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1.	Lennernäs, Maria, et al. (författare) Meals and shift work : food choice, time of day and meal environment - three important dimensions for rest and health 2013 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
2.	Stenberg, Gunilla, Med dr, 1968-, et al. (författare) Gender matters in physiotherapy 2022 Ingår i: Physiotherapy Theory and Practice. - : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 38:13, s. 2316-2329 Tidskriftsartikel (refereegranskat)abstract The World Health Organization states that gender has implications for health across the course of a person's life in terms of norms, roles and relations. It also has implications in rehabilitation. In this article, we argue the need of gender perspectives in the field of physiotherapy; gender matters and makes a difference in health and rehabilitation. We highlight a number of central areas where gender may be significant and give concrete examples of social gender aspects in physiotherapy practice and in diverse patient groups. We also discuss why it can be important to consider gender from an organizational perspective and how sociocultural norms and ideals relating to body, exercise and health are gendered. Further we present useful gender theories and conceptual frameworks. Finally, we outline future directions in terms of gender-sensitive intervention, physiotherapy education and a gendered application of the ICF model. We want to challenge physiotherapists and physiotherapy students to broaden knowledge and awareness of how gender may impact on physiotherapy, and how gender theory can serve as an analytical lens for a useful perspective on the development of clinical practice, education and research within physiotherapy.
3.	Dahl Lassen, Anne, et al. (författare) Food at Work around the Clock – The Nordic Model : report from a Nordic Workshop, November 4, 2016, Copenhagen, Denmark 2017 Bok (övrigt vetenskapligt/konstnärligt)abstract This report brings together 12 invited presentations and outcomes of a workshop on food and meals for employees working irregular hours “around the clock”. The workshop, “Food at work around the clock – The Nordic Model”, was hosted by the National Food Institute at the Technical University of Denmark on November 4, 2016, in Lyngby, near Copenhagen, Denmark. This was a culmination of the collaboration started in 2015 between researchers from the hosts institute, Gävle University and Kristianstad University in Sweden, and the School of Applied Educational Sciences and Teacher Education in Finland. The workshop was funded by the Nordic Council of Ministers.
4.	Einarsson, Sandra, 1981-, et al. (författare) Thinking and re-thinking : a qualitative study of university teachers' perspectives on the development process for a new online interprofessional education curriculum in a Swedish higher education institution 2023 Ingår i: Nordic Studies in Education. - : Cappelen Damm Akademisk. - 1891-5914 .- 1891-5949. ; 43:3, s. 225-240 Tidskriftsartikel (refereegranskat)abstract The objective was to reflect on the experience of working collaboratively across education programmes, departments, and faculties from the perspective of university teachers at a higher education institution. Nine teachers from five programmes working together to develop a new curriculum for interprofessional education (IPE) participated in a focus group discussion. Data were analysed using thematic analysis. Findings suggest that teacher experiences can be understood in terms of teamwork processes valued from both professional and IPE experiential variations within the group. Since findings illustrate pedagogical collaboration across department and faculty boundaries, they can inspire teachers who are planning a similar process.
5.	Eriksson, Maria, 1976- (författare) Creating customer value in commercial experiences 2009 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract There is a type of business offering gaining much attention, both in the media and in financial figures, which provides the customer with something extra, something to be remembered. This offering is a commercial experience. It is claimed that commercial experiences are different from traditional industry and mass-production and even separated from goods and services. The possibility of creating something extraordinary in order to gain profit is of increasing interest in today’s business world. Consumers are seeking for experiences to reach a higher level of personal growth, an experience that create personal identity and lead to long-lasting memories. This is something an increasing amount of consumers are willing to pay money for - the commercial experience market. The purpose of this thesis is to contribute knowledge about and a deeper understanding of commercial experiences, both in general and especially with regard to how customer value is created. The focus of the research was also to strengthen and support organizations that offer commercial experiences. In order to fulfill the purpose, two case studies were conducted with different focal points. The first aimed to find best practice and explore excellent ways of working when providing commercial experiences. The second study aimed to identify the needs for improvement to strengthen organizations offering commercial experiences. According to my findings, there seems to be several distinctions between commercial experiences and goods and services. These include; the level of price, the time spent by the customer, the customer affect as strongly emotional and maybe most importantly, the finding that commercial experiences create a higher level of customer value than goods and services. All this proves that the commercial experience is to be considered an offering on its own, a refined customer offer of higher value. Since commercial experiences are said to engage customers in an inherently memorable way, reaching a higher level of customer value than goods and services, is seen as a critical factor. Understanding what the customer really wants, needs and what builds customer value when offering commercial experiences then become particularly important as drivers of success. When studying a particular organization for best practice, several similarities between providing commercial experiences and working according to the core values of TQM were found and established as a factor of business excellence. Further when it comes to providing commercial experiences storytelling, theming and a creative environment stood out as additional factors of business excellence. Moreover, selecting the right co-workers based on their values rather than merely their skills and academic qualifications was seen as an important factor of success. The co-worker is often the co-creator of the experience together with the customer and therefore has an important part to play in the organization. Creating a corporate culture with co-workers sharing the values is seen as essential in order to run a successful business. It appears that any type of organization can provide an experience for the customer, the key is adding on the extra value to reach the level of attractive quality. The commercial experience is described as deeply affecting both the feelings and senses of the customer, resulting in new memories; it is a memorable event the customer is willing to pay for. The commercial experience contains elements of engagement, personal relevance, novelty, surprise and learning and is not limited to certain types of businesses. The fact that this is an area of increasing business interest but as yet a poorly explored one indicates that there is a need to develop improved ways of working, tools and methods, tailor-made for providing commercial experiences. Improved tools for identifying customer expectations and measuring customer satisfaction are clearly needed, especially since this is a growing industry that cannot be ignored. Welcome to further explore the experience economy where new memories are so highly valued that people are prepared to pay for them!
6.	Fountoulakis, Konstantinos N., et al. (författare) Gender, age at onset, and duration of being ill as predictors for the long-term course and outcome of schizophrenia : an international multicenter study 2022 Ingår i: CNS Spectrums. - : CAMBRIDGE UNIV PRESS. - 1092-8529 .- 2165-6509. ; 27:6, s. 716-723 Tidskriftsartikel (refereegranskat)abstract Background The aim of the current study was to explore the effect of gender, age at onset, and duration on the long-term course of schizophrenia. Methods Twenty-nine centers from 25 countries representing all continents participated in the study that included 2358 patients aged 37.21 +/- 11.87 years with a DSM-IV or DSM-5 diagnosis of schizophrenia; the Positive and Negative Syndrome Scale as well as relevant clinicodemographic data were gathered. Analysis of variance and analysis of covariance were used, and the methodology corrected for the presence of potentially confounding effects. Results There was a 3-year later age at onset for females (P < .001) and lower rates of negative symptoms (P < .01) and higher depression/anxiety measures (P < .05) at some stages. The age at onset manifested a distribution with a single peak for both genders with a tendency of patients with younger onset having slower advancement through illness stages (P = .001). No significant effects were found concerning duration of illness. Discussion Our results confirmed a later onset and a possibly more benign course and outcome in females. Age at onset manifested a single peak in both genders, and surprisingly, earlier onset was related to a slower progression of the illness. No effect of duration has been detected. These results are partially in accord with the literature, but they also differ as a consequence of the different starting point of our methodology (a novel staging model), which in our opinion precluded the impact of confounding effects. Future research should focus on the therapeutic policy and implications of these results in more representative samples.
