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1.	Liu, Yuanhua, 1971, et al. (author) Considering the importance of user profiles in interface design 2009 In: User Interfaces. ; , s. 23- Book chapter (other academic/artistic)abstract User profile is a popular term widely employed during product design processes by industrial companies. Such a profile is normally intended to represent real users of a product. The ultimate purpose of a user profile is actually to help designers to recognize or learn about the real user by presenting them with a description of a real user’s attributes, for instance; the user’s gender, age, educational level, attitude, technical needs and skill level. The aim of this chapter is to provide information on the current knowledge and research about user profile issues, as well as to emphasize the importance of considering these issues in interface design. In this chapter, we mainly focus on how users’ difference in expertise affects their performance or activity in various interaction contexts. Considering the complex interaction situations in practice, novice and expert users’ interactions with medical user interfaces of different technical complexity will be analyzed as examples: one focuses on novice and expert users’ difference when interacting with simple medical interfaces, and the other focuses on differences when interacting with complex medical interfaces. Four issues will be analyzed and discussed: (1) how novice and expert users differ in terms of performance during the interaction; (2) how novice and expert users differ in the perspective of cognitive mental models during the interaction; (3) how novice and expert users should be defined in practice; and (4) what are the main differences between novice and expert users’ implications for interface design. Besides describing the effect of users’ expertise difference during the interface design process, we will also pinpoint some potential problems for the research on interface design, as well as some future challenges that academic researchers and industrial engineers should face in practice.
2.	Svedbo Engström, Maria, 1980, et al. (author) A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability 2018 In: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 101:1, s. 139-146 Journal article (peer-reviewed)abstract Objective: To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes. Methods: In this methodological study, a questionnaire was developed over four phases using an iterative process. Expert reviews and cognitive interviews were conducted to evaluate content and face validity, and a postal survey was administered to evaluate test-retest reliability. Results: The expert reviews and cognitive interviews found the disease-specific questionnaire to be understandable, with relevant content and value for diabetes care. An item-level content validity index ranged from 0.6-1.0 and a scale content validity/average ranged from 0.7-1.0. The fourth version, with 33 items, two main parts and seven dimensions, was answered by 972 adults with type 1 and type 2 diabetes (response rate 61%). Weighted Kappa values ranged from 0.31-0.78 for type 1 diabetes and 0.27-0.74 for type 2 diabetes. Conclusions: This study describes the initial development of a disease-specific questionnaire in conjunction with the NDR. Content and face validity were confirmed and test-retest reliability was satisfactory. Practice implications: With the development of this questionnaire, the NDR becomes a clinical tool that contributes to further understanding the perspectives of adult individuals with diabetes. (c) 2017 Elsevier B.V. All rights reserved.
3.	Munthe, Christian, 1962 (author) David B. Resnik. Environmental Health Ethics. Cambridge: Cambridge University Press, 2012. xii + pp. 305. ISBN: 9781107617896 2013 In: Public Health Ethics. - : Oxford University Press (OUP). - 1754-9981 .- 1754-9973. Review (other academic/artistic)
4.	Törner, Marianne, 1953, et al. (author) Improving diabetes care for minority group adolescents - a stance in perceptions, attitudes, communication and context 2013 In: 39th annual conference of the International Society for Pediatric and Adolescent Diabetes. Oct 16-19, Gothenburg. Conference paper (other academic/artistic)
5.	Skånberg Dahlstedt, Ami, 1967 (author) Älskade Vampyr - om livet med ett barn med diabetes typ 1 2010 Book (other academic/artistic)abstract Älskade vampyr skildrar hur tillvaron ställs på ända för en svensk småbarnsfamilj när yngste sonen får en allvarlig diagnos: diabetes typ 1. Föräldrar och storebror tvingas anpassa sig till den nya situationen och framförallt vänja sig vid osäkerheten och rädslan för komplikationer som sjukdomen för med sig. Rutiner, kontroller och insulinsprutor blir sakta men säkert en naturlig del av tillvaron och de lyckas hålla ihop och hålla modet uppe. Och mer än så. De ger sig ut på äventyr tillsammans. Till Australien. Läsaren får en god inblick i hur det kan gå till när syskon, släkt, vänner, skol- och vårdpersonal, grannar med flera tvingas förhålla sig till den nya situationen - som väldigt många saknar kunskap om. Röster från läsare "Ami tröstar, förklarar, läker och bekräftar att man får lov att känna precis som man vill. Det är en bok som tar hand om känslorna när någon man älskar får en allvarlig sjukdom. Hennes bok handlar inte bara om diabetes, den handlar om alla som får kämpa för sin rätt att vara sig själva." Mia Skäringer, skådespelare och granne "Boken är skriven ur ett intressant och annorlunda perspektiv där författaren på ett gripande sätt tar med oss djupt in i vardagsdetaljerna hos en familj som lever med diabetes. Det är säkert många föräldrar som har barn med diabetes som kommer att känna igen sig i hur man från början kastas mellan hopp och förtvivlan, för att så småningom få ett nytt fäste i vardagen med diabetes. Diabeteslägret och sedan insulinpumpen blev en vändpunkt för Egil, och jag kan bara hålla med - pump är den bästa typen av behandling för ett barn med diabetes och på diabetesläger träffar man kompisar som förstår hur det är att ha diabetes." Ragnar Hanås, barnläkare och expert på diabetes typ 1
6.	Backman, Helena, et al. (author) Increased prevalence of allergic asthma from 1996 to 2006 and further to 2016 : results from three population surveys 2017 In: Clinical and Experimental Allergy. - : John Wiley & Sons. - 0954-7894 .- 1365-2222. ; 47:11, s. 1426-1435 Journal article (peer-reviewed)abstract BackgroundDuring the latter half of the 20th century, the prevalence of asthma and many other allergic diseases has increased. Information on asthma prevalence trends among adults after 2010, especially regarding studies separating allergic asthma from non-allergic asthma, is lacking.ObjectiveThe aim was to estimate prevalence trends of current asthma among adults, both allergic and non-allergic, from 1996 to 2016.MethodsThree cross-sectional samples from the same area of Sweden, 20-69 years, participated in surveys with the same questionnaire in 1996 (n=7104 participants, 85% response rate), 2006 (n=6165, 77%) and 2016 (n=5466, 53%), respectively. Allergic rhino-conjunctivitis (ARC) was used as a marker for allergic sensitization to define allergic asthma.ResultsThe prevalence of current asthma increased from 8.4% (95% CI: 7.8-9.0) in 1996 to 9.9% (95% CI: 9.2-10.6) in 2006 and 10.9% (95% CI: 10.1-11.7) in 2016 (P<.001). Allergic asthma increased from 5.0% (95% CI: 4.5-5.5) in 1996 to 6.0% (95% CI: 5.4-6.6) in 2006 and further to 7.3% (95% CI: 6.6-8.0) in 2016 (P<.001), while the prevalence of non-allergic asthma remained stable around 3.4%-3.8%. The increase in current asthma was most pronounced among women and among the middle-aged. Physician-diagnosed asthma, asthma medication use and ARC also increased significantly, while the prevalence of symptoms common in asthma such as wheeze and attacks of shortness of breath decreased slightly or was stable. The prevalence of current smoking decreased from 27.4% in 1996 to 12.3% in 2016.Conclusions and Clinical RelevanceThe prevalence of allergic asthma increased from 1996 to 2006 and further to 2016, while the prevalence of non-allergic asthma remained on a stable prevalence level. The prevalence of symptoms common in asthma decreased slightly or was stable despite a substantial decrease in the prevalence of current smoking. Clinicians should be aware that the previously observed increase in prevalence of allergic asthma is still ongoing.
