| 1. |
- Palm, Kristina, et al.
(författare)
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Digitalisering och arbetsmiljö
- 2020
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Ingår i: Framtidens arbetsmiljö – trender, digitalisering och anställningsformer. - 9789198596151 ; , s. 33-80
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Bokkapitel (refereegranskat)
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| 2. |
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| 3. |
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| 4. |
- Bergman, Stefan, 1959-, et al.
(författare)
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Chronic Widespread Pain in Adolescents Is Highly Associated to Stress and Anxiety
- 2015
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Ingår i: Arthritis & Rheumatology. - Hoboken, NJ : John Wiley & Sons. - 2326-5191 .- 2326-5205. ; 67:Suppl. S10
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Tidskriftsartikel (refereegranskat)abstract
- Background/Purpose: Chronic widespread pain (CWP), one of the hallmarks of fibromyalgia, is not uncommon in adolescents and it has previously been shown that adolescents with pain often become young adults with pain. CWP often co-varies with anxiety, depression, and stress symptoms in adults, but the knowledge regarding this is small in youth and young adults.The aim was to study the associations between CWP, anxiety, depression and stress in adolescents attending first year of high school.Methods: A computerized questionnaire to 296 adolescents attending Swedish high school, with validated questions regarding presence and distribution of pain (Epipain mannequin), stress symptoms (ELO question), anxiety and depression (Hospital Anxiety and Depression Scale – HADS), and health related quality of life (HRQL as measured by EQ5D). Pain was considered chronic when persistent for more than three months, and the subgroup CWP was defined according to the 1990 ACR criteria for fibromyalgia. Statistical analyses in SPSS v21 with comparison of means by Student’s t-test and proportions by chi2-test or Fischer’s exact test.Results: 257 (87%) out of 296 eligible students, mean (SD) age 16.1 (0.7) and 65.8% girls, responded to the questionnaire. Prevalence of chronic pain was 20.8% and that of the subgroup CWP was 4.7%, without any gender differences (boys 18.2% vs girls 22.2%; p=0.224, and 3.4% vs 5.4%; p=0.692). High level (4 or 5 on a 5 point scale) of stress symptoms were less common in boys (16.0% vs 28.2%; p=0.015), as was possible or probable anxiety (17.1% vs 44.4%; p<0.001), but not depression (10.3% vs 12.5%; p=0.764). Students with high level of stress reported CWP five times more often than those with less stress (30.4% vs 5.8%; p=0.001). Students with probable anxiety reported CWP ten times more often than students with no anxiety (17.6% vs 1.8%; p=0.001), and CWP was also more common, but not statistically significant, in students with probable depression (20.0% vs 3.1%; p=0.163). Those reporting CWP had significantly lower HRQL (0.58 vs 0.87; p=0.038) than students with no chronic pain.Conclusion: The high prevalence of chronic pain and the strong associations between CWP and reports of stress and anxiety in adolescents highlights that a multifactorial background to chronic pain must be considered early in life. An apparent lower score in EQ5D also indicates that the presence of CWP has an marked impact on HRQL also in adolescents.
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| 5. |
- Jakobsson, Kristina, et al.
(författare)
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Polybrominated diphenyl ethers in maternal serum, umbilical cord serum, colostrum and mature breast milk : Insights from a pilot study and the literature
- 2012
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 47, s. 121-130
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Tidskriftsartikel (refereegranskat)abstract
- Human serum and mother's milk are frequently used to assess exposure to polybrominated diphenyl ethers (PBDEs), including transplacental transfer to the foetus. However, little is known about the kinetics of PBDEs, especially the highly brominated BDE congeners.In this pilot study, maternal serum samples were collected from 10 women at delivery and five to six weeks post partum. Umbilical serum was also obtained. Milk was donated two to five days, and five to six weeks after delivery. The amount of PBDEs in these samples was determined using liquid–liquid extraction and GC/MS.Low, moderately and highly brominated diphenyl ethers were present in umbilical cord serum, indicating placental transfer. The lipid-adjusted levels of BDE-47, BDE-207 and BDE-209 were similar in maternal and umbilical cord serum, whereas the cord serum levels for the penta- to octa-BDEs quantified were lower than in maternal serum.Marked changes were seen in the congener pattern in breast milk during the first month of lactation, whereas maternal serum levels did not change significantly. The general pattern was an enrichment of low to moderately brominated congeners (i.e. from BDE-17 to BDE-154, with the exception of BDE-28) in colostrum compared with maternal serum. In contrast, more highly brominated congeners were found at similar, or lower levels in colostrum than in maternal serum. After the transition from colostrum to mature milk, the levels of BDE-153 and BDE-209 were substantially reduced, and BDE‐209 was below the limit of detection in 6 out of 9 samples.A literature review on the design and reporting of studies on the transfer of PBDEs from mother to infant revealed a lack of transparency in many cases. The use of the recently published STROBE-ME guidelines is therefore recommended.
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| 6. |
- Malmborg, Julia S, 1988-, et al.
(författare)
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Worse health status, sleeping problems, and anxiety in 16-year-old students are associated with chronic musculoskeletal pain at three-year follow-up
- 2019
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Ingår i: BMC Public Health. - London : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic musculoskeletal pain is common in adolescents, and it has been shown that adolescents with pain may become young adults with pain. Pain often coincides with psychosomatic symptoms in adults, but little is known about longitudinal associations and predictors of pain in adolescents. The aim was to investigate chronic musculoskeletal pain and its associations with health status, sleeping problems, stress, anxiety, depression, and physical activity in 16-year-old students at baseline, and to identify risk factors using a three-year follow-up. Methods: This was a longitudinal study of 256 students attending a Swedish upper secondary school. Questionnaires regarding chronic musculoskeletal pain and distribution of pain (mannequin), health status (EQ-5D3 L), sleeping problems (Uppsala Sleep Inventory), stress symptoms (single-item question), anxiety and depression (Hospital Anxiety and Depression Scale), and physical activity (International Physical Activity Questionnaire) were issued at baseline and follow-up. Student's t-test and chi2 test were used for descriptive statistics and logistic regression analyses were used to study associations between chronic pain and independent variables. Results: Fifty-two out of 221 students at baseline (23.5%) and 39 out of 154 students at follow-up (25.3%) were categorized as having chronic musculoskeletal pain. Chronic musculoskeletal pain at follow-up was separately associated with reporting of an EQ-5D value below median (OR 4.06, 95% CI 1.83-9.01), severe sleeping problems (OR 3.63, 95% CI 1.69-7.82), and possible anxiety (OR 4.19, 95% CI 1.74-10.11) or probable anxiety (OR 3.82, 95% CI 1.17-12.48) at baseline. Similar results were found for associations between chronic musculoskeletal pain and independent variables at baseline. In multiple logistic regression analysis, chronic musculoskeletal pain at baseline was a predictor of chronic musculoskeletal pain at follow-up (OR 2.99, 95% CI 1.09-8.24, R-2 = 0.240). Conclusion: Chronic musculoskeletal pain at baseline was the most important predictor for reporting chronic musculoskeletal pain at the three-year follow-up, but a worse health status, severe sleeping problems, and anxiety also predicted persistence or development of chronic musculoskeletal pain over time. Interventions should be introduced early on by the school health services to promote student health.