7.	Fountoulakis, Konstantinos N., et al. (författare) Staging of Schizophrenia With the Use of PANSS : An International Multi-Center Study 2019 Ingår i: International Journal of Neuropsychopharmacology. - : Oxford University Press. - 1461-1457 .- 1469-5111. ; 22:11, s. 681-697 Tidskriftsartikel (refereegranskat)abstract IntroductionA specific clinically relevant staging model for schizophrenia has not yet been developed. The aim of the current study was to evaluate the factor structure of the PANSS and develop such a staging method.MethodsTwenty-nine centers from 25 countries contributed 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Analysis of covariance, Exploratory Factor Analysis, Discriminant Function Analysis, and inspection of resultant plots were performed.ResultsExploratory Factor Analysis returned 5 factors explaining 59% of the variance (positive, negative, excitement/hostility, depression/anxiety, and neurocognition). The staging model included 4 main stages with substages that were predominantly characterized by a single domain of symptoms (stage 1: positive; stages 2a and 2b: excitement/hostility; stage 3a and 3b: depression/anxiety; stage 4a and 4b: neurocognition). There were no differences between sexes. The Discriminant Function Analysis developed an algorithm that correctly classified >85% of patients.DiscussionThis study elaborates a 5-factor solution and a clinical staging method for patients with schizophrenia. It is the largest study to address these issues among patients who are more likely to remain affiliated with mental health services for prolonged periods of time.
8.	Hammarström, Anne, et al. (författare) Developing a Tool for Increasing the Awareness about Gendered and Intersectional Processes in the Clinical Assessment of Patients : A Study of Pain Rehabilitation 2016 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:4 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: There is a need for tools addressing gender inequality in the everyday clinical work in health care. The aim of our paper was to develop a tool for increasing the awareness of gendered and intersectional processes in clinical assessment of patients, based on a study of pain rehabilitation.METHODS: In the overarching project named "Equal care in rehabilitation" we used multiple methods (both quantitative and qualitative) in five sub studies. With a novel approach we used Grounded Theory in order to synthesize the results from our sub studies, in order to develop the gender equality tool. The gender equality tool described and developed in this article is thus based on results from sub studies about the processes of assessment and selection of patients in pain rehabilitation. Inspired by some questions in earlier tools, we posed open ended questions and inductively searched for findings and concepts relating to gendered and social selection processes in pain rehabilitation, in each of our sub studies. Through this process, the actual gender equality tool was developed as 15 questions about the process of assessing and selecting patients to pain rehabilitation. As a more comprehensive way of understanding the tool, we performed a final step of the GT analyses. Here we synthesized the results of the tool into a comprehensive model with two dimensions in relation to several possible discrimination axes.RESULTS: The process of assessing and selecting patients was visualized as a funnel, a top down process governed by gendered attitudes, rules and structures. We found that the clinicians judged inner and outer characteristics and status of patients in a gendered and intersectional way in the process of clinical decision-making which thus can be regarded as (potentially) biased with regard to gender, socio-economic status, ethnicity and age.IMPLICATIONS: The clinical implications of our tool are that the tool can be included in the systematic routine of clinical assessment of patients for both awareness raising and as a base for avoiding gender bias in clinical decision-making. The tool could also be used in team education for health professionals as an instrument for critical reflection on gender bias.CONCLUSIONS: Thus, tools for clinical assessment can be developed from empirical studies in various clinical settings. However, such a micro-level approach must be understood from a broader societal perspective including gender relations on both the macro- and the meso-level.
9.	Hammarström, Anne, et al. (författare) Low-Educated Women with Chronic Pain Were Less Often Selected to Multidisciplinary Rehabilitation Programs 2014 Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:5 Tidskriftsartikel (refereegranskat)abstract Background: There is a lack of research about a potential education-related bias in assessment of patients with chronic pain. The aim of this study was to analyze whether low-educated men and women with chronic pain were less often selected to multidisciplinary rehabilitation than those with high education. Methods: The population consisted of consecutive patients (n = 595 women, 266 men) referred during a three-year period from mainly primary health care centers for a multidisciplinary team assessment at a pain rehabilitation clinic at a university hospital in Northern Sweden. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation National Pain Register. The outcome variable was being selected by the multidisciplinary team assessment to a multidisciplinary rehabilitation program. The independent variables were: sex, age, born outside Sweden, education, pain severity as well as the hospital, anxiety and depression scale (HADS). Results: Low-educated women were less often selected to multidisciplinary rehabilitation programs than high-educated women (OR 0.55, CI 0.30-0.98), even after control for age, being born outside Sweden, pain intensity and HADS. No significant findings were found when comparing the results between high-and low-educated men. Conclusion: Our findings can be interpreted as possible discrimination against low-educated women with chronic pain in hospital referrals to pain rehabilitation. There is a need for more gender-theoretical research emphasizing the importance of taking several power dimensions into account when analyzing possible bias in health care.
10.	Hill, Jason, et al. (författare) Unprecedented reorganization of holocentric chromosomes provides insights into the enigma of lepidopteran chromosome evolution 2019 Ingår i: Science Advances. - : American Association for the Advancement of Science (AAAS). - 2375-2548. ; 5:6 Tidskriftsartikel (refereegranskat)abstract Chromosome evolution presents an enigma in the mega-diverse Lepidoptera. Most species exhibit constrained chromosome evolution with nearly identical haploid chromosome counts and chromosome-level gene collinearity among species more than 140 million years divergent. However, a few species possess radically inflated chromosomal counts due to extensive fission and fusion events. To address this enigma of constraint in the face of an exceptional ability to change, we investigated an unprecedented reorganization of the standard lepidopteran chromosome structure in the green-veined white butterfly (Pieris napi). We find that gene content in P. napi has been extensively rearranged in large collinear blocks, which until now have been masked by a haploid chromosome number close to the lepidopteran average. We observe that ancient chromosome ends have been maintained and collinear blocks are enriched for functionally related genes suggesting both a mechanism and a possible role for selection in determining the boundaries of these genome-wide rearrangements.
11.	Jäderkvist Fegraeus, Kim, et al. (författare) Lack of significant associations with early career performance suggest no link between the DMRT3 "Gait Keeper" mutation and precocity in Coldblooded trotters 2017 Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 12:5 Tidskriftsartikel (refereegranskat)abstract The Swedish-Norwegian Coldblooded trotter (CBT) is a local breed in Sweden and Norway mainly used for harness racing. Previous studies have shown that a mutation from cytosine (C) to adenine (A) in the doublesex and mab-3 related transcription factor 3 (DMRT3) gene has a major impact on harness racing performance of different breeds. An association of the DMRT3 mutation with early career performance has also been suggested. The aim of the current study was to investigate this proposed association in a randomly selected group of CBTs. 769 CBTs (485 raced, 284 unraced) were genotyped for the DMRT3 mutation. The association with racing performance was investigated for 13 performance traits and three different age intervals: 3 years, 3 to 6 years, and 7 to 10 years of age, using the statistical software R. Each performance trait was analyzed for association with DMRT3 using linear models. The results suggest no association of the DMRT3 mutation with precocity (i.e. performance at 3 years of age). Only two traits (race time and number of disqualifications) were significantly different between the genotypes, with AA horses having the fastest times and CC horses having the highest number of disqualifications at 3 years of age. The frequency of the AA genotype was significantly lower in the raced CBT sample compared with the unraced sample and less than 50% of the AA horses participated in a race. For the age intervals 3 to 6 and 7 to 10 years the AA horses also failed to demonstrate significantly better performance than the other genotypes. Although suggested as the most favorable genotype for racing performance in Standardbreds and Finnhorses across all ages, the AA genotype does not appear to be associated with superior performance, early or late, in the racing career of CBTs.
12.	Law, Philip J., et al. (författare) Association analyses identify 31 new risk loci for colorectal cancer susceptibility 2019 Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 10 Tidskriftsartikel (refereegranskat)abstract Colorectal cancer (CRC) is a leading cause of cancer-related death worldwide, and has a strong heritable basis. We report a genome-wide association analysis of 34,627 CRC cases and 71,379 controls of European ancestry that identifies SNPs at 31 new CRC risk loci. We also identify eight independent risk SNPs at the new and previously reported European CRC loci, and a further nine CRC SNPs at loci previously only identified in Asian populations. We use in situ promoter capture Hi-C (CHi-C), gene expression, and in silico annotation methods to identify likely target genes of CRC SNPs. Whilst these new SNP associations implicate target genes that are enriched for known CRC pathways such as Wnt and BMP, they also highlight novel pathways with no prior links to colorectal tumourigenesis. These findings provide further insight into CRC susceptibility and enhance the prospects of applying genetic risk scores to personalised screening and prevention.
