| 1. |
- Andersson, Eva, 1958-, et al.
(author)
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Segregation och växande klyftor : En longitudinell studie
- 2021
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In: <em>Ungas uppväxtvillkor och integration </em>. - Stockholm. - 9789188021755
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Book chapter (peer-reviewed)abstract
- En utjämning av människors livschanser. Det har varit en bärande tanke i det svenska välfärdsbygget. I en marknadsekonomi som inte av sig själv ser till att utjämna klyftor kan välfärdsstaten hjälpa till att ge alla människor, oberoende av bakgrund, någorlunda likartade chanser den dag de tar steget ut i vuxenlivet och på egen hand ska ställas inför marknadens krav (Lindh, Malmberg, & Palme 2005). Den är en politik som tar sin början redan under fostertiden, med en mödravård som ska se till att de nyfödda ska ha en god hälsa. Och den fortsätter från förskoletiden ända fram till myndighetsdagen, och längre för dem som söker sig till högre utbildning. Huvuddelen av denna politik riktar sig direkt mot barnet och dess familj med hälsoinsatser, föräldraförsäkring, barnomsorg, undervisning, skolmåltider, socialförsäk- ringar, arbetslöshetsunderstöd, barnbidrag, försörjningsstöd, och även en arbetsmarknad med kollektivavtal och anställningstrygghet som ska ge inkomsttrygghet för vuxna individer, men därmed också inkomsttrygghet för deras barn. Vid sidan av denna individinriktade politik har välfärdsstaten också slagit vakt om uppväxtmiljön i en vidare bemärkelse. Även de bostadsområden där barn växer upp ska erbjuda stöd för deras utveckling till vuxna individer. Bostadsområden ska vara säkra och trygga, funktionella för lek, erbjuda närhet till förskola, skola och hälsovård samt kunna erbjuda fritidsaktiviteter. Bostadsområden ska dessutom föra med sig vuxna som kan vara goda förebilder och ett socialt stöd, varför t.ex. kriminalitet ska motverkas. Om man inom området socialpolitik till stöd för barns uppväxt i Sverige kommit långt i likvärdighet, så gäller inte detta förutsättningar knutna till barns och ungas geografiska hemvist, t.ex. i form av det egna bostadsområdet. Det framgår av tidigare forskning om barns och ungas geografiska kontext i Sverige att det skiljer sig stort i många avseenden (Andersson 2001).I detta kapitel belyser vi inkomstsegregation i Sverige, med särskilt fokus på fattiga områden och utrikes födda. Vi visar också vilka konsekvenser en uppväxt i fattiga områden får senare i livet vad gäller inkomst och utbildning. Vi undersöker även i vilken utsträckning unga, med och utan migrantbakgrund, bor kvar i fattiga områden som vuxna, och vilka faktorer som påverkar flyttningen bort från fattiga områden.
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| 2. |
- Hammarstrand, Sofia, et al.
(author)
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Perfluoroalkyl substances (PFAS) in drinking water and risk for polycystic ovarian syndrome, uterine leiomyoma, and endometriosis: A Swedish cohort study
- 2021
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In: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 157
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Journal article (peer-reviewed)abstract
- Background: Perfluorinated substances (PFAS) are chemicals with endocrine disruptive properties that may interfere with the female reproductive system. However, few studies have explored the association between benign gynecological diseases and high PFAS exposure. Objectives: The aim of this study was to investigate the possible associations between PFAS exposure and subsequent diagnosis of polycystic ovarian syndrome (PCOS), uterine leiomyoma (fibroids), and endometriosis in a cohort exposed to PFAS through drinking water. Material and methods: In 2013, high levels (with sum of PFAS above 10,000 ng/L), dominated by perfluorooctanesulfonic acid (PFOS) and perfluorohexane sulfonic acid (PFHxS), were found in the drinking water from one of the two waterworks in Ronneby, Sweden. The contamination came from firefighting foams used at a nearby airfield. Females of all ages (n = 29,106) who had ever resided in the municipality between 1985 and 2013 formed a cohort. Individual exposure was assessed based on municipality waterworks distribution data linked to annual residential address data; 27% of the females had ever lived at an address with PFAS-contaminated water. Gynecological health outcomes were retrieved from the Swedish National Patient Register. The Cox proportional hazards model was used to estimate the association between exposure and each diagnosis. Results: There were in all 161 cases of PCOS, 1,122 cases of uterine leiomyoma, and 373 cases of endometriosis. In women aged 20-50 years (n = 18,503), those with the highest estimated PFAS exposure had increased hazard ratios (HR) for PCOS (HR = 2.18; 95% confidence interval (CI) 1.43, 3.34) and uterine leiomyoma (HR = 1.28; 95% CI 0.95, 1.74). No increased HR for endometriosis was found (HR = 0.74; 95% CI 0.42, 1.29). Conclusions: Exposure to high levels of PFAS in drinking water was associated with increased risk of PCOS and possibly uterine leiomyoma, but not endometriosis. The findings for PCOS are consistent with prior studies reporting positive associations between PCOS and PFAS exposure at background levels.
