| 1. |
- Andersson, Eva, 1955, et al.
(författare)
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Adult-onset asthma and wheeze among irritant-exposed bleachery workers.
- 2003
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Ingår i: American journal of industrial medicine. - : Wiley. - 0271-3586. ; 43:5, s. 532-538
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Tidskriftsartikel (refereegranskat)abstract
- Background Whether new-onset asthma is associated with irritant exposure is unclear. The aim was to investigate if occupational exposure to irritant gases, especially repeated peak exposure (gassings), increased the risk of obstructive airways disease. Methods Data on airway symptoms and exposure among bleachery (n=101) and paper department workers (n=314) were collected by a questionnaire. Incidence rates and hazard ratios (HR) (Cox regression) were calculated. Non-responders were interviewed by telephone. Results The incidence rate for adult-onset physician-diagnosed asthma among bleachery workers reporting gassings giving rise to respiratory symptoms was 7.6/103 person-years and for those without gassings 2.2/103 person-years, compared to 1.0/103 person-years for paper workers. In a Cox regression model for asthma (n=12), stratified for sex, HR for gassings were 5.6 (95% confidence intervals (CI) 1.6–20), for hay fever 3.0 (95% CI 0.8–11), and for ever smoking 0.7 (95% CI 0.2–2.4). The same model for adult-onset wheeze gave HR of 5.2 (95% CI 2.2–12), 1.7 (95% CI 0.6–5.4), and 1.1 (95% CI 0.5–2.7), respectively. Conclusions Repeated peak exposure to irritant gases, here studied as gassings in the pulp industry, increased the risk for both adult-onset asthma and wheeze.
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| 3. |
- Ekström, Magnus Pär, et al.
(författare)
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The association of body mass index, weight gain and central obesity with activity-related breathlessness : the Swedish Cardiopulmonary Bioimage Study
- 2019
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 74:10, s. 958-964
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m(2)) is rapidly increasing globally and its impact on breathlessness is unclear.Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score >= 1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex.Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m(2); and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness.Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.
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| 5. |
- Haghighi, Mona, et al.
(författare)
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A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.
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| 6. |
- Kirvalidze, Mariam, et al.
(författare)
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Effectiveness of integrated person-centered interventions for older people's care : Review of Swedish experiences and experts' perspective
- 2024
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Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 0954-6820 .- 1365-2796.
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Tidskriftsartikel (refereegranskat)abstract
- Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field. image
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| 7. |
- Kokelj, Spela, 1992, et al.
(författare)
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Activation of the Complement and Coagulation Systems in the Small Airways in Asthma
- 2023
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Ingår i: Respiration. - : S. Karger. - 0025-7931 .- 1423-0356. ; 102:8, s. 621-631
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Tidskriftsartikel (refereegranskat)abstract
- Background: Several studies have shown the importance of the complement and coagulation systems in the pathogenesis of asthma. Objectives: We explored whether we could detect differentially abundant complement and coagulation proteins in the samples obtained from the small airway lining fluid by collection of exhaled particles in patients with asthma and whether these proteins are associated with small airway dysfunction and asthma control. Method: Exhaled particles were obtained from 20 subjects with asthma and 10 healthy controls (HC) with the PExA method and analysed with the SOMAscan proteomics platform. Lung function was assessed by nitrogen multiple breath washout test and spirometry. Results: 53 proteins associated with the complement and coagulation systems were included in the analysis. Nine of those proteins were differentially abundant in subjects with asthma as compared to HC, and C3 was significantly higher in inadequately controlled asthma as compared to well-controlled asthma. Several proteins were associated with physiological tests assessing small airways. Conclusions: The study highlights the role of the local activation of the complement and coagulation systems in the small airway lining fluid in asthma and their association with both asthma control and small airway dysfunction. The findings highlight the potential of complement factors as biomarkers to identify different sub-groups among patients with asthma that could potentially benefit from a therapeutic approach targeting the complement system.
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| 9. |
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Adapting to an Uncertain Climate -Lessons from Practice
- 2014
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Samlingsverk (redaktörskap) (populärvet., debatt m.m.)abstract
- Benefits policy developers and advisors, practitioners, researchers and others interested in dealing with uncertainty in climate adaptation decision-making Offers case studies from different geographical regions and a wide variety of real-life adaptation situations Presents a new support framework for climate change adaptation decisions under uncertainty Climate change highlights the challenges for long-term policy making in the face of persistent and irreducible levels of uncertainties. It calls for the development of flexible approaches, innovative governance and other elements that contribute to effective and adaptive decision-making. Exploring these new approaches is also a challenge for those involved in climate research and development of adaptation policy. Targeted specifically at policy developers and advisors, practitioners, climate knowledge brokers, researchers and interested adaptation decision-makers, this book differs from other titles addressing climate change adaptation and uncertainty by using real life cases to address distinct and pertinent uncertainties in actual adaptation situations. The editors introduce the role of uncertainties in informing adaptation decisions, showing why and how this is important, and why decisions do not have to wait until uncertainties are resolved. They go on to explore uncertainty assessments supporting decision-making on climate change adaptation, with sections on variability, uncertainty typology, climate change and projection of risks. A discussion of national adaptation planning follows with sections on sources and levels of uncertainty, communication of uncertainty and guidance for adaptation planning under uncertainty. The book provides a dozen real-life examples of adaptation decision making in the form of case studies: · Studies on water supply management in Portugal, England and Wales and Hungary · Studies on flooding, including flood risk in Ireland, coastal flooding and erosion in Southwest France and flood management in New Zealand’s Hutt River region · Studies on transport and utilities, including the Austrian Federal railway system and public transit in Dresden, and Québec hydro-electric power · A report examining communication of large numbers of climate scenarios in Dutch climate adaptation workshops The concluding section outlines a new support framework for adaptation decisions under uncertainty, as well as guidance, recommendations and decision support for readers to apply in their own work. In the spirit of the newly adopted EU Strategy on Adaptation to Climate Change, the book aims - as does the CIRCLE-2 project from which it emanates - to assist informed decision-making, and to provide added value through increased knowledge sharing.
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