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Sökning: LAR1:miun > Medicin och hälsovetenskap

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1.
  • Heikkilä, Katriina, et al. (författare)
  • Job strain and COPD exacerbations: an individual-participant meta-analysis
  • 2014
  • Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 44:1, s. 247-251
  • Tidskriftsartikel (refereegranskat)abstract
    • To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
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2.
  • Mosallanezhad, Z., et al. (författare)
  • A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
  • 2017
  • Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 70, s. 123-129
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chisquare tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results: The measurement model yielded a reasonable fit to the data, chi(2) = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037-0.058. The model fit for the conceptual model was acceptable; chi(2) = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074-0.093. SES itself was not a direct predictor of HS (beta = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (beta = 0.31, p < 0.001) or I (beta = 0.57, p < 0.001). Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. (C) 2017 Elsevier B.V. All rights reserved.
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3.
  • Leissner, Philip, et al. (författare)
  • The factor structure of the cardiac anxiety questionnaire, and validation in a post-MI population
  • 2022
  • Ingår i: BMC Medical Research Methodology. - : BioMed Central (BMC). - 1471-2288. ; 22
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: CVD-patients with higher levels of cardiac anxiety suffer psychologically, as well as being at increased risk for cardiac morbidity and mortality. Therefore it is important to be able to assess CA in a clinical setting. It is currently measured with the Cardiac Anxiety Questionnaire, which has conflicting findings regarding its factor structure, and it has not been validated in a Swedish population. This study aimed to examine the factor structure of CAQ and its psychometric properties in a Swedish CVD-population.Methods: Nine hundred thirty patients post-MI were recruited at different Swedish hospitals and completed the CAQ, along with several other questionnaires. Exploratory factor analysis and confirmatory factor analysis were conducted to explore factor structure and to inspect various factor solutions from previous research. Standard psychometric tests were performed for the CAQ to test its validity and reliability.Results: The exploratory analysis found a model with the factors Fear/Worry, Avoidance and Attention. The confirmatory factor analysis indicated that a 3-factor solution best fitted the data, but with certain items removed. Additionally, psychometric properties turned out acceptable in a Swedish post-MI population.Conclusions: We conclude that the original 3-factor structure of the CAQ is valid, but that the questionnaire could be revised in regard to some items. A shorter 10-items version could also be considered. We also confirm that the CAQ is a valid instrument to measure CA in a Swedish MI-population.
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4.
  • Middeldorp, Christel M., et al. (författare)
  • The Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia : design, results and future prospects
  • 2019
  • Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 34:3, s. 279-300
  • Tidskriftsartikel (refereegranskat)abstract
    • The impact of many unfavorable childhood traits or diseases, such as low birth weight and mental disorders, is not limited to childhood and adolescence, as they are also associated with poor outcomes in adulthood, such as cardiovascular disease. Insight into the genetic etiology of childhood and adolescent traits and disorders may therefore provide new perspectives, not only on how to improve wellbeing during childhood, but also how to prevent later adverse outcomes. To achieve the sample sizes required for genetic research, the Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia were established. The majority of the participating cohorts are longitudinal population-based samples, but other cohorts with data on early childhood phenotypes are also involved. Cohorts often have a broad focus and collect(ed) data on various somatic and psychiatric traits as well as environmental factors. Genetic variants have been successfully identified for multiple traits, for example, birth weight, atopic dermatitis, childhood BMI, allergic sensitization, and pubertal growth. Furthermore, the results have shown that genetic factors also partly underlie the association with adult traits. As sample sizes are still increasing, it is expected that future analyses will identify additional variants. This, in combination with the development of innovative statistical methods, will provide detailed insight on the mechanisms underlying the transition from childhood to adult disorders. Both consortia welcome new collaborations. Policies and contact details are available from the corresponding authors of this manuscript and/or the consortium websites.
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5.
  • Bayadsi, Haytham, 1987-, et al. (författare)
  • The correlation between small papillary thyroid cancers and gamma radionuclides Cs-137, Th-232, U-238 and K-40 using spatially-explicit, register-based methods
  • 2023
  • Ingår i: Spatial and Spatio-Temporal Epidemiology. - : Elsevier. - 1877-5845 .- 1877-5853. ; 47
  • Tidskriftsartikel (refereegranskat)abstract
    • A steep increase of small papillary thyroid cancers (sPTCs) has been observed globally. A major risk factor for developing PTC is ionizing radiation. The aim of this study is to investigate the spatial distribution of sPTC in Sweden and the extent to which prevalence is correlated to gamma radiation levels (Caesium-137 (Cs-137), Thorium-232 (Th-232), Uranium-238 (U-238) and Potassium-40 (K-40)) using multiple geospatial and geo-statistical methods. The prevalence of metastatic sPTC was associated with significantly higher levels of Gamma radiation from Th-232, U-238 and K-40. The association is, however, inconsistent and the prevalence is higher in densely populated areas. The results clearly indicate that sPTC has causative factors that are neither evenly distributed among the population, nor geographically, calling for further studies with bigger cohorts. Environ-mental factors are believed to play a major role in the pathogenesis of the disease.
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6.
