| 1. |
- Bousquet, Jean, et al.
(författare)
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Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018) : Change management in allergic rhinitis and asthma multimorbidity using mobile technology
- 2019
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Ingår i: Journal of Allergy and Clinical Immunology. - : Elsevier. - 0091-6749 .- 1097-6825. ; 143:3, s. 864-879
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Tidskriftsartikel (refereegranskat)abstract
- Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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| 2. |
- Menditto, Enrica, et al.
(författare)
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Adherence to treatment in allergic rhinitis using mobile technology : The MASK Study
- 2019
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Ingår i: Clinical and Experimental Allergy. - : WILEY. - 0954-7894 .- 1365-2222. ; 49:4, s. 442-460
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mobile technology may help to better understand the adherence to treatment. MASK-rhinitis (Mobile Airways Sentinel NetworK for allergic rhinitis) is a patient-centred ICT system. A mobile phone app (the Allergy Diary) central to MASK is available in 22 countries. Objectives: To assess the adherence to treatment in allergic rhinitis patients using the Allergy Diary App. Methods: An observational cross-sectional study was carried out on all users who filled in the Allergy Diary from 1 January 2016 to 1 August 2017. Secondary adherence was assessed by using the modified Medication Possession Ratio (MPR) and the Proportion of days covered (PDC) approach. Results: A total of 12143 users were registered. A total of 6949 users reported at least one VAS data recording. Among them, 1887 users reported >= 7 VAS data. About 1195 subjects were included in the analysis of adherence. One hundred and thirty-six (11.28%) users were adherent (MPR >= 70% and PDC <= 1.25), 51 (4.23%) were partly adherent (MPR >= 70% and PDC = 1.50) and 176 (14.60%) were switchers. On the other hand, 832 (69.05%) users were non-adherent to medications (MPR <70%). Of those, the largest group was non-adherent to medications and the time interval was increased in 442 (36.68%) users. Conclusion and clinical relevance: Adherence to treatment is low. The relative efficacy of continuous vs on-demand treatment for allergic rhinitis symptoms is still a matter of debate. This study shows an approach for measuring retrospective adherence based on a mobile app. This also represents a novel approach for analysing medication-taking behaviour in a real-world setting.
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| 4. |
- De Jager, Veronique, et al.
(författare)
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Early Bactericidal Activity of Meropenem plus Clavulanate (with or without Rifampin) for Tuberculosis : The COMRADE Randomized, Phase 2A Clinical Trial
- 2022
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 205:10, s. 1228-1235
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Carbapenems are recommended for treatment of drug-resistant tuberculosis. Optimal dosing remains uncertain.Objectives: To evaluate the 14-day bactericidal activity of meropenem, at different doses, with or without rifampin.Methods: Individuals with drug-sensitive pulmonary tuberculosis were randomized to one of four intravenous meropenem-based arms: 2 g every 8 hours (TID) (arm C), 2 g TID plus rifampin at 20 mg/kg once daily (arm D), 1 g TID (arm E), or 3 g once daily (arm F). All participants received amoxicillin/clavulanate with each meropenem dose. Serial overnight sputum samples were collected from baseline and throughout treatment. Median daily fall in colony-forming unit (CFU) counts per milliliter of sputum (solid culture) (EBA(CFU0-14)) and increase in time to positive culture (TTP) in liquid media were estimated with mixed-effects modeling. Serial blood samples were collected for pharmacokinetic analysis on Day 13.Measurements and Main Results: Sixty participants enrolled. Median EBA(CFU0-14) counts (2.5th-97.5th percentiles) were 0.22 (0.12-0.33), 0.12 (0.057-0.21), 0.059 (0.033-0.097), and 0.053 (0.035-0.081); TTP increased by 0.34 (0.21-0.75), 0.11 (0.052-037), 0.094 (0.034-0.23), and 0.12 (0.04-0.41) (log(10) h), for arms C-F, respectively. Meropenem pharmacokinetics were not affected by rifampin coadministration. Twelve participants withdrew early, many of whom cited gastrointestinal adverse events.Conclusions: Bactericidal activity was greater with the World Health Organization-recommended total daily dose of 6 g daily than with a lower dose of 3 g daily. This difference was only detectable with solid culture. Tolerability of intravenous meropenem, with amoxicillin/clavulanate, though, was poor at all doses, calling into question the utility of this drug in second-line regimens.
