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1.
  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • Grimby-Ekman, Anna, 1967, et al. (författare)
  • Pain intensity and pressure pain thresholds after a light dynamic physical load in patients with chronic neck-shoulder pain
  • 2020
  • Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Methods Twenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after. Results The chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day. Conclusions Patients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.
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  • Grundström, Hanna, 1982-, et al. (författare)
  • Pain catastrophizing is associated with pain thresholds for heat, cold and pressure in women with chronic pelvic pain
  • 2020
  • Ingår i: Scandinavian Journal of Pain. - : WALTER DE GRUYTER GMBH. - 1877-8860 .- 1877-8879. ; 20:3, s. 635-646
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: Psychological traits such as pain catastrophizing may play a role in the development of chronic pelvic pain (CPP). Pain catastrophizing is the tendency to amplify negative cognitive and emotional pain processes. The Pain Catastrophizing Scale (PCS) assesses elements of pain catastrophizing divided into three subgroups of factors (rumination, helplessness and magnification). Previous studies have shown associations between CPP and increased pain sensitivity, widespread generalized hyperalgesia, and decreased pain thresholds, but the relation between pain catastrophizing and specific pain thresholds has not yet been widely examined in this patient group. The aims of this study were (a) to determine if catastrophizing is increased in women with CPP compared with pain-free women, (b) to assess the importance of pain catastrophizing, psychological distress variables, and subjective pain sensitivity for pain thresholds of heat, cold and pressure in these two groups, and (c) to determine whether psychological variables or pain thresholds best contribute to the differentiation between CPP and controls. Methods: Thirty-seven women with chronic pelvic pain who underwent diagnostic laparoscopy on the suspicion of endometriosis participated along with 55 healthy and pain-free controls. All underwent quantitative sensory testing on six locations on the body to determine heat (HPT), cold (CPT) and pressure (PPT) pain thresholds. The PCS, the Pain Sensitivity Questionnaire (PSQ), the Hospital Anxiety Depression Scale, (HAUS) demographics and clinical data were collected prospectively. Principal component analysis and orthogonal partial least square regressions were used to assess the associations between PCS scores and pain thresholds. Results: The women with CPP scored significantly higher on PCS than the healthy controls. PCS-helplessness, PCS-rumination and HADS-depression were significantly associated with pain thresholds for the whole group. In the CPP group, PCS-rumination, body mass index and PSQ were significant regressors for HPT and CPT. The PCS and the HADS subscales were strongly intercorrelated in women with CPP and were stronger regressors of group membership than the three pain thresholds. In the group of healthy control women, no relationships were found to be significant. The psychological variables were somewhat stronger significant regressors than pain thresholds (also significant) for group membership. Conclusions: Women with CPP have significantly higher pain catastrophizing scores than women without CPP. The pain catastrophizing rumination factor is significantly associated with pain thresholds of heat and cold in CPP women. PCS and HADS are strongly intercorrelated and PSQ correlates positively with these variables. It seems that the psychological variables are important for group differentiation.
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  • Jalasto, Juuso, et al. (författare)
  • Occupation, socioeconomic status and chronic obstructive respiratory diseases – the EpiLung Study in Finland, Estonia and Sweden
  • 2022
  • Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 191
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To study occupational groups and occupational exposure in association with chronic obstructive respiratory diseases.Methods: In early 2000s, structured interviews on chronic respiratory diseases and measurements of lung function as well as fractional expiratory nitric oxide (FENO) were performed in adult random population samples of Finland, Sweden and Estonia. Occupations were categorized according to three classification systems. Occupational exposure to vapours, gases, dusts and fumes (VGDF) was assessed by a Job-Exposure Matrix (JEM). The data from the countries were combined.Results: COPD, smoking and occupational exposure were most common in Estonia, while asthma and occupations requiring higher educational levels in Sweden and Finland. In an adjusted regression model, non-manual workers had a three-fold risk for physician-diagnosed asthma (OR 3.18, 95%CI 1.07-9.47) compared to professionals and executives, and the risk was two-fold for healthcare & social workers (OR 2.28, 95%CI 1.14-4.59) compared to administration and sales. An increased risk for physician-diagnosed COPD was seen in manual workers, regardless of classification system, but in contrast to asthma, the risk was mostly explained by smoking and less by occupational exposure to VGDF. For FENO, no associations with occupation were observed.Conclusions: In this multicenter study from Finland, Sweden and Estonia, COPD was consistently associated with manual occupations with high smoking prevalence, highlighting the need to control for tobacco smoking in studies on occupational associations. In contrast, asthma tended to associate with non-manual occupations requiring higher educational levels. The occupational associations with asthma were not driven by eosinophilic inflammation presented by increased FENO.
