| 1. |
- Björklund, Martin, et al.
(author)
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The assessment of symptoms and functional limitations in low back pain patients : validity and reliability of a new questionnaire
- 2007
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In: European spine journal. - : Springer Science and Business Media LLC. - 0940-6719 .- 1432-0932. ; 16:11, s. 1799-1811
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Journal article (peer-reviewed)abstract
- Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.
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| 2. |
- Warenius, Linnéa, et al.
(author)
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Vulnerability and sexual and reproductive health among Zambian secondary school students
- 2007
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In: Culture, Health and Sexuality. - : Routledge. - 1369-1058 .- 1464-5351. ; 9:5, s. 533-544
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Journal article (peer-reviewed)abstract
- The present study aimed to explore secondary school students' needs in relation to sexual and reproductive health in order to inform efforts to improve the quality of health services available to young people. The study involved data collection from 716 11-22-year-old students in four secondary schools in an urban area in Zambia. Students completed a questionnaire and were invited to write down any inquiries they had regarding sexuality and reproduction. Findings revealed that boys and girls lack adequate information about human reproduction and STIs, including HIV. To avoid misconceptions and myths, they also need clear information on contraceptives and masturbation. Responses indicate that young people would welcome guidance and support related to contraception, pregnancy, abortion and STIs/HIV, but also on love and relationships. Culture, religion and gender are important factors influencing sexuality and sexual abuse. These issues need to be taken into consideration when developing youth-friendly programmes for young people
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| 3. |
- Wiitavaara, Birgitta, et al.
(author)
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Striking a balance - health experiences of male ambulance personnel with musculoskeletal symptoms : a grounded theory
- 2007
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In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 44:5, s. 770-779
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Journal article (peer-reviewed)abstract
- Background: Musculoskeletal disorders (MSD) are a dominant cause to long-term sick leave and early retirement. Some occupational groups are more affected than others and ambulance personnel are among them. Despite a vast amount of research, only a small part focuses the experiences of the affected.Objectives: The aim of the study was to explore the experience of illness and wellness in ambulance personnel with musculoskeletal symptoms.Design: An emerging design was used in accordance with Grounded Theory.Participants: Informants in the study were ten men with musculoskeletal symptoms, working as ambulance personnel at an ambulance station located in a mid-sized city in Sweden.Methods: Narrative interviews were performed, parallel to a constant comparative analysis.Results: The study resulted in a model, which describes the experience of illness and wellness as characterised by an effort to strike a balance. Wellness through nurturing appeared parallel to encountering illness as an experience and a threat. Accepting and handling illness was of importance to maintaining wellness, and wellness through nurturing was the motivation for accepting and handling illness.Conclusions: Enhancing the understanding of wellness and illness makes it possible to avoid undermining the meaningfulness that support accepting and handling illness, and by understanding different aspects of illness prevention can become facilitated. This is of importance as other aspects than solely physical have shown to be similarly important in the development of MSD.
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| 4. |
- Wiitavaara, Birgitta, et al.
(author)
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Striving for balance : a grounded theory study of health experiences of nurses with musculoskeletal problems
- 2007
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In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 44:8, s. 1379-1390
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Journal article (peer-reviewed)abstract
- Background: Musculoskeletal disorders (MSD) are one of the major causes of the high levels of long-term sickleave and early retirement, and healthcare personnel are among the occupational groups most affected. Only limited research in the area has focused on the experiences of those affected, and to increase the understanding of MSD, all dimensions of the health experiences need to be taken into consideration.Objectives: The aim of this paper was to explore the experiences of illness and wellness among female healthcare personnel with musculoskeletal symptoms.Design: A qualitative grounded theory approach guided the study in data collection and analysis.Settings: Medical and surgical ward units at three hospitals; one university hospital and two minor hospitals.Participants: Eight women, registered nurses and nursing aides, with neck, shoulder and/or back problems in early stages.Methods: A grounded theory approach was used with narrative thematic interviews and parallel data analysis with constant comparisons.Results: The analysis revealed a process of striving to reach a balance between illness and wellness, through accepting and handling illness. Illness appeared as a threat and an experience, while experiences of wellness were simultaneously nurtured. The informants were striving for balance through an inner reasoning leading to acceptance and by handling illness in various ways depending on the character of the illness.Conclusion: This paper indicates the diversity of the illness experience, the parallel importance of wellness, and the process of balancing these two in order to feel well enough. As previous research has shown that MSD has a multifactorial cause, a holistic view of health promotion, prevention and rehabilitation may provide a more effective tool than the bodily physical focus most frequently used today.
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| 5. |
- Andersson, Eva, 1955, et al.
(author)
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Cohort mortality study of Swedish pulp and paper mill workers-nonmalignant diseases
- 2007
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In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 33:6, s. 470-478
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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).
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| 6. |
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| 7. |
- Crenshaw, Albert G, et al.