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| 5. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Implementation of Activity-Based Workplaces (ABW)-The Importance of Participation in Process Activities
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:21
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Tidskriftsartikel (refereegranskat)abstract
- Relocation to new office solutions such as activity-based workplaces (ABW) has increased but satisfaction with the ABW among employees varies, and the importance of participation in the relocation process is unclear. This study aimed to examine the association between employees' extent of participation in the implementation process activities and satisfaction with the relocation to ABW. Data were collected from 699 employees in a Swedish governmental agency 3-months prior to, 3-months and 9-months after relocation to the ABW. Questionnaires were used to assess participation in process activities and perceived satisfaction with knowledge about working in ABW, office rules, and information and support during the process. Participation in activities was significantly associated with higher overall satisfaction with knowledge, office rules, information and support, and effects were generally more pronounced as the number of attended activities increased. Satisfaction also increased among non-participants, although without reaching the same levels as participants. Our results show the importance to offer and facilitate a high participation in the relocation process activities to obtain satisfaction with a relocation to ABW.
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| 6. |
- Bergsten, Eva L., 1969-, et al.
(författare)
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Relocation to Activity-Based Workplaces (ABW)-Importance of the Implementation Process
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:21
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Tidskriftsartikel (refereegranskat)abstract
- Activity-based workplaces (ABW) have been implemented in many organizations to offer office flexibility and decrease facility costs. Evaluations of the ABW implementation process are rare. The study aimed to examine the ABW relocation process of two offices in a Swedish governmental agency and to explore factors that influence the implementation process and satisfaction with it. Qualitative or quantitative data were collected on process variables (context, recruitment, reach, dose delivered, dose received, satisfaction), barriers and facilitators to the process were explored in focus group interviews, and immediate outcomes (perceived knowledge, understanding office rules, satisfying information and support) were measured by questionnaire before and after the relocation. The evaluation showed that recruitment was unsatisfactory and reach insufficient-and participation in activities was thus low for both offices. However, intended changes improved. Unclear aims of ABW, lack of manager support and, lack of communication were some of the reported barriers to participation, while a well-planned process, work groups, and program activities were facilitators. Thus, to increase satisfaction with the relocation, our results suggest that recruitment should be thoroughly planned, taking these factors into account to increase participation. This knowledge may be useful for planning and designing successful ABW relocations and evaluations.
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| 7. |
- Marcks, Nick, et al.
(författare)
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Re-appraisal of the obesity paradox in heart failure : a meta-analysis of individual data
- 2021
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Ingår i: Clinical Research in Cardiology. - : Springer Nature. - 1861-0684 .- 1861-0692. ; 110:8, s. 1280-1291
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Tidskriftsartikel (refereegranskat)abstract
- Background Higher body mass index (BMI) is associated with better outcome compared with normal weight in patients with HF and other chronic diseases. It remains uncertain whether the apparent protective role of obesity relates to the absence of comorbidities. Therefore, we investigated the effect of BMI on outcome in younger patients without co-morbidities as compared to older patients with co-morbidities in a large heart failure (HF) population. Methods In an individual patient data analysis from pooled cohorts, 5,819 patients with chronic HF and data available on BMI, co-morbidities and outcome were analysed. Patients were divided into four groups based on BMI (i.e. <= 18.5 kg/m(2), 18.5-25.0 kg/m(2); 25.0-30.0 kg/m(2); 30.0 kg/m(2)). Primary endpoints included all-cause mortality and HF hospitalization-free survival. Results Mean age was 65 +/- 12 years, with a majority of males (78%), ischaemic HF and HF with reduced ejection fraction. Frequency of all-cause mortality or HF hospitalization was significantly worse in the lowest two BMI groups as compared to the other two groups; however, this effect was only seen in patients older than 75 years or having at least one relevant co-morbidity, and not in younger patients with HF only. After including medications and N-terminal pro-B-type natriuretic peptide and high-sensitivity cardiac troponin concentrations into the model, the prognostic impact of BMI was largely absent even in the elderly group with co-morbidity. Conclusions The present study suggests that obesity is a marker of less advanced disease, but does not have an independent protective effect in patients with chronic HF. [GRAPHICS] .
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| 8. |
- Wijk, Katarina, et al.
(författare)
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Individual determinants of satisfaction with the work environment after relocation to activity-based workplaces: a prospective study
- 2023
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Ingår i: PLOS ONE. - : PLOS. - 1932-6203. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- Relocation to activity-based workplaces influences work environment satisfaction, but individual determinants of changes in satisfaction remain unknown. The aim of the present study was to determine whether age, gender, education, occupational position, or office type before relocation can predict work environment satisfaction among employees and managers relocated to activity-based offices. Respondents (n=422) rated work environment satisfaction three months before and nine months after relocation. The findings indicate that, on average, satisfaction decreased after relocation, while for some workers it increased. Occupational position and office type at baseline predicted changes in satisfaction with the work environment; specifically, managers and those working in open-plan offices before relocation reported a smaller decline in satisfaction after relocation, compared to those relocating from private offices. Participants with no university education were more satisfied with the physical and psychosocial work environment in activity-based workplaces than those with a university degree.
