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- Engström, Gunnar, et al.
(författare)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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- Persson, Eva-Kristina, et al.
(författare)
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Fathers' sense of security during the first postnatal week-A qualitative interview study in Sweden
- 2012
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 28:5, s. e697-e704
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Tidskriftsartikel (refereegranskat)abstract
- Background father's sense of security in the early postnatal period is important for the whole family. An instrument, which measures Parents' Postnatal Sense of Security (the PPSS instrument), is under development.Objective to explore and describe factors, which influence fathers' sense of security during the first postnatal week.Methods an explorative design with a qualitative approach was used. Thirteen fathers from three hospital uptake areas in Southern Sweden were interviewed using focus group discussions and individual interviews. Analysis was carried out using qualitative content analysis.Findings participation in the processes of pregnancy birth and early parenthood emerged as the main category for fathers' postnatal sense of security. The emergent categories were; ‘willingness to participate and take responsibility’, ‘being given the opportunity to take responsibility’, ‘being assured about mother's and baby's well-being’, ‘having someone to turn to—knowing who to ask’, ‘being met as an individual’ and ‘being met by competent and supporting staff’.Key conclusions and implications for practice new and specific items of importance when investigating fathers' sense of security during the early postnatal period have been pinpointed. Fathers' sense of early postnatal security may be enhanced by giving them a genuine opportunity to participate in the whole process and by giving them the opportunity to stay overnight at the hospital after the birth. Midwives and care organisations need to give clear information about where competent help and advice can be obtained at all hours. Midwives should strengthen the fathering role by acknowledging and listening to the father as an individual person.
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- Christian, Parul, et al.
(författare)
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Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries
- 2013
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 42:5, s. 1340-1355
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Low- and middle-income countries continue to experience a large burden of stunting; 148 million children were estimated to be stunted, around 30-40% of all children in 2011. In many of these countries, foetal growth restriction (FGR) is common, as is subsequent growth faltering in the first 2 years. Although there is agreement that stunting involves both prenatal and postnatal growth failure, the extent to which FGR contributes to stunting and other indicators of nutritional status is uncertain.METHODS:Using extant longitudinal birth cohorts (n = 19) with data on birthweight, gestational age and child anthropometry (12-60 months), we estimated study-specific and pooled risk estimates of stunting, wasting and underweight by small-for-gestational age (SGA) and preterm birth.RESULTS:We grouped children according to four combinations of SGA and gestational age: adequate size-for-gestational age (AGA) and preterm; SGA and term; SGA and preterm; and AGA and term (the reference group). Relative to AGA and term, the OR (95% confidence interval) for stunting associated with AGA and preterm, SGA and term, and SGA and preterm was 1.93 (1.71, 2.18), 2.43 (2.22, 2.66) and 4.51 (3.42, 5.93), respectively. A similar magnitude of risk was also observed for wasting and underweight. Low birthweight was associated with 2.5-3.5-fold higher odds of wasting, stunting and underweight. The population attributable risk for overall SGA for outcomes of childhood stunting and wasting was 20% and 30%, respectively.CONCLUSIONS:This analysis estimates that childhood undernutrition may have its origins in the foetal period, suggesting a need to intervene early, ideally during pregnancy, with interventions known to reduce FGR and preterm birth.
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| 7. |
- Cronholm, Stefan, et al.
(författare)
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Best Practice in IT Service Management : Experienced Strengths and Weaknesses of using ITIL
- 2016
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Ingår i: International Conference on Management, Leadership and Governance. - 9781910810842 ; , s. 60-67
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Konferensbidrag (refereegranskat)abstract
- This paper focuses on the management of IT services and especially on best practices in the IT sector. Successful organizations must continuously improve their business management, including their IT management, in order to retain competitive advantages, and thus they need to reflect upon and improve their ways of working. One important aspect of this is usage of best practices. Best practices are toolsets or frameworks for the management of business and IT alignment, and their purpose is to improve the quality of IT services through delivering superior results compared to other frameworks, time after time. The most cited, globally recognized and adopted best practice is Information Technology Infrastructure Library (ITIL). The problem we address is that there exist contradictory claims concerning the usefulness of best practices. Due to these contradictory claims, the purpose of this paper is to learn more about the strengths and weaknesses of ITIL. To fulfill the purpose of this paper, we have conducted a qualitative study where we have collected empirical experiences from use of ITIL. We have interviewed 15 IT managers and IT consultants about their experiences of using ITIL.We can conclude that previous findings are fragmented and thus we have presented a coherent and structured collection of empirical experiences categorized as strengths and weaknesses. The identified strengths are: high reliability, improved cost efficiency, a tool for communication and support for structured work. The identified weaknesses are: lack of concretion, adaptation difficulties, being too comprehensive and having high costs. These strengths and weaknesses have to be managed in accordance with the situation at hand. We believe that our findings can contribute in two ways: 1) they consist of a coherent and structured overview informing about both strengths and weaknesses, and 2) the weaknesses can be used as requirements for a redesign of ITIL. Our study has in a cumulative way advanced the state-of-the-art by adding new knowledge based on empirical data.
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| 8. |
- Engström, Gunnar, et al.
(författare)
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Cardiovagal Function Measured by the Deep Breathing Test : Relationships With Coronary Atherosclerosis
- 2022
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Ingår i: Journal of the American Heart Association. - 2047-9980. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Background The cardiovagal function can be assessed by quantification of respiratory sinus arrhythmia (RSA) during a deep breathing test. However, population studies of RSA and coronary atherosclerosis are lacking. This population-based study examined the relationship between RSA during deep breathing and coronary atherosclerosis, assessed by coronary artery calcium score (CACS). Methods and Results SCAPIS (Swedish Cardiopulmonary Bioimage Study) randomly invited men and women aged 50 to 64 years from the general population. CACS was obtained from computed tomography scanning, and deep breathing tests were performed in 4654 individuals. Expiration-inspiration differences (E-Is) of heart rates were calculated, and reduced RSA was defined as E-I in the lowest decile of the population. The relationship between reduced RSA and CACS (CACS≥100 or CACS≥300) was calculated using multivariable-adjusted logistic regression. The proportion of CACS≥100 was 24% in the lowest decile of E-I and 12% in individuals with E-I above the lowest decile (P<0.001), and the proportion of CACS≥300 was 12% and 4.8%, respectively (P<0.001). The adjusted odds ratio (OR) for CACS≥100 was 1.42 (95% CI, 1.10-1.84) and the adjusted OR for CACS≥300 was 1.62 (95% CI, 1.15-2.28), when comparing the lowest E-I decile with deciles 2 to 10. Adjusted ORs per 1 SD lower E-I were 1.17 (P=0.001) for CACS≥100 and 1.28 (P=0.001) for CACS≥300. Conclusions Low RSA during deep breathing is associated with increased coronary atherosclerosis as assessed by CACS, independently of traditional cardiovascular risk factors. Cardiovagal dysfunction could be a prevalent and modifiable risk factor for coronary atherosclerosis in the general population.
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