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| 7. |
- Malmborg, Julia, 1988-, et al.
(författare)
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Sleeping Problems and Anxiety is Associated to Chronic Multisite Musculoskeletal Pain in Swedish High School Students
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77:Suppl. 2, s. 226-226
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: The relationship between chronic multisite musculoskeletal pain (CMP) and sleep is complex, where pain can lead to sleeping problems and lack of sleep can intensify the pain perception. Most previous studies relates to adults, but adolescents may also suffer from CMP, and there is a need for more knowledge regarding the relationships between CMP and sleeping problems, stress, anxiety, depression, and health status.Objectives: To study background factors associated to CMP in first year Swedish high school students.Methods: First year Swedish high school students (n=296) were invited to complete questionnaires on chronic pain (mannequin with 18 body regions), sleeping problems (Uppsala Sleep Inventory, four items scored from 1–5), stress (ELO questions, scored from 1–5), anxiety and depression (Hospital Anxiety and Depression Scale, scored from 0–21), health status (EQ-5D, scored from 0 to 1, worst to best) and physical activity (International Physical Activity Questionnaire, categorised into low, moderate and high levels). Stress and sleeping items were dichotomized into 1–3 points (best) vs 4–5 points (worst). Individuals scoring at least severe problems (4 points) at one or more sleeping items were classified as having severe sleeping problems. HADS were categorised as non-cases (0–7), possible7–10 and probable cases (11–21 points). Students were grouped as having CMP (pain present in ≥3 regions) or not (no chronic pain or chronic pain in 1–2 regions). Multiple logistic regression analyses (adjusted for sex) with CMP as dependent variable were performed in SPSS, version 24.Results: 254 students (86% of total sample, 87 boys and 167 girls) with a mean age of 16.1 (SD 0.6) years participated in the study. CMP was present in 25 (9.8%) students with no differences between boys and girls (8.0% vs 10.8%; p=0.488). Having CMP was associated with reporting severe sleeping problems (OR 2.49, 95% CI: 1.06 to 5.81, p=0.035) with initiating sleep, maintaining sleep, early morning awakenings and/or not feeling restored after sleep in comparison to the other students. Students with CMP were more likely to be categorised as probable cases for anxiety (OR 3.06, 95% CI: 1.09 to 8.61, p=0.034), but there were no associations for possible cases for anxiety (OR 1.15, 95% CI: 0.38 to 3.51, p=0.800), possible cases (OR 2.03, 95% CI: 0.63 to 6.54), or probable cases for depression (OR 3.35, 95% CI: 0.33 to 33.83). There was a nearly significant association between stress and belonging to the CMP group (OR 2.31, 95% CI: 0.97 to 5.53, p=0.059). A higher self-reported health status was associated to a lower likelihood for CMP (OR 0.04, 95% CI: 0.01 to 0.27, p=0.001). Distribution of physical activity levels of low, moderate and high was not significantly associated to having CMP in comparison with not having it.Conclusions: One in ten high school students fulfilled criteria for having chronic multisite musculoskeletal pain. CMP was associated to sleeping problems, anxiety, and a worse health status. The results from this study may be used by school health-care professionals in their preventive work to promote student’s health.Disclosure of Interest: None declared
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| 8. |
- Palmer, Nicholette D, et al.
(författare)
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A genome-wide association search for type 2 diabetes genes in African Americans.
- 2012
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Ingår i: PloS one. - San Francisco : Public Library of Science (PLoS). - 1932-6203. ; 7:1, s. e29202-
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Tidskriftsartikel (refereegranskat)abstract
- African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P<0.0071), were directionally consistent in the Replication cohort and were associated with T2DM in subjects without nephropathy (P<0.05). Meta-analysis in all cases and controls revealed a single SNP reaching genome-wide significance (P<2.5×10(-8)). SNP rs7560163 (P = 7.0×10(-9), OR (95% CI) = 0.75 (0.67-0.84)) is located intergenically between RND3 and RBM43. Four additional loci (rs7542900, rs4659485, rs2722769 and rs7107217) were associated with T2DM (P<0.05) and reached more nominal levels of significance (P<2.5×10(-5)) in the overall analysis and may represent novel loci that contribute to T2DM. We have identified novel T2DM-susceptibility variants in the African-American population. Notably, T2DM risk was associated with the major allele and implies an interesting genetic architecture in this population. These results suggest that multiple loci underlie T2DM susceptibility in the African-American population and that these loci are distinct from those identified in other ethnic populations.
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| 9. |
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| 10. |
- Wennerholm, Ulla-Britt, 1948, et al.
(författare)
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Progesterone, cerclage, pessary, or acetylsalicylic acid for prevention of preterm birth in singleton and multifetal pregnancies : A systematic review and meta-analyses
- 2023
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Ingår i: Frontiers in Medicine. - : Frontiers Media S.A.. - 2296-858X. ; 10
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Forskningsöversikt (refereegranskat)abstract
- Background: Preterm birth is the leading cause of childhood mortality and morbidity. We aimed to provide a comprehensive systematic review on randomized controlled trials (RCTs) on progesterone, cerclage, pessary, and acetylsalicylic acid (ASA) to prevent preterm birth in asymptomatic women with singleton pregnancies defined as risk of preterm birth and multifetal pregnancies.Methods: Six databases (including PubMed, Embase, Medline, the Cochrane Library) were searched up to February 2022. RCTs published in English or Scandinavian languages were included through a consensus process. Abstracts and duplicates were excluded. The trials were critically appraised by pairs of reviewers. The Cochrane risk-of-bias tool was used for risk of bias assessment. Predefined outcomes including preterm birth, perinatal/neonatal/maternal mortality and morbidity, were pooled in meta-analyses using RevMan 5.4, stratified for high and low risk of bias trials. The certainty of evidence was assessed using the GRADE approach. The systematic review followed the PRISMA guideline.Results: The search identified 2,309 articles, of which 87 were included in the assessment: 71 original RCTs and 16 secondary publications with 23,886 women and 32,893 offspring. Conclusions were based solely on trials with low risk of bias (n = 50).Singleton pregnancies: Progesterone compared with placebo, reduced the risk of preterm birth < 37 gestational weeks: 26.8% vs. 30.2% (Risk Ratio [RR] 0.82 [95% Confidence Interval [CI] 0.71 to 0.95]) (high certainty of evidence, 14 trials) thereby reducing neonatal mortality and respiratory distress syndrome. Cerclage probably reduced the risk of preterm birth < 37 gestational weeks: 29.0% vs. 37.6% (RR 0.78 [95% CI 0.69 to 0.88]) (moderate certainty of evidence, four open trials). In addition, perinatal mortality may be reduced by cerclage. Pessary did not demonstrate any overall effect. ASA did not affect any outcome, but evidence was based on one underpowered study.Multifetal pregnancies: The effect of progesterone, cerclage, or pessary was minimal, if any. No study supported improved long-term outcome of the children.Conclusion: Progesterone and probably also cerclage have a protective effect against preterm birth in asymptomatic women with a singleton pregnancy at risk of preterm birth. Further trials of ASA are needed. Prevention of preterm birth requires screening programs to identify women at risk of preterm birth.
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| 11. |
- Abelsson, Tobias, et al.