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| 9. |
- Wijk, Katarina, et al.
(författare)
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Sense of Coherence, Health, Well-Being, and Work Satisfaction before and after Implementing Activity-Based Workplaces
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14
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Tidskriftsartikel (refereegranskat)abstract
- Activity-based workplaces (ABWs) are implemented with possible implications for health, well-being, and work satisfaction in the workplace. Drawing on the theoretical framework, i.e., sense of coherence (SOC), the aim was to investigate how indicators pf SOC-meaningfulness, manageability and comprehensibility-are associated with, or function as barriers or facilitators for, health, well-being and work satisfaction during relocation to an ABW. We followed the implementation of ABWs at the Swedish Transport Administration (2018-2019). Questionnaires were administered before (n= 536), 3 months (n= 409) and 9 months (n= 373) after relocation. Focus group interviews (15) were conducted before and after. Data were analyzed using repeated measures ANOVA and content analysis. Relocation to an ABW was associated with a reduced work satisfaction (physicalp< 0.001; psychosocialp< 0.001), and minor changes in health and occupational well-being during relocation (p> 0.001). The reduction in work satisfaction was smaller among employees with high meaningfulness in the relocation process (p< 0.001). All SOC indicators were positively associated with overall health, well-being and work satisfaction (p< 0.001). Interviews suggested that meaningfulness was facilitated by participation in the presented activities and that communication before relocation was crucial. The results indicate that organizations implementing ABWs should promote perceived meaningfulness in the process to mitigate possible declines in satisfaction with the physical and psychosocial work environment.
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| 10. |
- Zuberbier, T., et al.
(författare)
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Proposal of 0.5 mg of protein/100 g of processed food as threshold for voluntary declaration of food allergen traces in processed food-A first step in an initiative to better inform patients and avoid fatal allergic reactions: A GA(2)LEN position paper
- 2022
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Ingår i: Allergy. - : Wiley. - 0105-4538 .- 1398-9995. ; 77:6, s. 1736-1750
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Tidskriftsartikel (refereegranskat)abstract
- Background Food anaphylaxis is commonly elicited by unintentional ingestion of foods containing the allergen above the tolerance threshold level of the individual. While labeling the 14 main allergens used as ingredients in food products is mandatory in the EU, there is no legal definition of declaring potential contaminants. Precautionary allergen labeling such as "may contain traces of" is often used. However, this is unsatisfactory for consumers as they get no information if the contamination is below their personal threshold. In discussions with the food industry and technologists, it was suggested to use a voluntary declaration indicating that all declared contaminants are below a threshold of 0.5 mg protein per 100 g of food. This concentration is known to be below the threshold of most patients, and it can be technically guaranteed in most food production. However, it was also important to assess that in case of accidental ingestion of contaminants below this threshold by highly allergic patients, no fatal anaphylactic reaction could occur. Therefore, we performed a systematic review to assess whether a fatal reaction to 5mg of protein or less has been reported, assuming that a maximum portion size of 1kg of a processed food exceeds any meal and thus gives a sufficient safety margin. Methods MEDLINE and EMBASE were searched until 24 January 2021 for provocation studies and case reports in which one of the 14 major food allergens was reported to elicit fatal or life-threatening anaphylactic reactions and assessed if these occurred below the ingestion of 5mg of protein. A Delphi process was performed to obtain an expert consensus on the results. Results In the 210 studies included, in our search, no reports of fatal anaphylactic reactions reported below 5 mg protein ingested were identified. However, in provocation studies and case reports, severe reactions below 5 mg were reported for the following allergens: eggs, fish, lupin, milk, nuts, peanuts, soy, and sesame seeds. Conclusion Based on the literature studied for this review, it can be stated that cross-contamination of the 14 major food allergens below 0.5 mg/100 g is likely not to endanger most food allergic patients when a standard portion of food is consumed. We propose to use the statement "this product contains the named allergens in the list of ingredients, it may contain traces of other contaminations (to be named, e.g. nut) at concentrations less than 0.5 mg per 100 g of this product" for a voluntary declaration on processed food packages. This level of avoidance of cross-contaminations can be achieved technically for most processed foods, and the statement would be a clear and helpful message to the consumers. However, it is clearly acknowledged that a voluntary declaration is only a first step to a legally binding solution. For this, further research on threshold levels is encouraged.
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