SwePub
Sök i SwePub databas

  Utökad sökning

Träfflista för sökning "LAR1:miun ;pers:(Sundin Örjan)"

Sökning: LAR1:miun > Sundin Örjan

  • Resultat 1-10 av 144
Sortera/gruppera träfflistan
   
NumreringReferensOmslagsbildHitta
1.
  • Abbasi, Seyed (författare)
  • Determinants of social inequalities in cardiovascular disease among Iranian patients
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Background and objectives: Cardiovascular disease (CVD) is the single largest cause of mortality in the world. Similar to other health issues, CVD is generally affected either by individual risk factors, which may influence the risk for developing an illness or its complications, or by social indicators (social determinants of health). There is evidence from developed countries which shows that the so-called "upstream factors"—including social determinants such as political, social, spiritual, cultural, and economic factors—may affect the prevalence and incidence of CVD. Scarce evidence from studies in low- and middle-income countries also suggests that social factors may affect the distribution of CVD across population groups. However, there is a dearth of such data in Iran, where only a few small-sizedstudies have focused on the social determinants of health. Therefore, the present thesis sought to fill this gap by assessing the effects of socioeconomic status (SES) on the distribution of CVD and the relevant inequalities within the Iranian context.Methods: This thesis is based on four studies, which used data from the Tehran Heart Center’s Databases. In Study I, a total of 44,820 patients who underwent coronary angiography at Tehran Heart Center between 2005 and 2010 were recruited. Then, their pre- and post-procedural data—including demographics, CVD risk factors, symptoms, and laboratory tests—were compared between men and women. In Study II, 6,246 patients with acutecoronary syndrome who were hospitalized between March 2004 and August 2011 were included and, based on their education and their employment status, were divided into high- and low-SES groups. Thereafter, the effect of SES on the in-hospital death of the patients was evaluated. In Study III, 20,165 patients with documented coronary artery disease who underwent coronary angiography at Tehran Heart Center were enrolled and CVD risk factors and severity (measured by the Gensini score) were assessed among the six major Iranian ethnic groups. In Study IV, 9,088 patients with acute coronary syndrome who were hospitalized at Tehran Heart Center between May 2007and June 2014 were recruited and the association between in-hospital death due to acute coronary syndrome and place of residence (rural/urban) was assessed using logistic regression adjusted for potential confounders.Results: In this thesis, the data analyses were based on the hypothesis that there is a potential association between the different socioeconomic indicators and the selected cardiovascular outcomes. In Study I, among the recruited participant, 25,363 men and 11,995 women had coronary artery disease and the women not only were significantly older, less educated, and more overweight but also had higher blood levels of triglyceride, cholesterol, low-density lipoprotein, high-density lipoprotein, and fasting blood sugar than the men. Moreover, hypertension and diabetes mellitus showed the strongest association in the women with coronary artery disease (OR=3.45, 95% CI: 3.28to 3.61 and OR=2.37, 95% CI: 2.26 to 2.48, respectively). In addition, the frequency of post-procedural recommendations for non-invasive procedures was higher in the women than in the men (20.1% vs 18.6%; P<0.001). In StudyII, of the 6,246 recruited patients with acute coronary syndrome, 3,290individuals were considered low-SES and 2,956 high-SES individuals. In-hospital death occurred in 79 (1.26%) patients: 1.9% in the low-SES and 0.6% in the high-SES groups. After adjustment for the possible cofounders, our multivariate analysis demonstrated a significant effect of the patients’ SES on their in-hospital death and a lower in-hospital mortality rate was shown in the high-SES patients (OR=0.30, 95% CI: 