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1.
  • Nilsson, Kerstin, et al. (författare, creator_code:000000023193205X_t)
  • Can they Stay or Will They go?
  • 2024
  • Ingår i: Sustaniable Healthy Working life for All Ages. - Basel, Switzerland : MDPI. ; , s. 37-56
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • A larger amount of older people need to participate in working life due to the global demographic change. It is the employer, through the manager, who enables employees to have access to measures in the workplace that facilitate and enable a sustainable extended working life. The aim of this study was to evaluate work life factors associated with managers believing their employees can work versus wanting to work until age 65 or older. This cross-sectional study included 249 managers in the Swedish municipality sector. Logistic regression analysis was used to investigate associations between different univariate estimates and in data modelling using the SwAge-model. The result stated that 79% of managers believed their employees ‘can’ work and 58% of managers believed their employees ‘want to’ work until age 65 or older. Health, physical work environment, skills and competence are associated the strongest to managers believing employees ‘can’ work until age 65 or older. Insufficient social support at work and lacking possibilities for relocations associated the strongest to managers believing employees would not ‘want to’ work until age 65 or older. Though, several countries (especially in Europe) have included in their social policy measures that retirement age be increased after 65, proposing ages approaching 70. When these proposals become laws, through obligation, people will have no choice (if they want to or if they can continue working). However, people’s attitudes to work may be different (especially after the COVID-19 pandemic), and this analysis of the participating managers’ attitudes showed there is a difference between why employees ‘can’ versus ‘want’ to work respectively. Therefore, different strategies may be needed to contribute to employees both being able to and willing to participate in working life until an older age. These findings on managers’ perspectives, regarding whether they believe employees would be able to versus would want to work and the SwAge-model, will hopefully contribute to anincreased understanding of organisational actions and measures in the process of creating a sustainable extended working life and to increase senior employees’ employability.
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  • Arvidsson, Inger, et al. (författare)
  • Should I Stay or Should I Go? : Associations between Occupational Factors, Signs of Exhaustion, and the Intention to Change Workplace among Swedish Principals
  • 2023
  • Ingår i: Sustainable Healthy Working Life for All Ages. - : MDPI Books. ; , s. 139-158
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • A high turnover among principals may disrupt the continuity of leadership and negativelyaffect teachers and, by extension, the students. The aim was to investigate to what extent variouswork environment factors and signs of exhaustion were associated with reported intentions tochange workplace among principals working in compulsory schools. A web-based questionnaire wasadministered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of theassociations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, andthe intention to change workplace, using Generalized Estimating Equations models. Part II involved631 principals who participated in both surveys. The patterns of intended and actual changes ofworkplace across two years were described, together with associated changes of occupational factorsand signs of exhaustion. Supportive management was associated with an intention to stay, whiledemanding role conflicts and the feeling of being squeezed between management and co-workers(buffer-function) were associated with the intention to change workplace. The principals whointended to change their workplace reported more signs of exhaustion. To increase retention amongprincipals, systematic efforts are probably needed at the national, municipal, and local level, in orderto improve their working conditions
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  • Nilsson, Kerstin, et al. (författare)
  • The mental work environment and social work environment on the senior workforce
  • 2022
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: The Swedish Agency for Work Environment Expertise commissioned researchers atLund University, Kristianstad University and Malmö University to conduct a systematic reviewfocusing on the impact of the psychosocial work environment on the senior workforce (≥55 years ofage) in a Swedish context.Aims: To provide an overview of how psychosocial work environment and occupational healthfactors affect the senior workforce, and describe interventions designed to improve the workenvironment.Methods: The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA) were followed. The data bases: Pubmed, Cinahl, Scopus and Medline were searched forarticles published until 2021-07-10.Results: After deduplication 846 articles remained, of which 49 were selected for full text screening.After exclusion of studies with low quality 20 remained. The studies included in this literature reviewhave been thematized and analysed based on the nine determinant areas of the swAge model1, forthe ability and willingness to work in relation to ageing, to explain the complexity of predictors forthe senior workforce’s working life. These determinant areas are divided into predictors of: the workenvironment’s effects on health; the personal financial situation; the social support, relationships,and participation; as well as the execution of work tasks and activities.Conclusions: Several of the articles included in the literature review did not consider the definition ofage in relation to the senior workforce, despite age being the factor that characterizes anddistinguishes a senior employee. However, there were articles highlighting the significance ofconsidering the senior workforce based on their biological age, social age, and cognitive age ratherthan just their chronological age (i.e. how many years had passed since they were born). Severalgeneral suggestions were discernable in the articles included in the literature review that will bediscussed.
