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1.
  • Almén, Niclas, 1971- (författare)
  • A Cognitive Behavioral Model Proposing That Clinical Burnout May Maintain Itself
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:7
  • Forskningsöversikt (refereegranskat)abstract
    • Burnout is common in many countries and is associated with several other problems such as depression, anxiety, insomnia, and memory deficits, and prospectively it predicts long-term sick-leave, cardiovascular disease, and death. Clinical burnout or its residual symptoms often last several years and a common assumption is that recovery takes a long time by nature, despite full time sick-leave and the absence of work stress. The literature suggests models that hypothetically explain the development, but not maintenance, of the syndrome. Based on cognitive and behavioral principles, stress research, and stress theories, this paper describes a theoretical model explaining how clinical burnout can develop and be maintained. While the development of clinical burnout is mainly explained by prolonged stress reactions and disturbed recovery processes due to work related stressors, maintenance of the syndrome is particularly explained by prolonged stress reactions and disturbed recovery processes due to the new context of experiencing burnout and being on sick-leave. Worry about acquired memory deficits, passivity and excessive sleep, shame, fear of stress reactions, and the perception of not being safe are examples of responses that can contribute to the maintenance. The model has important implications for research and how to intervene in clinical burnout. For example, it can offer support to professional care providers and patients in terms of focusing on, identifying, and changing current contextual factors and behaviors that maintain the individual’s clinical burnout symptoms and by that facilitate burnout recovery. Regarding research, the model provides a highly important reason for researchers to study contextual factors and behaviors that contribute to the maintenance of clinical burnout, which has been neglected in research.
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2.
  • Arvidsson, Inger, et al. (författare)
  • Should I stay or should I go? Associations between occupational factors, signs of exhaustion and the intention to change workplace among swedish principals
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:10, s. 1-20
  • Tidskriftsartikel (refereegranskat)abstract
    • A high turnover among principals may disrupt the continuity of leadership and negatively affect teachers and, by extension, the students. The aim was to investigate to what extent various work environment factors and signs of exhaustion were associated with reported intentions to change workplace among principals working in compulsory schools. A web-based questionnaire was administered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of the associations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, and the intention to change workplace, using Generalized Estimating Equations models. Part II involved 631 principals who participated in both surveys. The patterns of intended and actual changes of workplace across two years were described, together with associated changes of occupational factors and signs of exhaustion. Supportive management was associated with an intention to stay, while demanding role conflicts and the feeling of being squeezed between management and co-workers (buffer-function) were associated with the intention to change workplace. The principals who intended to change their workplace reported more signs of exhaustion. To increase retention among principals, systematic efforts are probably needed at the national, municipal, and local level, in order to improve their working conditions.
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3.
  • Brogårdh, Christina, et al. (författare)
  • Fall-Related activity avoidance among persons with late effects of polio and its influence on daily life : A mixed-methods study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:13, s. 1-11
  • Tidskriftsartikel (refereegranskat)abstract
    • Falls are common among persons with late effects of polio (LEoP), which may lead to fear of falling and activity avoidance in everyday life. Here, we assessed the occurrence of fall-related activity avoidance among persons with LEoP and explored how these experiences influenced daily life. Fourteen ambulatory persons (seven women; mean age 70 years) with LEoP participated. They responded to the modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE) and participated in individual interviews, which were analysed by systematic text condensation. Each quotation was deductively analysed from its representation with regard to mSAFFE. We found that many persons often avoided activities related to standing and walking, for example, taking a bath, performing household chores, walking outdoors, attending social events if there were stairs in the building and travelling by public transport, due to fear of falling, increased pain and fatigability. To facilitate the performance of daily activities participants expressed that strategic thinking and aids were important to use. In conclusion, fall-related activity avoidance is common in persons with LEoP, which negatively influence daily life and social participation. To increase daily functioning in this population, fall-related activity avoidance should be included in a multifaceted fall management program.