7.	Nijsingh, Niels, 1977, et al. (author) Managing pollution from antibiotics manufacturing: charting actors, incentives and disincentives 2019 In: Environmental health. - : Springer Science and Business Media LLC. - 1476-069X. ; 18 Journal article (peer-reviewed)abstract Background Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An attempt to assess and reduce such discharges, however, quickly meets with complex realities that need to be understood to identify effective ways to move forward. This paper charts relevant key actor-types, their main stakes and interests, incentives that can motivate them to act to improve the situation, as well as disincentives that may undermine such motivation. Methods The actor types and their respective interests have been identified using research literature, publicly available documents, websites, and the knowledge of the authors. Results Thirty-three different actor-types were identified, representing e.g. commercial actors, public agencies, states and international institutions. These are in complex ways connected by interests that sometimes may conflict and sometimes pull in the same direction. Some actor types can act to create incentives and disincentives for others in this area. Conclusions The analysis demonstrates and clarifies the challenges in addressing industrial emissions of antibiotics, notably the complexity of the relations between different types of actors, their international dependency and the need for transparency. The analysis however also suggests possible ways of initiating incentive-chains to eventually improve the prospects of motivating industry to reduce emissions. High-resource consumer states, especially in multinational cooperation, hold a key position to initiate such chains.
8.	Bornehag, Carl-Gustaf, 1957-, et al. (author) The SELMA study : a birth cohort study in Sweden following more than 2000 mother-child pairs 2012 In: Paediatric and Perinatal Epidemiology. - Hoboken, USA : Wiley-Blackwell. - 0269-5022 .- 1365-3016. ; 26:5, s. 456-467 Journal article (peer-reviewed)abstract Background: This paper describes the background, aim and study design for the Swedish SELMA study that aimed to investigate the importance of early life exposure during pregnancy and infancy to environmental factors with a major focus on endocrine disrupting chemicals for multiple chronic diseases/disorders in offspring.Methods: The cohort was established by recruiting women in the 10th week of pregnancy. Blood and urine from the pregnant women and the child and air and dust from home environment from pregnancy and infancy period have been collected. Questionnaires were used to collect information on life styles, socio-economic status, living conditions, diet and medical history.Results: Of the 8394 reported pregnant women, 6658 were invited to participate in the study. Among the invited women, 2582 (39%) agreed to participate. Of the 4076 (61%) non-participants, 2091 women were invited to a non-respondent questionnaire in order to examine possible selection bias. We found a self-selection bias in the established cohort when compared with the non-participant group, e.g. participating families did smoke less (14% vs. 19%), had more frequent asthma and allergy symptoms in the family (58% vs. 38%), as well as higher education among the mothers (51% vs. 36%) and more often lived in single-family houses (67% vs. 60%).Conclusions: These findings indicate that the participating families do not fully represent the study population and thus, the exposure in this population. However, there is no obvious reason that this selection bias will have an impact on identification of environmental risk factors.
9.	Heikkilä, Katriina, et al. (author) Job strain and COPD exacerbations: an individual-participant meta-analysis 2014 In: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 44:1, s. 247-251 Journal article (peer-reviewed)abstract To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
10.	Hagström, Katja, 1975-, et al. (author) Exposure to wood dust, resin acids and volatile organic compounds during production of wood pellets 2008 In: Journal of Occupational and Environmental Hygiene. - Philadelphia, PA : Taylor and Francis. - 1545-9624 .- 1545-9632. ; 5:5, s. 296-304 Journal article (peer-reviewed)abstract The main aim of this study was to investigate exposure to airborne substances that are potentially harmful to health during the production of wood pellets, including wood dust, monoterpenes, and resin acids, and as an indicator of diesel exhaust nitrogen dioxide. In addition, area measurements were taken to assess background exposure levels of these substances, volatile organic compounds (VOCs), and carbon monoxide. Measurements were taken at four wood pellet production plants from May 2004 to April 2005. Forty-four workers participated in the study, and a total of 68 personal measurements were taken to determine personal exposure to wood dust (inhalable and total dust), resin acids, monoterpenes, and nitrogen dioxide. In addition, 42 measurements of nitrogen dioxide and 71 measurements of total dust, resin acids, monoterpenes, VOCs, and carbon monoxide were taken to quantify their indoor area concentrations. Personal exposure levels to wood dust were high, and a third of the measured levels of inhalable dust exceeded the Swedish occupational exposure limit (OEL) of 2 mg/m3. Parallel measurements of inhalable and total dust indicated that the former were, on average, 3.2 times higher than the latter. The data indicate that workers at the plants are exposed to significant amounts of the resin acid 7-oxodehydroabietic acid in the air, an observation that has not been recorded previously at wood processing and handling plants. The study also found evidence of exposure to dehydroabietic acid, and exposure levels for resin acids approached 74% of the British OEL for colophony, set at 50 microg/m3. Personal exposure levels to monoterpenes and nitrogen dioxide were low. Area sampling measurements indicated that aldehydes and terpenes were the most abundant VOCs, suggesting that measuring personal exposure to aldehydes might be of interest. Carbon monoxide levels were under the detection limit in all area measurements. High wood dust exposure levels are likely to have implications for worker health; therefore, it is important to reduce exposure to wood dust in this industry.
11.	Pasquini, Mirko, 1991 (author) Like ticking time bombs. Improvising structural competency to ‘Defuse’ the exploding of violence against emergency care workers in Italy 2023 In: Global Public Health. - : Informa UK Limited. - 1744-1692 .- 1744-1706. ; 18:1 Journal article (peer-reviewed)abstract While violence against health care workers is being progressively recognised as a serious problem in the healthcare industry, it remains an under-studied area of enquiry in global public health. Anthropologists have long observed that violence toward patients is tied to institutional care practises in multiple ways, including repression, misrecognition and silencing. But research on health care staff’s experience of violence is still lacking. This article aims to address this literature gap by providing research on the daily experience of vulnerability to violence that health care providers face during their work. To do so, the paper ethnographically explores the effects and perception of violence against health care workers in an emergency department (ED) in northern Italy, a place with a dramatic escalation of violent incidents. The article illustrates how the ED staff attended to the experience of suffering of potentially violent patients. In so doing, ED professionals shifted the responsibility of violence against them from violent individuals to violent structures shaping health inequities. The paper thus argues that ED professionals display a structural competence perspective when dealing with violence.
12.	Ruhayel, Yasir, et al. (author) Reduced risk of prostate cancer in infertile men compared to men with proven fertility: A nested case-control study 2008 In: European Urology Supplements. - 1569-9056. ; 7:3, s. 197-197 Conference paper (peer-reviewed)
13.	Andersson, Eva, 1955, et al. (author) Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases 2007 In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:6, s. 470-478 Journal article (peer-reviewed)abstract Objectives The aim of this study was to determine mortality among pulp and paper mill workers according to the main mill pulping process, department, and gender, particular reference being given to diseases of the circulatory and respiratory systems.Methods The cohort of 18 163 men and 2 291 women employed between 1939 and 1999 and with >1 year of employment was followed for mortality from 1952 to 2001 (acute myocardial infarction from 1969). Standardized mortality ratios (SMR) with 95% confidence intervals (95% CI) were estimated by comparing the observed number of deaths with the expected number for the entire Swedish population. Exposure was assessed from personnel files in the mills. Data from an exposure measurement database are also presented.Results There were 5898 deaths in the cohort. Total mortality had an SMR of 1.02 (95% CI 0.98–1.06) for the men in the sulfate mills and an SMR of 0.93 (95% CI 0.90–0.97) for the men in the sulfite mills. Mortality from acute myocardial infarction was increased among the men in both the sulfate and sulfite mills [SMR 1.22 (95% CI 1.12–1.32) and SMR 1.11 (95% CI 1.02–1.21), respectively] and by department in sulfate pulping (SMR 1.29, 95% CI 1.07–1.54), paper production (SMR 1.26, 95% CI 1.06–1.49), and maintenance (SMR 1.16, 95% CI 1.02–1.30). Mortality from cerebrovascular disease, diabetes mellitus, and nonmalignant respiratory diseases was not increased.Conclusions Death from acute myocardial infarction, but not cerebrovascular diseases, was increased in this cohort and was probably related to a combination of different occupational exposures (eg, dust, sulfur compounds, shift work, and noise).