13.	Lehti, Arja, et al. (författare) Walking down 'Via Dolorosa' from primary health care to the specialty pain clinic : patient and professional perceptions of inequity in rehabilitation of chronic pain 2017 Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:1, s. 45-53 Tidskriftsartikel (refereegranskat)abstract OBJECTIVE: To analyse patient and professional perceptions about (in)equity of care and rehabilitation of chronic pain patients from primary health care to assessment at a specialty rehabilitation clinic.SETTING AND METHODS: This qualitative study consists one focus group interview with eight general practitioners who refer patients to pain rehabilitation clinics, 10 individual interviews with patients who were assessed at a pain rehabilitation clinic and seven interviews with professionals participating in multimodal assessment teams at a pain rehabilitation clinic. Interview analysis was conducted by the grounded theory method.RESULTS: The core category Via Dolorosa, the way of suffering and pain, captured how gender and sociocultural context may contribute to advantages and disadvantages during patient journeys from primary health care to a pain rehabilitation clinic. Patients and professionals perceived pain as a low-ranking illness, and women and men used different gendered strategies to legitimise the pain and to be taken seriously. Being 'a proper patient ready to change' and having 'likeness' between patients and professionals were viewed as advantageous in rehabilitation of pain patients. Patients with higher educational levels were perceived as easier to interact with and had better access to health care. Professional thoughts about gender norms influenced the rehabilitation options. The rehabilitation programme was seen by several professionals to be better suited for women than men, which could lead to unequal care.CONCLUSION: From an equity and gender perspective, our study highlights the complexity in rehabilitation of chronic pain patients - both from patient and professional perspectives. Awareness of gendered and the biased preconceptions and norms is crucial when professionals struggle to offer equitable health care and rehabilitation.
14.	Lennernäs Wiklund, Maria, 1956-, et al. (författare) Meals and shift work : food choice, time of day and meal environment - three important dimensions for rest and health 2013 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
15.	Linander, Ida, 1987-, et al. (författare) Ett spektrum av sexuella samtycken : En intervjustudie om samtycke hos sexuellt aktiva vuxna 2020 Rapport (övrigt vetenskapligt/konstnärligt)abstract Studien undersöker hur sexuellt samtycke förstås, praktiseras och upplevs: Samtycke anses ofta vara en typ av avtal för sexuell aktivitet, men definitionen av sexuellt samtycke är komplex. Tidigare forskning har till stor del fokuserat på amerikanska collegestudenter, och det har saknats svenska empiriska studier som undersöker sexuellt samtycke i befolkningen.Syftet med den här studien är därför att undersöka hur sexuellt samtycke förstås, praktiseras och upplevs i sexuella relationer bland vuxna i Sverige idag.Studien är en kvalitativ intervjustudie med 31 sexuellt aktiva personer 23–61 år. Deltagarna rekryterades via annonser i lokaltidningar, breda Facebook-grupper och på stora arbetsplatser. Intervjuerna var semi-strukturerade och berörde sexuell kommunikation, sexuella relationer och erfarenheter av sexuellt samtycke. Intervjumaterialet analyserades med hjälp av tematisk analys.Samtycke kan placeras in på ett spektrum: Analysen av intervjuerna resulterade i ett huvudtema: Ett spektrum av samtycken: kontextuellaoch kontinuerliga sexuella praktiker. Huvudtemat beskriver hur samtycke är mångfacetterat och uttrycks olika beroende av situation,relation och föreställningar om kvinnlig och manlig sexualitet och sexuell praktik. Det beskriver också hur samtycke i sig och hur samtycke kommuniceras är föränderligt och pågående, bådeöver tid och i den sexuella situationen. Huvudtemat beskriver vidare hur deltagarnas förståelse, praktik och upplevelser av samtycke och brist på samtycke kan placeras in på ett spektrummellan fullkomligt samförstånd och avsaknad av samtycke, det vill säga i form av övergrepp och sexuellt våld. Däremellan kan kommunikationen vara bättre eller sämre, och förväntningar på kvinnlig och manlig sexualitet kan spela in i vad som upplevs eller förstås som samtycke. Gråzoner för vad som upplevs som självklart och lustfyllt, eller obekvämt eller tveksamt är en del av samtyckets spektrum. Huvudtemat byggs upp av fem underteman:1. Kommunikation – så tydligt, så svårt belyser deltagarnas syn på tydlig och lyhördkommunikation som en nyckel till ett fungerande sexuellt samtycke och samspel. Samtidigt upplever deltagarna att det är svårt att kommunicera om sex och samtycke, och att de därför kan behöva träna på det och finna forum för att förbättra dessa färdigheter. Vidare beskriver deltagarna att typen av kommunikation skiljer sig åt mellan olika slags sexuella situationer och praktiker. Det som upplevs som tabubelagt kan också försvåra en god kommunikation.2. Sex och samspel i samförstånd belyser hur sexuellt samtycke när det fungerar bra förstås som självklart och ömsesidigt. Det beskriver hur samtycken kan förändras och fungera olika beroende på situation och utifrån individuella och relationella faktorer. Samtycket är någonting pågående som sker här och nu.3. Samtyckets gråzoner beskriver upplevelser där deltagarna varit osäkra på sitt eget eller andras samtycke, och erfarenheter av att bristande lust har omvandlats till samtycke efter hand.4. Avsaknad av samtycke handlar om att samtycke inte uppnås utan på olika sätt överträds, exempelvis i form av sexuellt våld. Temat handlar också om konsekvenserna av att bära med sig dessa erfarenheter. 5. Att navigera och utmana föreställningar och praktiker för sexualitet belyser hur olika föreställningar om och förväntningar på sexuellt beteende utifrån kön påverkar hur deltagarna förstår, kommunicerar och praktiserar sexuellt samtycke. I temat ingår inslag av att utmana förväntningar på romantisk och tvåsam kärlek. Viktiga insikter för arbetet för sexuell hälsa och motsexuellt våld: Kunskapen från studien kan öka förståelsen för hur sexuellt aktiva vuxna kommunicerar, praktiserar och upplever sexuellt samtycke. Detta har både vetenskaplig och samhälleligbetydelse. Insikterna kan bidra till att utveckla det hälsofrämjande arbetet för sexuell hälsa samtutveckla interventionerna i det förebyggande arbetet och de behandlande insatserna vid sexuellatrakasserier och sexuellt våld.
16.	Linander, Ida, 1987-, et al. (författare) Power and subjectivity : Making sense of sexual consent among adults living in Sweden 2021 Ingår i: NORA. - : Routledge. - 0803-8740 .- 1502-394X. ; 29:2, s. 110-123 Tidskriftsartikel (refereegranskat)abstract While sexual consent has been a hot topic during recent years in the Swedish context, there is a lack of empirical studies on the issue. The aims of this study were to analyse how adults in Sweden experience and make sense of sexual (non)consent in sexual encounters, and to contribute to a conceptual discussion of sexual consent, especially in relation to a Foucauldian understanding of power and subjectivity.The analysis is based on 31 interviews with adults living in Sweden. Participants describe consenting to sex due to being exposed to interpersonal forms of power, ranging from violence and clear violations of consent to nagging and being subjected to pressure from others. But they also feel pressure and give consent to sex based on self-regulation and disciplinary forms of power, connected to normative ideals about "the good relationship", monogamy and heterosexuality, men and women, and age. Our Foucauldian analytical lens allowed us to explore and challenge understandings of autonomous, rational subjects who communicate consent on the basis of authentic feelings. It also provided an analytical strategy for analysing and understanding the complex power relations that matter in the negotiation of sexual consent.
