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- Vimaleswaran, Karani S, et al.
(author)
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Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study.
- 2014
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In: The lancet. Diabetes & endocrinology. - 2213-8595 .- 2213-8587. ; 2:9, s. 719-29
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Journal article (peer-reviewed)abstract
- Background Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk. Methods In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium. Findings In phenotypic analyses (up to n=49363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (β per 10% increase, −0·12 mm Hg, 95% CI −0·20 to −0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97–0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, −0·02 mm Hg, −0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of −0·10 mm Hg in systolic blood pressure (−0·21 to −0·0001; p=0·0498) and a change of −0·08 mm Hg in diastolic blood pressure (−0·15 to −0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96–0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of −0·29 mm Hg in diastolic blood pressure (−0·52 to −0·07; p=0·01), a change of −0·37 mm Hg in systolic blood pressure (−0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87–0·97; p=0·002). Interpretation Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study.
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| 2. |
- Abrahamsson, Marcus, et al.
(author)
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A study of the performance of risk and vulnerability assessments by Swedish Public Agencies
- 2012
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In: Proceedings of the 4th International Disaster and Risk Conference: Integrative Risk Management in a Changing World - Pathways to a Resilient Society, IDRC Davos 2012. ; , s. 15-18
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Conference paper (peer-reviewed)abstract
- Risk and vulnerability assessments (RVA) are vital components of the work conducted by public agencies at different levels, as part of the processes for governing and managing risks in the society. In Sweden, public agencies at all levels are required by legislation to perform risk and vulnerability assessments within their respective area of responsibility. The present paper presents a study of how Swedish municipalities, county administrative boards and national authorities work with RVAs, with a special focus on three aspects of such assessments that are highlighted in the legislation: vital societal functions, critical dependencies, and capability assessment. The main data collection technique was semi-structured interviews and a total of 25 actors were included and interviewed. The goal was to achieve a good representation of the different actors that perform RVAs. Thus 5 national authorities, 5 county administrative boards, and 15 municipalities were chosen in order to obtain a representative functional distribution (in terms of national authorities responsible for different sectors), geographic distribution as well as size distribution. The study shows that there is rather large variety of approaches, perspectives and views adopted by different actors, all with different advantages and drawbacks. It is argued that the findings of the study can be used to improve the RVA-practices of public authorities.
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| 3. |
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| 4. |
- Assarlind, Marcus, 1983, et al.
(author)
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Adopting new ways of working in small and medium-sized enterprises: findings from interventions in 12 European companies
- 2013
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In: Total Quality Management and Business Excellence. - : Informa UK Limited. - 1478-3371 .- 1478-3363. ; 24:8, s. 945-958
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Journal article (peer-reviewed)abstract
- This paper elaborates on the factors to be considered in order for interventions (activities aimed at introducing new ways of working through a series of focused activities in an organisation) to lead to long-term effects inside small and medium-sized enterprises (SMEs). Its purpose of it is to describe how interventions can be carried out in order for SMEs to adopt new ways of working by understanding the context, process and content of an intervention. The results of this study suggest that in designing interventions for the SMEs, the context aspects of an intervention must be carefully considered. Not only is the process or context of an intervention important, but so is the content. As a consequence, we suggest content that accomplishes the following: (1) supports the formulation of strategies; (2) encourages dialogue and (3) uses company data. The paper is based on a multiple case study of 12 SMEs from 6 European countries undergoing similar interventions within the FutureSME project. These long-term relationships within a large-scale project have provided access and a rare opportunity to conduct research on this often overlooked business sector. The empirical data have been collected through company presentations, structured reports and narratives. The material has been subject to a cross-case analysis.
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| 5. |
- Assarlind, Marcus, 1983, et al.
(author)
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Designing interventions in SMEs: Experiences from a pan-European multiple case study
- 2012
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In: Proceedings of the 15th QMOD-ICQSS conference. - 9788389333469 ; , s. 123-135
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Conference paper (peer-reviewed)abstract
- PurposeThe purpose of this paper is to describe how interventions can be carried out in order for small and medium sized companies (SMEs) to adopt new ways of working, by understanding the context, process and content of the intervention. Interventions are defined as activities aimed at introducing new ways of working through a series of focused activities in the organization.Design/methodology/approachThe work was part of an EU-funded project called FutureSME aiming at aiding SMEs in becoming more competitive. This paper is based on a multiple case study of twelve SMEs from six European countries undergoing similar interventions. The empirical data has been collected through presentations by company representatives, A3 reports including structured information about the intervention and its outcome, and case essays containing subjective descriptions of respective company’s experiences from the interventions. The material has been subject to a cross-case analysis.FindingsThis paper elaborates on previous research on important factors to consider in order for interventions to lead to long-term effects in SMEs. The results from this study suggest that in the design of the interventions at SMEs, one needs to carefully consider the context aspects regarding the intervention, which is seen as a deficiency in the project. It is also pointed out that not only the process or context of the intervention is of importance, but also the content. We suggest content that 1) supports the formulation of strategies, 2) encourages dialogue, and 3) uses company data. Hence, when designing an intervention in SMEs it is beneficial if the content have such characteristics, and by inclusion both short-term success and long-term sustainability are more likely as a result of the intervention.Research limitations/implicationsThis paper does not deal with how to motivate SMEs to initiate an intervention process.Originality/valueIntervention studies have mostly focused on larger companies. The special set-up with dedicated external support and a long term relationship within a large-scale project has provided access to a study of twelve SMEs across Europe and has provided a rare opportunity for research.
