| 1. |
- Acosta, Stefan, et al.
(författare)
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Short-Term Complications and Outcomes in Pharmaco-Mechanical Thrombolysis First and Catheter-Directed Thrombolysis First in Patients with Acute Lower Limb Ischemia
- 2023
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Ingår i: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096. ; 94, s. 253-262
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pharmaco-mechanical thrombolysis (PMT) has emerged as a treatment option in patients with acute lower limb ischemia (ALI), especially Rutherford IIb (motor deficit) for rapid revascularization, but supportive data is scarce. The aim of the present study was to compare the effects of thrombolysis, complications, and outcomes of PMT first versus catheter-directed thrombolysis (CDT) first in a large cohort of patients with ALI. Methods: All endovascular thrombolytic/thrombectomy events in patients with ALI performed between January 1st, 2009, and December 31st, 2018 (n = 347) were included. Successful thrombolysis/thrombectomy was defined as complete or partial lysis. Reasons for using PMT were described. Complications such as major bleeding, distal embolization, and new onset of renal impairment, and major amputation and mortality at 30 days were compared between PMT (AngioJet) first and CDT first groups in a multivariable logistic regression model with adjustment for age, gender, atrial fibrillation, and Rutherford IIb. Results: The most common reason for initial use of PMT was the need for rapid revascularization, and the most common reason for use of PMT after CDT was the insufficient effect of CDT. Presentation of Rutherford IIb ALI was more common in the PMT first group (36.2% vs. 22.5%, respectively, P = 0.027). Among the 58 patients receiving PMT first, 36 (62.1%) were terminated within a single session of therapy without need of CDT. The median duration of thrombolysis was shorter (P < 0.001) for the PMT first group (n = 58) compared to the CDT first group (n = 289) (4.0 hr vs. 23.0 hr, respectively). There was no significant difference in amount of tissue plasminogen activator given, successful thrombolysis/thrombectomy (86.2% and 84.8%), major bleeding (15.5% and 18.7%), distal embolization (25.9% and 16.6%), major amputation or mortality at 30-days (13.8% and 7.7%) in the PMT first compared to the CDT first group, respectively. The proportion of new onset of renal impairment was higher in the PMT first compared to the CDT first group (10.3% vs. 3.8%, respectively), and the increased odds (odds ratio 3.57, 95% confidence interval 1.22–10.41) were maintained in the adjusted model. In Rutherford IIb ALI, no difference in rate of successful thrombolysis/thrombectomy (76.2% and 73.8%), complications or 30-day outcomes was found between PMT first (n = 21) and CDT (n = 65) first group. Conclusions: PMT first appears to be a good treatment alternative to CDT in patients with ALI, including Rutherford IIb. The found renal function deterioration in the PMT first group needs to be evaluated in a prospective, preferably randomized trial.
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| 2. |
- Andersen, I, et al.
(författare)
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Does job strain mediate the effect of Socio-economic Group on smoking behaviour? The impact of different health policies in Denmark and Sweden
- 2008
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 36:6, s. 598-606
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to compare the impact of socioeconomic groups (SEG) on the risk of being a daily smoker or quitter, and to investigate whether the potentially mediating effect of psychosocial working conditions was similar in the Danish and the Swedish populations. Methods: The study populations consisted of 10,049 employed participants, aged 18-64 years, 51% women, randomly selected from the general populations in the Oresund region, 1999-2000. Odds ratios (OR) for daily-smokers and "non-quitters'' were computed for two age-groups and two SEGs in gender specific models, stratified by country. The association between SEG, current smoking, quitting, and influence at work, job demand and jobstrain, respectively, was tested by means of logistic regression. Results: The contextual determinants defined by country had a different effect on smoking prevalence among men and women and among age groups. Low influence and job strain seemed to have an effect on smoking among Danish women, but not among Swedish women. The OR of being a daily smoker were higher in men than women among younger Danes, but higher in women than men among Swedes. The prevalence of low influence, high demand and job strain was higher and more socially skewed among the Swedes, but did not mediate the effect of SEG on smoking behaviour. Conclusions: The smoking prevalence was lower and the quit-rates higher among Swedes than Danes. Both countries had social differences in smoking that in absolute terms were rather similar, but in relative terms were higher in Sweden. The mediating effect of psychosocial working conditions was lacking. The determinants of smoking behaviours must be found somewhere else in the social and cultural context.
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| 3. |
- Axén, Iben, et al.
(författare)
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Can a workplace dialogue impact the perceived influence of neck and/or backpain on everyday activities and performance at work? A secondary analysis from the randomized controlled trial WorkUp
- 2022
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Neck- and back- pain are highly prevalent conditions in Sweden and world-wide. Such pain often has consequences on everyday activities, work- and personal life. One consequence is work absence and decreased productivity at work. Adding a workplace dialogue to structured physiotherapy was recently found to lead to increased workability, i.e., not being on sick leave during the 12th month of follow up. Aim: The aim of the study was to explore the effect of a workplace dialogue intervention on secondary outcomes: perceived impact of neck and/or back pain on everyday activities and on performance at work, and total days of sick leave during 12 month follow up. A further aim was to examine associations between perceived influence of pain, and sick leave. Method: Patients with neck and/or back pain in primary care in the south of Sweden were randomized into structured physiotherapy alone (n = 206) or with the addition of a workplace dialogue (n = 146). Data regarding the pain’s influence on everyday activities and on performance at work were collected using weekly text messages for 52 weeks. The pattern of change in perceived influence of neck and/or back pain on everyday activities and performance at work was compared between the groups with linear mixed models. Cross sectional correlations between perceived influence of neck and/or back pain on everyday activities and performance at work, and days of sick leave, during the preceding four weeks at months 3, 6, 9 and 12 were examined. Result: We found no differences in change of perceived influence of neck and/or back pain on daily activities or perceived performance at work, or total days of sick leave during the 12 months of follow up between the groups with structured physiotherapy with or without a workplace dialogue. There was a weak to moderate positive correlation between days of sick leave and perceived influence of neck and/or back pain on everyday activities and performance at work (rho 0.28–0.47). Conclusion: A workplace dialogue was not found to affect the perceived impact of neck and/or back pain on everyday activities and performance at work. Trial registration: ClinicalTrials.gov ID: NCT02609750.
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| 4. |
- Biru, Mulatu, et al.
(författare)
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Prophylactic treatment uptake and compliance with recommended follow up among HIV exposed infants : a retrospective study in Addis Ababa, Ethiopia
- 2011
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Ingår i: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 4, s. 563-563
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children are being infected by HIV/AIDS mainly through mother-to-child transmission. In Ethiopia currently more than 135,000 children are living with HIV/AIDS. The aim of this study was to describe the pattern of ARV uptake after birth, co-trimoxazole prophylaxis and follow up compliance, and to examine which factors are associated with the intervention outcome.METHODS: A retrospective quantitative study design was used for data collection through two hospitals. All infants who were delivered by HIV infected mothers between October 2008 and August 2009 were included and information regarding treatment adherence during their first 6 months of age was collected.FINDINGS: 118 HIV exposed infant-mother pairs were included in the study. 107 (90.7%) infants received ARV prophylaxis at birth. Sixty six (56%) of the infants were found to be adherent to co-trimoxazole prophylactic treatment. The majority (n = 110(93.2%)) of infants were tested HIV negative with DNA/PCR HIV test at the age of sixth weeks. Infants who took ARV prophylaxis at birth were found to be more likely to adhere with co-trimoxazole treatment: [OR = 9.43(95% CI: 1.22, 72.9)]. Similarly, infants whose mothers had been enrolled for HIV/ART care in the same facility [OR = 14(95% CI: 2.6, 75.4)], and children whose fathers were tested and known to be HIV positive [OR = 3.0(95% CI: 1.0, 9.0)] were more likely to adhere than their counterparts. Infants feeding practice was also significantly associated with adherence χ2 -test, p < 0.01.CONCLUSION: The proportion of ARV uptake at birth among HIV exposed infants were found to be high compared to other similar settings. Mother-infant pair enrolment in the same facility and the infant's father being tested and knew their HIV result were major predictors of infants adhering to treatment and follow up. However, large numbers of infants were lost to follow up.
