| 1. |
- Alinaghizadeh, Hassan, et al.
(författare)
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Cancer incidence in northern Sweden before and after the Chernobyl nuclear power plant accident
- 2014
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Ingår i: Radiation and Environmental Biophysics. - : Springer Science and Business Media LLC. - 0301-634X .- 1432-2099. ; 53:3, s. 495-504
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Tidskriftsartikel (refereegranskat)abstract
- Sweden received about 5 % of the total release of Cs-137 from the Chernobyl nuclear power plant accident in 1986. The distribution of the fallout mainly affected northern Sweden, where some parts of the population could have received an estimated annual effective dose of 1-2 mSv per year. It is disputed whether an increased incidence of cancer can be detected in epidemiological studies after the Chernobyl nuclear power plant accident outside the former Union of Soviet Socialist Republics. In the present paper, a possible exposure-response pattern between deposition of Cs-137 and cancer incidence after the Chernobyl nuclear power plant accident was investigated in the nine northernmost counties of Sweden (2.2 million inhabitants in 1986). The activity of Cs-137 from the fallout maps at 1986 was used as a proxy for the received dose of ionizing radiation. Diagnoses of cancer (ICD-7 code 140-209) from 1980 to 2009 were received from the Swedish Cancer Registry (273,222 cases). Age-adjusted incidence rate ratios, stratified by gender, were calculated with Poisson regression in two closed cohorts of the population in the nine counties 1980 and 1986, respectively. The follow-up periods were 1980-1985 and 1986-2009, respectively. The average surface-weighted deposition of Cs-137 at three geographical levels; county (n = 9), municipality (n = 95) and parish level (n = 612) was applied for the two cohorts to study the pre- and the post-Chernobyl periods separately. To analyze time trends, the age-standardized total cancer incidence was calculated for the general Swedish population and the population in the nine counties. Joinpoint regression was used to compare the average annual percent change in the general population and the study population within each gender. No obvious exposure-response pattern was seen in the age-adjusted total cancer incidence rate ratios. A spurious association between fallout and cancer incidence was present, where areas with the lowest incidence of cancer before the accident coincidentally had the lowest fallout of Cs-137. Increasing the geographical resolution of exposure from nine county averages to 612 parish averages resulted in a two to three times higher value of variance in the regression model. There was a secular trend with an increase in age-standardized incidence of cancer in both genders from 1980 to 2009, but significant only in females. This trend was stronger and statistically significant for both genders in the general Swedish population compared to the nine counties. In conclusion, using both high quality cancer registry data and high resolution exposure maps of Cs-137 deposition, it was not possible to distinguish an effect of Cs-137 on cancer incidence after the Chernobyl nuclear power plant accident in Sweden.
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| 2. |
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| 3. |
- Alinaghizadeh, Hassan, Statistiker, 1961-
(författare)
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Radioactive fall-out from the Chernobyl nuclear power plant accident in 1986 and cancer rates in Sweden, a 25-year follow up
- 2019
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The current research aimed to study the association between exposure to low-dose radiation fallout after the Chernobyl accident in 1986 and the incidence of cancer in Sweden.Methods: A nationwide study population, selecting information from nine counties out of 21 in Sweden for the period from 1980 – 2010.In the first study, an ecological design was defined for two closed cohorts from 1980 and 1986. A possible exposure response pattern between the exposure to 137Cs on the ground and the cancer incidence after the Chernobyl nuclear power plant accident was investigated in the nine northernmost counties of Sweden (n=2.2 million). The activity of 137Cs at the county, municipality and parish level in 1986 was retrieved from the Swedish Radiation Safety Authority (SSI) and used as a proxy for received dose of ionizing radiation. Information about diagnoses of cancer (ICD-7 code 140-209) from 1958 – 2009 were received from the Swedish Cancer Registry, National Board of Health and Welfare (368,244 cases were reported for the period 1958 to 2009). The incidence rate ratios were calculated by using Poisson Regression for pre-Chernobyl (1980 – 1986) and post-Chernobyl (1986 – 2009) using average deposition of 137Cs at three geographical levels: county (n=9), municipality (n=95), and parish level (n=612). Also, a time trend analysis with age standardized cancer incidence in the study population and in the general Swedish population was drawn from 1980 – 2009.In the second study, a closed cohort was defined as all individuals living in the three most contaminated counties in mid-Sweden in 1986. Fallout of 137Cs was retrieved as a digital map from the Geological Survey of Sweden, demographic data from Statistics Sweden, and cancer diagnosis from the Swedish Cancer Registry, National Board of Health and Welfare. Individuals were assigned an annual 137Cs exposure based on their place of residence (1986 through 1990), from which 5-year cumulative 137Cs exposures were calculated, accounting for the physical decay of 137Cs and changing residencies. Hazard ratios for having cancer during the follow-up period, adjusted for age, sex, rural/non-rural residence, and pre-Chernobyl total cancer incidence, were calculated.Results: No obvious exposure-response pattern in the age-standardized total cancer incidence rate ratios could be seen in the first study. However, a spurious association between the fallout and cancer incidence was present, where areas with the lowest incidence of cancer before the accident coincidentally had the lowest fallout of cesium-137. Increasing the geographical resolution of exposure from the average values of nine counties to the average values of 612 parishes resulted in two to three times higher degree of variance explanation by regression model. There was a secular trend, with an increase in age standardized incidence of cancer from 1980 – 2009. This trend was stronger in the general Swedish population compared to the nine counties of the present study.In the second study, 734,537 people identified were divided into three exposure categories: the first quartile was low exposure (0.0 to 45.4 kBq/m2), the second and third quartiles were intermediate exposure (45.41 to 118.8 kBq/m2), and the fourth quartile was highest exposure (118.81 to 564.71 kBq/m2). Between 1991 and 2010, 82,495 cancer cases were registered in the three counties. Adjusted HRs (95% CI) were 1.03 (1.01 to 1.05) for intermediate exposure, and 1.05 (1.03 to 1.07) for the highest exposure, when comparing to the reference exposure.Conclusion: Using the ecological data, there was no exposure response trend; however, after refining the data to the individual level of exposure, there was an overall exposure response pattern. Nonetheless, due to the time dependency, these results were restricted to the age group of 25 – 49 among males. Using register-based data only, for determining the association between low-dose exposure to radiation and the risk of developing cancer, is difficult since we cannot control for other significant factors that are associated with cancer.
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| 4. |
- Alinaghizadeh, Hassan, et al.
(författare)
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Total cancer incidence in relation to 137Cs fallout in the most contaminated counties in Sweden after the Chernobyl nuclear power plant accident : a register-based study
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:12
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine the total cancer incidence in relation to a 5-year exposure to caesium-137 ((137)Cs) from the 1986 Chernobyl nuclear power plant accident.METHODS: A closed cohort was defined as all individuals living in the three most contaminated counties in mid-Sweden in 1986. Fallout of (137)Cs was retrieved as a digital map from the Geological Survey of Sweden, demographic data from Statistics Sweden, and cancer diagnosis from the National Board of Health and Welfare. Individuals were assigned an annual (137)Cs exposure based on their place of residence (1986-1990), from which 5-year cumulative (137)Cs exposures were calculated, accounting for the physical decay of (137)Cs and changing residencies. HRs were adjusted for age, sex, rural/non-rural residence and pre-Chernobyl total cancer incidence.RESULTS: The 734 537 people identified were categorised by exposure: the first quartile was low exposure (0.0-45.4 kBq/m(2)), the second and third quartiles were intermediate exposure (45.41-118.8 kBq/m(2)), and the fourth quartile was the highest exposure (118.81-564.71 kBq/m(2)). Between 1991 and 2010, 82 495 cancer cases were registered in the 3 counties. Adjusted HRs (95% CI) were 1.03 (1.01 to 1.05) for intermediate exposure and 1.05 (1.03 to 1.07) for the highest exposure compared to the reference exposure.CONCLUSIONS: We found a small overall exposure-response pattern of the total cancer incidence related to (137)Cs after adjustment for age, sex, rural residence and pre-Chernobyl cancer incidence.