0.09 to 0.98; P=0.046). In Study III, the Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest frequency of having at least four simultaneous risk factors. Additionally, the mean Gensini score was lowest in the Lurs (67.5±52.8) and highest among the Gilaks (77.1±55.9). The multivariable regression analysis indicated that the Gilaks showed the worst CVD severity (β: 0.056, 95% CI: 0.009 to 0.102; P=0.018), followed by the Turks (β: 0.032, 95% CI: 0.005 to 0.059; P=0.020), and the lowest CVD severity, was detected in the Lurs (β: -0.087, 95% CI: -0.146 to -0.027;P=0.004). Study IV showed that while smoking (P=0.002), positive family history of coronary artery disease (P=0.003), higher body mass index (P=0.013),and hyperlipidemia (P=0.026) were more prevalent in the urban patients, the rural patients showed lower educational levels (P<0.001) and higher frequency of unemployment (P=0.009). Meanwhile, in-hospital death occurred in 135 (1.5%) patients: 125 (1.5%) urban and 10 (1.2%) rural. To adjust the effects of the possible confounders, we utilized the Firth regression model, which showed no significant difference regarding in-hospital death betweenthe rural and urban patients (OR=1.57, 95% CI: 0.376 to 7.450; P=0.585).Conclusions: The aim of this thesis was to investigate the effects of social determinants (particularly SES) on CVD and its modifiable risk factors among Iranian patients. Results showed that medical treatment for CVD was more recommended (by treating physicians) to the women than the men, and the low-SES patients with acute coronary syndrome were more likely to die in the hospital than their high-SES counterparts. In addition, the thesis found heterogeneity in the distribution of the traditional risk factors for CVD as well as CVD severity in the major Iranian ethnic groups. Further, there were no differences concerning the in-hospital death rates due to acute coronary syndrome between the urban and rural patients after adjustment for the potential confounders.
  •  
2.
  • Abbasi, Seyed H, et al. (författare)
  • Ethnic differences in the risk factors and severity of coronary artery disease : a patient-based study in Iran
  • 2018
  • Ingår i: Journal of Racial and Ethnic Health Disparities. - : Springer Berlin/Heidelberg. - 2197-3792 .- 2196-8837. ; 5:3, s. 623-631
  • Tidskriftsartikel (refereegranskat)abstract
    • 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.
  •  
3.
  • Abbasi, Seyed H, et al. (författare)
  • Gender Differences in the Risk of Coronary Artery Disease in Iran
  • 2012
  • Ingår i: Iranian Journal of Public Health. - 0304-4556. ; 41:3, s. 36-47
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.
  •  
4.
  • Abbasi, Seyed Hesameddin, et al. (författare)
  • Mortality from Acute Coronary Syndrome: Does Place of Residence Matter?
  • 2022
  • Ingår i: Journal of Teheran University Heart Center. - : Tehran University of Medical Sciences. - 1735-8620 .- 2008-2371. ; 17:2, s. 56-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment.Methods: Between May 2007 and January 2018, patients admitted with ACS were included. The patients’ demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders.Results: Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585).Conclusion: This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.
  •  
5.
  •  
6.
  • Abbasi, Seyed, et al. (författare)
  • Socioeconomic status and in hospital mortality of acute corony syndrome: Can education and occupation serves as preventive measures?
  • 2015
  • Ingår i: International Journal of Preventive Medicine. - : Medknow. - 2008-7802 .- 2008-8213. ; 6
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in‑hospital mortality of patients with the acute coronarysyndrome (ACS) according to their SES.Methods: All patients admitted to Tehran Heart Center due to 1st‑time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low‑SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high‑SES patients. Demographic, clinical, paraclinical, and in‑hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in‑hospital mortality was evaluated.Results: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low‑SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in‑hospital mortality of the ACS patients in that the high‑SES patients had a lower in‑hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094–0.980; P = 0.046).Conclusions: This study found that patients with low SES were at a higher risk of in‑hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.