17.	Lowden, Arne, et al. (författare) Eating and shift work : effects on habits, metabolism and performance 2010 Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 36:2, s. 150-162 Tidskriftsartikel (refereegranskat)abstract Compared to individuals who work during the day, shift workers are at higher risk of a range of metabolic disorders and diseases (eg, obesity, cardiovascular disease, peptic ulcers, gastrointestinal problems, failure to control blood sugar levels, and metabolic syndrome). At least some of these complaints may be linked to the quality of the diet and irregular timing of eating, however other factors that affect metabolism are likely to play a part, including psychosocial stress, disrupted circadian rhythms, sleep debt, physical inactivity, and insufficient time for rest and revitalization. In this overview, we examine studies on food and nutrition among shift workers [ie, dietary assessment (designs, methods, variables) and the factors that might influence eating habits and metabolic parameters]. The discussion focuses on the quality of existing dietary assessment data, nutritional status parameters (particularly in obesity), the effect of circadian disruptions, and the possible implications for performance at work. We conclude with some dietary guidelines as a basis for managing the nutrition of shift workers.
18.	Mancina, Rosellina Margherita, et al. (författare) The MBOAT7-TMC4 Variant rs641738 Increases Risk of Nonalcoholic Fatty Liver Disease in Individuals of European Descent. 2016 Ingår i: Gastroenterology. - : Elsevier BV. - 1528-0012 .- 0016-5085. ; 150:5, s. 1219-1230 Tidskriftsartikel (refereegranskat)abstract Nonalcoholic fatty liver disease (NAFLD) is a leading cause of liver damage and is characterized by steatosis. Genetic factors increase risk for progressive NAFLD. A genome-wide association study showed that the rs641738 C>T variant in the locus that contains the membrane bound O-acyltransferase domain-containing 7 gene (MBOAT7, also called LPIAT1) and transmembrane channel-like 4 gene (TMC4) increased the risk for cirrhosis in alcohol abusers. We investigated whether the MBOAT7-TMC4 is a susceptibility locus for the development and progression of NAFLD.
19.	Molnar, Maria, et al. (författare) Hyperglycaemia increases S100β after short experimental cardiac arrest 2014 Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 58:1, s. 106-113 Tidskriftsartikel (refereegranskat)abstract BACKGROUND:Hyperglycaemia is associated with aggravated ischaemic brain injury. The main objective of this study was to investigate the effects on cerebral perfusion of 5 min of cardiac arrest during hyperglycaemia and normoglycaemia.METHODS:Twenty triple-breed pigs (weight: 22-29 kg) were randomised and clamped at blood glucose levels of 8.5-10 mM [high (H)] or 4-5.5 mM [normal (N)] and thereafter subjected to alternating current-induced 5 min-cardiac arrest followed by 8 min of cardiopulmonary resuscitation and direct current shock to restore spontaneous circulation.RESULTS:Haemodynamics, laser Doppler measurements and regional venous oxygen saturation (HbO2 ) were monitored, and biochemical markers in blood [S100β, interleukin (IL)-6 and tumour necrosis factor (TNF)] quantified throughout an observation period of 3 h. The haemodynamics and physiological measurements were similar in the two groups. S100β increased over the experiment in the H compared with the N group (P < 0.05). IL-6 and TNF levels increased across the experiment, but no differences were seen between the groups.CONCLUSIONS:The enhanced S100β response is compatible with increased cerebral injury by hyperglycaemic compared with normoglycaemic 5 min of cardiac arrest and resuscitation. The inflammatory cytokines were similar between groups.
20.	Nyberg, Maria, et al. (författare) I tid och otid - arbetsmåltidens betydelse för återhämtning och hälsa 2013 Konferensbidrag (övrigt vetenskapligt/konstnärligt)
21.	Nyberg, Maria, et al. (författare) Impossible meals? : the food and meal situation of flight attendants in Scandinavia – a qualitative interview study 2017 Ingår i: Appetite. - : Elsevier BV. - 0195-6663 .- 1095-8304. ; 113:1, s. 162-171 Tidskriftsartikel (refereegranskat)abstract The working conditions of flight attendants (FAs) often involve extended and irregular working hours, short rest periods, difficulties in planning for breaks and high demands of service provision. Moreover, work schedules including early check-in, shifts during circadian low and time-zone transitions imply constant exposure to alterations in circadian systems and related health risks. The aim of this explorative study was to investigate how the organisation of work, time and place influence the food and meal situation of FAs when at work, focusing on patterns, form and social context of meals. The research questions posed were how food and meals at work were characterised and perceived among the FAs, and what strategies were adopted to manage the food and meal situation. Qualitative, semi-structured interviews were conducted with fourteen FAs working in Scandinavia. The results indicated that the organisation of work, time and place have a major influence on the meal situation at work, and how food and meals are perceived and managed by FAs. The work was defined as fragmented and inconsistent regarding time and place resulting in scattered meals and a more snack-based form of eating. The meal situation was characterised by irregularity as well as unpredictability. Eating took place when food was available and when there was enough time to eat, rather than being guided by hunger or social context. Various strategies such as eating in prevention, using emergency food, avoiding certain food and drinks or eating little or nothing at all were used to manage the unpredictability of the meal situation as well as the gap between organisational and individual times. The findings demonstrated the individual responsibility to solve the meal at work, e.g. to solve organisational times.
22.	Nyberg, Maria, et al. (författare) Impossible meals? : the food and meal situation of flight attendants in Scandinavia: a qualitative interview study 2017 Ingår i: Appetite. - 0195-6663 .- 1095-8304. ; 113, s. 162-171 Tidskriftsartikel (refereegranskat)abstract The working conditions of flight attendants (FAs) often involve extended and irregular working hours, short rest periods, difficulties in planning for breaks and high demands of service provision. Moreover, work schedules including early check-in, shifts during circadian low and time-zone transitions imply constant exposure to alterations in circadian systems and related health risks. The aim of this explorative study was to investigate how the organisation of work, time and place influence the food and meal situation of FAs when at work, focusing on patterns, form and social context of meals. The research questions posed were how food and meals at work were characterised and perceived among the FAs, and what strategies were adopted to manage the food and meal situation. Qualitative, semi-structured interviews were conducted with fourteen FAs working in Scandinavia. The results indicated that the organisation of work, time and place have a major influence on the meal situation at work, and how food and meals are perceived and managed by FAs. The work was defined as fragmented and inconsistent regarding time and place resulting in scattered meals and a more snack-based form of eating. The meal situation was characterised by irregularity as well as unpredictability. Eating took place when food was available and when there was enough time to eat, rather than being guided by hunger or social context. Various strategies such as eating in prevention, using emergency food, avoiding certain food and drinks or eating little or nothing at all were used to manage the unpredictability of the meal situation as well as the gap between organisational and individual times. The findings demonstrated the individual responsibility to solve the meal at work, e.g. to solve organisational times.
23.	Pirazzi, Carlo, et al. (författare) PNPLA3 has retinyl-palmitate lipase activity in human hepatic stellate cells 2014 Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 23:15, s. 4077-4085 Tidskriftsartikel (refereegranskat)abstract Retinoids are micronutrients that are stored as retinyl esters in the retina and hepatic stellate cells (HSCs). HSCs are key players in fibrogenesis in chronic liver diseases. The enzyme responsible for hydrolysis and release of retinyl esters from HSCs is unknown and the relationship between retinoid metabolism and liver disease remains unclear. We hypothesize that the patatin-like phospholipase domain-containing 3 (PNPLA3) protein is involved in retinol metabolism in HSCs. We tested our hypothesis both in primary human HSCs and in a human cohort of subjects with non-alcoholic fatty liver disease (N = 146). Here we show that PNPLA3 is highly expressed in human HSCs. Its expression is regulated by retinol availability and insulin, and increased PNPLA3 expression results in reduced lipid droplet content. PNPLA3 promotes extracellular release of retinol from HSCs in response to insulin. We also show that purified wild-type PNPLA3 hydrolyzes retinyl palmitate into retinol and palmitic acid. Conversely, this enzymatic activity is markedly reduced with purified PNPLA3 148M, a common mutation robustly associated with liver fibrosis and hepatocellular carcinoma development. We also find the PNPLA3 I148M genotype to be an independent (P = 0.009 in a multivariate analysis) determinant of circulating retinol-binding protein 4, a reliable proxy for retinol levels in humans. This study identifies PNPLA3 as a lipase responsible for retinyl-palmitate hydrolysis in HSCs in humans. Importantly, this indicates a potential novel link between HSCs, retinoid metabolism and PNPLA3 in determining the susceptibility to chronic liver disease.