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| 5. |
- Borgh, Madeleine, et al.
(författare)
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Organisational factors and occupational balance in working parents in Sweden
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:3, s. 409-416
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Tidskriftsartikel (refereegranskat)abstract
- Background: Parents with small children constitute a vulnerable group as they have an increased risk of sick leave due to stress-related disorders compared to adults without children. It has been shown that mothers and fathers to small children together spend more time in paid work than any other group, which could create negative stress and an experience of low occupational balance. Aim: The aim of this study was to examine associations between organisational factors and occupational balance among parents with small children in Sweden. Methods: Data were collected by a survey including questions about occupational balance, organisational factors and age, sex, employment rate, work position, monthly household income, number of children at home, separation/divorce last five years and overtime. The total number of parents included in this study was 718 (490 mothers and 228 fathers). Logistic regression models were applied to examine the odds ratios for occupational balance in relation to organisational factors. Results: Parents who experienced positive attitudes towards parenthood and parental leave among colleagues and managers were more likely to experience high occupational balance than parents who experienced negative or neutral attitudes. Having a clear structure for handover when absent from work was also strongly associated with high occupational balance. Conclusions : The result of the present study indicates that some organisational factors could be important for the occupational balance of parents with small children.
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| 6. |
- Brogårdh, Christina, et al.
(författare)
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Self-Perceived Life Satisfaction during the First Wave of the COVID-19 Pandemic in Sweden : A Cross-Sectional Study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- Currently, there is limited knowledge on how the Swedish strategy with more lenient public health restrictions during the COVID-19 pandemic has influenced people's life satisfaction. Here, we investigated self-reported life satisfaction during the first wave of the pandemic in Sweden, and perceived changes in life satisfaction in relation to various sociodemographic factors. A total of 1082 people (mean age 48 (SD 12.2); 82% women) responded to an online survey during autumn 2020 including the "Life Satisfaction Questionnaire-11". A majority (69%) were satisfied with life as a whole, and with other important life domains, with the exception of contact with friends and sexual life. An equal share reported that life as a whole had either deteriorated (28%) or improved (29%). Of those that perceived a deterioration, 95% considered it to be due to the pandemic. Regarding deteriorated satisfaction with life as a whole, higher odds were found in the following groups: having no children living at home; being middle aged; having other sources of income than being employed; and having a chronic disease. The Swedish strategy might have contributed to the high proportion of satisfied people. Those who perceived a deterioration in life satisfaction may, however, need attention from Swedish Welfare Authorities.
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| 7. |
- Dell'Isola, Andrea, et al.
(författare)
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Factors Associated With the Outcome of a First-Line Intervention for Patients With Hip or Knee Osteoarthritis or Both : Data From the BOA Register
- 2020
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Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 100:10, s. 1771-1781
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study explored the association of patients' demographics, health status, symptom severity, previous osteoarthritis (OA) care, and psychological status with the change in pain severity following a first-line intervention including education and exercise for OA provided nationwide in Swedish primary care. METHODS: This register-based cohort study included 23,309 people with knee or hip OA from the Better Management of Patients with OA register. Linear regression models were used to assess the association of independent variables with the change in pain from baseline to 3 and 12 months. All the analyses were stratified based on the affected joint (hip vs knee). RESULTS: In people with hip and people with knee OA, high levels of baseline pain were associated with decreased pain at both follow-ups (3 months: knee B = -.67; hip B = -.64; 12 months: knee B = -.70; hip B = -.66), whereas being older, overweight, or female had a weak or no association. Finally, at both follow-ups, bilateral OA was associated with increased pain only in people with knee OA, whereas comorbidities and the willingness to undergo surgery were associated with increased pain regardless of the affected joint. CONCLUSIONS: Baseline pain showed the strongest association among the analyzed variables, whereas sex, age, and body mass index appear to be weakly associated with the pain change after a first-line intervention. Comorbidities and willingness to undergo surgery showed a potentially important association and may have a negative impact on the pain change following a first-line intervention. IMPACT: In people with hip or knee OA, age, sex, body mass index, and previous surgery are only weakly associated with the change in pain after a first-line intervention supporting the evidence recommending exercise and education as a foundation for all OA therapy. Having comorbidities and being willing to undergo surgery is associated with a worse outcome from a first-line intervention, including exercise and education. Individualized treatments addressing the disease perception and the specific comorbidity profile may improve the outcomes.
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| 8. |
- Eek, Frida, et al.
(författare)
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Attitude and flexibility are the most important work place factors for working parents' mental wellbeing, stress, and work engagement.
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 41:7, s. 692-705
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The need to combine active employment and parenthood is a reality for many parents today. Knowing more about which work place factors are associated with better or worse health could help employers to form a work environment that provides optimal conditions to maintain or increase health and work engagement in this group. The aim of this study was to explore possible associations between different subjective and objective work factors and benefits, and a range of outcome variables such as stress, symptom report, wellbeing, work-related fatigue, work engagement, and work-family conflict among working mothers and fathers with small children. Methods: Cross-sectional analyses of associations between work place factors categorised into three different dimensions; flexibility, benefits, and attitude and the outcome measures were performed, including questionnaire responses from 1562 working parents. Results: The results showed that work place factors related to flexibility and, especially among women, attitude to parenthood appear to have the strongest effect on working parents' subjective stress and wellbeing, while benefits appear to have less impact. Except regarding factors related to attitudes at the work place, most associations were similar among men and women. Conclusions: Most likely, different factors are better suited or more important for some individuals than others depending on their total work, as well as family situation and also depending on individual factors such as personality and priorities. A positive attitude towards parenthood and a flexible work situation seem, however, beneficial for the general wellbeing and work engagement among working parents.
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| 9. |
- Eek, Frida, et al.
(författare)
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Cortisol, sleep, and recovery: some gender differences but no straight associations
- 2012
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 37:1, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- Abstract in UndeterminedBACKGROUND: Work related fatigue has been suggested as a link in the assumed sequence of events between repeated adverse work demands and the development of work related stress, which may be associated with changes in concentrations of cortisol, psychological overload and, in the long run, health problems. Insufficient sleep is a contributing factor to lack of recovery, but previous studies on associations between subjective aspects of sleep and recovery, and cortisol, have been inconclusive. The aim with the present study was to examine possible associations between cortisol measures and (I) self-rated recovery, (II) occupational fatigue and (III) subjective sleep quality the night preceding cortisol sampling. Further, possible gender differences were tested. METHODS: Salivary cortisol was measured in 581 persons during a working day, at awakening, +30min and in the evening. Various measures of subjective sleep and recovery were analyzed in relation to cortisol. RESULTS: Few correlations between cortisol and any sleep- or recovery parameters were found. However, some significant associations were found between cortisol and a few measures of more chronic aspects of sleep and recovery. Gender stratified analyses showed somewhat differing associations among men and women. This indicates that possible associations and pathways between lack of recovery/sleepiness and cortisol, and in the long run, unhealth, may not be similar for men and women.
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| 10. |
- Eek, Frida, et al.