14.	Ekblom Bak, Elin, 1981-, et al. (author) Accelerometer derived physical activity patterns in 27.890 middle‐aged adults : The SCAPIS cohort study 2022 In: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 32:5, s. 866-880 Journal article (peer-reviewed)abstract The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle-aged men and women, and to study differences between subgroups of socio-demographic, socio-economic, and lifestyle-related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an “at-risk” behavior, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.
15.	Eklund, Mona, et al. (author) Outcomes of activity-based assessment (BIA) compared with standard assessment in occupational therapy 2008 In: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 15:4, s. 196-203 Journal article (peer-reviewed)abstract This study was aimed at investigating the outcomes of an activity-based assessment (BIA) compared with standard assessment (SA) for evaluating clients undergoing psychiatric occupational therapy. Patients admitted to a psychiatric occupational therapy unit were randomized into the BIA or the SA assessment. The outcome indicators were (a) clients' satisfaction with the occupational therapy during the assessment period, (b) clients' awareness of capacities and occupational problems, (c) satisfaction with the assessment among the referring physicians, and (d) outcomes of the intervention following the assessment, in terms of changes in occupational performance and satisfaction. The groups did not differ in awareness of occupational problems, but the BIA group was more satisfied than the SA group with the support of their contact person and with the group leader during the period of assessment. Furthermore, physicians receiving feedback on patients in the BIA group were more satisfied than those receiving feedback on patients in the SA group. However, the groups did not differ concerning change during the treatment period in occupational performance or satisfaction. Thus, there was no difference between the assessment methods regarding the outcomes of the treatment following assessment. Minor advantages from the patients' perspective were found, in terms of better satisfaction in the BIA group, and from the referring physicians' perspective the BIA clearly seemed more satisfying than the SA. Thus, the findings showed that the BIA possessed better qualities than the SA regarding the indicators pertaining to satisfaction, but not concerning awareness of capacities and problems or the outcome of the subsequent treatment.
16.	Öhlen, Joakim, 1958-, et al. (author) Conceptual development of "at-homeness'' despite illness and disease : A review 2014 In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 9 Research review (peer-reviewed)abstract Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness.'' The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness'' was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness'' are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.
17.	Hallingström, Maria, et al. (author) The association between selected mid-trimester amniotic fluid candidate proteins and spontaneous preterm delivery 2020 In: Journal of Maternal-Fetal and Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 33:4, s. 583-592 Journal article (peer-reviewed)abstract Objective: The aim of this study was to explore inflammatory response and identify early potential biomarkers in mid-trimester amniotic fluid associated with subsequent spontaneous preterm delivery (PTD). Methods: A cohort study was performed at Sahlgrenska University Hospital/Östra, Gothenburg, Sweden, between 2008 and 2010. Amniotic fluid was collected from consecutive women undergoing mid-trimester transabdominal genetic amniocentesis at 14–19 gestational weeks. Clinical data and delivery outcome variables were obtained from medical records. The analysis included 19 women with spontaneous PTD and 118 women who delivered at term. A panel of 26 candidate proteins was analyzed using Luminex xMAP technology. Candidate protein concentrations were analyzed with ANCOVA and adjusted for plate effects. Results: The median gestational age at delivery was 35 + 3 weeks in women with spontaneous PTD and 40 + 0 weeks in women who delivered at term. Nominally significantly lower amniotic fluid levels of adiponectin (PTD: median 130,695 pg/mL (IQR 71,852–199,414) vs term: median 185,329 pg/mL (IQR (135,815–290,532)), granulocyte-macrophage colony stimulating factor (PTD: median 137 pg/mL (IQR 74–156) vs term: median 176 pg/mL (IQR 111–262)), and macrophage migration inhibitory factor (PTD: median 3025 pg/mL (IQR 1885–3891) vs term: median 3400 pg/mL (IQR 2181–5231)) were observed in the spontaneous PTD group, compared with the term delivery group, after adjusting for plate effects. No significant differences remained after Bonferroni correction for multiple comparisons. Conclusions: Our results are important in the process of determining the etiology behind spontaneous PTD but due to the non-significance after Bonferroni correction, the results should be interpreted with caution. Further analyses of larger sample size will be required to determine whether these results are cogent and to examine whether microbial invasion of the amniotic cavity or intra-amniotic inflammation occurs in asymptomatic women in the mid-trimester with subsequent spontaneous PTD.
18.	van Vught, Anneke J. A. H., et al. (author) Association between intake of dietary protein and 3-year-change in body growth among normal and overweight 6-year-old boys and girls (CoSCIS) 2010 In: Public Health Nutrition. - Cambridge United Kingdom : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 13:5, s. 647-653 Journal article (peer-reviewed)abstract Objective: Growth hormone (GH) affects linear growth and body composition, by increasing the secretion of insulin-like growth factor-I (IGF-I), muscle protein synthesis and lipolysis. The intake of protein (PROT) as well as the specific amino acids arginine (ARG) and lysine (LYS) stimulates GH/IGF-I secretion. The present paper aimed to investigate associations between PROT intake as well as intake of the specific amino acids ARG and LYS, and subsequent 3-year-change in linear growth and body composition among 6-year-old children.Design: Children's data were collected from Copenhagen (Denmark), during 2001-2002, and again 3 years later. Boys and girls were separated into normal weight and overweight, based on BMI quintiles. Fat-free mass index (FFMI) and fat mass index (FMI) were calculated. Associations between change (Delta) in height, FMI and FFMI, respectively, and habitual PROT intake as well as ARG and LYS were analysed by multiple linear regressions, adjusted for baseline height, FMI or FFMI and energy intake, age, physical activity and socio-economic status.Setting: Eighteen schools in two suburban communities in the Copenhagen (Denmark) area participated in the study. SUBJECTS: In all, 223 children's data were collected for the present study.Results: High ARG intake was associated with linear growth (beta = 1.09 (se 0.54), P = 0.05) among girls. Furthermore, in girls, DeltaFMI had a stronger inverse association with high ARG intake, if it was combined with high LYS intake, instead of low LYS intake (P = 0.03). No associations were found in boys.Conclusion: In prepubertal girls, linear growth may be influenced by habitual ARG intake and body fat gain may be relatively prevented over time by the intake of the amino acids ARG and LYS.
19.	Larsson, Matz, et al. (author) Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden : before and after the implementation of a smoke-free law 2008 In: Scandinavian Journal of Work, Environment and Health. - Helsingfors : Institutet för arbetshygien. - 0355-3140 .- 1795-990X. ; 34:4, s. 267-277 Journal article (peer-reviewed)abstract Objectives This study attempted to identify changes in exposure to environmental tobacco smoke, as well as symptoms and attitudes among hospitality workers after the introduction of extended smoke-free workplace legislation.Methods A total of 37 volunteers working in bingo halls and casinos (gaming workers) and 54 bars and restaurant employees (other workers) in nine Swedish communities participated in the study. Altogether 71 of 91 persons (14 daily smokers and 57 nonsmokers) participated in both the preban baseline survey and the follow-up 12 months after the ban. Exposure to environmental tobacco smoke, smoking habits, respiratory and sensory symptoms, and attitudes towards the ban were recorded, and spirometry was carried out.Results The frequency of reported respiratory and sensory symptoms was approximately halved among the nonsmokers in both occupational groups after the introduction of the ban. Initially 87% had exposure to environmental tobacco smoke that was over the nicotine cut-off level chosen to identify possible health risk (<0.5 µg/m3), while, after the ban, it was only 22%, a relative risk of 0.25 (95% confidence interval 0.15–0.41). The risk decreased in both occupational groups, but gaming workers experienced the highest preban exposure levels. Attitudes towards the legislation were largely positive, particularly after the ban. However, there was no notable change in lung function, and there was no notable reduction in the number of cigarettes consumed by smokers.Conclusions The introduction of smoke-free legislation was associated with a substantial reduction in respiratory and sensory symptoms, as well as reduced exposure to environmental tobacco smoke at work, particularly among gaming workers.
