| 1. |
- Andersson, John, et al.
(författare)
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PM2.5 exposure and olfactory functions
- 2022
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Ingår i: International Journal of Environmental Health Research. - : Taylor & Francis Group. - 0960-3123 .- 1369-1619. ; 32:11, s. 2484-2495
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Tidskriftsartikel (refereegranskat)abstract
- Growing evidence indicates that air pollution can negatively impact cognitive functions. The olfactory system is interesting in this context as it is directly exposed to pollutants and also associated with cognitive functions. The aim of this study was to investigate long- and short-term PM2.5 exposure in association with olfactory functions. Scores from odor tests were obtained from the Betula project - a longitudinal cohort study. Estimates of annual mean PM2.5 concentrations at the participants' residential address were obtained from a dispersion-model. Daily mean PM2.5 concentrations were obtained from a measuring station close to the test location. We found a positive association between long-term PM2.5 exposure and odor identification, i.e. exposure was associated with a better ability to identify odors. We also found an interaction effect between PM2.5 and age on odor identification. We found no associations between any PM2.5 exposure and odor detection or between short-term PM2.5 exposure and olfactory functions.
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| 2. |
- Azfar, Hossain Syed, et al.
(författare)
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Cardiovascular Disease and Mental Distress Among Ethnic Groups in Kyrgyzstan
- 2021
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress.Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress.Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups.Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
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| 3. |
- Enkvist, Hampus, et al.
(författare)
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Stress, mental ill-health and functional somatic syndromes in incident and chronic sleep disturbance in a general adult population
- 2023
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Ingår i: Health Psychology and Behavioral Medicine. - : Taylor & Francis. - 2164-2850. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Sleep disturbance may constitute health problems for the afflicted individual, but documentation of its chronicity is sparse. The objective was to investigate the extent to which incident and chronic sleep disturbance are associated with stress, mental ill-health and functional somatic syndromes.Design: This was a prospective, longitudinal study with 3-year interval between two assessments (T1 and T2), with a population-based sample forming groups with incident sleep disturbance (disturbance only at T2; n = 303), chronic sleep disturbance (disturbance at T1 and T2; n = 343) and without sleep disturbance (neither at T1 nor T2; n = 1421). Questionnaire data were used at T2 of physician-based diagnosis of anxiety disorder, depression, exhaustion syndrome, and functional somatic syndrome as well as of degree of stress, burnout, anxiety and depression.Results: Significant associations were found between chronic sleep disturbance and all four diagnoses (odds ratios = 1.74–2.19), whereas incident sleep disturbance was associated only with exhaustion syndrome and depression (odds ratios = 2.18–2.37). Degree of stress, burnout, anxiety and depression increased significantly from the referents to incident and chronic sleep disturbance, in that order (eta2 = 0.083–0.166), except for the two latter groups not differing in depression.Conclusion: The findings imply that healthcare professionals should be observant regarding various conditions of, apart from stress, mental ill-health and functional somatic syndromes in patients who present themselves with sleep disturbance, and in particular chronic disturbance.
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| 4. |
- Höglund, Per, 1969-, et al.
