| 1. |
- Andersson, Susanne, et al.
(författare)
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It's up to me! Experiences of living with pre-diabetes and the increased risk of developing type 2 diabetes mellitus
- 2008
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Ingår i: Primary Care Diabetes. - Amsterdam : Elsevier. - 1751-9918 .- 1878-0210. ; 2:4, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore experiences of pre-diabetes and the associated increased risk of type 2 diabetes mellitus. Methods: Eight participants with pre-diabetes were interviewed for a 45-60 min period. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological hermeneutic approach. Results: Living with pre-diabetes means existing on the borderline of being healthy and suffering from T2DM. Three themes were formulated; "seeing possibilities in an uncertain future", "facing obstacles and loss of liberty" and "balancing between possibilities and obstacles" Being on the borderline and balancing between possibilities and obstacles were interpreted as a distressing feeling of being at increased risk of developing T2DM, although this feeling can change to one of either facing possibilities or facing obstacles. Conclusions: Special focus must be directed towards persons with pre-diabetes, as they are caught between possibilities and obstacles. Advanced care in the form of health dialogues can convince these people of their own abilities to influence the outcome of pre-diabetes. The result of this study can guide health care practitioners in comprehending each participant's understanding of the situation, thus helping them to create pedagogical dialogues in which patients' experiences, conceptions, explanations as well as explicit and implicit questions are identified. © 2008 Primary Care Diabetes Europe.
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| 2. |
- Andersson, Susanne, 1957, et al.
(författare)
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Perceived symptoms in people living with impaired glucose tolerance.
- 2011
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437. ; 2011:Article ID 937038
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to identify symptoms in people with impaired glucose tolerance (IGT) and describe their experiences of living with the symptoms which they related to their condition. Twenty-one participants, from a cross-sectional population-based study, diagnosed as having IGT, were invited for an interview. The interviews were analyzed in two phases by means of a manifest and latent content analysis. The narratives included seven categories of symptoms (and more than 25 different symptoms) presented by the respondents. This study shows that symptoms such as the patient's own interpretation of different perceptions in the body must be considered, as well as signs and/or objective observations. Symptoms ought to be seen as complementary components in the health encounter and health conversation. The results of this study indicate that health professionals should increase their awareness of the balance between the implicit and the explicit bodily sensations that individuals communicate. Further studies are needed.
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| 3. |
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| 4. |
- Andersson, Susanne, 1957, et al.
(författare)
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The association between self-rated health and impaired glucose tolerance in Swedish adults: A cross-sectional study
- 2013
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 31:2, s. 111-118
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate gender differences in the association between self-rated health (SRH) and impaired glucose tolerance (IGT) in subjects unaware of their glucose tolerance. Design. A cross-sectional population-based study. Setting. The two municipalities of Vara and Skövde in south-western Sweden. Subjects. A total of 2502 participants (1301 women and 1201 men), aged 30–75, were randomly selected from the population. Main outcome measures. IGT was regarded as the outcome measure and SRH as the main risk factor. Results. The prevalence of IGT was significantly higher in women (11.9%) than in men (10.1%), (p = 0.029), as was the prevalence of low SRH (women: 35.4%; men: 22.1%, p = 0.006). Both men and women with low SRH had a poorer risk factor profile than those with high SRH, and a statistically significant crude association between SRH and IGT was found in both men (OR = 2.8, 95% CI 1.8–4.4) and women (OR = 1.5, 95% CI 1.0–2.2, p = 0.033). However, after controlling for several lifestyle factors and biomedical variables, the association was attenuated and remained statistically significant solely in men (OR = 2.3, 95% CI 1.2–4.3). Conclusion. The gender-specific associations found between SRH and IGT suggest that SRH may be a better indicator of IGT in men than in women. Future studies should evaluate the utility of SRH in comparison with objective health measures as a potential aid to health practitioners when deciding whether to screen for IGT and T2DM.
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| 5. |
- Andersson, Susanne, et al.