20.	Björk Skuladottir, Edda, et al. (author) Translation and validation of Assessment of Work Performance (AWP) into the Icelandic language and culture 2021 In: Work. - : IOS PRESS. - 1875-9270 .- 1051-9815. ; 69:4, s. 1305-1316 Journal article (peer-reviewed)abstract BACKGROUND:Evidence-based services in vocational rehabilitation call for valid and reliable assessments of work performance for intervention planning and safe return to work for individuals with illness or injuries. Assessments that are easy to use, culturally adapted, and in a language professionals and clients understand is important for their utility. Translation and adaption of assessments to new languages and cultures are of importance to maintain high standards of assessments and the quality of services in the vocational rehabilitation setting. OBJECTIVE:The aim of this study was to translate and adapt the Assessment of Work Performance (AWP), into the Icelandic language and culture. Furthermore, to investigate the content validity and utility of the evaluation instrument. METHODS:The study was conducted in two phases. The first phase, based on the Dual-Panel translation method, included two expert panels performing translation and cultural adaption of the original Swedish AWP. In the second phase field testing of the translated instrument was followed by an online survey among vocational rehabilitation professionals for content validation and utility. RESULTS:The results of the study showed satisfactory opinions from experienced professionals toward the content validity, translation, cultural adaption, and utility of the Icelandic version of the AWP. CONCLUSIONS:The study indicates that the Dual-Panel translation method is a valid method when translating instruments from one language and culture to another. Furthermore, the results of the study imply that the AWP can be regarded as content valid up to an acceptable degree for implementation in vocational rehabilitation services in Iceland.
21.	Mohammad, Salahuddin, et al. (author) Job satisfaction and job tenure of people with mental health disorders : a UK Biobank cohort study 2023 In: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 51:8, s. 1248-1257 Journal article (peer-reviewed)abstract Aims:Job satisfaction plays an important role for the life quality and health of working individuals. While studies have shown that self-reported mental health conditions such as stress, anxiety and depression are associated with job satisfaction, a large population-based study exploring and comparing self-reported physician posed diagnosed conditions and their association with job satisfaction and job tenure is missing. This study addresses the gap along with exploring the impact of the neurotic personality trait and other possible contributing factors.Methods:Sixteen mental health disorders diagnosed by physicians, categorised into four major groups were investigated in relation to employment status (108,711 participants) and in relation to job satisfaction and job tenure (34,808 participants). Analyses were performed using linear regression adjusted for age, sex, townsend deprivation index, body mass index, education, physical activity, work hours and neuroticism.Results:Neurotic and stress disorders, eating disorders and other mental health disorders were strongly associated with lower job satisfaction and shorter job tenure in both unadjusted and adjusted analyses. Neuroticism was strongly linked to job satisfaction but was not associated with job tenure.Conclusions:Study findings clarify the complex relationship of mental health with job satisfaction and job tenure, which is very important to understand in designing measures to improve working life participation of individuals with mental health issues.
22.	Zetterlund, Christina, et al. (author) The relationship between low vision and musculoskeletal complaints : a case control study between age-related macular degeneration patients and age-matched controls with normal vision 2009 In: Journal of optometry. - Barcelona : Elsevier BV. - 1989-1342 .- 1888-4296. ; 2:3, s. 127-133 Journal article (peer-reviewed)abstract INTRODUCTION: Age-related Macular Degeneration (ARMD) patients often describe complaints from neck and scapula area muscles and a decreased postural control. In clinical assessment, these complaints are considered to be due to old age.PURPOSE: This study focuses on low-vision patients with ARMD, comparing them to age-matched controls without any eye disease, in order to evaluate if the linkage between self-rated visual complaints and musculoskeletal complaints is more prominent when low vision is present.METHODS: In a cross-sectional study, 24 ARMD patients, aged 65 to 85, were compared to a group of 24 controls without visual problems having a similar age distribution. Visual acuity, the need for magnification plus other optical and visual parameters were assessed. Visual, musculoskeletal and balance/proprioceptive complaints were collected by means of a self-rating questionnaire. The Visual Functioning Questionnaire - Near Activities Subscale (VFQ–NAS) was used to evaluate visual function and related complaints.RESULTS: The correlation between visual complaints and musculoskeletal complaints yielded significant values of the correlation coefficient when performed separately within each group, as well as when calculated on the entire data set [ARMD, Spearman’s rho (ρ)=0.60, P=0.002; control group ρ=0.59, P=0.004; both groups together ρ=0.50 P<0.001]. Stepwise multiple regression analysis supported the hypothesized effect of vision (Visual complaints + Minimum readable typefaces) on musculoskeletal complaints, (r2=0.42, P<0.05). CONCLUSIONS: The results in this study support the hypothesis that a relationship exists between visual and musculoskeletal problems.
23.	Munthe, Christian, 1962 (author) Evaluative and Normative Conflicts As A Challenge for Managing Antibiotic Resistance 2016 In: Kickoff meeting of the Centre for Antibiotic Resistance Research (CARe), Aspenäs Herrgård, April 8, 2016. Conference paper (other academic/artistic)
24.	Kumar, P., et al. (author) Chapter 15 - Ultrafine Particles Pollution and Measurements 2016 In: Comprehensive Analytical Chemistry. - : Elsevier. - 9780444636058 ; , s. 369-390 Book chapter (peer-reviewed)
25.	Terio, Minna, et al. (author) What's in it for me? : A process evaluation of the implementation of a mobile phone-supported intervention after stroke in Uganda 2019 In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19 Journal article (peer-reviewed)abstract BackgroundThe prevalence of stroke in Uganda is increasing. In stroke rehabilitation, information and communication technology has been shown to have potential in improving service delivery in high-income countries but there is limited knowledge of its use and impact in low-income countries.The aim of the study was to evaluate the implementation process of a mobile phone-supported family-centred rehabilitation intervention and to gain knowledge on the mechanisms of impact as well as the contextual factors that might have affected the implementation process and its outcome.MethodThis was a single-case study design using the integrated Promoting Action on Research Implementation in Health Services framework and the Medical Research Council guidance as frameworks. Quantitative process data was derived from 14 log books used by occupational therapists during the implementation. Qualitative semi-structured interviews were conducted with 12 implementers in different professions, 12months into the implementation, in order to obtain the primary data. Secondary data was derived from six semi-structured interviews conducted directly after pre-intervention workshops and 6 months later. The framework method was used in the data analysis.ResultsIn 11 out of 14 cases, the clients were compliant with the intervention. Yet, challenges such as technical problems were reported. The target of conducting 16 phone calls for each client was achieved to 74%. Eight categories emerged from the qualitative analysis of the interviews including: 1) perceptions on facilitation, 2) using scientific and experience-based knowledge, 3) tailoring the intervention, 4) supportive working culture, 5) barriers to the service delivery, 6) implementers' interaction with the intervention, 7) perceptions on motivations and values, and 8) improving the model and enabling sustainability. Mechanisms contributing to the implementation of the intervention included engaged facilitators and motivated participants. Challenges in the client recruitment and poor information dissemination were some of the mechanisms impeding the implementation.ConclusionsThe intervention was partially delivered in accordance with the logic model for the project, where the implementation process was influenced by several barriers in the context such as technical setbacks. However, there were also several mediators in the process driving the project forward, including strong facilitation and motivated participants.
