| 1. |
- Browaldh, Lars, et al.
(författare)
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Celiaki är en vanlig sjukdom som är lätt att missa
- 2014
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Ingår i: Läkartidningen. - : Swedish Medical Association. - 0023-7205 .- 1652-7518. ; 111:11, s. 484-488
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Tidskriftsartikel (refereegranskat)abstract
- Celiaki ansågs länge som en ovanlig barnsjukdom, men är en vanlig sjukdom som drabbar alla åldrar. Genomförda screeningar av normalbefolkningen visar att merparten inte fått diagnos eller behandling. Den kliniska bilden varierar: alltifrån diffusa besvär eller inga symtom alls till allvarliga gastrointestinala symtom med grav avmagring och tillväxtrubbning till följd av malabsorption. Klinisk misstanke om eller hereditet för celiaki bör föranleda analys av specifika serologiska markörer. Gastroskopi med tunntarmsbiopsi bör övervägas för att bekräfta eller utesluta diagnosen.
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| 2. |
- Ivarsson, Anneli, et al.
(författare)
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Prevalence of Childhood Celiac Disease and Changes in Infant Feeding
- 2013
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Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 131:3, s. E687-E694
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Between 1984 and 1996, Sweden experienced an "epidemic" of clinical celiac disease in children andlt;2 years of age, attributed partly to changes in infant feeding. Whether infant feeding affects disease occurrence and/or the clinical presentation remains unknown. We investigated and compared the total prevalence of celiac disease in 2 birth cohorts of 12-year-olds and related the findings to each cohorts ascertained infant feeding. less thanbrgreater than less thanbrgreater thanMETHODS: A 2-phase cross-sectional screening study was performed in which 13 279 children from 2 birth cohorts participated: children born during the epidemic (1993) and children born after the epidemic (1997). Previously diagnosed cases were reported and confirmed. Blood samples were analyzed for serological markers and children with positive values were referred for small intestinal biopsy. Infant feeding practices in the cohorts were ascertained via questionnaires. Prevalence comparisons were expressed as prevalence ratios. less thanbrgreater than less thanbrgreater thanRESULTS: The total prevalence of celiac disease was 29 in 1000 and 22 in 1000 for the 1993 and 1997 cohorts, respectively. Children born in 1997 had a significantly lower risk of having celiac disease compared with those born in 1993 (prevalence ratio: 0.75; 95% confidence interval: 0.60-0.93; P = .01). The cohorts differed in infant feeding (specifically, in the proportion of infants introduced to dietary gluten in small amounts during ongoing breastfeeding). less thanbrgreater than less thanbrgreater thanCONCLUSIONS: A significantly reduced prevalence of celiac disease in 12-year-olds indicates an option for disease prevention. Our findings suggest that the present infant feeding recommendation to gradually introduce gluten-containing foods from 4 months of age, preferably during ongoing breastfeeding, is favorable. Pediatrics 2013;131:e687-e694
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| 3. |
- Nordyke, Katrina, et al.
(författare)
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Health-related quality-of-life in children with coeliac disease, measured prior to receiving their diagnosis through screening
- 2011
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Ingår i: Journal of Medical Screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 18:4, s. 187-192
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare the health-related quality-of-life (HRQoL) of children with screening-detected coeliac disease (CD), before they learned of their diagnosis, with that of children without CD and in those previously diagnosed with CD. Methods In a cross-sectional CD screening study ('ETICS': Exploring the Iceberg of Coeliacs in Sweden), of 10,041 Swedish 12-year-olds invited, 7567 (75%) consented to participate, and 7208 (72%) children without previously diagnosed CD had serological markers analysed. Before the screening results were known, 7218 children (72%) and 6524 of their parents (65%) answered questionnaires. Questionnaires included the Swedish child-friendly pilot version of the EQ-5D instrument and proxy version of the EQ-5D instrument, which are generic tools used to describe HRQoL. Results We found no significant difference in HRQoL between the groups of children with screening-detected CD, without CD, and those previously diagnosed with CD. Conclusion The HRQoL reported by 12-year-olds with screening-detected CD, before they learned of their diagnosis, was not worse than that of the children without CD or those previously diagnosed with CD. Thus, mass screening for CD should not be justified on the basis that children with unrecognized CD have a poor HRQoL. However, because these children rated their HRQoL before diagnosis and treatment, they may not have recognized or perceived symptoms as severe enough to seek medical attention which demonstrates how difficult clinical/active case finding can be. Mass screening may still, therefore, be considered if the aim is early detection and prevention of future complications.
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| 4. |
- Norström, Fredrik, et al.
(författare)
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Parents' willingness to pay for coeliac disease screening of their child.
- 2011
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - Jpgn. - 1536-4801 .- 0277-2116. ; 52:4, s. 452-459
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: : The aim of this study is to determine Swedish parents' willingness to pay (WTP) for coeliac disease (CD) screening of their child. SUBJECTS AND METHODS: : CD screening was undertaken involving 10,041 12-year-old children, with 7567 (75%) agreeing to participate. Blood samples from the children were analysed for CD serological markers. Parents received a questionnaire including a scenario describing the health-related risks of having CD and screening and diagnostic procedures. Parents were also asked whether they were willing to pay for CD screening, should this not be offered free of charge, and, if so, what their maximum WTP would be. Their WTP was compared with the average cost per child for the screening and case ascertainment procedures. RESULTS: : The questionnaire was answered by 6524 parents, and of 6057 valid responses 63% stated that they were willing to pay something. The mean WTP was 79 EUR and the median 10 EUR. The average cost per child for the screening and case ascertainment procedures was 47 EUR, which 23% of the parents stated they were willing to pay. Parents' WTP increased with higher education and income, and with child symptoms that may indicate CD. CONCLUSIONS: : Swedish parents' WTP for school-based CD screening of their child was higher than the average cost per child; however, only a minority of the parents were willing to pay that amount.
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| 5. |
- Webb, Charlotta, et al.
(författare)
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Accuracy in Celiac Disease Diagnostics by Controlling the Small-bowel Biopsy Process
- 2011
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Ingår i: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - : Lippincott, Williams and Wilkins. - 0277-2116 .- 1536-4801. ; 52:5, s. 549-553
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In a Swedish celiac disease screening study (Exploring the Iceberg of Celiacs in Sweden), we systematically reviewed the clinical diagnostic procedures with the aim to evaluate the diagnostic accuracy and to take advantage of lessons learned for improving diagnostic routines. Materials and Methods: A school-based celiac disease screening study involving 5 Swedish centers, with 10,041 invited 12-year-olds with 7567 consenting participation. All 192 children with elevated serological markers were recommended to undergo small-bowel biopsy, performed and evaluated according to local clinical routines. All of the mucosal specimens were reevaluated by 1 and, when needed, 2 expert pathologists to reach diagnostic consensus. Results: Small-bowel biopsies were performed in 184 children: 130 by endoscopy and 54 by suction capsule. Endoscopic biopsies were inconclusive in 0.6%, compared with 7.4% of biopsies by suction capsule. A patchy enteropathy was found in 9.1%. Reevaluation by the expert pathologist resulted in 6 additional cases with celiac disease and 1 cleared. Sixteen children with normal or inconclusive biopsies, 4 after endoscopy, and 12 after suction capsule were endoscopically rebiopsied, resulting in another 8 cases. The celiac disease prevalence of 30 of 1000 (95% confidence interval 26-34) was not statistically different from that previously reported. Conclusions: The present review revealed the importance of controlling each step of the diagnostic procedure. Several cases would have been missed by relying only on local routines. To improve the quality of childhood celiac disease diagnostics, we recommend multiple endoscopic biopsies from both proximal and distal duodenum and standardized evaluation by a pathologist with good knowledge of celiac disease.
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| 6. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Growth hormone dose-dependent pubertal growth : a randomized trial in short children with low growth hormone secretion
- 2014
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Ingår i: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 82:3, s. 158-170
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency.Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height.Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS.Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.
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| 7. |
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Arbete: Passion och exploatering
- 2011
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Det har skett omfattande förändringar i samhället som påverkar både våra möjligheter på arbetsmarknaden och våra föreställningar om arbete. De självstyrande, kreativa och alltmer innovationsinritade delarna av arbetsmarkanden och de allt hårdare reglerade delarna av arbetsmarkanden kan beskrivas i termer av en ökad polarisering. Detta får också konsekvenser för hur förhållandet mellan exploatering, passion och arbete kan förstås. Föreliggande nummer av tidskriften Arbetsliv i omvandling försöker på olika sätt att belysa denna problematik. Inledningsvis diskuteras de två centrala begreppen, passion och exploatering, i syfte att visa hur dessa kan utgöra analytiska redskap när man närmar sig olika områden och problem knutna till arbete och arbetsliv. Med hjälp av ett antal exempel lyfts därefter olika aspekter fram som speglar de förändringar som präglar dagens arbetsmarknad. Bidragen försöker var och en på sitt att visa hur olika individer och yrkesgrupper hanterar sina liv i spänningsfältet mellan passion och exploatering
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| 8. |
- Asplund, Sara, 1976, et al.
(författare)
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Extended analysis of the effect of learning with feedback on the detectability of pulmonary nodules in chest tomosynthesis
- 2011
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. ; 7966
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of section images of the chest, resulting in a reduction of disturbing anatomy at a moderate increase in radiation dose compared to chest radiography. In a previous study, we investigated the effects of learning with feedback on the detection of pulmonary nodules in chest tomosynthesis. Six observers with varying degrees of experience of chest tomosynthesis analyzed tomosynthesis cases for presence of pulmonary nodules. The cases were analyzed before and after learning with feedback. Multidetector computed tomography (MDCT) was used as reference. The differences in performance between the two readings were calculated using the jackknife alternative free-response receiver operating characteristics (JAFROC-2) as primary measure of detectability. Significant differences between the readings were found only for observers inexperienced in chest tomosynthesis. The purpose of the present study was to extend the statistical analysis of the results of the previous study, including JAFROC-1 analysis and FROC curves in the analysis. The results are consistent with the results of the previous study and, furthermore, JAFROC-1 gave lower p-values than JAFROC-2 for the observers who improved their performance after learning with feedback. © 2011 SPIE.
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| 9. |
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| 10. |
- Asplund, Sara, 1976, et al.
(författare)
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Learning aspects and potential pitfalls regarding detection of pulmonary nodules in chest tomosynthesis and proposed related quality criteria.
- 2011
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Ingår i: Acta radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 52:5, s. 503-512
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Tidskriftsartikel (refereegranskat)abstract
- Background In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of an arbitrary number of section images of the chest, resulting in a moderately increased radiation dose compared to chest radiography. Purpose To investigate the effects of learning with feedback on the detection of pulmonary nodules for observers with varying experience of chest tomosynthesis, to identify pitfalls regarding detection of pulmonary nodules, and present suggestions for how to avoid them, and to adapt the European quality criteria for chest radiography and computed tomography (CT) to chest tomosynthesis. Material and Methods Six observers analyzed tomosynthesis cases for presence of nodules in a jackknife alternative free-response receiver-operating characteristics (JAFROC) study. CT was used as reference. The same tomosynthesis cases were analyzed before and after learning with feedback, which included a collective learning session. The difference in performance between the two readings was calculated using the JAFROC figure of merit as principal measure of detectability. Results Significant improvement in performance after learning with feedback was found only for observers inexperienced in tomosynthesis. At the collective learning session, localization of pleural and subpleural nodules or structures was identified as the main difficulty in analyzing tomosynthesis images. Conclusion The results indicate that inexperienced observers can reach a high level of performance regarding nodule detection in tomosynthesis after learning with feedback and that the main problem with chest tomosynthesis is related to the limited depth resolution.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Cederkrantz, Elin, et al.
(författare)
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Evaluation of Effects on the Peritoneum After Intraperitoneal α-Radioimmunotherapy with (211)At.
- 2012
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Ingår i: Cancer biotherapy & radiopharmaceuticals. - : Mary Ann Liebert Inc. - 1557-8852 .- 1084-9785. ; 27:6, s. 353-364
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The introduction of the short-lived α-emitter (211)At to intraperitoneal radioimmunotherapy has raised the issue of the tolerance dose of the peritoneum. The short range of the α-particles (70μm) and the short half-life (7.21h) of the nuclide yield a dose distribution in which the peritoneum is highly irradiated compared with other normal tissues. To address this issue, mice were injected with (211)At-trastuzumab to irradiate the peritoneum to absorbed doses ranging between 0 and 50 Gy and followed for up to 34 weeks. The peritoneum-to-plasma clearance of a small tracer, (51)Cr-ethylenediamine tetraacetic acid, was measured for evaluation of the small solute transport capacity of the peritoneal membrane. The macroscopic status of the peritoneum and the mesenteric windows was documented when the mice were sacrificed. Biopsies of the peritoneum were taken for morphology and immunohistochemical staining against plasminogen activator inhibitor-1 and calprotectin. Peritoneum-to-plasma clearance measurements indicated a dose-dependent decrease in peritoneal transport capacity in irradiated mice. However, macroscopic and microscopic evaluations of the peritoneal membrane showed no difference between irradiated mice versus controls. The results imply that the peritoneal membrane tolerates absorbed doses as high as 30-50 Gy from α-particle irradiation with limited response.
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| 15. |
- Elmarghani, Ahmed, 1975-, et al.
(författare)
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Contribution of pharmaceuticals, fecal bacteria and endotoxin to the inflammatory responses to inland waters
- 2014
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 488-489, s. 228-235
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Tidskriftsartikel (refereegranskat)abstract
- The increasing contamination of freshwater with pharmaceuticals, surfactants, pesticides and other organic compounds are of major concern. As these contaminants are detected at trace levels in the environment it is important to determine if they elicit biological responses at the observed levels. In addition to chemical pollutants, there is also a concern for increasing levels of bacteria and other microorganisms in freshwater systems. In an earlier study, we observed the activation of inflammatory systems downstream of a wastewater treatment plant (WWTP) in southern Sweden. We also observed that the water contained unidentified components that were pro-inflammatory and potentiated the immune response in human urinary bladder epithelial cells. In order to determine if these effects were unique for the studied site or represent a common response in Swedish water, we have now performed a study on three WWTPs and their recipient waters in central Sweden. Analysis of immune responses in urinary bladder epithelial cells, monocyte-like cells and blood mononuclear cells confirm that these waters activate the immune system as well as induce pro-inflammatory responses. The results indicate that the cytokine profiles correlate to the endotoxin load of the waters rather than to the levels of pharmaceuticals or culturable bacteria load, suggesting that measurements of endotoxin levels and immune responses would be a valuable addition to the analysis of inland waters.
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| 16. |
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| 17. |
- Guy, Lionel, et al.
(författare)
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Adaptive Mutations and Replacements of Virulence Traits in the Escherichia coli O104:H4 Outbreak Population
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:5, s. e63027-
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Tidskriftsartikel (refereegranskat)abstract
- The sequencing of highly virulent Escherichia coli O104:H4 strains isolated during the outbreak of bloody diarrhea and hemolytic uremic syndrome in Europe in 2011 revealed a genome that contained a Shiga toxin encoding prophage and a plasmid encoding enteroaggregative fimbriae. Here, we present the draft genome sequence of a strain isolated in Sweden from a patient who had travelled to Tunisia in 2010 (E112/10) and was found to differ from the outbreak strains by only 38 SNPs in non-repetitive regions, 16 of which were mapped to the branch to the outbreak strain. We identified putatively adaptive mutations in genes for transporters, outer surface proteins and enzymes involved in the metabolism of carbohydrates. A comparative analysis with other historical strains showed that E112/10 contained Shiga toxin prophage genes of the same genotype as the outbreak strain, while these genes have been replaced by a different genotype in two otherwise very closely related strains isolated in the Republic of Georgia in 2009. We also present the genome sequences of two enteroaggregative E. coli strains affiliated with phylogroup A (C43/90 and C48/93) that contain the agg genes for the AAF/I-type fimbriae characteristic of the outbreak population. Interestingly, C43/90 also contained a tet/mer antibiotic resistance island that was nearly identical in sequence to that of the outbreak strain, while the corresponding island in the Georgian strains was most similar to E. coli strains of other serotypes. We conclude that the pan-genome of the outbreak population is shared with strains of the A phylogroup and that its evolutionary history is littered with gene replacement events, including most recently independent acquisitions of antibiotic resistance genes in the outbreak strains and its nearest neighbors. The results are summarized in a refined evolutionary model for the emergence of the O104:H4 outbreak population.
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| 18. |
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| 19. |
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| 20. |
- Holth, Line, et al.
(författare)
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Genusarbetsdelning - exploatering av kvinnors arbetskraft
- 2011
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Artikeln diskuterar genusarbetsdelning som särskiljande då det gäller synen på kvinnors och mäns arbete och arbetsvillkor i Sverige i ett historiskt perspektiv och med en startpunkt i industrialiseringsprocessen. Fokus ligger på villkoren idag och på hur det moderna arbetslivet formats utifrån föreställningar kopplade till denna process. Artikeln diskuterar vad detta betyder då vi idag talar om work life balance och jämställdhet. Artikeln går bortom arbetsbegreppets könsneutrala förståelse och "fyller" det med kvinnor och män.
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| 21. |
- Höög, Elisabet, 1962-, et al.
(författare)
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Challenges in managing a multi-sectoral health promotion program
- 2013
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Ingår i: Leadership in Health Services. - : Emerald Group Publishing Limited. - 1751-1879 .- 1751-1887. ; 26:4, s. 368-386
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to investigate program management teams’ views on issuesand challenges in managing a large, multi-sectoral child health promotion program in Sweden.Design/methodology/approach: In total, 17 participants representing two autonomous programmanagement teams, one strategic and one operational, were interviewed. Analysis of interview datawas complemented with reviews of program documents.Findings: Program management teams identified important issues concerning the program’sformal structure, goals, role distribution, and change and dissemination processes, but lacked a sharedmental model of the situation. Inter and intra group communication, long- and short-term strategicplanning were further areas in need of improvement. While issues and challenges might seem to beagreed upon by the program’s change agents, closer inspection reveals variation in key characteristicsas well as in perspectives on solutions.Originality/value: Health promotion programs are challenging. Researchers trying tounderstand program success have focused on particular interventions, contextual factors andprogram recipients. Less research has focused on the internal processes of teams tasked withwide-ranging change mandates and the effects such processes can have on program outcomes. Thisstudy contributes to a deeper understanding on internal processes and mental models of changeagent teams.
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| 22. |
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| 23. |
- Ivarsson, Bo, 1947-
(författare)
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Tools for Outcome-informed management of mental illness : Psychometric properties of instruments of the Swedish clinical multicenter Quality Star cohort
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this thesis was to investigate the psychometric properties of three global user subjective measures of the ”The Quality Star” clinical review model: Consumer Satisfaction Scale, Global Quality of Life scale, and Perceived Global Distress scale. The mental health implementation context of this review model emphasizes the client as an agent of change, taking part in shared decision making in an empowered role as collaborative partner to the professional clinicians. In Paper I study the patient self-rating Consumer Satisfaction Scale gave results comparable to those obtained by independent interviewer assessors. Out of cost-effective perspective professional time is saved and logistics simplified. In Paper II the visual analogue self-rating Global Quality of Life scale was shown to have satisfactory test-retest reliability, and concurrent validity with the “Life as a whole” item of Manchester Short Assessment of Quality of Life (MANSA). The patients’ conceptualizations of the scale based on associative findings with a number of validating instruments were consistent with expected areas of concern for Serious Mentally Ill persons. Similarly, in Paper III the visual analogue scale the Perceived Global Distress scale, showed acceptable clinical test-retest reliability, and concurrent validity with the MANSA item, “How satisfied are you with your mental health”. In associative analyses it was found that depressive, anxiety, interpersonal and existential elements contributed to the patient´s conceptualization of the construct. In Paper IV, a previous finding suggesting that women were more satisfied with the health care and had better social functioning compared to men was further elaborated investigating the discriminative properties of the subjective instruments. In the multi-centre cohort of 2552 patients it was possible to detect differences between genders and functional levels professionally assessed with the split version of Global Assessment of Functioning rating scale. The General discussion underlines that although subjective measures tend to have strong interrelations, supporting earlier findings, one has to use multiple measures for an optimal management of mental illness as the subjective outcome ratings have to be individually interpreted in a feed-back dialogue with the patient and be compared to observational assessments.
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| 24. |
- Ivarsson, Lars, 1969-
(författare)
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Att förena passion med försörjning : En diskussion om hobby och arbete i det senmoderna samhället
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Vissa sätt att försörja sig på benämns i termer av drömyrke, såsom att vara idrottare, musiker, konstnär, författare, skådespelare etc. De här människorna är ofta passionerade över området och utövandet ifråga, och har alltsedan unga år drömt om att kunna leva på sitt stora intresse. Att livnära sig på sådant som andra får lov att ägna sig åt på sin fritid tycks vara förenad med en allmän uppfattning om att det är inte bara självförverkligande, utan också bekymmerslöst. Men är det så?I den här boken diskuteras förekomsten av att förena passion med försörjning, och den förhärligande bild som allmänheten tycks ha angående så kallade drömyrken, verkar inte helt överensstämmande med verkligheten.Arbetslivsforskningen har till stor del negligerat frågan om passion och förvånande finns det knappt några texter som fokuserar på fenomenet att försörja sig på sin hobby. I det senmoderna individualiserade samhället där individerna alltmer uppmanas att ”göra sin grej” blir det angeläget att undersöka de villkor och konsekvenser som följer av detta. Förhoppningsvis kan den här boken ge viss insikt i vad ett förenande av passion och försörjning innebär. Och förhoppningsvis ger den inspiration till ytterligare forskning på området.
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| 25. |
- Ivarsson, Lars, 1969-
(författare)
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Att förvandla hobby till försörjning
- 2011
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Ingår i: Arbete: Passion och exploatering. - Växjö : Linnéuniversitetet. - 9789186983260 ; , s. 67-85
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Bokkapitel (refereegranskat)
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| 26. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Att leverera hantverkstjänster – en studie av näringsidkares upplevelser av affärsrelationen
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Under 2009 inkom det omkring 10 000 klagomål rörande hantverkare och hantverkstjänster till landets konsumentvägledningar. Detta är en ökning med tio procent jämfört med året innan. Vanligtvis handlar klagomålen om att hantverkstjänsten blivit dyrare än överenskommet eller att arbetet inte har utförts på det sätt konsumenten räknat med. Anledningen till det ökade klagomålet på hantverkstjänster kan enligt Helena Olofsson, boendeexpert på Konsumentverket, möjligtvis hänvisas till införandet av ROT-avdraget (Renovering, Ombyggnad, Tillbyggnad) som i korthet innebär attprivatkunder som anlitar hantverkare kan få en skattereduktion på 50 procentav arbetskostnaden. Denna förklaring bygger på ett antagande om att ROTavdragetmedför att fler personer väljer att anlita hantverkare nu närkostnaderna blir väsentligt lägre. Det förefaller logiskt att ett ökat anlitande också medför ett ökande av kunders missnöje och därmed klagomål. Den ökande andelen klagomål har föranlett en rad delstudier kring hur kunderoch hantverkare upplever affärsrelationen. Två av dessa är kvantitativt orienterade och vänder sig till privatkunder respektive hantverkare, i syfte att kartlägga utbredningen av kundmissnöje. Föreliggande rapport fokuserarnäringsidkares upplevelser av relationen.
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| 27. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Konsumenters upplevelser av telekombranschen
- 2011
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Ingår i: Fördjupad analys av marknaden för mobiltelefoni,bredband och sampaketerade telekomtjänster. - Karlstad : Konsumentverket. ; , s. 159-221
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 28. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Kundrelationer i hantverksbranschen : Hantverkares respektive konsumenters upplevelser och erfarenheter
- 2013
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kundrelationer har intresserat forskare och praktiker under tämligen lång tid. Ofta har man intagit ett kundperspektiv och försökt klargöra vad kunder värdesätter för att sedan kunna utveckla eller bibehålla så kallat kundfokus i syfte att nå företagsmässig framgång. Vad som anses vara ett framgångsrecept inom i synnerhet företagsekonomisk tjänsteforskning är att bemöta kunderna på ett unikt sätt, gärna kompletterat med förträfflig service. Vid sidan av studierna som intresserar sig för kunders önskemål och krav finns det undersökningar som fokuserar arbetssituationen hos anställdas, dvs de som förväntas uppfylla kundernas önskemål. Oavsett om det är kunder eller anställda som fokuseras placeras de mellanmänskliga relationerna – dvs själva mötet – oftast i fokus.Föreliggande rapport består av två separata kvalitativa studier inom området för hantverkstjänster: en med inriktning på leverantörsidan (dvs hantverkare), en med inriktning på mottagarsidan (dvs konsumenter). Genom att intervjua både hantverkare och konsumenter ges en nyanserad bild av kundrelationen.Båda dessa studier har utförts på uppdrag av Konsumentverket.