(författare)
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The association between self-reported lack of sleep, low vitality and impaired glucose tolerance : A Swedish cross-sectional study
- 2013
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The increased incidence of impaired glucose tolerance (IGT), are serious public health issues, and several studies link sleeping disorders with increased risk of developing type 2 diabetes, impaired glucose tolerance and insulin resistance (IR). This study explore how self-reported lack of sleep and low vitality, are associated with IGT in a representative Swedish population. Methods. A cross-sectional survey conducted in two municipalities in South-western Sweden. Participants aged 30-75 were randomly selected from the population in strata by sex and age. Altogether, 2,816 participants were surveyed with a participation rates at 76%. Participants with normal glucose tolerance (n=2,314), and those with IGT (n=213) were retained for analyses. The participants answered a questionnaire before the oral glucose tolerance test (OGTT). Associations for questions concerning sleeping disorders, vitality and IGT were analysed using logistic regression and were expressed as odds ratios (OR) with 95% CI. Results: In men a statistically significant age-adjusted association was found between self-reported lack of sleep and IGT: OR 2.4 (95% CI: 1.1-5.4). It did not weaken after further adjustment for body mass index (BMI), smoking, education, and leisure time physical activity 2.3 (1.0-5.5, p=0.044). No such associations were found in females. Corresponding age-adjusted associations between low vitality and IGT in both men 2.8 (1.3-5.8), and women 2.0 (1.2-3.4) were successively lost with increasing adjustment. Conclusions: Insufficient sleep seems independently associated with IGT in men, while low vitality was not independently associated with IGT neither in men nor women, when multiple confounders are considered. IGT should be considered in patients presenting these symptoms, and underlying mechanisms further explored. © 2013 Andersson et al.; licensee BioMed Central Ltd.
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| 6. |
- Buschard, Karsten, et al.
(författare)
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Low serum concentration of sulfatide and presence of sulfated lactosylceramid are associated with Type 2 diabetes. The Skaraborg Project
- 2005
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 22:9, s. 1190-8
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The glycosphingolipid sulfatide (sulfated galactosyl-ceramide) increases exocytosis of beta-cell secretory granules, activates K(ATP)-channels and is thereby able to influence insulin secretion through its presence in the islets. A closely related compound, sulfated lactosylceramide (sulf-lac-cer), is present in the islets during fetal and neonatal life when, as in Type 2 diabetes, insulin is secreted autonomically without the usual first phase response to glucose. The aim was to examine whether serum concentrations of these glycolipids are associated with Type 2 diabetes. METHODS: A case-control study, comprising 286 women and 283 men, was designed using a population-based sample of patients with Type 2 diabetes and a population survey. RESULTS: Low serum concentrations of sulfatide were associated with Type 2 diabetes, independent of traditional risk factors for diabetes in a sex-specific analysis: odds ratio (OR) 2.1 (95% confidence interval 1.1, 3.9) in men, and 2.3 (1.2, 4.3) in women, comparing the lowest and the highest tertiles. Type 2 diabetes was also associated with detectable amounts of sulf-lac-cer in serum: OR 1.7 (0.9, 3.4) in men, and 7.6 (3.8, 15.2) in women. After adjustment for confounding from other diabetes risk factors, these associations remained basically unchanged. The connections between sulfatide and Type 2 diabetes, and sulf-lac-cer and Type 2 diabetes were independent of each other. Insulin resistance (HOMA-IR) was negatively correlated with sulfatide concentration and positively correlated with sulf-lac-cer (both P < 0.0001, independently). CONCLUSIONS: We report a new, robust and highly significant independent association between Type 2 diabetes and serum concentrations of sulfatide in both sexes, and sulf-lac-cer in females. The associations were also independent of other known diabetes risk factors.
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| 7. |
- Emma, Lindblad, et al.
(författare)
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Experiences of the new role of advanced practice nurses in Swedish primary health care--a qualitative study
- 2010
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Ingår i: International Journal of Nursing Practice. - 1322-7114. ; 2010:16, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate and describe the experiences of the first advanced practice nurses (APNs), a new profession for Swedish health care, and of their supervising general practitioners (GPs), regarding the new role and scope of practice of APNs in primary health care. Individual interviews were conducted with the four first APNs and one focus group interview was conducted with five supervising physicians. The material was transcribed verbatim and analysed using latent content analysis. The respondents expressed confidence and trust in the new role of APNs. Some opposition to this new role from the GPs and other colleagues was observed, but was nonetheless overcome. The experiences of the APN role indicate that the new role is clearly demarcated from the role of physicians. The APNs were considered an extra resource for both the GPs and other nurses, which contributed to an increased availability of care for patients. The APN role requires an explicit definition and demarcation in relation to responsibility and roles among colleagues. Further development of the APN role presupposes the right to prescribe medication and order treatments, as well as an evaluation of patient, organizational and inter-professional perspectives on the matter.
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| 8. |
- Ljungvall, Åsa, et al.