(författare)
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Quality and availability of information in primary healthcare: the patient perspective
- 2020
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 38:1, s. 33-41
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore lived experiences of patients communicating with and receiving information from primary health care. Design: Qualitative study analysing transcribed interviews by descriptive content analysis. Setting: Recruitment and interviews took place in southern Sweden in three primary care centres where privacy and undisturbed interview environments was ensured. Subjects: 17 primary care patient informants, 9 men and 8 women aged 31 - 84 years with varying educational levels from primary school to post graduates. Main outcome measures: Thematic categories and subcategories reporting the lived experience of the patients. Results: The analysis yielded three categories and identified as a main theme a feeling of unpredictability based on the emotional aspects of feeling lost and vulnerable when trying to access primary care. The category" Need for easy access" illustrated emotional aspects of importance to patients when contacting primary health care." Need for individual adaptation" described the need to individually adapt health related information." Information exchange" comprised experiences of information evaluation and understanding new information. Conclusions: Patients generally trusted the information received, but experienced a lack of communication, which evoked feelings of unpredictability and abandonment. Experiences of limited access to primary health care and the need for varying degrees of adaptation on the part of the individual were factors of concern for how patients experienced the care.
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| 12. |
- Abelsson, Tobias, et al.
(författare)
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The dilemma of the split between theory and reality as experienced by primary healthcare professionals: a mixed methods study of evidence-based practice in a primary care context
- 2024
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Ingår i: BMC PRIMARY CARE. - 2731-4553. ; 25:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrimary care depends upon a good information flow across professional and structural boundaries to provide the best care for patients. Previous research has mainly focused on Evidence-Based Practice (EBP) within specific professions. Mapping of pan-professional experiences of and attitudes to EBP in publicly funded clinical practice is necessary to deepen the understanding of EBP and its implementation. Thus, this study aimed to investigate healthcare professionals' experiences of and attitudes towards working in accordance with EBP in primary care.MethodsThe study used a convergent mixed methods design divided into two strands: a quantitative enquiry tool (Evidence-Based Practice Attitude Scale, EBPAS) and a set of qualitative interviews analysed by means of qualitative content analysis. Both strands included all primary care employees with patient interaction in the studied county (n = 625), including doctors, nurses, physiotherapists, psychologists and assistant nurses. Out of the original 625 healthcare professionals, 191 finished the first strand and 8 volunteered for the second strand (2 nurses, 2 physiotherapists, 1 psychiatrist and 3 doctors).ResultsThe EBPAS value of 2.8 (max 4) indicated a generally positive attitude towards EBP amongst the population, which was also evident in the interviews. However, there were additional experiences of not having the ability or resources to engage in EBP. This was illustrated by the theme that emerged from the qualitative content analysis: "The dilemma of the split between theory and reality". Due to the organisational and managerial focus on efficiency rather than quality of care, there were few or no incentives for promoting individual educational or research development.ConclusionsAlthough the general attitude towards EBP is positive, experiences of practising it differ. There is a need to increase knowledge of EBP concepts, requirements and implementation in the clinical setting. The absence of opportunities to do research and collegial debate about new ways of finding and implementing research-based evidence results might influence the quality of care.
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| 13. |
- Aili, Katarina, 1980-, et al.
(författare)
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Long-term trajectories of chronic musculoskeletal pain: a 21-year prospective cohort latent class analysis
- 2021
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Ingår i: Pain. - Philadelphia, PA : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 162:5, s. 1511-1520
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Tidskriftsartikel (refereegranskat)abstract
- Our knowledge of the prevalence, impact, and outcomes of chronic pain in the general population is predominantly based on studies over relatively short periods of time. The aim of this study was to identify and describe trajectories of the chronic pain status over a period of 21 years. Self-reported population data (n = 1858) from 5 timepoints were analyzed. Pain was categorized by: no chronic pain (NCP), chronic regional pain (CRP), and chronic widespread pain (CWP). Latent class growth analysis was performed for identification of trajectories and logistic regression analysis for identification of predictors for pain prognosis. Five trajectories were identified: (1) persistent NCP (57%), (2) migrating from NCP to CRP or CWP (5%), (3) persistent CRP or migration between CRP and NCP (22%), (4) migration from CRP to CWP (10%), and (5) persistent CWP (6%). Age, sleeping problems, poor vitality, and physical function at baseline were associated with pain progression from NCP. Female gender, seeking care for pain, lack of social support, poor physical function, vitality, and mental health predicted poor pain prognosis among those with CRP. In conclusion, chronic pain was common in the population including 6% reporting persistent CWP, although the majority persistently reported NCP. Most people had stable pain status, but some had ongoing change in pain status over time including people who improved from chronic pain. It was possible to identify clinically relevant factors, characterizing trajectories of chronic pain development, that can be useful for identifying individuals at risk and potential targets for intervention.
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| 14. |
- Aili, Katarina, 1980-, et al.
(författare)
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Long term trajectories of chronic widespread pain : a 21-year prospective cohort latent class analysis
- 2019
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Ingår i: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl 2, s. 239-239
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic widespread pain (CWP) is common (population prevalence of approximately 10%) and has a significant impact on the individual, healthcare, and society. Currently little is known about the actual course of CWP over time, in particular the pathways to the development and maintenance of CWP. One useful way to understand these pathways is to identify common clusters of people who share pain trajectories. Such information is clinically useful to identify factors that predict development, persistence, and resolution of CWP.Objectives: To identify different longitudinal pain trajectories over a period of 21 years.Methods: A 21-year longitudinal open-population cohort of n=1858 adults (aged 20-74) who completed surveys relating to their pain status in at least three of the five time points 1995, 1998, 2003, 2007, and 2016. Pain status (presence of persistent pain) was ascertained from a report of painful regions (0-18) on a pain mannequin and categorised into: NCP (No chronic pain), CRP (Chronic regional pain) and CWP (chronic widespread pain). Latent Class Growth Analysis (LCGA) was carried out based on these categories. Participants were assigned to a trajectory cluster where the posterior probability was the highest. Model fit was assessed by statistical indices and clinical interpretations of clusters.Results: LCGA identified five clusters describing different pathways of NCP, CRP and CWP over the 21 years. The cluster “Persistent NCP” was the most common pathway (n = 1052, 57%) representing those with no chronic pain over the whole time period. The “Persistent CRP or Migration from CRP to NCP” cluster included 411 individuals (22%) representing a group with stable or improving regional pain. In the groups who were shown to increase pain status, the “Migration from NCP to CRP or CWP” cluster included 92 individuals (5%), and there were 184 individuals (10%) in the cluster “Migration from CRP to CWP” representing a group with regional pain who developed CWP. The final cluster “Persistent CWP” included 119 individuals (6%) representing those with stable CWP throughout the time period. Figure 1 presents the mean number of pain sites over time by cluster.Conclusion: This study showed that whilst half of adults report no chronic pain over 21 years, a substantial proportion develop CWP or have persistent CWP over this time period. Whilst a common trajectory was movement from chronic regional pain to no chronic pain, a pattern of improving CWP was not seen suggesting this is an uncommon trajectory. This is the first study to show long-term trajectories for CWP, and further work is now required to understand factors that may identify individuals at risk of worsening pain status and factors that might promote improvement. These identified pathways of chronic pain over a lifespan improve the understanding of long-term development of chronic pain and chronic widespread pain. © Aili et al. 2019. No commercial re-use. See rights and permissions. Published by BMJ.