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  • Bennet, Tova, et al. (författare)
  • Den rättspsykiatriska vården är inte rättssäker – agera nu
  • 2020
  • Ingår i: Göteborgs-Posten. - Göteborg : Göteborgposten. - 1103-9345. ; :Oktober 19
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Det svenska rättssystemet som tillåter att vi dömer psykiskt sjuka för brott och att personer som saknar vårdbehov kan hållas frihetsberövade inom rättspsykiatrin under mycket lång tid med oklart vårdinnehåll, är unikt och har fått rättmätig kritik under lång tid. Ändå händer ingenting. 
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9.
  • Fromell, Karin, et al. (författare)
  • Assessment of the Role of C3(H2O) in the Alternative Pathway
  • 2020
  • Ingår i: Frontiers in Immunology. - : Frontiers Media SA. - 1664-3224. ; 11
  • Tidskriftsartikel (refereegranskat)abstract
    • In this study we investigate the hydrolysis of C3 to C3(H2O) and its ability to initiate activation via the alternative pathway (AP) of the complement system. The internal thioester bond within C3 is hydrolyzed by water in plasma because of its inherent lability. This results in the formation of non-proteolytically activated C3(H2O) which is believed have C3b-like properties and be able to form an active initial fluid phase C3 convertase together with Factor B (FB). The generation of C3(H2O) occurs at a low but constant rate in blood, but the formation can be greatly accelerated by the interaction with various surfaces or nucleophilic and chaotropic agents. In order to more specifically elucidate the relevance of the C3(H2O) for AP activation, formation was induced in solution by repeated freeze/thawing, methylamine or KCSN treatment and named C3(x) where the x can be any of the reactive nucleophilic or chaotropic agents. Isolation and characterization of C3(x) showed that it exists in several forms with varying attributes, where some have more C3b-like properties and can be cleaved by Factor I in the presence of Factor H. However, in common for all these variants is that they are less active partners in initial formation of the AP convertase compared with the corresponding activity of C3b. These observations support the idea that formation of C3(x) in the fluid phase is not a strong initiator of the AP. It is rather likely that the AP mainly acts as an amplification mechanism of complement activation that is triggered by deposition of target-bound C3b molecules generated by other means.
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  • Gerogianni, Alexandra, et al. (författare)
  • Heme Interferes With Complement Factor I-Dependent Regulation by Enhancing Alternative Pathway Activation
  • 2022
  • Ingår i: Frontiers in Immunology. - : Frontiers Media S.A.. - 1664-3224. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Hemolysis, as a result of disease or exposure to biomaterials, is characterized by excess amounts of cell-free heme intravascularly and consumption of the protective heme-scavenger proteins in plasma. The liberation of heme has been linked to the activation of inflammatory systems, including the complement system, through alternative pathway activation. Here, we investigated the impact of heme on the regulatory function of the complement system. Heme dose-dependently inhibited factor I-mediated degradation of soluble and surface-bound C3b, when incubated in plasma or buffer with complement regulatory proteins. Inhibition occurred with factor H and soluble complement receptor 1 as co-factors, and the mechanism was linked to the direct heme-interaction with factor I. The heme-scavenger protein hemopexin was the main contaminant in purified factor I preparations. This led us to identify that hemopexin formed a complex with factor I in normal human plasma. These complexes were significantly reduced during acute vasoocclusive pain crisis in patients with sickle cell disease, but the complexes were normalized at their baseline outpatient clinic visit. Hemopexin exposed a protective function of factor I activity in vitro, but only when it was present before the addition of heme. In conclusion, we present a mechanistic explanation of how heme promotes uncontrolled complement alternative pathway amplification by interfering with the regulatory capacity of factor I. Reduced levels of hemopexin and hemopexin-factor I complexes during an acute hemolytic crisis is a risk factor for heme-mediated factor I inhibition.
