| 21. |
- Sandström, Agneta, 1959-, et al.
(författare)
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Cognitive deficits in relation to personality type and hypothalamic-pituitary-adrenal (HPA) axis dysfunction in women with stress-related exhaustion
- 2011
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Ingår i: Scandinavian Journal of Psychology. - Oxford : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 52:1, s. 71-82
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Tidskriftsartikel (refereegranskat)abstract
- Exhaustion caused by long-term work-related stress may cause cognitive dysfunction. We explored factors that may link chronic stress and cognitive impairment. Personality, psychiatric screening, and behavior were assessed by self-reporting measures in 20 female patients (mean age 39.3 years; range 26–53) with a preliminary diagnosis of stress-related exhaustion and in 16 healthy matched controls. Cognitive performance was investigated with a detailed neuropsychological test battery. Cortisol axis function was assessed by urinary and saliva collections of cortisol, dexamethasone suppression, Synacthen response, and corticotropin-releasing hormone (CRH) tests. Proinflammatory cytokines were measured. Hippocampal volumes were estimated by magnetic resonance imaging. Multivariate and univariate statistical methods were used to explore putative differences between groups and factors linked to cognitive impairment. Cognitive function clearly differed between groups, with decreased attention and visuospatial memory in the patient group, suggesting frontal cortex/medial temporal cortex-network dysfunction. Increased harm avoidance and persistence was present among patients, with lowered self-directedness linked to lower quality of life, increased anxious and depressive tendencies, and experiences of psychosocial stress. Attention was decreased with concomitantly impaired visuospatial memory. The pituitary (adrenocorticotropic hormone, ACTH) response to CRH was decreased in patients, with an increased cortisol/ACTH response to CRH. However, cortisol production rates, diurnal or dexamethasone-suppressed saliva cortisol levels, and the cortisol response to Synacthen were unaltered. Hippocampal volumes did not differ between groups. These findings suggest that cognitive dysfunction in stress-related exhaustion is linked to distinct personality traits, low quality of life, and a decreased ACTH response to CRH.
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| 22. |
- Sanner, Margareta A., et al.
(författare)
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Obstacles to organ donation in Swedish intensive care units
- 2006
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 32:5, s. 700-7
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Tidskriftsartikel (refereegranskat)abstract
- Objective To identify obstacles to organ donation in Swedish intensive care units.Design A survey exploring attitudes and experiences of organ donation activities was sent to half of all anaesthetists and all neurosurgeons in Sweden (n = 644). Total response rate was 67%; 69% from the anaesthetists and 54% from the neurosurgeons.Results Neurosurgeons had more experiences of caring for potential donors and requesting donation than anaesthetists. Twenty-seven percent of the anaesthetists were not confident with clinical neurological criteria for brain incarceration. Nine per cent found donation activities solely burdensome, and 14% wanted an external team to take over the donation request. A quarter regarded the request definitely as an extra load on the family, and more than half of the respondents had refrained from asking in emotionally strained situations. Forty-nine per cent had a neutral approach to relatives when requesting donation while 38% had a pro-donation approach. Thirty-six per cent terminated ventilator treatment for a potential donor without waiting for total brain infarction. Lack of resources in the ICUs resulted in not identifying a possible donor according to 29% of respondents. Knowing the prior wish of the deceased was regarded as the single most important factor that facilitated the work with organ donation for the intensivists.Conclusions The identified obstacles (neutral approach of donation request, ethical problems concerning the potential donor and the relatives, varying competence in diagnosing total brain infarction, and lack of intensive care bed resources) require tailored efforts in order to increase organ donation. Checking these factors can be used as a quality control when analysing donation activities at hospitals.
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| 23. |
- Ahlgren, Christina, et al.
(författare)
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Struggle for time to teach. Teachers experiences of their work situation.
