| 1. |
- Acosta, Stefan, et al.
(författare)
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Short-Term Complications and Outcomes in Pharmaco-Mechanical Thrombolysis First and Catheter-Directed Thrombolysis First in Patients with Acute Lower Limb Ischemia
- 2023
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Ingår i: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096. ; 94, s. 253-262
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pharmaco-mechanical thrombolysis (PMT) has emerged as a treatment option in patients with acute lower limb ischemia (ALI), especially Rutherford IIb (motor deficit) for rapid revascularization, but supportive data is scarce. The aim of the present study was to compare the effects of thrombolysis, complications, and outcomes of PMT first versus catheter-directed thrombolysis (CDT) first in a large cohort of patients with ALI. Methods: All endovascular thrombolytic/thrombectomy events in patients with ALI performed between January 1st, 2009, and December 31st, 2018 (n = 347) were included. Successful thrombolysis/thrombectomy was defined as complete or partial lysis. Reasons for using PMT were described. Complications such as major bleeding, distal embolization, and new onset of renal impairment, and major amputation and mortality at 30 days were compared between PMT (AngioJet) first and CDT first groups in a multivariable logistic regression model with adjustment for age, gender, atrial fibrillation, and Rutherford IIb. Results: The most common reason for initial use of PMT was the need for rapid revascularization, and the most common reason for use of PMT after CDT was the insufficient effect of CDT. Presentation of Rutherford IIb ALI was more common in the PMT first group (36.2% vs. 22.5%, respectively, P = 0.027). Among the 58 patients receiving PMT first, 36 (62.1%) were terminated within a single session of therapy without need of CDT. The median duration of thrombolysis was shorter (P < 0.001) for the PMT first group (n = 58) compared to the CDT first group (n = 289) (4.0 hr vs. 23.0 hr, respectively). There was no significant difference in amount of tissue plasminogen activator given, successful thrombolysis/thrombectomy (86.2% and 84.8%), major bleeding (15.5% and 18.7%), distal embolization (25.9% and 16.6%), major amputation or mortality at 30-days (13.8% and 7.7%) in the PMT first compared to the CDT first group, respectively. The proportion of new onset of renal impairment was higher in the PMT first compared to the CDT first group (10.3% vs. 3.8%, respectively), and the increased odds (odds ratio 3.57, 95% confidence interval 1.22–10.41) were maintained in the adjusted model. In Rutherford IIb ALI, no difference in rate of successful thrombolysis/thrombectomy (76.2% and 73.8%), complications or 30-day outcomes was found between PMT first (n = 21) and CDT (n = 65) first group. Conclusions: PMT first appears to be a good treatment alternative to CDT in patients with ALI, including Rutherford IIb. The found renal function deterioration in the PMT first group needs to be evaluated in a prospective, preferably randomized trial.
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| 2. |
- Andersen, I, et al.
(författare)
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Does job strain mediate the effect of Socio-economic Group on smoking behaviour? The impact of different health policies in Denmark and Sweden
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 36:6, s. 598-606
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to compare the impact of socioeconomic groups (SEG) on the risk of being a daily smoker or quitter, and to investigate whether the potentially mediating effect of psychosocial working conditions was similar in the Danish and the Swedish populations. Methods: The study populations consisted of 10,049 employed participants, aged 18-64 years, 51% women, randomly selected from the general populations in the Oresund region, 1999-2000. Odds ratios (OR) for daily-smokers and "non-quitters'' were computed for two age-groups and two SEGs in gender specific models, stratified by country. The association between SEG, current smoking, quitting, and influence at work, job demand and jobstrain, respectively, was tested by means of logistic regression. Results: The contextual determinants defined by country had a different effect on smoking prevalence among men and women and among age groups. Low influence and job strain seemed to have an effect on smoking among Danish women, but not among Swedish women. The OR of being a daily smoker were higher in men than women among younger Danes, but higher in women than men among Swedes. The prevalence of low influence, high demand and job strain was higher and more socially skewed among the Swedes, but did not mediate the effect of SEG on smoking behaviour. Conclusions: The smoking prevalence was lower and the quit-rates higher among Swedes than Danes. Both countries had social differences in smoking that in absolute terms were rather similar, but in relative terms were higher in Sweden. The mediating effect of psychosocial working conditions was lacking. The determinants of smoking behaviours must be found somewhere else in the social and cultural context.