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4.
  • Colombo, P. E., et al. (författare)
  • Optimizing School Food Supply: Integrating Environmental, Health, Economic, and Cultural Dimensions of Diet Sustainability with Linear Programming
  • 2019
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 16:17
  • Tidskriftsartikel (refereegranskat)abstract
    • There is great potential for reducing greenhouse gas emissions (GHGE) from public-sector meals. This paper aimed to develop a strategy for reducing GHGE in the Swedish school food supply while ensuring nutritional adequacy, affordability, and cultural acceptability. Amounts, prices and GHGE-values for all foods and drinks supplied to three schools over one year were gathered. The amounts were optimized by linear programming. Four nutritionally adequate models were developed: Model 1 minimized GHGE while constraining the relative deviation (RD) from the observed food supply, Model 2 minimized total RD while imposing stepwise GHGE reductions, Model 3 additionally constrained RD for individual foods to an upper and lower limit, and Model 4 further controlled how pair-wise ratios of 15 food groups could deviate. Models 1 and 2 reduced GHGE by up to 95% but omitted entire food categories or increased the supply of some individual foods by more than 800% and were deemed unfeasible. Model 3 reduced GHGE by up to 60%, excluded no foods, avoided high RDs of individual foods, but resulted in large changes in food-group ratios. Model 4 limited the changes in food-group ratios but resulted in a higher number of foods deviating from the observed supply and limited the potential of reducing GHGE in one school to 20%. Cost was reduced in almost all solutions. An omnivorous, nutritionally adequate, and affordable school food supply with considerably lower GHGE is achievable with moderate changes to the observed food supply; i.e., with Models 3 and 4. Trade-offs will always have to be made between achieving GHGE reductions and preserving similarity to the current supply.
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5.
  • Ekvall Hansson, Eva, et al. (författare)
  • Gait flexibility among older persons significantly more impaired in fallers than non-fallers-a longitudinal study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:13, s. 1-13
  • Tidskriftsartikel (refereegranskat)abstract
    • Gait disorders are a relevant factor for falls and possible to measure with wearable devices. If a wearable sensor can detect differences in gait parameters between fallers and non-fallers has not yet been studied. The aim of this study was to measure and compare gait parameters, vestibular function, and balance performance between fallers and non-fallers among a group of older persons. Participants were senior members (n = 101) of a Swedish non-profit gymnastic association. Gait parameters were obtained using an inertial measurement unit (IMU) that the participants wore on the leg while walking an obstacle course and on an even surface. Vestibular function was assessed by the Head-shake test, the Head impulse test, and the Dix-Hallpike maneuver. Balance was assessed by the Timed Up and Go, the Timed Up and Go manual, and the Timed Up and Go cognitive tests. Falls during the 12-month follow-up period were monitored using fall diaries. Forty-two persons (41%) had fallen during the 12-month follow-up. Fallers had more limited ability to vary their gait (gait flexibility) than non-fallers (p < 0.001). No other differences between fallers and non-fallers were found. The use of gait flexibility, captured by an IMU, seems better for identifying future fallers among healthy older persons than Timed Up and Go or Timed Up and Go combined with a cognitive or manual task.
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6.
  • Khalaf, Atika, 1973-, et al. (författare)
  • Female university students’ physical activity levels and associated factors : a cross-sectional study in southwestern Saudi Arabia
  • 2013
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 10:8, s. 3502-3517
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The high prevalence of physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to examine the prevalence of physical activity (PA) and associated factors among female university students. Methods: This cross-sectional study involved 663 randomly selected female university students who completed the Arab Teens Life Style questionnaire. Data included measurements of anthropometric, socioeconomic and environmental factors, as well as self-reported PA. Ordinal regression was used to identify associated factors with low, moderate and high PA levels. Results: The mean age of participants was 20.4 years (SD 1.5). Mean BMI of the students in relation to PA were 23.0, 22.9, 22.1 for high, moderate and low levels of activity, respectively. The analysis revealed significantly higher PA levels among married students, those with high educated mothers, and those who lived far from parks, and lower activity levels among underweight students. Conclusions: This study raises four important determinants for female university students’ PA levels. These factors could be of great importance in the endeavor to prevent the health-threatening increase in physical inactivity patterns and thus non-communicable diseases and obesity where the focus should be on the specific situation and needs of women in Saudi Arabia.