(författare)
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Misreporting and misclassification: implications for socioeconomic disparities in body-mass index and obesity
- 2015
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Ingår i: European Journal of Health Economics. - : Springer Science and Business Media LLC. - 1618-7598 .- 1618-7601. ; 16:1, s. 5-20
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Tidskriftsartikel (refereegranskat)abstract
- Body-mass index (BMI) has become the standard proxy for obesity in social science research. This study deals with the potential problems related to, first, relying on self-reported weight and height to calculate BMI (misreporting), and, second, the concern that BMI is a deficient measure of body fat (misclassification). Using a regional Swedish sample, we analyze whether socioeconomic disparities in BMI are biased because of misreporting, and whether socioeconomic disparities in the risk of obesity are sensitive to whether BMI or waist circumference is used to define obesity. Education and income are used as socioeconomic indicators. The overall conclusion is that misreporting and misclassification may indeed matter for estimated educational and income disparities in BMI and obesity. In the misreporting part we find that women with higher education misreport less than those with lower education, leading to underestimation of the education disparity when using self-reported information. In the misclassification part we find that the probability of being misclassified decreases with income, for both men and women. Among women, the consequence is a steeper income gradient when obesity is defined using waist circumference instead of BMI. Among men the income gradient is statistically insignificant irrespective of how obesity is defined, but when estimating the probability of obesity defined by waist circumference, an educational gradient, which is not present when classifying men using BMI, arises.
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| 9. |
- Ahmadi, Nasser, 1958, et al.
(författare)
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Breathlessness in everyday life from a patient perspective: A qualitative study using diaries
- 2014
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Ingår i: Palliative & supportive care. - Cambridge, United Kingdom : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 12:3, s. 189-194
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Breathlessness is a subjective symptom, which makes it difficult to define and understand. The aim of the present study was to illuminate how patients suffering from breathlessness experience their everyday life. Method: The study was a qualitative study, and the focus of the analysis was the patients’ descriptions of their experiences of breathlessness using a diary with two unstructured questions for a period of 7 consecutive days. Sixteen participants: 7men, mean age 65+7 (range 55–73 years old), and 9 women, mean age 65+9 (range 50–72 years old) participated in the study. Results: Two themes emerged from the analysis: 1) Impaired quality of life and 2) symptom tolerance and adaptation. The theme “impaired quality of life” included the categories limited physical ability, psychological burdens, and social life barriers. The theme “symptom tolerance and adaptation” included importance of health care, social support, hobbies and leisure activities, and coping strategies. Significance of results: The findings in our study showed that patients, in spite of considerable difficulties with shortness of breath, found relief in several types of activities, in addition to drug therapy. The result indicates that the “biopsychosocial model” is an appealing approach that should be discussed further to gain a better understanding of breathlessness.
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| 10. |
- Ahmadi, Nasser, 1958, et al.
(författare)
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Clinical characteristics of asymptomatic left ventricular diastolic dysfunction and its association with self-rated health and N-terminal B-type natriuretic peptide: a cross-sectional study
- 2016
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Ingår i: Esc Heart Failure. - : Wiley. - 2055-5822. ; 3:3, s. 205-211
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Tidskriftsartikel (refereegranskat)abstract
- Aims Left ventricular hypertrophy, obesity, hypertension, and N-terminal B-type natriuretic peptide (Nt-proBNP) predict left ventricular diastolic dysfunction with preserved systolic function (DD-PSF). Self-rated health (SRH) is shown to be associated with chronic diseases, but the association of SRH with DD-PSF is unclear. In light of the clinical implications of DD-PSF, the following goals are of considerable importance: (1) to determine the role of SRH in patients with DD-PSF in the general population and (2) to study the association between Nt-proBNP and DD-PSF. Methods and results The current study is a cross-sectional study conducted on a random sampling of a rural population. Individuals 30-75 years of age were consecutively subjected to conventional echocardiography and tissue velocity imaging. Data were collected on 500 (48%) men and 538 (52%) women (n = 1038). DD-PSF was the main outcome, and SRH and Nt-proBNP were the primary indicators. Diabetes mellitus, hypertension, and obesity were accounted for as major confounders of the association with SRH. DD-PSF was identified in 137 individuals, namely, 79 men (15.8%) and 58 women (10.8%). In a multivariate regression model, SRH (OR 2.95; 95% CI 1.02-8.57) and Nt-proBNP (quartile 4 vs. quartile 1 OR 4.23; 95% CI 1.74-10.26) were both independently associated with DD-PSF. Conclusions SRH, evaluated based on a descriptive question on general health, should be included in the diagnostic process of DD-PSF. In agreement with previous studies, our study confirms that Nt-proBNP is a major indicator of DD-PSF.