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| 3. |
- Andersson, Dan, 1967-
(author)
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Exploring Perceptions of Route Environments in Relation to Walking
- 2024
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Doctoral thesis (other academic/artistic)abstract
- Background: Every walk takes place in a route environment, which can play an important role in deterring or facilitating walking. The focus of this thesis is on the perceptions of environmental variables, and how they relate to appraisals of route environments as hindering – stimulating for walking and unsafe – safe for reasons of traffic, in two metropolitan environments. Another focus is to expand the state of knowledge concerning the criterion-related validity of the Active Commuting Route Environment Scale (ACRES).Methods: Commuting pedestrians in Greater Stockholm, Sweden, were recruited via advertisements. From the inner urban area there were 294 participants (77% women), aged 49.5 years, and from the suburban areas there were 233 participants (82% women), aged 50.0 years. 77 individuals walked in both areas. The participants evaluated their commuting route environments using the ACRES. Correlation, multiple regression, and mediation analyses were used to explore the relationships between the variables. Comparisons of environmental ratings between groups and settings were performed with t-tests. Studies 1 and 2 focused on the inner urban area and studies 3 and 4 on the suburban areas. Studies 1 and 3 focused exclusively on the relations between the four motorized traffic variables (vehicle speed, vehicle flow, noise, and exhaust fumes), and their relations to the outcome variables (hinders – stimulates walking and unsafe – safe traffic). Studies 2 and 4 utilised proxies from studies 1 and 3 and combined them with other environmental variables to further the understanding of route environmental variables in relation to walking.Results: In both areas, aesthetics and greenery were positively related to stimulating walking, whereas noise, a proxy for motorized traffic, was negatively related. Aesthetics was also positively related to unsafe – safe traffic in the inner urban area, whereas greenery had the corresponding role in suburbia. Another important finding was that greenery also influenced aesthetics positively in both areas. Thus, greenery had both a direct and an indirect positive effect. On the other hand, noise influenced aesthetics negatively in the inner urban area, whereas vehicle flow had the corresponding role in suburbia. A number of variables conjointly influenced the outcome unsafe – safe traffic negatively in both areas (speeds of motor vehicles, noise, conflicts, congestion: pedestrians, red lights, and course of the route). The route environment profiles differed distinctly between the two areas.Conclusions: Several route environmental variables appear to be particularly influential in relation to pedestrian commuting, e.g., aesthetics, greenery, and noise. An important finding is that both positive and negative interactions, between certain predictor variables, were disclosed. The contrasting route environment profiles in the different settings strengthen the criterion-related validity of the ACRES. The findings expands the state of knowledge concerning the relations between the environment and walking. If implemented, these findings can influence public health positively.
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| 4. |
- Alfvén, Gösta, et al.
(author)
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Increased muscle activity response during startle in children and adolescents with pain in the head, neck and abdomen due to stress
- 2020
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Conference paper (peer-reviewed)abstract
- Background: Headache of stress etiology is a common, worldwide medical problem with high sick leave and large economic consequences. There is a need to improve the understanding of underlying neurobiological processes. Research show that headache of stress etiology often is one symptom in a complex of multiple pains and augmented widespread muscular tension with a specific pattern of tender points (1). Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain including headache. Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of headache and other pain and must be heeded in the treatment of patients with pain related to stress. 1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).
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| 5. |
- Alfvén, Gösta, et al.