(författare)
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Impact of group interventions on stress and sleep problems in primary care
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The majority of patients who seek help for stress and sleep problems do so in primary health care in Sweden. However, the resources for psychological treatment are limited. The aim of this study was to assess the effectiveness of a low-intensity student-led group interventions, applying cognitive behavioral therapy (CBT) with an indicated prevention approach in primary care for recovery and reducing symptoms of stress and sleep disturbance.Methods: Using a quasi-experimental design, interventions were conducted for stress (n=274, mean age=38 years, 75% women) and sleep (n=106, mean age=44 years, 56% women) problems in consecutively recruited primary care patients. These were compared with a control group (n=221, mean age=45 years, 91% women) recruited via social media. The interventions were CBT-based psychoeducative group interventions that consisted of four 90-min sessions and led by psychology students. Assessment was completed at pre- and post-intervention and at 3-month follow-up. Main outcome measures were the 10-item Perceived Stress Scale and the Shirom-Melamed Burnout Questionnaire for the stress intervention, and the Karolinska Sleep Questionnaire for the sleep intervention. The Hospital Anxiety and Depression Scale and the 15-item Patient Health Questionnaire were used to assess anxiety, depression and somatization as secondary outcome measures for both interventions. Analysis of covariance (pre- vs post-intervention) and reliable change index (pre-intervention vs three-month follow-up) were applied.Results: Statistically significant, but small effects of improved health in comparison to the control group were found on stress and burnout (η2=.021-.030) in the stress intervention, and on sleep (η2=.017) in the sleep intervention. The proportion of patients in the stress intervention with a reliable improvement at three-month follow-up was 28% for stress and 59% for burnout, and 0% and 33%, respectively, for the control group. Among those with a reliable improvement in burnout, 31% also met a recovery criterion (<4.0). In the sleep intervention, 25% of the patients showed a reliable improvement in sleep and 61% in burnout, and 6% and 33%, respectively, for the control group. The effects of the stress intervention were statistically significant, but small on anxiety and depression (η2=.021-.047), as were the effects of the sleep intervention on stress and burnout (η2=.017-.026). Conclusion: The results suggest that psychology students can effectively provide a low-intensity group-delivered CBT intervention for patients exhibiting symptoms of stress, burnout and sleep disturbance in routine general medical practice, offering promising opportunities for scalability expansion. Although the average treatment effects were small, a substantial proportion of the patients showed reliable improvement or recovery at 3-month follow-up. This suggests that the interventions decrease the prevalence of burnout and sleep disturbance or improve the well-being of individuals experiencing mental distress.
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| 5. |
- Höglund, Per, et al.
(författare)
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Risk factors for insomnia and burnout : a longitudinal population-based cohort study
- 2023
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Ingår i: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:4, s. 798-812
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Tidskriftsartikel (refereegranskat)abstract
- Insomnia and burnout are highly prevalent in the general population, calling for understanding of its causes. Taking a broad approach, the aim of this study was to determine various mental and somatic risk factors for development of insomnia and burnout and stratifying for sex and age group. Questionnaire data were used from a Swedish population-based sample aged 18–79 years, from which cohorts without insomnia (n = 1702) and without burnout (n = 1972) at baseline were followed-up after 3 years. Self-reports of eight mental and somatic conditions at baseline were used as independent variables in logistic regression analyses to predict development of insomnia and burnout at 3-year follow-up. All eight studied conditions were significant risk factors for development of both insomnia (odds ratio, OR = 1.62–2.73) and burnout (OR = 2.20–3.21). Burnout and poor self-rated health had the highest ORs for insomnia, and poor self-rated health, anxiety and somatic symptoms had the highest ORs for burnout. The ORs were generally similar between men and women, whereas age groups tended to differ in some of the risk factors. The study highlights the importance of a broad assessment of both mental and somatic conditions in the prevention of insomnia and burnout.