24.	Sidenvall, Birgitta, et al. (författare) Elderly patients' meal patterns : A retrospective study 1996 Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 9:4, s. 263-272 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty-five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.
25.	Strömbäck, Maria, 1965-, et al. (författare) Complex symptomatology among young women who present with stress-related problems 2015 Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:2, s. 234-247 Tidskriftsartikel (refereegranskat)abstract Introduction: In Scandinavia and globally, mental health and stress-related problems among adolescent girls and young women are public health concerns that need attention. The aim of this study was to investigate mental health and somatic symptoms with a special focus on internalized problems, self-image, and body-mind aspects of body perception in a group of adolescent girls and young women presenting with stress-related problems at a youth-friendly Swedish health center, and to compare them with normative and clinical reference groups.Methods: The participants were 47 adolescent girls and young women, aged 17 to 25 years. The Adult Self Report (ASR), Social Analysis of Social Behavior (SASB) and Body Perception Questionnaire (BPQ) were used to measure multiple symptom areas.Results: Compared to reference groups, adolescent girls and young women report complex symptomatology with high levels of internalized problems such as anxiousness, depression, and somatic complaints. This manifested in attention problems, negative self-image, and perceived bodily discomfort and distrust.ConclusionAdolescent girls and young women emerging into adulthood present complex symptomatology of stress-related problems. This study gathered valuable information about their symptoms when they were seeking help. These young women showed higher symptom frequency than normative groups, and similar or higher symptom frequency than other clinical groups. Our findings of internalised and cognitive problems, including impaired self-image and body perceptions, point to the need for preventive strategies and tailored multidisciplinary interventions involving body-based methods to meet this complexity. Using tenets of stress theory, the complex symptomatology may be understood as logical responses to overwhelming stimuli and demands that exceed their ability to cope and disturb their ‘equilibrium’. However, the complex gendered interplays between various external/internal stressors and a broad range of stress responses and health outcomes need further study in a long-term perspective.
26.	Strömbäck, Maria, et al. (författare) Creating space for youth in physiotherapy : related to gender and embodied empowerment 2017 Ingår i: Physiotherapy in mental health and psychiatry. - : Elsevier. - 9780702072680 ; , s. 290-298 Bokkapitel (refereegranskat)
27.	Strömbäck, Maria, 1965-, et al. (författare) Gender-sensitive and youth-friendly physiotherapy : Steps toward a stress management intervention for girls and young women 2016 Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 32:1, s. 20-33 Tidskriftsartikel (refereegranskat)abstract This article describes and evaluates initial steps of a gender-sensitive, youth-friendly group intervention model designed for teenage girls and young women who experience stress-related or psychosomatic problems. Fifty-four young women (16–25 years of age) participated in a gendersensitive physiotherapy stress management course at a youth health center. Inclusion criteria were self-defined stress-related problems and a wish to participate in the group intervention. Measurements of aspects of body perception, self-image, multiple somatic problems, and mental health symptom areas were assessed both before and after intervention with the Body Perception Questionnaire ad modum Schiöler, social analysis of social behavior, and Adult Self-Report scale. Significant positive changes were found in aspects of body perception, self-image, and mental health and somatic symptoms. The changes were most significant in lower internalization of anxiety and depression symptoms. Symptoms such as headaches and sleeping problems decreased. Participants were more satisfied with their bodies and more able to listen to body signals. Among cognitive issues, significant change occurred in thought problems, but not in attention problems. The intervention model needs further evaluation in controlled trials, but is promising and should be developed further in other physiotherapy settings and subgroups of young people.
28.	Strömbäck, Maria, et al. (författare) 'Girls need to strengthen each other as a group' : experiences from a gender-sensitive stress management intervention by youth-friendly Swedish health services: a qualitative study 2013 Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 13:907, s. 1-17 Tidskriftsartikel (refereegranskat)abstract Mental health problems among young people, and girls and young women in particular, are a well-known health problem. Such gendered mental health patterns are also seen in conjunction with stress-related problems, such as anxiety and depression and psychosomatic complaints. Thus, intervention models tailored to the health care situation experienced by young women within a gendered and sociocultural context are needed. This qualitative study aims to illuminate young women's experiences of participating in a body-based, gender-sensitive stress management group intervention by youth-friendly health services in northern Sweden.A physiotherapeutic body-based, health-promoting, gender-sensitive stress management intervention was created by youth-friendly Swedish health services. The stress management courses (n = 7) consisted of eight sessions, each lasting about two hours, and were led by the physiotherapist at the youth centre. The content in the intervention had a gender-sensitive approach, combining reflective discussions; short general lectures on, for example, stress and pressures related to body ideals; and physiotherapeutic methods, including body awareness and relaxation. Follow-up interviews were carried out with 32 young women (17--25 years of age) after they had completed the intervention. The data were analysed with qualitative content analysis.The overall results of our interview analysis suggest that the stress management course we evaluated facilitated 'a space for gendered and embodied empowerment in a hectic life', implying that it both contributed to a sense of individual growth and allowed participants to unburden themselves of stress problems within a trustful and supportive context. Participants' narrated experiences of 'finding a social oasis to challenge gendered expectations', 'being bodily empowered', and 'altering gendered positions and stance to life' point to empowering processes of change that allowed them to cope with distress, despite sometimes continuously stressful life situations. This intervention also decreased stress-related symptoms such as anxiousness, restlessness, muscle tension, aches and pains, fatigue, and impaired sleep.The participants' experiences of the intervention as a safe and exploratory space for gendered collective understanding and embodied empowerment further indicates the need to develop gender-sensitive interventions to reduce individualisation of health problems and instead encourage spaces for collective support, action, and change.
29.	Strömbäck, Maria, et al. (författare) ”Jag skakar” tjejers uttryck för psykisk ohälsa 2015 Ingår i: När livet känns fel. - Stockholm : Myndigheten för ungdoms- och civilsamhällesfrågor. ; , s. 174-196 Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract Hur tänker unga kvinnor själva om sin psykiska hälsa och hur tar den sig uttryck? Artikeln fördjupar förståelsen för hur tonårstjejer och unga kvinnor uttrycker psykisk ohälsa utifrån egna berättelser. Ofta använder de bildspråk, liknelser och metaforer för att förklara och begripliggöra hur de mår och hur de har det i livet. Avslutningsvis diskuterar vi de unga kvinnornas erfarenheter utifrån genus- och maktperspektiv.
30.	Strömbäck, Maria, 1965- (författare) Skapa rum. Ung femininitet, kroppslighet och psykisk ohälsa : genusmedveten hälsofrämjande intervention. 2014 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Mental health problems among young people, girls and young women in particular, are a serious public health problem. Gendered patterns of mental illness are seen in conjunction with stress-related problems such as anxiety, depression, and psychosomatic complaints. Intervention models tailored to the health care situation are therefore in need of development and evaluation. The overall aim of this thesis is to develop knowledge and understanding for young women’s mental health, stress-related, and bodily problems from a psychosomatic and gender theory perspective, and to evaluate a gender sensitive physiotherapeutic intervention model consisting of a stress management course for young women with stress-related problems.The thesis consists of four studies. The overall research design combines qualitative and quantitative methods in which questionnaires and interviews were used to explore participant experiences and symptoms linked to perceived stress before and after the intervention. Data consisted of a cumulative sample of 65 young women, 16 to 25 years of age, who attended the youth-friendly health center because of stress-related problems. In paper I, multiple symptom areas of mental health and somatic problems, self-image and aspects of body perception were measured before the course. Participants were 47 of the young women. The results were compared with published normative and clinical reference groups. In paper II, the young women’s experiences of living stressful femininity were analysed with a qualitative content analysis using gender theoretical and phenomenological perspectives as an interpretative frame. The study was based on interviews with 25 of the women. In paper III, follow-up interviews were done with 32 of the women after completion of the course. Data was using qualitative content analysis to illuminate experiences of participating in the course. In paper IV, the course was evaluated by measuring changes in multiple symptom areas using the Adult Self Report (ASR), Social Analysis of Social Behaviour (SASB), and Body Perception Questionnaire (BPQ). Participants were 54 of the women who completed measurements finishing the course.Young women present complex symptomatology of stress-related problems. The total burden of symptoms plus the narrated experiences highlight how renegotiations of gender constructions and handling of normative and stressful femininity constrain access to bodily resources. After the stress management course, their measured and narrated experiences show positive changes and release of mental health and stress problems, including a more positive self-image and sense of enhanced confidence in their bodies. Experiences of the course as a safe and explorative space for gendered collective understanding and embodied empowerment indicate the need to develop gender-sensitive interventions. The thesis contributes to youth and gender theoretical perspectives with integration of psychosomatic and psychiatric physiotherapy. A broader awareness of how gender constructions and sociocultural aspects are significant in the understanding of psychosomatic expressions of mental ill health and young femininity is valuable in development of theory and interventions in physiotherapy, as well as into other fields.