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| 15. |
- Aili, Katarina, 1980-, et al.
(författare)
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Passive coping strategies but not physical function are associated with worse mental health, in women with chronic widespread pain – a mixed method study
- 2019
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Ingår i: Annals of the Rheumatic Diseases. - London, UK : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 78:Suppl 2, s. 2159-2159
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic widespread pain (CWP) is a common condition (approximately 10% prevalence), that affects women twice as often as men. There is a lack of knowledge in how different coping strategies relates to health status during CWP development in a general population.Objectives: To explore different ways of coping with CWP and to relate the different coping strategies to health-related factors, before and after developing CWP.Methods: A sequential explorative mixed methods study including 19 women 45-67 of age, who had reported CWP in a survey 2016, but not in 1995. Individual interviews were analysed with a phenomenographic approach, and resulted in four categories of coping strategies. These categories were further explored with regard to four dimensions of health status (physical function, bodily pain, vitality and mental health) as measured by SF-36 (0-100, a lower score indicates more disability) and sleep problems measured both in 1995, and 2016.Results: The qualitative analysis revealed four categories representing different coping strategies, where each woman was labelled by the most dominant category; the mastering woman, the persistent woman, the compliant woman and the conquered woman. The first two categories emerged as being active coping strategies, and the latter two as passive. Women with passive strategies reported significantly lower vitality (median 57.5 vs 75, p=0.007) and worse mental health (median 54 vs 93, p=0.021) in 1995, before they had developed CWP compared with those with active coping strategies. No differences were seen between the groups on physical function, bodily pain or sleep.In 2016, there were still a difference between the passive and active group regarding mental health (median 56 vs 80, p=0.022), but not for vitality (median 35 vs 40, p=0.707). No differences were seen between the groups on physical function or bodily pain. All eight women with passive strategies reported problems with sleep in 2016, as compared to 6 of the 11 women with active strategies (p=0.045).Conclusion: Women that reported CWP in 2016, but not in 1995, described both active and passive coping strategies. The qualitative findings were associated with differences in vitality and mental health already in 1995, before they had developed CWP. Further, those with passive coping strategies reported worse health with regard to mental health and sleep problems in 2016. Interestingly, the groups did not differ in bodily pain or physical function neither in 1995 nor in 2016, which implicates the importance for the clinician to take the typical coping strategy into consideration, when meeting these patients in clinical settings. © Aili, Bergman, Bremander, Haglund & Larsson 2019. No commercial re-use. See rights and permissions. Published by BMJ.
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| 16. |
- Aili, Katarina, et al.
(författare)
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Sleep problems and fatigue as a predictor for the onset of chronic widespread painover a 5- and 18-year perspective : a 20-year prospective study
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77, s. 87-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: If localised pain represent one end of a pain spectra, with overall better general health, chronic widespread pain (CWP) and fibromyalgia represent the other end of the spectra with worse general health and more comorbidities with other somatic diseases and mental illness. Sleep problems and fatigue are common among individuals reporting CWP and previous research indicate that sleep problems may be an important predictor for pain prognosis.Objectives: The aim of this population-based study was to investigate if sleep problems and fatigue predict the onset of CWP 5 and 18 years later.Methods: In order to get more stable baseline classifications of CWP, a wash-out period was used, including only individuals who had not reported CWP (according to ACR 1990 criteria for fibromyalgia) at baseline (−98) and three years prior baseline (−95). In all, data from 1249 individuals entered the analyses for the 5 year follow-up (−03) and 791 entered for the 18 year follow-up (−16). Four parameters related to sleep (difficulties initiating sleep, maintaining sleep, early morning awakening and non-restorative sleep), and one parameter related to fatigue (SF-36 vitality scale) were investigated as predictors for CWP. Binary logistic regression analysis were used for analyses.Results: All investigated parameters predicted the onset of CWP five years later (problems with initiating sleep (OR 1.91; 1.16–3.14), maintaining sleep (OR 1.85; 1.14–3.01), early awakening (OR 2.0; 1.37–3.75), non-restorative sleep (OR 2.27; 1.37–3.75) and fatigue (OR 3.70; 1.76–7.84)) in a model adjusted for age, gender, socio-economy and mental health. All parameters except problems with early awakening predicted the onset of CWP also 18 years later. In all, 785 individuals did not report any of the sleeping problems at baseline (fatigue not included), 268 reported one of the problems, 167 two, 128 three and 117 subjects reported to have all four sleep problems. Reporting all four sleep problems was significantly associated with CWP at follow-up at both time points when adjusting for age, gender, socio economy and mental health (OR 4.00; 2.03–7.91 and OR 3.95; 1.90–8.20); adjusting for age, gender, socio economy and number of pain regions (OR 2.94; 1.48–5.82 and OR 2.65; 1.24–5.64) and in a model adjusting for age, gender, socio economy and pain severity (OR 2.97;1.53–5.76; and OR 3.02;1.47–6.21) for the 5 year and 18 year follow-up respectively, compared to not reporting any of the sleep problems at baseline.Conclusions: Both sleeping problems and fatigue predicts the onset of CWP 5- and 18 years later. The results highlight the importance of the assessment of sleep quality in the clinic.
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| 17. |
- Aili, Katarina, 1980-, et al.
(författare)
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Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5-and 18-year perspective
- 2018
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline.MethodsTo get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were investigated as predictors separately and simultaneously in binary logistic regression analyses.ResultsThe results showed that problems with initiating sleep, maintaining sleep, early awakening and non-restorative sleep predicted the onset of CWP over a 5-year (OR 1.85 to OR 2.27) and 18-year (OR 1.54 to OR 2.25) perspective irrespective of mental health (assessed by SF-36) at baseline. Also fatigue predicted the onset of CWP over the two-time perspectives (OR 3.70 and OR 2.36 respectively) when adjusting for mental health. Overall the effect of the sleep problems and fatigue on new onset CWP (over a 5-year perspective) was somewhat attenuated when adjusting for pain at baseline but remained significant for problems with early awakening, non-restorative sleep and fatigue. Problems with maintaining sleep predicted CWP 18years later irrespective of mental health and number of pain regions (OR 1.72). Reporting simultaneous problems with all four aspects of sleep was associated with the onset of CWP over a five-year and 18-yearperspective, irrespective of age, gender, socio economy, mental health and pain at baseline. Sleep problems and fatigue predicted the onset of CWP five years later irrespective of each other.ConclusionSleep problems and fatigue were both important predictors for the onset of CWP over a five-year perspective. Sleep problems was a stronger predictor in a longer time-perspective. The results highlight the importance of the assessment of sleep quality and fatigue in the clinic.
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| 18. |
- Aili, Katarina, et al.
