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Sökning: WFRF:(Larsson Margareta)

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1.
  • Arnardóttir, Ragnheiður Harpa, 1963- (författare)
  • Physical Training and Testing in Patients with Chronic Obstructive Pulmonary Disease (COPD)
  • 2007
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aims of the studies were to investigate the effects of different training modalities on exercise capacity and health-related quality of life (HRQoL) in patients with moderate or severe COPD and, further, to explore two of the physical tests used in pulmonary rehabilitation.In study I, the 12-minute walking distance (12MWD) did not increase on retesting in patients with exercise-induced hypoxemia (EIH) whereas 12MWD increased significantly on retesting in the non-EIH patients. In study II, we found that the incremental shuttle walking test was as good a predictor of peak exercise capacity (W peak) as peak oxygen uptake (VO2 peak) is. In study III, we investigated the effects of two different combination training programmes when training twice a week for eight weeks. One programme was mainly based on endurance training (group A) and the other on resistance training and callisthenics (group B). W peak and 12MWD increased in group A but not in group B. HRQoL, anxiety and depression were unchanged in both groups. Ratings of perceived exertion at rest were significantly lower in group A than in group B after training and during 12 months of follow-up. Twelve months post-training, 12MWD was back to baseline in group A, but significantly shorter than at baseline in group B. Thus, a short endurance training intervention delayed decline in 12MWD for at least one year. Patients with moderate and severe COPD responded to training in the same way. In study IV, both interval and continuous endurance training increased W peak, VO2 peak, peak exhaled carbon dioxide (VCO2 peak) and 12MWD. Likewise, HRQoL, dyspnoea during activities of daily life, anxiety and depression improved similarly in both groups. At a fixed, submaximal workload (isotime), the interval training reduced oxygen cost and ventilatory demand significantly more than the continuous training did.
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2.
  • Bernhardsson, Susanne, 1958, et al. (författare)
  • Digital physiotherapy assessment vs conventional face-to-face physiotherapy assessment of patients with musculoskeletal disorders: A systematic review.
  • 2023
  • Ingår i: PloS One. - : Public Library of Science (PLoS). - 1932-6203. ; 18:3
  • Forskningsöversikt (refereegranskat)abstract
    • This systematic review aimed to assess the certainty of evidence for digital versus conventional, face-to-face physiotherapy assessment of musculoskeletal disorders, concerning validity, reliability, feasibility, patient satisfaction, physiotherapist satisfaction, adverse events, clinical management, and cost-effectiveness.Eligibility criteria: Original studies comparing digital physiotherapy assessment with face-to-face physiotherapy assessment of musculoskeletal disorders. Systematic database searches were performed in May 2021, and updated in May 2022, in Medline, Cochrane Library, Cinahl, AMED, and PEDro. Risk of bias and applicability of the included studies were appraised using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Quality Appraisal of Reliability Studies tool. Included studies were synthesised narratively. Certainty of evidence was evaluated for each assessment component using GRADE.Ten repeated-measures studies were included, involving 193 participants aged 23-62 years. Reported validity of digital physiotherapy assessment ranged from moderate/acceptable to almost perfect/excellent for clinical tests, range of motion, patient-reported outcome measures (PROMs), pain, neck posture, and management decisions. Reported validity for assessing spinal posture varied and was for clinical observations unacceptably low. Reported validity and reliability for digital diagnosis ranged from moderate to almost perfect for exact+similar agreement, but was considerably lower when constrained to exact agreement. Reported reliability was excellent for digital assessment of clinical tests, range of motion, pain, neck posture, and PROMs. Certainty of evidence varied from very low to high, with PROMs and pain assessment obtaining the highest certainty. Patients were satisfied with their digital assessment, but did not perceive it as good as face-to-face assessment.Evidence ranging from very low to high certainty suggests that validity and reliability of digital physiotherapy assessments are acceptable to excellent for several assessment components. Digital physiotherapy assessment may be a viable alternative to face-to-face assessment for patients who are likely to benefit from the accessibility and convenience of remote access.The review was registered in the PROSPERO database, CRD42021277624.
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4.
  • Faniband, Moosa, et al. (författare)
  • Biomarkers of Exposure to Pyrimethanil After Controlled Human Experiments
  • 2019
  • Ingår i: Journal of Analytical Toxicology. - : Oxford University Press (OUP). - 1945-2403 .- 0146-4760. ; 43:4, s. 277-283
  • Tidskriftsartikel (refereegranskat)abstract
    • Pyrimethanil (PYM) is a fungicide used pre- and post-harvest on many crops. It has a low acute toxicity but is of toxicological concern because of its antiandrogenic properties. The aim of the current work was to investigate some metabolism and estimate elimination kinetics of PYM in humans after experimental oral and dermal exposure. A liquid chromatography triple quadrupole mass spectrometry (LC-MS-MS) method was developed and validated for the analysis of PYM and its metabolite 4-hydroxypyrimethanil (OH-PYM) in human urine. The method was applied to analyze urine obtained from two volunteers experimentally exposed to PYM. The elimination of OH-PYM seemed to follow first-order kinetics and a two-phase excretion. After the oral exposure, the elimination half-life of OH-PYM in the rapid phase was 5 and 3 h for the female and male volunteer, respectively. In the slower phase, it was 15 h in both volunteers. After the dermal exposure, the half-life in the rapid phase was 8 h in both volunteers. In the slower phase, it was 30 and 20 h, respectively. About 80% of the oral dose was recovered as urinary OH-PYM in both volunteers. The dermal dose recovered as urinary OH-PYM was 9.4% and 19%, in the female and male volunteer, respectively. OH-PYM was mainly found as a conjugate of sulfonate and glucuronic acid. No free PYM was found. The analytical method showed good within-run, between-run and between-batch precision with a coefficient of variation between 6% and 12%. A limit of detection of 0.1 ng/mL and a limit of quantification of 0.4 ng/mL were achieved for both the analytes. The method was applied to biomonitor PYM exposure in populations in Sweden. OH-PYM was detected in nearly 50% and 96% of samples from the environmentally and occupationally exposed populations, respectively.