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| 6. |
- Höglund, Per, 1969-
(författare)
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Stress, sleep disturbance, and related ill-health : from prevalence and risk-factors to indicated interventions
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- With focus on stress-related ill-health and insomnia/sleep disturbance, the overall aim of this thesis was to determine severity and prevalence, risk factors and effectiveness of low-intensity group sessions. This was accomplished by taking epidemiological and quasi-experimental approaches. With the aim of examining symptom severity and prevalence of insomnia, burnout, anxiety, depression, and somatization across different age groups and sexes, Study I used cross-sectional data (n=3406) from the baseline data collection of the Västerbotten Environmental Health Study (VEHS). In comparison to men, women in most age groups exhibited higher levels of symptom severity and prevalence of caseness in various mental health conditions. Insomnia (28.6%) and burnout (17.3%) were common in the population.With focus on risk factors for insomnia and burnout, Study II used a longitudinal design and VEHS data (n=1702–1972) to compare a range of mental and somatic conditions in a general population. The results showed that all examined health conditions were risk factors for cases of insomnia and burnout. For example, insomnia can increase the risk of developing burnout (odds ratio: 2.67), and burnout increase the risk of developing insomnia (odds ratio: 2.73), underscoring the importance of early detection and prevention. The aim of Study III was to examine the effectiveness of four low-intensity group sessions for stress (n=274) and sleep disturbance (n=106) conducted by psychology students. A non-randomized controlled trial design was used in primary care with naturally occurring groups. A control group (n=221) was recruited via social media. Whereas effects were small at post-treatment, a substantial proportion of the patients showed a reliable improvement or recovery at 3-month follow-up. This thesis provides support for the assumption that severity and prevalence of insomnia, burnout, anxiety, depression, and somatization are common in the population. Burnout and insomnia are mutual risk factors and underscore the importance of indicated prevention in primary care. Low-intensity group interventions facilitated by non-experts can be effective and scalable for patients with stress and sleep disturbance.
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| 7. |
- Landis, Basile Nicolas, et al.
(författare)
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"Taste Strips" - a rapid, lateralized, gustatory bedside identification test based on impregnated filter papers.
- 2009
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Ingår i: Journal of neurology. - : Springer Science and Business Media LLC. - 1432-1459 .- 0340-5354. ; 256:2, s. 242-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To elaborate normative values for a clinical psychophysical taste test ("Taste Strips"). BACKGROUND: The "Taste Strips" are a psychophysical chemical taste test. So far, no definitive normative data had been published and only a fairly small sample size has been investigated. In light of this shortcoming for this easy, reliable and quick taste testing device, we attempted to provide normative values suitable for the clinical use. SETTING: Normative value acquisition study, multicenter study. METHODS: The investigation involved 537 participants reporting a normal sense of smell and taste (318 female, 219 male, mean age 44 years, age range 18-87 years). The taste test was based on spoon-shaped filter paper strips ("Taste Strips") impregnated with the four (sweet, sour, salty, and bitter) taste qualities in four different concentrations. The strips were placed on the left or right side of the anterior third of the extended tongue, resulting in a total of 32 trials. With their tongue still extended, patients had to identify the taste from a list of four descriptors, i. e., sweet, sour, salty, and bitter (multiple forced-choice). To obtain an impression of overall gustatory function, the number of correctly identified tastes was summed up for a "taste score". RESULTS: Taste function decreased significantly with age. Women exhibited significantly higher taste scores than men which was true for all age groups. The taste score at the 10(th) percentile was selected as a cut-off value to distinguish normogeusia from hypogeusia. Results from a small series of patients with ageusia confirmed the clinical usefulness of the proposed normative values. CONCLUSION: The present data provide normative values for the "Taste Strips" based on over 500 subjects tested.
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| 8. |
- Lindahl, Bernt, et al.
(författare)
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Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk
- 2020
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Ingår i: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 27:2, s. 209-215
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors.Methods: Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated.Results: About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results.Conclusions: Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.
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| 9. |
- Nordin, Gustav, et al.
(författare)
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Somatic symptoms in sleep disturbance
- 2023
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Ingår i: Psychology, Health & Medicine. - : Taylor & Francis Group. - 1354-8506 .- 1465-3966. ; 28:4, s. 884-894
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Tidskriftsartikel (refereegranskat)abstract
- Despite sleep disturbance and somatic symptoms being common health complaints, the relationship between these disturbances and single somatic symptoms is not well documented. The objectives of this study were to (i) identify somatic symptoms that are particularly associated with sleep disturbance, here referred to as somatic symptoms related to sleep disturbance (SS-SD), (ii) determine increased risk of sleep disturbance for each SS-SD and for a certain number of SS-SD, with and without controlling for anxiety and depression, and (iii) determine sensitivity and specificity for identifying sleep disturbance based on number of SS-SD in a general Swedish sample. Population-based, cross-sectional data based on validated questionnaire instruments were used from participants who constituted a sleep disturbance (n = 864) or a reference (n = 2340) group. Among 15 common somatic symptoms, stomach pain, back pain nausea/gas/indigestion, dizziness, and constipation/loose bowels/diarrhea were identified as SS-SD, with odds ratios of increased risk of sleep disturbance that ranged from 1.93 to 2.44 (1.36–1.79 and 1.54–1.91 when controlled for anxiety and depression, respectively). The risk of sleep disturbance increased by 1.44 times for each SS-SD (1.25 and 1.30 when controlled for anxiety and depression, respectively). A cutoff of two/three or more SS-SD had a sensitivity of 72.5/54.2% and a specificity of 50.0/69.7% for identifying sleep disturbances. When patients present with these somatic symptoms with or without a pathophysiological explanation, primary care clinicians may consider screening for sleep disturbance.