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  • Grosso, Giorgia, et al. (författare)
  • The Complex Relationship between C4b-Binding Protein, Warfarin, and Antiphospholipid Antibodies
  • 2021
  • Ingår i: Thrombosis and Haemostasis. - : Georg Thieme Verlag KG. - 0340-6245 .- 2567-689X. ; 121:10, s. 1299-1309
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Low levels of total C4b-binding protein (C4BPt), a circulating inhibitor of the classical/lectin complement pathways, were observed in patients with antiphospholipid antibodies (aPLs) and during warfarin treatment. Objectives To investigate the associations between aPL and C4BPt in patients with persistently positive (++) aPL, with/without clinical manifestations and systemic lupus erythematosus (SLE), and in controls. Furthermore, we explored the impact of anticoagulation on C4BPt and in relation to complement activation. Methods In a cross-sectional design we investigated defined subgroups: primary (p) antiphospholipid syndrome (APS, N =67), aPL++ individuals without clinical manifestations (aPL carriers, N =15), SLE-aPL++ ( N =118, among them, secondary [s] APS, N =56), aPL negative (-) SLE (SLE-aPL-, N =291), and 322 controls. Clinical characteristics, including treatment, were tabulated. C4BPt was determined with a magnetic bead method. Complement proteins (C1q, C2, C3, C4, C3a, C3dg, sC5b-9, factor I [FI]) were measured. A mediation analysis was performed to decompose the total effect of aPL++ on C4BPt into the direct and indirect effects of aPL++ through warfarin. Results Overall, C4BPt is 20% decreased in aPL++ patients, regardless of SLE, APS, clinical manifestations, and aPL profile. C4BPt levels associate positively with complement proteins C1q, C2, C3, and C4, and negatively with complement activation product C3dg. In the SLE group, warfarin treatment contributes to approximately half of the C4BPt reduction (9%) Conclusion Both aPLs and warfarin are associated with C4BPt reduction. Complement activation in aPL++ patients may partly be explained by impaired inhibition through depressed C4BPt levels. Further studies are needed to understand the clinical implications.
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  • Herrström, Kerstin, et al. (författare)
  • Assessment of search strategies in literature-review-based candidate theses within a nursing program
  • 2020
  • Ingår i: Advances in Medical Education and Practice. - : Dove Medical Press Ltd.. - 1179-7258. ; 11, s. 71-77
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The majority of candidate theses in baccalaureate nursing programs in Sweden are written as literature studies. Being able to carry out a systematic and structured literature search is an essential part of thesis-related work. Aim: The aim of the current study was to investigate changes in nursing students’ search strategies in candidate theses. Methods: A retrospective, quantitative study design was obtained. Librarians (n = 2) and teachers (n = 4) randomly examined selected candidate theses (every third thesis, n = 89) from the years 2012, 2014, and 2016. Results: The result showed a significant improvement over the years (from 2012 and 2014 to 2016) regarding the use of a sufficient number of synonyms, matching search terms to the respective database, use of the Boolean operator OR, and the use of subject headings and free text searches. Use of the title/abstract search largely disappeared. There was a significant change in the types of searches being done. The searches have become more structured in later years as the use of block searches increased significantly; in other words, more systematic and relevant searches have been done in recent years. Conclusion: The result of this study shows that the quality of the students’ search strategies improved significantly during the studied years. It is recommended that search documents are used in both formative and summative assessments to evaluate students’ search strategies. Educational development in the form of enhanced collaboration between librarians and teachers in nursing programs is recommended because it might help to develop student search strategies in literature-based candidate theses.
