
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2018 (English)In: Journal of Psychiatry and Behavioral Sciences, ISSN 2637-8027, no 4, article id 1018Article in journal (Refereed) Published
Abstract [en]

Background:  Suicide is a leading cause of death worldwide and becoming a public health concern among adolescents. However, adolescent suicidal behaviour is a neglected public health issue, especially in low-income countries such as Bangladesh. Of great importance is the understanding of which factors might be related to this growing public problem. 

Objective: To examine the relationship between parental socio-economic position and suicide ideation among adolescents in rural Bangladesh

Methods: A cross-sectional survey was conducted in 2013 among 2,476 adolescents, aged 14-19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district, which is a surveillance area of the Centre for Injury Prevention and Research, Bangladesh (CIPRB).

Descriptive statistics and binary logistic regression analyses were used to analyze the data. Comparisons of proportions between groups were carried out using the χ2 test. Multivariate logistic regression analysis was used to examine the relationship between parental co-variants and suicidal thoughts among adolescents. The significance level was set atp <0.05. All analyses were performed using SPSS 20.

Results: The majority of parents had education only up to primary school (mothers 58.7% and fathers 49.5%). Most of them were farmers (53.3% of fathers) and housewives (96.5% of mothers). Monthly income and expenditure of the adolescent’s parents were mainly upto 10,000 taka only. Suicidal ideation is more common among adolescents of low income group parents 104 (5.5%) and who were not living with their parents 18 (8.2%). Adolescent’s suicidal ideation was found to be significantly associated with education, marital status and house ownership of their parents. Not being able to live with their parents was also a significant factor. Parents who received education up to SSC had odds ratio of 2.10 (1.21,3.64) and 1.92 (1.15, 3.23) for mothers and fathers respectively. Parent’s income or expenditure was not associated with adolescent’s suicidal ideation. Adolescent’s suicidal ideation of single parents had higher odds (OR 3.00, CI 1.75-5.19) in comparison to adolescents who had both parents. Adolescents whose parents owned a house and who weren’t living withtheir parents had odds ratios of 0.14 (0.05,0.35), and 1.80 (1.07,3.03) respectively. After adjusting for other covariates parents’ marital status and house ownership significantly associated with the adolescent suicide ideation.

Conclusion: Parental socio-economic position was associated with suicidal ideation. Adolescent with single parents were more likely to report suicidal ideation. Low parental education and socio-economic status, marital status, house ownership, not living with parents at home as well as adolescent loneliness were the important factors for suicidal ideation.

Keywords
Parents; Socio-economic; Suicidal ideation; Rural; Adolescents
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-36045 (URN)10.33582/2637-8027/1018 (DOI)
Projects
Suicide ideation among adolescents in Rural Bangladesh
Note

Open Access/ Research Article

Available from: 2019-04-25 Created: 2019-04-25 Last updated: 2019-05-07Bibliographically approved
Hiswåls, A.-S., Walander, A., Soares, J. & Macassa, G. (2017). Employment Status, Anxiety and Depression in a Municipal Context. Research in Health Science, 2(1)
Open this publication in new window or tab >>Employment Status, Anxiety and Depression in a Municipal Context
2017 (English)In: Research in Health Science, ISSN 2470-6213, Vol. 2, no 1Article in journal (Refereed) Published
Abstract [en]

Objectives: This  study  aimed  to  investigate  the  prevalence  of  anxiety  and  depression  by  employment status among a sample of the working age population residing in Gävle Municipality in Sweden.

Methods:  A  total  of  241  persons  completed  a  self-administered  postal  questionnaire  in  the  baseline survey  of  the  Gävle  Household,  Labour  Market  and  Health  Outcomes  (GHOLDH)  survey,  which collected  information  on  the  employment  status  and  psychological  health  (anxiety  and  depression) among persons aged 18-65 years. Descriptive and multivariate analyses were performed.

Results:  The  prevalence  and  risk  of  anxiety  and  depression  were  high  among  people  who  were  out  of work. In the multiple regression analysis, compared to employed people, those who were not employed had a risk of anxiety of 7.76 (5.97-9.75) and 4.67 (3.60-5.74) for depression.

Conclusion: The prevalence of anxiety and depression was higher among those who were out of labour marketas compared to those employed. Furthermore, people who were out of work had a higher risk of anxiety and depression. The odds were slightly higher for anxiety than for depression.