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| 10. |
- Nordin, Maria, 1967-, et al.
(författare)
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Coping strategies, social support and responsibility in chemical intolerance
- 2010
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Ingår i: Journal of Clinical Nursing. - : Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 19:15/16, s. 2162-2173
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To study coping strategies, social support and responsibility for improvement in chemical intolerance (CI). Background. Limited knowledge of CI among health professionals and lay persons places demands on the chemically intolerant individual’s coping strategies and perception of social support and ability to take responsibility for improvement. However, there is sparse literature on these issues in CI. Design. A cross-sectional, questionnaire-based, quasi-experimental study. Method. Fifty-nine persons with mild, 92 with moderate and 31 with severe CI participated by rating (i) usage and effectiveness of six problem- and six emotion-focused coping strategies, (ii) emotional, instrumental and informative support provided by various sources and (iii) society’s and the inflicted individual’s responsibility for improvement. Results. The participants reported that the most commonly used and effective coping strategies were avoiding odorous/pungent environments and asking persons to limit their use of odorous/pungent substances (problem-focused strategies) as well as accepting the situation and reprioritising (emotion-focused strategies). High intolerance severity was associated with problemfocused coping strategies and relatively low intolerance with emotion-focused strategies. More emotional than instrumental and informative support was perceived, predominantly from the partner and other family members. Responsibility attributed to society was also found to increase from mild to moderate/severe intolerance. Conclusions. Certain coping strategies are more commonly used and perceived as more effective than others in CI. However, intolerance severity plays a role regarding both coping strategies and responsibility. Emotional support appears to be the most available type of support.
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| 11. |
- Nordin, Steven, 1960-, et al.
(författare)
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Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age
- 2023
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Ingår i: Psychology and Health. - : Routledge. - 0887-0446 .- 1476-8321.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.
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| 12. |
- Näslund, Ulf, et al.
(författare)
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Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) : a pragmatic, open-label, randomised controlled trial
- 2019
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 393:10167, s. 133-142
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.
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| 13. |
- Paulin, Johan, et al.
(författare)
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Associations between hyperacusis and psychosocial work factors in the general population
- 2019
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 92:1, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We investigated the association between hyperacusis and aspects of psychosocial work environment in a general population. The objectives were to investigate (1) prevalence and characteristics (among age, sex, access to social support at home, education, smoking, physical exercise, and perceived general health) of hyperacusis in a general working population and (2) associations between hyperacusis and psychosocial factors in the work environment. The psychosocial work aspects included effort, reward, overcommitment, worry, and social and emotional support.Methods: Using data from a sample stratified for age and sex from the Österbotten Environmental Health Study in Finland, currently employed participants with self-reported hyperacusis and referents were compared on questionnaire instruments quantifying six aspects of their psychosocial work environment.Results: Among 856 currently employed participants, 47 constituted a hyperacusis group and 809 a reference group. The hyperacusis group scored significantly higher than the referents on worry at work, social support at work, and reward at work, but not on emotional support at work, work overcommitment, or effort at work. About 40% of the hyperacusis group scored on the upper quartile of the three former work environment factors, with odds ratios ranging from 1.91 to 2.56.Conclusions: The results suggest that worrying about aspects at work, perceiving low social support, and not perceiving being rewarded at work are associated with hyperacusis.