  •  
7.
  • Almén, Niclas, 1971-, et al. (författare)
  • Behavioral Stress Recovery Management Intervention for People With High Levels of Perceived Stress : A Randomized Controlled Trial
  • 2020
  • Ingår i: International Journal of Stress Management. - : American Psychological Association (APA). - 1072-5245 .- 1573-3424. ; 27:2, s. 183-194
  • Tidskriftsartikel (refereegranskat)abstract
    • Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a behaviorally oriented stress recovery management intervention for people experiencing high levels of stress. A total of 73 individuals with experiences of stress symptoms and high levels of perceived stress (>= 25 on the Perceived Stress Scale) were randomly allocated to either a 10-week intervention group or a waiting-list control group. Participants were assessed at preintervention, postintervention, and 3-month follow-up. The Perceived Stress Scale, questions about tension, and the Shirom-Melamed Burnout Questionnaire were used as primary outcome measures. and the Hospital Anxiety and Depression Scale was used as a secondary outcome measure. Data were analyzed following the intention-to-treat principle. The analysis demonstrated statistically significant improvements for all measures at posttreatment and at follow-up. The between-groups effect sizes were high at posttreatment and moderate-to-high at follow-up. Intervention focused on stress recovery behavior seems to be an effective way of reducing perceived stress, tension, burnout symptoms, anxiety, and depression in people with stress symptoms and high levels of perceived stress in everyday life. The tested intervention warrants further research. Other stress recovery behavior interventions need to be tested to draw conclusions on the efficacy of stress recovery behavior interventions in general regarding stress and burnout.
  •  
8.
  • Almén, Niclas, 1971-, et al. (författare)
  • Burn Out: Effects Of A Brief Behavioral Recovery Program
  • 2019
  • Ingår i: Libro de Actas. - Granada. ; , s. 269-
  • Konferensbidrag (refereegranskat)abstract
    • Background: Continuous and prolonged exposure to stressors or unsuccessfully dealing with such exposure has been suggested as precursors for burnout. Current research indicates that such stress problems could be conceptualized as deficiencies in recovery between periods of stress. The purpose of this study was to evaluate the efficacy of a brief stress-recovery behavior intervention for people experiencing high levels of stress. Method: Seventy-three individuals with experiences of stress symptoms and high levels of perceived stress (≥ 25 on the Perceived Stress Scale) were randomly allocated to either a 12-week intervention group (INT) or a waiting list control group (WLC). Participants were assessed at pre-intervention, post-intervention and at 3-month follow-up. Data, including indices of Heart Rate Variability (HRV), Perceived stress scale (PSS), questions about tension, Shirom-Melamed Burnout Questionnaire (SMBQ), and the Hospital Anxiety and Depression Scale (HADS) as a secondary outcome measure, will be analyzed and presented following the intention-to-treat principle.
  •  
9.
  • Almén, Niclas, 1971-, et al. (författare)
  • Bättre arbetsmiljö ger fler psykologer
  • 2018
  • Ingår i: Dagens medicin. - Stockholm. - 1402-1943. ; :27 augusti
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • I vårt debattinlägg betonade vi att psykisk ohälsa är ett vida utbrett problem och att patienter inte får effektiv hjälp eftersom det finns ett omfattande underskott på psykologer inom primärvården. Vi var kritiska till Centerpartiets vårdreform som riskerar medföra att problemet förvärras eftersom det inte skulle öka antalet psykologer vilka kan genomföra de behandlingar som Socialstyrelsen rekommenderar.