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7.
  • Nilsson, Kerstin, et al. (författare)
  • Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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8.
  • Nilsson, Kerstin, et al. (författare, creator_code:000000023193205X_t)
  • Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI Multidisciplinary Digital Publishing Institute. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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9.
  • Westblad, Niklas, et al. (författare)
  • The Effect of Autoregulated Flywheel and Traditional Strength Training on Training Load Progression and Motor Skill Performance in Youth Athletes.
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:7
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The effects of flywheel resistance training (FRT) on youth are relatively unknown. The aim of this study was to compare the effects of autoregulated FRT with traditional strength training (TST) on jumping, running performance and resistance training load progression in youth athletes. Thirty youth athletes (11.8 ± 0.9 yr) were matched for peak height velocity (PHV) status and block-randomised into two groups: FRT (n = 15, PHV -0.8 ± 1.6) and TST (n = 15, PHV -0.8 ± 1.5). Twelve resistance training sessions over a six-week intervention with flywheel or barbell squats were performed using autoregulated load prescription. Squat jump (SJ); countermovement jump (CMJ); and 10 m, 20 m and 30 m sprints were assessed pre- and post-intervention. The external load increased similarly for FRT and TST (z = 3.8, p = 0.06). SJ increased for both groups (p < 0.05) but running performance was unaffected (p > 0.05).CONCLUSIONS: FRT resulted in similar load progression and motor skill development in youth athletes as TST, but the perceived exertion was less. Autoregulation is a practical method for adjusting training load during FRT and should be considered as an alternative to autoregulated TST.
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10.
  • Zubak, Zoran, et al. (författare)
  • A Prospective study on the influence of scholastic factors on the prevalence and initiation of illicit drug misuse in adolescence
  • 2018
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 15:5, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: This study aimed to prospectively investigate the scholastic factors related to illicit drug misuse (IDM) and the initiation of IDM among older adolescents from Bosnia andHerzegovina. Methods: This 2-year prospective study included 436 participants (202 females), who were an average of 16 years old at the beginning of the study (baseline). The participants were tested at baseline and follow-up (20 months later). The predictors included variables of scholastic-achievement (grade point average, school absences, unexcused absences and behavioral grade). The criteria were: (i) IDM at baseline; (ii) IDM at follow-up; and (iii) initiation of IDM over the study course. Results: Logistic regression indicated increased odds of IDM in adolescents who were more frequent absent from school (baseline: Odds Ratio (OR): 3.73, 95% Confidence Interval (CI): 2.12–6.57; follow-up: OR: 2.91, 95% CI: 1.90–4.65). The lower grade point average and more unexcused absences were evidenced for adolescents who consumed drugs on follow-up(OR: 1.67, 95% CI: 1.11–2.51; OR: 1.74, 95% CI: 1.30–2.32 for grade point average and unexcused absences, respectively). Initiation of IDM was predicted by frequent absences from school (OR: 2.2,95% CI: 1.3–3.8), and lower behavioral grades (OR: 1.9, 95% CI: 1.2–3.3). Conclusions: The findings confirmed strong correlations between scholastic failure and IDM. Absences from school and lower behavioral grades at baseline were predictive of the initiation of IDM in older adolescents.
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11.