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| 6. |
- Berndt, Sonja I., et al.
(author)
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Genome-wide meta-analysis identifies 11 new loci for anthropometric traits and provides insights into genetic architecture
- 2013
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In: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 45:5, s. 501-U69
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Journal article (peer-reviewed)abstract
- Approaches exploiting trait distribution extremes may be used to identify loci associated with common traits, but it is unknown whether these loci are generalizable to the broader population. In a genome-wide search for loci associated with the upper versus the lower 5th percentiles of body mass index, height and waist-to-hip ratio, as well as clinical classes of obesity, including up to 263,407 individuals of European ancestry, we identified 4 new loci (IGFBP4, H6PD, RSRC1 and PPP2R2A) influencing height detected in the distribution tails and 7 new loci (HNF4G, RPTOR, GNAT2, MRPS33P4, ADCY9, HS6ST3 and ZZZ3) for clinical classes of obesity. Further, we find a large overlap in genetic structure and the distribution of variants between traits based on extremes and the general population and little etiological heterogeneity between obesity subgroups.
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| 7. |
- Carlbring, Per, 1972-, et al.
(author)
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Individually-tailored, Internet-based treatment for anxiety disorders: A randomized controlled trial
- 2011
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In: BEHAVIOUR RESEARCH AND THERAPY. - : Elsevier Science B.V., Amsterdam.. - 0005-7967 .- 1873-622X. ; 49:1, s. 18-24
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Journal article (peer-reviewed)abstract
- Previous studies on Internet-based treatment with minimal to moderate therapist guidance have shown promising results for a number of specific diagnoses. The aim of this study was to test a new approach to Internet treatment that involves tailoring the treatment according to the patients unique characteristics and comorbidities. A total of 54 participants, regardless of specific anxiety diagnosis, were included after an in-person, semi-structured diagnostic interview and randomized to a 10 week treatment program or to a control group. Treatment consisted of a number of individually-prescribed modules in conjunction with online therapist guidance. Significant results were found for all dependent measures both immediately following treatment and at 1 and 2 year intervals. Mean between-group effect size including measures of anxiety, depression and quality of life was Cohens d = 0.69 at post-treatment, while the mean within-group effect size was d = 1.15 at post-treatment and d = 1.13 and d = 1.04 at 1 and 2 year follow-up respectively. The tentative conclusion drawn from these results is that tailoring the Internet-based therapy can be a feasible approach in the treatment of anxiety in a homogeneous population.
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| 8. |
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| 9. |
- Dellve, Lotta, et al.
(author)
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Lean implementation approaches at different levels in Swedish hospitals : the impor¬tance for working conditions, worker engagement, health and performance.
- 2014
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Conference paper (peer-reviewed)abstract
- This paper reports result from one-year follow up in a research program with the overall aim to investigate how implementations of lean in health care affect working conditions, health, and performance of employees at five Swedish hospitals. This paper summarizes the implementation approaches, and their importance at short-term follow up for performance (with regard to active work with improvements), perceived working conditions and stress-related health among the healthcare workers. The implementation strategies and pace varied between the hospitals and between the strategic and operative levels. This short-term follow up showed that physical stress-related symptoms had increased overall but the cognitive stress had increased only in hospitals implementing lean. In hospitals with high implementation pace, there were more improvement work among the employees, but higher quantitative demands and lower job satisfaction.
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| 10. |
- Dellve, Lotta, 1965-, et al.
(author)
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Lean implementation approaches at different levels in Swedish hospitals : the importance for working conditions, worker engagement, health and performance
- 2014
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Conference paper (peer-reviewed)abstract
- BackgroundSwedish healthcare organizations are investing heavily in internal reforms. Lean has been frequently used as an overall concept to improve care processes and decrease costs. Some evidence shows positive results, especially if work environment issues are considered in parallel with other desired outcomes. However, there are considerable difficulties in evaluating lean as a concept since its application and interpretation seem to vary widely. Further, like for other management concepts, lean outcomes crucially depend on the implementation process.Aim This program investigates implementations of lean and lean-like developments of processes of care, and how these affect the working conditions, health, and performance of healthcare employees. We also investigated organizational factors and conditions that mediated specific outcomes.MethodMixed method design: questionnaire to employees (n=880) and managers (n=320), qualitative interviews (n=55) and observations with follow up during three years. Five hospitals were selected, and within them five units that were connected by their flow of acute care patients, i.e. the emergency unit, the medical and surgical emergency ward (or ICU at small hospital) as well as one medical and one surgical ward. Initially we used qualitative-driven analyses and thereafter quantitative-driven mixed method analysis.ResultsThe implementation strategies varied between the hospitals and between the strategic and operative levels. Strategic managers also used different approaches to overcome the gap between strategic and operative levels. Operative managers shared similarities in their stepwise and coaching approaches encouraging participation among employees, but differences regarding how assignments were delegated. Social capital and attitudes among health care profession were of importance for employees’ work engagement and active engagement in development work.
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