26.	Wennberg, Maria, 1974- (author) Biomarkers of fish consumption and risk of stroke or myocardial infarction 2010 Doctoral thesis (other academic/artistic)abstract The effect of fish consumption on the risk of cardiovascular disease has been extensively studied. Omega-3 fatty acids present in fish, namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been found to have beneficial effects through several mechanisms. In addition, selenium, an antioxidant, may be protective. Fish also represents the main human exposure source to the pollutant methylmercury (MeHg), which is associated with elevated cardiovascular risk in previous studies. The aim of this thesis was to evaluate whether MeHg is associated with the risk of myocardial infarction (MI) or stroke, whether EPA+DHA or selenium (Se) have protective associations, and if the overall association between fish consumption and risk of stroke or MI is detrimental or protective. A prospective incident case-control study design was used to study effects on stroke or MI. Three hundred and sixty-nine cases with twice as many matched controls were included in the study on stroke, while 431 cases with 499 controls participated in the MI study, all from the Northern Sweden Health and Disease Study. The data was collected from health examinations of the population from 1986 until 1999. Also, time trends in burdens of mercury (Hg), lead (Pb) and cadmium (Cd) in erythrocytes (Ery) from 1990 to 1999 were examined. The food frequency questionnaire (FFQ) used in the case-control studies was correlated with measurements of fatty acids in erythrocyte membranes as biomarkers of intake. In this northern Swedish population, levels of Ery-Hg and Ery-Pb decreased during the 1990´s, but Ery-Cd decreased only in smoking men. No significant associations were found between Ery-Hg or levels of EPA+DHA and the risk of stroke. Men reporting fish consumption >3 meals/week had an elevated risk of stroke. In the MI study, higher levels of Ery-Hg were associated with lower risk of MI. No clear associations were found for reported fish consumption, levels of EPA+DHA or Ery-Se. The validated FFQ has a fair reliability in estimating intake of fatty acids EPA and DHA. However, the low variation in fish consumption in the general population in combination with different versions of the FFQ (with pre-defined, multiple choice alternatives) decreased the reliability of self-reported fish consumption in the case-control studies on risk of stroke or MI. In conclusion, MeHg has no harmful association regarding the risk of stroke or MI in this population with generally low exposure levels. The protective association regarding risk of MI is probably due to Ery-Hg being a biomarker for consumption of fish, a source of other beneficial nutrients. Thus, in this population the benefits of the nutrients in fish appear to overcome the potential harm of MeHg. The finding of elevated stroke risk related to high fish consumption in men will be investigated further.
27.	Hedman, Linnea, 1979-, et al. (author) Population-based study shows that teenage girls with asthma had impaired health-related quality of life 2017 In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 106:7, s. 1128-1135 Journal article (peer-reviewed)abstract AimThis study examined the health-related quality of life (HRQoL) of teenagers with and without asthma, including the impact of their sex, allergic conditions, smoking, living conditions and physical activity.MethodsThe Obstructive Lung Disease in Northern Sweden (OLIN) studies recruited a cohort of schoolchildren in 2006. The parents of all children aged seven to eight years in three municipalities were invited to complete a questionnaire and 2585 (96%) participated. The cohort was followed up at the ages of 11–12 years and 14–15 years with high participation rates. At 14–15 years, the HRQoL questionnaire KIDSCREEN-10 and Asthma Control Test were added.ResultsGirls with current asthma at 14–15 years had a lower mean HRQoL score than girls without asthma (46.4 versus 49.3, p < 0.001), but this was not seen among boys (53.8 versus 52.8, p = 0.373). Poor HRQoL was related to current asthma, uncontrolled asthma and teenage onset of asthma. It was also related to eczema, living in a single-parent household, maternal smoking, daily smoking and inversely related to physical activity.ConclusionTeenage girls with asthma had lower HRQoL than girls without asthma. Possible interventions to improve HRQoL among teenagers with asthma were identified as follows: increasing asthma control, preventing smoking and promoting physical activity.
28.	Stridsman, Caroline, et al. (author) Adolescent girls with asthma have worse asthma control and health-related quality of life than boys : A population based study 2017 In: Pediatric Pulmonology. - : John Wiley & Sons. - 8755-6863 .- 1099-0496. ; 52:7, s. 866-872 Journal article (peer-reviewed)abstract BackgroundPopulation-based studies investigating health-related quality of life (HRQoL) among asthmatic adolescents are rare. Further, among subjects with asthma, HRQoL may be affected by asthma control and severity.AimTo investigate HRQoL in relation to asthma control and asthma severity among adolescents.MethodAs a part of the population-based OLIN pediatric study, 266 adolescents with current asthma (14-15 yr) were identified. N = 247 completed the DISABKIDS HRQoL asthma module, including the domains impact and worry. The Asthma Control Test (ACT) was used and a disease severity score was calculated based on symptoms and medicine use.ResultsThe prevalence of current asthma was 11%. Well-controlled asthma was reported by 15% of the adolescents, and 53% had partly controlled asthma. The prevalence of uncontrolled asthma was significantly higher among girls than boys (38% vs 25%), and girls also reported lower HRQoL scores. There was a fairly strong correlation between the ACT and DISABKIDS scores. Independent risk factors for low HRQoL impact (a score <67) were female sex (OR 4.66, 95%CI 1.82-9.54) and decreased ACT scores (1.38, 1.18-1.62). Risk factors for low HRQoL worry (a score <70) were female sex (3.33, 1.41-7.86), decreased ACT scores (1.35, 1.16-1.57), severe asthma (6.23, 1.46-16.50), and having current eczema (2.68, 1.00-7.24).ConclusionOnly a minority of the asthmatic adolescents reported well-controlled asthma, and poor asthma control and female sex were risk factors for low HRQoL. Our results demonstrate that evaluation of asthma control is of great importance for asthma management.
29.	Stridsman, Caroline, et al. (author) Fatigue affects health status and predicts mortality among subjects with COPD-report from the population-based OLIN COPD study 2015 In: COPD. - : Informa UK Limited. - 1541-2555 .- 1541-2563. ; 12:2, s. 199-206 Journal article (peer-reviewed)abstract Background: COPD is associated to increased fatigue, decreased health status and mortality. However, these relationships are rarely evaluated in population-based studies. Aims: To describe the relationship between health status, respiratory symptoms and fatigue among subjects with and without COPD. Further, to evaluate whether fatigue and/or health status predicts mortality in these groups. Methods: Data were collected in 2007 from the population-based OLIN COPD study. Subjects participated in lung function tests and structured interviews, and 434 subjects with and 655 subjects without COPD were identified. Fatigue was assessed by FACIT-Fatigue and health status by the generic SF-36 questionnaire including physical (PCS) and mental (MCS) components. Mortality data until February 2012 were collected. Results: Fatigue greatly impacts the physical and mental dimensions of health status, both among subjects with and without COPD. Among subjects with clinically significant fatigue, COPD subjects had significantly lower PCS-scores compared to non-COPD subjects. Fairly strong correlations were found between FACIT-F, SF-36 PCS and MCS, respectively. In multivariate models adjusting for covariates, increased fatigue, decreased physical and mental dimensions of health status were all associated to mortality in subjects with COPD (OR 1.06, CI 1.02-1.10, OR 1.04, CI 1.01-1.08 and OR 1.06, CI 1.02-1.10), but not in non-COPD. Conclusions: Fatigue and decreased health status were closely related among subjects with and without COPD. Not only physical health status, but also fatigue and mental health predicted mortality among subjects with COPD. Fatigue assessed by FACIT-F, can be a useful instrument of prognostic value in the care of subjects with COPD.