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  • Khamisi, Selwan, et al. (författare)
  • Comparison between thyroid stimulating immunoglobulin and TSH-receptor antibodies in management of Graves' orbitopathy
  • 2023
  • Ingår i: Experimental and clinical endocrinology & diabetes. - : Georg Thieme Verlag KG. - 0947-7349 .- 1439-3646. ; 131:04, s. 236-241
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives TSH-receptor antibodies (TRAb) targeting the TSH receptor (TSH-R) induce hyperthyroidism in Graves´ disease (GD). Graves´ orbitopathy (GO) is influenced by stimulation of the TSH-R in the orbita. GO has been, among other factors, linked to high TRAb levels. Thyroid stimulating immunoglobulins (TSI) is a relatively new method for assessing TSH-receptor antibodies. The aim of this study was to investigate the role of TSI in the management of GO.Methods Patients with newly diagnosed GD (n=30, median age 55 years (range 35–72), 29 women) received pharmacological therapy (methimazole+++thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. Eleven patients had GO at diagnosis, and another six developed GO during treatment. Blood samples for TSI and other thyroidal biomarkers were obtained at baseline and on five occasions during the 24-month follow-up. Twenty-two subjects completed the drug regimen without surgery or radioiodine treatment.Results At baseline, TSI was highly correlated with TRAb (r s =0.64, p<0.001), and both assays similarly correlated to fT3 values. TSI and TRAb did not differ significantly between GO and non-GO patients for visit v1 (n=30, 17 GO during the whole study) or at follow-up (n=22, 12 GO during the whole study). During follow-up, levels of TSI and TRAb decreased and normalized in both groups.Conclusion The present study does not support any added benefit of TSI compared to TRAb for the prediction and management of GO.
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  • Larsson, Kristina, et al. (författare)
  • Health care professionals' experiences of supporting persons with metabolic risk factors to increase their physical activity level : a qualitative study in primary care
  • 2023
  • Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis Group. - 0281-3432 .- 1502-7724. ; 41:2, s. 116-131
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To be regularly physically active is of major importance for the health of people with metabolic risk factors. Many of these persons are insufficiently active and in need of support. This study aimed to explore barriers and facilitators perceived by health care professionals' within Swedish primary care in their work to support persons with metabolic risk factors to increase their physical activity.Design: A qualitative design with focus group discussions was used. The data were analysed using qualitative content analysis with a manifest, inductive approach.Setting: Primary health care in five Swedish healthcare regions.Subjects: Nine physiotherapists, ten physicians and five nurses participated in six digital focus group discussions including two to six participants.Results: Barriers and facilitators to supporting persons with metabolic risk factors to increase their physical activity were found within four generic categories, where the barriers and facilitators related to each generic category: 'Patient readiness for change', 'Supporting the process of change', 'The professional role', and 'The organisation of primary care'.Conclusion: The findings suggests that barriers and facilitators for supporting patients with metabolic risk factors can be found at several levels within primary care, from individual patient and the health care professionals to the organisational level. In the primary care setting, this should be highlighted when implementing support to increase physical activity in people with metabolic risk factors.KEY POINTSHealth care professionals within primary care are in a position to support people with metabolic risk factors to increase their physical activity.Barriers and facilitators to support the patients should be addressed at several levels within primary care.The study highlights factors on multiple levels such as professional responsibility, organisational prioritisation and resources, and the challenge to motivate behaviour change.