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| 5. |
- Berlin, Anita, et al.
(författare)
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Psychometric characteristics of a modified Sympathy-Acceptance-Understanding-Caring competence model questionnaire among foreign-born parents encountering nurses in primary child health care services
- 2016
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 17:3, s. 298-310
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to determine the psychometric properties of the Sumpathy-Acceptance-Understanding-Caring Competence (SAUK) model questionnaire for foreign-born parents evaluating nursing encounters in the Swedish Primary Child Health Care (PCHC) services. Multicultural encounters in child health care from the nursing perspectives are challenging and problematic worlwide. A suitable theory-based and validated questionnaire is needed for foreign-born parents to assess the quality of their encounters with nurses. The SAUC questionnaire, modified for use by new, foreign-born parents using the Swedish PCHC services, was evaluated for its congruence with the theory of Confirming Encounter. The study was ethically approved and data were collected between March and August 2009 from 83 new foreign-born parents seen at 50 clinics. Exploratory factor analysis was used to identifiy related factors, and goodness-of-fit tests were used to estimate theoretical consistency. Confirmatory Factor Analysis was used to verify the results. The questionnaire had satisfactory theoretical consistency with the theory of Confirming Encounter. Three factors identified by exploratory factor analysis and confirmed by confirmatory factor analysis - person support, self-support, and self-perspective support - indicated internal consistency and validated the three factors implicit in the Confirming Encounter. In addition, a new factor, concordance, was identified that is compatible with the theory. To conclude, despite the fact that a modified questionnaire have its limitations results demonstrate that the SAUC-model questionnaire seems to be a reliable and valid nursing quality-control measure with which foreign-born parents can evaluate the qualities of a confirming encounter with nurses. However, we suggest the need for testing the questionnaire in a larger population.
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| 6. |
- Blom, May, et al.
(författare)
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Daily stress and social support among women with CAD : results from a 1-year randomized controlled stress management intervention study.
- 2009
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 16:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Psychosocial stress may play a causative role in development and progression of coronary artery disease (CAD).PURPOSE: We investigated the effects of a 1-year stress management program on daily stress behavior and social support among female CAD patients.METHOD: Women, 247 (RESULTS: Daily stress scores for the intervention and control groups were at baseline 39.5 +/- 8.1 vs. 37.2 +/- 9.1 (p = 0.06), 10 weeks 37.2 +/- 8.0 vs. 35.5 +/- 9.4 (p = 0.20), 1-year 36.1 +/- 7.2 vs. 35.9 +/- 8.5 (p = 0.85), and at 1-2 year follow-up 34.0 +/- 7.8 vs. 35.3 +/- 8.7 (p = 0.32), respectively. Intention to treat analyses showed interaction between treatment and time [F(3,213) = 2.72; p = 0.01] reflecting that the decrease was more pronounced in the intervention group. There was no evidence for a difference in change concerning social support.CONCLUSION: CAD women in the intervention group had a more pronounced reduction of self-rated daily stress behavior over time compared to controls. However, as the intervention group had higher baseline values, due to regression toward the mean, we have no evidence that the difference in decrease of daily stress was due to the intervention.
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| 7. |
- Blom, May, et al.
(författare)
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Work and marital status in relation to depressive symptoms and social support among women with coronary artery disease.