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| 29. |
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| 30. |
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| 31. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Personal business on company time
- 2012
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Ingår i: 30th International Labour Process Conference.
-
Konferensbidrag (refereegranskat)
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| 32. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Personal internet usage at work : A source of recovery
- 2011
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Ingår i: Journal of workplace rights. - 1938-4998. ; 16:1, s. 63-81
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Tidskriftsartikel (refereegranskat)abstract
- Despite enormous productivity increases during recent decades, it has been claimed that workers’ engagement in non-work-related activities severely damages companies’ productivity development. Currently, personal Internet usage seems to be the most upsetting of these activities. There is a widespread notion among management-friendly researchers, employers, and the media that all non-work-related activities are deviant and should be defeated at all costs. This conceptual article gives an overview of the organisational behaviour literature dealing with non-work-related activities at work. The prohibitive approach is both inconsistent and in practice unenforceable. This is especially true since an increasing proportion of today’s private Internet usage at work is carried out by employees using their private smartphones, a fact that has not been considered in previous research. This article contrasts theories and ideas that private Internet usage at work is deviant with theoretical overviews arguing that non-work-related activities are an expression of normal action and behaviour, which can be explained with the help of both work-life balance theory and theories on resistance. An additional concept is recovery, which has not previously been used in the debate on Internet usage. Today’s workplaces are populated by engaged employees who work at a fast pace and need recovery, well-deserved micro-pauses, and breaks from demanding work. Furthermore, some Internet surfing is actually a consequence of organisations’ inability to come up with decent work tasks to fill the whole day. The aim of this article is to point out the recovery functions of personal Internet usage in today’s working life, primarily in terms of employees’ well-being and dignity. This article contributes to the debate by proposing eight situations in which the employee should be allowed to “cyberloaf” without being disciplined. The article also suggests empirical investigations that may be carried out with regard to the views and effects of personal Internet use at work in four different settings, that is, where employees’ private Internet usage is officially forbidden, seemingly forbidden, allowed, or encouraged.
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| 33. |
- Ivarsson, Lars, et al.
(författare)
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Privata angelägenheter på jobbet
- 2012
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 18:3, s. 9-20
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Tidskriftsartikel (refereegranskat)abstract
- Arbetsgivarna har alltid haft ett stort intresse av att anställda utför det arbete de har betalt för att göra. För närvarande kretsar debatten om anställdas engagemang i privata angelägenheter såsom internetanvändning. I artikeln granskas den existerande forskningens förklaringar samtidigt som vi efterlyser forskning som bättre beaktar de positiva effekterna av fenomenet. Det krävs systematiska studier av både upplevda och faktiska effekter för att nyansera den tidvis hätska debatten.
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| 34. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Service Work and Employee Experience of the Service Encounter
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Due to the very nature of service work, a vast majority of research has focused on interpersonal aspects. There are mainly two perspectives; the first takes departure from the customers’ point of view and focus on customer satisfaction and business success.The second, rather critical, perspective highlights the employees’ experiences of the service interaction. Our purpose is to combine, summarize, and test – often the oreticaland sometimes normative – proposals and statements from both these perspectives. The empirical data is derived from (a) a questionnaire to a random sample of 2000 Swedish employees with daily customer/client contact in their work, and (b) in-depth interviews with 21 employees, working as shop assistants, receptionists, travel agents etc. The study covers areas such as routinization; superiority and subordination; customer identification; rapport; aesthetic labour; the use of humour, charm and flirt; and the dealing with troublesome or rude customers. Our research shows how service encounters are a source of well-being, satisfaction, and commercial success, as well as a source of control and stress. The employees have to suppress their own feelings; they lie to customers, and are often mistreated. As many as half of the employees state that they regularly have to deal with troublesome or rude customers. This situation is even worse for women.
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| 35. |
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| 36. |
- Jordansson, Birgitta, 1952, et al.
(författare)
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Exploatering eller passion - sjuksköterskor i forskarutbildning
- 2011
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Artikeln handlar om sjuksköterskor som efter många år i yrkesverksamhet väljer att påbörja forskarutbildning. Valet studeras i ljuset av en professionaliseringsprocess på sjuksköterskans egna villkor, dvs utifrån omvårdnadsfältets förutsättningar och ses som en möjlighet att bryta en strukturell maktordning mellan kategorierna läkare och sjuksköterska. Fokus i artikeln ligger på de villkor enskilda sjuksköterskor möter och dessa kan diskuteras utifrån begreppen passion respektive exploatering.
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| 37. |
- Kylberg, Karin, et al.
(författare)
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Exclusion of mRNPs and ribosomal particels from a thin zone beneath the nuclear envelope revealed upon inhibition of transport
- 2010
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Ingår i: Experimental Cell Research. - : Elsevier. - 0014-4827 .- 1090-2422. ; 316:6, s. 1028-1038
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Tidskriftsartikel (refereegranskat)abstract
- We have studied the nucleocytoplasmic transport of a specific messenger RNP (mRNP) particle, named Balbiani ring (BR) granule, and ribosomal RNP (rRNP) particles in the salivary glands of the dipteran Chironomus tentans. The passage of the RNPs through the nuclear pore complex (NPC) was inhibited with the nucleoporin-binding wheat germ agglutinin, and the effects were examined by electron microscopy. BR mRNPs bound to the nuclear basket increased in number, while BR mRNPs translocating through the central channel decreased, suggesting that the initiation of translocation proper had been inhibited. The rRNPs accumulated heavily in nucleoplasm, while no or very few rRNPs were recorded within nuclear baskets. Thus, the transport of rRNPs had been blocked prior to the entry into the baskets. Remarkably, the rRNPs had been excluded both from baskets and the space in between the baskets. We propose that normally basket fibrils move freely and repel RNPs from the exclusion zone unless the particles have affinity for and bind to nucleoporins within the baskets.