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  • Kassymova, Gulnara, 1972- (författare)
  • The impact of postoperative telephone follow-up contacts on recovery after benign hysterectomy : with emphasis on health-related quality of life, postoperative symptoms, and health economics
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • BackgroundThe course of a postoperative recovery is important for both patient and healthcare services. Efforts to expedite and improve recovery in a safe and cost-effective manner are therefore highly desirable from the perspective of both parties. Telephone follow-up (TFU) has been suggested as a way to improve postoperative recovery and reduce the burden of the healthcare service. This thesis intends to investigate these issues. The overall purpose of the thesis was twofold: to evaluate the effects of nurse-led TFU contacts on the recovery after benign hysterectomy, and to make a health economic analysis of TFU. The specific aims of the thesis were a) to evaluate whether TFU, particularly when combined with structured-oriented coaching, facilitated postoperative recovery in terms of health-related quality of life (HRQoL), the duration of sick leave, and the occurrence of unplanned telephone contacts (uTCs) and unplanned visits (uVs) in the postoperative period, b) to determine if the TFUs affected postoperative symptoms and the consumption of analgesics, c) to analyze whether symptoms of anxiety and depression, and low stress-coping capacity had an impact on the effect of TFU on recovery and the occurrence of uTCs and uVs, and d) to provide a health economic evaluation of the TFU from the healthcare and societal perspectives. By addressing these aims, the intention of the thesis was to contribute with important knowledge to the existing sparse body of science concerning clinical outcomes after nurse-led TFUs and their impact on recovery outcomes after benign hysterectomy. Material and methodsA four-armed, semi-blinded, randomized controlled trial was conducted at the departments of obstetrics and gynecology in five public hospitals in the southeast health region of Sweden from October 2011 to May 2017. The study comprised 487 women between 18 and 60 years old who underwent abdominal or vaginal hysterectomy for benign gynecological conditions. The treatments to be investigated were different nurse-led TFU models and consisted of four groups: Group A had no planned follow-up contact with the healthcare service after discharge (control group); Group B had one planned, structured TFU session with the research nurse (RN) on the day after discharge; Group C had a planned, structured TFU session with the RN on the day after discharge and then once weekly for six weeks; and Group D had a planned, structured, oriented coaching TFU session with the RN on the day after discharge and then once weekly for six weeks. The specific content of the TFUs in Groups B and C, as well as the oriented coaching TFU model in Group D, were outlined in the study. Demographic and clinical data relevant to the study were collected prospectively. Sick leave duration, analgesic consumption, uTC, and uV were recorded from discharge until the six-week follow-up visit with the RN. HRQoL was measured by means of the EuroQoL-5 Dimension with three levels and the Short Form Health Survey with 36 items. Psychological distress was evaluated using the Hospital Anxiety and Depression Scale and the Stress-Coping Inventory. Postoperative symptoms were assessed using the Swedish Postoperative Symptoms Questionnaire. The health economics were evaluated using a cost minimization analysis. The estimation of hospital costs was based on the principles of the Cost Per Patient (CPP) method and the prices from the CPP list for 2022 from the University Hospital in Linköping were applied. ResultsRegardless of the TFU model, women achieved baseline levels of HRQoL four weeks after surgery and no difference was seen between the intervention groups in the trajectory of recovery of HRQoL. The duration of sick leave was similar across all intervention groups, ranging from 26.8 to 28.1 days. There were no significant differences in the trajectory of the intensity of postoperative symptoms or analgesic consumption between the intervention groups. Approximately 46% of the women had uTC and 45% had uV. The oriented coaching TFU was associated with a 33% lower occurrence of uTC compared with other TFU models. Women who had uTC reported higher levels of pain intensity and sum scores of postoperative symptoms, especially when the uTC was followed by a uV. Symptoms of depression, anxiety, and low stress coping capacity did not affect the effects of the TFU models on recovery trajectories, although there were strong associations between symptoms of anxiety, depression and low stress-coping capacity and all recovery measures. In addition, uTCs were more frequent among women with anxiety. The total costs per patient more than doubled in the groups with repeated TFUs compared with the group with no TFU. The coaching TFU group had lower costs for informal care. ConclusionsNurse-led TFU after benign hysterectomy in the form used in the present study did not expedite or improve the postoperative recovery concerning HRQoL, sick leave duration postoperative symptoms, or analgesic consumption. However, nurse-led TFU with structured coaching reduced the occurrence of uTC to healthcare providers, but not uVs. Symptoms of anxiety increased the occurrence of uTC and pain seemed to be a significant cause of both uTCs and uVs, The effect of the TFU on the recovery did not seem to be affected by the psychological state of proneness to anxiety, depression, or low stress-coping capacity. Nurse-led TFUs were cost-driving for the healthcare systems and can be seen as an inefficient use of healthcare resources. 