(författare)
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Differences in socioeconomic and gender inequalities in tobacco smoking in Denmark and Sweden; a cross sectional comparison of the equity effect of different public health policies
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Denmark and Sweden are considered to be countries of rather similar socio-political type, but public health policies and smoking habits differ considerably between the two neighbours. A study comparing mechanisms behind socioeconomic inequalities in tobacco smoking, could yield information regarding the impact of health policy and -promotion in the two countries. Methods: Cross-sectional comparisons of socioeconomic and gender differences in smoking behaviour among 6 995 Danish and 13 604 Swedish persons aged 18-80 years. Results: The prevalence of smoking was higher in Denmark compared to Sweden. The total attributable fraction (TAF) of low education regarding daily smoking was 36% for Danish men and 35% for Danish women, and 32% and 46%, respectively, for Swedish men and women. TAF of low education regarding continued smoking were 16.2% and 15.8% for Danish men and women, and 11.0% and 18.8% for Swedish men and women, respectively The main finding of the study was that the socioeconomic patterning of smoking, based on level of education and expressed as the relative contribution to the total burden of smoking exposure, was rather different in Sweden and Denmark. Moreover, these differences were modified by gender and age. As a general pattern, socioeconomic differences in Sweden tended to contribute more to the total burden of this habit among women, especially in the younger age groups. In men, the patterns were much more similar between the two countries. Regarding continued smoking/unsuccessful quitting, the patterns were similar for women, but somewhat different for men. Here we found that socioeconomic differences contributed more to overall continued smoking in Danish men, especially in the middle-age and older age strata. Conclusion: The results imply that Swedish anti-smoking policy and/or implemented measures have been less effective in a health equity perspective among the younger generation of women, but more effective among men, compared to Danish policy implementation. The results also raises the more general issue regarding the possible need for a trade-off principle between overall population efficacy versus equity efficacy of anti-tobacco, as well as general public health policies and intervention strategies.
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| 11. |
- Eek, Frida, et al.
(författare)
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Factors associated with BMI change over five years in a Swedish adult population. Results from the Scania Public Health Cohort Study.
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 37, s. 532-544
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: On account of the increasing worldwide problems associated with overweight and obesity, the aim of the present study was to examine BMI change over 5 years in relation to different lifestyle-, demographic- and psychosocial work-related factors. METHODS: A cohort of 9913 persons responded to an identical survey in 2000 and 2005. BMI change over the period was examined in relation to gender, age, educational level, physical activity, job strain, and baseline BMI. RESULTS: Mean BMI as well as prevalence of overweight and obesity increased in the cohort; most among younger persons. In all groups but younger women, BMI increase was greatest in the lowest baseline BMI quartile. Low education was associated with increased BMI at baseline, but not with BMI change over time except among young women. Exercisers had lower BMI than non-exercising persons, and exercise pattern over time was also significantly associated with BMI change. The greatest BMI increase was found among exercise drop-outs, while those who had taken up exercise during the study period were the only group who did not show a significant BMI increase over the study period. Job strain showed inconsistent associations with BMI change. CONCLUSIONS: Although socioeconomic differences in BMI were observed, these inequalities did not appear to be increasing, except among young women. Persons with a low initial BMI increased more in weight than persons with a high initial BMI. Exercise behaviour appeared to be an important factor for maintaining, or avoiding heavy increase in, BMI.
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| 12. |
- Eek, Frida, et al.
(författare)
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Factors associated with prospective development of environmental annoyance
- 2010
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 1879-1360 .- 0022-3999. ; 69:1, s. 9-15
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Idiopathic environmental intolerance (IEI) has in cross-sectional studies been associated with emotional problems and psychiatric disorders. However, in the absence of prospective studies it has not been possible to determine whether emotional problems precede the onset of IEI, or are a consequence of IEI. The purpose of this study was to address this issue in a prospective panel study design. Methods: The study sample (n=10 275) responded to a postal survey that included five questions regarding annoyance from environmental factors, at baseline and at follow-up five years later. Associations between a number of self-rating scales of stress, subjective health, and working conditions at baseline on one hand, and development of environmental annoyance from baseline to follow-up on the other, were examined. Results: Participants having developed environmental annoyance between baseline and follow-up had at baseline reported more subjective health complaints, higher levels of stress, strain, and lack of recovery, more dissatisfaction with their work situation, and lower personal social support, compared to participants not developing environmental annoyance. Conclusion: Elevated subjective health complaints, high stress in daily life and a strained work situation, all possible signs of sustained arousal, increase the risk of developing annoyance to environmental factors. The results fit the hypothesis that reduced subjective health, over the course of time, may be attributed to environmental factors. (C) 2010 Elsevier Inc. All rights reserved.
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| 13. |
- Eek, Frida, et al.
(författare)
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Gender inequality at home is associated with poorer health for women.
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 43:2, s. 176-182
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Tidskriftsartikel (refereegranskat)abstract
- Background: As more women have joined the work force, the difference in employment rate between men and women has decreased, in Sweden as well as many other countries. Despite this, traditional gender patterns regarding, for example, responsibility for household duties still remain. Women are on sick leave more often than men, and previous studies have indicated that an unequal split of household responsibilities and perceived gender inequality could be associated with negative health outcomes. Aims: The aim of the present study was to explore whether an unequal distribution of responsibilities in the home was related to various health related outcomes among women. Methods: A sample consisting of 837 women living in a relationship, and working at least 50% of full time, responded to a questionnaire including information about division of responsibilities at home as well as various psychological and physiological health related outcomes. Results: The results showed that women living in relationships with perceived more unequal distribution of responsibility for house hold duties showed significantly higher levels of perceived stress, fatigue, physical/psychosomatic symptoms, and work family conflict compared with women living in more equal relationships. They also had significantly increased odds for insufficient time for various forms of recovery, which may further contribute to an increased risk of poor health. Conclusions: Although an increasing employment rate among women is valuable for both society and individuals, it is important to work towards greater gender equality at home to maintain this development without it having a negative effect on women's health and well-being.
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| 14. |
- Eek, Frida, et al.
(författare)
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Health Care Utilisation and Attitudes towards Health Care in Subjects Reporting Environmental Annoyance from Electricity and Chemicals.
- 2009
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Ingår i: Journal of Environmental and Public Health. - : Hindawi Limited. - 1687-9813 .- 1687-9805. ; 2009:Apr 14
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Tidskriftsartikel (refereegranskat)abstract
- Environmentally intolerant persons report decreased self-rated health and daily functioning. However, it remains unclear whether this condition also results in increased health care costs. The aim of this study was to describe the health care consumption and attitudes towards health care in subjects presenting subjective environmental annoyance in relation to the general population, as well as to a group with a well-known disorder as treated hypertension (HT). Methods. Postal questionnaire (n = 13 604) and record linkage with population-based register on health care costs. Results. Despite significantly lower subjective well being and health than both the general population and HT group, the environmentally annoyed subjects had lower health care costs than the hypertension group. In contrast to the hypertension group, the environmentally annoyed subjects expressed more negative attitudes toward the health care than the general population. Conclusions. Despite their impaired subjective health and functional capacity, health care utilisation costs were not much increased for the environmentally annoyed group. This may partly depend on negative attitudes towards the health care in this group.
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Eek, Frida, et al.