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| 38. |
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| 39. |
- Myléus, Anna, et al.
(författare)
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Early infections are associated with increased risk for celiac disease : an incident case-referent study
- 2012
-
Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 12, s. 194-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Celiac disease is defined as a 'chronic small intestinal immune-mediated enteropathy precipitated by exposure to dietary gluten in genetically predisposed individuals'. Sweden has experienced an "epidemic" of celiac disease in children below two years of age. Celiac disease etiology is considered multifactorial; however, little is known regarding potential risk-or protecting factors. We present data on the possible association between early infectious episodes and celiac disease, including their possible contribution to the Swedish celiac disease epidemic. Methods: A population-based incident case-referent study (475 cases, 950 referents) with exposure information obtained via a questionnaire (including family characteristics, infant feeding, and the child's general health) was performed. Celiac disease cases were diagnosed before two years of age, fulfilling the diagnostic criteria of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition. Referents were randomly selected from the national population register after fulfilling matching criteria. The final analyses included 954 children, 373 (79%) cases and 581 (61%) referents, with complete information on main variables of interest in a matched set of one case with one or two referents. Results: Having three or more parental-reported infectious episodes, regardless of type of infection, during the first six months of life was associated with a significantly increased risk for later celiac disease, and this remained after adjusting for infant feeding and socioeconomic status (odds ratio [OR] 1.5; 95% confidence interval [CI], 1.1-2.0; P=0.014). The celiac disease risk increased synergistically if, in addition to having several infectious episodes, infants were introduced to dietary gluten in large amounts, compared to small or medium amounts, after breastfeeding was discontinued (OR 5.6; 95% CI, 3.1-10; P<0.001). Conclusion: This study suggests that having repeated infectious episodes early in life increases the risk for later celiac disease. In addition, we found a synergistic effect between early infections and daily amount of gluten intake, more pronounced among infants for whom breastfeeding had been discontinued prior to gluten introduction. Regarding contribution to the Swedish celiac disease epidemic, which partly was attributed to concurrent changes in infant feeding, early infections probably made a minor contribution via the synergistic effect with gluten amount.
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| 40. |
- Myleus, Anna, 1978-, et al.
(författare)
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Early vaccinations are not risk factors for Celiac Disease
- 2012
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Ingår i: Pediatrics. - : American Academy of Pediatrics (AAP). - 0031-4005 .- 1098-4275. ; 130:1, s. E63-E70
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate if changes in the national Swedish vaccination program coincided with changes in the celiac disease (CD) incidence rate in infants (ie, the Swedish CD Epidemic), and to assess the potential association between these vaccinations and CD risk.METHODS: All studies were based on the National Swedish Childhood Celiac Disease Register. Using an ecological approach, we plotted changes over time in the national vaccination program in the graph displaying CD incidence rate. A population-based incident case-referent study of invited infants was performed. Exposure information was received through a questionnaire and child health clinic records. Vaccines explored were diphtheria/tetanus, pertussis (acellular), polio (inactivated), Haemophilus influenzae type b (conjugated), measles/mumps/rubella, and live attenuated bacillus Calmette-Guerin (BCG) in children with increased tuberculosis risk. Findings were subjected to a birth cohort analysis.RESULTS: Introduction of pertussis vaccine coincided in time with decreasing CD incidence rates. In the infant case-referent study, however, neither vaccination against pertussis (odds ratio 0.91; 95% confidence interval 0.60-1.4), nor against Haemophilus influenzae type b or measles/mumps/rubella was associated with CD. Coverage for the diphtheria/tetanus and polio vaccines was 99%. BCG was associated with reduced risk for CD (adjusted odds ratio 0.54; 95% confidence interval 0.31-0.94). Discontinuation of general BCG vaccination did not affect the cumulative incidence of CD at age 15 years.CONCLUSIONS: Early vaccinations within the national Swedish program were not associated with CD risk, nor could changes in the program explain the Swedish epidemic. A protective effect by BCG was suggested, which could be subject to further studies. Pediatrics 2012;130:e63-e70
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| 41. |
- Nordyke, Katrina, et al.
(författare)
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Health-related quality of life in adolescents with screening-detected celiac disease, before and one year after diagnosis and initiation of gluten-free diet, a prospective nested case-referent study
- 2013
-
Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Celiac disease (CD) is a chronic disorder in genetically predisposed individuals in which a small intestinal immune-mediated enteropathy is precipitated by dietary gluten. It can be difficult to diagnose because signs and symptoms may be absent, subtle, or not recognized as CD related and therefore not prompt testing within routine clinical practice. Thus, most people with CD are undiagnosed and a public health intervention, which involves screening the general population, is an option to find those with unrecognized CD. However, how these screening-detected individuals experience the diagnosis and treatment (gluten-free diet) is not fully understood. The aim of this study is to investigate the health-related quality of life (HRQoL) of adolescents with screening-detected CD before and one year after diagnosis and treatment.METHODS: A prospective nested case-referent study was done involving Swedish adolescents who had participated in a CD screening study when they were in the sixth grade and about 12 years old. Screening-detected adolescents (n = 103) and referents without CD who participated in the same screening (n = 483) answered questionnaires at the time of the screening and approximately one year after the screening-detected adolescents had received their diagnosis that included the EQ-5D instrument used to measure health status and report HRQoL.RESULTS: The HRQoL for the adolescents with screening-detected CD is similar to the referents, both before and one year after diagnosis and initiation of the gluten-free diet, except in the dimension of pain at follow-up. In the pain dimension at follow-up, fewer cases reported problems than referents (12.6% and 21.9% respectively, Adjusted OR 0.50, 95% CI 0.27-0.94). However, a sex stratified analysis revealed that the significant difference was for boys at follow-up, where fewer screening-detected boys reported problems (4.3%) compared to referent boys (18.8%) (Adjusted OR 0.17, 95% CI 0.04-0.73).CONCLUSIONS: The findings of this study suggest that adolescents with unrecognized CD experience similar HRQoL as their peers without CD, both before and one year after diagnosis and initiation of gluten-free diet, except for boys in the dimension of pain at follow-up.