  •  
10.
  • Almén, Niclas, 1971-, et al. (författare)
  • Effects of a Recovery-Focused Intervention for Stress Management : A Randomized Controlled Trial
  • 2015
  • Konferensbidrag (refereegranskat)abstract
    • AbstractINTRODUCTIONStress symptoms, burnout, poor mental health and long-term sick leave related to these are major problems in Sweden and elsewhere. Evidence-based prevention and treatment efforts are lacking. Research indicates that stress related health problems primarily could be conceptualized as deficiencies in recovery responses between stress periods rather than high level of stress responses per se. Therefore it is relevant to examine whether it is effective to intervene the recovery behavior – instead of the stress behavior - of people with stress symptoms.OBJECTIVESThe primary purpose of this study was to investigate if a behavioral oriented recovery management intervention could enhance “recovery behaviors” and experiences of recovery and reduce stress related ill health.METHODS A group based intervention program focusing exclusively on “recovery behavior” in everyday life (earlier developed and tested in two pilot studies) was evaluated in an experimental group study. The intervention consisted of seven group sessions of 2.5 hours over a period of approximately 10 weeks supplemented by an internet based treatment support system. Self- referred subjects with scores above 24.4 on the Perceived stress scale were randomized to the intervention (n=26) or a waiting-list (n=33).RESUL TStatistically significant and clinically relevant effects were achieved for the intervention group compare to the waiting-list group: recovery behaviors and experiences of recovery were increased, and levels of perceived stress, worry, anxiety, depression and exhaustion were decreased.DISCUSSION These results are in line with two previous pilot studies that we have done. A behavioral and recovery oriented intervention seems to be effective to increase the recovery of the individual and decrease stress related ill health. There are reasons to continue to explore the potential of recovery-oriented interventions for example for different populations (such as people with more extensive clinical health problems) and in different contexts. 
  •  
Skapa referenser, mejla, bekava och länka
  • Resultat 1-10 av 144
Typ av publikation
tidskriftsartikel (113)
konferensbidrag (14)
doktorsavhandling (10)
bokkapitel (4)
annan publikation (2)
rapport (1)
visa fler...
visa färre...
Typ av innehåll
refereegranskat (111)
övrigt vetenskapligt/konstnärligt (30)
populärvet., debatt m.m. (3)
Författare/redaktör
Sundin, Örjan, 1952- (68)
Lisspers, Jan (19)
Macassa, Gloria (16)
Soares, Joaquim J. F ... (13)
Soares, Joaquim (13)
visa fler...
Bernhardsson, Jens (12)
Öhman, Arne (12)
Jansson, Billy, 1963 ... (11)
Bjärtå, Anna, 1974- (10)
Barros, Henrique (9)
Lindert, Jutta (9)
Almén, Niclas, 1971- (8)
Barros, H (8)
Lindert, J (7)
Nygren, Åke (6)
Ioannidi-Kapolou, E (6)
Ryden, Lars (5)
Soares, Joaquim, 194 ... (5)
Soares, Joaquim, Pro ... (5)
Öst, Lars-Göran (5)
Ekdahl, Johanna, 197 ... (5)
Sundin, Örjan, profe ... (5)
Melchiorre, Maria Ga ... (5)
Hatzidimitriadou, El ... (5)
Toth, Olga (5)
Hatzidimitriadou, E (5)
Toth, O (5)
Costa, D. (4)
Bjärtå, Anna (4)
Viitasara, Eija (4)
Costa, Diogo (4)
Fredrikson, Mats (3)
Blom, M. (3)
Abbasi, Seyed (3)
Macassa, Gloria, Pro ... (3)
Soares, J (3)
Jalali, Arash (3)
Pagani, M (3)
Esteves, Francisco, ... (3)
Norlund, Fredrika (3)
Tornvall, Per (3)
Åhs, Fredrik (3)
Frick, Mats (3)
Flykt, Anders (3)
Thomtén, Johanna, 19 ... (3)
Sackey, Peter (3)
Burell, Gunilla (3)
Collste, Olov (3)
Soares, Joaquim J. F ... (3)
visa färre...
Lärosäte
Mittuniversitetet (144)
Karolinska Institutet (22)
Högskolan i Gävle (13)
Uppsala universitet (5)
Stockholms universitet (4)
Göteborgs universitet (2)
visa fler...
Kungliga Tekniska Högskolan (1)
Örebro universitet (1)
Linnéuniversitetet (1)
visa färre...
Språk
Engelska (126)
Svenska (17)
Norska (1)
Forskningsämne (UKÄ/SCB)
Samhällsvetenskap (98)
Medicin och hälsovetenskap (30)

År

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy