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Sökning: WFRF:(Larsson Britt)

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1.
  • Larsson, Britt-Marie, et al. (författare)
  • Effects of 5-lipoxygenase inhibitor zileuton on airway responses to inhaled swine house dust in healthy subjects
  • 2006
  • Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 100:2, s. 226-37
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Inhalation of swine house dust induces acute airway inflammation and increased bronchial responsiveness in healthy subjects. OBJECTIVE: The aim of the study was to investigate whether 5-lipoxygenase products such as leukotrienes may have a role in this reaction. METHODS: Twenty-three healthy subjects were randomised into two groups receiving treatment with either zileuton (600 mg) or placebo four times a day. After 5 days of treatment, all subjects were exposed for 3h in a swine barn. Bronchial responsiveness, exhaled nitric oxide (NO), and mediators in nasal lavage (NAL), blood and urine were measured before and after the exposure. RESULTS: The exposure induced an increased bronchial responsiveness to methacholine in both groups with 2-3 doubling concentration steps, no significant difference between treatments. Leukotriene E(4) in urine increased significantly following exposure in the placebo group from 37.3 (29.1-45.6) (mean (95% confidence interval)) ng/mmol creatinine to 47.7 (36.3-59.0) ng/mmol creatinine (P<0.05), but not in the zileuton group. The post-exposure increase of LTB(4) levels in NAL fluid was totally abolished in the zileuton group (P<0.05 vs. the placebo). The levels of exhaled NO increased significantly (P<0.01), two-fold in both groups. The PGD(2) metabolite 9alpha, 11beta-PGF(2) increased in placebo-treated subjects (P<0.01; P<0.05 vs. zileuton), strengthening mast cell participation. Neutrophil counts and levels of IL-6 in peripheral blood increased in both groups, with a significantly larger increase in zileuton treated subjects (P<0.05 and P<0.001, respectively compared to placebo). CONCLUSIONS: Pre-treatment with clinically recommended doses of the 5-lipoxygenase inhibitor zileuton did not affect the increase of bronchial reactivity induced by swine dust exposure. The intervention totally abolished the LTB(4) release in NAL fluid, but only partially inhibited the formation of leukotrienes as monitored by urinary levels. The enhanced increase of neutrophils and IL-6 in peripheral blood in the zileuton group, suggests that inhibition of 5-lipoxygenase may have pro-inflammatory effects.
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2.
  • Allard, Christina, et al. (författare)
  • Rasbiologiskt språkbruk i statens rättsprocess mot sameby : DN Debatt 2015-06-11
  • 2015
  • Annan publikation (populärvet., debatt m.m.)abstract
    • Statens hantering av forskningsresultat i rättsprocessen med Girjas sameby utgör ett hot mot Sverige som rättsstat och kunskapsnation. Åratal av svensk och internationell forskning underkänns och man använder ett språkbruk som skulle kunna vara hämtat från rasbiologins tid. Nu måste staten ta sitt ansvar och börja agera som en demokratisk rättsstat, skriver 59 forskare.
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3.
  • Gerdle, Björn, et al. (författare)
  • Influences of Sex, Education, and Country of Birth on Clinical Presentations and Overall Outcomes of Interdisciplinary Pain Rehabilitation in Chronic Pain Patients : A Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)
  • 2020
  • Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:8
  • Tidskriftsartikel (refereegranskat)abstract
    • This study investigates the effects of sex, education, and country of birth on clinical presentations and outcomes of interdisciplinary multimodal pain rehabilitation programs (IMMRPs). A multivariate improvement score (MIS) and two retrospective estimations of changes in pain and ability to handle life situations were used as the three overall outcomes of IMMRPs. The study population consisted of chronic pain patients within specialist care in the Swedish Quality Registry for Pain Rehabilitation (SQRP) between 2008 and 2016 at baseline (n = 39,916), and for the subset participating in IMMRPs (n = 14,666). A cluster analysis based on sex, education, and country of origin revealed significant differences in the following aspects: best baseline clinical situation was for European women with university educations and the worst baseline clinical situation was for all patients born outside Europe of both sexes and different educations (i.e., moderate-large effect sizes). In addition, European women with university educations also had the most favorable overall outcomes in response to IMMRPs (small effect sizes). These results raise important questions concerning fairness and equality and need to be considered when optimizing assessments and content and delivery of IMMRPs for patients with chronic pain.
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4.
  • Korotkova, Marina, 1954, et al. (författare)
  • Gender-related long-term effects in adult rats by perinatal dietary ratio of n-6/n-3 fatty acids.
  • 2005
  • Ingår i: American journal of physiology. Regulatory, integrative and comparative physiology. - : American Physiological Society. - 0363-6119 .- 1522-1490. ; 288:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Epidemiological studies in humans have shown that perinatal nutrition affects health later in life. We have previously shown that the ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) in the maternal diet affects serum leptin levels and growth of the suckling pups. The aim of the present study was to investigate the long-term effects of various ratios of the dietary n-6 and n-3 PUFA during the perinatal period on serum leptin, insulin, and triacylglycerol, as well as body growth in the adult offspring. During late gestation and throughout lactation, rats were fed an isocaloric diet containing 7 wt% fat, either as linseed oil (n-3 diet), soybean oil (n-6/n-3 diet), or sunflower oil (n-6 diet). At 3 wk of age, the n-6/n-3 PUFA ratios in the serum phospholipids of the offspring were 2.5, 8.3, and 17.5, respectively. After weaning, all pups were given a standard chow. At the 28th postnatal wk, mean body weight and fasting insulin levels were significantly increased in the rats fed the n-6/n-3 diet perinatally compared with the other groups. The systolic blood pressure and serum triacylglycerol levels were only increased in adult male rats of the same group. These data suggest that the balance between n-6 and n-3 PUFA during perinatal development affects several metabolic parameters in adulthood, especially in the male animals.
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5.
  • Larsson, Britt, et al. (författare)
  • The prevalences of cytochrome c oxidase negative and superpositive fibres and ragged-red fibres in the trapezius muscle of female cleaners with and without myalgia and of female healthy controls
  • 2000
  • Ingår i: Pain. - 1872-6623 .- 0304-3959. ; 84:2-3, s. 379-387
  • Tidskriftsartikel (refereegranskat)abstract
    • The association of cytochrome c oxidase negative fibres (COX-negative) and ragged-red fibres (RR-fibres) with work related trapezius myalgia has been proposed. Hitherto studies have been small or without control groups. The aim of the present study was to investigate the prevalences of RR-fibres and COX-negative fibres in female cleaners with (n=25) and without (n=23) trapezius myalgia and in clinically healthy female teachers (n=21). The cleaners did mainly floor cleaning requiring monotonous loading on the trapezius muscle. A questionnaire covering background data and aspects of pain (prevalence, duration, intensity and influence on daily living) was answered. Biopsies were obtained from the trapezius muscle by an open surgical technique. The three groups did not differ in prevalence of COX-negative or COX-superpositive (i.e. type-I fibres with extremely strong brownish reaction in both the COX and SDH/COX stainings) fibres. The prevalence of COX-negative fibres was age dependent. Two subgroups of RR-fibres were present when stained for COX; COX-negative (73%) and COX-superpositive (26%) fibres. Forty-two percent of the COX-negative fibres were RR-fibres and 79% of the COX-superpositive were RR-fibres. A significantly (P=0.002) higher proportion of the COX-superpositive fibres in the cleaners were RR-fibres compared to the teachers. Multivariate regression analysis revealed that age, occupation as cleaner and a tender point in the trapezius were significantly associated with increased prevalences of RR-fibres; a cleaner with a tender point had a 4.35 higher prevalence of RR-fibres compared to a teacher without a tender point. No correlations between other pain related variables and prevalence of RR-fibres were noted. In conclusion, RR-fibres but not COX-negative or COX-superpositive fibres were correlated with cleaning work tasks and with a tender point in the trapezius.
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6.
  • Palstam, Annie, 1981, et al. (författare)
  • Perceived exertion at work in women with fibromyalgia: Explanatory factors and comparison with healthy women
  • 2014
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 46, s. 773-780
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate perceived exertion at work in women with fibromyalgia. Design: A controlled cross-sectional multi-centre study. Subjects and methods: Seventy-three women with fibromyalgia and 73 healthy women matched by occupation and physical workload were compared in terms of perceived exertion at work (0–14), muscle strength, 6-min walk test, symptoms rated by Fibromyalgia Impact Questionnaire (FIQ), work status (25–100%), fear avoidance work beliefs (0–42), physical activity at work (7–21) and physical workload (1–5). Spearman’s correlation coefficient and linear regression analysis were conducted. Results: Perceived exertion at work was significantly higher in the fibromyalgia group than in the reference group (p = 0.002), while physical activity at work did not differ between the groups. Physical capacity was lower and symptom severity higher in fibromyalgia compared with references (p < 0.05). In fibromyalgia, perceived exertion at work showed moderate correlation with physical activity at work, physical workload and fear avoidance work beliefs (rs = 0.53– 0.65, p < 0.001) and a fair correlation with anxiety (rs = 0.26, p = 0.027). Regression analysis indicated that the physical activity at work and fear avoidance work beliefs explained 50% of the perceived exertion at work. Conclusion: Women with fibromyalgia perceive an elevated exertion at work, which is associated with physical workrelated factors and factors related to fear and anxiety.
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7.
  • Sundelöf, Andreas, et al. (författare)
  • Fisk- och skaldjursbestånd i hav och sötvatten 2021 : Resursöversikt
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES). Sammantaget redovisas tillståndet för 107 bestånd av 48 fisk- och skaldjursarter.De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten är en beställning från Havs- och vattenmyndigheten (HaV) till Sveriges lantbruksuniversitet (SLU) och utgör ett viktigt kunskapsunderlag till myndighetens arbete. Den uppfyller de krav som finns inom EU:s gemensamma fiskeripolitik om att basera förvaltningen på bästa tillgängliga vetenskap. Denna rapport är också ett stöd till det arbete som beskrivs närmare i strategin för framtidens fiske och tillhörande handlingsplaner för vattenbruk, yrkes- och fritidsfiske som HaV och Jordbruksverket har tagit fram i dialog med fiskets och vattenbrukets intressenter.
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8.
  • Söderlund Schaller, Anne, 1967- (författare)
  • Impact of Pain and Evaluation of Education and Self-Care in Patients with Head and Neck Cancer
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • It is not unusual for patients with head and neck cancer (HNC) to suffer from both tumor and treatment-related pain that is difficult to alleviate despite individualized pharmacological treatment.The presence of concomitant various dimensions of pain in patients during the often difficult period following radiotherapy (RT) has not been elucidated. Several aspects concerning the importance of relatives for HNC patients have been addressed. However, little attention has been given to how relatives perceive patients with HNC pain and it is important to further elucidate this sparsely studied topic. Knowledge about health-related quality of life (HR-QoL) in this patient group during early RT is limited and needs to be assessed in relation to diagnosis and treatment. Self-care (SC) refers to what patients do on their own to achieve, maintain, and promote optimal health and may help reduce pain for several pain conditions. The impact of patient education and SC on pain and other common HNC symptoms need further clarification.The aims of this thesis were:to describe experiences and perceptions of pain in patients with HNC shortly after RTto describe how relatives perceived the patient’s situation, especially concerning pain, and how they experienced their own situationto identify factors that impact HR-QoL during early RTto develop effective pain management strategies, maintain activities of daily living, and promote HR-QoL in patients with HNC undergoing RT using patient education and SC instruction.In paper I patients with HNC described existential pain – expressed as fear of death, meaninglessness and guilt – already during and shortly after RT. Physical pain, psychological distress and social withdrawal played a significant role. Patients with HNC who were treated with RT should also proactively be offered treatment for the various dimensions of pain.In paper II relatives described their mental stress in response to a challenging situation that required their active support to help ease the patient's difficult condition. The interviews with relatives also revealed a lack of personal knowledge and frustration over the inability to participate in patient care, as well as inadequate support from the healthcare system. Early interventions from the healthcare system on behalf of the relatives may be necessary to meet these needs.In Paper III regression models revealed that pain intensity and symptoms of depression adversely affected HR-QoL in patients with HNC during early RT. Customized prehabilitation programs aimed at preventing pain and symptoms of depression could help preserve good HR-QoL.Paper IV assessed individual patient education and SC initiatives that resulted in a tendency for lower pain intensity during a portion of RT. One way to potentially enhance the benefits of education and SC could be to improve for example patient motivation and self-efficacy, as well as to optimize supportive efforts from caregivers.In conclusion, by identifying factors that can impact HR-QoL and evaluating the effect of patient education and SC, this thesis contributes to knowledge on perceived pain and the patient’s situation during and shortly after RT in patients with HNC and their relatives. This thesis points to the need for evaluation and further development of patient education and effective SC strategies for pain in patients with HNC undergoing RT, as well as for development and evaluation of support strategies for patients with pain and their families during and after RT.
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9.
  • Östrand, Fredrik, et al. (författare)
  • Stereoisomeric composition of the sex pheromone of the pine sawfly Microdiprion pallipes (Hym., Diprionidae)
  • 2003
  • Ingår i: Chemoecology. - : Springer Science and Business Media LLC. - 0937-7409 .- 1423-0445. ; 13:3, s. 155-162
  • Tidskriftsartikel (refereegranskat)abstract
    • The basic chemical structure of the sex pheromone of the pine sawfly Microdiprion pallipes (Fallen) has earlier been identified as the propionate ester of (2S,3S,7 R/S,11 R/S)/(2R,3R,7 R/S,11 R/S)-3,7,11-trimethyl-2-tridecanol. We now report the results from further investigations on the male response to individual stereoisomers and to blends of stereoisomers, both in electroantennographic (EAG) recordings and in field trapping experiments. We also present our attempts to determine the stereochemistry of the compounds present in females of M. pallipes. By comparing gas chromatograms and mass spectra obtained from natural extracts with those from synthetic compounds it was found that the females contain one or more of the four (2S,3S,7 R/S,11 R/S)-3,7,11-trimethyl-2-tridecanol isomers (SS++-1). The active pheromone component is the corresponding propionate ester 2. In EAG experiments, males responded most strongly to five propionate ester samples, namely two four-isomer blends: SS++-2 and SR++-2, and three individual stereoisomers: SSSR-, SRRR- and SRSR-2. In a series of field trapping experiments it was found that males were attracted to the SR++-2 four-isomer blend and to the individual isomer SSSR-2. Based on the EAG-recordings and field responses of males and the stereoisomers found in the females, we suggest that the propionate ester of (2S,3S,7S,11R)-3,7,11-trimethyl-2-tridecanol (SSSR-2) is used as a main component of the sex pheromone in M. pallipes. Apparently the males react to other stereoisomers in addition to that or those produced by the females.
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11.
  • Adman, Per, et al. (författare)
  • 171 forskare: ”Vi vuxna bör också klimatprotestera”
  • 2019
  • Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447.
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
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13.
  • Améen, Caroline, 1975, et al. (författare)
  • Effects of gender and GH secretory pattern on sterol regulatory element-binding protein-1c and its target genes in rat liver.
  • 2004
  • Ingår i: American journal of physiology. Endocrinology and metabolism. - : American Physiological Society. - 0193-1849 .- 1522-1555. ; 287:6
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated whether the sexually dimorphic secretory pattern of growth hormone (GH) in the rat regulates hepatic gene expression of sterol regulatory element-binding protein-1c (SREBP-1c) and its target genes. SREBP-1c, fatty acid synthase (FAS), and glycerol-3-phosphate acyltransferase (GPAT) mRNA were more abundant in female than in male livers, whereas acetyl-CoA carboxylase-1 (ACC1) and stearoyl-CoA desaturase-1 (SCD-1) were similarly expressed in both sexes. Hypophysectomized female rats were given GH as a continuous infusion or as two daily injections for 7 days to mimic the female- and male-specific GH secretory patterns, respectively. The female pattern of GH administration increased the expression of SREBP-1c, ACC1, FAS, SCD-1, and GPAT mRNA, whereas the male pattern of GH administration increased only SCD-1 mRNA. FAS and SCD-1 protein levels were regulated in a similar manner by GH. Incubation of primary rat hepatocytes with GH increased SCD-1 mRNA levels and decreased FAS and GPAT mRNA levels but had no effect on SREBP-1c mRNA. GH decreased hepatic liver X receptor-alpha (LXRalpha) mRNA levels both in vivo and in vitro. Feminization of the GH plasma pattern in male rats by administration of GH as a continuous infusion decreased insulin sensitivity and increased expression of FAS and GPAT mRNA but had no effect on SREBP-1c, ACC1, SCD-1, or LXRalpha mRNA. In conclusion, FAS and GPAT are specifically upregulated by the female secretory pattern of GH. This regulation is not a direct effect of GH on hepatocytes and does not involve changed expression of SREBP-1c or LXRalpha mRNA but is associated with decreased insulin sensitivity.
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15.
  • Andersson, Patrik, 1974, et al. (författare)
  • Framtidsbilder för samhällsbyggnad
  • 2006
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Framtidsbilder för samhällsbyggnad 2020De kommande 15 åren står institutionen för Bygg- och miljöteknik inför stora förändringar. Därför har institutionen initierat projektet Framtidsbilder 2020 där man engagerat en framtidspanel bestående av elva yngre disputerade forskare. Arbetet inleddes med ett breddgruppsmöte där 110 personer representerande institutionens personal och studenter deltog. Vid mötet identifierades ett antal trender och osäkra utvecklingar som påverkar framtiden inom samhällsbyggnadsområdet. Deltagarna bidrog också med idéer till en önskvärd utveckling, vilket har sammanställts och utgör grunden till en gemensam önskvärd framtid/vision för institutionen. Materialet från breddgruppsmötet har bearbetats av Framtidspanelen och resulterat i fyra scenarier som beskriver hur samhällsbyggnadsområdet kan se ut år 2020. Syftet med framtidsbilderna är att de ska vara vägledande för institutionens beslut och förhållningssätt under de kommande åren.Fyra scenarierTurning TorsoSamhället präglas av en ekonomi som är på uppgång, och av ett nytänkande och öppet samhälle. Materiell status och individualism är viktigt. Detta leder till en hög arbetsbelastning samt krav på exklusiva varor av hög kvali-tet. Det finns en stor medvetenhet om miljöpåverkan och klimatförändringar och lösningarna för att klara energiförsörjningen är innovativa.Eco-metropolenDet sveper en grön våg genom dagens samhälle. Under de senaste 15 åren har vi insett att jorden skall vara en bebolig plats även åt dem som kommer efter oss. Vi söker ständigt efter nya, mer förfinade metoder att tillvarata de resurser vi har. Samhället och individen är i balans. Ekonomin är god och vi är miljömedvetna, trygga och integrerade. Nytänkande premieras och icke- materialistiska värderingar står högt i kurs. Vi tänker individuellt, men agerar mer än gärna för kollektivets bästa. Utbildning är gratis TrädgårdsstadenEtt samhälle där vi lärt oss hantera stress, men känner oss otrygga och helst umgås i slutna sociala sammanhang. Vi bor enkelt inne i stan, eller gärna på landsbygden nära storstäderna. Minskade behov av högutbildade i samhället gör att vi har svårt att rekrytera studenter till teknikutbildningar. Det traditionella tankesättet leder till kulturkrockar med företag och personer från andra länder.Gated communitiesFörsämrad ekonomi och ökad egoism har lett fram till ett stressat, otryggt och segregerat samhälle. Accelererande klimatförändringar och ökad miljö-påverkan skrämmer oss, men trots det åtgärdar vi inte problemen, utan koncentrerar oss på konsekvenserna. Arbetslöshet i samhällsbyggnadssek-torn leder till sänkt status för samhällsbyggaren. Vi har därför svårt att rekrytera studenter, och även forskningen har låg status.
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16.
  • Arnardottir, Steinunn, et al. (författare)
  • Long-term outcomes of patients with acromegaly: a report from the Swedish Pituitary Register
  • 2022
  • Ingår i: European Journal of Endocrinology. - : European Society of Endocrinology. - 1479-683X .- 0804-4643. ; 186:3, s. 329-339
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To describe the treatment and long-term outcomes of patients with acromegaly from all healthcare regions in Sweden. Design and methods: Analysis of prospectively reported data from the Swedish Pituitary Register of 698 patients (51% females) with acromegaly diagnosed from 1991 to 2011. The latest clinical follow-up date was December 2012, while mortality data were collected for 28.5 years until June 2019. Results: The annual incidence was 3.7/million; 71% of patients had a macroadenoma, 18% had visual field defects, and 25% had at least one pituitary hormone deficiency. Eighty-two percent had pituitary surgery, 10% radiotherapy, and 39% medical treatment. At the 5- and 10-year follow-ups, insulin-like growth factor 1 levels were within the reference range in 69 and 78% of patients, respectively. In linear regression, the proportion of patients with biochemical control including adjuvant therapy at 10 years follow-up increased over time by 1.23% per year. The standardized mortality ratio (SMR) (95% CI) for all patients was 1.29 (1.11-1.49). For patients with biochemical control at the latest follow-up, SMR was not increased, neither among patients diagnosed between 1991 and 2000, SMR: 1.06 (0.85-1.33) nor between 2001 and2011, SMR: 0.87 (0.61-1.24). In contrast, non-controlled patients at the latest follow-up from both decades had elevated SMR, 1.90 (1.33-2.72) and 1.98 (1.24-3.14), respectively. Conclusions: The proportion of patients with biochemical control increased over time. Patients with biochemically controlled acromegaly have normal life expectancy, while non-controlled patients still have increased mortality. The high rate of macroadenomas and unchanged age at diagnosis illustrates the need for improvements in the management of patients with acromegaly.
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17.
  • Björklund, Erika, 1972- (författare)
  • Constituting the Healthy Employee? : Governing gendered subjects in workplace health promotion
  • 2008
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • With a post-structural approach and an analytical focus on processes of governmentality and biopower, this study is concerned with how discourses of health are contextualized in educational practice and interaction between educators and participants in workplace health promotion (WHP) interventions. Of concern are issues of the discursive production, regulation and representation of power, knowledge and subjects as gendered beings in workplace health promotion interventions. The methods for generating data are participant observation, interviews and gathering of documentation pertaining to four different workplace health promotion interventions. Based on these data, the thesis offers an analysis of the health discourses drawn on in the interventions and the technologies of power and of the self by which the participants are governed and invited to govern themselves in the name of health. It also asks what practices and positions that thus come to be made available or not to the participants. Two health discourses are identified: the biomedical discourse and the wellness discourse. Both discourses are drawn on in all four studied interventions, the biomedical discourse being the dominating discourse drawn on. The biomedical discourse is informed by scientific ‘facts’ and statistics and is underpinned by a notion of risk. The wellness discourse is informed by an understanding of health as a subjective embodied experience and is underpinned by a notion of pleasure. Drawing on these discourses, the responsibility for health is placed with the participants and the healthy participant/employee is constituted as a rationally motivated risk-avoider and disciplined pleasure seeker who is both willing and able to actively make ‘good’ choices regarding their lifestyle. Furthermore, and informed by essentialist and heteronormative ideas about gender, the ideal healthy person is modelled on a male norm, representing women as the deviant Other.
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18.
  • Borssén, Magnus, et al. (författare)
  • DNA methylation holds prognostic information in relapsed precursor B-cell acute lymphoblastic leukemia
  • 2018
  • Ingår i: Clinical Epigenetics. - : BIOMED CENTRAL LTD. - 1868-7083 .- 1868-7075. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Few biological markers are associated with survival after relapse of B-cell precursor acute lymphoblastic leukemia (BCP-ALL). In pediatric T-cell ALL, we have identified promoter-associated methylation alterations that correlate with prognosis. Here, the prognostic relevance of CpG island methylation phenotype (CIMP) classification was investigated in pediatric BCP-ALL patients.Methods: Six hundred and one BCP-ALL samples from Nordic pediatric patients (age 1-18) were CIMP classified at initial diagnosis and analyzed in relation to clinical data.Results: Among the 137 patients that later relapsed, patients with a CIMP-profile (n = 42) at initial diagnosis had an inferior overall survival (pOS(5years) 33%) compared to CIMP+ patients (n = 95, pOS(5years) 65%) (p = 0.001), which remained significant in a Cox proportional hazards model including previously defined risk factors.Conclusion: CIMP classification is a strong candidate for improved risk stratification of relapsed BCP-ALL.
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19.
  • Broeren, Jurgen, et al. (författare)
  • Exploration of computer games in rehabilitation for brain damage
  • 2008
  • Ingår i: Proceedings of the 7th International Conference on Disability, Virtual Reality and Associated Technologies. ; , s. 75-80
  • Konferensbidrag (refereegranskat)abstract
    • Cognitive and physical deficits are consequences of stroke/traumatic brain injuries (TBI). Without rehabilitation activity problems persist i.e. limitations to handle personal care, the work situation, and recreational activities. The aim of this study is to test an application of Virtual Reality (VR) technology with 3D computer games as an occupational therapy assessment/treatment method in rehabilitation for patients with cognitive and physical deficits. We also wanted to investigate if playing computer games resulted in improved cognitive function. An easy-to-use semi-immersive workbench with haptic game selection menu was located at an activity centre. The training activities were 3D computer games. Every time an activity was run, data about the hand movements were collected and analyzed. Quantitative variables were time (s) to perform the test, average velocity (m/s) and, tremor or uncertainty in movements HPR). Executive functioning was examined by utilizing Trial Making Test. The intervention involved five patients. Results provide evidence to support the use of 3D computer games in cognitive rehabilitation. As an implementation tool within the occupational therapy area, this technology seems to be well adapted to the technological and economical development of society in Sweden.
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20.
  • Bryhn, Andreas, et al. (författare)
  • Fisk- och skaldjursbestånd i hav och sötvatten 2019 : Resursöversikt
  • 2020
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Fisken i havet är en resurs som rör sig fritt över nationella gränser. EU har därför en gemensam fiskeripolitik (GFP). Många arter som är viktiga för Sverige regleras inte i GFP och förvaltas därför nationellt.Denna rapport syftar till att:beskriva utvecklingen av fiskeripolitikenförklara den nuvarande politikens mål och regelverk och dess relation till mål och regler på miljöområdetförklara politikens nationella genomförande och det nationella handlingsutrymmetexemplifiera hur Havs- och vattenmyndigheten arbetat med att reglera fisket.
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21.
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22.
  • Bränholm, Inga-Britt, et al. (författare)
  • Långtidssjukskrivning förändrar livet
  • 1995
  • Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 92:23, s. 2421-2124
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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23.
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24.
  • Bäckryd, Emmanuel, et al. (författare)
  • Do low levels of Beta-endorphin in the cerebrospinal fluid indicate defective top-down inhibition in patients with chronic neuropathic pain? A cross-sectional, comparative study
  • 2014
  • Ingår i: Pain medicine (Malden, Mass.). - : Wiley-Blackwell. - 1526-2375 .- 1526-4637. ; 15:1, s. 111-119
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivePain medicine still lacks mechanism-specific biomarkers to guide diagnosis and treatment, and defective top-down modulation is an important factor in the pathophysiology of chronic pain conditions. Using modern analytical tools and advanced multivariate statistical analysis, the aim of this study was to revisit two classical potential biomarkers of pro- and anti-nociception in humans (substance P and beta-endorphin), focusing particularly on the cerebrospinal fluid (CSF).DesignCross-sectional, comparative, observational study.SubjectsPatients with chronic, post-traumatic and/or post-surgical, neuropathic pain refractory to conventional treatment (N = 15) and healthy controls (N = 19) were included.MethodsSamples were taken from CSF and blood, and levels of substance P and beta-endorphin were investigated using a Luminex technology kit.ResultsWe found low levels of beta-endorphin in the CSF of neuropathic pain patients (66 ± 11 pcg/mL) compared with healthy controls (115 ± 14 pcg/mL) (P = 0.017). Substance P levels in the CSF did not differ (20 ± 2 pcg/mL, 26 ± 2, P = 0.08). However, our multivariate data analysis showed that belonging to the patient group was associated with low levels of both substances in the CSF. A higher correlation between the levels of beta-endorphin and substance P in CSF was found in healthy controls than in patients (rs = 0.725, P < 0.001 vs rs = 0.574, P = 0.032).ConclusionsPatients with chronic neuropathic pain due to trauma or surgery had low levels of beta-endorphin in the CSF. We speculate that this could indicate a defective top-down modulation of pain in chronic neuropathic pain. Our results also illustrate the importance of taking a system-wide, multivariate approach when searching for biomarkers.
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25.
  • Bäckryd, Emmanuel, et al. (författare)
  • Plasma pro-inflammatory markers in chronic neuropathic pain: A multivariate, comparative, cross-sectional pilot study
  • 2016
  • Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; :10, s. 1-5
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Caused by a lesion or disease of the somatosensory system, neuropathic pain is notoriously difficult to treat with conventional analgesics. It has been suggested that inflammatory cytokines play a role in the development and maintenance of neuropathic pain. But human studies of these substances are relatively few and partly contradictory. Objectives: To simultaneously investigate the plasma levels of chemokine interleukin 8 (IL-8) and the cytokines IL-6, IL-1, and Granulocyte macrophage colony-stimulating factor (GM-CSF) in patients with peripheral neuropathic pain (most of whom due to failed back surgery syndrome) (n = 14) compared to controls (n = 17). Results: IL-6 was significantly higher in patients than in controls (0.92 ± 0.12 pg/ml vs. 0.57 ± 0.08 pg/ml, p = 0.012). IL-1, IL-8, and GM-CSF levels did not differ between the two groups. A multivariate analysis showed a tendency for patients also to have higher GM-CSF plasma levels than controls. Conclusions: This study found an increased level of IL-6 in plasma in patients with neuropathic pain, but not for the other pro-inflammatory substances investigated. There are several possible confounders not registered or controlled for in this and other studies of neuropathic pain. Implications: Larger studies that take several possible confounders into consideration are needed to further investigate the levels of plasma cytokines in different pain conditions. © 2015 Scandinavian Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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26.
  • Bäckryd, Emmanuel, 1974- (författare)
  • The Cerebrospinal Fluid in Severe Pain Conditions : Clinical, Pharmacological and Proteomic Aspects
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The treatment of both cancer pain and non-cancer chronic pain is still suboptimal. The overall aim of this PhD thesis was to conduct translational pain research at the interface between clinical pain medicine and the field of human proteomics, using the practice of intrathecal analgesia at our institution as a starting point. Hence, the cerebrospinal fluid (CSF) is at the centre of the present dissertation, both as a target for infusing analgesics (Papers I and II – clinical and pharmacological aspects) and as an important biofluid for human biomarker studies (Papers III and IV – proteomic aspects). In Paper I, 28 cases of intrathecal analgesia in cancer patients were prospectively followed. Movement-evoked breakthrough pain remained a major clinical problem throughout the study month despite otherwise successful intrathecal analgesia (defined as good control of spontaneous resting pain paralleled by a marked decrease of concomitant systemic opioid doses). This study therefore illustrates the importance of considering not only spontaneous resting pain but also movement-evoked breakthrough pain.In Paper II, an expert-based algorithm for trialing the intrathecal analgesic ziconotide by bolus injections was evaluated in an open-label study of 23 patients with chronic neuropathic pain. We found few responders (13%) according to the strict criteria of the algorithm, but ziconotide bolus injection trialing seems feasible. The predictive power of ziconotide bolus trialing remains unclear, and the pharmacological profile of ziconotide (with very slow tissue penetration due to high hydrophilicity) calls the rationale for ziconotide bolus trialing into question.In Paper III, we found low levels of beta-endorphin in the CSF of chronic neuropathic pain patients (n=15) compared to healthy controls (n=19). We speculate that this might indicate dysfunctional top-down control of nociception. Substance P levels in the CSF did not differ by univariate statistics. In Paper IV, the CSF proteome of 11 patients with chronic neuropathic pain and 11 healthy controls was exploratively studied, combining gel-based proteomics with multivariate data analysis. After eliminating four proteins associated with age, 32 proteins were found to highly discriminate between groups. Among these, the seven proteins having the highest discriminatory power between patients and controls were: one isoform of angiotensinogen, two isoforms of alpha-1-antitrypsin, three isoforms of haptoglobin, and one isoform of pigment epithelium-derived factor.In conclusion, this PhD thesis demonstrates the fruitfulness of studying the CSF, both as a target for infusing analgesics and as a potential mirror of the neurobiological processes involved in pathological pain conditions. The thesis points to the need for more research into the mechanisms of different pain conditions, in order to hopefully achieve the vision of mechanism-based pain diagnoses.
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27.
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28.
  • Carling, Tobias, et al. (författare)
  • Hyperparathyroidism of multiple endocrine neoplasia type 1 : candidate gene and parathyroid calcium sensing protein expression
  • 1995
  • Ingår i: Surgery. - 0039-6060 .- 1532-7361. ; 118:6, s. 924-931
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND:Hyperparathyroidism affects most patients with multiple endocrine neoplasia type 1 (MEN 1). This study investigates expression of the candidate MEN1 gene phospholipase C beta 3 (PLC beta 3) and expression and function of a putative calcium sensing protein (CAS) in hyperparathyroidism of MEN 1.METHODS:In 31 parathyroid glands from 17 patients with MEN 1, CAS distribution was studied immunohistochemically and parallel sections were explored for PLC beta 3 mRNA expression by in situ hybridization. Enzymatically dispersed parathyroid cells were analyzed for cytoplasmic calcium concentrations [Ca2+]i and parathyroid hormone (PTH) release.RESULTS:All glands exhibited a heterogeneously reduced CAS immunoreactivity, especially meager in nodularly assembled parathyroid cells. Calcium regulated [Ca2+]i and PTH release tended to be more deranged in the glands possessing the lowest immunostaining. Parathyroid PLC beta 3 invariably was homogeneously expressed, and this included even MEN 1 patients with reduced PLC beta 3 expression in endocrine pancreatic tumors.CONCLUSIONS:The findings support variable calcium insensitivity of [Ca2+]i and PTH release in hyperparathyroidism of MEN 1, apparently coupled to heterogeneously reduced CAS expression. For clarification of the role of PLC beta 3 in MEN 1 parathyroid tumorigenesis further study of this protein is required.
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29.
  • Conley, Daniel, et al. (författare)
  • Hypoxia is increasing in the coastal zone of the Baltic Sea
  • 2011
  • Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 45:16, s. 6777-6783
  • Tidskriftsartikel (refereegranskat)abstract
    • Hypoxia is a well-described phenomenon in the offshore waters of the Baltic Sea with both the spatial extent and intensity of hypoxia known to have increased due to anthropogenic eutrophication, however, an unknown amount of hypoxia is present in the coastal zone. Here we report on the widespread unprecedented occurrence of hypoxia across the coastal zone of the Baltic Sea. We have identified 115 sites that have experienced hypoxia during the period 1955-2009 increasing the global total to ca. 500 sites, with the Baltic Sea coastal zone containing over 20% of all known sites worldwide. Most sites experienced episodic hypoxia, which is a precursor to development of seasonal hypoxia. The Baltic Sea coastal zone displays an alarming trend with hypoxia steadily increasing with time since the 1950s effecting nutrient biogeochemical processes, ecosystem services, and coastal habitat.
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30.