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| 11. |
- Al-Majdoub, Mahmoud, et al.
(författare)
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Population-level analysis to determine parameters that drive variation in the plasma metabolite profiles
- 2018
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Ingår i: Metabolites. - : MDPI AG. - 2218-1989. ; 8:4
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Tidskriftsartikel (refereegranskat)abstract
- The plasma metabolome is associated with multiple phenotypes and diseases. However, a systematic study investigating clinical determinants that control the metabolome has not yet been conducted. In the present study, therefore, we aimed to identify the major determinants of the plasma metabolite profile. We used ultra-high performance liquid chromatography (UHPLC) coupled to quadrupole time of flight mass spectrometry (QTOF-MS) to determine 106 metabolites in plasma samples from 2503 subjects in a cross-sectional study. We investigated the correlation structure of the metabolite profiles and generated uncorrelated metabolite factors using principal component analysis (PCA) and varimax rotation. Finally, we investigated associations between these factors and 34 clinical covariates. Our results suggest that liver function, followed by kidney function and insulin resistance show the strongest associations with the plasma metabolite profile. The association of specific phenotypes with several components may suggest multiple independent metabolic mechanisms, which is further supported by the composition of the associated factors. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
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| 12. |
- Altersved, Ewa, et al.
(författare)
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Advanced practice nurses : A new resource for Swedish primary health-care teams
- 2011
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Ingår i: International Journal of Nursing Practice. - : John Wiley & Sons. - 1322-7114 .- 1440-172X. ; 17:2, s. 174-180
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Tidskriftsartikel (refereegranskat)abstract
- Advanced practice nurses: A new resource for Swedish primary health-care teams This study is associated with the first evaluation of the four first advanced practice nurses (APNs), part of a primary health-care team in Sweden. The aim is to describe health-care teams' experiences of the new APN role and investigate what opportunities and barriers to the role exist. Eighty-one respondents answered a 14-question questionnaire with a Likert scale and one open-ended question. The Kruskal-Wallis test was used to investigate differences between professional groups' answers. The qualitative material was analysed using deductive content analysis. Though mostly positive experiences of the role were found, differences did exist between the professional groups. APNs are considered a resource in that access to care, cooperation and patient flow increased. Barriers include APNs' limited autonomy and inability to prescribe medication. To further develop the role, the right to prescribe medication and strategic leadership within the Swedish health-care system, policy and legislation are needed.
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| 13. |
- Arvidsson, Daniel, et al.
(författare)
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Cross-cultural validation of a simple self-report instrument of physical activity in immigrants from the Middle East and native Swedes.
- 2014
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:3, s. 255-262
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To investigate cross-cultural validity of a simple self-report instrument of physical activity intended to be used in Swedish health care. Methods: A validation study performed in 599 Iraqis (58% men) and 553 Swedes (53% men) aged 30-75 years living in the city of Malmö, Sweden. The self-report instrument by the Swedish National Board of Health and Welfare was compared to corresponding measures assessed from accelerometry as reference. Results: The agreement between the methods in assessing the participants as sufficiently/insufficiently physically active (cut-point 150 min/week) was 65% in the Iraqis and 52% in the Swedes (p<0.001). The proportion disagreement where the self-reported physical activity was sufficient but insufficient according to the accelerometry was 26% and 45% in Iraqis and Swedes, respectively. Physical activity time (min/week) was overestimated by self-report compared to accelerometry by 71% in the Iraqis and 115% in the Swedes (p<0.001). The smallest and largest overestimation was seen in Iraqi (57%) and Swedish (139%) women, respectively. The deviation of the self-report instrument compared to accelerometry was related to the physical activity level, as the overestimation mainly occurred at lower physical activity. Conclusions: The self-report instrument proposed by the Swedish National Board of Health and Welfare may overestimate the proportion sufficiently physically active, but to an extent depending on cultural background and gender.
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| 14. |
- Arvidsson, Daniel, et al.