(författare)
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Scientific approach and attitudes among clinically working physiotherapists in Sweden -a cross sectional survey
- 2023
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Ingår i: Archives of Physiotherapy. - : Springer Nature. - 2057-0082. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Evidence based medicine (EBM) should be an endeavor within all healthcare professions. Knowledge and understanding of science are important prerequisites of EBM.Objective The aim was to examine and compare perspectives on science and perceived inhibiting and facilitating factors for the assimilation and implementation of scientific information among clinically working specialist- and nonspecialist physiotherapists in Sweden.Methods A cross-sectional survey study was conducted via a web-based questionnaire. Clinically active physiotherapists in Sweden were invited to participate. Attitudes and perspectives were compared between physiotherapists with completed or on-going specialist training, and non-specialists.Results In total, 1165 physiotherapists responded to the survey (75.5%, (n = 870) women, mean age 44.8 (SD 12.1), whereof 25.5% (n = 319) with completed or ongoing specialist training). The majority of participants had a high interest in science but did not consider a general scientific approach to be applied within physiotherapy. The main perceived inhibiting factor for a clinical practice more based on scientific evidence was lack of time. Specialists had in general higher interest and ability to interpret and evaluate science, and prioritized scientific evidence to a higher extent.Conclusion Among respondents, a scientific approach was considered valuable within physiotherapy but not considered fully applied in practice. The higher interest and perceived ability to interpret science among specialists indicates that further education and specialist training can increase both interest and understanding of science among physiotherapists.
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| 19. |
- Eek, Frida, et al.
(författare)
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Scientific approach, attitudes, and perspectives on research among Swedish physiotherapy students—a cross-sectional study
- 2024
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Ingår i: BMC Medical Education. - 1472-6920. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Scientific evidence is important to evidence-based practice. Hence, the application of evidence-based practice requires relevant skills and an understanding of science, which therefore need to be learned and trained during the undergraduate program in physiotherapy. The aim of this study was to investigate attitudes, perceived competence, and conditions for a scientific approach among physiotherapy students in Sweden, and to compare attitudes and perceived competence between students in different program years. Methods: Physiotherapy students from six universities (n = 1499) were invited to respond to a digital survey. The survey contained questions regarding attitudes toward science, perceived competence in research interpretations and open comments regarding requirements for a strengthened scientific approach during education. Comparisons between education years were performed with ANOVA/Kruskal‒Wallis test (scale outcomes) and logistic regression (binary outcomes). Results: A total of 466 students responded to the survey. In total, 57% (n = 266) of the students had a high interest in science. No significant difference in interest in science was found between students in the three program years, but 75% (n = 347) reported increased interest during the program. A perceived high ability to understand the structure and performance of scientific studies was reported by 31% (n = 144), to evaluate the methodology by 16% (n = 72) and to interpret statistical results from scientific studies by 12% (n = 55). The lowest perceived competence was reported among students in their second year (p < 0.05). A majority of the students (88%; n = 410) reported a perceived personal need for strengthened conditions for a scientific approach, with suggested prerequisites during education via increased theoretical and applied understanding of the research. Conclusion: Even though this study does not fully cover physiotherapy students at all undergraduate programmes in Sweden, the results support that a scientific approach and training should be strengthened during education to enable physiotherapists to understand and interpret science and to fully apply an evidence-based approach in upcoming clinical practice. Both theoretical and applied knowledge and understanding are needed.
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| 20. |
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| 21. |
- Eek, Frida, et al.
(författare)
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Self-perceived changes in physical activity and the relation to life satisfaction and rated physical capacity in swedish adults during the covid-19 pandemic—a cross sectional study
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:2
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 restrictions may prevent people from reaching recommended levels of physical activity (PA). This study examines self-perceived changes in the extent and intensity of PA during the COVID-19 pandemic, and the relation between perceived changes in PA and general life satisfaction and perceived physical capacity. A total of 1318 participants (mean age 47.8 SD12.6; 82.1% women) were recruited through social media in Sweden during autumn 2020. The survey included questions regarding perceived changes in PA compared to the previous year, the “Rating of Perceived Capacity” scale and “Life Satisfaction Questionnaire-11”. A change in PA was reported by 65% of participants. More participants reported an increase (36%) than a decrease (29%), however a decrease in PA was significantly more often considered to be due to the pandemic. The highest odds of decreased PA was found in the oldest age group (70+ years) (OR 2.8; 95% CI 1.4–5.7). Those who reported decreased levels of PA reported lower life satisfaction and aerobic capacity than the other groups (p > 0.001). Decreased physical activity was reported by many, but an equal share reported increased activity during the pandemic. The highest odds for decreased activity was found in the oldest group—the group that has been subjected to the strictest recommended COVID-19 restrictions in Sweden.
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| 22. |
- Eek, Frida
(författare)
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Subjective annoyance attributed to electrical equipments and smells - Epidemiology and stress physiology
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Self-reported annoyance from electrical equipment has been in evidence since the mid-eighties, and the first reports of illness from everyday chemicals arose already in the 1960?s. However, the extent of the problem or the mechanisms behind the development of environmentally related annoyance has not yet been fully established. Increased vulnerability to stress has been suggested to be a possible mechanism behind sensitivity to electricity and common smells. The aim of this thesis was to estimate the prevalence of annoyance related to electrical and chemical factors in a Swedish general population, and to assess possible relations to subjective health, daily functioning and health care utilisation. A further aim was to disclose differential patterns of cortisol secretion in three environmentally annoyed groups, compared with non-annoyed persons, and to test whether the environmentally annoyed subjects would fail to show a suppressed hypothalamic-pituitary-adrenal (HPA) response after an overnight dexamethasone suppression test. A population based health survey encompassing 13 604 persons were used for the epidemiological analyses regarding prevalence of environmental annoyance, and relation to subjective health and well being. Record linkage was performed to analyse health care utilisation. The stress study included 141 subjects, recruited from the survey population. During a two-week period, the participants filled in a logbook including questions regarding sleep quality, subjective stress and health complaints. During four days, the participants also collected saliva samples, four samples each day, with reference to awakening. The functioning of the HPA axis was tested by an overnight dexamethasone suppression test. Annoyance attributed to environmental factors was common in the general Scanian population studied. Of the respondents, 30% stated to be annoyed to any degree, and 6% reported ?much? annoyance, attributed to some electrical factors, chemicals or smells. Subjects associating annoyance with electrical factors, chemicals or smells rated their overall health and functional capacity significantly poorer than the general population. Despite this, the health care utilisation was not much increased in a group with annoyance attributed to both electricity and chemicals/smells. In the stress study, the environmentally annoyed subjects did not present elevated physiological stress levels during daily life. The group with annoyance attributed to both electricity and smells experienced higher levels of subjective stress and health complaints during the two-week period, although these feelings did not influence the HPA activity. All groups showed normal suppression of the HPA axis after ingestion of dexamethasone. Subjective annoyance attributed to electrical and chemical factors was common in the population. Subjects attributing annoyance to both electrical and chemical factors appeared to be the most affected regarding subjective stress and well being. However, no evidence of elevated physiological stress response was found in any of the examined groups.
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| 23. |
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| 24. |
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| 25. |
- Garde, A. H., et al.
(författare)
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Effects of lifestyle factors on concentrations of salivary cortisol in healthy individuals
- 2009
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Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 69:2, s. 242-250
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Tidskriftsartikel (refereegranskat)abstract
- Objective . Salivary cortisol is widely used in occupational health research. However, many ordinary daily activities can influence the concentrations of cortisol and the interpretation of field studies. The aim of the present study was to evaluate the effect of lifestyle factors on salivary cortisol in everyday settings. Material and methods . Healthy employees participated in one or more sub-studies on the effect of eating a vegetable salad versus protein-rich mid-day meal (n=40), drinking coffee and smoking (n=12), drinking alcohol (n=32), awakening at different times (n=29) and exercising (n=21). Cortisol in saliva was measured by radioimmunoassay (RIA). Results . When eating a mid-day meal, salivary cortisol was increased by 10 % (CI -1 % to 24 %) 1 h after eating compared to before eating in the case of both types of meal. Salivary cortisol increased by 80 % (CI 9 % to 199 %) after exercising compared to before exercise. The relative awakening response was approximately 100 % when using an alarm clock on both work-days and days off. However, the awakening response was 39 % (CI 10 % to 75 %) on a day off with spontaneous awakening. No effects of alcohol, coffee or smoking were observed. Discussion . In field studies, the biological variation in salivary cortisol may be reduced by restricting physical exercise and in collecting pre-meal samples. However, the protein content of food and moderate consumption of alcohol had no effect on concentrations of cortisol. Differences in relative awakening responses on work-days and days off are related to time and mode of awakening.