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  • Lindelöf, Linnea, et al. (författare)
  • A survey of ficolin-3 activity in Systemic Lupus Erythematosus reveals a link to hematological disease manifestations and autoantibody profile
  • 2024
  • Ingår i: Journal of Autoimmunity. - : Elsevier. - 0896-8411 .- 1095-9157. ; 143
  • Tidskriftsartikel (refereegranskat)abstract
    • The complement system plays a central role in the pathogenesis of Systemic Lupus Erythematosus (SLE), but most studies have focused on the classical pathway. Ficolin-3 is the main initiator of the lectin pathway of complement in humans, but its role in systemic autoimmune disease has not been conclusively determined. Here, we combined biochemical and genetic approaches to assess the contribution of ficolin-3 to SLE risk and disease manifestations. Ficolin-3 activity was measured by a functional assay in serum or plasma samples from Swedish SLE patients (n = 786) and controls matched for age and sex (n = 566). Genetic variants in an extended 300 kb genomic region spanning the FCN3 locus were analyzed for their association with ficolin-3 activity and SLE manifestations in a Swedish multicenter cohort (n = 985). Patients with ficolin-3 activity in the highest tertile showed a strong enrichment in an SLE cluster defined by anti-Sm/DNA/nucleosome antibodies (OR 3.0, p < 0.001) and had increased rates of hematological disease (OR 1.4, p = 0.078) and lymphopenia (OR = 1.6, p = 0.039). Genetic variants associated with low ficolin-3 activity mapped to an extended haplotype in high linkage disequilibrium upstream of the FCN3 gene. Patients carrying the lead genetic variant associated with low ficolin3 activity had a lower frequency of hematological disease (OR 0.67, p = 0.018) and lymphopenia (OR 0.63, p = 0.031) and fewer autoantibodies (p = 0.0019). Loss-of-function variants in the FCN3 gene were not associated with SLE, but four (0.5 %) SLE patients developed acquired ficolin-3 deficiency where ficolin-3 activity in serum was depleted following diagnosis of SLE. Taken together, our results provide genetic and biochemical evidence that implicate the lectin pathway in hematological SLE manifestations. We also identify lectin pathway activation through ficolin-3 as a factor that contributes to the autoantibody response in SLE.
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  • Nagel, Cicilia, et al. (författare)
  • Nurses’ Work Environment during the COVID-19 Pandemic in a Person-Centred Practice : A Systematic Review
  • 2022
  • Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 14:10, s. 1-36
  • Forskningsöversikt (refereegranskat)abstract
    • The work environment and especially the psychosocial work environment influence the mental and physical well-being of employees. The aim of this study was to identify and analyse the state of knowledge regarding nurses’ work situation, health, and person-centred work during the COVID-19 pandemic through a systematic review. Methods: Systematic Review, nine included articles. The theoretical swAge model was used as the framework in a deductive content analysis. Results: The result was presented in the nine determinate areas from the swAge model and showed that all nine determinate areas of the swAge model were of importance to both the nurses’ sustainable work situation during the COVID-19 pandemic and to person-centred care. The COVID-19 pandemic has had a negative effect on nurses’ health, both physically but especially psychologically, with high levels of depression, anxiety, and burnout. Nurses experienced a lack of control and support from organizations. They had to work with limited resources and sometimes care for patients beyond their expertise. Conclusion: There is a further need for more studies that address person-centredness from an organisational perspective with the intention to develop strategies and measure activities on how to make the nurses’ work situation more sustainable, and to increase their ability to give more person-centred care.