(author)
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New Understanding of Psychosomatic Pain
- 2021
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In: Journal of Pain Management & Medicine. - : Walsh Medical Media. - 2684-1320. ; 7:3, s. 1-4
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Journal article (peer-reviewed)abstract
- For better understanding and better care of psychosomatic pain valid and reliable diagnostic criteria is a prerequisite. The startle reflex is of importance for the understanding of the stress induced pain and the increased excitability in several muscles. The pattern of increased muscle tension and tenderness that can be found in these patterns can be of valuable diagnostic support. Decreased oxytocin and increased cortisol is a sign of right brain dominance in stress and indicate psuchosomatic pain. The omega-3 and omega-6 changes are in indication metabolic pain mechanism of interest for future study. Treatment is reccomended to be guided by the knowledge here described.
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| 6. |
- Alfvén, Gösta, et al.
(author)
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Stress and recurrent abdominal pain.
- 2023
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In: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 112:11, s. 2312-2316
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Journal article (peer-reviewed)abstract
- We discuss the aetiology of recurrent abdominal pain of non-organic origin, according to the Rome Criteria for Functional Gastrointestinal Disorders and a psychogenic hypothesis. Stress activates the brain-gut axis, which is important for local gut symptoms, such as abdominal pain, but it also causes pain in other areas, including the head, back and chest. Our research has indicated that the startle reflex plays a dominant role in this stress-induced pain pattern, which is manifested in the whole body. Localised abdominal pain can be part of a general negative stress reaction that causes multiple pains in other areas of the body.
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| 7. |
- Alfvén, G, et al.
(author)
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The Dangerous Staircase of Stress
- 2021
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In: Anesthesia & Pain Research. - : SciVision Publishers. - 2639-846X. ; 5:2, s. 1-6
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Journal article (other academic/artistic)abstract
- Chronic negative stress may be the start of a progress of illness, that may end in serious troubles for the affected. In this Perspective we highlight the steps in such a progress, what we call a staircase of stress. This underlines the importance of recognition, understanding and therapeutic measures at an early stage of the stress disorders.
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| 8. |
- Alfvén, Gösta, et al.
(author)
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Understanding pain of stress etiology, comprising changes in muscle excitability, hormones and the nervous system.
- 2020
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Conference paper (peer-reviewed)abstract
- G. Alfvén1, E. Andersson2, 31. Clintec, Karolinska Institute, Stockholm, Sweden. 2. The Department of Neuroscience, Karolinska institute, Stockholm, Sweden. 3. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.Corresponding author: G Alfvén (gosta.alfven@slmk.org) Karolinska Institute, SwedenABSTRACT Background: Recurrent pain of stress etiology is a common, worldwide problem with impaired quality of life and decreased school attendance. Research show that pain of stress etiology, often called psychosomatic pain, often is a complex of multiple pains, other symptoms and augmented widespread muscular tension with a specific pattern of tender points (1). Objective and Method: We will in a clinical context present electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain. Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 23 matched controls. Also, higher resting muscle activity was shown. We will also present data showing increased cortisol and decreased oxytocin and increased risk for developing fibromyalgia in children with psychosomatic pain. Conclusion. Stressors potentiated the startle reaction with increased muscle activity in rest and increased excitability. These reactions and increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of recurrent pain and must be heeded in the treatment of patients with pain related to stress. 1. Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019; Jun4.doi:10.1111/apa.14884.2. Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.3. Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).
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| 9. |
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| 10. |
- Alfvén, Gösta, et al.
(author)
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Understanding stress comprising changes in muscle excitability, hormones and the nervous system.
- 2020
-
Conference paper (peer-reviewed)abstract
- G. Alfvén1, E. Andersson2, 31. Clintec, Karolinska Institute 2. Department of Neuroscience, Karolinska institute, 3. Swedish School of Sport and Health Sciences, -all Stockholm, Sweden.Corresponding author: G Alfvén (gosta.alfven@slmk.org) ABSTRACT Background: Negative stress is very common, always affecting brain and body resulting in different symptoms often called psychosomatic. To better understand stress, it is important to overcome the mind-body dichotomy and explore how they are connected. Objective and Method: We will present in children with recurrent stress related pain, some hormonal changes and electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple psychosomatic pain (1). Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 21 matched controls. Also, higher resting muscle activity was found in these children as well as increased cortisol and decreased oxytocin. Conclusion. Stressors evoke stress response for example in the amygdala, which can trigger and potentiate the startle reaction with amplified muscle excitability and tonus. These reactions and the increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of psychosomatic pain and must be heeded in the treatment of patients with pain related to stress. 1.Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019;Jun4.doi:10.1111/apa.14884.2.Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.3.Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).
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