(författare)
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Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective 11 Medical and Health Sciences 1117 Public Health and Health Services
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 19:1
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Forskningsöversikt (refereegranskat)abstract
- Background: Previous research suggests that sleep problems may be an important predictor for chronic widespread pain (CWP). With this study we investigated both sleep problems and fatigue as predictors for the onset of CWP over a 5-year and an 18-year perspective in a population free from CWP at baseline. Methods: To get a more stable classification of CWP, we used a wash-out period, including only individuals who had not reported CWP at baseline (1998) and three years prior baseline (1995). In all, data from 1249 individuals entered the analyses for the 5-year follow-up and 791 entered for the 18-year follow-up. Difficulties initiating sleep, maintaining sleep, early morning awakening, non-restorative sleep and fatigue were investigated as predictors separately and simultaneously in binary logistic regression analyses. Results: The results showed that problems with initiating sleep, maintaining sleep, early awakening and non-restorative sleep predicted the onset of CWP over a 5-year (OR 1.85 to OR 2.27) and 18-year (OR 1.54 to OR 2.25) perspective irrespective of mental health (assessed by SF-36) at baseline. Also fatigue predicted the onset of CWP over the two-time perspectives (OR 3.70 and OR 2.36 respectively) when adjusting for mental health. Overall the effect of the sleep problems and fatigue on new onset CWP (over a 5-year perspective) was somewhat attenuated when adjusting for pain at baseline but remained significant for problems with early awakening, non-restorative sleep and fatigue. Problems with maintaining sleep predicted CWP 18 years later irrespective of mental health and number of pain regions (OR 1.72). Reporting simultaneous problems with all four aspects of sleep was associated with the onset of CWP over a five-year and 18-yearperspective, irrespective of age, gender, socio economy, mental health and pain at baseline. Sleep problems and fatigue predicted the onset of CWP five years later irrespective of each other. Conclusion: Sleep problems and fatigue were both important predictors for the onset of CWP over a five-year perspective. Sleep problems was a stronger predictor in a longer time-perspective. The results highlight the importance of the assessment of sleep quality and fatigue in the clinic.
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| 19. |
- Aili, Katarina, et al.
(författare)
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Women’s experiences of coping with chronic widespread pain – a qualitative study
- 2018
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 77, s. 1815-1815
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately ten percent of the population report chronic widespread pain (CWP), the condition is more common among women than men. For most people, the pain interferes with many aspects of every-day life and implies large consequences. However, the group reporting CWP is heterogeneous and there is a need for better understanding of the different strategies used for coping with pain in every-day life.Objectives: The purpose of this study was to describe women’s experiences of how to cope with CWP.Methods: The study had a descriptive design with a qualitative content analysis approach. Individual interviews were conducted with 19 women, 31–66 of age, who had reported CWP in a survey 2016. CWP was defined according to the 1990 ACR criteria for fibromyalgia. To be considered chronic, the pain should have persisted for more than three months during the last 12 months. A manifest qualitative content analysis was used to analyze the main question “How do you cope with your chronic widespread pain?” The analysis resulted in four categories.Results: Women described their coping with CWP in four different ways; to take control, to continue as usual, to follow instructions and to rest. To take control meant to make deliberate decisions to handle everyday day life. It also meant to take care of oneself, to think positive and to exercise at an adequate level. To continue as usual meant not to listen to body signals and either to ignore or accept the pain. To follow instructions meant listening to the health professionals and following advices, but without taking any part of the responsibility for the treatment outcome. To rest meant to perceive an unreasonable need for recovery, to resign and let the pain set the terms for the daily living.Conclusions: Women expressed different ways of coping with CWP including both active and passive strategies. The coping strategies included two dimensions, where one ranged from actively taking control over the pain, to passively following instructions and the other from actively continue as usual by either accepting or ignoring the pain to passively rest and being mastered by pain.
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| 20. |
- Al Nimer, Faiez, et al.
(författare)
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Lipocalin-2 is increased in progressive multiple sclerosis and inhibits remyelination
- 2016
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Ingår i: Neurology. - 2332-7812. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We aimed to examine the regulation of lipocalin-2 (LCN2) in multiple sclerosis (MS) and its potential functional relevance with regard to myelination and neurodegeneration. Methods: We determined LCN2 levels in 3 different studies: (1) in CSF and plasma from a case-control study comparing patients with MS (n = 147) with controls (n = 50) and patients with relapsing-remitting MS (n = 75) with patients with progressive MS (n = 72); (2) in CSF and brain tissue microdialysates from a case series of 7 patients with progressive MS; and (3) in CSF at baseline and 60 weeks after natalizumab treatment in a cohort study of 17 patients with progressive MS. Correlation to neurofilament light, a marker of neuroaxonal injury, was tested. The effect of LCN2 on myelination and neurodegeneration was studied in a rat in vitro neuroglial cell coculture model. Results: Intrathecal production of LCN2 was increased predominantly in patients with progressive MS (p < 0.005 vs relapsing-remitting MS) and displayed a positive correlation to neurofilament light (p = 0.005). Levels of LCN2 in brain microdialysates were severalfold higher than in the CSF, suggesting local production in progressive MS. Treatment with natalizumab in progressive MS reduced LCN2 levels an average of 13% (p < 0.0001). LCN2 was found to inhibit remyelination in a dose-dependent manner in vitro. Conclusions: LCN2 production is predominantly increased in progressive MS. Although this moderate increase does not support the use of LCN2 as a biomarker, the correlation to neurofilament light and the inhibitory effect on remyelination suggest that LCN2 might contribute to neurodegeneration through myelination-dependent pathways.
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| 21. |
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| 22. |
- Andersson, Maria L.E. 1968-, et al.
(författare)
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Associations between metabolic factors and radiographic knee osteoarthritis in early disease-a cross-sectional study of individuals with knee pain
- 2022
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Metabolic factors have been shown to be associated to severe radiographic knee osteoarthritis (RKOA). However, more knowledge is needed in early clinical knee osteoarthritis (KOA). The aim was to study associations between metabolic factors and radiographic knee osteoarthritis (OA) in individuals with knee pain. A second aim was to study associations between metabolic factors and RKOA in those with normal BMI and in those overweight/obese, respectively. Method This cross-sectional study included 282 individuals with knee pain (without cruciate ligament injury) and aged 30-67 years, and 70% women. Waist circumference, body mass index (BMI), proportion of fat and visceral fat area (VFA) were assessed. RKOA was defined as Ahlback grade 1 in at least one knee. Fasting blood samples were taken and triglycerides, cholesterol (total, low density lipoprotein (LDL) and high density lipoprotein (HDL)), C-reactive protein (CRP), glucose, HbA1C were analysed. Metabolic syndrome was defined in accordance with the International Diabetes Federation (IDF). Associations were analysed by logistic regression. Results Individuals with RKOA were older, had higher BMI, higher VFA, larger waist circumference and had increased total cholesterol, triglycerides and LDL-cholesterol, but not fasting glucose. There was no difference between the group with RKOA vs. non-radiographic group regarding the presence of metabolic syndrome. In a subgroup analysis of individuals with normal BMI (n = 126), those with RKOA had higher VFA, more central obesity, higher levels of CRP and total cholesterol, compared with individuals without RKOA. In individuals with obesity, age was the only outcome associated to RKOA. Conclusion There were clear associations between metabolic factors and RKOA in individuals with knee pain, also in those with normal BMI. In individuals with obesity age was the only variable associated to RKOA.
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| 23. |
- Andersson, Maria L.E., et al.