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  • Larsson, Kristina, et al. (författare)
  • Predictors associated with an increase in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention
  • 2024
  • Ingår i: BMC Public Health. - 1471-2458. ; 24
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: This study aimed to explore predictors associated with intermediate (six months) and post-intervention (24 months) increases in daily steps among people with prediabetes or type 2 diabetes participating in a two-year pedometer intervention.Methods: A secondary analysis was conducted based on data from people with prediabetes or type 2 diabetes from two intervention arms of the randomised controlled trial Sophia Step Study. Daily steps were measured with an ActiGraph GT1M accelerometer. Participants were divided into two groups based on their response to the intervention: Group 1) ≥ 500 increase in daily steps or Group 2) a decrease or < 500 increase in daily steps. Data from baseline and from six- and 24-month follow-ups were used for analysis. The response groups were used as outcomes in a multiple logistic regression together with baseline predictors including self-efficacy, social support, health-related variables, intervention group, demographics and steps at baseline. Predictors were included in the regression if they had a p-value < 0.2 from bivariate analyses.Results: In total, 83 participants were included. The mean ± SD age was 65.2 ± 6.8 years and 33% were female. At six months, a lower number of steps at baseline was a significant predictor for increasing ≥ 500 steps per day (OR = 0.82, 95% CI 0.69-0.98). At 24 months, women had 79% lower odds of increasing ≥ 500 steps per day (OR = 0.21, 95% CI 0.05-0.88), compared to men. For every year of increase in age, the odds of increasing ≥ 500 steps per day decreased by 13% (OR = 0.87, 95% CI 0.78-0.97). Also, for every step increase in baseline self-efficacy, measured with the Self-Efficacy for Exercise Scale, the odds of increasing ≥ 500 steps per day increased by 14% (OR = 1.14, 95% CI 1.02-1.27).Conclusions: In the Sophia Step Study pedometer intervention, participants with a lower number of steps at baseline, male gender, lower age or higher baseline self-efficacy were more likely to respond to the intervention with a step increase above 500 steps per day. More knowledge is needed about factors that influence response to pedometer interventions.
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  • Larsson, Kristina, et al. (författare)
  • Relative time in physical activity and sedentary behaviour across a 2-year pedometer-based intervention in people with prediabetes or type 2 diabetes : A secondary analysis of a randomised controlled trial
  • 2023
  • Ingår i: Journal of Activity, Sedentary and Sleep Behaviors. - 2731-4391. ; 2:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: People with prediabetes or type 2 diabetes (T2D) need to be physically active, including moderate-to-vigorous intensity physical activity (MVPA) and light-intensity physical activity (LIPA) and reduce time in sedentary behaviour (SB). Few studies have evaluated the effect of randomised controlled trials taking all movement behaviours into account. This study aimed to investigate the effects of a 2-year pedometer-based intervention in people with prediabetes or T2D on relative time in movement behaviours.Methods: Secondary analysis of longitudinal data on individuals with prediabetes or T2D from a three-armed randomised controlled trial, the Sophia Step Study, was conducted. The three groups were (1) a multi‑component group (self‑monitoring of steps with a pedometer plus counselling), (2) a single‑component group (self‑monitoring of steps with a pedometer, without counselling), and (3) a standard care group (control). The three behaviours MVPA, LIPA and SB during waking hours were measured with an ActiGraph GT1M accelerometer at baseline, 6, 12, 18 and 24 months. Relative time in MVPA, LIPA and SB for each participant at each time point was calculated and used as outcome measures. Linear mixed models assessed the effect of the intervention over time.Results: In total 184 participants with mean (SD) age 64.3 (7.6) years and 41% female was included. In the multi-component group, compared to the control group, a significant group-by-time interaction effect for relative time in all three behaviours was found at 6 and 18 months and for MVPA and SB at 24 months. In the single-component group, compared to the control group, an effect occurred in the MVPA and SB behaviours at 6 months and MVPA and LIPA at 24 months. The estimated marginal means ranged from 0.9 to 1.5% of more MVPA, 1.9–3.9% of less LIPA and from 0.5% of less SB to 1.7 more SB in the intervention groups compared to the control group.Conclusions: The findings show a beneficial effect on all behaviours over time in the two intervention groups compared to the control group. A more pronounced effect occurred in the multi-component intervention compared to the single-component intervention, implicating the importance of counselling in pedometer-based interventions.Trial registration ClinicalTrials.gov, NCT02374788
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  • Larsson, Kristina (författare)
  • Supporting healthy movement behaviours in people with metabolic risk, prediabetes, or type 2 diabetes in primary health care
