| 1. |
- Escher, Cecilia, et al.
(författare)
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Fear of making a mistake : a prominent cause of stress for COVID-19 ICU staff-a mixed-methods study
- 2023
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Ingår i: BMJ Open Quality. - : BMJ. - 2399-6641. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionThe COVID-19 pandemic has had a profound effect on many domains of healthcare. Even in high-income countries such as Sweden, the number of patients has vastly outnumbered the resources in affected areas, in particular during the first wave. Staff caring for patients with COVID-19 in intensive care units (ICUs) faced a very challenging situation that continued for months. This study aimed to describe burnout, safety climate and causes of stress among staff working in COVID-19 ICUs.MethodA survey was distributed to all staff working in ICUs treating patients with COVID-19 in five Swedish hospitals during 2020 and 2021. The numbers of respondents were 104 and 603, respectively. Prepandemic data including 172 respondents from 2018 served as baseline.ResultsStaff exhaustion increased during the pandemic, but disengagement decreased compared with prepandemic levels (p<0.001). Background factors such as profession and work experience had no significant impact, but women scored higher in exhaustion. Total workload and working during both the first and second waves correlated positively to exhaustion, as did being regular ICU staff compared with temporary staff. Teamwork and safety climate remained unchanged compared with prepandemic levels.Respondents reported 'making a mistake' as the most stressful of the predefined stressors. Qualitative analysis of open-ended questions identified 'lack of knowledge and large responsibility', 'workload and work environment', 'uncertainty', 'ethical stress' and 'organization and teamwork' as major causes of stress.ConclusionDespite large workloads, disengagement at work was low in our sample, even compared with prepandemic levels. High levels of exhaustion were reported by the ICU staff who carried the largest workload. Multiple significant causes of stress were identified, with fear of making a mistake the most significant stressor.
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| 2. |
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| 3. |
- Osika, Walter, et al.
(författare)
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Utbildning av hållbara vårdgivare förutsättning för hållbara sjukvårdssystem och samhällen
- 2023
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Ingår i: Sociamedicinsk tidskrift. - : SMT.
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Bokkapitel (refereegranskat)abstract
- Stress påverkar prestation, patientsäkerhet och arbetsmiljö inom hälso- ochsjukvården. Under kriser såsom tex Covid-19 pandemin, kan hög arbetsbelastning och arbete under tidspress, med begränsade resurser, då svåra beslut och prioriteringar behöver göras, leda till moralisk stress, vilket om det återkommande sker leda till moralisk ”skada” och stressrelaterad ohälsa. Därför är det viktigt att sjukvårdspersonal redan under sin utbildning får lära sig om hur de påverkas av stress och att identifiera olika moraliskt utmanande situationer, att de får träna olika stresshanteringsmetoder, samt tillämpa dem i olika simulerade akutmedicinska situationer. Utöver kunskap om stress utifrån ett individperspektiv behövs insikter kring hur stress kan genereras utifrån strukturella/organisatoriska förhållande som kan behöva åtgärdas i stället för eller parallellt med insatser på individ eller gruppnivå.
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| 4. |
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| 5. |
- Björkblom, Carina, et al.