  • Tuvesson, Hanna, et al. (författare)
  • Psychosocial Work Environment, Stress Factors and Individual Characteristics among Nursing Staff in Psychiatric In-Patient Care
  • 2014
  • Ingår i: International Journal of Environmental Research and Public Health. - Basel, Switzerland : MDPI. - 1661-7827 .- 1660-4601. ; 11:1, s. 1161-1175
  • Tidskriftsartikel (refereegranskat)abstract
    • The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristicsMastery, Moral Sensitivity, Perceived Stress, and Stress of Conscienceare related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.
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12.
  • Buli, Benti Geleta, et al. (författare)
  • Active Commuting and Healthy Behavior among Adolescents in Neighborhoods with Varying Socioeconomic Status : The NESLA Study
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:7
  • Tidskriftsartikel (refereegranskat)abstract
    • (1) Background: The World Health Organization recommends active commuting as a source of physical activity. Active commuting is determined by various factors, including the socioeconomic status (SES) of families and neighborhoods, distance to schools, perceived neighborhood safety, lifestyles, and availability of walkways and biking paths. This study aimed to assess factors associated with modes of transportation to and from school among adolescents aged 16–19 living in a middle-sized city in Sweden. (2) Method: Three hundred and fourteen students, of whom 55% were females, from schools in the city of Västerås participated in the study. Printed as well as web-based self-administered questionnaires were used to collect the data. (3) Results: Adolescents living in high SES neighborhoods were 80% more likely to bike or walk to school (OR = 1.80; CI: 1.01, 3.20) than adolescents living in low SES neighborhoods. Furthermore, active commuting was associated with higher consumption of fruits and vegetables (OR = 1.77; CI: 1.05, 2.97) and less consumption of junk foods (OR = 0.43; CI: 0.26, 0.71), as compared to passive commuting. (4) Conclusions: Active commuting is a cost-effective and sustainable source of regular physical activity and should be encouraged at a societal level. 
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13.
  • Lõhmus, Mare, et al. (författare)
  • Combined Exposure to Birch Pollen and Thunderstorms Affects Respiratory Health in Stockholm, Sweden—A Time Series Analysis
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:10, s. 5852-5852
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Thunderstorm asthma is a term used to describe surges in acute respiratory illnesses following a thunderstorm and is often attributed to an intense exposure to aeroallergens. Several episodes of thunderstorm asthma have been observed worldwide; however, no such cases have been described in Sweden. In Sweden, the most prominent exposure to air-borne pollen occurs during the blooming of the birch. We aimed to explore the associations between respiratory health and the combined exposure to thunderstorms and birch pollen. Methods: We investigated the association between the daily numbers of outpatient visits due to respiratory cases and the combined exposure to thunderstorms and birch pollen during the period of 1 May–31 September in 2001–2017, in Stockholm County, Sweden, by using time series analysis with log linear models. Results: We detected noticeable increases in the number of outpatient visits on both the same day (max 26%; 95% CI 1.16–1.37) and the day after (max 50%; 95% CI 1.32–1.70) the occurrence of a thunderstorm, when the concentrations of birch pollen and the number of lightning discharges were within the highest categories. Conclusions: It is possible that co-exposure to heavy thunderstorms and high concentrations of birch pollen affects the respiratory health of the Stockholm population. To the best of our knowledge, this is the first study addressing the thunderstorm-related respiratory illnesses in Sweden and the effects of birch pollen. Our study may be important for future public health advice related to thunderstorm asthma.
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14.