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| 26. |
- Gohir, Sameer Akram, et al.
(författare)
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Effectiveness of Internet-Based Exercises Aimed at Treating Knee Osteoarthritis : The iBEAT-OA Randomized Clinical Trial
- 2021
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:2, s. 210012-210012
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Osteoarthritis is a prevalent, debilitating, and costly chronic disease for which recommended first-line treatment is underused.Objective: To compare the effect of an internet-based treatment for knee osteoarthritis vs routine self-management (ie, usual care).Design, Setting, and Participants: This randomized clinical trial was conducted from October 2018 to March 2020. Participants included individuals aged 45 years or older with a diagnosis of knee osteoarthritis recruited from an existing primary care database or from social media advertisements were invited. Data were analyzed April to July 2020.Interventions: The intervention and control group conformed to first-line knee osteoarthritis treatment. For the intervention group, treatment was delivered via a smartphone application. The control group received routine self-management care.Main Outcomes and Measures: The primary outcome was change from baseline to 6 weeks in self-reported pain during the last 7 days, reported on a numerical rating scale (NRS; range, 0-10, with 0 indicating no pain and 10, worst pain imaginable), compared between groups. Secondary outcomes included 2 physical functioning scores, hamstring and quadriceps muscle strength, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quantitative sensory testing.Results: Among a total of 551 participants screened for eligibility, 146 were randomized and 105 were analyzed (mean [SD] age, 66.7 [9.2] years, 71 [67.1%] women), including 48 participants in the intervention group and 57 participants in the control group. There were no significant differences in baseline characteristics between the groups. At the 6-week follow-up, the intervention group showed a greater NRS pain score reduction than the control group (between-group difference, -1.5 [95% CI, -2.2 to -0.8]; P < .001). Similarly, the intervention group had better improvements in the 30-second sit-to-stand test (between-group difference, 3.4 [95% CI, 2.2 to 4.5]; P < .001) and Timed Up-and-Go test (between-group difference, -1.8 [95% CI, -3.0 to -0.5] seconds; P = .007), as well as the WOMAC subscales for pain (between-group difference, -1.1 [95% CI, -2.0 to -0.2]; P = .02), stiffness (between-group difference, -1.0 [95% CI, -1.5 to -0.5]; P < .001), and physical function (between-group difference, -3.4 [95% CI, -6.2 to -0.7]; P = .02). The magnitude of within-group changes in pain (d = 0.83) and function outcomes (30 second sit-to-stand test d = 1.24; Timed Up-and-Go test d = 0.76) in the intervention group corresponded to medium to very strong effects. No adverse events were reported.Conclusions and Relevance: These findings suggest that this internet-delivered, evidence-based, first-line osteoarthritis treatment was superior to routine self-managed usual care and could be provided without harm to people with osteoarthritis. Effect sizes observed in the intervention group corresponded to clinically important improvements.Trial Registration: ClinicalTrials.gov Identifier: NCT03545048.
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| 27. |
- Halford, Christina, et al.
(författare)
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Perceived Stress, Psychological Resources and Salivary Cortisol
- 2012
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Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608050710 - 9781608053421 ; , s. 67-86
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Bokkapitel (refereegranskat)abstract
- The aim of this chapter was to analyze associations between measures of cortisol in saliva withmeasures of perceived stress, using the Perceived Stress Scale (PSS), and of psychological resources interms of mastery, locus of control, self-esteem and sense of coherence. Only studies on healthy individualswere included and cortisol measures were grouped into single time point measures, deviation measures,Area Under the Curve (AUC), laboratory test responses, and dexamethasone suppression. For bothPerceived Stress Scale (PSS) and for psychological resources, most results of associations with salivacortisol were nonsignificant particularly for single measures and for cortisol awakening response. For PSSthe largest proportion of significant findings (38%) was seen for morning AUC, however with conflictingresults. For psychological resource constructs, mastery and sense of coherence were related to lower cortisollevel at baseline in standardized rest and high mastery was related to steeper diurnal slope in two studies.For self-esteem, no associations showed significant results. Differences in findings may to a large extent bedependent on theoretical assumptions made and methods used
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| 28. |
- Håkansson, Carita, et al.
(författare)
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Insufficient time for leisure and perceived health and stress in working parents with small children
- 2016
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Ingår i: Work. - 1875-9270. ; 55:2, s. 453-461
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: More knowledge about how recovery may promote health among parents with small children is needed.OBJECTIVE: To explore whether insufficient time for leisure was associated with poorer perceived health and higher stress in working parents. A further aim was to explore potential gender differences in the association between insufficient time for leisure and poor perceived health.METHODS: A postal survey including the perceived stress scale and three measures of subjective health - self-rated health (SF-36), work-related fatigue (Swedish occupational fatigue questionnaire), and Lund subjective health complaints - as well as questions about time for leisure was completed by 965 women and 597 men. Risk ratios for poor perceived health and stress were estimated using Poisson regression, in which also gender interaction was analysed.RESULTS: The results showed higher risk for perceived stress among parents reporting insufficient time for relaxation, and more subjective health complaints among those reporting insufficient time to spend with their children. Overall, effects were larger among women than among men.CONCLUSION: A good balance between work and leisure seems to be of importance for working parents' perceived health and stress.
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| 29. |
- Håkansson, Carita, et al.
(författare)
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Occupational balance, work and life satisfaction in working cohabiting parents in Sweden
- 2019
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 47:3, s. 366-374
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Occupational balance is the experience of having the right amount and right variation between work, domestic work, leisure, rest, and sleep. There is limited knowledge about which factors predict parents’ combined occupational balance, and if the combined occupational balance is associated with work and life satisfaction.Aim: The first aim was to explore whether domestic work and childcare at baseline predicted combined occupational balance at follow-up among working cohabiting parents. The second aim was to explore associations between different combinations of occupational balance, and work and life satisfaction at follow-up.Method: A sample of 139 cohabiting parents responded to a questionnaire. Cohabiting parents can experience their occupational balance differently, and in the present study their experiences were divided into high and low after the median. The parents’ balance was then combined in terms of high-high, high-low and low-low. Associations between childcare, domestic work, work and life satisfaction, and combined occupational balance were analysed with multinomial logistic regression analyses.Results: Satisfaction with the division of domestic work predicted a high-high occupational balance in parent couples. Associations were found between high-high as well as high-low combined occupational balance and life satisfaction, and between high-high occupational balance and work satisfaction.Conclusions: It seems important for both parents in a couple to experience satisfaction with the division of domestic work to experience high occupational balance as well as work and life satisfaction.
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| 30. |
- Ivarsson, Anna, et al.
(författare)
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The relationship between physical workload and quality within line-based assembly
- 2016
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Ingår i: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 59:7, s. 23-913
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Tidskriftsartikel (refereegranskat)abstract
- Reducing costs and improvement of product quality are considered important to ensure productivity within a company. Quality deviations during production processes and ergonomics have previously shown to be associated. This study explored the relationship between physical workload and real (found during production processes) and potential (need of extra time and assistance to complete tasks) quality deviations in a line-based assembly plant. The physical workload on and the work rotation between 52 workstations were assessed. As the outcome, real and potential quality deviations were studied during 10 weeks. Results show that workstations with higher physical workload had significantly more real deviations compared to lower workload stations. Static work posture had significantly more potential deviations. Rotation between high and low workload was related to fewer quality deviations compared to rotation between only high workload stations. In conclusion, physical ergonomics seems to be related to real and potential quality deviation within line-based assembly. Practitioner Summary: To ensure good productivity in manufacturing industries, it is important to reduce costs and improve product quality. This study shows that high physical workload is associated with quality deviations and need of extra time and assistance to complete tasks within line-based assembly, which can be financially expensive for a company.
