| 1. |
- Pistone, Isabella, 1987, et al.
(författare)
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Suicidprevention genom utbildning och medvetandegöranden : En systematisk litteraturöversikt över förebyggande insatser utanför hälso- och sjukvården
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna systematiska litteraturöversikt är att 1) kartlägga utbildning och medvetandegörande insatser, utanför hälso- och sjukvården, som förebygger suicid, och 2) bedöma effekterna av dessa insatser. De mest utvärderade insatserna är utbildningar för s.k. mediatorer, även benämnda gatekeepers som oftast riktar sig till vuxna, och utbildningar i skolan som riktar sig direkt till barn och unga. Utbildningsinsatserna bygger i stort på att öka deltagarnas kunskaper och färdigheter för att antingen kunna agera som mediatorer och hjälpa andra personer som mår dåligt, eller kunna hjälpa sig själva till att förbättra den psykiska hälsan och förebygga suicid. Kartläggningen visar att många studier har en robust studiedesign såsom kontrollerade studier med eller utan randomisering. Studierna spretar dock metodologiskt (t.ex. olika utfall och uppföljningstider), vilket gör det svårt att sammanväga de uppmätta effekterna. De viktigaste resultaten visar att: • Utbildningsinsatser som är riktade till barn och unga kan minska antalet självrapporterade suicidförsök och suicidtankar. Utbildningar som riktas direkt till elever är troligtvis effektivare än utbildningar som är riktade till lärare och annan skolpersonal som ska agera som hjälpare/gatekeepers (s.k. mediatorsutbildningar). • Effekten av utbildningsinsatser kan bero på flera faktorer, bl.a. på deltagarnas personliga egenskaper, t.ex. utbildningsnivå. Gene rellt sett krävs det mer forskning på området, framförallt större studier med längre uppföljningstider för att avgöra insatsernas effekt bland vuxna. Litteraturen identifierades via strukturerade sökningar i vetenskapliga databaser, via handsökningar och via en genomgång av referenslistor. Två omfattande sökningar i databaser genomfördes. Den första var inriktad på insatser som har ett uttalat syfte att förebygga suicid. Den andra var en breddad sökning som även omfattade insatser som ska förebygga psykisk ohälsa. Av de totalt 24 548 unika publikationer som identifierades var 173 relevanta för denna litteraturöversikt. De utfall som undersöktes var kunskaper om och attityder till suicid, färdigheter i att ingripa och förekomsten av suicidtankar och suicidförsök. Sammanlagt 41 av publikationerna kunde användas för att sammanväga effekterna genom metaanalys och narrativ analys. Baserat på litteraturen i denna översikt går det inte att uttala sig om utbildningsinsatsers effekt på antalet fullbordade suicid. Dels är det svårt att koppla förändringar i suicidtal till en isolerad preventionsinsats, dels skulle sådana effektstudier kräva mycket stora studiepopulationer och långa uppföljningstider för att ge statistiskt robusta resultat eftersom suicid är en relativt ovanlig händelse. Enskilda utbildningar och medvetandegörande insatser bör därför ses som en del av ett bredare suicidpreventivt arbete som omfattar insatser inom flera samhällssektorer.
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| 2. |
- Pistone, Isabella, 1987, et al.
(författare)
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The effects of educational interventions on suicide: A systematic review and meta-analysis
- 2019
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Ingår i: International Journal of Social Psychiatry. - : SAGE Publications. - 0020-7640 .- 1741-2854. ; 65:5, s. 399-412
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Forskningsöversikt (refereegranskat)abstract
- Background: Suicide is a major public health problem. Educational interventions for preventing suicidal behaviour are widely used, although little is known regarding the collective effectiveness of these interventions. Aim: We evaluated the existing evidence for the effectiveness of education interventions in the prevention of suicidal behaviour. Methods: In this systematic review and meta-analysis, we searched multiple databases using terms related to suicide prevention. The articles were reviewed by two independent reviewers, and the quality of evidence was rated according to Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data from individual studies were combined in meta-analyses. Results: We identified 41 studies evaluating two different types of interventions: school-based education interventions and gatekeeper training. Education interventions showed significant gains in terms of knowledge and attitudes, though the effects seem to vary depending on subjects’ personal characteristics. School-based education interventions significantly reduced suicidal ideation and suicide attempts in youths. Gatekeeper training showed no significant effect on suicide attempts or gatekeeper skills, though the quality of evidence for the estimate, according to GRADE criteria, was rated as very low. Conclusion: The results of this study indicate that school-based education interventions are effective in preventing suicidal ideation and suicide attempts. In clinical practice, as well as in research, the development and implementation of educational interventions should focus on participants’ individual characteristics.