30.	Lo Martire, Riccardo, et al. (author) Construction of a web-based questionnaire for longitudinal investigation of work exposure, musculoskeletal pain and performance impairments in high-performance marine craft populations 2017 In: BMJ Open. - : BMJ. - 2044-6055. ; 7:7 Journal article (peer-reviewed)abstract OBJECTIVE: High-performance marine craft personnel (HPMCP) are regularly exposed to vibration and repeated shock (VRS) levels exceeding maximum limitations stated by international legislation. Whereas such exposure reportedly is detrimental to health and performance, the epidemiological data necessary to link these adverse effects causally to VRS are not available in the scientific literature, and no suitable tools for acquiring such data exist. This study therefore constructed a questionnaire for longitudinal investigations in HPMCP.METHODS: A consensus panel defined content domains, identified relevant items and outlined a questionnaire. The relevance and simplicity of the questionnaire's content were then systematically assessed by expert raters in three consecutive stages, each followed by revisions. An item-level content validity index (I-CVI) was computed as the proportion of experts rating an item as relevant and simple, and a scale-level content validity index (S-CVI/Ave) as the average I-CVI across items. The thresholds for acceptable content validity were 0.78 and 0.90, respectively. Finally, a dynamic web version of the questionnaire was constructed and pilot tested over a 1-month period during a marine exercise in a study population sample of eight subjects, while accelerometers simultaneously quantified VRS exposure.RESULTS: Content domains were defined as work exposure, musculoskeletal pain and human performance, and items were selected to reflect these constructs. Ratings from nine experts yielded S-CVI/Ave of 0.97 and 1.00 for relevance and simplicity, respectively, and the pilot test suggested that responses were sensitive to change in acceleration and that the questionnaire, following some adjustments, was feasible for its intended purpose.CONCLUSIONS: A dynamic web-based questionnaire for longitudinal survey of key variables in HPMCP was constructed. Expert ratings supported that the questionnaire content is relevant, simple and sufficiently comprehensive, and the pilot test suggested that the questionnaire is feasible for longitudinal measurements in the study population.
31.	Rask-Andersen, Anna, 1952-, et al. (author) Health-related quality of life as associated with asthma control, psychological status and insomnia 2022 In: Upsala Journal of Medical Sciences. - Uppsala : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127 Journal article (peer-reviewed)abstract Background: Asthma is associated not only with lower health-related quality of life (HRQL) but also with psychological health and insomnia. The aim of this study was to investigate associations between HRQL, asthma symptoms, psychological status and insomnia in adults from three Nordic countries.Methods: This study comprised 2,270 subjects aged 29–55 from Sweden, Iceland and Norway. HRQL was measured with the 36-Item Short Form Health Survey (SF-36). The physical (PCS) and mental health (MCS) component scores were calculated with higher values, indicating better health status. Symptoms of depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS). Insomnia was assessed with the Basic Nordic Sleep Questionnaire. An asthma score consisting of a sum of the positive answers to five respiratory symptoms was used in the analysis. Spirometry and allergy tests were also performed.Results: High HADS and sleep disturbance scores were both related to a low PCS and MCS, respectively, after adjusting for confounders. High age and high body mass index (BMI) were associated with low scores on the PCS, whilst the opposite was found for the MCS. A higher asthma score was related to a low PCS. An interaction between the HADS and the asthma symptom score was observed for the PCS (P = 0.0002), where associations between psychological status and the PCS were more pronounced for individuals with more symptoms than for individuals without symptoms.Conclusions: In this study, we found that HRQL of life was independently related to the HADS, insomnia and asthma symptoms. Further prospective studies to identify the most efficient target for intervention in order to improve asthma control are needed.
32.	Wold, Agnes E, 1955, et al. (author) Överrösta fossillobbyn – kräv bindande klimatavtal 2015 In: Göteborgsposten. - 1103-9345. ; :2015-11-28 Journal article (other academic/artistic)
33.	Gio-Batta, Monica, et al. (author) Fecal short chain fatty acids in children living on farms and a link between valeric acid and protection from eczema. 2020 In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1 Journal article (peer-reviewed)abstract Children growing up on farms have low rates of allergy, but the mechanism for this protective effect has not been fully elucidated. Short chain fatty acids (SCFAs) produced by the gut microbiota may play a role in protection from allergy. We measured fecal SCFA levels in samples collected from 28 farming and 37 control children over the first 3years of life using gas chromatography. Data on diet and other host factors were recorded and allergy was diagnosed at 8years of age. Among all children, median propionic and butyric acid concentration increased over the first 3years, and longer SCFAs typically appeared by 1year of age. Farm children had higher levels of iso-butyric, iso-valeric and valeric acid at 3years of age than rural controls. In addition, children with elder siblings had higher levels of valeric acid at 3years of age, and dietary factors also affected SCFA pattern. High levels of valeric acid at 3years of age were associated with low rate of eczema at 8years of age. The fecal SCFA pattern in farm children suggests a more rapid maturation of the gut microbiota. Valeric acid or associated microbes may have protective potential against eczema.
34.	Rhen, Ida-Märta, 1975, et al. (author) Inter- and intra-rater reliability of the OCRA checklist method in video-recorded manual work tasks 2020 In: Applied Ergonomics. - : Elsevier Ltd. - 0003-6870 .- 1872-9126. ; 84 Journal article (peer-reviewed)abstract Observation-based risk assessments are often used for evaluation of biomechanical workload and the condition of the workplace ergonomics. However, the inter- and intra-rater reliability of the methods used for the assessments are insufficiently studied. The OCRA checklist method, included as a reference method in the ISO and CEN standards regarding upper limb repetitive risk assessment, was in this study investigated regarding its reliability. Eleven ergonomists were educated within the method. Each ergonomist risk-assessed ten video-recorded manual work tasks, on two occasions. The average inter-rater agreement of the five overall risk levels was 39% and the linearly weighted kappa was 0.43, the intra-rater dittos were 45% and 0.52. Both indicating a moderate reliability, but lower than what could be expected. The levels might be sufficient for coarse surveys. However, for risk assessments before and after an intervention, complementing technical methods should be considered.
35.	Antoniewicz, Lukasz, et al. (author) Acute Effects of Electronic Cigarette Inhalation on the Vasculature and the Conducting Airways 2019 In: Cardiovascular Toxicology. - : Springer. - 1530-7905 .- 1559-0259. ; 19:5, s. 441-450 Journal article (peer-reviewed)abstract The use of electronic cigarettes has increased exponentially since its introduction onto the global market in 2006. However, short- and long-term health effects remain largely unknown due to the novelty of this product. The present study examines the acute effects of e-cigarette aerosol inhalation, with and without nicotine, on vascular and pulmonary function in healthy volunteers. Seventeen healthy subjects inhaled electronic cigarette aerosol with and without nicotine on two separate occasions in a double-blinded crossover fashion. Blood pressure, heart rate, and arterial stiffness measured by pulse wave velocity and pulse wave analysis were assessed at baseline, and then at 0 h, 2 h, and 4 h following exposure. Dynamic spirometry and impulse oscillometry were measured following vascular assessments at these time points, as well as at 6 h following exposure. e-Cigarette aerosol with nicotine caused a significant increase in heart rate and arterial stiffness. Furthermore, e-cigarette aerosol-containing nicotine caused a sudden increase in flow resistance as measured by impulse oscillometry, indicating obstruction of the conducting airways. Both aerosols caused an increase in blood pressure. The present study indicates that inhaled e-cigarette aerosol with nicotine has an acute impact on vascular and pulmonary function. Thus, chronic usage may lead to long-term adverse health effects. Further investigation is warranted.
36.	Gabrielsson, Hanna, 1977-, et al. (author) Views on everyday life among adults with spina bifida : an exploration through photovoice 2020 In: International Journal of Qualitative Studies on Health and Well-being. - : Co-Action Publishing. - 1748-2623 .- 1748-2631. ; 15:1 Journal article (peer-reviewed)abstract The aim of this study was to actively integrate expertise of persons living with spina bifida, to explore conditions embedded in their everyday life. This was important because young adults with spina bifida risk not being able to fully participate in the community on equal terms and in accordance with their own preferences. Photovoice, a community-based participatory research approach, was utilized to engage participants through dialogue and photography. An exhibition was created to share results with community and stakeholders. An overarching theme that characterized the experiences of the group was, "an adaptation for us, but it works for no one". Findings are presented as: "Accessibility-a never-ending project," "Tensions of a normative view," and "Power to influence." Findings integrated everyday life metaphors photographically depicted by broken elevators, unsafe transportation, closed doors and not experiencing real opportunities of involvement. Tensions in everyday life experienced by persons living with spina bifida can inform conditions relevant and necessary to support community participation, particulary among persons living with disability.