(författare)
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Vigorous Physical Activity may be Important for the Insulin Sensitivity in Immigrants From the Middle East and Native Swedes
- 2015
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Ingår i: Journal of Physical Activity & Health. - : Human Kinetics. - 1543-3080 .- 1543-5474. ; 12:2, s. 273-281
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare physical activity measures and their associations with insulin sensitivity, beta-cell function and body mass index (BMI) between Iraqi immigrants and native Swedes. Methods: A cross-sectional study of 493 Iraqis (58% men) and 469 Swedes (54% men) aged 30 to 75 years living in the city of Malmo, Sweden. Accelerometry was used for physical activity measures (sedentary time, breaks in sedentary time, moderate and vigorous physical activity, total counts). Insulin sensitivity index and oral disposal index were determined from an oral glucose tolerance test and BMI by body weight and height. Results: Iraqi men were less physically active than Swedish men, while the physical activity was more similar in the women. BMI was a strong predictor of insulin sensitivity and beta-cell function and frequently associated with the physical activity measures. BMI modified the associations of insulin sensitivity and beta-cell function with the physical activity measures to such extent that only VPA and total counts show direct associations with insulin sensitivity in addition to the indirect associations via BMI. Iraqi women demonstrated weaker associations compared with Swedish women. Conclusions: Physical activity and performed at vigorous intensity may be important mainly for the insulin sensitivity in Iraqi immigrants and native Swedes.
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| 15. |
- Bennet, Louise, et al.
(författare)
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A family history of diabetes determines poorer glycaemic control and younger age of diabetes onset in immigrants from the Middle East compared with native Swedes
- 2015
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Ingår i: Diabetes & Metabolism. - : Elsevier BV. - 1262-3636 .- 1878-1780. ; 41:1, s. 45-54
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Tidskriftsartikel (refereegranskat)abstract
- Aims. - Immigrant populations from the Middle East develop diabetes earlier than indigenous European populations; however, the underlying etiology is poorly understood. This study looked at the risk factors associated with early diabetes onset and, in non-diabetics, glycaemic control in immigrants from Iraq compared with native Swedes. Methods. - This cross-sectional population-based study comprised 1398 Iraqi immigrants and 757 Swedes (ages 30-75 years) residing in the same area of Malmo, Sweden. Outcomes were age at diabetes onset and glycaemic control (HbA(1c)) as assessed by Cox proportional hazards and linear regression, respectively. Results. - In Iraqis vs Swedes, clustering in the family history (in two or more relatives) was more prevalent (23.2% vs 3.6%, P<0.001) and diabetes onset occurred earlier (47.6 years vs 53.4 years, P=0.001). Having an Iraqi background independently raised the hazard ratio (HR) for diabetes onset. Diabetes risk due to family history was augmented by obesity, with the highest HRs observed in obese participants with clustering in the family history (HR: 5.1, 95% CI: 3.2-8.2) after adjusting for country of birth and gender. In participants without previously diagnosed diabetes (Iraqis: n=1270; Swedes: n=728), HbA(1c), levels were slightly higher in Iraqis than in Swedes (4.5% vs 4.4%, P=0.038). This difference was explained primarily by clustering in the family history rather than age, obesity, lifestyle or socioeconomic status. Conclusion. - The study shows that the greater predisposition to diabetes in Middle Eastern immigrants may be explained by a more extensive family history of the disorder; clinical interventions tailored to Middle Eastern immigrants with such a family history are thus warranted.
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| 16. |
- Bennet, Louise, et al.
(författare)
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Cardiovascular disease in relation to diabetes status in immigrants from the Middle East compared to native Swedes: a cross-sectional study.
- 2013
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Type 2 diabetes is highly prevalent in immigrants to Sweden from Iraq, but the prevalence of cardiovascular disease (CVD) and its risk factors are not known. In this survey we aimed to compare the prevalence of CVD and CVD-associated risk factors between a population born in Iraq and individuals born in Sweden. METHODS: This population-based, cross-sectional study comprised 1,365 Iraqi immigrants and 739 Swedes (age 30-75 years) residing in the same socioeconomic area in Malmö, Sweden. Blood tests were performed and socio-demography and lifestyles were characterized. To investigate potential differences in CVD, odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by multivariate logistic regression analysis with adjustment for metabolic, lifestyle and psychosocial risk factors for CVD. Outcome measures were odds of CVD. RESULTS: There were no differences in self-reported prevalence of CVD between Iraqi- and Swedish-born individuals (4.0 vs. 5.5%, OR 0.9, 95% CI 0.4-1.8). However, the prevalence of type 2 diabetes was higher in Iraqi compared to Swedish participants (8.4 vs. 3.3%, OR=4.2, 95% CI 2.6-6.7). Moreover, among individuals with type 2 diabetes, Iraqis had a higher prevalence of CVD (22.8 vs. 8.0%, OR=4.2, 95% CI 0.9-20.0), after adjustment for age and sex. By contrast, among those without diabetes, immigrants from Iraq had a lower prevalence of CVD than Swedes (2.2 vs. 5.5%, OR=0.6, 95% CI 0.3-0.9).Type 2 diabetes was an independent risk factor for CVD in Iraqis only (OR=6.8, 95% CI 2.8-16.2). This was confirmed by an interaction between country of birth and diabetes (p=0.010). In addition, in Iraqis, type 2 diabetes contributed to CVD risk to a higher extent than history of hypertension (standardized OR 1.5 vs. 1.4). CONCLUSIONS: This survey indicates that the odds of CVD in immigrants from Iraq are highly dependent on the presence or absence of type 2 diabetes and that type 2 diabetes contributes with higher odds of CVD in Iraqi immigrants compared to native Swedes. Our study suggests that CVD prevention in immigrants from the Middle East would benefit from prevention of type 2 diabetes.