- 2007
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Ingår i: Journal of Women's Health. - : Mary Ann Liebert Inc. - 1540-9996 .- 1931-843X. ; 16:9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Work and marital status have been shown to be associated with health outcome in women. However, the effect of employment and marriage on psychosocial functioning has been studied predominantly in healthy subjects. We investigated whether work and marital status are associated with depressive symptoms, social support, and daily stress behavior in women with coronary artery disease (CAD).METHODS: Data of 105 women with CAD and of working age were analyzed. General linear models were used to determine the association between work and marital status and depressive symptoms, social support, and daily stress behavior.RESULTS: Women who were working at the time of measurement had lower levels of depressive symptoms (7.0 +/- 1.2 vs. 12.1 +/- 0.9, p < 0.01) and higher levels of social support (21.6 +/- 1.0 vs. 18.9 +/- 0.7, p = 0.03) than the nonworking women, whereas marital status was not related to any of the outcome variables. Results were similar after adjusting for potential confounders, that is, age, education, self-reported health, and risk factors for CAD. There was no significant interaction between marital status and working status on depressive symptoms, social support, or daily stress behavior.CONCLUSIONS: In women with CAD, all <65 years of age, after a cardiac event, patients working had lower levels of depressive symptoms and a better social integration than those not working, regardless of reason for being nonemployed. Daily stress behavior, depression, and social support did not differ between cohabiting and not cohabiting women. Future interventions should take into consideration that women with CAD who are unemployed may have a higher risk for depression and social isolation and, therefore, poor clinical outcomes.
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| 8. |
- Bos (Sparén), Elisabeth, et al.
(författare)
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Factors associated with student learning processes in primary health care units : a questionnaire study
- 2015
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:1, s. 170-175
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Clinical placement plays a key role in education intended to develop nursing and caregiving skills. Studies of nursing students' clinical learning experiences show that these dimensions affect learning processes: (i) supervisory relationship, (ii) pedagogical atmosphere, (iii) management leadership style, (iv) premises of nursing care on the ward, and (v) nursing teachers' roles. Few empirical studies address the probability of an association between these dimensions and factors such as student (a) motivation, (b) satisfaction with clinical placement, and (c) experiences with professional role models.OBJECTIVE: The study aimed to investigate factors associated with the five dimensions in clinical learning environments within primary health care units.DESIGN AND METHODS: The Swedish version of Clinical Learning Environment, Supervision and Teacher, a validated evaluation scale, was administered to 356 graduating nursing students after four or five weeks clinical placement in primary health care units. Response rate was 84%. Multivariate analysis of variance is determined if the five dimensions are associated with factors a, b, and c above.RESULTS: The analysis revealed a statistically significant association with the five dimensions and two factors: students' motivation and experiences with professional role models. The satisfaction factor had a statistically significant association (effect size was high) with all dimensions; this clearly indicates that students experienced satisfaction.CONCLUSIONS: These questionnaire results show that a good clinical learning experience constitutes a complex whole (totality) that involves several interacting factors. Supervisory relationship and pedagogical atmosphere particularly influenced students' satisfaction and motivation. These results provide valuable decision-support material for clinical education planning, implementation, and management.
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| 9. |
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| 10. |
- Ghaffari, Mostafa, et al.
(författare)
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Assessment of the Psychosocial Work Environment among Health Care Workers and Its Association with Work and Socioeconomic Status
- 2017
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Ingår i: Archives of neuroscience. - : Briefland. - 2322-3944 .- 2322-5769. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: The health care sector constitutes one of the largest sources of employment worldwide.Objective: The aim of this study was to describe the psychosocial status of health care workers and its association with different covariates.Methods: Health care workers from different universities, hospitals, clinics, urban and rural health centers took part in this cross-sectional study. The medium version of COPSOQ was used to evaluate the association between COPSOQ and covariates. The multivariate analyses of variance and covariance were employed to determine multivariate and univariate associations between all psychosocial dimensions and covariates.Results: Most COPSOQ scores showed a good internal consistency and reliability, with total Cronbach’s alpha of 0.76. The study population comprised 7,027 health care workers among whom 64% were female. The results indicated that nurses are more exposed to the psychosocial work environment compared to the other groups of workers within the health care settings.Conclusions: Nurses had a significantly higher risk regarding almost all the psychosocial factors. Considering that the main shortage of human resources in our study population belonged to the nursing group, this bad situation is not surprising. Healthcare workers, especially nurses, are facing various psychosocial factors more than other workers are, because all these factors are in the healthcare environment at the same time.
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