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| 3. |
- Axén, Iben, et al.
(författare)
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Can a workplace dialogue impact the perceived influence of neck and/or backpain on everyday activities and performance at work? A secondary analysis from the randomized controlled trial WorkUp
- 2022
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neck- and back- pain are highly prevalent conditions in Sweden and world-wide. Such pain often has consequences on everyday activities, work- and personal life. One consequence is work absence and decreased productivity at work. Adding a workplace dialogue to structured physiotherapy was recently found to lead to increased workability, i.e., not being on sick leave during the 12th month of follow up. Aim: The aim of the study was to explore the effect of a workplace dialogue intervention on secondary outcomes: perceived impact of neck and/or back pain on everyday activities and on performance at work, and total days of sick leave during 12 month follow up. A further aim was to examine associations between perceived influence of pain, and sick leave. Method: Patients with neck and/or back pain in primary care in the south of Sweden were randomized into structured physiotherapy alone (n = 206) or with the addition of a workplace dialogue (n = 146). Data regarding the pain’s influence on everyday activities and on performance at work were collected using weekly text messages for 52 weeks. The pattern of change in perceived influence of neck and/or back pain on everyday activities and performance at work was compared between the groups with linear mixed models. Cross sectional correlations between perceived influence of neck and/or back pain on everyday activities and performance at work, and days of sick leave, during the preceding four weeks at months 3, 6, 9 and 12 were examined. Result: We found no differences in change of perceived influence of neck and/or back pain on daily activities or perceived performance at work, or total days of sick leave during the 12 months of follow up between the groups with structured physiotherapy with or without a workplace dialogue. There was a weak to moderate positive correlation between days of sick leave and perceived influence of neck and/or back pain on everyday activities and performance at work (rho 0.28–0.47). Conclusion: A workplace dialogue was not found to affect the perceived impact of neck and/or back pain on everyday activities and performance at work. Trial registration: ClinicalTrials.gov ID: NCT02609750.
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| 4. |
- Biru, Mulatu, et al.
(författare)
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Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants : a retrospective study in Addis Ababa, Ethiopia
- 2011
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Ingår i: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 4, s. 563-563
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome.METHODS: A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected.FINDINGS: 118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (n = 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence χ2 -test, p < 0.01.CONCLUSION: The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.
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| 5. |
- Borgh, Madeleine, et al.
(författare)
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Organisational factors and occupational balance in working parents in Sweden
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:3, s. 409-416
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents with small children constitute a vulnerable group as they have an increased risk of sick leave due to stress-related disorders compared to adults without children. It has been shown that mothers and fathers to small children together spend more time in paid work than any other group, which could create negative stress and an experience of low occupational balance. Aim: The aim of this study was to examine associations between organisational factors and occupational balance among parents with small children in Sweden. Methods: Data were collected by a survey including questions about occupational balance, organisational factors and age, sex, employment rate, work position, monthly household income, number of children at home, separation/divorce last five years and overtime. The total number of parents included in this study was 718 (490 mothers and 228 fathers). Logistic regression models were applied to examine the odds ratios for occupational balance in relation to organisational factors. Results: Parents who experienced positive attitudes towards parenthood and parental leave among colleagues and managers were more likely to experience high occupational balance than parents who experienced negative or neutral attitudes. Having a clear structure for handover when absent from work was also strongly associated with high occupational balance. Conclusions : The result of the present study indicates that some organisational factors could be important for the occupational balance of parents with small children.