  • Courseaux, A, et al. (författare)
  • Definition of the minimal MEN 1 candidate area based on a 5-Mb integrated map proximal to 11q13 : The european consortium on men1
  • 1996
  • Ingår i: Genomics. - : Elsevier BV. - 0888-7543 .- 1089-8646. ; 37:3, s. 345-353
  • Tidskriftsartikel (refereegranskat)abstract
    • Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder with a high penetrance characterized by tumors of the parathyroid glands, the endocrine pancreas, and the anterior pituitary. The MEN1 gene, a putative tumor suppressor gene, has been mapped to a 3- to 8-cM region in chromosome 11q13 but it remains elusive as yet. We have combined the efforts and resources from four laboratories to form the European Consortium on MEN1 with the aims of establishing the genetic and the physical maps of 11q13 and of further narrowing the MEN1 region. A 5-Mb integrated map of the region was established by fluorescence in situ hybridization on both metaphase chromosomes and DNA fibers, by hybridization to DNA from somatic cell hybrids containing various parts of human chromosome 11, by long-range restriction mapping, and by characterization of YACs and cosmids. Polymorphic markers were positioned and ordered by physical mapping and genetic linkage in 86 MEN1 families with 452 affected individuals. Two critical recombinants identified in two affected cases placed the MEN1 gene in an approximately 2-Mb region around PYGM, flanked by D11S1883 and D11S449.
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31.
  • Dong, Huan-Ji, et al. (författare)
  • Facing obesity in pain rehabilitation clinics: Profiles of physical activity in patients with chronic pain and obesity-A study from the Swedish Quality Registry for Pain Rehabilitation (SQRP)
  • 2020
  • Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 15:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The obesity epidemic has influenced pain rehabilitation clinics. To date, little is known about baseline level of physical activity (PA) in patients referred to pain rehabilitation clinics. We aimed to investigate the PA levels of patients referred to pain rehabilitation clinics and to evaluate the effect of excess weight on PA level. Methods and findings Data were obtained from the Swedish Quality Registry for Pain Rehabilitation between 2016 and 2017. These data included PA time (everyday PA and physical exercise per week), Body Mass Index (BMI), sociodemographic factors, chronic pain and psychological aspects (e.g., pain intensity, depressive and anxiety symptoms and insomnia problems). Insufficient PA was defined as less than 150 minutes per week. We performed logistic regressions as well as orthogonal partial least square regression to estimate the effects of excess weight on PA. Over one-fourth of the patients were classified as obese (BMI >= 30 kg/m(2), 871/3110, 25.3%) and nearly one-third of these patients were classified as severely obese (BMI >= 35 kg/m(2), 242/871, 27.8%). Time estimations for physical exercise varied among the BMI groups, but patients in the higher BMI category were more likely to spend less time on everyday PA. Compared to normal weight, mild obesity [odds ratio (OR) 0.65, 95% confidence interval (CI) 0.53-0.81] and severe obesity (OR 0.56, 95% CI 0.42-0.74) were associated with less PA. Mild obese patients had an elevated risk of 65% and severe obese patients had an elevated risk of 96% for insufficient PA. Increased pain intensity was positively related to insufficient PA (OR 1.17, 95% CI 1.06-1.29) among the obese patients. Conclusion Having low PA is very common for patients referred to pain rehabilitation clinics, especially for those with comorbid obesity. As a first step to increase PA, obese patients need to be encouraged to increase the intensity and amount of less painful daily PA.
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32.
  • Dong, Huan-Ji, 1981-, et al. (författare)
  • Factors Associated with Life Satisfaction in Older Adults with Chronic Pain (PainS65+)
  • 2020
  • Ingår i: Journal of Pain Research. - Macclesfield, United Kingdom : DOVE MEDICAL PRESS LTD. - 1178-7090. ; 13, s. 475-489
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Chronic pain in later life is a worldwide problem. In younger patients, chronic pain affects life satisfaction negatively; however, it is unknown whether this outcome will extend into old age.Objective: This study examines which factors determine life satisfaction in older adults who suffer from chronic pain with respect to socio-demographics, lifestyle behaviors, pain, and comorbidities.Methods: This cross-sectional study recruited a random sample of people ≥ 65 years old living in south-eastern Sweden (N= 6611). A postal survey addressed pain aspects and health experiences. Three domains from the Life Satisfaction Questionnaire (LiSat-11) were used to capture the individual’s estimations of overall satisfaction (LiSat-life), somatic health (LiSat-somhealth), and psychological health (LiSat-psychhealth).Results: Respondents with chronic pain (2790, 76.2± 7.4 years old) rated lower on life satisfaction than those without chronic pain, with medium effect size (ES) on LiSat-somhealth (r = 0.38, P < 0.001) and small ES on the other two domains (r < 0.3). Among the respondents with chronic pain, severe pain (OR 0.29– 0.59) and pain spreading (OR 0.87– 0.95) were inversely associated with all three domains of the LiSat-11. Current smoking, alcohol overconsumption, and obesity negatively affected one or more domains of the LiSat-11. Most comorbidities were negatively related to LiSat-somhealth, and some comorbidities affected the other two domains. For example, having tumour or cancer negatively affected both LiSat-life (OR 0.62, 95% CI 0.44– 0.88) and LiSat-somhealth (OR 0.42, 95% CI 0.24– 0.74). Anxiety or depression disorders had a negative relationship both for LiSat-life (OR 0.54, 95% CI 0.38– 0.78) and LiSat-psychhealth (OR 0.10, 95% CI 0.06– 0.14).Conclusion: Older adults with chronic pain reported lower life satisfaction but the difference from their peers without chronic pain was trivial, except for satisfaction with somatic health. Pain management in old age needs to consider comorbidities and severe pain to improve patients’ life satisfaction.
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33.
  • Dong, Huan-Ji, 1981-, et al. (författare)
  • Is excess weight a burden for older adults who suffer chronic pain?
  • 2018
  • Ingår i: BMC Geriatrics. - : BMC. - 1471-2318. ; 18
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundObesity and chronic pain are common comorbidities and adversely influence each other. Advanced age is associated with more comorbidities and multi-morbidities. In this study, we investigated the burden of overweight/obesity and its comorbidities and their associations with chronic pain in a random population sample of Swedish older adults.MethodsThe cross-sectional analysis involved a random sample of a population65years in south-eastern Sweden (N=6243). Data were collected from a postal questionnaire that addressed pain aspects, body mass index (BMI), and health experiences. Chronic pain was defined as pain during the previous three months. According to the 0-10 Numeric Rating Scale, pain scored 7 corresponds to severe pain. Binary logistic regression was used to determine the variables associated to pain aspects.ResultsA total of 2633 (42%) reported chronic pain. More obese older adults (BMI 30kg/m(2)) experienced chronic pain (58%) than those who were low-normal weight (BMI amp;lt;25kg/m(2), 39%) or overweight (25BMI amp;lt;30kg/m(2), 41%). Obese elderly more frequently had pain in extremities and lower back than their peers. In the multivariate model, obesity (Odds Ratio (OR) 1.59, 95% Confidence Interval (CI) 1.33-1.91) but not overweight (OR 1.08, 95% CI 0.95-1.22) was associated with chronic pain. Obesity (OR 1.53, 95% CI 1.16-2.01) was also significantly related to severe pain. We also found other comorbidities - i.e., traumatic history (OR 2.52, 95% CI 1.99-3.19), rheumatic diseases (OR 5.21, 95% CI 4.54-5.97), age85years (OR 1.66, 95% CI 1.22-2.25), and depression or anxiety diagnosis (OR 1.83, 95% CI 1.32-2.53) - showed stronger associations with pain aspects than weight status. Conclusion: In older adults, excess weight (BMI 30 or above) is a potentially modifiable factor but not the only risk factor that is associated with chronic pain and severe pain. Future studies should investigate the effectiveness of interventions that treat comorbid pain and obesity in older adults.
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34.
  • Dong, Huan-Ji, et al. (författare)
  • Maintenance of quality of life improvement for patients with chronic pain and obesity after interdisciplinary multimodal pain rehabilitation - A study using the Swedish Quality Registry for Pain Rehabilitation
  • 2019
  • Ingår i: European Journal of Pain. - : WILEY. - 1090-3801 .- 1532-2149. ; 23:10, s. 1839-1849
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Throughout the world many people have both obesity and chronic pain, comorbidities that decrease Health-Related Quality of Life (HRQoL). It is uncertain whether patients with comorbid obesity can maintain improved HRQoL after Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). Methods Data from 2016, 2017, and 2018 were obtained from a national pain database for Swedish specialized pain clinics and collected at three time points: Pre-IMMPR; Post- IMMPR; and 12-month follow-up (FU-IMMPR). Participants (N = 872) reported body weight, height, pain aspects, and HRQoL (RAND 36-Item Health Survey). Severe obesity (Body Mass Index, BMI amp;gt;= 35 kg/m(2)) was defined according to WHO classifications. We used linear mixed regression models to examine BMI group differences in HRQoL over time. Results More than 25% of patients (224/872) were obese and nearly 30% (63/224) of these were severely obese. All BMI groups improved significantly in both physical and mental composites of HRQoL after IMMPR (Pre- vs. Post-IMMPR, p amp;lt; .001). The improvements were maintained at a 12-month follow-up (Post- vs. FU-IMMPR, p amp;gt; .05). The severe obesity group had the lowest physical health score and least improvement (pre- vs. FU-IMMPR, Cohens d = o.422, small effect size). Severe obesity had negative impact on physical health (beta = -4.39, p amp;lt; .05) after controlling for sociodemographic factors and pain aspects. Conclusion Improvements in HRQoL after IMMPR were achieved and maintained across all weights, including patients with comorbid obesity. Only severe obesity was negatively associated with physical health aspects of HRQoL. Significance Patients with chronic pain and comorbid obesity achieve sustained Health-Related Quality of Life (HRQoL) improvements from Interdisciplinary Multimodal Pain Rehabilitation (IMMPR). This finding suggests that rehabilitation professionals should consider using IMMPR for patients with comorbid obesity even though their improvement may not reach the same level as for non-obese patients.