37.	Brännström, Margareta, et al. (author) Effectiveness of the Liverpool care pathway for the dying in residential care homes: An exploratory, controlled before-and-after study 2016 In: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 30:1, s. 54-63 Journal article (peer-reviewed)abstract Background: Clinical pathways aim to ensure that individuals receive appropriate evidence-based care and interventions, with the Liverpool Care Pathway for the Dying Patient focusing on end of life. However, controlled studies of the Liverpool Care Pathway for the Dying Patient, particularly outside of cancer settings, are lacking. Aim: To compare the effects of the Liverpool Care Pathway for the Dying Patient and usual care on patients' symptom distress and well-being during the last days of life, in residential care homes. Design: Exploratory, controlled before-and-after study. During a 15-month baseline, usual care was carried out in two areas. During the following 15-months, usual care continued in the control area, while residential care home staff implemented Liverpool Care Pathway for the Dying Patient use in the intervention area. The intervention was evaluated by family members completing retrospective symptom assessments after the patient's death, using the Edmonton Symptom Assessment System and Views of Informal Carers - Evaluation of Services. Settings/participants: Patients who died at all 19 residential care homes in one municipality in Sweden. Results: Shortness of breath (estimate=-2.46; 95% confidence interval=-4.43 to -0.49) and nausea (estimate=-1.83; 95% confidence interval=-3.12 to -0.54) were significantly reduced in Edmonton Symptom Assessment System in patients in the intervention compared to the control area. A statistically significant improvement in shortness of breath was also found on the Views of Informal Carers - Evaluation of Services item (estimate=-0.47; 95% confidence interval=-0.85 to -0.08). Conclusion: When implemented with adequate staff training and support, the Liverpool Care Pathway for the Dying Patient may be a useful tool for providing end-of-life care of elderly people at the end of life in non-cancer settings.
38.	Stanaway, Jeffrey D., et al. (author) Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017 2018 In: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994 Journal article (peer-reviewed)abstract Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
39.	Gyllensten, Kristina, 1977, et al. (author) Older assistant nurses’ motivation for a full or extended working life 2019 In: Ageing and Society. - 0144-686X .- 1469-1779. ; 39:12, s. 2699-2713 Journal article (peer-reviewed)abstract The aim of this study was to explore older workers’ motivation for a full or extended working life. With particular focus on assistant nurses aged 55–64 years, working in the elderly care sector. Focus group interviews were conducted with five different groups of assistant nurses. Inductive thematic analysis was used to analyse the interviews and five main themes were developed from the data: ‘Organisational issues’, ‘Health-related problems’, ‘Private issues’, ‘Meaningfulness and appreciation’ and ‘Social support’. Several of the main themes concerned problems with too high work demands of the assistant nurses. These findings suggest that it is important to improve the working conditions of assistant nurses in order to create a more sustainable working life. Increasing the number of staff and improving recovery opportunities and work–life balance could be important steps to improving the working conditions for this group. Finally, upgrading the competency and professionalism of assistant nurses could help to increase the motivation for a full or extended working life.
40.	Mazaheri, Monir, et al. (author) Experiences of dementia in a foreign country : qualitative content analysis of interviews with people with dementia 2014 In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 14, s. 794- Journal article (peer-reviewed)abstract Background: Dementia is a worldwide health concern of epidemic proportions. Research in the field of subjective experience of dementia suffers from a lack of diversity of their participants including immigrants. Different portraits of life with dementia could help us understand how people with dementia conceptualise their experiences of dementia and how they live. Our study aimed to explore the subjective experiences of living with dementia among Iranian immigrants in Sweden.Methods: Qualitative content analysis of interviews with fifteen people with dementia from Iranian immigrant backgrounds were conducted (8 females and 7 males).Results: Three themes and seven associated sub-themes were revealed. The themes included: Being a person with dementia means living with forgetfulness (personal sphere), living with forgetfulness in the private sphere means feeling incompetent but still loved, living with forgetfulness in the public sphere means feeling confident and secure but also isolated.Conclusions: Living with dementia for the participants meant living with forgetfulness. They experienced feeling incompetent but still loved within their families and feeling confident and secure but also isolated in the society. Educating people with dementia and their families about the course and process of dementia may help them understand the changes better and adjust their expectations. Our study can provide a basis for healthcare workers to understand the experiences of living with dementia from this specific perspective.
41.	Sandberg, David, 1980, et al. (author) The impact of sleepiness on lane positioning in truck driving 2013. - 1 In: Driver Distraction and Inattention. - Farnham : Ashgate. - 9781409425854 - 9781315578156 ; , s. 405-416, s. 405-416 Book chapter (peer-reviewed)abstract This chapter concerns the detection of sleepiness in truck drivers. Data obtained from a driver sleepiness study involving real-world driving are used in order to analyse the performance of several sleepiness indicators based on driving behavior; such as, for example, variability in lateral position and heading angle. Contrary to the results obtained for passenger cars, for heavy trucks it is found that indicators based on variability provide little or no information; their performance does not rise significantly above chance levels.However, the data indicate that there is a significant difference in the average lane position for sleepy and alert drivers, respectively, such that a sleepy driver generally places the vehicle closer (by about 0.2 m) to the centre of the road than an alert driver. The analysis also shows a significant, monotonous, increase in average lateral position (measured from the right, outer, lane boundary towards the lane centre) between the four cases of (i) daytime alert driving, (ii) daytime sleepy driving, (iii) night-time alert driving and (iv) nighttime sleepy driving.
42.	Rosengren, Annika, 1951, et al. (author) COVID-19 in people aged 18–64 in Sweden in the first year of the pandemic: Key factors for severe disease and death 2022 In: Global Epidemiology. - : Elsevier BV. - 2590-1133. ; 4 Journal article (peer-reviewed)abstract Background: Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. Objectives: We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18–64. Methods: We conducted a registry-based study in Swedish citizens aged 18–64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Results: Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·13, 95%CI 2·91–3·36, and a PAF of 32·2% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35–1·6, blue-collar workers 1·18, 95%CI 1·06–1·31, school staff 1·21, 95%CI 1·01–1·46, and health and social care workers 1·89, 95%CI 1·67–2·135) compared with people able to work from home, with altogether about 13% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·79, 95%CI 1·34–2·38 and 1·37, 95%CI 1·04–1·81, with adjusted PAFs of altogether 9%. Conclusion: Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.
43.	Hedblom, Marcus, et al. (author) Reduction of physiological stress by urban green space in a multisensory virtual experiment 2019 In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9 Journal article (peer-reviewed)abstract Although stress is an increasing global health problem in cities, urban green spaces can provide health benefits. There is, however, a lack of understanding of the link between physiological mechanisms and qualities of urban green spaces. Here, we compare the effects of visual stimuli (360 degree virtual photos of an urban environment, forest, and park) to the effects of congruent olfactory stimuli (nature and city odours) and auditory stimuli (bird songs and noise) on physiological stress recovery. Participants (N = 154) were pseudo-randomised into participating in one of the three environments and subsequently exposed to stress (operationalised by skin conductance levels). The park and forest, but not the urban area, provided significant stress reduction. High pleasantness ratings of the environment were linked to low physiological stress responses for olfactory and to some extent for auditory, but not for visual stimuli. This result indicates that olfactory stimuli may be better at facilitating stress reduction than visual stimuli. Currently, urban planners prioritise visual stimuli when planning open green spaces, but urban planners should also consider multisensory qualities.