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| 17. |
- Bennet, Louise, et al.
(författare)
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Diastolic dysfunction is associated with sedentary leisure time physical activity and smoking in females only
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 28:3, s. 172-178
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Left ventricular diastolic dysfunction with preserved systolic function (DD-PSF) is associated with an increased risk of morbidity and mortality. Population-based surveys studying the associations between DD-PSF and lifestyle-associated risk factors, such as leisure time physical activity (LTPA) and smoking, are scarce. Thus, the aims were to explore the associations between DD-PSF and LTPA and smoking, employing optimal echocardiographic techniques. Design. Cross-sectional study conducted from 2001 to 2003. Setting.The study was conducted in a random sample of a rural Swedish population. Subjects. Men and women of 30–75 years of age were consecutively invited for conventional echocardiography and tissue velocity imaging (n = 1149). Structured questionnaires and physical examinations were conducted using standardized methods. Main outcome measures. DD-PSF was defined according to the European Society of Cardiology criteria excluding subjects with ejection fraction < 45%, or a self-reported history of heart failure. Results. Complete information was available in 500 men and 538 women. In a multivariate model, DD-PSF was independently associated with sedentary LTPA and smoking in females; sedentary LTPA odds ratio (OR) 2.91, 95% confidence interval (CI) 1.02 to 8.27, and smoking OR 3.42, 95% CI 1.35 to 8.64. The probability of identifying DD-PSF in females with a sedentary LTPA was 37% and increased to 80% if they also had hypertension and were obese. Conclusions. Sedentary LTPA and smoking are independently associated with DD-PSF in females. Identification of a sedentary lifestyle in females increases the probability of diagnosing DD-PSF.
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| 18. |
- Bennet, Louise, et al.
(författare)
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Dubbelt så hög risk för diabetes typ 2 hos svenskar födda i Irak
- 2015
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Ingår i: Läkartidningen. - 0023-7205. ; 112:16, s. 1-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The MEDIM study reports that Immigrants from the Middle East to Sweden – independently of other diabetes related risk factors – have a twice as high type 2 diabetes risk as compared to non-immigrated Swedes. Diabetes onset occurs 6 years earlier in this group and is partly explained by family history and/or obesity. But the MEDIM study has identified that Middle Eastern background per se is an independent risk factor for earlier disease onset. Immigrants from the Middle East free of diabetes have a more pronounced insulin resistance and worse glycaemic control than non-immigrated Swedes independently of age, obesity or other risk factors for diabetes. To be able to reduce the risk of diabetes and offer an equal health care, glucose/HbA1c should be controlled on wide indications, and risk evaluation and preventive actions provided earlier for this population at high risk for type 2 diabetes. © 2015, Swedish Medical Association. All rights reserved.
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| 19. |
- Bennet, Louise, et al.
(författare)
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Ethnicity is an independent risk indicator when estimating diabetes risk with FINDRISC scores: A cross sectional study comparing immigrants from the Middle East and native Swedes
- 2014
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 8:3, s. 231-238
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study sought to compare type 2 diabetes (T2D) risk indicators in Iraqi immigrants with those in ethnic Swedes living in southern Sweden. Methods: Population-based, cross-sectional cohort study of men and women, aged 30-75 years, born in Iraq or Sweden conducted in 2010-2012 in Malmö, Sweden. A 75 g oral glucose tolerance test was performed and sociodemographic and lifestyle data were collected. T2D risk was assessed by the Finnish Diabetes Risk Score (FINDRISC). Results: In Iraqi versus Swedish participants, T2D was twice as prevalent (11.6 vs. 5.8%, p < 0.001). A large proportion of the excess T2D risk was attributable to larger waist circumference and first-degree family history of diabetes. However, Iraqi ethnicity was a risk factor for T2D independently of other FINDRISC factors (odds ratio (OR) 2.5, 95% CI 1.6-3.9). The FINDRISC algorithm predicted that more Iraqis than Swedes (16.2 vs. 12.3%, p < 0.001) will develop T2D within the next decade. The total annual costs for excess T2D risk in Iraqis are estimated to exceed 2.3 million euros in 2005, not accounting for worse quality of life. Conclusions: Our study suggests that Middle Eastern ethnicity should be considered an independent risk indicator for diabetes. Accordingly, the implementation of culturally tailored prevention programs may be warranted. © 2014 Primary Care Diabetes Europe.