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| 3. |
- Roca Rubio, Maria Fernanda, 1989-, et al.
(författare)
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Associations between various markers of intestinal barrier and immune function after a high-intensity exercise challenge
- 2024
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Ingår i: Physiological Reports. - : John Wiley & Sons. - 2051-817X. ; 12:10
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Tidskriftsartikel (refereegranskat)abstract
- Strenuous exercise can result in disruption of intestinal barrier function and occurrence of gastrointestinal symptoms. The aim of this exploratory study was to elucidate systemic effects of increased intestinal permeability after high-intensity exercise. Forty-one endurance-trained subjects performed a 60-min treadmill run at 80% VO2max. Small intestinal permeability was measured as urinary excretion ratio of lactulose/rhamnose (L/R). Blood, saliva and feces were analyzed for gut barrier and immune-related biomarkers. The exercise challenge increased several markers of intestinal barrier disruption, immune function and oxidative stress. We found a negative correlation between L/R ratio and uric acid (r = -0.480), as well as a positive correlation between the L/R ratio and fecal chromogranin A in male participants (r = 0.555). No significant correlations were found between any of the markers and gastrointestinal symptoms, however, perceived exertion correlated with the combination of IL-6, IL-10 and salivary cortisol (r = 0.492). The lack of correlation between intestinal permeability and gastrointestinal symptoms could be due to minor symptoms experienced in lab settings compared to real-life competitions. The correlation between L/R ratio and uric acid might imply a barrier-protective effect of uric acid, and inflammatory processes due to strenuous exercise seem to play an important role regarding physical exhaustion.
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| 4. |
- Alijagic, Andi, 1992-, et al.
(författare)
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Immunotoxic, genotoxic, and endocrine disrupting impacts of polyamide microplastic particles and chemicals
- 2024
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 183
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Tidskriftsartikel (refereegranskat)abstract
- Due to their exceptional properties and cost effectiveness, polyamides or nylons have emerged as widely used materials, revolutionizing diverse industries, including industrial 3D printing or additive manufacturing (AM). Powder-based AM technologies employ tonnes of polyamide microplastics to produce complex components every year. However, the lack of comprehensive toxicity assessment of particulate polyamides and polyamide-associated chemicals, especially in the light of the global microplastics crisis, calls for urgent action. This study investigated the physicochemical properties of polyamide-12 microplastics used in AM, and assessed a number of toxicity endpoints focusing on inflammation, immunometabolism, genotoxicity, aryl hydrocarbon receptor (AhR) activation, endocrine disruption, and cell morphology. Specifically, microplastics examination by means of field emission scanning electron microscopy revealed that work flow reuse of material created a fraction of smaller particles with an average size of 1-5 µm, a size range readily available for uptake by human cells. Moreover, chemical analysis by means of gas chromatography high-resolution mass spectrometry detected several polyamide-associated chemicals including starting material, plasticizer, thermal stabilizer/antioxidant, and migrating slip additive. Even if polyamide particles and chemicals did not induce an acute inflammatory response, repeated and prolonged exposure of human primary macrophages disclosed a steady increase in the levels of proinflammatory chemokine Interleukin-8 (IL-8/CXCL-8). Moreover, targeted metabolomics disclosed that polyamide particles modulated the kynurenine pathway and some of its key metabolites. The p53-responsive luciferase reporter gene assay showed that particles per se were able to activate p53, being indicative of a genotoxic stress. Polyamide-associated chemicals triggered moderate activation of AhR and elicited anti-androgenic activity. Finally, a high-throughput and non-targeted morphological profiling by Cell Painting assay outlined major sites of bioactivity of polyamide-associated chemicals and indicated putative mechanisms of toxicity in the cells. These findings reveal that the increasing use of polyamide microplastics may pose a potential health risk for the exposed individuals, and it merits more attention.
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| 5. |
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| 6. |
- Aro, Rudolf, 1992-, et al.