  • Edqvist, Malin, 1971, et al. (författare)
  • Midwives' Management during the Second Stage of Labor in Relation to Second-Degree Tears-An Experimental Study
  • 2017
  • Ingår i: Birth. - : Wiley. - 0730-7659 .- 1523-536X. ; 44:1, s. 86-94
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women.METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care. Crude and Adjusted OR (95% CI) were calculated between the intervention and the standard care group, for the various explanatory variables.RESULTS: A total of 597 primiparous women participated in the study, 296 in the intervention group and 301 in the standard care group. The prevalence of second-degree tears was lower in the intervention group: [Adj. OR 0.53 (95% CI 0.33-0.84)]. A low prevalence of episiotomy was found in both groups (1.7 and 3.0%). The prevalence of epidural analgesia was 61.1 percent. Despite the high use of epidural analgesia, the midwives in the intervention group managed to use the intervention.CONCLUSION: It is possible to reduce second-degree tears among primiparous women with the use of a multifaceted midwifery intervention without increasing the prevalence of episiotomy. Furthermore, the intervention is possible to employ in larger maternity wards with midwives caring for women with both low- and high-risk pregnancies.
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7.
  • Eklund, Linda, et al. (författare)
  • An experimental exposure study revealing composite airway effects of physical exercise in a subzero environment
  • 2021
  • Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 80:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Exposure to a cold climate is associated with an increased morbidity and mortality, but the specific mechanisms are largely unknown. People with cardiopulmonary disease and winter endurance athletes are particularly vulnerable. This study aimed to map multiple domains of airway responses to exercise in subzero temperature in healthy individuals.Thirty-one healthy subjects underwent whole-body exposures for 50 minutes on two occasions in an environmental chamber with intermittent moderate-intensity exercise in +10 °C and -10 °C. Lung function, plasma/urine CC16 , and symptoms were investigated before and after exposures.Compared to baseline, exercise in -10 °C decreased FEV1 (p=0.002), FEV1/FVC (p<0.001), and increased R20Hz (p=0.016), with no differences between exposures. Reactance increased after +10 °C (p=0.005), which differed (p=0.042) from a blunted response after exercise in -10 °C. Plasma CC16 increased significantly within exposures, without differences between exposures. Exercise in -10 °C elicited more intense symptoms from the upper airways, compared to +10 °C. Symptoms from the lower airways were few and mild. Short-duration moderate-intensity exercise in -10 °C induces mild symptoms from the lower airways, no lung function decrements or enhanced leakage of biomarkers of airway epithelial injury, and no peripheral bronchodilatation, compared to exercise in +10 °C. 
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8.
  • Essner, Ann, et al. (författare)
  • Comparison of Polar® RS800CX heart rate monitor and electrocardiogram for measuring inter-beat intervals in healthy dogs
  • 2015
  • Ingår i: Physiology and Behavior. - : Elsevier. - 0031-9384 .- 1873-507X. ; 138:January, s. 247-253
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of the present study was to assess the criterion validity, relative reliability and level of agreement ofPolar® RS800CX heart rate monitor measuring inter-beat intervals (IBIs), compared to simultaneously recordedelectrocardiogram (ECG) in dogs.Methods: Five continuous minutes of simultaneously recorded IBIs from Polar® RS800CX and Cardiostore ECG in11 adult healthy dogs maintaining standing position were analyzed. Polar® data was statistically compared toECG data to assess for systematic differences between the methods. Three different methods for handling missingIBI data were used. Criterion validities were calculated by intraclass correlation coefficients (ICCs) and corresponding95% confidence intervals (CIs). Relative reliabilities and levels of agreement were calculated by ICCsand the Bland and Altman analysis for repeated measurements per subject.Results: Correlation coefficients between IBI data from ECG and Polar® RS800CX varied between 0.73 and 0.84depending on how missing values were handled. Polar® was over- and underestimating IBI data compared toECG. The mean difference in log transformed (base10) IBI data was 0.8%, and 93.2% of the values were withinthe limits of agreement. Internally excluding three subjects presenting IBI series containing more than 5% erroneousIBIs resulted in ICCs between 0.97 and 0.99. Bland and Altman analysis (n = 8) showed mean differencewas 1.8 ms, and 98.5% of the IBI values were plotted inside limits of agreement.Conclusion: This study showed that Polar® systematically biased recorded IBI series and that it was fundamentalto detect measurement errors. For Polar® RS800CX heart rate monitor to be used interchangeably to ECG, byshowing excellent criterion validity and reliable IBI measures in group and individual samples, only less than5% of artifacts could be accepted.
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9.
  • Gunnarsson, A Birgitta, 1958, et al. (författare)
  • Catching sight of well-being despite a stress-related disorder
  • 2022
  • Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 29:8, s. 699-707
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Stress-related disorders cause suffering and difficulties in managing occupations and relationships in everyday life. A previous study of women with stress-related disorders, who photographed well-being and talked about the photographs in interviews, showed that moments of well-being still exist but further knowledge is needed about their perceptions of participating in such a study. Aim To describe how people with stress-related disorders experience taking photographs related to well-being in everyday life and reflecting on and talking about these photographs. Material and methods Twelve women, 27-54 years with stress-related disorders were recruited from primary healthcare centres. They participated in interviews based on the photographs and qualitative content analysis was used. Results One theme 'catching a glimpse of and momentarily capturing well-being' and four categories were identified: 'Photographing moments of well-being visualizes well-being', 'Using photographs could either facilitate or complicate the narrative', 'Changing perspective in everyday life' and 'Creating recollections of well-being'. Conclusions and significance Introducing a focus on well-being in everyday life despite living with a stress-related disorder might contribute a valuable complement to stress rehabilitation for occupational therapists and other health professionals. Using photographs as a basis for reflections about everyday life and health/well-being also seems positive for this group.
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10.
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