31.	Strömbäck, Maria, 1965-, et al. (författare) The corporeality of living stressful femininity : a gender–theoretical analysis of young Swedish women’s stress experiences 2014 Ingår i: Young - Nordic Journal of Youth Research. - : Sage Publications. - 1103-3088 .- 1741-3222. ; 22:3, s. 271-289 Tidskriftsartikel (refereegranskat)abstract This article analyzes young Swedish women’s experiences of living stressful femininity from an existentialist gender theoretical perspective. The study is based on qualitative interviews with 25 women, aged 17–25, who had registered for a stress management course at a youth health centre. Our analysis suggests that their experiences of stress can be related to the renegotiation of gender constructions that have occurred within the Swedish society. The young female subject can be viewed as living through a historic break between a historical position as a subordinated ‘Other’ while simultaneously having to navigate within contemporary discourses of successful femininity. The doing of normative femininity resulted in an exhausting and draining self-evaluating circle. The experiences of having a painful and collapsing body led to a sense of loss of access to and confidence in their bodies. This should be understood as a loss both of subjectivity and connectedness with the corporeality of existence.
32.	Stålnacke, Britt-Marie, et al. (författare) Is there a gender bias in recommendations for further rehabilitation in primary care of patients with chronic pain after an interdisciplinary team assessment? 2015 Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 47:4, s. 365-371 Tidskriftsartikel (refereegranskat)abstract Objective: To examine potential gender bias in recommendations of further examination and rehabilitation in primary care for patients with chronic musculoskeletal pain after an interdisciplinary team assessment. Methods: The population consisted of consecutive patients (n=589 women, 262 men) referred during a 3-year period from primary healthcare for assessment by interdisciplinary teams at a pain specialist rehabilitation clinic. Patient data were collected from the Swedish Quality Registry for Pain Rehabilitation. The outcome was defined as the examination or rehabilitation that was specified in the patient's record. Results: Men had a significantly higher likelihood than women of being recommended physiotherapy and radiological examination, and the gender difference was not explained by confounding variables and covariates (age, marital status, ethnicity, education, working status, pain severity, pain interference, pain sites, anxiety and depression). There was no significant gender difference in recommendations to treatment by specialist physician, occupational therapist, psychologist or social worker. Conclusion: Our findings indicate that the interdisciplinary teams in specialist healthcare may discriminate against women with chronic pain when physiotherapy and radiological investigation are recommended. The team's choice of recommendations might be influenced by gendered attitudes, but this field of research needs to be studied further.
33.	Wallin, Gisela van der Ster, et al. (författare) Comparisons between recalled and observed dietary intake in anorectics and bulimics : A validation study 1995 Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 8:3, s. 201-208 Tidskriftsartikel (refereegranskat)abstract A validation study was performed in order to compare the observed versus the self-reported food consumption in anorectics (n = 9), anorectic bulimics (n = 6) and bulimics (n = 10). The observed meals (breakfast, lunch and/or dinner) were served in a hospital setting. Foods on plates were unobtrusively weighed before and after serving to each subject, and the foods consumed were compared with data from a 24-hour recall the subsequent day. Data analyses via a nutrient database comprised amounts of food items from seven food groups as well as energy, macro nutrients, vitamin C, calcium and iron. Analyses of recalled intakes showed consistently high correlations with observed intakes, suggesting that the 24-hour recall gives valid results, and could thus be suitable for this category of patients. This notion contrasts with previous statements, although no validation studies have been undertaken in order to support this view
34.	Wiklund, Emelie, 1992-, et al. (författare) "A constant battle against sedentary lifestyle and screen time" : Swedish school nurses' views on school children's physical activity and its promotion - a grounded theory study. 2024 Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media S.A.. - 2624-9367. ; 6 Tidskriftsartikel (refereegranskat)abstract School nurses are in a key position to promote children's physical activity. They engage all children in health dialogues and use different approaches to inform children about physical activity and motivate them to change their physical activity level. In a school context, it is important to explore and problematize school nurses' views of children's physical activity and the influence of these views on their professional practice in the school health service. Identifying and problematizing school nurses' views of physical activity would enable them to create improved guidelines and equivalent ways of working in the future. Therefore, this study aims to discursively explore Swedish school nurses' views on school children's physical activity and its promotion and elucidate them through a discursive framework based on sensitizing concepts. This study uses a qualitative research design with a constructivist grounded theory approach. Semi-structured interviews were conducted with 24 school nurses. The analysis resulted in a core category describing how school nurses use intertwined views to lead children from sedentarity to physical activity. Furthermore, the school nurses' practices were identified in three categories: fostering everyday movement as a tool for health, battling children's sedentarity under difficult conditions, and promoting everyday movement and compensating for unequal access. The results indicate that school nurses lack common and clear guidelines for their mission to promote physical activity to children, which may lead to inequality in access to physical activity for children and young people.
35.	Wiklund, Emelie, 1992-, et al. (författare) Facilitators and barriers in interprofessional collaboration around physical activity on prescription-a focus group study in a Swedish school setting. 2024 Ingår i: Frontiers in Sports and Active Living. - : Frontiers Media S.A.. - 2624-9367. ; 6 Tidskriftsartikel (refereegranskat)abstract In Swedish school health services, local initiatives have been taken to use physical activity on prescription (PAP) to encourage physically inactive children to become more active. Previous research shows that interprofessional collaboration plays a crucial role in promoting physical activity in children, as well as in promoting health in schools. However, there is a lack of knowledge about PAP for children in the school setting, including how medical and educational staff can work together to encourage children who have been recommended PAP. Therefore, this study aims to explore the perceived facilitators and barriers concerning interprofessional collaboration regarding physical activity on prescription in the school setting, as viewed from the professionals' perspectives. Semi-structured interviews were conducted with 21 professionals who work with the method in school settings. The data were analyzed using Reflexive Thematic Analysis. The results reveal both barriers and facilitators for interprofessional collaboration on PAP in the school setting, as perceived by professionals. Organizational and structural obstacles within school institutions hinder collaboration, while a shared commitment to PAP, characterized by consensus-building, acts as a facilitating factor. PAP for children in a school setting is still an unexplored area and further research is required.
36.	Wiklund, Emelie, 1992-, et al. (författare) Physical activity on prescription “not a quick fix” : school nurses’ experiences of promoting and tailoring physical activity to children in Swedish compulsory school 2023 Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. Tidskriftsartikel (refereegranskat)abstract This study aimed to explore school nurses’ experience of using physical activity on prescription with children in Swedish compulsory school. Semistructured interviews were conducted with 24 school nurses who had the educational qualification to prescribe physical activity. The analysis resulted in one overarching theme, “A delicate process of tailoring physical activity on prescription to a child's social context,” and two categories: “Promoting joyful physical activity through individualization and support” and “Dealing with dilemmas and challenges,” with related subcategories. The results demonstrate the importance of tailoring prescribed physical activity to each individual child, their living conditions, and the school context. In addition, they highlight the nurses’ working conditions and collaborations as important prerequisites when initiating physical activity on prescription. In conclusion, the results suggest that school nurses perceive physical activity on prescription as a useful tool in the school context, but it needs to be tailored to each individual child.