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| 6. |
- Brogårdh, Christina, et al.
(författare)
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Self-Perceived Life Satisfaction during the First Wave of the COVID-19 Pandemic in Sweden : A Cross-Sectional Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- Currently, there is limited knowledge on how the Swedish strategy with more lenient public health restrictions during the COVID-19 pandemic has influenced people's life satisfaction. Here, we investigated self-reported life satisfaction during the first wave of the pandemic in Sweden, and perceived changes in life satisfaction in relation to various sociodemographic factors. A total of 1082 people (mean age 48 (SD 12.2); 82% women) responded to an online survey during autumn 2020 including the "Life Satisfaction Questionnaire-11". A majority (69%) were satisfied with life as a whole, and with other important life domains, with the exception of contact with friends and sexual life. An equal share reported that life as a whole had either deteriorated (28%) or improved (29%). Of those that perceived a deterioration, 95% considered it to be due to the pandemic. Regarding deteriorated satisfaction with life as a whole, higher odds were found in the following groups: having no children living at home; being middle aged; having other sources of income than being employed; and having a chronic disease. The Swedish strategy might have contributed to the high proportion of satisfied people. Those who perceived a deterioration in life satisfaction may, however, need attention from Swedish Welfare Authorities.
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| 7. |
- Dell'Isola, Andrea, et al.
(författare)
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Factors Associated With the Outcome of a First-Line Intervention for Patients With Hip or Knee Osteoarthritis or Both : Data From the BOA Register
- 2020
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 100:10, s. 1771-1781
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study explored the association of patients' demographics, health status, symptom severity, previous osteoarthritis (OA) care, and psychological status with the change in pain severity following a first-line intervention including education and exercise for OA provided nationwide in Swedish primary care. METHODS: This register-based cohort study included 23,309 people with knee or hip OA from the Better Management of Patients with OA register. Linear regression models were used to assess the association of independent variables with the change in pain from baseline to 3 and 12 months. All the analyses were stratified based on the affected joint (hip vs knee). RESULTS: In people with hip and people with knee OA, high levels of baseline pain were associated with decreased pain at both follow-ups (3 months: knee B = -.67; hip B = -.64; 12 months: knee B = -.70; hip B = -.66), whereas being older, overweight, or female had a weak or no association. Finally, at both follow-ups, bilateral OA was associated with increased pain only in people with knee OA, whereas comorbidities and the willingness to undergo surgery were associated with increased pain regardless of the affected joint. CONCLUSIONS: Baseline pain showed the strongest association among the analyzed variables, whereas sex, age, and body mass index appear to be weakly associated with the pain change after a first-line intervention. Comorbidities and willingness to undergo surgery showed a potentially important association and may have a negative impact on the pain change following a first-line intervention. IMPACT: In people with hip or knee OA, age, sex, body mass index, and previous surgery are only weakly associated with the change in pain after a first-line intervention supporting the evidence recommending exercise and education as a foundation for all OA therapy. Having comorbidities and being willing to undergo surgery is associated with a worse outcome from a first-line intervention, including exercise and education. Individualized treatments addressing the disease perception and the specific comorbidity profile may improve the outcomes.
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| 8. |
- Eek, Frida, et al.
(författare)
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Attitude and flexibility are the most important work place factors for working parents' mental wellbeing, stress, and work engagement.