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5.
  • Lindqvist, Maria, 1975- (författare)
  • Experiences of counselling on physical activity during pregnancy Gestational diabetes mellitus : screening and pregnancy outcomes
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundOverweight and obesity are global health problems with several adverse health effects that threaten public health. In Sweden, almost four of ten pregnant women are overweight or obese, conditions that are associated with adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), a metabolic disorder that complicates pregnancy. Globally, physical inactivity is the fourth leading risk factor for mortality. The recommendation for physical activity (i.e., ≥150 minutes/week) issued by the Professional Associations for Physical Activity and the Swedish National Board of Health and Welfare is in line with the recommendations by the WHO. Physical activity during pregnancy is generally safe and beneficial for both the pregnant woman and her fetus and can maintain or improve fitness and may further improve pregnancy outcomes. However, pregnant women tend to lower their physical activity when entering pregnancy. Midwives working in antenatal care (ANC) in Sweden play a prominent role in promoting a healthy lifestyle through counselling pregnant women on lifestyle, including physical activity during pregnancy. Individual counselling on physical activity encourages pregnant women to maintain their pre-pregnant leisure time physical activity throughout their pregnancy.AimsThis thesis has three main aims. First, this thesis investigated guidelines for screening of GDM, risk factors, and pregnancy outcomes in relation to GDM. Second, it investigated physical activity during pregnancy and pregnancy outcomes. Third, it explored midwives’ and pregnant women’s experiences with counselling that addressed physical activity during pregnancy.MethodsStudy I and III are cross-sectional studies using data from the Maternal Health Care Register and the Salut Register. A total of 184,183 pregnant women were included in Study I (2011-2012) and 3,868 in Study III (2011-2012). Several statistical analyses were used: two-independent samples t-test, Pearson’s Chi-Square test, and univariate and multivariate logistic regression analyses. Study II and IV are qualitative studies applying qualitative content analysis. Study II included 41 midwives who were interviewed in eight focus group discussions (FGD). Study IV included 14 pregnant women who participated in individual in-depth interviews.Main findingsThere was no consensus in Sweden regarding clinical guidelines for screening regimes or 2-hour cut-off value for diagnosis of GDM from 2011 through 2012. Four screening regimes were applied in Sweden during this time period: A) universal screening with a 2-hour cut-off value of 10.0 mmol/L; B) selective screening with a 2-hour cut-off value of
8.9 mmol/L; C) selective screening with a 2-hourcut-off value of 10.0 mmol/L; and D) selective screening with
a 2-hour cut-off value of 12.2 mmol/L. The highest prevalence of GDM was found where selective screening was applied with a 2-hour cut-off value of 8.9 mmol/L. Unemployment, low educational level, and non-Nordic origin were all risk factors for GDM, and a BMI ≥30 kg/m2 almost four-doubled the risk for GDM compared to pregnant women with BMI <30 kg/m2. Increasing OGTT-values were associated with increasing risk of adverse pregnancy outcomes (Paper I). Midwives in antenatal care perceived counselling as both challenging and as an opportunity to promote a healthy lifestyle for pregnant women. As the theme “An on-going individual adjustment” revealed, the midwives tried to adjust their counselling to each pregnant woman’s individual needs. Counselling pregnant women on physical activity was seen as complex and ambiguous with a risk of being rejected by the women if the advice was delivered too straightforward. Instead, the midwives were “tiptoeing” around the sensitive topics (Paper II). Almost half of pregnant women reported that they achieved the recommended level of physical activity duringpregnancy (i.e., ≥150 minutes/week). These pregnant women were characterized by lower BMI, higher educational level, and very good or good self-rated health (SRH) compared to the pregnant women who did not achieve the recommended level (Paper III). Pregnant women reported a desire for individual counselling on physical activity during pregnancy. The theme that emerged was “Longing for fulfilment of individual needs and expectations”, which reflected the wish that midwives’ counselling on physical activity should be based on pregnant women’s individual needs instead of merely providing general advice. Some participants reported receiving encouragement and support, but others believed they were provided insufficient counselling on physical activity and that the midwife had her own agenda focusing mostly on medical surveillance (Paper IV).ConclusionsNo consensus regarding clinical guidelines and diagnostic criterion for GDM existed in Sweden during 2011 to 2012. Obesity was a strong risk factor for development of GDM, and low socio-economic status and non-Nordic origin were also demonstrated as significant risk factors. Positively, almost half of the pregnant women reached the recommended level of physical activity during pregnancy. Participants fulfilling the recommendation were characterized by lower BMI, higher education, and very good or good self-rated health. Midwives strived to adjust and individualize their counselling on physical activity; however, some of the pregnant women could experience the counselling on physical activity being too general. Clearly, healthcare professionals should encourage fertile and pregnant women to be physically active, especially overweight and obese pregnant women who report low levels of physical activity, in order to improve overall health in this population. 