  • Nivestam, Anna, et al. (författare)
  • Give older persons a voice in the society : By using information compiled during preventive home visits on a societal level
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:14, s. 1-17
  • Tidskriftsartikel (refereegranskat)abstract
    • Preventive home visits (PHVs) are offered to older persons with the purpose of promoting health and preventing risks on an individual level. However, aspects of health need to be considered on a societal level as well. This study aims to get a deeper understanding of perceptions of the usability of the information compiled during the PHVs to promote health, among older persons, on a societal level. Three online focus groups were conducted with heads of unit of PHVs, heads of department, and politicians responsible for health and welfare in seven municipalities in Sweden (n = 12). The findings were visualised in the core category Enable an inclusive society and the interrelated categories Monitoring determinants of health and Enabling exchange of information. The information from the PHVs could be used to monitor determinants of health by identifying assets, challenges, shifts, trends, and future needs in the society. Moreover, exchange of information from the PHVs could occur within and outside the health and welfare organisation. However, the potential use was affected by hindrances illustrated in the category Obstacles to interpreting and communicating the information. To conclude, using the information from the PHVs could possibly contribute to an inclusive society, where persons not usually represented in decision making are given a voice. 
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15.
  • Schön Persson, Sophie, 1979-, et al. (författare)
  • Meetings are an important prerequisite for flourishing workplace relationships
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:15, s. 1-13
  • Tidskriftsartikel (refereegranskat)abstract
    • Relationships among colleagues, managers, and care recipients are mutually important, and need to be highlighted in workplace health promotion. The aim was to explore prerequisites for flourishing workplace relationships in a municipal healthcare setting for old people. As part of this process, we explored the staff’s suggestions on how work relationships could be improved. The study had a salutogenic and participatory approach, examining staff perceptions of what was required for flourishing relationships to be created, and their suggestions for the relationships to be more promotive. Four multi-stage focus groups, which met three times each, were conducted with staff (n = 26) in old age healthcare settings. A deductive analysis was performed, based on components of the flourishing concept: challenge, connectivity, autonomy, and competence. Informal and formal meetings at work were shown to build positively perceived relationships. The study describes meetings and relationships connected to the four components of flourishing. Suggestions for improving work relationships are also presented. This study contributes to workplace health promotion, and has a salutogenic and participatory focus on how to explore workplace relationships as a resource. The flourishing concept shows how workplace relationships can be explored as prerequisites for workplace health promotion.
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16.
  • Aamodt, Ina Thon, et al. (författare)
  • Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:23
  • Tidskriftsartikel (refereegranskat)abstract
    • Self-care monitoring at home can be a challenge for patients with heart failure (HF). Tools that leverage information and communication technology (ICT), comprise medical devices, or have written material may support their efforts at home. The aim of this study was to describe HF patients experiences and their prioritization of tools that support, or could support, self-care monitoring at home. A descriptive qualitative design employing semi-structured interviews was used with HF patients living at home and attending an HF outpatient clinic in Norway. We used a deductive analysis approach, using the concept of self-care monitoring with ICT tools, paper-based tools, medical devices, and tools to consult with healthcare professionals (HCPs) as the categorization matrix. Nineteen HF patients with a mean age of 64 years participated. ICT tools are used by individual participants to identify changes in their HF symptoms, but are not available by healthcare services. Paper-based tools, medical devices, and face-to-face consultation with healthcare professionals are traditional tools that are available and used by individual participants. HF patients use traditional and ICT tools to support recognizing, identifying, and responding to HF symptoms at home, suggesting that they could be used if they are available and supplemented by in-person consultation with HCPs.
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17.
  • Aartolahti, Eeva, et al. (författare)
  • Perceived opportunities for physical activity and willingness to be more active in older adults with different physical activity levels
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:11
  • Tidskriftsartikel (refereegranskat)abstract
    • This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21–6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels (p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.
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18.