(författare)
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Substitutes for regulated plasticizers
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- A literature and database review was conducted with the aim of identifying substitute substances forregulated plasticizers that are of relevance within Sweden. Based on this survey substitute substanceswere prioritized and suggested for national screening studies.Information sources used were lists/databases, scientific literature, reports, interviews with businessorganizations (within or connected to the plasticizers industry), manufacturers, importers and users.Plasticizers that are already regulated or on their way to be have been listed, as well as a list of possiblesubstitute substances for these regulated plasticizers.The first list of potential candidates for screening constituted 152 substances. To be able to prioritizebetween identified plasticizers, a multicriteria model was developed based on usage, presence ofsubstance on different lists, and classification. In total 40 substances were selected for further evaluation.As volume is a critical parameter for exposure, 15 substances were thereafter selected. This prioritizationwas crosschecked with the information obtained from interviews with selected representatives from theindustry, which added one more substance to the priority list. Since the Swedish Environmental ProtectionAgency requested that substances previously included in various screenings should be excluded, the finallist consisted of eleven selected plasticizers.From the developed multicriteria model, the following plasticizers were identified: Dipropylene glycoldibenzoate (DGD); Alkanes, C14-17, chloro; Dioctyl adipate (DOA); Benzyl 3-isobutyryloxy-1-isopropyl-2,2-dimethylpropyl phthalate; 2,2,4-trimethyl-1,3 pentanediol di-isobutyrate (TXIB); Diisononyl adipate(DINA); Diethylene glycol dibenzoate (DEGD; DEGDB); Hexanedioic acid, polymer with 1,4-butanedioland 2,2-dimethyl-1,3-propanediol, isononyl ester (Palamoll 654; Palamoll 656); Epoxidised soybean oil(ESBO); (second DINP line) 1,2-Benzenedicarboxylic acid, di-C8-10-branched alkyl esters, C9-rich(DINP); and Tris-2-ethylhexyl trimellitate (TOTM).These plasticizers are suggested to be prioritized in future screening studies.
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| 6. |
- Schwarz, Johanna, et al.
(författare)
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Does sleep deprivation increase the vulnerability to acute psychosocial stress in young and older adults?
- 2018
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 96, s. 155-165
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Tidskriftsartikel (refereegranskat)abstract
- Sleep loss and psychosocial stress often co-occur in today’s society, but there is limited knowledge on the combined effects. Therefore, this experimental study investigated whether one night of sleep deprivation affects the response to a psychosocial challenge. A second aim was to examine if older adults, who may be less affected by both sleep deprivation and stress, react differently than young adults. 124 young (18–30 years) and 94 older (60–72 years) healthy adults participated in one of four conditions: i. normal night sleep & Placebo-Trier Social Stress Test (TSST), ii. normal night sleep & Trier Social Stress Test, iii. sleep deprivation & Placebo-TSST, iv. sleep deprivation & TSST. Subjective stress ratings, heart rate variability (HRV), salivary alpha amylase (sAA) and cortisol were measured throughout the protocol. At the baseline pre-stress measurement, salivary cortisol and subjective stress values were higher in sleep deprived than in rested participants. However, the reactivity to and recovery from the TSST was not significantly different after sleep deprivation for any of the outcome measures. Older adults showed higher subjective stress, higher sAA and lower HRV at baseline, indicating increased basal autonomic activity. Cortisol trajectories and HRV slightly differed in older adults compared with younger adults (regardless of the TSST). Moreover, age did not moderate the effect of sleep deprivation. Taken together, the results show increased stress levels after sleep deprivation, but do not confirm the assumption that one night of sleep deprivation increases the responsivity to an acute psychosocial challenge.
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| 8. |
- Rakow, Alexander, et al.
(författare)
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Decreased heart rate variability in children born with low birth weight
- 2013
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 74:3, s. 339-343
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low birth weight (LBW) is associated with cardiovascular morbidity in adulthood. Imbalance in the autonomic nervous system (ANS) has been implicated as a mechanism behind the developmental programming of cardiovascular function. We hypothesized that deviations in the ANS function are seen in children born with LBW. METHODS: Eighty-six children were included: 31 born pre-term (<32 wk gestational age), 27 born at term but small for gestational age (SGA), and 28 born at term with normal birth weight (control). Twenty-four-hour Holter-electrocardiogram monitoring was performed at an average age of 9 y. Heart rate variability results were analyzed using frequency and time domain methods. RESULTS: All frequency components and both time domain parameters tested were significantly lower in the preterm and SGA children compared with controls. The low frequency/high frequency ratio was not significantly different between children born with LBW and controls. CONCLUSION: The autonomic control appears to be affected in children born with LBW despite gestational age at birth. Decreased total power, as an estimation of the ANS's global activity, rather than the balance between parasympathetic and sympathetic modulation might be an early marker of cardiovascular disease later on in life for LBW born children.
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| 9. |
- Ericson, Mats, 1959-
(författare)
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Tentativt kvantitativ analys av högskoleverkets utvärderingar av utbildningskvalitet år 2011-2012.