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| 42. |
- Nordyke, Katrina, et al.
(författare)
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How do children experience participating in a coeliac disease screening? A qualitative study based on childrens written narratives
- 2010
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Ingår i: SCANDINAVIAN JOURNAL OF PUBLIC HEALTH. - : Sage. - 1403-4948 .- 1651-1905. ; 38:4, s. 351-358
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore how 12-year-old Swedish children experienced being involved in a coeliac disease (CD) screening. Methods: A qualitative approach was used to analyse short narratives written by children who had taken part in a school-based CD screening. Narratives were written after blood sampling, but prior to learning of the test results. Through an oscillation between the texts, codes, subcategories and four categories, a theme was generated describing the childrens experience. Results: The theme "A Journey towards Confidence" captures the overall experience of the screening. It illustrates that, although some children faced fear or anxiety, overall they had or were provided tools allowing them to cope well and experience a journey towards confidence. The categories describe conditions that contributed to the experience. The first, being involved, reflects the importance of involvement in receiving information and deciding to participate. Being a "good citizen" refers to feeling a duty to help and a trust to be treated fairly. Being able to cope with the screening was influenced by the childrens ability to manage sensations and support received. The last category, being able to balance risk, illustrates that the children were able to balance the risks of screening when they had a realistic understanding of the disease and their vulnerability and had tamed their anxiety. Conclusions: This study increases the understanding of how 12-year-old Swedish children experienced participating in a CD screening and describes conditions important for a positive experience. We show that, although some children faced anxiety, they had, or were provided with, tools allowing them to cope well and gain confidence.
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| 43. |
- Nordyke, Katrina, 1975-
(författare)
-
Mass screening for celiac disease : a public health intervention from the participant perspective
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Celiac disease (CD) is a chronic disorder in genetically predisposed individuals in which damage to the small intestine is caused by eating foods containing gluten. The prevalence has been shown to vary from around 1-3%, but most people with CD are undiagnosed. An option for finding those with unrecognized CD would include screening the general population, i.e., mass screening. However, screening identifies a pre-disease or disease condition in people who are presumed healthy and have not sought help. Therefore, the impacts of the screening process and being diagnosed through screening should be explored before such a public health intervention is considered. A population-based CD screening study involving 12-year-olds was undertaken in Sweden and provided an opportunity to explore these issues related to CD screening.Aims To make inferences about the potential impacts mass screening for CD can have on participants by exploring experiences and outcomes for participants involved in CD screening study.Methods and Subjects Both qualitative (short written narratives) and quantitative (questionnaires with EQ-5D instrument) methods were used. Children who participated in the CD screening study were invited to write narratives at the time of the screening, before screening results were known, describing their experience with the screening (n=240). The EQ-5D instrument was used to measure and compare health-related quality of life reported by participants at the time of the screening and one year after the screening-detected participants received their diagnosis (screening-detected n=103, referents n=483). Those with screening-detected CD were also invited to write narratives one and five years after their diagnosis. In these narratives the adolescents described how it felt to be diagnosed with CD, how it felt to live with CD, and if they thought all children should be screened (one-year follow-up n=91, five-year follow-up n=72). Results Even though some children experienced fear and anxiety during the screening, overall they had, or were provided with, tools that allowed them to cope well with the screening. The health-related quality of life reported by those with screening-detected CD was similar before and one year after diagnosis (and similar to that of the referents). We also found that after five years of living with the diagnosis there had been maintenance and evolution in the beliefs and practices of these adolescents. Being detected through screening and the threat of complications impacted how they felt about the diagnosis, coped with the gluten-free diet, and what they thought about CD screening. Five years after the screening-detected diagnosis the adolescents have adjusted to the disease and adapted new habits and coping strategies to deal with the gluten-free diet. However, there are still those who doubt the accuracy and benefit of the diagnosis. Conclusions Our findings suggest that it is possible for participants to avoid excess anxiety during CD screening. However, there was not consensus among participants that being detected and treated had improved their health-related quality of life or that the immediate benefits outweighed the harm caused by being detected in this way. When considering mass screening, the affect on the participants is important to take into account and our findings shed light on some of the potential impacts a CD mass screening could have on participants.
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| 44. |
- Norström, Fredrik, et al.
(författare)
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A gluten-free diet effectively reduces symptoms and health care consumption in a Swedish celiac disease population
- 2012
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Ingår i: BMC Gastroenterology. - 1471-230X. ; 12:1, s. 125-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A gluten-free diet is the only available treatment for celiac disease. Our aim was to investigate the effect of a gluten-free diet on celiac disease related symptoms, health care consumption, and the risk of developing associated immune-mediated diseases.METHODS: A questionnaire was sent to 1,560 randomly selected members of the Swedish Society for Coeliacs, divided into equal-sized age- and sex strata; 1,031 (66%) responded. Self-reported symptoms, health care consumption (measured by health care visits and hospitalization days), and missed working days were reported both for the year prior to diagnosis (normal diet) and the year prior to receiving the questionnaire while undergoing treatment with a gluten-free diet. Associated immune-mediated diseases (diabetes mellitus type 1, rheumatic disease, thyroid disease, vitiligo, alopecia areata and inflammatory bowel disease) were self-reported including the year of diagnosis.RESULTS: All investigated symptoms except joint pain improved after diagnosis and initiated gluten-free diet. Both health care consumption and missed working days decreased. Associated immune-mediated diseases were diagnosed equally often before and after celiac disease diagnosis.CONCLUSIONS: Initiated treatment with a gluten-free diet improves the situation for celiac disease patients in terms of reduced symptoms and health care consumption. An earlier celiac disease diagnosis is therefore of great importance.
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| 45. |
- Norström, Fredrik, et al.