  • Abdullah, Abu Sayeed Md., et al. (författare)
  • Effects of climate change and maternal morality : Perspective from case studies in the rural area of Bangladesh
  • 2019
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:23
  • Tidskriftsartikel (refereegranskat)abstract
    • This study explored the community perception of maternal deaths influenced by natural disaster (flood), and the practice of maternal complications during natural disaster among the rural population in Bangladesh. It also explored the challenges faced by the community for providing healthcare and referring the pregnant women experiencing complications during flood disaster. Three focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted in the marginalized rural communities in the flood-prone Khaliajhuri sub-district, Netrakona district, Bangladesh. Flood is one of the major risk factors for influencing maternal death. Pregnant women seriously suffer from maternal complications, lack of antenatal checkup, and lack of doctors during flooding. During the time of delivery, it is difficult to find a skilled attendant, and referring the patient with delivery complications to the healthcare facility. Boats are the only mode of transport. The majority of maternal deaths occur on the boats during transfer from the community to the hospital. Rural people feel that the maternal deaths influenced by natural disaster are natural phenomena. Pre-preparation is needed to support pregnant women during disasters. There is unawareness of maternal health, related care, and complications during disasters among local health service providers and volunteers. 
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19.
  • Abe, Takafumi, et al. (författare)
  • Assessing the impact of a hilly environment on depressive symptoms among community-dwelling older adults in japan : A cross-sectional study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.
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20.
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21.
  • Ahlström, Gerd, et al. (författare)
  • Quality of Life among Next of Kin of Frail Older People in Nursing Homes : An Interview Study after an Educational Intervention concerning Palliative Care
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:5
  • Tidskriftsartikel (refereegranskat)abstract
    • One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of frail older persons in nursing homes after an educational intervention concerning palliative care. This qualitative interview study with 37 next of kin used an abductive design with deductive and inductive content analysis. The deductive analysis confirmed the three themes of QoL from the study before the implementation: (1) orientation to the new life-situation, (2) challenges in the relationship, and (3) the significance of the quality of care in the nursing home. The inductive analysis resulted in the sub-theme “Unspoken palliative care”. Being the next of kin of an older person living in a nursing home can be distressing despite round-the-clock care, so staff need to apply a more explicitly palliative care perspective. Future research needs to evaluate the influence of meaning-focused coping on next of kin’s QoL and integrate this knowledge in psychosocial interventions. Clinical Trial Database for Clinical Research: KUPA project NCT02708498.
  •  
22.
  • Ahmad, Naveed, et al. (författare)
  • Corporate social responsibility at the micro-level as a “new organizational value” for sustainability : Are females more aligned towards it?
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:4
  • Tidskriftsartikel (refereegranskat)abstract
    • While prior studies have largely addressed corporate social responsibility (CSR) at a macro or institutional level, its importance at the micro or individual level is to date underexplored, especially in the context of developing economies. Further, it is not clear from the studies in the extant literature how the role of females is more important in the context of environmental management as compared to males. Similarly, micro-level CSR (MCSR) is emerging as a “new organizational value”, and the organizations that acknowledge this “new organizational value” and incorporate it into their business operations are likely to achieve sustainability objectives far better as compared to their counterparts. The present study investigates the impact of MCSR on employees’ pro-environmental behavior with the moderating effect of gender in the healthcare sector of Pakistan. The data were collected from five large hospitals in the city of Lahore through a self-administered questionnaire and analyzed using structural equation modeling (SEM) in AMOS software. A total of 533 out of 800 responses were received, which were used for data analysis of the present study. The results revealed that MCSR positively influences employee’s pro-environmental behavior, and gender moderates this relationship but the moderating effect of females is stronger as compared to males. The findings of the present study would help policymakers understand the importance of MCSR as a “new organizational value” to influence employees’ pro-environmental behavior with a special focus to promote the proactive role of females at workplaces.
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23.