(author)
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Impact of time pressure and pauses on physiological responses to standardized computer mouse use : a review of three papers focusing on mechanisms behind computer-related disorders
- 2007
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In: Scandinavian Journal of Work, Environment and Health. - Helsinki : Scandinavian journal of work, environment & health. - 0355-3140 .- 1795-990X. ; :Suppl 3, s. 68-75
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Journal article (peer-reviewed)abstract
- This paper reviews three computer mouse studies in our laboratory in which our emphasis was on mechanisms behind computer-related disorders. Our approach was sequentially (i) to determine the validity of a laboratory model for computer mouse use (painting rectangles) for studying musculoskeletal disorders, (ii) to use this model to study time pressure and precision demands on position sense and muscular oxygenation, and (iii) to use this model to determine the effect of pauses (active versus passive) on these parameters. Kinematic data for the painting model showed constrained movements of the wrist similar to that of CAD (computer-aided design) work, a support for its validity for a real-life situation. Changes in forearm oxygenation were associated with time pressure and precision demands, a potential for insight into the underlying pathophysiological mechanisms. Increasing trends in oxygenation and blood volume were associated with pauses, especially active pauses, a possible explanation for the alleviating effect of discomfort experienced in real-life situations when a pause is implemented.
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| 8. |
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| 9. |
- Hedlund, Ebba
(author)
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International migration and coronary heart disease
- 2007
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Doctoral thesis (other academic/artistic)abstract
- In today’s globalised world, with considerable international migration, knowledge about the health of immigrants is becoming increasingly important. In Sweden, about 13% of the population or over one million persons are born outside the country. Large groups have moved to Sweden from Finland, other Nordic countries, the Baltic States and other Eastern European countries, Western Europe, Turkey, Iran, Iraq, and Latin America.The aim of the thesis was to describe incidence of myocardial infarction (MI) among foreign-born persons compared to Sweden-born, taking into consideration gender, socio-economic status and time spent in Sweden and to evaluate if the long term trend of decreasing MI incidence in Sweden was present in immigrants to Sweden. In addi-tion, the aim was to analyse survival after a first MI among immigrants and Sweden-born. Furthermore, the aim was to investigate to what extent migration from Finland to Sweden is related to the access to welfare components including education and socio-economic status as well as social support and coronary heart disease (CHD) prevalence.The association between country of birth and incident MI was studied by case control methods. The study base consisted of subjects 30-74 years of age in Stockholm County during the 20 year period 1977-96. Incident cases of first acute MI were identified us-ing registers of hospital discharges and deaths and controls were selected randomly from the study base. In the sampling of controls, sampling fractions were known, which enabled estimates of person time at risk and incidence rates employed in the analyses of time trends. Information on country of birth was obtained from national censuses and from a register on immigration. The study of survival utilised all the cases in the case control study. Cases surviving 28 days were followed with regard to mortality during one year.In the studies of welfare components and CHD in Finnish twins, the study population consisted of twin pairs of the Finnish Twin Cohort Study where at least one twin had lived one year or more in Sweden. The study included 1,534 migrant or non-migrant subjects and 251 complete twin pairs discordant regarding residency in Sweden. Emi-grant twins were compared to non-migrant co-twins regarding welfare components and prevalence of CHD. Data on welfare components and CHD was assessed by an exten-sive questionnaire administered in 1998 including questions on social factors, health, life style factors and migration history.Immigrants to Sweden had a higher incidence of first MI including non-fatal as well as fatal cases compared to Sweden-born during the period 1977-96 after adjustment for age and socioeconomic group. Immigrant men had a decreasing time trend of MI inci-dence during the period 1977-96 of the same magnitude as Sweden-born but among women immigrants had a somewhat less pronounced decline compared to natives. Fur-thermore immigrants did not have an increased case fatality within 28 days after a first MI compared to Sweden-born persons when differences in socioeconomic group were accounted for. Subjects born in Finland however had an increased case fatality during the first ten years in Sweden among men and after 20 years in Sweden among women. These results suggest that differences in CHD mortality between foreign-born and Sweden-born are primarily due to a higher disease incidence rather than a lower sur-vival. Migration from Finland to Sweden did not substantially improve access to central welfare components for the migrants but a reduced prevalence of CHD in emigrants compared to non-migrants was observed, taking genetic and early childhood factors into account.In conclusion the results of this thesis reinforce the impression that immigrants to Swe-den, from a number of countries including Finland, are at increased risk of MI com-pared to native Swedes. Concerning immigrants from Finland this appears to be the case in spite of a certain reduction in CHD prevalence associated with migration to Sweden.
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| 10. |
- Hermansson, Jonas, et al.
(author)
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Ischemic stroke and shift work.
- 2007
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In: Scand J Work Environ Health. - 0355-3140 .- 1795-990X. ; 33:6, s. 435-9
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Journal article (peer-reviewed)
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