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| 31. |
- Jonsdottir, Ingibjörg H., et al.
(författare)
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Mental Health and Salivary Cortisol
- 2012
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Ingår i: The Role of Saliva in Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608053421 ; , s. 129-166
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Bokkapitel (refereegranskat)
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| 32. |
- Jonsdottir, Ingibjörg H., et al.
(författare)
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Mental Health and Salivary Cortisol
- 2012
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Ingår i: The Role of Saliva Cortisol Measurement in Health and Disease. - : Bentham eBooks. - 9781608050710 - 9781608053421 ; , s. 129-166
-
Bokkapitel (refereegranskat)abstract
- Abstract: The aim of this chapter was to analyze associations between measures of cortisol in salivaand mental health and to see if divergent results were functions of the methods used. Measures ofmental health outcome included Major Depressive Disorder (MDD), symptoms of depression, andsymptoms of anxiety, Burnout (BO), and Vital Exhaustion (VE). Only studies on otherwise healthyindividuals were included. Cortisol measures were grouped into single time point measures, measuresof deviations, laboratory test responses, Area Under the Curve (AUC), and response to dexamethasone.Some consistency is seen for MDD, mainly higher mean levels. The results regarding single measuresand depressive mood are less consistent, but the overall picture for depression shows poorer diurnaldeviation and response to stress. Inconsistency among papers studying depression seems to be relatedmainly to the study population. Very few significant findings were found for anxiety, therefore cortisoldoes not seem to be strongly related to anxiety. Most of the statistical analysis does not show asignificant relationship between BO and cortisol, and when these are present, the results areinconsistent. One explanation seems to be the measures of BO used, probably due to the differentconceptual basis for BO. VE measured using the Maastricht Questionnaire seems to be related to apoorer cortisol response to stress and poorer diurnal deviation. The coexistence of BO and VE in manystudies does make it difficult to conclude how the different concepts are related to cortisol. However, aninteresting difference appeared between MDD and VE in response to dexamethasone administration,showing lower suppression in MDD patients and higher suppression in VE patients. A generalconclusion for all mental health measures is that a large proportion of non-significant findings are dueto low power and few sampling days combined with low contrasts between study groups and withinstudy populations. Generally, deviation measures such as diurnal deviation seem to be more validmeasures compared with single measures to capture possible changes in the hypothalamus-pituitaryadrenal axis, measured using salivary cortisol.
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| 33. |
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| 34. |
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| 35. |
- Jönsson, Thérése, et al.
(författare)
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Factors associated with clinically relevant pain reduction after a self-management program including education and exercise for people with knee and/or hip osteoarthritis : Data from the BOA register
- 2023
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:2 February
-
Tidskriftsartikel (refereegranskat)abstract
- Aim To examine the associations between individual- and disease-related factors and the odds of reaching a clinically relevant pain reduction in people with knee and/or hip osteoarthritis (OA) who underwent a first-line self-management program. Materials and methods An observational registry-based study including people with knee (n = 18,871) and hip (n = 7,767) OA who participated in a self-management program including education and exercise and had data recorded in the Better Management of patients with Osteoarthritis (BOA) register. We used multivariable logistic regression models to study the association between sex, age, body mass index (BMI), education, comorbidity, pain frequency, walking difficulties, willingness to undergo surgery and the odds of reaching a clinically relevant pain reduction (decrease of >33% on a 0–10 NRS scale) 3 and 12 months after the intervention. All analyses were stratified by joint (knee/hip). Results Both in the short- and long-term follow-up, a younger age (18–65 years), a lower BMI (< 25), a higher level of education (university), the absence of comorbidities impacting the ability to walk, less frequent pain and not being willing to undergo surgery were associated with higher odds of reaching a clinically relevant pain reduction in people with knee OA. We found similar results for people with hip OA, but with larger uncertainty in the estimates (wider 95% CI). Conclusion Our study suggests that early fist line self-management interventions delivered when people have unilateral hip or knee OA with less frequent pain and are unwilling to undergo surgery, may be important for reaching a clinically relevant pain reduction after participation. Providing the most appropriate treatment to the right patient at the right time is a step in reducing the burden of OA for society and the patient.
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| 36. |
- Jönsson, Thérése, et al.
(författare)
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The better management of patients with osteoarthritis program : Outcomes after evidence-based education and exercise delivered nationwide in Sweden
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:9
-
Tidskriftsartikel (refereegranskat)abstract
- We evaluated a structured education- and exercise-based self-management program for patients with knee or hip osteoarthritis (OA), using a registry-based study of data from 44,634 patients taken from the Swedish “Better Management of Patients with Osteoarthritis” registry. Outcome measures included a numeric rating scale (NRS), EuroQol five dimension scale (EQ-5D), Arthritis self-efficacy scale (ASES-pain and ASES-other symptoms), pain frequency, any use of OA medication, desire for surgery, fear–avoidance behavior, physical activity, and sick leave were reported at baseline, 3 and 12 month. Changes in scale variables were analyzed using general linear models for repeated measures and changes in binary variables by McNamara’s test. All analyses were stratified by joint. At the 3-month follow-up, patients with knee (n = 30686) and hip (n = 13948) OA reported significant improvements in the NRS-pain, the EQ-5D index, the ASES-other symptoms, and ASES-pain scores with standardized effect size (ES) ranges for patients with knee OA of 0.25–0.57 and hip OA of 0.15–0.39. Significantly fewer patients reported pain more than once weekly, took OA medication, desired surgery, showed fear–avoidance behavior, and were physically inactive. At the 12-month follow-up, patients with knee (n = 21647) and hip (n = 8898) OA reported significant improvements in NRS-pain, EQ-5D index, and a decrease in ASES-other symptoms and ASES-pain scores with an ES for patients with knee OA of –0.04 to 0.43 and hip OA of –0.18 to 0.22. Significantly fewer patients reported daily pain, desired surgery (for hip OA), reported fear–avoidance behavior, and reported sick leave. Following these interventions, patients with knee and hip OA experienced significant reductions in symptoms and decreased willingness to undergo surgery, while using less OA medication and taking less sick leave. The results indicate that offering this program as the first-line treatment for OA patients may reduce the burden of this disease.
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| 37. |
- Jönsson, Thérése, et al.
(författare)
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The effect of education and supervised exercise on physical activity, pain, quality of life and self-efficacy - an intervention study with a reference group.