  • Ahmad, Naveed, et al. (författare)
  • The inter-relation of corporate social responsibility at employee level, servant leadership, and innovative work behavior in the time of crisis from the healthcare sector of pakistan
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Organizational crisis can serve as a base to provide an opportunity to an organization for enhancing individuals, organizations, and communities. The healthcare sector is one of those sectors that remains under continuous pressure to provide high-quality service delivery to the patients. Hence, the requirement of innovation for this sector is huge when compared to other sectors. The majority of the previous studies have investigated the phenomenon of CSR at the employee’s level (CSR-E) to influence employee behavior positively. However, the importance of CSR-E to enhance the innovative capability of the employees at the workplace is not well-explored in extant literature. Moreover, it is not clear from previous studies how the concept of servant leadership can explain the employee’s engagement towards innovative work behavior (EIB). Thus, the current survey aims to test the relationship of CSR-E and EIB in the healthcare sector of Pakistan with the mediating effect of servant leadership. The data of the current study were obtained through a self-administered (paper-pencil) survey and they were analyzed through the structural equation modeling (SEM) technique. The empirical results of SEM analysis revealed that CSR-E and EIB are positively related and servant leadership partially mediates this relationship. The findings of the current study will be helpful for policymakers to improve their understanding towards CSR-E to induce EIB in the time of crisis. At the same time, the current study also highlights the importance of servant leadership to the policymakers in encouraging the employees to display their innovative capability at the workplace to serve their organization during the time of crisis.
  •  
24.
  • Ahmed, Toqeer, et al. (författare)
  • Climate change, water quality and water-related challenges : A review with focus on Pakistan
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 17:22, s. 1-22
  • Forskningsöversikt (refereegranskat)abstract
    • Climate variability is heavily impacting human health all around the globe, in particular, on residents of developing countries. Impacts on surface water and groundwater resources and water-related illnesses are increasing, especially under changing climate scenarios such as diversity in rainfall patterns, increasing temperature, flash floods, severe droughts, heatwaves and heavy precipitation. Emerging water-related diseases such as dengue fever and chikungunya are reappearing and impacting on the life of the deprived; as such, the provision of safe water and health care is in great demand in developing countries to combat the spread of infectious diseases. Government, academia and private water bodies are conducting water quality surveys and providing health care facilities, but there is still a need to improve the present strategies concerning water treatment and management, as well as governance. In this review paper, climate change pattern and risks associated with water-related diseases in developing countries, with particular focus on Pakistan, and novel methods for controlling both waterborne and water-related diseases are discussed. This study is important for public health care, particularly in developing countries, for policy makers, and researchers working in the area of climate change, water quality and risk assessment.
  •  
25.
  • Ahmed, Toqeer, et al. (författare)
  • Water-related impacts of climate change on agriculture and subsequently on public health : A review for generalists with particular reference to Pakistan
  • 2016
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 13:11
  • Forskningsöversikt (refereegranskat)abstract
    • Water-related impacts due to change in climatic conditions ranging from water scarcity to intense floods and storms are increasing in developing countries like Pakistan. Water quality and waterborne diseases like hepatitis, cholera, typhoid, malaria and dengue fever are increasing due to chaotic urbanization, industrialization, poor hygienic conditions, and inappropriate water management. The morbidity rate is high due to lack of health care facilities, especially in developing countries. Organizations linked to the Government of Pakistan (e.g., Ministry of Environment, Ministry of Climate Change, Planning and Development, Ministry of Forest, Irrigation and Public Health, Pakistan Meteorological Department, National Disaster Management, Pakistan Agricultural Research Centre, Pakistan Council for Research in Water Resources, and Global Change Impact Study Centre), United Nation organizations, provincial government departments, non-governmental organizations (e.g., Global Facility and Disaster Reduction), research centers linked to universities, and international organizations (International Institute for Sustainable Development, Food and Agriculture, Global Climate Fund and World Bank) are trying to reduce the water-related impacts of climate change, but due to lack of public awareness and health care infrastructure, the death rate is steadily increasing. This paper critically reviews the scientific studies and reports both at national and at international level benefiting generalists concerned with environmental and public health challenges. The article underlines the urgent need for water conservation, risk management, and the development of mitigation measures to cope with the water-related impacts of climate change on agriculture and subsequently on public health. Novel solutions and bioremediation methods have been presented to control environmental pollution and to promote awareness among the scientific community. The focus is on diverse strategies to handle the forthcoming challenges associated with water resources management.
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