Keywords
Gävle, employment status, anxiety, depression
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-30394 (URN)10.22158/rhs.v2n1p12 (DOI)
Available from: 2017-03-06 Created: 2017-03-06 Last updated: 2019-01-31Bibliographically approved
Macassa, G., Bergström, H., Malstam, E., Hiswåls, A.-S., Soares, J., Ahmadi, N. & Marttila, A. (2017). Experiences of employment precariousness and psychological well-being in east central Sweden. Health Science Journal, 11(2)
Open this publication in new window or tab >>Experiences of employment precariousness and psychological well-being in east central Sweden
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2017 (English)In: Health Science Journal, ISSN 1108-7366, Vol. 11, no 2Article in journal (Refereed) Published
Abstract [en]

Background: In the past decade, temporary employment arrangements, including fixed-term and sub-contracted jobs, as well as project work, on-call work and work via temporary-help agencies have increased in developed countries, including Sweden. The objective of this study was to explore precariously employed individuals’experiences and perceptions of employment strain and its effect on their psychological well-being in Gävleborg County, Sweden.

Methods: Semi-structured interviews were conducted with 16 respondents residing in Gävleborg County about their experiences of precarious employment and their perceptions of the relationship between their precarious employment and psychological well-being. Thematic analysis was conducted to relate the results to the employment strain framework.

Results: The main theme to emerge in the data was managing stress. Respondent’s perceived significant stress related to keeping employment as well as having future work. In addition, they had difficulties in coping with everyday life because of economic strain, lack of work opportunities and isolation.

Conclusions: The results of this study highlight how precariously employed individuals are unable to cope with the stress related to uncertainty in maintaining their current work or having control of their working hours. In addition, the results indicate that precariously employed workers experience economic strain related to income uncertainty, which affects their ability to cope with dailylife.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-30643 (URN)10.21767/1791-809X.1000491 (DOI)
Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2018-03-23Bibliographically approved
Hiswåls, A.-S., Marttila, A., Mälstam, E. & Macassa, G. (2017). Experiences of unemployment and well-being after jobb loss during economic recession: results of a qualitative study in East Central Sweden. Journal of Public Health Research, 6(3), 135-141
Open this publication in new window or tab >>Experiences of unemployment and well-being after jobb loss during economic recession: results of a qualitative study in East Central Sweden
2017 (English)In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 6, no 3, p. 135-141Article in journal (Refereed) Published
Abstract [en]

Introduction: Several studies have revealed an association between unemployment and ill health, and shown that unemployment can affect people differently. This study aimed to provide an understanding of the experiences of unemployment and perceptions of wellbeing among persons who involuntary lost their work during the recent economic recession in Gävle Municipality. Methods: Sixteen unemployed men and women aged 28-62 were interviewed face-to-face. A purposeful sampling strategy was used in order to suit the research question and to increase the variation among informants. The interview texts were analysed using thematic analysis. Results: Six different themes emerged from the accounts: The respondents perceived work as the basis for belonging, and loss of work affected their social life and consumption patterns due to changes in their financial situation. They also expressed feelings of isolation, loss of self-esteem, and feelings of hopelessness, which affected their physical well-being. Longer duration of unemployment increased the respondents’ negative emotions. The respondents reported activities, structure, and affiliation in other contexts as part of their coping strategy against poor mental health. Conclusions: After job loss, the respondents experienced feelings of loss of dignity and belonging as a human being. They also felt worry, insecurity, and stress due to their changed financial situation, which in turn led to isolation and loss of self-esteem. Social support and having other activities gave the respondents structure and meaning.

Keywords
Out of work, perceived wellbeing, qualitative approach, recession time
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32006 (URN)10.4081/jphr.2017.995 (DOI)000440723600002 ()2-s2.0-85038114572 (Scopus ID)
Available from: 2017-11-03 Created: 2017-11-03 Last updated: 2018-08-17Bibliographically approved
Macassa, G., Winersjö, R., Wijik, K., Magrath, C., Ahmadi, N. & Soares, J. (2017). Fear of crime and its relationship with self-reported health and stress among men. Journal of Public Health Research, 6(3), 169-174
Open this publication in new window or tab >>Fear of crime and its relationship with self-reported health and stress among men
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2017 (English)In: Journal of Public Health Research, ISSN 2279-9028, E-ISSN 2279-9036, Vol. 6, no 3, p. 169-174Article in journal (Refereed) Published
Abstract [en]

Background: Fear of crime is a growing social and public health problem globally, including in developed countries such as Sweden. This study investigated the impact of fear of crime on self-reported health and stress among men living in Gävleborg County.Design and Methods: The study used data collected from 2993 men through a cross sectional survey in the 2014 Health in Equal Terms survey. Descriptive and logistic regression analyses were carried out to study the relationship between fear of crime and self-reported health and stress. Results: There was a statistically significant association between fear of crime and self-reported poor health and stress among men residing in Gävleborg County. In the bivariate analysis, men who reported fear of crime had odds of 1.98 (CI 1.47- 2.66) and 2.23 (CI 1.45-3.41) respectively. Adjusting for demographic, social and economic variables in the multivariate analysis only reduced the odds ratio for self-reported poor health to 1.52 (CI 1.05-2.21) but not for self-reported stress with odds of 2.22 (1.27-3.86). Conclusions: Fear of crime among men was statistically significantly associated with self-reported poor health and stress in Gävleborg County. However, the statistically significant relationship remained even after accounting for demographic, social and economic factors, which warrants further research to better understand the role played by other variables.