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  • Nilsson, Kerstin, et al. (författare)
  • Are My Employees Able to and Do They Want to Work? : The Baseline Investigation in a Follow up Study Regarding Managers’ Attitudes and Measures to Increase Employees’ Employability in an Extended Working Life
  • 2021
  • Ingår i: Proceedings of the 21st Congress of the International Ergonomics Association (IEA 2021) : Volume II: Inclusive Design - Volume II: Inclusive Design. - Cham : Springer International Publishing. - 2367-3389 .- 2367-3370. - 9783030746049 - 9783030746056 ; 220, s. 10-16
  • Konferensbidrag (refereegranskat)abstract
    • Background: The demographic change affects the retirement age, which has been postponed in many countries. Therefore, the number of senior employees is increasing in the world. However, managers’ attitudes towards their employees’ employability affect the employees’ possibilities regarding whether they can and want to work. Objective: The aim of this study was to evaluate managers’ attitudes towards their employees’ employability and what factors and measures that affect whether employees can and want to work in an extended working life. Method: The study population in this study consists of 249 municipality managers in Sweden, from a baseline investigation in a follow up study following the swAge-questionnaire. The data was analysed through the method of logistic regression. Results: 79% of the managers stated that their employees ‘can’ work and 58% that their employees ‘want to’ work until 65 years or older. Managers believed their employees’ health, physical work environment, skills and competence were associated to if they would be able to work until 65 years or older. Lack of support in the social work environment and lack of possibilities to arrange relocations if needed were associated to whether managers believed their employees want to work. Conclusions: The results indicate that the postponement the retirement age must be followed by measures in the employees’ work situation in order to decrease demands, increase rotation or change work tasks if needed, as well as increased possibilities to recuperate through reduced workload, reduced work pace and reduced working hours. The results will hopefully contribute to the understanding of needed organisational measures in the process of extending working life.
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  • Nilsson, Kerstin, et al. (författare)
  • Are my employees able to and do they want to work? The baseline investigation in a follow up study regarding managers’ attitudes and measures to increase employees’ employability in an extended working life
  • 2021
  • Ingår i: Proceedings of the 21st congress of the international ergonomics association (IEA 2021). - Cham : Springer. - 9783030746049 - 9783030746056 ; , s. 10-16
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Background: The demographic change affects the retirement age, which has been postponed in many countries. Therefore, the number of senior employees is increasing in the world. However, managers’ attitudes towards their employees’ employability affect the employees’ possibilities regarding whether they can and want to work.Objective: The aim of this study was to evaluate managers’ attitudes towards their employees’ employability and what factors and measures that affect whether employees can and want to work in an extended working life.Method: The study population in this study consists of 249 municipality managers in Sweden, from a baseline investigation in a follow up study following the swAge-questionnaire. The data was analysed through the method of logistic regression.Results: 79% of the managers stated that their employees ‘can’ work and 58% that their employees ‘want to’ work until 65 years or older. Managers believed their employees’ health, physical work environment, skills and competence were associated to if they would be able to work until 65 years or older. Lack of support in the social work environment and lack of possibilities to arrange relocations if needed were associated to whether managers believed their employees want to work.Conclusions: The results indicate that the postponement the retirement age must be followed by measures in the employees’ work situation in order to decrease demands, increase rotation or change work tasks if needed, as well as increased possibilities to recuperate through reduced workload, reduced work pace and reduced working hours. The results will hopefully contribute to the understanding of needed organisational measures in the process of extending working life.