(författare)
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Delay to celiac disease diagnosis and its implications for health-related quality of life
- 2011
-
Ingår i: BMC Gastroenterology. - London : BioMed Central. - 1471-230X. ; 11:1, s. 118-
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To determine how the delay in diagnosing celiac disease (CD) has developed during recent decades and how this affects the burden of disease in terms of health-related quality of life (HRQoL), and also to consider differences with respect to sex and age.METHODS: In collaboration with the Swedish Society for Coeliacs, a questionnaire was sent to 1,560 randomly selected members, divided in equal-sized age- and sex strata, and 1,031 (66%) responded. HRQoL was measured with the EQ-5D descriptive system and was then translated to quality-adjusted life year (QALY) scores. A general population survey was used as comparison.RESULTS: The mean delay to diagnosis from the first symptoms was 9.7 years, and from the first doctor visit it was 5.8 years. The delay has been reduced over time for some age groups, but is still quite long. The mean QALY score during the year prior to initiated treatment was 0.66; it improved after diagnosis and treatment to 0.86, and was then better than that of a general population (0.79).CONCLUSIONS: The delay from first symptoms to CD diagnosis is unacceptably long for many persons. Untreated CD results in poor HRQoL, which improves to the level of the general population if diagnosed and treated. By shortening the diagnostic delay it is possible to reduce this unnecessary burden of disease. Increased awareness of CD as a common health problem is needed, and active case finding should be intensified. Mass screening for CD might be an option in the future.
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| 46. |
- Nyström, Monica Elisabeth, et al.
(författare)
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Change and learning strategies in large scale change programs : describing the variation of strategies used in a health promotion program
- 2013
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Ingår i: Journal of Organizational Change Management. - : Emerald Group Publishing Limited. - 0953-4814 .- 1758-7816. ; 26:6, s. 1020-1044
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose The study identifies the variation of change strategies used in a complex large scale change program in health and social services in Sweden, aimed at changing professionals' health promoting practices. The purpose is to investigate the change strategies used over time and describe the potential variation in key change agent views, using a framework inspired by De Caluwe and Vermaak's multi paradigm change typology.Design/methodology/approach The first six years of the regional multi-sector program are examined. Results are based on content analyses of interviews with key change actors, and archival data describing program activities. Respondents belonged to either the strategic or the operational program management team, representing different sectors of health and social services in a region.Findings Multiple strategy paradigms showed varying influence over the program's different phases, partly due to program progress, change agent influence and/or varying contextual demands. Respondents' views on strategies and program focus varied depending on their program roles. Respondents expressed insights about the varying conditions for change and on the conflicting expectations within and between program management teams.Originality/value This study introduces the application of a new framework on a large scale, complex change program. The framework sheds light on a number of basic assumptions and change strategies that can be further compared with content and context factors, barriers, facilitators, outcomes, and in turn with other programs.
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| 47. |
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| 48. |
- Ode, Amanda, et al.
(författare)
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Determinants of maternal and fetal exposure and temporal trends of perfluorinated compounds.
- 2013
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Ingår i: Environmental Science and Pollution Research. - : Springer Science and Business Media LLC. - 1614-7499 .- 0944-1344. ; 20:11, s. 7970-7978
-
Tidskriftsartikel (refereegranskat)abstract
- In recent years, some perfluorinated compounds (PFCs) have been identified as potentially hazardous substances which are harmful to the environment and human health. According to limited data, PFC levels in humans could be influenced by several determinants. However, the findings are inconsistent. In the present study, perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) were measured in paired maternal and cord serum samples (N = 237) collected between 1978 and 2001 in Southern Sweden to study the relationship between these and to investigate several potential determinants of maternal and fetal exposure to PFCs. Time trends of PFCs in Swedish women were also evaluated. The study is a part of the Fetal Environment and Neurodevelopment Disorders in Epidemiological Research project. PFOS, PFOA, and PFNA levels (median) were higher in maternal serum (15, 2.1, and 0.24 ng/ml, respectively) than in cord serum (6.5, 1.7, and 0.20 ng/ml, respectively). PFC levels were among the highest in women originating from the Nordic countries and the lowest in women from the Middle East, North Africa, and sub-Saharan Africa. Multiparous women had lower serum PFOA levels (1.7 ng/ml) than primiparous women (2.4 ng/ml). Maternal age, body mass index, cotinine levels, and whether women carried male or female fetuses did not affect serum PFC concentrations. Umbilical cord serum PFC concentrations showed roughly similar patterns as the maternal except for the gestational age where PFC levels increased with advancing gestational age. PFOS levels increased during the study period in native Swedish women. In summary, PFOS levels tend to increase while PFOA and PFNA levels were unchanged between 1978 and 2001 in our study population. Our results demonstrate that maternal country of origin, parity, and gestational age might be associated with PFC exposure.
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| 49. |
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| 50. |
- Rignell-Hydbom, Anna, et al.
(författare)
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A nested case-control study of intrauterine exposure to persistent organochlorine pollutants in relation to risk of type 1 diabetes.
- 2010
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The incidence of type 1 diabetes in Europe is increasing at a rate of about 3% per year and there is also an increasing incidence throughout the world. Type 1 diabetes is a complex disease caused by multiple genetic and environmental factors. Persistent organochlorine pollutants (POPs) have been suggested as a triggering factor for developing childhood type 1 diabetes. The aim of this case-control study was to assess possible impacts of in utero exposure to POPs on type 1 diabetes. METHODOLOGY/ PRINCIPAL FINDINGS: The study was performed as a case-control study within a biobank in Malmö, a city located in the Southern part of Sweden. The study included 150 cases (children who had their diagnosis mostly before 18 years of age) and 150 controls, matched for gender and day of birth. 2,2',4,4',5,5'-hexachlorobiphenyl (PCB-153) and the major DDT metabolite 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE) were used as a biomarkers for POP exposure. When comparing the quartile with the highest maternal serum concentrations of PCB-153 with the other quartiles, an odds ratio (OR) of 0.73 (95% confidence interval [CI] 0.42, 1.27) was obtained. Similar results was obtained for p,p'-DDE (OR 0.56, 95% CI 0.29, 1.08). CONCLUSIONS: The hypothesis that in utero exposure to POPs will trigger the risk for developing type 1 diabetes was not supported by the results. The risk estimates did, although not statistically significant, go in the opposite direction. However, it is not reasonable to believe that exposure to POPs should protect against type 1 diabetes.
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