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35.
  • Dragioti, Elena, Ph.D., et al. (författare)
  • A cross-sectional study of factors associated with the number of anatomical pain sites in an actual elderly general population: results from the PainS65+cohort
  • 2017
  • Ingår i: Journal of Pain Research. - : DOVE MEDICAL PRESS LTD. - 1178-7090. ; 10, s. 2009-2019
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Several studies have illustrated that multisite pain is more frequent than single pain site, and it is associated with an array of negative consequences. However, there is limited knowledge available about the potential factors associated with multisite pain in the elderly general population. Objective: This cross-sectional study examines whether the number of anatomical pain sites (APSs) is related to sociodemographic and health-related factors in older adults including oldestold ages using a new method (APSs) to assess the location of pain on the body. Materials and methods: The sample came from the PainS65+ cohort, which included 6,611 older individuals (mean age = 76.0 years; standard deviation [SD] = 7.4) residing in southeastern Sweden. All the participants completed and returned a postal survey that measured sociodemographic data, total annual income, pain intensity and frequency, general well-being, and quality of life. The number of pain sites (NPS) was marked on a body manikin of 45 sections, and a total of 23 APSs were then calculated. Univariable and multivariable models of regression analysis were performed. Results: Approximately 39% of the respondents had at least two painful sites. The results of the regression analysis showed an independent association between the APSs and the age group of 75-79 years, women, married, high pain intensity and frequency, and low well-being and quality of life, after adjustments for consumption of analgesics and comorbidities. The strongest association was observed for the higher frequency of pain. Conclusion: Our results suggest that APSs are highly prevalent with strong relationships with various sociodemographic and health-related factors and concur well with the notion that multisite pain is a potential indicator of increased pain severity and impaired quality of life in the elderly. Our comprehensive method of calculating the number of sites could be an essential part of the clinical presentation, assessment, and treatment of multisite pain.
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36.
  • Dragioti, Elena, et al. (författare)
  • A Meta-Epidemiological Appraisal of the Effects of Interdisciplinary Multimodal Pain Therapy Dosing for Chronic Low Back Pain
  • 2019
  • Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 8:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Using a meta-analysis, meta-regression, and a meta-epidemiological approach, we conducted a systematic review to examine the influence of interdisciplinary multimodal pain therapy (IMPT) dosage on pain, disability, return to work, quality of life, depression, and anxiety in published randomised controlled trials (RCTs) in patients with non-specific chronic low back pain (CLBP). We considered all RCTs of IMPT from a Cochrane review and searched PubMed for additional RCTs through 30 September 2018. A subgroup random-effects meta-analysis by length, contact, and intensity of treatment was performed followed by a meta-regression analysis. Using random and fixed-effect models and a summary relative odds ratio (ROR), we compared the effect sizes (ES) from short-length, non-daily contact, and low-intensity RCTs with long-length, daily contact, and high-intensity RCTs. Heterogeneity was quantified with the I-2 metric. A total of 47 RCTs were selected. Subgroup meta-analysis showed that there were larger ES for pain and disability in RCTs with long-length, non-daily contact, and low intensity of treatment. Larger ES were also observed for quality of life in RCTs with short-length, non-daily contact, and low intensity treatment. However, these findings were not confirmed by the meta-regression analysis. Likewise, the summary RORs were not significant, indicating that the length, contact, and intensity of treatment did not have an overall effect on the investigated outcomes. For the outcomes investigated here, IMPT dosage is not generally associated with better ES, and an optimal dosage was not determined.
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37.
  • Dragioti, Elena, Ph.D., et al. (författare)
  • Association of insomnia severity with well-being, quality of life and health care costs: A cross-sectional study in older adults with chronic pain (PainS65+)
  • 2018
  • Ingår i: European Journal of Pain. - : WILEY. - 1090-3801 .- 1532-2149. ; 22:2, s. 414-425
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundInsomnia is one of the most common complaints in chronic pain. This study aimed to evaluate the association of insomnia with well-being, quality of life and health care costs. MethodsThe sample included 2790 older individuals (median age=76; interquartile range [IQR]=70-82) with chronic pain. The participants completed a postal survey assessing basic demographic data, pain intensity and frequency, height, weight, comorbidities, general well-being, quality of life and the insomnia severity index (ISI). Data on health care costs were calculated as costs per year (Euro prices) and measured in terms of outpatient and inpatient care, pain drugs, total drugs and total health care costs. ResultsThe overall fraction of clinical insomnia was 24.6% (moderate clinical insomnia: 21.9% [95% CI: 18.8-23.3]; severe clinical insomnia: 2.7% [95% CI: 1.6-3.2]). Persons who reported clinical insomnia were more likely to experience pain more frequently with higher pain intensity compared to those reported no clinically significant insomnia. Mean total health care costs were Euro 8469 (95% CI: Euro4029-Euro14,271) for persons with severe insomnia compared with Euro 4345 (95% CI: Euro4033-Euro4694) for persons with no clinically significant insomnia. An association between severe insomnia, well-being, quality of life, outpatient care, total drugs costs and total health care costs remained after controlling for age, sex, pain intensity, frequency, body mass index and comorbidities using linear regression models. ConclusionsOur results determine an independent association of insomnia with low health-related quality of life and increased health care costs in older adults with chronic pain. SignificanceThe concurrence and the severity of insomnia among older adults with chronic pain were associated with decreased well-being and quality of life, and increased health care costs to society.
  •  
38.
  • Dragioti, Elena, Ph.D., et al. (författare)
  • EFFECTIVENESS OF MULTIDISCIPLINARY PROGRAMMES FOR CLINICAL PAIN CONDITIONS: AN UMBRELLA REVIEW
  • 2018
  • Ingår i: Journal of Rehabilitation Medicine. - : FOUNDATION REHABILITATION INFORMATION. - 1650-1977 .- 1651-2081. ; 50:9, s. 779-791
  • Forskningsöversikt (refereegranskat)abstract
    • Objective: To evaluate the strength of the evidence for multimodal/multidisciplinary rehabilitation programmes (MMRPs) for common pain outcomes. Data sources: PubMed, PsychInfo, PEDro and Co-chrane Library were searched from inception to August 2017. Study selection: Meta-analyses of randomized controlled trials or controlled clinical trials and qualitative systematic reviews of randomized controlled trials and non-randomized controlled trials were considered eligible. Data extraction: Two independent reviewers abstracted data and evaluated the methodological quality of the reviews. The strength of the evidence was graded using several criteria. Data synthesis: Twelve meta-analyses, including 134 associations, and 24 qualitative systematic reviews were selected. None of the associations in meta-analyses and qualitative systematic reviews were supported by either strong or highly suggestive evidence. In meta-analyses, only 8 (6%) associations that were significant at p-value amp;lt;= 0.05 were supported by suggestive evidence, whereas 44 (33%) associations were supported by weak evidence. Moderate evidence was found only in 4 (17%) qualitative systematic reviews, while 14 (58%) qualitative systematic reviews had limited evidence. Conclusion: There is no evidence that MMRPs are effective for prevalent clinical pain conditions. The majority of the evidence remains ambiguous and susceptible to biases due to the small sample size of participants and the limited number of studies included.
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39.
  • Dragioti, Elena, Ph.D., et al. (författare)
  • Insomnia severity and its relationship with demographics, pain features, anxiety, and depression in older adults with and without pain: cross-sectional population-based results from the PainS65+cohort
  • 2017
  • Ingår i: Annals of General Psychiatry. - : BIOMED CENTRAL LTD. - 1744-859X. ; 16
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Insomnia is a major cause of concern in the elderly with and without pain. This study set out to examine the insomnia and its correlates in a large sample of community adults aged amp;gt;= 65 years. Methods: A cross-sectional postal survey was completed by 6205 older individuals (53.8% women; mean age = 76.2 years; SD = 7.5). The participants also completed the Insomnia Severity Index (ISI) and questionnaires assessing pain intensity, pain spreading, anxiety, depression, and basic demographic information. The sample was divided into three groups based on the presence and duration of pain: chronic pain (CP; n = 2790), subacute pain (SP; n = 510), and no pain (NP; n = 2905). Results: A proportion of each of the groups had an ISI score of 15 or greater (i.e., clinical insomnia): CP = 24.6%; SP = 21.3%; and NP = 13.0%. The average scores of ISI differed significantly among CP, SP, and NP groups (p amp;lt; 0.001). Stratified regression analyses showed that pain intensity, pain spreading, anxiety, and depression were independently related to insomnia in the CP group. Anxiety and depression were independently related to insomnia in the SP group, but only anxiety was significantly associated with insomnia in the NP group. Age and sex were not associated with insomnia. Conclusions: This study confirms that insomnia is not associated with chronological aging per se within the elderly population. Although the possible associations of insomnia with pain are complex, ensuing from pain intensity, pain spreading, anxiety, and depression, our results highlighted that anxiety was more strongly associated with insomnia in all groups than the depression and pain characteristics. Therapeutic plans should consider these relations during the course of pain, and a comprehensive assessment including both pain and psychological features is essential when older people are seeking primary health care for insomnia complaints.