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| 14. |
- Sundström, Anna, 1979-, et al.
(författare)
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Construct validation and normative data for different versions of the Shirom-Melamed burnout questionnaire/measure in a Swedish population sample
- 2023
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Ingår i: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:3, s. 499-515
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Tidskriftsartikel (refereegranskat)abstract
- The overall aim of the present study was to examine the construct validity of different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/M) suggested in previous work, as well as to provide normative data for a large population-based sample in Sweden with a broad range in age. Cross-sectional data from the Västerbotten Environmental Health Study in Sweden were used. The 3406 participants (56% women) in this study, aged 18–79 years, constituted a random sample stratified for age and sex. Participants responded to a questionnaire including the 4-factor 22-item version of the SMBM as well as background questions and a number of validated questionnaire instruments assessing for example, sleep disturbance, depression, anxiety, perceived stress, and somatic symptoms. The dimensionality of different versions of the SMBM were examined with confirmatory factor analysis. A modified 4-factor 19-item model of the SMBM provided good model-fit, and two 2-factor models (11-item and 6-item) provided excellent model fit. The relationships to relevant psychological constructs provided support for convergent validity for the suggested versions of the SMBM. Finally, normative data were obtained for a broad age group for the different versions. In conclusion, we suggest that for assessing the core of the burnout construct in terms of emotional and physical exhaustion and cognitive weariness, the SMBM-11 or SMBM-6 for repeated measures, are to be used. For a broader assessment of burnout incorporating both symptoms and information about the process of exhaustion via the subscales of listlessness and tension, we recommend the use of the modified 4-factor SMBM-19.
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| 15. |
- Andersson, Elin M., et al.
(författare)
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Cognitive and emotional reactions to pictorial-based risk communication on subclinical atherosclerosis : a qualitative study within the VIPVIZA trial
- 2023
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 41:1, s. 69-80
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Tidskriftsartikel (refereegranskat)abstract
- Objectives, setting and subjects: Atherosclerosis screening with ultrasound is non-invasive and can be used as part of risk communication. The potential of personalised and pictorial-based risk communication is assessed in VIPVIZA, a population-based randomised controlled trial that aims at optimising cardiovascular disease (CVD) prevention by investigating the impact of visualisation of subclinical atherosclerosis. The present aim was to explore cognitive and emotional reactions evoked by the intervention as well as attitudes to any implemented life style changes in VIPVIZA participants in the intervention group with improved health status and furthermore to study possible interactions between these factors. Understanding mechanisms of action was central since non-adherence to preventive guidelines are often faced in clinical practice. Design: In-depth interviews with 14 individuals were analysed with qualitative content analysis. Results: Cognitive and emotional processes were highly interlinked and described by the main theme Cognitive and emotional reactions in strong interplay for orchestration of health oriented behavioural change. The informants’ descriptions revealed two distinctly different psychological processes which constituted the two subthemes, Problem-focused coping and Encouragement-driven process. Conclusions: The results highlight that an interaction between emotional reactions and efficacy beliefs is important in facilitating behavioural change. Furthermore, the results underscore the importance of the risk message being perceived as clear, accurate, reliable and also emotionally engaging and thereby show why atherosclerosis screening and pictorial-based risk communication have the potential to contribute to effective CVD prevention strategies and shared decision making in primary care.
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| 16. |
- Andersson, Elin M, et al.
(författare)
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Does a multi-component intervention including pictorial risk communication about subclinical atherosclerosis improve perceptions of cardiovascular disease risk without deteriorating efficacy beliefs?