- 2011
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 40:Suppl 1, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this study was to from a gender perspective, explore elementary school teacher' experiences of their work situation, and identify conditions that could be health risks. Participants: Eighteen female teachers who work in an elementary school in Northern Sweden. Method: Thematic interviews were conducted using an interview guide. The interviews were tape-recorded and transcribed verbatim. Qualitative content analysis was used to analyse the transcribed text and interpretations were made within gender theory. Results: Four categories emerged: "Squeezed between dream and reality", "Effort to keep up with demands", "We can make it together" and "The school needs men's qualities". The categories were linked together with the theme "A struggle for time to teach". The theme describes the conflict between the teachers' ambitions to teach and create a stimulating learning environment versus the increased need for behaviour control that took time from classroom work. Beside work at the school, the teachers carried a large burden of domestic work.Conclusions: Teachers' work includes both endless demands and great joy. Their work is structured within the schools gender system in which caring duties are subordinated despite a growing demand for behaviour control. Traditional gender roles affect their domestic work load.
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| 24. |
- Alenius, Gerd-Marie, 1957-
(författare)
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A Clinical and Genetic Study of Psoriatic Arthritis
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psoriatic arthritis (PsA) is an inflammatory joint disease associated with psoriasis. PsA has a heterogeneous pattern, expressed by different manifestations such as mild mono-oligoarthritis or very severe, erosive and destructive polyarthritis. Measurable inflammatory activity is not always prominent. The aetiology is unknown but genetic factors are believed to be of importance. The pattern of inheritance is proposed to be polygenic. The aim of this study was to estimate the prevalence of joint and axial manifestations, characterise the disease in relation to inflammatory and genetic markers, and to identify disease susceptibility gene(s) for PsA in patients from northern Sweden. All patients from the city of Umeå (n=276), selected from a community and hospital based psoriasis register (n=1737) at the Dept of Dermatology, were invited to a prevalence study. Two hundred-two patients were examined and 97 (48%) had inflammatory manifestations such as peripheral arthritis, axial disease, undifferentiated spondylarthropathy (uSpA) and enthesopathies. Of the 67 patients (33 %) with peripheral arthritis and/or axial disease, 30 were not previously diagnosed. The association of clinical manifestations and potential markers of aggressive joint disease with HLA associations were analysed in 88 patients with PsA. We were not able to confirm findings of other groups reporting strong association with several HLA-antigens. The prevalence of HLA-B17, B37 and B62 was increased compared with controls, but the strongest predictive factors among our patients for an aggressive disease, in a multiple logistic analysis, were polyarthritic disease and distal interphalangeal engagement. In order to investigate for disease susceptibility genes, five genetic loci were analysed with microsatellites and single nucleotide polymorphisms in an association study of 120 patients with PsA. There was a significant association with the TNFB locus on chromosome 6p but not with any other loci examined; 1q21 (PSORS4), 3q21 (PSORS5), 8q24 and CTLA4. When stratifying for the TNFB alleles the association was confined to allele 123. In a subgroup of patients who were HLA-typed (n=83), we were not able to verify linkage disequilibrium with the TNFB allele 123 and the HLA antigens; B17, B27, B37, B62 or Cw*0602. The presence of renal abnormalities was evaluated as a manifestation of systemic inflammation in 73 patients with PsA. Renal abnormalities defined as decreased creatinine-clearance (≤ mean - 2SD) and/or urinary albumin >25 mg/24 h was found in 23% of the patients. The predictive factors for renal abnormalities was inflammatory activity (ESR > 25 mm/h and/or CRP >15 mg/L) indicating a systemic effect in some of the patients. In conclusion, we found high prevalence of inflammatory manifestations in patients with psoriasis. There was no strong association between PsA and HLA antigens and predictive factors for aggressive disease were polyarthritic disease and DIP joint engagement. The TNFB locus was associated with PsA and there were no linkage disequilibrium with the HLA antigens B17, B27, B62 or Cw*0602. There were evidence for systemic effects as renal abnormalities in patients with PsA and measurable inflammatory activity.
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| 25. |
- Alfredsson, Lars, et al.