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  • Nilsson, Kerstin, et al. (författare)
  • Can They Stay or Will They Go? : A Cross Sectional Study of Managers' Attitudes towards Their Senior Employees
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 19:3
  • Tidskriftsartikel (refereegranskat)abstract
    • A larger amount of older people need to participate in working life due to the global demographic change. It is the employer, through the manager, who enables employees to have access to measures in the workplace that facilitate and enable a sustainable extended working life. The aim of this study was to evaluate work life factors associated with managers believing their employees can work versus wanting to work until age 65 or older. This cross-sectional study included 249 managers in the Swedish municipality sector. Logistic regression analysis was used to investigate associations between different univariate estimates and in data modelling using the SwAge-model. The result stated that 79% of managers believed their employees 'can' work and 58% of managers believed their employees 'want to' work until age 65 or older. Health, physical work environment, skills and competence are associated the strongest to managers believing employees 'can' work until age 65 or older. Insufficient social support at work and lacking possibilities for relocations associated the strongest to managers believing employees would not 'want to' work until age 65 or older. Though, several countries (especially in Europe) have included in their social policy measures that retirement age be increased after 65, proposing ages approaching 70. When these proposals become laws, through obligation, people will have no choice (if they want to or if they can continue working). However, people's attitudes to work may be different (especially after the COVID-19 pandemic), and this analysis of the participating managers' attitudes showed there is a difference between why employees 'can' versus 'want' to work respectively. Therefore, different strategies may be needed to contribute to employees both being able to and willing to participate in working life until an older age. These findings on managers' perspectives, regarding whether they believe employees would be able to versus would want to work and the SwAge-model, will hopefully contribute to an increased understanding of organisational actions and measures in the process of creating a sustainable extended working life and to increase senior employees' employability.
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  • Nilsson, Kerstin, et al. (författare)
  • Management, Measures and Maintenance: : Success and Setbacks in Interventions Promoting a Healthy and Sustainable Employability and Working Life for All Ages
  • 2021
  • Ingår i: Proceedings of the 21st Congress of the International Ergonomics Association (IEA 2021) : Volume II: Inclusive Design - Volume II: Inclusive Design. - Cham : Springer International Publishing. - 2367-3389 .- 2367-3370. - 9783030746049 - 9783030746056 ; 220, s. 17-24, s. 17-24
  • Konferensbidrag (refereegranskat)abstract
    • Background: The labour force is ageing due to the demographic change and the postponement of old-age retirement in many countries. Objective: In order to increase the possibility for employees to maintain their employability and to keep working in an extended working life this intervention project tested a distance education as a technique to integrate a theoretical model for a sustainable working life for all ages (the swAge-model) as a practical management tool in fourteen municipality managers’ ordinary work situation. Results: Most of the participating managers had difficulty completing the entire training program in this intervention project due to external circumstances, such as the COVID-19 pandemic and re-organisations, and because no extra time during working hours had been allocated to the managers to participate in the intervention project. Despite this, all participating managers appreciated being given the opportunity to participate and take part in the content of the intervention. Everyone considered the theoretical model, the wage model, on which the intervention project was based, to be very useful and to have given them new insights into their managerial duties. Conclusions: If society and organisations want a larger amount of employees to participate in working life until an older age, they also need to allocate working hours for managers to acquire new knowledge on how to create healthy and sustainable workplaces for all ages, as well as to implement these tools, measures and working methods permanently in the daily organisational work.
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24.
  • Nilsson, Kerstin, et al. (författare)
  • Managers’ Attitudes to Different Action Proposals in the Direction to Extended Working Life : A Cross-Sectional Study
  • 2022
  • Ingår i: Sustainability (Switzerland). - : MDPI AG. - 2071-1050. ; 14:4
  • Tidskriftsartikel (refereegranskat)abstract
    • In many countries, the retirement age is postponed due to the global demographic change, and a larger amount of older people need to participate in working life. However, how and what measures and action proposals that could extend and increase employees’ voluntary and sustainable participation in working life have not entirely been investigated. The employer is responsible for enabling employees’ access to measures that facilitate participation in the workplace, for enabling employability and a sustainable extended working life. The aim of this cross-sectional study was to evaluate Swedish managers’ attitude to action proposals that could increase employees’ participation in an extended working life. Logistic regression analysis was used to investigate associa-tions between different univariate estimates and in data modelling. The nine determinate areas of the swAge model, for a sustainable working life and employability, was used as analysis model, i.e., self-rated health and diagnoses; physical work environment; mental work environment; work schedule, work pace and time for recuperation; financial incentives; personal social environment; social work environment; stimulation, motivation and self-crediting through work tasks; and com-petence, skills and knowledge development. The results stated decreased physical work demands to be the final measure in the multivariate modelling associated to whether the managers believe their employees ‘can work’ until age 65 and older, however, changing work tasks in the workplace when needed, rotation between different work tasks to decrease physical as well as mental work-load and strain, and decreased mental work demands proved to be statistically significant in the univariate estimates. The strongest measure activity in the organisations, associated to managers believing their employees ‘want to work’ until age 65 and older in the multivariate modelling, was decreased work pace, however, increased time for recuperation between work shifts also proved to be statistically significant in the univariate estimate. The management’s perspectives on measures and action proposals associated to whether employees ‘can’ and ‘want’ to work will hopefully con-tribute to an increased understanding in society and the organisational process of creating a sustainable extended working life.