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to investigate if a pedometer-based intervention inthe primary health care setting can support people with prediabetes or type 2 diabetestowards healthier movement behaviours. Moreover, health care professionals’experiences of supporting people with metabolic risk factors to increase theirphysical activity were explored.This thesis consists of four papers based on data from two research studies. Paper I,II, and III are based on a randomised controlled trial called the Sophia Step Study,which is a two-year, three-armed pedometer-based intervention. The three groupscomprised a multi-component group that received a pedometer and extracounselling, a single-component group that received a pedometer, and a controlgroup that received standard care.The aim of the Sophia Step Study was to support individuals with prediabetes or type2 diabetes in becoming regularly physically active by reporting their daily number ofsteps, with or without extra counselling. Paper IV is based on a qualitative interviewstudy that explored nurses’, physicians’, and physiotherapists’ experiences in primaryhealth care when supporting patients with metabolic risk factors to physical activity.In paper I, the effects of self-monitoring steps with or without counselling supportfor HbA1c, other cardiometabolic risk factors and physical activity during the twoyearintervention were evaluated. In paper II, the effects of the intervention wereevaluated on relative time in different movement behaviours. In paper III, predictorsassociated with intermediate and post intervention increases in steps were explored. Finally, in paper IV, barriers and facilitators perceived by health care professionalswho work within Swedish primary care to support people with metabolic risk factorsto increase their physical activity were explored.The results show that the Sophia Step Study did not have an effect on the primaryoutcome HbA1c. However, a significant effect was found for the multi-componentgroup on absolute time in moderate-to-vigorous physical activity during the entiretwo-year period, as well as for the single-component group at six months. No effect, however, was found for the absolute time in the other movement behaviours, thenumber of daily steps, any of the biomarkers or the anthropometric variables. Usingrelative time, instead of absolute time, when evaluating the effect showed a morepronounced effect in all movement behaviours within both intervention groups overthe two-year period. At six months, lower number of steps at baseline was asignificant predictor for increasing ≥500 steps per day. At 24 months, men, youngerparticipants, and those with higher self-efficacy at baseline had significantly higherodds for increasing ≥500 steps per day. Barriers and facilitators for supportingpeople with metabolic risk factors in increasing their physical activity, as experiencedby nurses, physiotherapists and physicians, were identified at multiple levels,represented by four generic categories: ‘Patient readiness for change’, ‘Supporting theprocess of change’, ‘The professional role’, and ‘The organisation of primary care’.The overall conclusion is that the self-monitoring of steps with a pedometer seems tobe an effective behaviour change technique in maintaining healthy movementbehaviours; however, the counselling component of the intervention did not seem toimprove the effect. In addition, the intervention did not find evidence for improvedmetabolic control or improved cardiometabolic risk factors. Moreover, barriers toand facilitators for supporting patients with metabolic risk factors can be found atseveral levels within primary care, from individual patients and health careprofessionals to the organisational level. In the primary health care setting, thisshould be emphasised when implementing support with the intention to increasephysical activity in people with metabolic risk factors, prediabetes or type 2 diabetes.
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23.
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24.
  • Lysenkova Wiklander, Mariya, et al. (författare)
  • Genomic, transcriptomic and epigenomic sequencing data of the B-cell leukemia cell line REH
  • 2023
  • Ingår i: BMC Research Notes. - : BioMed Central (BMC). - 1756-0500. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesThe aim of this data paper is to describe a collection of 33 genomic, transcriptomic and epigenomic sequencing datasets of the B-cell acute lymphoblastic leukemia (ALL) cell line REH. REH is one of the most frequently used cell lines for functional studies of pediatric ALL, and these data provide a multi-faceted characterization of its molecular features. The datasets described herein, generated with short- and long-read sequencing technologies, can both provide insights into the complex aberrant karyotype of REH, and be used as reference datasets for sequencing data quality assessment or for methods development.Data descriptionThis paper describes 33 datasets corresponding to 867 gigabases of raw sequencing data generated from the REH cell line. These datasets include five different approaches for whole genome sequencing (WGS) on four sequencing platforms, two RNA sequencing (RNA-seq) techniques on two different sequencing platforms, DNA methylation sequencing, and single-cell ATAC-sequencing.