Keywords
Fear of crime, men, self-reported health and stress, Gävleborg County
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-32093 (URN)10.4081/jphr.2017.1010 (DOI)000440723600007 ()2-s2.0-85052228321 (Scopus ID)
Available from: 2017-11-17 Created: 2017-11-17 Last updated: 2018-10-03Bibliographically approved
Eslami, B., Macassa, G., Melchiorre, M. G., Barros, H., Viitasara, E., Lindert, J., . . . Soares, J. J. .. (2017). Life-time abuse and mental health among older persons: a European study. Journal of Aggression, Maltreatment & Trauma, 26(6), 590-607
Open this publication in new window or tab >>Life-time abuse and mental health among older persons: a European study
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2017 (English)In: Journal of Aggression, Maltreatment & Trauma, ISSN 1092-6771, E-ISSN 1545-083X, Vol. 26, no 6, p. 590-607Article in journal (Refereed) Published
Abstract [en]

This study aimed to investigate the association of lifetime abuse and mental health among older persons, considering associated factors (e.g., demographics) through a cross-sectional design. We recruited 4,467 women and men ages 60–84 years from 7 European cities. Mental health was measured with the Hospital Anxiety and Depression Scale, and abuse (psychological, physical, sexual, financial, and physical injuries) based on the Revised Conflict Tactics Scale and the UK survey of abuse/neglect of older people. Multiple logistic regression analyses showed that country of residence, low educational level, and experienced financial strain increased the odds of probable cases of anxiety and depression. Female sex, white-collar profession, and financial support by social/other benefits/or partner income were associated with higher odds of anxiety, while older age and experience of lifetime injury were associated with increased odds of depressive symptoms. The findings of this study indicate that socioeconomic factors, as well as experienced lifetime severe physical abuse leading to injuries, are significant in perceived mental health of adults in later life.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-30084 (URN)10.1080/10926771.2017.1330295 (DOI)000409344800002 ()2-s2.0-85021064195 (Scopus ID)
Available from: 2017-02-09 Created: 2017-02-09 Last updated: 2017-10-23Bibliographically approved
Fraga, S., Soares, J. J. .., Melchiorre, M., Barros, H., Eslami, B., Ioannidi-Kapolou, E., . . . Viitasara, E. (2017). Lifetime Abuse and Quality of Life among Older People. Health & Social Work, 42(4), 215-222
Open this publication in new window or tab >>Lifetime Abuse and Quality of Life among Older People
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2017 (English)In: Health & Social Work, ISSN 0360-7283, E-ISSN 1545-6854, Vol. 42, no 4, p. 215-222Article in journal (Refereed) Published
Abstract [en]

Few studies have evaluated the impact of lifetime abuse on quality of life (QoL) among older adults. By using a multinational study authors aimed to assess the subjective perception of QoL among people who have reported abuse during the course of their lifetime. The respondents (N = 4,467; 2,559 women) were between the ages of 60 and 84 years and living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain, and Sweden). Lifetime abuse was assessed by using a structured questionnaire that allowed to assess lifetime experiences of abuse. QoL was assessed with the World Health Organization Quality of Life–Old module. After adjustment for potential confounders, authors found that to have had any abusive experience decreased the score of sensory abilities. Psychological abuse was associated with lower autonomy and past, present, and future activities. Physical abuse with injuries significantly decreased social participation. Intimacy was also negatively associated with psychological abuse, physical abuse with injury, and sexual abuse. The results of this study provide evidence that older people exposed to abuse during their lifetime have a significant reduction in QoL, with several QoL domains being negatively affected.