37.	Wiklund, Emelie, et al. (författare) 'Strong is the new skinny' : navigating fitness hype among teenagers in northern Sweden 2019 Ingår i: Sport, Education and Society. - Abingdon : Routledge. - 1357-3322 .- 1470-1243. ; 24:5, s. 441-454 Tidskriftsartikel (refereegranskat)abstract An increased interest in health, diet, and physical activity exist among young people, in this study termed 'fitness hype'. Viewing the body and health as commodities can be understood as part of a healthism discourse. In this study, we explored how Swedish high school students perceive and negotiate the trend regarding exercise, diet and body ideals.Semi-structured interviews were conducted with ten high school students, aged 16 to 18 years, from various educational programs and with varying levels of physical activity. Using qualitative content analysis, we developd one overarching theme navigating life satisfaction in the face of an 'unhealthy fitness hype'. Four additional, interrelated categories showed how the young people negotiated this developing trend through: 1) the quest for social recognition and value, 2) social media sets the standards, 3) the paradox of strong and skinny as the new standard, and 4) the need for new safety nets. Our results highlight the young people's perceptions of an excessive and influential focus on health and exercise in contemporary society. They described a fitness hype as exorbitant and unhealthy ideals of body and exercise, and understood this as problematic. Social media was seen as contributing to this hype as a powerful arena for 'the quest for social recognition and value'. While not all the young people felt negatively affected by the fitness hype, they perceived its influence on their lives. Further, body and fitness ideals were gendered. Teenage girls faced the paradox of shaping themselves as 'strong and skinny'. Social ties were recognized as an important safety net, particularly classmates, sports mates, and coaches. Knowledge of these problems from the perspective of young people is crucially needed among health professionals and educators. Further research should explore additional support strategies, and young people's experiences of fitness hype among additional youth groups.
38.	Wiklund, Maria, et al. (författare) Access to rehabilitation : patient perceptions of inequalities in access to specialty pain rehabilitation from a gender and intersectional perspective 2016 Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 9 Tidskriftsartikel (refereegranskat)abstract Background: Long-term musculoskeletal pain is common, particularly among women. Pain conditions are a concern in primary health care, and people with severe and complex pain are referred to specialty health care. There is gender bias in access, counselling, assessment, and treatment of long-term pain.Objective: This study explores patient accounts and perceptions about important (social) factors for accessing specialised pain rehabilitation from gender and intersectional equality perspectives. We aimed to identify potential biases and inequalities in accessing rehabilitation resources at a specialised rehabilitation clinic.Design: Individual semi-structured interviews were conducted with 10 adults after an assessment or completion of a specialised rehabilitation programme in northern Sweden. Qualitative content analysis was used to explore patients’ perceptions of important factors for accessing rehabilitation.Results: One main theme was formulated as Access to rehab – not a given. Three categories of perceived inequality were demonstrated: power of gender, power of social status, and power of diagnosis. Participants perceived rehabilitation as a resource that is not equally available, but dependent on factors such as gender, socio-economic status, ability to work, ethnicity, or age, and more subtle aspects of social status and habitus (e.g. appearance, fitness, and weight). The character of diagnosis received (medical versus psychiatric or social) was also noted.Conclusions: It is crucial that professionals are aware of how potential inequalities related to gender, social status, and diagnosis, and their intersections, can be created, perceived, and have influence on the processes of assessment and treatment. Reduction of social determinants of health and biases remain important within global, national, and local contexts.
39.	Wiklund, Maria, et al. (författare) Challenging individualized discourses on girls’ stress 2011 Konferensbidrag (refereegranskat)
40.	Wiklund, Maria, 1962-, et al. (författare) Dissonanser och möjligheter : i ljuset av genus, normativitet och samhällets individualisering 2015 Ingår i: När livet känns fel. - Stockholm : mucf.se. ; , s. 153-173 Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract I denna fördjupande artikel riktar vi blickarna mot ungas psykiska ohälsa – dissonanser och möjligheter – i förhållande till genuskonstruktioner, normativitet och inflytelserika samhällstrender som individualisering.
41.	Wiklund, Maria, et al. (författare) En ribba att nå : Unga kvinnors förkroppsligade stress i en neoliberal och könad kontext 2013 Ingår i: Tidskrift för Genusvetenskap. - Linköping : Tema Genus, Linköpings universitet. - 1654-5443 .- 2001-1377. ; :2-3, s. 57-85 Tidskriftsartikel (refereegranskat)abstract I föreliggande artikel är vårt syfte att synliggöra och problematisera tonårsflickors och unga kvinnors upplevda och förkroppsligade stress och psykiska ohälsa i förhållande till en könad samhällelig kontext – vilket vi menar har relevans för såväl folkhälsovetenskaplig forskning som för genusvetenskaplig flickforskning. Genom sammanförandet av historiska, sociokulturella, politiska och hälsorelaterade infallsvinklar från olika forskningsfält belyser vi komplexiteten och motstridigheterna i fenomenet/problemet ”unga tjejers stress” med utgångspunkt i vår empiriskt baserade forskning om unga kvinnor, kroppslighet och psykisk ohälsa. Några av våra frågeställningar lyder: Vad och hur berättar unga kvinnor själva om sin upplevda stress och livssituation, och vilka centrala teman kan vi skönja i deras berättelser? Hur kan unga kvinnors stress och psykiska ohälsa kontextualiseras, förstås och begripliggöras utifrån historiska, politiska, sociokulturella och genusrelaterade perspektiv? Hur förkroppsligas den sociala kontexten i unga kvinnors berättade upplevelser och uttryck av stress?
42.	Wiklund, Maria, 1962-, et al. (författare) Från genusblind till genusmedveten : Teoridriven interventionsutveckling i ungdomsvänlig miljö 2015 Ingår i: Fysioterapi. - Stockholm. - 1653-5804. ; :03, s. 24-30 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Ungas psykiska och psykosomatiska hälsa är ett högaktuellt område där fysioterapeuter kan bidra med kunskap om det komplexa samspelet mellan kropp och psyke – i den här artikeln tolkad i en samhällskontext genomsyrad av genus. Resultaten och erfarenheterna kommer från ett forskningsprojekt där vi utvecklat och utvärderat stresshanteringskurser för tjejer vid en ungdomshälsomottagning i Umeå, Ungdomshälsan. Ungdomshälsan är specifikt inrättad för unga med psykosociala och psykiska problem. Under tiden för forskningsprojektet upptäckte man på Ungdomshälsan nyttan av fysioterapeutisk kompetens. I denna artikel ger vi några exempel från den genusmedvetna teori- och metodutveckling som vi själva bedriver med fokus på ungas hälsa, kroppslighet och rörelsefrihet ur olika sociokulturella och genusteoretiska perspektiv. Inför framtiden ser vi en stor potential i genus- och kontextmedveten metod och teori inom olika grenar av fysioterapi.
43.	Wiklund, Maria, et al. (författare) Stress hos unga - samband med ångest, hälsobesvär och genus 2013 Ingår i: BestPractice - Psykiatri/Neurologi. Yrkesdialog mellan specialister. - Ballerup, Danmark. ; 4:14, s. 7-11 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
44.	Wiklund, Maria, 1962-, et al. (författare) Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender : a cross-sectional school study in Northern Sweden 2012 Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:993 Tidskriftsartikel (refereegranskat)abstract Purpose: Adolescent subjective health has become a public health concern in Sweden and worldwide. The purpose of this study is to investigate perceived stress and subjective health complaints among older adolescents.Methods: Data were derived from a school-based survey with a sample consisting of 16–18 year olds (n=1027), boys and girls, in high school grades 1 and 2, from different educational programs in three public high schools within a university municipality in northern Sweden. Perceived stress, self-rated health, subjective health complaints, anxiety, and depression, were measured with a questionnaire including a set of instruments.Results: A large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference; girls reported two to three-fold higher proportions of subjective health complaints such as headache, tiredness and sleeping difficulties, musculoskeletal pain, as well as sadness and anxiety. Pressure and demands correlated strongly with psychosomatic symptoms (r=0.71) and anxiety (r=0.71).Conclusions: The results indicate that subjective health complaints are prevalent during adolescence, especially in girls, and furthermore that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in adolescent health needs to be further explored.