44.	Kjellberg, Anders, 1942-, et al. (author) Stress, energy and psychosocial conditions in different types of call centres 2010 In: Work. - 1051-9815 .- 1875-9270. ; 36:1, s. 9-25 Journal article (peer-reviewed)abstract Objective: To identify risk indicators for high stress and low mental energy as well as to describe psychosocial working conditions at different types of call centres. Participants: 1183 operators from 28 call centres in Sweden, both external and internal, with different levels of task complexity, ownership and geographical location. Method: A cross sectional questionnaire study. Results: The stress level was moderately high and the energy level fairly high. Stress levels tended to be lower and psychosocial conditions better with increasing level of task complexity. Fourteen per cent of the operators were in a state of high stress/low energy ("worn out") and 47% in high stress/high energy ("committed under pressure"). Operators in a state of low stress/high energy ("committed without pressure") were most likely to report a better health status. High stress and lack of energy was mainly associated with time pressure, low decision latitude, and lack of social and supervisor support. Conclusions: Time pressure in combination with lack of support and influence should be seen as a potential high risk situation for the development of a "worn-out" state among call centre operators. Management should make use of this knowledge in order to promote a long lasting efficient and healthy call centre work.
45.	Ahlborg, Gunnar, 1948, et al. (author) Reproductive effects of chemical exposures in health professions 1995 In: Journal of Occupational and Environmental Medicine. - 1076-2752. ; 37:8, s. 957-61 Research review (peer-reviewed)abstract Numerous chemical substances are handled by persons working in the health care sector. At exposure levels that may occur in the occupational setting, some of these substances are potentially harmful to the reproductive processes. Among the potentially harmful substances are anesthetic gases, antineoplastic agents, and sterilants. The epidemiological evidence of increased risks for adverse reproductive effects (eg, subfertility, spontaneous abortions, congenital defects) from such exposure is not unequivocal. However, due to the toxic potential, exposures should be kept at a minimum, and this may be especially important for workers who are pregnant or are planning to achieve pregnancy.
46.	Lindqvist, A, et al. (author) Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients 1997 In: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 17:2, s. 159-169 Journal article (peer-reviewed)abstract Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P < 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P < 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P < 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 < 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r > or = 0.76; P < or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure.
47.	Wiebert, P., et al. (author) Mortality, morbidity and occupational exposure to airway-irritating agents among men with a respiratory diagnosis in adolescence 2008 In: Occupational and Environmental Medicine. - London : BMJ Publishing Group Ltd. - 1351-0711 .- 1470-7926. ; 65:2, s. 120-125 Journal article (other academic/artistic)abstract Objectives: To examine the influence of an airway diagnosis in adolescence on future health and occupation in Swedish men.Methods: Data were collected from the linkage of four Swedish national registers: the Military Service Conscription Register, the Population and Housing Censuses, the Inpatient Care Register and the National Cause of Death Register. A job-exposure matrix for airway-irritating substances was developed for application on the conscription cohort. The cohort included 49 321 Swedish men born 1949–51. Three groups—(1) healthy, (2) asthmatics (mild and severe asthma) and (3) subjects with allergic rhinitis without concurrent asthma—were identified at conscription and analysed for mortality, in-patient care and strategies for choice of occupation with emphasis on airway-irritating job exposure. Analyses were adjusted for smoking and childhood socioeconomic position.Results: The prevalence of total asthma was 1.8%, severe asthma 0.45% and allergic rhinitis 2.7%. Mortality for all causes was significantly higher in total asthma, hazard ratio (HR) 1.49 (95% CI 1.00 to 2.23), and lower in allergic rhinitis, HR 0.52 (95% CI 0.30 to 0.91). Asthma was a risk factor for inpatient care while allergic rhinitis was associated with less in-patient care (odds ratio (OR) for total asthma 1.16 (95% CI 1.00 to 1.34), severe asthma 1.38 (95% CI 1.04 to 1.85), allergic rhinitis 0.92 (95% CI 0.82 to 1.03)). Those with asthma tended to avoid jobs with a high probability for airway-irritating exposure (OR 0.88, 95% CI 0.71 to 1.09), but not to the same extent as subjects with allergic rhinitis (OR 0.58, 95% CI 0.47 to 0.70) (ORs from 1990).Conclusion: Subjects with asthma did not change their exposure situation to the same extent as subjects with allergic rhinitis. Further, asthmatics had an increased risk for morbidity and mortality compared to healthy subjects and subjects with allergic rhinitis.
48.	Antona-Makoshi, Jacobo, et al. (author) Analysis of Traumatic Brain Injuries Sustained by Occupants in Japanese Brand Car Crashes in the US 2018 In: International Journal of Automotive Engineering. - : Society of Automotive Engineers of Japan. - 2185-0992 .- 2185-0984. ; 9:3, s. 145-450 Journal article (peer-reviewed)abstract This study estimates, by means of an analysis of accident data from the US, the incidence and risk of car crash related traumatic brain injuries for occupants in Japanese brand cars. The study incorporated crash type, crash severity, car model year, belt use and the victim's age and sex. Concussion risk was the highest among all brain injury categories for all crash types and severities; females were at higher risks than males. When concussions were excluded, Subdural Haemorrhages, Intracranial Haemorrhages and Sub-Arachnoid Haemorrhages comprised the most frequent injury categories. Elderly occupants were at considerably higher risks than non-elderly for these bleeding injuries.
49.	Grubb, Anders, et al. (author) Cystatin C, a marker for successful aging and glomerular filtration rate, is not influenced by inflammation. 2011 In: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 1502-7686 .- 0036-5513. ; 71, s. 145-149 Journal article (peer-reviewed)abstract Abstract Background. The plasma level of cystatin C is a better marker than plasma creatinine for successful aging. It has been assumed that the advantage of cystatin C is not only due to it being a better marker for glomerular filtration rate (GFR) than creatinine, but also because an inflammatory state of a patient induces a raised cystatin C level. However, the observations of an association between cystatin C level and inflammation stem from large cohort studies. The present work concerns the cystatin C levels and degree of inflammation in longitudinal studies of individual subjects without inflammation, who undergo elective surgery. Methods. Cystatin C, creatinine, and the inflammatory markers CRP, serum amyloid A (SAA), haptoglobin and orosomucoid were measured in plasma samples from 35 patients the day before elective surgery and subsequently during seven consecutive days. Results. Twenty patients had CRP-levels below 1 mg/L before surgery and low levels of the additional inflammatory markers. Surgery caused marked inflammation with high peak values of CRP and SAA on the second day after the operation. The cystatin C level did not change significantly during the observation period and did not correlate significantly with the level of any of the four inflammatory markers. The creatinine level was significantly reduced on the first postoperative day but reached the preoperative level towards the end of the observation period. Conclusion. The inflammatory status of a patient does not influence the role of cystatin C as a marker of successful aging, nor of GFR.
50.	Brännström, Jonas, et al. (author) Psychosocial work environment among Swedish audiologists 2013 In: International Journal of Audiology. - : Informa Healthcare. - 1499-2027 .- 1708-8186. ; 52:3, s. 151-161 Journal article (peer-reviewed)abstract Objective: The study examined the self-reported psychosocial work environment for audiologists working in three practice types (public, completely private, and private but publicly funded).Design: A cross-sectional e-mail survey using the demand-control-support questionnaire, a short version of the effort-reward imbalance (ERI) questionnaire, and descriptive data.Study sample: Five-hundred Swedish licensed audiologists.Results: Overall, the results indicate differences in psychosocial work environment pertaining to the practice types. These differences are small and the type explains few percent of the variability accounted in the measures of psychosocial work environment. Social support seems important for the psychosocial work environment and is considered a reward in itself. Using the demand-control model, 29% of the audiologists reported working in a high-stress psychosocial work environment. Using the ERI-ratio to estimate the imbalance between effort and reward it was shown that that 86% of the participants experienced an unfavorable work situation where the rewards do not correspond to the efforts made.Conclusions: The organizational framework has minor effect on self-reported psychosocial work environment for Swedish licensed audiologists. The percentage of unfavorable ERI-ratios seen in Swedish audiologists seems conspicuously high compared to other working populations in general, but also compared to other health service workers.

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