- 2018
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Ingår i: BMC Musculoskeletal Disorders. - : BioMed Central. - 1471-2474. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Individuals with knee and hip osteoarthritis (OA) are less physically active than people in general, and many of these individuals have adopted a sedentary lifestyle. In this study we evaluate the outcome of education and supervised exercise on the level of physical activity in individuals with knee or hip OA. We also evaluate the effect on pain, quality of life and self-efficacy.METHODS: Of the 264 included individuals with knee or hip OA, 195 were allocated to the intervention group. The intervention group received education and supervised exercise that comprised information delivered by a physiotherapist and individually adapted exercises. The reference group consisted of 69 individuals with knee or hip OA awaiting joint replacement and receiving standard care. The primary outcome was physical activity (as measured with an accelerometer). The secondary outcomes were pain (Visual Analog Scale), quality of life (EQ-5D), and self-efficacy (Arthritis Self-Efficacy Scale, pain and other symptoms subscales). Participants in both groups were evaluated at baseline and after 3 months. The intervention group was also evaluated after 12 months.RESULTS: No differences were found in the number of minutes spent in sedentary or in physical activity between the intervention and reference groups when comparing the baseline and 3 month follow-up. However, there was a significant difference in mean change (mean diff; 95% CI; significance) between the intervention group and reference group favoring the intervention group with regard to pain (13; 7 to 19; p < 0.001), quality of life (- 0.17; - 0.24 to - 0.10; p < 0.001), self-efficacy/other symptoms (- 5; - 10 to - 0.3; p < 0.04), and self-efficacy/pain (- 7; - 13 to - 2; p < 0.01). Improvements in pain and quality of life in the intervention group persisted at the 12-month follow-up.CONCLUSIONS: Participation in an education and exercise program following the Swedish BOA program neither decreased the average amount of sedentary time nor increased the level of physical activity. However, participation in such a program resulted in decreased pain, increased quality of life, and increased self-efficacy.TRIAL REGISTRATION: The trial is registered with ClinicalTrials.gov. Registration number: NCT02022566 . Retrospectively registered 12/18/2013.
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| 38. |
- Karlson, Björn, et al.
(författare)
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Cortisol variability and self-reports in the measurement of work-related stress
- 2011
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Ingår i: Stress and Health. - : Wiley. - 1532-3005. ; 27:2, s. 11-24
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Tidskriftsartikel (refereegranskat)abstract
- We examined whether a high cortisol awakening response (CAR) and low cortisol decline over the day (CDD) are related to self-reported work stress and well-being, and whether there are gender differences in these relationships. Three hundred eighty-three working men and women responded to a survey measuring job stress factors, mastery at work, symptoms and well-being. Salivary cortisol was sampled at awakening, after 45 min and at 21:00, from which the variables CAR and CDD were defined. A high CAR was associated with lower perceived job control and work mastery, and poorer well-being. Low CDD was associated only with higher job demands, but the self-report scores showed a number of interactions between cortisol group and gender. Among women, those showing a low CDD, compared with those with a higher CDD, had more favourable scores on a number of job stress factors and symptom load. In contrast, among men, a similar comparison showed those with low CDD to have poorer scores on job stress factors and symptom load. We conclude that individuals displaying high CAR or low CDD differ from those not displaying these cortisol profiles in self-report of work stress and well-being, and that gender differences appear in these relationships.
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| 39. |
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| 40. |
- Karlson, Björn, et al.
(författare)
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Effects on sleep-related problems and self-reported health after a change of shift schedule.
- 2009
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Ingår i: Journal of Occupational Health Psychology. - : American Psychological Association (APA). - 1076-8998 .- 1939-1307. ; 14:2, s. 97-109
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Tidskriftsartikel (refereegranskat)abstract
- This study prospectively examined the effects of a change of shift schedule from a fast forward-rotating schedule to a slowly backward-rotating one. The initial schedule had a forward rotation from mornings to afternoons to nights over 6 consecutive days, with 2 days on each shift followed by 4 days off before the next iteration of the cycle, whereas the new schedule had a slower backward rotation from mornings to nights to afternoons, with 3 days on a given shift followed by 3 days off before the next shift. Shift workers (n = 118) were compared with a reference group of daytime workers (n = 67) from the same manufacturing plant by means of questionnaires covering subjective health, sleep and fatigue, recovery ability, satisfaction with work hours, work-family interface, and job demands, control, and support. Data were collected 6 months before implementing the new schedule and at a follow-up 15 months later. As predicted, on most dimensions measured the shift workers displayed clear improvements from initially poorer scores than daytime workers, and the daytime workers displayed no improvements. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Karonen, Emil, et al.
(författare)
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Prophylactic and Therapeutic Fasciotomy for Acute Compartment Syndrome after Revascularization for Acute Lower Limb Ischemia—Renal and Wound Outcomes
- 2023
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Ingår i: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096. ; 88, s. 154-163
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Tidskriftsartikel (refereegranskat)abstract
- Background: Acute Compartment Syndrome (ACS) is a significant complication after revascularization for acute lower limb ischemia (ALI). High risk patients sometimes undergo prophylactic fasciotomy (PF) to prevent ACS. Patients that develop ACS undergo therapeutic fasciotomy (TF). The optimal timing of fasciotomy has been debated. The aim of this study was to describe and compare renal and wound outcomes in patients undergoing PF and TF. Methods: A retrospective cohort study including 76 patients undergoing PF (n = 40) or TF (n = 36) after revascularization for ALI between 2006 and 2018. Estimated glomerular filtration rate (e-GFR) was used to evaluate renal function and compare within (paired-samples t-test) and between (analysis of variance) groups. Wound complications and healing time were compiled from the complete wound healing period and compared between groups with Pearson's chi-squared-and log-rank test, respectively. Results: E-GFR improved over the in-hospital period with 8.2 ml/min/1.73 m2 (95% confidence interval [CI] 2.4–14.1, P = 0.007) in the PF group and 4.4 ml/min/1.73 m2 (95% CI 1.2–7.7, P = 0.010) in the TF group, with no significant difference between the 2 groups (0.3 ml/min/1.73 m2, 95% CI −6.7 to 7.4, P = 0.93). The wound infection rate was higher after TF (PF = 60.6 % and TF = 82.4 %, P = 0.048), whereas rate of other wound complications (PF = 61.3 % and TF = 35.3%, P = 0.036) was higher after PF. Conclusions: Overall wound complications were high, whereas renal function improved during in-hospital stay. A more conservative approach to fasciotomy could avoid unnecessary fasciotomies and reduce wound complications, while holding the potential to sufficiently preserve renal function if fasciotomy is needed for ACS. This would be possible and safe if an early diagnosis and treatment of ACS can be ensured.
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| 45. |
- Karonen, Emil, et al.
(författare)
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Sex differences in outcomes after revascularization for acute lower limb ischemia : Propensity score adjusted analysis
- 2024
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Ingår i: World Journal of Surgery. - 0364-2313. ; 48:3, s. 746-755
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous reports have suggested higher rates of mortality and amputation for female patients in acute lower limb ischemia (ALI). The aims of the present study were to investigate if there is a difference in mortality, amputation, and fasciotomy between the sexes. Methods: A retrospective cohort study of consecutive patients undergoing index revascularization for ALI between 2001 and 2018 was conducted. A propensity score was created through a logistic regression with female/male sex as an outcome. Cox regression analyses for 90-day and 1-year mortality, combining major amputation/mortality, and logistic regression for major bleeding and fasciotomy, were performed. All analyses were performed with and without adjusting for propensity score. Results: A total of 709 patients were included in the study of which 45.9% were women. Mean age was 72.1 years. Females were older and had higher rates of atrial fibrillation, embolic disease, and lower estimated glomerular filtration rate, while men more often had anemia and chronic peripheral arterial disease. Mortality at 1 year was 21.2% for women and 14.7% for men. The adjusted hazard ratio for 1-year mortality was 0.99 (95% CI 0.67–1.46). Fasciotomy was performed in 7.1% of female and 12.8% of male patients; the adjusted odds ratio was 0.52 (95% CI 0.29–0.91). Conclusion: Sex was not found to be an independent risk factor for mortality or combined major amputation/mortality after revascularization for acute lower limb ischemia, whereas women had lower odds of undergoing fasciotomy. Whether women are underdiagnosed or do not develop acute compartment syndrome in the lower leg as often as men should be evaluated prospectively.
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| 46. |
- Lindeberg, Sara, et al.
(författare)
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Exhaustion measured by the SF-36 vitality scale is associated with a flattened diurnal cortisol profile.