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| 20. |
- Bergman, Karin, et al.
(författare)
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Patients' satisfaction with the care offered by advanced practice nurses: a new role in Swedish primary care
- 2013
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Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 19:3, s. 326-333
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to describe patients’ satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi-squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN-led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents’ comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.
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| 21. |
- Boström, Kristina Bengtsson, et al.
(författare)
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Polymorphisms in alpha - and betaadrenergic receptor genes, hypertension and obstructive sleep apnea. The Skaraborg Sleep Study. J Hypertension
- 2010
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Ingår i: International Journal of Hypertension. - 2090-0392. ; 2010:Art ID 458410
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Tidskriftsartikel (refereegranskat)abstract
- The sympathetic nervous system and the adrenergic receptors play an important role in regulation of blood pressure. This study explored the associations between functional polymorphisms of the α(2B)-, β(1)-, and β(2)-adrenergic receptor genes and obstructive sleep apnea (OSA) in hypertensive patients and hypertension in patients with OSA in a populationbased sample of 157 hypertensive patients and 181 healthy control subjects. Only the Arg389Gly polymorphism of the β(1)-adrenergic receptor gene was associated with increased risk for mild OSA in hypertensive patients (Arg/Arg versus Gly/Arg/Gly/Gly, 2.1, 95% CI, 1.02-4.7). Hypertensive men carrying the Arg389Arg genotype had higher crude and age-adjusted AHI than carriers of the Arg389Gly/Gly389Gly genotypes. When adjusted also for BMI this difference became borderline significant. This difference was not observed in women. The risk of hypertension in mild OSA was associated with increasing number of Arg-alleles (Arg/Arg OR 5.4, 95% CI 1.4-21.2).
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| 22. |
- Carrera-Bastos, Pedro, et al.
(författare)
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Total adiponectin in indigenous Melanesians on Kitava
- 2024
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Ingår i: AMERICAN JOURNAL OF HUMAN BIOLOGY. - 1042-0533 .- 1520-6300.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Experimental and small human studies have indicated that high total adiponectin levels have beneficial cardiometabolic effects. In contrast, however, high total adiponectin levels are also associated with higher all-cause and cardiovascular mortality in thoroughly adjusted epidemiological studies. To gain further insight into these seemingly contradictory results, we report results on total adiponectin from the indigenous Melanesian population of Kitava, Trobriand Islands, Papua New Guinea, where an apparent absence of cardiometabolic disease has been previously reported. Methods: Fasting levels of serum total adiponectin were measured cross-sectionally in >= 40-year-old Kitavans (n = 102) and Swedish controls matched for age and sex (n = 108). Multivariable linear regression was used for the analysis of associations with total adiponectin when controlled for group, sex, smoking, hypertension and/or type 2 diabetes, age, and body mass index. Results: Total adiponectin was lower for Kitavans compared to Swedish controls (Median [Mdn] 4.6 mu g/mL, range 1.0-206 mu g/mL and Mdn 9.7 mu g/mL, range 3.1-104 mu g/mL, respectively, r = .64, p < .001). Lower total adiponectin was associated with Kitavan group, male sex (only in Swedish controls), smoking (only in Kitavans and Swedish controls combined), younger age (not in Swedish controls), higher BMI, lower total, low-density lipoprotein, high-density lipoprotein (HDL) (only in Kitavans and Swedish controls combined), and non-HDL cholesterol, and higher anti-PC IgG (only in Kitavans and Swedish controls combined). Conclusion: Total adiponectin in Kitavans was significantly lower than in Swedish controls.
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| 23. |
- Cunningham, S. G., et al.