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40.
  • Dragioti, Elena, et al. (författare)
  • Longitudinal Associations between Anatomical Regions of Pain and Work Conditions: A Study from The SwePain Cohort
  • 2019
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 16:12
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated the time-based associations between workload (physical and mechanical), psychosocial work stressors (demands, control, and support), and the number of anatomical regions with pain (ARP). This population-based study with a two-year follow-up included 11,386 responders (5125 men, 6261 women; mean age: 48.8 years; SD: 18.5) living in south-eastern Sweden. Predictive associations were assessed through generalised linear models, and changes over time were examined using a generalised estimating equation. The results of both models were reported as parameter estimates (B) with 95% confidence interval (CIs). Mean changes in the number of ARP, workload, and psychosocial work stressors were stable over time. High mechanical workload and job demands were likely associated with the number of ARP at the two-year follow-up. In the reverse prospective model, we found that the number of ARP was also associated with high physical and mechanical workload and low job control and support. In the two time-based models of changes, we found a reciprocal association between number of ARP and mechanical workload. Our results add epidemiological evidence to the associations between work conditions and the extent of pain on the body. Components of work conditions, including job demands and mechanical strain, must be considered when organisations and health policy makers plan and employ ergonomic evaluations to minimise workplace hazards in the general population.
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41.
  • Dragioti, Elena, et al. (författare)
  • Predictive association between immigration status and chronic pain in the general population: results from the SwePain cohort
  • 2020
  • Ingår i: BMC Public Health. - : BMC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPrevious studies suggest that immigration may influence the experience of pain.ObjectiveThis population-based study examines whether immigration status is associated with chronic pain (CP), chronic widespread pain (CWSP), and severe CP at a two-year follow-up. We also tested mediation by mood status (i.e., anxiety and depression).Methods15, 563 participants from a representative stratified random sample of 34,000 individuals living in south-eastern Sweden completed a postal survey, during 2013-2015, that included the following data: immigration status; presence of CP (pain lasting at least 3 months) and CWSP (a modified classification of widespread pain for use in epidemiological studies); severity of CP based on a numeric rating scale; and depression, anxiety, economic situation, and sociodemographic information. We applied logistic regressions using the generalized estimating equations (GEE), with Swedish-born as the reference group and path analyses models.ResultsCompared to the Swedish-born participants (n =14,093;90%), the immigrants (n =1470;10%) had an elevated risk of all pain outcomes (CP: odds ratio [OR]=1.18; 95% confidence interval [CI=1.04-1.33, CWSP: OR=1.39; 95% CI: 1.15-1.69 and severe CP: 1.51; 95% CI: 1.23-1.87) after adjustments. Path analyses showed that baseline age, immigrant status, and financial hardship had a significant influence on chronic pain outcomes at follow-up with baseline mood status as the mediator. Immigration status was also associated with age and financial hardship.ConclusionImmigrants may have increased risk of chronic pain, widespread pain, and severe pain and this risk is mediated by mood status. Targeted interventions better tailored to the socio-economic and psychological status of immigrants with chronic pain are warranted.
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42.
  • Dragioti, Elena, et al. (författare)
  • Prevalence of different pain categories based on pain spreading on the bodies of older adults in Sweden: a descriptive-level and multilevel association with demographics, comorbidities, medications, and certain lifestyle factors (PainS65+)
  • 2016
  • Ingår i: Journal of Pain Research. - : DOVE MEDICAL PRESS LTD. - 1178-7090. ; 9, s. 1131-1141
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and objective: There is limited knowledge about the prevalence of pain and its relation to comorbidities, medication, and certain lifestyle factors in older adults. To address this limitation, this cross-sectional study examined the spreading of pain on the body in a sample of 6611 subjects amp;gt;= 65 years old (mean age = 75.0 years; standard deviation [SD] = 7.7) living in southeastern Sweden. Methods: Sex, age, comorbidities, medication, nicotine, alcohol intake, and physical activity were analyzed in relation to the following pain categories: local pain (LP) (24.1%), regional pain medium (RP-Medium) (20.3%), regional pain heavy (RP-Heavy) (5.2%), and widespread pain (WSP) (1.7%). Results: RP-Medium, RP-Heavy, and WSP were associated more strongly with women than with men (all pamp;lt;0.01). RP-Heavy was less likely in the 80-84 and amp;gt;85 age groups compared to the 65-69 age group (both pamp;lt;0.01). Traumatic injuries, rheumatoid arthritis/osteoarthritis, and analgesics were associated with all pain categories (all pamp;lt;0.001). An association with gastrointestinal disorders was found in LP, RP-Medium, and RP-Heavy (all pamp;lt;0.01). Depressive disorders were associated with all pain categories, except for LP (all pamp;lt;0.05). Disorders of the central nervous system were associated with both RP-Heavy and WSP (all pamp;lt;0.05). Medication for peripheral vascular disorders was associated with RP-Medium (pamp;lt;0.05), and hypnotics were associated with RP-Heavy (pamp;lt;0.01). Conclusion: More than 50% of older adults suffered from different pain spread categories. Women were more likely to experience greater spreading of pain than men. A noteworthy number of common comorbidities and medications were associated with increased likelihood of pain spread from LP to RP-Medium, RP-Heavy, and WSP. Effective management plans should consider these observed associations to improve functional deficiency and decrease spreading of pain-related disability in older adults.
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43.
  • Dragioti, Elena, Ph.D., et al. (författare)
  • Reported outcomes in published systematic reviews of interdisciplinary pain treatment: Protocol for a systematic overview
  • 2020
  • Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 9:5
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Interdisciplinary pain treatment (IPT) is a complex intervention; its outcomes are very diverse, as are the methodologies for handling those outcomes. This diversity may hamper evidence-based decision making. Presently, there is no gold standard recommendation of how to select reported outcomes in published systematic reviews and meta-analyses to explicitly demonstrate the effectiveness of IPT. Objective: In this systematic overview, we aim to evaluate the reported outcome domains and measurements across published systematic reviews and meta-analyses and to identify any methods, considerations, and discussion regarding the handling of the chosen outcome domains and measurements. Methods: This article describes the protocol for a systematic overview of the outcomes reported in published systematic reviews and meta-analyses of randomized control trials for the effectiveness of IPT versus any control. To this end, we searched the PubMed, Cochrane Library, and Epistemonikos databases from inception to December 2019. Two independent investigators screened the titles, the abstracts of the identified records, and the full texts of the potentially eligible systematic reviews and meta-analyses, performed data extraction according to predefined forms, and rated the quality of the included systematic reviews and meta-analyses. The quality of the included systematic reviews and meta-analyses will be rated with AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. Data will be analyzed descriptively and stratified by AMSTAR 2. Results: We introduced the rationale and design of a systematic overview to summarize and map the chosen IPT outcome domains and the methods of handling these outcomes reported in published systematic reviews and meta-analyses. As of December 2019, we collected 5229 systematic reviews, of which 147 (2.81%) were examined in-depth for eligibility. Topline results are anticipated by September 2020. Conclusions: The results of this study will be published as soon as they are available. Our results will fill a gap in the related literature and will be used to inform the development of a set of recommendations that can be applied in systematic reviews and hopefully serve as a gold standard. © 2020 JMIR Publications. All rights reserved.
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44.
  • Eberhardt, Kerstin, et al. (författare)
  • Measuring health related quality of life in patients with rheumatoid arthritis--reliability, validity, and responsiveness of a Swedish version of RAQoL.
  • 2002
  • Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 31:1, s. 6-12
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To adapt the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire for Swedish patients and evaluate psychometric properties in a prospective study. METHODS: Reliability was assessed in 61 patients filling in RAQoL two times with one week's interval. 114 patients completed RAQoL and Nottingham Health Profile (NHP) on 2-3 occasions 6 months apart. Validity was evaluated comparing RAQoL-scores to disease-related variables and NHP subscales. Standardized response mean was applied to calculate responsiveness with the RA-related variables as external indicators of change. RESULTS: Test-retest reliability was high and internal consistency sufficient. RAQoL correlated as expected to NHP section scores. In a multivariate model the Stanford Health Assessment Questionnaire disability index (HAQ) and general health could explain 40% and disease activity measures 13% of the variance of RAQoL. Correlations between change scores of clinical variables and RAQoL and NHP were weak but positive. Standardized response means regarding change of disease activity, HAQ, and general health were small but in the same range for both RAQoL and NHP. CONCLUSION: The Swedish RAQoL had similar measurement properties as the original version. However, responsiveness regarding condition specific measures was not better than for the generic instrument NHP.