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:7, s. 692-705
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The need to combine active employment and parenthood is a reality for many parents today. Knowing more about which work place factors are associated with better or worse health could help employers to form a work environment that provides optimal conditions to maintain or increase health and work engagement in this group. The aim of this study was to explore possible associations between different subjective and objective work factors and benefits, and a range of outcome variables such as stress, symptom report, wellbeing, work-related fatigue, work engagement, and work-family conflict among working mothers and fathers with small children. Methods: Cross-sectional analyses of associations between work place factors categorised into three different dimensions; flexibility, benefits, and attitude and the outcome measures were performed, including questionnaire responses from 1562 working parents. Results: The results showed that work place factors related to flexibility and, especially among women, attitude to parenthood appear to have the strongest effect on working parents' subjective stress and wellbeing, while benefits appear to have less impact. Except regarding factors related to attitudes at the work place, most associations were similar among men and women. Conclusions: Most likely, different factors are better suited or more important for some individuals than others depending on their total work, as well as family situation and also depending on individual factors such as personality and priorities. A positive attitude towards parenthood and a flexible work situation seem, however, beneficial for the general wellbeing and work engagement among working parents.
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| 9. |
- Eek, Frida, et al.
(författare)
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Cortisol, sleep, and recovery: some gender differences but no straight associations
- 2012
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 37:1, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedBACKGROUND: Work related fatigue has been suggested as a link in the assumed sequence of events between repeated adverse work demands and the development of work related stress, which may be associated with changes in concentrations of cortisol, psychological overload and, in the long run, health problems. Insufficient sleep is a contributing factor to lack of recovery, but previous studies on associations between subjective aspects of sleep and recovery, and cortisol, have been inconclusive. The aim with the present study was to examine possible associations between cortisol measures and (I) self-rated recovery, (II) occupational fatigue and (III) subjective sleep quality the night preceding cortisol sampling. Further, possible gender differences were tested. METHODS: Salivary cortisol was measured in 581 persons during a working day, at awakening, +30min and in the evening. Various measures of subjective sleep and recovery were analyzed in relation to cortisol. RESULTS: Few correlations between cortisol and any sleep- or recovery parameters were found. However, some significant associations were found between cortisol and a few measures of more chronic aspects of sleep and recovery. Gender stratified analyses showed somewhat differing associations among men and women. This indicates that possible associations and pathways between lack of recovery/sleepiness and cortisol, and in the long run, unhealth, may not be similar for men and women.
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| 10. |
- Eek, Frida, et al.
(författare)
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Differences in socioeconomic and gender inequalities in tobacco smoking in Denmark and Sweden; a cross sectional comparison of the equity effect of different public health policies
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Denmark and Sweden are considered to be countries of rather similar socio-political type, but public health policies and smoking habits differ considerably between the two neighbours. A study comparing mechanisms behind socioeconomic inequalities in tobacco smoking, could yield information regarding the impact of health policy and -promotion in the two countries. Methods: Cross-sectional comparisons of socioeconomic and gender differences in smoking behaviour among 6 995 Danish and 13 604 Swedish persons aged 18-80 years. Results: The prevalence of smoking was higher in Denmark compared to Sweden. The total attributable fraction (TAF) of low education regarding daily smoking was 36% for Danish men and 35% for Danish women, and 32% and 46%, respectively, for Swedish men and women. TAF of low education regarding continued smoking were 16.2% and 15.8% for Danish men and women, and 11.0% and 18.8% for Swedish men and women, respectively The main finding of the study was that the socioeconomic patterning of smoking, based on level of education and expressed as the relative contribution to the total burden of smoking exposure, was rather different in Sweden and Denmark. Moreover, these differences were modified by gender and age. As a general pattern, socioeconomic differences in Sweden tended to contribute more to the total burden of this habit among women, especially in the younger age groups. In men, the patterns were much more similar between the two countries. Regarding continued smoking/unsuccessful quitting, the patterns were similar for women, but somewhat different for men. Here we found that socioeconomic differences contributed more to overall continued smoking in Danish men, especially in the middle-age and older age strata. Conclusion: The results imply that Swedish anti-smoking policy and/or implemented measures have been less effective in a health equity perspective among the younger generation of women, but more effective among men, compared to Danish policy implementation. The results also raises the more general issue regarding the possible need for a trade-off principle between overall population efficacy versus equity efficacy of anti-tobacco, as well as general public health policies and intervention strategies.
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