(författare)
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Cohort profile: the Halland osteoarthritis (HALLOA) cohort-from knee pain to osteoarthritis: a longitudinal observational study in Sweden
- 2022
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Ingår i: Bmj Open. - London : BMJ. - 2044-6055. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The overall objective in this study is to investigate the early development of radiographic knee osteoarthritis (OA) and its association with hand or/and knee OA, metabolic diseases, biomarkers, chronic pain, physical function and daily physical activity types. Participants The Halland osteoarthritis (HALLOA) cohort is a longitudinal cohort study that includes individuals with knee pain in the southwest of Sweden. Enrolment took place from 2017 to 2019. The inclusion criteria were current knee pain, with no former known radiographic knee OA and no cruciate ligament rupture or rheumatological disorder. The participants were recruited: (1) when seeking care for knee pain in primary healthcare or (2) by advertisements in local newspapers. There are 306 individuals included in the study, mean age (SD) 51.7 (8.7) years and 69% are women. The baseline and follow-ups include clinical tests, radiographical examinations, blood samples, metabolic measures, pain pressure thresholds, tests of physical functions, daily physical activity types and patient-reported outcomes. Findings to date There were associations between metabolic factors and radiographic knee OA, even in those with normal body mass index at baseline. In addition, clinical hand OA was positively associated with fasting plasma glucose. We also found that modifiable factors as increased visceral fat and total body fat were associated with increased pain sensitivity among individuals with knee pain. Future plans By studying possible pathophysiological mechanisms of OA over time, we aim to provide new insights on OA progression, identify usable preventive measures helping the clinicians in the management of the disease and improve health for the patients. It is also important to study the development of chronic pain in OA, to get tools to identify individuals at risk and to be able to offer them treatment.
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| 24. |
- Andersson, Maria L.E. 1968-, et al.
(författare)
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Metabolic factors associated to clinical hand osteoarthritis in individuals with knee pain
- 2020
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl. 1, s. 1734-1734
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is some evidence supporting associations between metabolic factors, clinical hand osteoarthritis (OA) and radiographic knee OA. However, more studies are needed regarding early knee OA.Objectives: The aim was to study associations between metabolic factors and clinical hand OA at baseline in a cohort of individuals with knee pain, with and without radiographic knee OA.Methods: In an ongoing five-year longitudinal study of knee pain, hand OA was assessed by clinical examinations in 296 of the included individuals at baseline [1]. BMI, waist circumference (WC) and blood pressure was measured. Body composition was assessed with Inbody 770. Fasting plasma glucose, triglycerides, cholesterol, HDL-and LDL-cholesterol and HbA1c was analysed. Metabolic syndrome (MetS)was present if central obesity (WC ≥94 cm in men and ≥80cm in women) plus any two of the following factors: raised blood pressure (systolic blood pressure ≥ 130 or diastolic blood pressure ≥ 85 mm Hg or treatment of hypertension), raised triglycerides (≥ 1.7 mmol/L or specific treatment), reduced HDL-cholesterol (men < 1.03 mmol/L and women < 1.29 mmol/L or specific treatment), raised glucose (glucose ≥ 5.6 mmol/L, or type 2 diabetes). Hand strength and self-reported disability of the arm, shoulder and hand (quickDASH) was assessed.The individuals were divided according to having clinical hand OA or not, according to Altman [1]. The associations between background factors and clinical hand OA were calculated by crude logistic regression analyses, adjusting for age and sex.Results: Fifty-five percent of the individuals in the study was overweight or obese, 40% had MetS and 23% had radiographic knee OA. In total 34% of the individuals had clinical hand OA. The group with hand OA were older, had higher proportion of body fat, fasting plasma glucose, HbA1C, worse quickDASH score and lower hand strength, table 1. Clinical hand OA was significantly associated to higher age (OR 1.04, 95%CI 1.01-1.07), higher fasting plasma glucose (1.56, 1.05-2.30), worse quickDASH (1.04, 1.02-1.06) and lower hand strength (0.99, 0.99 -0.998), but not to proportion of body fat and HbA1c.Conclusion: In this cross-sectional study, the only metabolic factor associated with clinical hand OA was fasting plasma glucose. Contrary to other studies, there were no gender differences found. The association between development of clinical hand OA and metabolic factors in individuals with knee pain need to be further assessed in longitudinal studies.
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| 25. |
- Andersson, Maria L.E. 1968-, et al.
(författare)
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Metabolic Factors Associated to Radiographic Knee Osteoarthritis in Individuals with Knee Pain
- 2020
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 79:Suppl. 1, s. 793-793
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Tidskriftsartikel (refereegranskat)abstract
- Metabolic factors have been shown to be associated to radiographic knee osteoarthritis (OA) [1]. More knowledge about associations between metabolic factors and early clinical knee OA is needed.Objectives:The aim was to study associations between metabolic factors and radiographic knee OA in individuals with knee painMethods:In total 272 individuals with radiographs at baseline, from an ongoing longitudinal study of knee pain (without cruciate ligament injury), were included in the present cross-sectional study. At baseline BMI, waist circumference (WC) and visceral fat area (VFA) were assessed. Fasting plasma glucose, triglycerides, cholesterol, HDL-and LDL-cholesterol were analysed. Metabolic syndrome (MetS) was present if central obesity (WC ≥94 cm in men and ≥80cm in women) plus any two of the following factors: raised blood pressure (systolic blood pressure ≥ 130 or diastolic blood pressure ≥ 85 mm Hg or treatment of hypertension), raised triglycerides (≥ 1.7 mmol/L or specific treatment), reduced HDL-cholesterol (men < 1.03 mmol/L and women < 1.29 mmol/L or specific treatment), raised glucose (glucose ≥ 5.6 mmol/L, or type 2 diabetes).The individuals were divided in two groups according to Ahlbäck [2], one group, who had grade I or more in at least one knee (radiographic knee OA, ROA) n=62 and the other group, not fulfilling Ahlbäck criteria (no radiograhic knee OA, No OA) n=211. The associations between metabolic factors and knee OA were calculated by crude logistic regression analyses, adjusting for age and sex.Results:The group with radiographic knee OA were older, had higher BMI, higher amount of visceral fat and more had central obesity, table 1. Ninety- four percent of the group with ROA had central obesity compared to 76%, p=0.002 in the no OA group. There was no difference between the groups regarding MetS, 44% in the ROA group vs. 39%, p=0.5. The group with ROA had increased cholesterol, triglycerides and LDL-cholesterol. There were no differences in fasting glucose between the groups, though both groups had a mean glucose value in the upper range of normal value, table 1. Factors associated to having radiographic knee OA were age (OR 1.11, 95% CI 1.06-1.17), BMI (1.07, 1.003-1.13), central obesity (3.91, 1.32-11.61) and raised triglycerides (2.35, 1.03-5.38).Table 1.Baseline descriptivesNo OAMean (sd)ROAMean(sd)p-valueN21162Age50 (9)56 (4)<0.001Sex, women, %66710.454BMI25.9 (4.7)27.7 (4.7)0.007VFA (cm2)109 (53)126 (52)0.026WC, cm94 (13)99 (13)0.006Raised Blood pressure, %66530.063Cholesterol (mmol/L)5.2 (1.0)5.5 (1.1)0.033Triglycerides (mmol/L)1.0 (0.6)1.2 (0.7)0.035Raised triglycerides, %9210.008LDL-cholesterol (mmol/L)3.4 (1.0)3.7 (1.1)0.027HDL-cholesterol (mmol/L)1.7 (0.4)1.7 (0.5)0.547Reduced HDL11150.460Glucose (mmol/L)5.5 (0.9)5.5 (0.5)0.858Conclusion:There were associations between some metabolic factors and radiographic knee OA in individuals with knee pain. Fasting glucose was increased in both groups. The associations between metabolic risk factors and the development of knee OA needs to be assessed in longitudinal studies.References:[1]Sellam J, Bone Spine 2013;80:568-73.[2]Ahlback S,. Acta Radiol Diagn (Stockh) 1968Suppl 277:7-72.Disclosure of Interests:None declared
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| 26. |
- Andersson, Siv Folkhammar, et al.