(författare)
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Job strain and major risk factors for coronary heart disease. : Baseline results from the WOLF Study
- 2002
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Ingår i: Scandinavian Journal of Work, Environment & Health. - 0355-3140. ; 28:4, s. 238-248
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Tidskriftsartikel (refereegranskat)abstract
- The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.
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| 26. |
- Anderzén, Ingrid, et al.
(författare)
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Samverkan i Resursteam : effekter på organisation, hälsa och sjukskrivning
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vi utvärderar samverkansformen Resursteam, som bedrivits som ett försök för att minska långa sjukskrivningar. Resursteam innebär att ett team med hand-läggare från Försäkringskassan, husläkare, sjukgymnast och beteendevetare, vid regelbundna möten bedömer sjukskrivna personers rehabiliteringsbehov och ger förslag på åtgärder. Det övergripande syftet är att skatta effekten av Resursteam på den försäkrades sjukskrivningslängd och självskattade hälsa. Vi har genomfört (i) en kartläggning av verksamheten, (ii) en enkätstudie till sjuk-skrivna som deltagit i Resursteam och till jämförelsepersoner samt (ii) skattat effekten av Resursteam på självskattad hälsa och sjukskrivning. Resultaten är entydiga och visar på inga eller negativa effekter för de personer som ingått i Resursteam. Som exempel kan nämnas att tiden i sjukskrivning förlängs med cirka 20 procent i genomsnitt.
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| 27. |
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| 28. |
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Arbete, hälsa och kön
- 2008
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Under åren 2007 och 2008 har ett antal forskare vid Mittuniversitetet arbetat inom ramen för projektet ”Hälsofrämjande i arbetslivet” vars mål var att öka kunskapen om faktorer som bidrar till ett friskare arbetsliv och ökat kvinnligt företagande, samt hur de strukturella förutsättningarna kan anpassas för att gynna en önskvärd utveckling i Jämtlands län. Rapporten ”Arbete, hälsa och kön” redovisar i olika kapitel stora delar av den forskning som bedrivits kring dessa områden. Anledningen till att resultaten redovisas i rapportserien Genusstudier vid Mittuniversitetet, som är en del av den verksamhet som bedrivs inom ramen för Forum för genusvetenskap, är att texterna till stora delar diskuterar och analyserar könsdimensionen och att de därmed är goda exempel på den omfattande forskning som bedrivs vid Mittuniversitetet om mäns och kvinnors (skilda) livsvillkor. Rapporten består av sju kapitel som ur olika perspektiv och med hjälp av olika metodologiska angreppssätt analyserar och diskuterar frågor kring arbete, hälsa och kön. De olika metoder som används är textanalys, intervjuer samt kvantitativa analyser och de empiriska underlagen spänner från regionala data från Jämtland till nationella och internationella undersökningar. Oavsett om data anknyter till jämtlandsregionen eller ej så bidrar de med en ökad kunskap om olika relationer mellan arbetsliv, hälsa, kön och genus i denna region. Innehåll: Mikael Nordenmark: Inledning Lena Karlqvist: Arbetsmiljö, jämställdhet och hälsa vid Företag/Organisationer i Jämtland och Västernorrland Erna Danielsson och Johanna Overud: Frivillighet, skyldighet eller frivillig skyldighet? Om genus och handlingsutrymme i civilsamhället Stig Vinberg: Mikroföretagande - kön, arbetsvillkor och hälsa Mikael Nordenmark: Är upplevelse av stress mellan arbetsliv och familjeliv ett hinder för kvinnors arbetsmarknadsdeltagande Kristina Zampoukos: "Det lilla extra" - om ekonomiserigen av vård och omsorg och det meningsfulla arbetet Patrik Millet: Ledarstilar, kontroll, nätverk och finansiell prestation i små och medelstora företag i Jämtland Stig Vinberg: Ledarskap för ett hälsosamt arbetsliv - reflektioner utifrån tre jämtländska projekt
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