Keywords
abuse, aging, quality of life, violence
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-29163 (URN)10.1093/hsw/hlx036 (DOI)000414389500004 ()29025015 (PubMedID)2-s2.0-85034853034 (Scopus ID)
Projects
ABUEL
Available from: 2016-10-29 Created: 2016-10-29 Last updated: 2018-01-19Bibliographically approved
Begum, A., Rahman, A. F., Rahman, A., Soares, J., Khankeh, H. R. & Macassa, G. (2017). Prevalence of suicide ideation among adolescents and young adults in Bangladesh. International Journal of Mental Health, 46(3), 177-187
Open this publication in new window or tab >>Prevalence of suicide ideation among adolescents and young adults in Bangladesh
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2017 (English)In: International Journal of Mental Health, ISSN 0020-7411, E-ISSN 1557-9328, Vol. 46, no 3, p. 177-187Article in journal (Refereed) Published
Abstract [en]

Suicide is a leading cause of death world-wide. However, adolescent suicidal behavior is a neglected public health issue, especially in low-income countries such as Bangladesh. The study was conducted to estimate the prevalence of suicidal ideation among adolescents in a rural community and to examine factors associated with suicidal ideation. A cross-sectional survey was carried out in 2013 among 2,476 adolescents aged 14–19 years, selected randomly from a rural community of Bangladesh. An adapted version of the WHO/SUPRE-MISS questionnaire was used to collect data in the Raiganj sub-district. A two stage screening was performed to identify the suicidal ideation cases. It was found that the life-time prevalence for suicidal ideation was 5 percent among adolescents. The majority of the adolescents with suicidal ideation were females 66 (52.8%), unmarried 103 (82.4%), and students 92 (73%). Suicidal ideation was statistically significantly associated with age, education, occupation, living with parents or others, and house ownership. Respondents who were aged 18–19 years, had secondary school certificate (SSC) and secondary school certificate (HSC) or higher education, were day laborers, had own house, and do not lived with parents had odds ratios of 2.31 (CI 1.46–3.65), 2.38 (CI 1.51–3.77), 4.15 (CI 2.41–7.14), 0.28 (CI 0.13–0.60), 0.14(CI 0.05–0.35), and 1.80 (CI 1.07–3.03), respectively. Among adolescents, the prevalence of life-time suicidal ideation was moderately high. Age, education, occupation, house ownership, and living with parents were statistically significantly associated with suicidal ideation. It is important to design and implement effective community based suicide prevention programs for adolescents in Bangladesh.

Keywords
Adolescents, rural, suicidal ideation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-30597 (URN)10.1080/00207411.2017.1304074 (DOI)000416758800003 ()2-s2.0-85017473895 (Scopus ID)
Available from: 2017-04-14 Created: 2017-04-14 Last updated: 2017-12-21Bibliographically approved
Melchiorre, M. G., Di Rosa, M., Lamura, G., Torres-Gonzales, F., Lindert, J., Stankunas, M., . . . Soares, J. J. F. (2016). Abuse of Older Men in Seven European Countries: a Multilevel Approach in the Framework of an Ecological Model. PLoS ONE, 11(1), 1-28, Article ID e0146425.
Open this publication in new window or tab >>Abuse of Older Men in Seven European Countries: a Multilevel Approach in the Framework of an Ecological Model
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 1, p. 1-28, article id e0146425Article in journal (Refereed) Published
Abstract [en]

BackgroundSeveral studies on elder abuse indicate that a large number of victims are women, but others report that men in later life are also significantly abused, especially when they show symptoms of disability and poor health, and require help for their daily activities as a result. This study focused on the prevalence of different types of abuse experienced by men and on a comparison of male victims and non-victims concerning demographic/socio-economic characteristics, lifestyle/health variables, social support and quality of life. Additionally, the study identified factors associated with different types of abuse experienced by men and characteristics associated with the victims.MethodsThe cross-sectional data concerning abuse in the past 12 months were collected by means of interviews and self-response during January-July 2009, from a sample of 4,467 not demented individuals aged between 60–84 years living in seven European countries (Germany, Greece, Italy, Lithuania, Portugal, Spain and Sweden). We used a multilevel approach, within the framework of an Ecological Model, to explore the phenomenon of abuse against males as the complex result of factors from multiple levels: individual, relational, community and societal.ResultsMultivariate analyses showed that older men educated to higher levels, blue-collar workers and men living in a rented accommodation were more often victims than those educated to lower levels, low-rank white-collar workers and home owners, respectively. In addition, high scores for factors such as somatic and anxiety symptoms seemed linked with an increased probability of being abused. Conversely, factors such as increased age, worries about daily expenses (financial strain) and greater social support seemed linked with a decreased probability of being abused.ConclusionsMale elder abuse is under-recognized, under-detected and under-reported, mainly due to the vulnerability of older men and to social/cultural norms supporting traditional male characteristics of stoicism and strength. Further specific research on the topic is necessary in the light of the present findings. Such research should focus, in particular, on societal/community aspects, as well as individual and family ones, as allowed by the framework of the Ecological Model, which in turn could represent a useful method also for developing prevention strategies for elder abuse.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-26662 (URN)10.1371/journal.pone.0146425 (DOI)000368528400036 ()2-s2.0-84958205951 (Scopus ID)
Available from: 2015-12-18 Created: 2015-12-18 Last updated: 2017-12-01Bibliographically approved
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