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- En kvantitativ analys av Högskoleverkets (HSV) utvärderingar av utbildningskvalitet har genomförts såväl beskrivande som med försök till statistisk prövning av tänkbara samband mellan olika kvantitativa variabler och nyckeltal karaktäriserande universiteten och högskolornas verksamhet. Ett sammanvägt mått "Utbildningskvalitet" för de olika lärosätena bildades baserat på de av HSV för respektive utbildning använda omdömena "Bristande kvalitet" (= 1 p), "Hög kvalitet" (= 2 p) och "Mycket hög kvalitet" (= 3 p). "Utbildningskvaliteten" kan därmed arbiträrt anta ett värde mellan 1 till 3 där ett högre värde anger en högre bedömd kvalitet. De i juli 2012 av HSV publicerade utvärderingarna av 481 olika utbildningar/examina vid 28 st lärosäten ingick i den deskriptiva redovisningen. För statistiska test av eventuella samband mellan "Utbildningskvalitet" och olika kvantitativa variabler och nyckeltal eller skillnader mellan olika grupperingar av lärosätena inkluderades enbart de 17 st lärosäten som hade tio eller fler utvärderingar genomförda (totalt 429 utvärderingar).Resultaten av de statistiska analyserna indikerar att den i HSV:s utvärderingar gjorda bedömningen av utbildningarnas kvalitet ("Utbildningskvalitet") positivt samvarierar med hur mycket forskning ett lärosäte har uttryckt i absoluta ekonomiska tal. Det finns ett negativt men statistiskt säkerställt samband mellan bedömd "Utbildningskvalitet" och hur mycket utbildning ett lärosäte har i relativa tal i förhållande till forskning. Ju högre andel forskning, ju högre bedömd "Utbildningskvalitet". Något statistiskt säkerställt samband mellan den av HSV bedömda kvaliteten i utbildningen och antalet studenter, total ekonomisk omsättning eller graden av lärosätenas uppdragsutbildning återfanns inte.När lärosätena grupperades i de två kategorierna "Universitet" respektive "Högskolor" återfanns ingen statistiskt säkerställd skillnad i bedömd "Utbildningskvalitet" mellan kategorierna. Vid en gruppering av lärosätena i de två kategorierna "Äldre universitet" (inrättade före 1999) respektive "Nya universitet och högskolor" erhölls en statistiskt säkerställd skillnad med högre bedömd "Utbildningskvalitet" för gruppen "Äldre universitet".Då studien enbart omfattar de första 19 av de av HSV planerade drygt hundra bedömda huvudområdena så kan studien rimligen inte anses som representativ och generaliserbar för hela högskolesektorns olika utbildningsområden. Denna studie måste därför betraktas som tentativ och av mer hypotesgenererande karaktär.
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| 10. |
- Krantz, Göran, et al.
(författare)
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Bodily Movements Influence HeartRate Variability (HRV) Responses toIsolated Melodic Intervals
- 2011
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Ingår i: Music and Medicine. - : Sage. - 1943-8621 .- 1943-863X. ; 3:2, s. 108-113
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine self-rated emotions and psychophysiological reactions during two contrasting professional experiences of piano playing. Three internationally well-known professional solo pianists were the study participants. They performed a self-selected piece and a difficult prima vista piece. Heart rate (HR) and its variability (HRV) as well as breathing were measured. Psychological reactions were assessed before and after the performance by means of visual analogue scale (VAS). There was a higher HR during the self-selected piece than during the prima vista piece. Respiration rate on the other hand was higher and End tidal CO2 (ETCO2) was lower during the prima vista piece. The difficult playing was characterized by an increase in breathing and by an initially more pronounced (but not sustained) activation of the vagal nerve as well as a more sustained activation of the sympathetic system in the assigned piece than in the self-selected situation. In this study of 3 cases, there were indications that professional piano players may activate the parasympathetic system during a cognitively demanding task. Further studies should investigate the physiological differences between attention with mental effort and effortless attention during music performances.
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