(författare)
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Arthritis management in primary care : A study of physiotherapists' current practice, educational needs and adherence to national guidelines
- 2017
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Ingår i: Musculoskeletal Care. - Chichester : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 15:4, s. 333-340
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With an increasing number of patients with osteoarthritis (OA) and rheumatoid arthritis (RA) in primary care, our aim was to investigate arthritis-related practice in physiotherapy and to study adherence to evidence-based care.METHODS: Seventy physiotherapists (PTs) working in primary care were emailed a questionnaire to investigate current practice and the number of roles assumed by PTs, the degree of confidence, educational needs and adherence to national guidelines in managing patients with OA or RA. Interventions supported by national guidelines were compared with reports of treatment modalities in the questionnaire.RESULTS: Sixty-four (91%) PTs responded, and they reported a higher degree of confidence in assessment, treatment and education of patients with OA than for those with RA (p < 0.001). The total number of roles assumed by the PTs was higher in the management of OA than for RA (p < 0.001). PTs who assumed a greater number of roles also reported a stronger degree of confidence in assessing OA (p = 0.036). Those who assumed fewer roles also reported less confidence in RA treatment (p = 0.045). Recommendations in the guidelines were followed by the majority of PTs for eight of 11 treatment modalities in OA and for six of six in RA.CONCLUSIONS: PTs reported a lower degree of confidence and the assumption of fewer roles in managing patients with RA compared with OA. There was good adherence to the national guidelines for almost all the treatment modalities listed. Even so, the results indicate a need for education, especially in chronic inflammatory arthritis care.
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| 27. |
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| 28. |
- Arnesson, Kerstin, 1958-, et al.
(författare)
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Ett nödvändigt ont? : En studie om privata konsulter som genomför barnavårdsutredningar i Sverige
- 2021
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Ingår i: Socialvetenskaplig tidskrift. - Linköping : Förbundet för forskning i socialt arbete (FORSA). - 1104-1420 .- 2003-5624. ; 28:2, s. 129-144
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Tidskriftsartikel (refereegranskat)abstract
- Private consultants carrying out child protection investigations is a relatively new phenomenon in Swedish child welfare. The purpose of the study is to map and deepen the knowledge of the extent of private consultants handling and carrying out child protection investigations and to describe incentives to engage private consultants or terminate assignments in municipalities and town districts. Strategically, the empirical material has been obtained from three counties/22 municipalities and one big town/10 town districts in Sweden. The collection of the empirical material was implemented through structured telephone interviews with a high degree of standardized questions. The result shows that the number of child protection investigations in the examined municipalities/town districts increased markedly from 2013 to 2017, which led to a higher workload, a worse work environment and difficulties in recruiting experienced social secretaries. The majority of the municipalities solved the situation that had arisen by engaging private consultants. The situation gave rise to a market orientation of the investigating part of child welfare and a new arena for private actors was created. Generally, negative experiences of engaging consultants appear in regard to both the quality of the child protection investigations and the work environment at the workplace. The understanding was also that it was an expensive solution. The demand for consultants who could carry out child protection investigations was large and they could therefore dictate the conditions. The experience of the municipalities and town districts was strengthened over time, which meant that they acquired more knowledge of how to be clear in contracts regarding requirements of competence, experience, scope, content and quality. It is not entirely clear which development we can predict, more than stating that the private actors are established in social child welfare.
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| 29. |
- Arnesson, Kerstin, et al.
(författare)
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”Man får inte ta någon genväg in i konsultarbetet”
- 2023
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 29:2, s. 26-44
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Tidskriftsartikel (refereegranskat)abstract
- I artikeln fördjupas kunskapen om den privata konsultens väg in i arbetet som konsult, tiden som konsult och väg ut mot andra uppdrag. Resultatet visar att vägen in och vägen ut, utifrån ett tidsgeografiskt perspektiv, vilar på samma restriktioner, det vill säga brist på makt och inflytande och krav på samordning. Tilläggas kan en önskan om frihet som sedan övergår till en längtan efter trygga anställningsvillkor. För studiens respondenter blev tiden som konsult ett tillfälligt mellanrum och det är viktigt att det blir så även för socialförvaltningar. Risken finns dock att det blir en mer permanent lösning på svåra situationer.
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| 30. |
- Arnesson, Kerstin, 1958-, et al.
(författare)
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”Man får inte ta någon genväg in i konsultarbetet” : En studie om privata konsulter som genomför barnavårdutredningar vid svenska socialförvaltningar
- 2023
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Ingår i: Arbetsmarknad & Arbetsliv. - : Karlstad University and University of Gothenburg. - 1400-9692 .- 2002-343X. ; 29:2, s. 26-44
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Tidskriftsartikel (refereegranskat)abstract
- I artikeln fördjupas kunskapen om den privata konsultens väg in i arbetet som konsult, tiden som konsult och väg ut mot andra uppdrag. Resultatet visar att vägen in och vägen ut, utifrån ett tidsgeografiskt perspektiv, vilar på samma restriktioner, det vill säga brist på makt och inflytande och krav på samordning. Tilläggas kan en önskan om frihet som sedan övergår till en längtan efter trygga anställningsvillkor. För studiens respondenter blev tiden som konsult ett tillfälligt mellanrum och det är viktigt att det blir så även för socialförvaltningar. Risken finns dock att det blir en mer permanent lösning på svåra situationer.
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| 31. |
- Axelsson, Jonas, et al.
(författare)
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Inflytande som medel för att hantera maktobalans
- 2016. - 1
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Ingår i: Makt och inflytande i arbetslivet. - Stockholm : Premiss förlag. - 9789186743536 ; , s. 13-32
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 32. |
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| 33. |
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| 34. |
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| 35. |
- Bergman, Ann, 1963-, et al.
(författare)
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Arbetsvillkor och coaching
- 2017
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Ingår i: Arbetsmarknad & Arbetsliv. - karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 23:3, s. 4-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 36. |
- Bergman, Ann, 1963-
(författare)
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Att leda inom äldreomsorgen : En litteraturgenomgång av enhetschefers organisatoriska sammanhang och arbetsvillkor
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med föreliggande rapport är att belysa ett antal villkor som påverkar arbetssituationen för personal inom äldreomsorgen i allmänhet och enhetscheferna i synnerhet. Detta sker med hjälp av en orientering i litteratur och studier inom områdena organisation, chef- och ledarskap, tjänstekvalitet, psykosocial arbetsmiljö och arbetsvillkor. Den litteratur som ligger till grund för rapporten är i första hand empiriskt förankrade studier rörande vård- och omsorgsarbete, men det finns även inslag av teoretiska modeller och resonemang. De teoretiska bidragen innefattar främst diskussioner om vad som avses med relevanta begrepp som organisation, tjänstekvalitet, chef- och ledarskap och arbetsvillkor samt hur dessa kan hjälpa oss förstå enhetschefernas arbetssituation.