- 2024
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 341
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pictorial communication about subclinical atherosclerosis can improve cardiovascular disease (CVD) risk, but whether it leads to long-term shifts in self-rated CVD risk (risk perception) and beliefs about possibility to influence personal risk (efficacy beliefs) is unknown.Purpose: To study the impact of personalized color-coded and age-related risk communication about atherosclerosis and motivational conversation, compared to traditional risk factor-based communication, on risk perception and efficacy beliefs. Also, whether risk perception increases with message severity.Method: The effect of the pragmatic RCT Visualization of Asymptomatic Atherosclerotic Disease for Optimum Cardiovascular Prevention (VIPVIZA) was analyzed using a linear mixed effects model with risk perception and efficacy believes at 1-year and 3-year follow up as dependent variables. Participants’ (n = 3532) CVD risk perception and efficacy beliefs were assessed with visual analog scales (0–10). Fixed effects were group (intervention vs control), time point (1 year or 3 years) and interaction between group and time point. Further, the models were adjusted for corresponding baseline measurement of the dependent variable and a baseline × time point interaction. Effect of pictorial color-coded risk in the intervention group was investigated using a corresponding mixed effects model, but with pictorial risk group (message severity) as exposure instead of intervention group.Results: After one year, the intervention group rated their CVD risk as higher (m = 0.46, 95% CI 0.32–0.59), with an effect also after 3 years (m = 0.57, 95% CI 0.43–0.70). The effect was consistent in stratified analyses by sex and education. Overall, no effect on efficacy beliefs was observed. In the intervention group, differences in CVD risk perception were found between participants with different color-coded risk messages on atherosclerosis status.Conclusion: Personalized, color-coded and age-related risk communication about atherosclerosis had an effect on risk perception with an effect also after 3 years, whereas overall, no effect on efficacy beliefs was observed.
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| 17. |
- Andersson, Elin M., et al.
(författare)
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From risk communication about asymptomatic atherosclerosis to cognitive and emotional reactions and lifestyle modification
- 2023
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Ingår i: BMC Psychology. - : BioMed Central (BMC). - 2050-7283. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Non-adherence in the general population to preventive guidelines on cardiovascular disease calls for an interdisciplinary approach acknowledging psychological factors of relevance for risk communication and lifestyle modification. Evidence is building up regarding the advantage of sharing arterial imaging evidence of subclinical atherosclerosis with asymptomatic individuals, but there is limited understanding of how this relates to mechanisms of importance for behavioural change. Longitudinal studies on associations between patients’ reactions and lifestyle modification are missing. The population-based randomized controlled trial VIPVIZA investigates the impact of pictorial information about subclinical atherosclerosis, added to traditional risk factor-based communication. The intervention includes a personalized, colour-coded and age-related risk communication strategy and a motivational conversation, and has been shown to reduce cardiovascular disease risk. Methods: In the present study we assessed cognitive and emotional reactions to the intervention, and how these reactions are associated to lifestyle modification. The participants’ evaluation of the risk communication was assessed in the intervention group (n=1749). Lifestyle modification was assessed with a lifestyle index based on physical activity, diet, smoking and alcohol consumption at baseline and after 3 years. Associations between cognitive and emotional response and lifestyle modification were tested with analyses of covariance in a subset of participants (n=714-857).Results: The intervention increased understanding of personal CVD risk, the possibility to influence the risk, and how to influence the risk. Severity of atherosclerosis was associated with emotional reactions, but emotions of strong negative valence were uncommon. Cognitive response and emotional arousal evoked by the intervention were positively associated with lifestyle modification, whereas negative emotions in isolation were not. High level of cognitive response in combination with high level of emotional arousal was found to be most beneficial for lifestyle modification.Conclusions: The results demonstrate the potential of communicating asymptomatic atherosclerosis with a pictorial, colour-coded and age-related strategy, also including a motivational conversation. Furthermore, the results show the importance of CVD risk communication evoking engagement, and that an interaction between cognitive and emotional reactions might be central for sustained lifestyle modification. Our results also indicate that, in an asymptomatic population, atherosclerosis screening may strengthen disease prevention and health promotion.
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| 18. |
- Andersson, Linus, 1979-, et al.
(författare)
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Attention bias and sensitization in chemical sensitivity.