45.	Wissing, Ulla, 1945-, et al. (författare) Meal patterns and meal quality in patients with leg ulcers 2000 Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 13:1, s. 3-12 Tidskriftsartikel (refereegranskat)abstract Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers.Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients.Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.
46.	Wissing, Ulla, et al. (författare) Monitoring of dietary quality in outpatients by qualitative meal classification method 1998 Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 11:2, s. 125-133 Tidskriftsartikel (refereegranskat)abstract Background: The aim of this study was to evaluate whether qualitative meal-classification used as a dietary evaluation tool reflects eating frequency and key nutrients in the diet, and whether it could be used to monitor the dietary quality in elderly outpatients. The qualitative meal-classification tool used was based on eight food categories combined into four types of meals: Complete, Incomplete, Less Balanced and Vegetarian Meals, and three types of snacks: High-, Mixed- and Low-Quality Snacks.Methods: Dietary intake was assessed during 7 consecutive days by use of an estimated food record in nine elderly women with leg ulcers. Mean 7-day dietary intakes of energy, macronutrients, beta-carotene, retinol, vitamin E, ascorbic acid, calcium, iron, zinc and dietary fibre were calculated. Each eating event was classified in accordance with the food-based classification method. The frequency of the four types of meals and three types of snacks, their energy content and nutrients, and their contribution to total intake were subsequently analysed.Results: Meals were associated with a higher energy, vitamin and mineral content than were snacks. Complete Meals were the major source for beta-carotene and ascorbic acid. Intakes from Low-Quality Snacks were relatively high in energy, fat and sucrose.Conclusion: The qualitative meal-classification tool was found to be simple to use and useful for reflecting meal order and the nutritional roles of different types of meals and snacks in the diet. This method is recommended for dietary monitoring.
47.	Wissing, Ulla, et al. (författare) Nutritional intake and physical activity in leg ulcer patients 1997 Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 25:3, s. 571-578 Tidskriftsartikel (refereegranskat)abstract The aim of the study was to describe the nutritional intake, meal patterns, physical activity and need for help in nine women living in their own homes and being treated for venous leg ulcers. Food habits were identified by use of interviews and food diaries completed by the women during a period of seven days. The intake of energy and nutrients from 304 eating events during seven days was calculated and meal patterns were evaluated using a qualitative system for meal classification. Physical activity and the degree of need were identified with the help of interviews. The intakes of energy and key nutrients for wound healing, such as protein, vitamin C and zinc, were not optimal according to the Swedish nutrition recommendations, although food habits were well organized. Most of the women had hardly any physical activities and the need of help and support varied, from daily visits to visits every second week.
48.	Witjes, J. Alfred, et al. (författare) EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer – An International Collaborative Multistakeholder Effort : Under the Auspices of the EAU-ESMO Guidelines Committees 2020 Ingår i: European Urology. - : Elsevier. - 0302-2838 .- 1873-7560. ; 77:2, s. 223-250 Tidskriftsartikel (refereegranskat)abstract BACKGROUND: Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial.OBJECTIVE: To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management.DESIGN: A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference.SETTING: Online Delphi survey and consensus conference.PARTICIPANTS: The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Statements were ranked by experts according to their level of agreement: 1-3 (disagree), 4-6 (equivocal), and 7-9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus).RESULTS AND LIMITATIONS: Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease.CONCLUSIONS: These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach.PATIENT SUMMARY: This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available.
49.	Åhlander, Anna, et al. (författare) Living (dys)regulated and alienated young masculinity : young men's embodied experiences of mental disorders and suicidality 2023 Ingår i: Counselling and Psychotherapy Research. - : John Wiley & Sons. - 1473-3145 .- 1746-1405. ; 23:4, s. 893-905 Tidskriftsartikel (refereegranskat)abstract Introduction: Mental disorders, such as depression and anxiety with interlinked suicidality, are the leading cause of health-related disability among young men. Knowledge of the interaction between emotional, bodily, social and gendered mental health processes in young men is limited and therefore needed.Aim: This study aimed to explore young men's lived embodied experiences of mental disorders and suicidality, and to conceptualise these by integrating affective–emotional, physiological, social and gendered processes.Methods: Semistructured individual interviews were conducted with 13 young men who had sought professional help for mental disorders and suicidality. Grounded theory (GT) was used with a social constructivist perspective.Results: The results comprise one core category - Living (dys)regulated and alienated young masculinity - with related categories “battling with the emotional body,” “suffering in social silence” and “balancing embodied darkness and distress.” The GT illustrates how young men navigate and manage their embodied and emotional suffering in a context of “regulative” masculine and social norms alongside insufficient social support.Conclusion: Our results suggest that young men's lived embodied experiences of mental disorders and suicidality can be understood as a dynamic process of internal and external “(dys)regulation and alienation.” The generated GT provides a broad tentative explanation model, contributing to theory development, and serves as a basis for gender-sensitive interventions - in both psychotherapy and physiotherapy - integrating body, mind and the social context.
50.	Abbaspour, Sara, 1984- (författare) Proposing Combined Approaches to Remove ECG Artifacts from Surface EMG Signals 2015 Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract Electromyography (EMG) is a tool routinely used for a variety of applications in a very large breadth of disciplines. However, this signal is inevitably contaminated by various artifacts originated from different sources. Electrical activity of heart muscles, electrocardiogram (ECG), is one of sources which affects the EMG signals due to the proximity of the collection sites to the heart and makes its analysis non-reliable. Different methods have been proposed to remove ECG artifacts from surface EMG signals; however, in spite of numerous attempts to eliminate or reduce this artifact, the problem of accurate and effective de-noising of EMG still remains a challenge. In this study common methods such as high pass filter (HPF), gating method, spike clipping, hybrid technique, template subtraction, independent component analysis (ICA), wavelet transform, wavelet-ICA, artificial neural network (ANN), and adaptive noise canceller (ANC) and adaptive neuro-fuzzy inference system (ANFIS) are used to remove ECG artifacts from surface EMG signals and their accuracy and effectiveness is investigated. HPF, gating method and spike clipping are fast; however they remove useful information from EMG signals. Hybrid technique and ANC are time consuming. Template subtraction requires predetermined QRS pattern. Using wavelet transform some artifacts remain in the original signal and part of the desired signal is removed. ICA requires multi-channel signals. Wavelet-ICA approach does not require multi-channel signals; however, it is user-dependent. ANN and ANFIS have good performance, but it is possible to improve their results by combining them with other techniques. For some applications of EMG signals such as rehabilitation, motion control and motion prediction, the quality of EMG signals is very important. Furthermore, the artifact removal methods need to be online and automatic. Hence, efficient methods such as ANN-wavelet, adaptive subtraction and automated wavelet-ICA are proposed to effectively eliminate ECG artifacts from surface EMG signals. To compare the results of the investigated methods and the proposed methods in this study, clean EMG signals from biceps and deltoid muscles and ECG artifacts from pectoralis major muscle are recorded from five healthy subjects to create 10 channels of contaminated EMG signals by adding the recorded ECG artifacts to the clean EMG signals. The artifact removal methods are also applied to the 10 channels of real contaminated EMG signals from pectoralis major muscle of the left side. Evaluation criteria such as signal to noise ratio, relative error, correlation coefficient, elapsed time and power spectrum density are used to evaluate the performance of the proposed methods. It is found that the performance of the proposed ANN-wavelet method is superior to the other methods with a signal to noise ratio, relative error and correlation coefficient of 15.53, 0.01 and 0.98 respectively.

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