(författare)
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Combustion ion chromatography for extractable organofluorine analysis
- 2021
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Ingår i: iScience. - : Cell Press. - 2589-0042. ; 24:9
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Tidskriftsartikel (refereegranskat)abstract
- Combustion ion chromatography (CIC) has found a role in environmental analytical chemistry for fluorine content analysis. It is used for extractable organofluorine (EOF) analysis to evaluate perfluoroalkyl and polyfluoroalkyl substances (PFASs) and other organofluorine burden. The prevailing assumption has been that all PFASs are incinerated in CIC and matrix components have no impact on this process, but this has not been experimentally evaluated. In this work, the combustion efficiencies of 13 different PFASs were determined (66-110%). A notable difference was observed between calibrating the CIC with inorganic fluorine or organofluorine. Potential interferences from cations and coextracted matrix components from whole blood and surface water samples were evaluated. These observations should be acknowledged when performing EOF analysis using CIC, overlooking either non-100% combustion efficiencies or the differences in calibrating the CIC with inorganic fluorine or organofluorine could lead to underestimating EOF content and through that to misguide policy decisions.
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| 7. |
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| 8. |
- Aro, Rudolf, 1992-, et al.
(författare)
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Extractable organofluorine analysis: A way to screen for elevated per- and polyfluoroalkyl substance contamination in humans?
- 2022
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 159
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Tidskriftsartikel (refereegranskat)abstract
- The ubiquitous occurrence of a few per- and polyfluoroalkyl substances (PFAS) in humans and the environment has been previously reported. However, the number of PFAS humans and the environment are potentially exposed to is much higher, making it difficult to investigate every sample in detail. More importantly, recent studies have shown an increasing fraction of potentially unknown PFAS in human samples. A screening tool for identifying samples of concern that may contain high PFAS levels, to be studied more thoroughly, is needed. This study presents a simplified workflow to detect elevated PFAS levels using extractable organofluorine (EOF) analysis. A fluorine mass balance analysis on samples with high EOF, targeting 63 PFAS, can then confirm the PFAS contamination. Whole blood samples from a cohort of individuals with historical drinking water contamination from firefighting foams (n = 20) in Ronneby (Sweden) and a control group (n = 9) with background exposure were used as a case study. The average EOF concentration in the Ronneby group was 234 ng/ mL F (<107-592 ng/mL F) vs 24.8 ng/mL F (17.6-37.8 ng/mL F) in the control group. The large difference (statistically significant, p < 0.05) in the EOF levels between the exposed and control groups would have made it possible to identify samples with high PFAS exposure only using EOF data. This was confirmed by target analysis, which found an average n-ary sumation PFAS concentration of 346 ng/mL in the exposed group and 7.9 ng/mL in the control group. The limit of quantification for EOF analysis (up to 107 ng/mL F using 0.5 mL whole blood) did not allow for the detection of PFAS levels in low or sub parts per billion (ng/mL) concentrations, but the results indicate that EOF analysis is a suitable screening method sensitive enough to detect elevated/significant/exposure above background levels by known or unknown PFAS.
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| 9. |
- Aro, Rudolf, 1992-, et al.
(författare)
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Fluorine Mass Balance Analysis of Effluent and Sludge from Nordic Countries
- 2021
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Ingår i: ACS - ES & T Water. - : American Chemical Society (ACS). - 2690-0637. ; 1:9, s. 2087-2096
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Tidskriftsartikel (refereegranskat)abstract
- Recent publications have highlighted the ubiquitous presence of unidentified organofluorine compounds, whose environmental occurrence is poorly understood. In this study, wastewater treatment plant (WWTP) effluent and sludge samples from seven countries were analyzed for extractable organofluorine (EOF) and target PFAS, to evaluate which compounds are released back into the environment. Fluorine mass balance analysis of effluent samples (n = 14) revealed that on average 90% of the EOF could not be explained by the 73 PFAS monitored in this investigation. The levels of EOF in effluent (324–1460 ng of F/L) and sludge (39–210 ng of F/g of dry weight) indicate that a substantial amount of organofluorine compounds is released back into nature. A commonly overlooked PFAS class, ultra-short-chain PFCAs, accounted for 4% of EOF on average, while the remaining 71 compounds explained only a further 6% of EOF on average. The highest number of PFAS was detected in the effluent dissolved phase (37), compared to 29 and 23 PFAS in sludge and effluent particulate phase, respectively. The increased concentrations of EOF in both WWTP effluent and sludge are of concern, as the chemical species contained therein remain largely unknown, and thus, their potential health and environmental risks cannot be assessed.
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