(författare)
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Core Standards of the EUBIRO Project Defining a European Diabetes Data Dictionary for Clinical Audit and Healthcare Delivery
- 2016
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 55:2, s. 166-176
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Tidskriftsartikel (refereegranskat)abstract
- Background: A set of core diabetes indicators were identified in a clinical review of current evidence for the EUBIROD project. In order to allow accurate comparisons of diabetes indicators, a standardised currency for data storage and aggregation was required. We aimed to define a robust European data dictionary with appropriate clinical definitions that can be used to analyse diabetes outcomes and provide the foundation for data collection from existing electronic health records for diabetes. Methods: Existing clinical datasets used by 15 partner institutions across Europe were collated and common data items analysed for consistency in terms of recording, data definition and units of measurement. Where necessary, data mappings and algorithms were specified in order to allow partners to meet the standard definitions. A series of descriptive elements were created to document metadata for each data item, including recording, consistency, completeness and quality. Results: While datasets varied in terms of consistency, it was possible to create a common standard that could be used by all. The minimum dataset defined 53 data items that were classified according to their feasibility and validity. Mappings and standardised definitions were used to create an electronic directory for diabetes care, providing the foundation for the EUBIROD data analysis repository, also used to implement the diabetes registry and model of care for Cyprus. Conclusions: The development of data dictionaries and standards can be used to improve the quality and comparability of health information. A data dictionary has been developed to be compatible with other existing data sources for diabetes, within and beyond Europe.
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| 24. |
- Cunningham, S G, et al.
(författare)
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Core Standards of the EUBIROD Project. Defining a European Diabetes Data Dictionary for Clinical Audit and Healthcare Delivery.
- 2016
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Ingår i: Methods of information in medicine. - 2511-705X. ; 55:2, s. 166-76
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Tidskriftsartikel (refereegranskat)abstract
- A set of core diabetes indicators were identified in a clinical review of current evidence for the EUBIROD project. In order to allow accurate comparisons of diabetes indicators, a standardised currency for data storage and aggregation was required. We aimed to define a robust European data dictionary with appropriate clinical definitions that can be used to analyse diabetes outcomes and provide the foundation for data collection from existing electronic health records for diabetes.Existing clinical datasets used by 15 partner institutions across Europe were collated and common data items analysed for consistency in terms of recording, data definition and units of measurement. Where necessary, data mappings and algorithms were specified in order to allow partners to meet the standard definitions. A series of descriptive elements were created to document metadata for each data item, including recording, consistency, completeness and quality.While datasets varied in terms of consistency, it was possible to create a common standard that could be used by all. The minimum dataset defined 53 data items that were classified according to their feasibility and validity. Mappings and standardised definitions were used to create an electronic directory for diabetes care, providing the foundation for the EUBIROD data analysis repository, also used to implement the diabetes registry and model of care for Cyprus.The development of data dictionaries and standards can be used to improve the quality and comparability of health information. A data dictionary has been developed to be compatible with other existing data sources for diabetes, within and beyond Europe.
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| 25. |
- Daka, Bledar, 1976, et al.
(författare)
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Circulating concentrations of endothelin-1 predict coronary heart disease in women but not in men: A longitudinal observational study in the Vara-Skövde Cohort
- 2015
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- © 2015 Daka et al.Background: The vasoconstricting peptide endothelin-1 has been proposed to be a marker of cardiovascular disease. Our aim was to investigate whether circulating endothelin-1 levels predict coronary heart disease (CHD) in Sweden. Methods: In 2002-2005, 2816 adult participants (30-74 years) were randomly selected from two municipalities in south-western Sweden. Cardiovascular risk factors and endothelin-1 levels were assessed at baseline, and incident CHD was followed-up in all participants through 2011. After exclusion of 50 participants due to known CHD at baseline and 21 participants because of unsuccessful analysis of endothelin-1, 2745 participants were included in the study. In total, 72 CHD events (52 in men and 20 in women) were registered during the follow-up time. Results: We showed that baseline circulating endothelin-1 levels were higher in women with incident CHD than in women without CHD (3.2 pg/ml, SE: 0.36 vs 2.4 pg/ml, SE: 0.03, p = 0.003) whereas this difference was not observed in men (2.3 pg/ml, SE: 0.16 vs 2.3 pg/ml, SE: 0.04, p = 0.828). An age-adjusted Cox proportional regression analysis showed an enhanced risk of CHD with increasing baseline endothelin-1 levels in women (hazard ratio (HR) = 1.51, 95 % CI = 1.1-2.1, p = 0.015) but not in men (HR = 0.98, 95 % CI = 0.8-1.2, p = 0.854). Furthermore, the predictive value of endothelin-1 for incident CHD in women was still significant after adjustments for age, HOMA-IR, apolipoprotein (apo)B/apoA1 and smoking (HR = 1.53, CI = 1.1-1.2, p = 0.024). Conclusion: Circulating endothelin-1 levels may predict CHD in women.
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