- 2008
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 33, s. 471-477
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Tidskriftsartikel (refereegranskat)abstract
- The possible association between stress-related exhaustion and reduced activity in the hypothalamo-pituitary-adrenal (HPA) axis is increasingly in focus. The aim of the present study was to examine whether exhaustion measured in a non-patient population is associated with alterations in diurnal cortisol profile. The study population included 78 working individuals. The study group was dichotomised into exhausted and non-exhausted groups by means of the SF-36 vitality scale. Salivary cortisol was measured at three times during 1 workday: at awakening, 30min after awakening, and in the evening. The results showed that diurnal cortisol variation was significantly reduced in exhausted individuals. The difference in cortisol variation was mainly due to lowered morning cortisol in the exhausted group. Differences in cortisol levels at each sampling time or in mean diurnal output of cortisol were not statistically significant. The results would support the notion that exhaustion is associated with HPA axis hypoactivity as assessed by salivary cortisol. Furthermore, the SF-36 vitality provides a measure of exhaustion that may be useful in epidemiological studies in order to explore long-term health effects of stress-related exhaustion.
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| 47. |
- Lindholm, Beata, et al.
(författare)
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Dyskinesia and FAB score predict future falling in Parkinson's disease
- 2019
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 139:6, s. 512-518
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Tidskriftsartikel (refereegranskat)abstract
- A growing body of research highlights the importance of cognition for prediction of falls in Parkinson's disease (PD). However, a previously proposed prediction model for future near falls and falls in PD, which includes history of near falls, tandem gait, and retropulsion, was developed without considering cognitive impairment. Therefore, by using a sample of 64 individuals with relatively mild PD and not excluding those with impaired cognition we aimed to externally validate the previously proposed model as well as to explore the value of additional predictors that also consider cognitive impairment. Since this validation study failed to support the proposed model in a PD sample including individuals with impaired global cognition, extended analyses generated a new model including dyskinesia (item 32 of Unified PD Rating Scale) and frontal lobe impairment (Frontal Assessment Battery—FAB) as significant independent predictors for future near falls and falls in PD. The discriminant ability of this new model was acceptable (AUC, 0. 80; 95% CI 0.68-0.91). Replacing the continuous FAB scores by a dichotomized version of FAB with a cut-off score ≤14 yielded slightly lower but still acceptable discriminant ability (AUC, 0. 79; 95% CI 0.68-0.91). Further studies are needed to test our new model and the proposed cut-off score of FAB in additional samples. Taken together, our observations suggest potentially important additions to the evidence base for clinical fall prediction in PD with concomitant cognitive impairment.
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| 48. |
- Lindman, Ida, et al.
(författare)
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Improvements After Arthroscopic Treatment for Femoroacetabular Impingement Syndrome in High-Level Ice Hockey Players : 2-Year Outcomes by Player Position
- 2021
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Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ice hockey players often undergo arthroscopic treatment for femoroacetabular impingement syndrome (FAIS); however, only a few studies have reported postoperative patient-reported outcomes. It has been debated whether player position is related to FAIS. Purpose: To evaluate the change in patient-reported outcome measures (PROMs) in high-level ice hockey players from presurgery to 2 years after arthroscopic treatment for FAIS. The secondary aim was to evaluate differences in outcomes among player positions and whether stick handedness is related to the side of the symptomatic hip. Study Design: Case series; Level of evidence, 4. Methods: Ice hockey players undergoing treatment for FAIS between 2011 and 2019 were prospectively included. Preoperative and 2-year follow-up scores were collected for the following PROMs: HAGOS (Copenhagen Hip and Groin Outcome Score), iHOT-12 (12-item International Hip Outcome Tool), EQ-5D (EuroQol–5 Dimensions) and EQ-VAS (EuroQol–Visual Analog Scale), Hip Sports Activity Scale, and visual analog scale for overall hip function. Player position and stick handedness were collected from public sources. Preoperative and follow-up outcomes were compared for the entire cohort and among player positions. Results: The cohort included 172 ice hockey players with a mean age of 28 years, a mean body mass index of 25.6, and a mean symptom duration of 46.3 months. In the 120 players with 2-year follow-up data, there was significant improvement in all PROMs as compared with presurgery: HAGOS subscales (symptoms, 47.5 vs 68.0; pain, 57.0 vs 75.8; activities of daily living, 62.5 vs 81.0; sports, 40.0 vs 64.7; physical activity, 30.9 vs 57.2; quality of life, 32.5 vs 57.8), iHOT-12 (45.2 vs 66.7), EQ-5D (0.59 vs 0.75), EQ-VAS (68.3 vs 73.2), and visual analog scale for overall hip function (49.6 vs 69.2) (P <.0001 for all). At 2-year follow-up, 83% reported satisfaction with the procedure. There was no difference in the improvement in PROMs among player positions. Further, there was no significant relationship between stick handedness and side of symptomatic hip; however, because of the number of bilateral procedures and large number of left-handed shooters, no conclusions could be drawn. Conclusion: High-level ice hockey players undergoing arthroscopic treatment for FAIS reported improvements in PROMs 2 years after surgery, regardless of player position.
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| 49. |
- Mellergård, Emelia, et al.
(författare)
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Developing a web-based support using self-affirmation to motivate lifestyle changes in type 2 diabetes : A qualitative study assessing patient perspectives on self-management and views on a digital lifestyle intervention
- 2021
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 24, s. 100384-100384
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of the present study was to explore patients' experiences of diabetes self-management and views on a digital lifestyle intervention using self-affirmation to motivate lifestyle changes.Methods: Semi-structured interviews focusing on needs, attitudes, and barriers to diabetes self-management were conducted with 22 individuals with type 2 diabetes recruited from the All New Diabetics in Scania (ANDIS) cohort. The interviews were followed by three additional study visits, where participants gave feedback on computer-based assignments based on self-affirmation. Interviews and feedback were qualitatively analyzed using thematic analysis.Results: Participants described a range of barriers to diabetes self-management, and a varying sense of urgency and distress related to diabetes management. A need for accessible, reliable, and relevant information was reported, as well as a sense that required lifestyle changes was incompatible with current life situation. Further, the use of self-affirmation was described as relevant, motivating and engaging.Conclusions: Barriers to diabetes self-management need to be addressed when supporting diabetes self-management, e.g. through carefully matching the support to the patient's readiness to change, supporting patient autonomy and focusing on long-term changes. Using self-affirmation may raise acceptability of a digital lifestyle intervention and help connect diabetes self-management with overall life context, by guiding the patient to focus on personal relevance.
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| 50. |
- Mellergård, Emelia, et al.
(författare)
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Effects of perceived competence, negative appraisal, and motivation orientation on glycemic stability in individuals with type 2 diabetes :A prospective cohort study
- 2021
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918. ; 15:2, s. 269-274
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Tidskriftsartikel (refereegranskat)abstract
- Aims: HbA1c variability is targeted as a part of clinical risk assessment in type 2 diabetes. Psychological factors such as patient competence, adjustment to diabetes, and motivation, may influence glycemic control. The objective of the present study was to determine if perceived competence, diabetes appraisal, and motivation predicted HbA1c variability, and to examine differences regarding these factors in relation to diabetes duration, in individuals with type 2 diabetes. Methods: Data on perceived competence, appraisal of diabetes, and motivation orientation from 158 individuals with type 2 diabetes were analyzed as potential predictors of HbA1c at five measurement points over a time period of 24 months. Associations between psychological factors and HbA1c variability were examined through multiple linear regression analyses, and differences in psychological measures between groups with different diabetes duration were examined using ANOVA. Results: Negative appraisal of diabetes predicted higher HbA1c variability and was associated with higher baseline HbA1c, and greater perceived competence predicted lower HbA1c variability. Conclusions: The results indicate that lower levels of diabetes distress, as well as confidence in one's ability to manage diabetes, could potentially predict better glycemic control.
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