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| 37. |
- Bergman, Ann, 1963-, et al.
(författare)
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Att lämna yrket eller stanna kvar, organisationskultur och sexuella trakasserier, delat ledarskap samt arbetets estetik
- 2019
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 25:2, s. 4-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Tre av detta nummers artiklar berör organisation på ett eller annat sätt.Det handlar om varför poliser väljer att frivilligt säga upp sig och lämnayrket; sexuella trakasserier och hur sådana hanteras i mansdomineradeorganisationer samt erfarenheter av delat ledarskap i skolväsendet. Den sistaartikeln utgörs av en essä om hur arbete har framställts i bildkonst, musik ochlitteratur. Detta nummer av Arbetsmarknad & Arbetsliv avslutas med att JanCh Karlsson recenserar boken Job Quality in an Era of Flexibility. Experiences ina European Context.
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| 38. |
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| 39. |
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| 40. |
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| 41. |
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| 42. |
- Bergman, Ann-Charlotte
(författare)
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Mass spectrometry in peptide and tumor marker analysis
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Integration of preparative protein and peptide separations with analytical techniques, in particular mass spectrometry (MS), is important. This thesis describes preparation via capillary electrophoresis and two-dimensional (2-D) gel electrophoresis for identification and structure determination of polypeptides. Protocols for protein identification via mass spectrometry were developed. Applications in sequence determination of peptides and in screening of proteins extracted from solid tumor material were tested. Preparative capillary electrophoresis of peptide samples and subsequent characterization of fractionated material with matrix-assisted laser desorption ionization (MALDI)-MS is feasible provided the same electrolyte is not used for both separation and collection because of a risk for signal suppression in the mass analysis. To avoid suppression, separate electrolytes were used, phosphate buffer for good resolution in the separations and trifluoroacetic acid for improved signal to-noise ratio and resolution of sodium adducts in the mass analysis. To increase the preparative capacity in capillary electrophoresis and to prevent wall adsorption and band-broadening, a low amount of ethylene glycol was used in both sample and buffers. C-terminal sequence analysis of peptides was carried out using a mixture of two carboxypeptidases, CPP and CPY. The resulting amino acid sequence was determined via MALDI-MS. To distinguish Lys from Gln, which have similar mass, Lys was derivatized to homoarginine. For ladder sequencing of peptides containing Cys, this amino acid was converted to 4-tialaminine. The protein expression patterns of oncogene-transformed cell lines and tumor cells of different malignancies from breast, lung and ovary were analyzed by 2-D gel electrophoresis. The purpose was to find proteins which can be of potential use as tumor markers. Different protocols were tested for isolation of the protein fragments from the gel matrix. In-gel digestion using modified trypsin with extensive washings to remove salts and detergents was essential, together with precautions to avoid introduction of keratin contaminants and polymers. Both MALDI-MS and ion-trap LC (liquid chromatography)-MS/MS were applied for identification of gel-separated proteins. In general, MALDI-MS is more sensitive than ESI (electrospray ionization)-MS, less affected by contaminants and can serve as a first screening step as several samples can be analyzed sequentially. LC on line with ESI-MS means sample clean-up before analysis of separate peptide components. This set-up is possible to automatize and suppression is reduced, which both are advantages in relation to nanospray technology.
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| 43. |
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| 44. |
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| 45. |
- Bergman, Ann, et al.
(författare)
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Digitala strategier för att hantera relationen mellan arbete och övrigt liv
- 2020
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Ingår i: Att arbeta för lika villkor: Ett genus- och maktperspektiv på arbete och organisation. - 9789144135045
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Bokkapitel (refereegranskat)abstract
- Det här kapitlet fokuserar på relationen mellan arbetsliv och övrigt liv och ett antal digitala strategier som används för att hantera denna. Tidigare forskning har visat att kvinnor i jämförelse med män möter en större utmaning i hanterandet av denna gränsdragning, givet att kvinnor, traditionellt sett, har haft ansvaret för barn samt utfört mer av det obetalda arbetet i hemmet (Hochschild & Machung 2012). Kapitlet belyser denna gränsdragningsproblematik med ett specifikt fokus på hur den tar sig uttryck i samband med användandet av informations- och kommunikationsteknologi (IKT). De digitala gränshanteringsstrategierna kan förstås utifrån ett aktörsorienterat synssätt med fokus på individen, dennas intentioner och personliga preferenser. De kan även förstås utifrån ett strukturellt synsätt med fokus på strukturella villkor inom arbetsliv och privatliv. Kapitlet belyser hur aktör och struktur samverkar genom att presentera resultat från en kvalitativ studie av anställda inom industrin.
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| 46. |
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| 47. |
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| 48. |
- Bergman, Ann, 1963-, et al.
(författare)
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Employee Availability for Work and Family : Three Swedish Case Studies
- 2007
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Ingår i: Employee relations. - : Emerald. - 0142-5455 .- 1758-7069. ; 29:4, s. 400-414
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to explore the concept of availability, both empirically and theoretically, in the context of three Swedish organisations, and identifies the structural influences on availability patterns for work and family. Design/methodology/approach - The article is based on quantitative case studies using employer records and an employee questionnaire in three organisations. Multivariate descriptive statistics and multivariate logistic regression are used to illustrate and analyse patterns of availability for work and family. Findings - The descriptive data demonstrate the influence of the organisational context and type of production process, as well as gender, on availability patterns. Patterns of work availability appeared to differ across the organisations to a greater extent than patterns of family availability, which were highly gendered. The logistic regression results indicated that: occupation was a significant influence on both temporal and spatial availability patterns across the organisations; gender was the most significant influence on time spent on household work and part-time working for parents with young children; age of employees and age of employees' children were the most significant factors influencing the use of time off work for family. Research limitations/implications - Analysis limited to case studies. More extensive quantitative research would be needed to make empirical generalisations. Qualitative research would be needed to establish whether and how employees are able to make use of different availability patterns to improve their work-life balance. Originality/value - The concept of availability is a new way of trying to capture and analyse tensions in people's everyday lives as they try to manage multiple demands.
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| 49. |
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| 50. |
- Bergman, Ann, 1963-
(författare)
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Equality Versus Difference and Beyond : Analytical and Political Consequences
- 1999
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Ingår i: Making Working Life Work. - Karlstad : Karlstads universitet. ; , s. 19-33
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The article is a discussion of some of the feminist attempts to transcend certain of the problems related to the idea of equality and the visions which surround it. Concepts such as equality, sameness and difference and the relationship between them are central to such a discussion. The article begins with a consideration of whether women and men are fundamentally the same or if they are two different kinds. The discussion is then extended to include a wider definition of the concept of difference, since the concept complicates the issue in that it concerns not only differences between the sexes but also those within them. In its turn, this leads to a consideration of the importance of an ontologically based feminist analysis for a greater understanding of the relationship between the sexes and for emancipatory potentials
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