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45.
  • Eberhardt, Kerstin, et al. (författare)
  • Work Disability in Rheumatoid Arthritis -- Development over 15 Years and Evaluation of Predictive Factors Over Time.
  • 2007
  • Ingår i: Journal of Rheumatology. - 0315-162X. ; 34:3, s. 481-487
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To investigate work disability rates over 15 years in an early rheumatoid arthritis (RA) cohort and to evaluate predictive factors during the course of the study. Methods. All patients with early RA of working age (n = 148) were followed and treated at a team care unit. Mean disease duration at inclusion was 1 year. Work characteristics and disease-related variables were recorded annually. Logistic regression analyses were performed to identify predictors for work disability after 5, 10, and 15 years. Results. Work disability rates were 28%, 35%, 39%, and 44% at study start and after 5, 10, and 15 years, respectively. Forty-seven patients reduced working hours and 34 changed work tasks during the study time. Older age, less education, heavy manual work, and much activity limitation assessed by Health Assessment Questionnaire (HAQ) were predictors of work disability. Demographics and work factors had best predictive value in the early phase, while HAQ was a strong predictor at all points in time. Odds ratios for baseline HAQ, 5 year HAQ, and 10 year HAQ were 6.3, 9.6, and 4.1 for work disability after 5, 10, and 15 years, respectively. Conclusion. The prevalence of work disability was 28% at inclusion. After 15 years' followup the prevalence was 44%, which is lower than previously reported. HAQ was the single prognostic factor with strong predictive value throughout the study.
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46.
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47.
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48.
  • Einarsson, Snorri, 1973, et al. (författare)
  • Weight reduction intervention for obese infertile women prior to IVF: a randomized controlled trial.
  • 2017
  • Ingår i: Human reproduction (Oxford, England). - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 32:8, s. 1621-1630
  • Tidskriftsartikel (refereegranskat)abstract
    • Does an intensive weight reduction programme prior to IVF increase live birth rates for infertile obese women?An intensive weight reduction programme resulted in a large weight loss but did not substantially affect live birth rates in obese women scheduled for IVF.Among obese women, fertility and obstetric outcomes are influenced negatively with increased risk of miscarriage and a higher risk of maternal and neonatal complications. A recent large randomized controlled trial found no effect of lifestyle intervention on live birth in infertile obese women.A prospective, multicentre, randomized controlled trial was performed between 2010 and 2016 in the Nordic countries. In total, 962 women were assessed for eligibility and 317 women were randomized. Computerized randomization with concealed allocation was performed in the proportions 1:1 to one of two groups: weight reduction intervention followed by IVF-treatment or IVF-treatment only. One cycle per patient was included.Nine infertility clinics in Sweden, Denmark and Iceland participated. Women under 38 years of age planning IVF, and having a BMI ≥30 and <35 kg/m2 were randomized to two groups: an intervention group (160 patients) with weight reduction before IVF, starting with 12 weeks of a low calorie liquid formula diet (LCD) of 880 kcal/day and thereafter weight stabilization for 2-5 weeks, or a control group (157 patients) with IVF only.In the full analysis set (FAS), the live birth rate was 29.6% (45/152) in the weight reduction and IVF group and 27.5% (42/153) in the IVF only group. The difference was not statistically significant (difference 2.2%, 95% CI: 12.9 to -8.6, P = 0.77). The mean weight change was -9.44 (6.57) kg in the weight reduction and IVF group as compared to +1.19 (1.95) kg in the IVF only group, being highly significant (P < 0.0001). Significantly more live births were achieved through spontaneous pregnancies in the weight reduction and IVF group, 10.5% (16) as compared to the IVF only group 2.6% (4) (P = 0.009). Miscarriage rates and gonadotropin dose used for IVF stimulation did not differ between groups. Two subgroup analyses were performed. The first compared women with PCOS in the two randomized groups, and the second compared women in the weight reduction group reaching BMI ≤ 25 kg/m2 or reaching a weight loss of at least five BMI units to the IVF only group. No statistical differences in live birth rates between the groups in either subgroup analysis were found.The study was not powered to detect a small increase in live births due to weight reduction and was not blinded for the patients or physician. Further, the intervention group had a longer time to achieve a spontaneous pregnancy, but were therefore slightly older than the control group at IVF. The study only included women with a BMI lower than 35 kg/m2.The study suggests that weight loss for obese women (BMI: 30-34.9 kg/m2) may not rectify the outcome in IVF cycles, although a significant higher number of spontaneous conceptions occurred in the weight loss group. Also, the study suggests that intensive weight reduction with LCD treatment does not negatively affects the results.The study was funded by Sahlgrenska University Hospital (ALFGBG-70 940), Merck AB, Solna, Sweden (an affiliate of Merck KGaA, Darmstadt, Germany), Impolin AB, Hjalmar Svensson Foundation and Jane and Dan Olsson Foundation. Dr Thurin-Kjellberg reports grants from Merck, non-financial support from Impolin AB, during the conduct of the study, and personal fees from Merck outside the submitted work. Dr Friberg reports personal fees from Ferring, Merck, MSD, Finox and personal fees from Studentlitteratur, outside the submitted work. Dr Englund reports personal fees from Ferring, and non-financial support from Merck, outside the submitted work. Dr Bergh reports and has been reimbursed for: writing a newsletter twice a year (Ferring), lectures (Ferring, MSD, Merck), and Nordic working group meetings (Finox). Dr Karlström reports lectures (Ferring, Finox, Merck, MSD) and Nordic working group meetings (Ferring). Ms Kluge, Dr Einarsson, Dr Pinborg, Dr Klajnbard, Dr Stenlöf, Dr Larsson, Dr Loft and Dr Wistrand have nothing to disclose.ClinicalTrials.gov number, NCT01566929.23-03-2012.05-10-2010.
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49.
  • Ekerljung, Linda, 1979, et al. (författare)
  • Has the increase in the prevalence of asthma and respiratory symptoms reached a plateau in Stockholm, Sweden?
  • 2010
  • Ingår i: The International Journal of Tuberculosis and Lung Disease. - 1027-3719 .- 1815-7920. ; 14:6, s. 764-771
  • Tidskriftsartikel (refereegranskat)abstract
    • SETTING: An increase in the prevalence of asthma has previously been reported worldwide. However, the current trend is debatable. OBJECTIVE: To assess changes in the prevalence of asthma and respiratory symptoms in a defined study area in Stockholm, Sweden, using identical methods. DESIGN: A questionnaire was sent by mail in 1996 and 2007 to randomly selected subjects aged 20-69 years. On both occasions, 8000 subjects received the questionnaire, with response rates of 72% and 68%, respectively. Questions on asthma, respiratory symptoms, asthma medication and possible determinants were included. Logistic regression analysis was used to assess determinants. RESULTS: Ever asthma increased from 8.7% in 1996 to 11.0% in 2007 and physician-diagnosed asthma from 7.6% to 9.3%. The proportion of asthma patients reporting one to two symptoms increased by 14% during the study period. There were few significant changes in the prevalence of respiratory symptoms: wheeze in the previous 12 months (15.9-17.3%), wheezing with breathlessness apart from cold (3.2-4.1%) and recurrent wheeze (8.3-6.8%). There was no major difference in the risk factor pattern between the surveys. CONCLUSION: An increase in the prevalence of asthma with few symptoms as well as an unchanged prevalence of symptoms was demonstrated, which may indicate a change in diagnostic practices.
  •  
50.
  • Ekerljung, Linda, 1979, et al. (författare)
  • Incidence and prevalence of adult asthma is associated with low socio-economic status
  • 2010
  • Ingår i: The Clinical Respiratory Journal. - 1752-6981 .- 1752-699X. ; 4:3, s. 147-56
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Low socio-economic status is often related to health problems; however, previous studies on asthma, usually cross-sectional, yield inconsistent results. In this study, longitudinal and cross-sectional data on the association between socio-economic status and asthma as well as respiratory symptoms among adults are presented. Methods: A postal questionnaire was sent on two occasions, 1996 and 2006, to a randomly selected sample of subjects aged 20–69 years in 1996. In total, 4479 subjects participated in both surveys. The questionnaire included questions on asthma, respiratory symptoms and possible determinants. Logistic regression analysis, adjusted for potential confounders, was used to study the association between asthma, respiratory symptoms and socio-economic status. Results: Manual workers in service had the highest prevalence and cumulative incidence for all investigated symptoms and asthma. Despite a large decrease in smokers, the increase in incident bronchitic symptoms was higher than the increase of incident asthma and incident asthmatic symptoms. Low socio-economic status, rhinitis and a family history of asthma were risk factors for having and developing asthma and respiratory symptoms. Conclusion: Low socio-economic status is significantly associated with an increased risk for prevalent and incident asthma and respiratory symptoms in this longitudinal population-based survey. The increase in risk was most pronounced in manual workers. Several studies have recently shown an association between low socio-economic status and respiratory symptoms and we conclude that asthma can not be considered as a disease that mainly affects the middle and upper socio-economic classes.
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