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25.
  • Rossen, Jenny, et al. (författare)
  • Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes-the Sophia Step Study
  • 2021
  • Ingår i: International Journal of Behavioral Nutrition and Physical Activity. - : BioMed Central. - 1479-5868. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: This aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes.METHODS: The Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model.RESULTS: and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group.CONCLUSION: This 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes.TRIAL REGISTRATION: ClinicalTrials.gov, NCT02374788 . Registered 2 March 2015-Retrospectively registered.
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26.
  • Rossen, Jenny, et al. (författare)
  • Physical activity patterns among individuals with prediabetes or type 2 diabetes across two years : A longitudinal latent class analysis
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:6
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: This study aimed to identify distinct profiles of physical activity (PA) patterns among individuals with prediabetes or type 2 diabetes participating in a two-year PA trial and to investigate predictors of the profiles.METHODS: Data (n = 168, collected 2013-2020) from the cohort of a randomized trial aimed at increasing PA in individuals with prediabetes and type 2 diabetes were used. PA and sedentary behaviours were assessed by waist-worn ActiGraph GT1M accelerometers at baseline and at 6, 12, 18 and 24 months. Fifteen PA and sedentary variables were entered into a latent class mixed model for multivariate longitudinal outcomes. Multinominal regression analysis modelled profile membership based on baseline activity level, age, gender, BMI, disease status and group randomisation.RESULTS: Two profiles of PA patterns were identified: "Increased activity" (n = 37, 22%) included participants increasing time in PA and decreasing sedentary time. "No change in activity" (n = 131, 78%) included participants with no or minor changes. "Increased activity" were younger (p = 0.003) and more active at baseline (p = 0.011), compared to "No change in activity". No other predictor was associated with profile membership.CONCLUSIONS: A majority of participants maintained PA and sedentary patterns over two years despite being part of a PA intervention. Individuals improving PA patterns were younger and more active at baseline.
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27.
  • Wiklund, Tobias, et al. (författare)
  • Insomnia is a risk factor for spreading of chronic pain : A Swedish longitudinal population study (SwePain)
  • 2020
  • Ingår i: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 24:7, s. 1348-1356
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Recent evidence suggests that insomnia negatively influences the occurrence of generalized pain. This study examined whether insomnia is a risk factor for the transition from local pain to generalized pain (i.e., spreading of pain).METHODS: This longitudinal study, with a follow-up of 24 months, included 959 participants (mean age: 55.8 years; SD: 13.9) with local or regional pain at baseline. Participants were grouped by insomnia symptoms as measured by the Insomnia Severity Index. Spreading of pain was measured by body manikins based on the spatial distribution of pain on the body. We defined two outcome categories; one with relatively localized pain (i.e., local pain and moderate regional pain ), and one with relatively generalized pain (i.e., substantial regional pain and widespread pain). Baseline age, sex, education, depressive symptoms, anxiety symptoms, catastrophizing, pain intensity, and spread of pain were also included in the Generalized Linear Model analysis.RESULTS: The unadjusted model showed that the risk of spreading of pain increased with an increase in insomnia symptoms (no insomnia: 55.4%; subthreshold insomnia: 25.4% moderate insomnia: 16.5% and severe insomnia: 2.7%). The risk increased in a dose-dependent manner; moderate insomnia risk ratio (RR) 2.34 (95% confidence interval [CI]: 1.34 - 4.09) and severe insomnia RR 4.13 (95% CI: 1.56 - 10.92). The results were maintained in the fully adjusted model although moderate regional pain was the strongest predictor RR 6.95 (95% CI: 3.11-15.54).CONCLUSION: Our findings show a strong prospective relationship between insomnia symptoms and the transition from relatively localized to generalized pain.
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