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6.
  • Norén, Erika, et al. (författare)
  • Biomonitoring of organophosphorus flame retardants in a Swedish population – Results from four investigations between years 2000 - 2013
  • 2017
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Flame retardants are chemical substances used in furniture, plastics, building materials, several household products and consumer goods to reduce their flammability. Their widespread use has resulted in measurable concentrations of the compounds or their residues in the environment, biota and human biological samples. The previously used brominated flame retardants were found to be persistent and to have bioaccumulative and neurotoxic potential, which raised public awareness. The use of the emerging organophosphorus compounds have increased after phasing out some brominated flame retardants. The chemical properties and health impacts of the organophosphorus flame retardants have not been studied to the same extent. The effects on public health and the environment due to the exposure from their widespread occurrence are therefore unclear.The aim of this study is to analyse exposure levels of the organophosphorus flame retardants TBP, TPP, TDCIPP and TBOEP in urine samples from a Swedish population of young men. The samples were collected through the enrolment for military service. Urine samples from year 2000, 2004, 2009 and 2013 were analysed for selected biomarkers of exposure with LC-MS/MS. The statistical analysis focused on temporal trends of the measured exposure levels.The metabolites DBP, DPP and BDCIPP were found in concentrations above LOD (0.03 – 0.1 ng/ml) in the majority of the samples, and DPP in all samples. BBOEP were only found above LOD in some samples and in very low concentrations. There was a statistically significant decreasing trend for the concentrations of DBP over time
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7.
  • Norén, Erika, et al. (författare)
  • Tidstrender för ftalater, bisfenoler, polyaromatiska kolväten (PAH:er) och triklosan i urinprov hos unga män och kvinnor – Resultat från fyra undersökningar mellan år 2000 - 2013
  • 2017
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Befolkningen exponeras dagligen för en mängd olika miljögifter via föroreningar i utomhusmiljön, ämnen i byggnadsmaterial samt vid konsumtion av livsmedel och andra produkter. Halter av ämnen som kan medföra en risk för miljö eller hälsa mäts och kontrolleras till viss mån i miljön och i de flesta produktgrupper genom stickprov. Hur höga halter av dessa ämnen som kommer in i kroppen hos människor studeras inte lika mycket. I denna studie har halter av biomarkörer från vanligt förekommande ämnen i grupperna ftalater, bisfenoler, polyaromatiska kolväten (PAH) och triklosan analyserats i urin från unga män och kvinnor i Skåne som ett mått på exponeringen. Fokus har även varit på tidstrender genom statistisk analys av halterna vid fyra olika provtagningsår mellan år 2000 och 2013. De ämnen och utvalda biomarkörer som ingick i analysen var DEHP (MCMHP), DIDP (MCINP), DPHP (MPHHP), DINCH (MOINCH), bisfenol A (BPA), 2,2-bisfenol F (2,2-BPF), 4,4-bisfenol F (4,4-BPF), bisfenol S (BPS), fenantren (1-PH), pyren (2-OH-PH) och triklosan (TCS). Studien ska ses som ett komplement till den tidigare publicerade rapporten av Jönsson et al. (2014).Utvalda exponeringsbiomarkörer för samtliga ämnen gick att detektera i prover från alla provtagningsår utom 2,2-BPF som endast förekom i koncentrationer över LOD i enstaka urinprover år 2004 - 2013. Vanligast förekommande och högst halter var det för biomarkörerna för triklosan, bisfenol A och ftalaterna DEHP och DPHP. Dock minskade både medel- och mediankoncentrationerna av dessa ämnen över tid, med en signifikant nedåtgående trend för DEHP. Den alternativa mjukgöraren DINCH som är en ersättare för ftalater hade främst halter under LOD de första två åren men en tendens till ökning över tid med mediankoncentrationer över LOD både år 2009 och 2013. Övriga biomarkörer förekom i halter över LOD, men låga koncentrationer, och ingen tydlig trend syntes över tid.Resultatet visar en del exponeringstrender som tycks reflektera utfasning av vissa uppmärksammade ämnen. De utfasade ämnena har dock ersatts av nya snarlika ämnen, exempelvis mjukgöraren DINCH som i denna studie ser ut att öka.
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8.
  • Ahlqvist, Eva-Maria, et al. (författare)
  • Allt ljus på Montessoripedagogiken
  • 2007
  • Ingår i: Sydsvenska Dagbladet. ; :2007-05-21
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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