- 2009
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Ingår i: Journal of psychosomatic research. - : Elsevier BV. - 1879-1360 .- 0022-3999. ; 66:5, s. 407-16:66, s. 407-416
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We investigated whether persons with self-reported chemical sensitivity (CS) have an attention bias and enhanced sensitization to chemical exposure. METHODS: Chemosomatosensory, olfactory, and auditory event-related potentials (ERPs) were recorded from 21 CS subjects and 17 controls in attend and ignore conditions. Reaction times (RTs) and magnitude estimations of perceived intensity were collected in the attend condition. ERPs were averaged over attention conditions and during the first/second part of the testing. RESULTS: ERP patterns indicated that CS subjects did not habituate to the same extent as the controls and had difficulties ignoring the chemical exposure. CS subjects had faster overall RT, and the perceived intensities for the chemosomatosensory stimuli did not decrease with time in the CS group, which was the case for the controls. CONCLUSIONS: These results indicating attention bias and enhanced sensitization in CS suggest alterations in central, cognitive responses to chemical exposure.
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| 19. |
- Andersson, Linus, 1979-, et al.
(författare)
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Chemosensory attention, habituation and detection in women and men
- 2011
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Ingår i: International Journal of Psychophysiology. - : Elsevier. - 0167-8760 .- 1872-7697. ; 79, s. 316-322
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate whether there are differences between women and men in how chemosensory stimuli are processed. Event-related potentials from 36 participants (18 men) showed that women had larger P3 amplitudes when attending, but not when ignoring CO 2 but not for n-butanol, compared with men. The main finding was that women and men differ in cognitive measures of chemosensory processing.
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| 20. |
- Andersson, Linus, et al.
(författare)
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Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity
- 2016
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 89:1, s. 79-88
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol.Methods: We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorantn-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which then-butanol concentration increased and reached a plateau at 11.5 mg/m3.Results: MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses.Conclusions: We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.
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| 21. |
- Andersson, Linus, 1979-, et al.
(författare)
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On the relation between capsaicin sensitivity and responsiveness to CO2: detection sensitivity and event-related brain potentials.
- 2009
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Ingår i: International archives of occupational and environmental health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 82:3, s. 285-90
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Sensory hyperreactivity (SHR) with predominantly airway symptoms is a subgroup of chemical intolerance to various environmental substances with pungent/odorous properties. The hallmark of SHR is sensitivity to capsaicin inhalation, resulting in extensive coughing likely to be mediated by a C-fiber hyperreactivity of the airway sensory neurons. However, it is not clear whether capsaicin sensitivity implies a greater sensitivity to chemosomatosensory substances in general. Therefore, the present study tested the hypothesis of an association between capsaicin cough sensitivity and sensitivity to CO(2) with respect to detection sensitivity and electrophysiological brain response. METHODS: A correlational study was employed to investigate the relation between capsaicin cough sensitivity and detection thresholds and chemosomatosensory event-related potentials (ERPs) for CO(2) presented in the nasal cavity in 35 persons varying in capsaicin cough sensitivity. RESULTS: Number of coughs were found to correlate negatively with CO(2) threshold and tended to correlate negatively also with N1 and P2 latencies of the chemosomatosensory ERP for CO(2). No tendencies of correlations were found between number of coughs and latencies for olfactory and auditory ERPs, recorded for comparison, but, unexpectedly, were found between number of coughs and auditory N1 amplitude. CONCLUSIONS: The results imply that capsaicin cough sensitivity, such as in SHR, is related to higher detection sensitivity, and tends to be related to faster cortical processing of other chemosomatosensory substances, at least of CO(2).
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| 22. |
- Andersson, Linus, 1979-, et al.
(författare)
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Prevalence and risk factors for chemical sensitivity and sensory hyperreactivity in teenagers
- 2008
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Ingår i: International journal of hygiene and environmental health. - : Elsevier. - 1438-4639 .- 1618-131X. ; 211:5-6, s. 690-697
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of chemical sensitivity (CS) and sensory hyperreactivity (SHR) was assessed in a teenage population. Among a random sample of 401 teenagers, 326 (81.3%) answered questionnaires assessing sensitivity to chemicals and noise, anxiety and depression. A subgroup of 85 teenagers conducted a capsaicin inhalation test. The estimated prevalence was 15.6% for general self-reported CS, 3.7% for CS with affective and behavioral consequences, about 1% for SHR. Sensitivity variables were positively intercorrelated. Risk factors for general CS were noise sensitivity (OR: 2.1), probable anxiety (OR: 2.5) and female sex (OR: 2.0). CS problems seem to be present also in teenagers, although less so than in adults. Furthermore, CS seems to be related to other environmental sensitivities.
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| 23. |
- Andersson, Maria J E, et al.
(författare)
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The idiopathic environmental intolerance symptom inventory: development, evaluation, and application.
- 2009
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Ingår i: Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. - : American College of Occupational and Environmental Medicine. - 1536-5948 .- 1076-2752. ; 51:7, s. 838-47
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To develop, evaluate, and apply a questionnaire-based instrument for investigation of specific symptoms in idiopathic environmental intolerance (IEI), called the Idiopathic Environmental Intolerance Symptom Inventory (IEISI). METHODS: Participants with IEI to chemicals responded to 82 candidate symptoms and to three subscales of the Quick Environmental Exposure and Sensitivity Inventory (QEESI) at a test (n = 207) and retest (n = 193) occasion. RESULTS: The 27 most commonly reported symptoms were selected and grouped into five symptom categories. Internal consistency, test-retest reliability, and concurrent validity were found to be satisfying. Cluster analysis identified two subgroups of IEI to chemicals. CONCLUSIONS: The results provide support for the IEISI being a reliable, valid, and fast tool for the study of specific symptom prevalence in IEI and encourage further study of subgroups.
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| 24. |
- Bengtsson, Anna, 1973-, et al.
(författare)
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The beneficial effect over 3 years by pictorial information to patients and their physician about subclinical atherosclerosis and cardiovascular risk : results from the VIPVIZA randomized clinical trial
- 2021
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Ingår i: American Journal of Preventive Cardiology. - : Elsevier. - 2666-6677. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Non-adherence to guidelines and preventive measures is a major challenge, particularly so to ob- tain long-term adherence to lifestyle changes and recommended medication. The objective was to investigate if pictorial information regarding subclinical carotid atherosclerosis provided to individuals and physicians gave sustained effects on cardiovascular risk beyond the previously reported effect after 1 year and up to 3 years. Methods: A Prospective Randomized Open Blinded End-point (PROBE) trial. Within a CVD prevention program in Västerbotten County, Sweden, 3532 healthy individuals aged 40, 50 or 60 years were enrolled and 1:1 ran- domized to intervention ( n = 1749; pictorial information with additional prevention materials to participants and physicians) or control group ( n = 1783; no pictorial information to participants and physicians). Preventive measures were managed within primary care. Participants were investigated at baseline during 2013–2016 and at follow-up after 1 and 3 years. Results: A beneficial effect on cardiovascular risk was observed at 3-year follow-up; Framingham Risk Score (FRS) was 13.38 for the intervention group and 14.08 for the control group ( p = 0.047) and SCORE was 1.69 vs. 1.82 ( p = 0.022). The effect observed at 1-year was sustained over 3 years after adjustment for sex and education and more pronounced among participants with a severe atherosclerotic picture at baseline.Conclusions: This study provides evidence of sustained beneficial effects on the adherence to prevention guidelines over 3 years of pictorial information about subclinical carotid atherosclerosis, resulting in lower cardiovascular risk regardless of sex and educational level. Direct visualization of the underlying still subclinical atherosclerotic disease, rather than just indirect information about risk factors and statistical risk of future myocardial infarction, stroke and death, is one way to tackle the problem of non-adherence to prevention of cardiovascular diseases.
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| 25. |
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