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25.
  • Nilsson, Kerstin, et al. (författare)
  • Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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26.
  • Nilsson, Kerstin, et al. (författare, creator_code:000000023193205X_t)
  • Organisational Measures and Strategies for a Healthy and Sustainable Extended Working Life and Employability-A Deductive Content Analysis with Data Including Employees, First Line Managers, Trade Union Representatives and HR-Practitioners
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI Multidisciplinary Digital Publishing Institute. - 1661-7827 .- 1660-4601. ; 18:11, s. 1-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Due to the global demographic change many more people will need to work until an older age, and organisations and enterprises need to implement measures to facilitate an extended working life. The aim of this study was to investigate organisational measures and suggestions to promote and make improvements for a healthy and sustainable working life for all ages in an extended working life. This is a qualitative study, and the data were collected through both focus group interviews and individual interviews that included 145 participants. The study identified several suggestions for measures and actions to increase employability in the themes: to promote a good physical and mental work environment; to promote personal financial and social security; to promote relations, social inclusion and social support in the work situation; and to promote creativity, knowledge development and intrinsic work motivation, i.e., based on the spheres of determination in the theoretical swAge-model (sustainable working life for all ages). Based on the study results a tool for dialogue and discussion on employee work situation and career development was developed, and presented in this article. Regular conversations, communication and close dialogue are needed and are a prerequisite for good working conditions and a sustainable working environment, as well as to be able to manage employees and develop the organisation further. The identified measures need to be revisited regularly throughout the employees' entire working life to enable a healthy and sustainable working life for all ages.
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27.
  • Nilsson, Kerstin, et al. (författare)
  • Senior arbetskraft : en systematisk kunskapssammanställning med fokus på mental arbetsmiljö och arbetssocial miljö i Sverige
  • 2022
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Tidigare forskning har belyst ett antal faktorer som påverkar arbetslivet för äldre medarbetare, bland annat åldersdiskriminering och negativa attityder till äldre medarbetare, förändring av kognitiv och fysisk förmåga vid stigande ålder samt sambandet mellan en god arbetsmiljö och ökningen i arbetsmarknadsdeltagande bland äldre medarbetare. I en kunskapssammanställning har vi sammanställt resultat från forskning om den seniora arbetskraftens psykosociala arbetsmiljö i ett svenskt sammanhang.Begreppet psykosocial arbetsmiljö är i sammanställningen uppdelat i mental arbetsmiljö och arbetssocial miljö och utgår från följande frågeställningar:Vilka huvudsakliga risker i den mentala och arbetssociala miljön har identifierats i forskning som fokuserar på senior arbetskraft?Hur påverkar digitalisering på arbetsplatsen och arbetslivet den psykosociala arbetsmiljön för senior arbetskraft?Hur påverkar distans- och hemarbete den psykosociala arbetsmiljön för senior arbetskraft?
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28.
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29.
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30.
  • Sandholm, Kerstin, et al. (författare)
  • Quantification of Complement Proteins with Special Reference to C1q : Multiplex Versus ELISA Versus Rocket Immunoelectrophoresis Versus Nephelometry
  • 2021
  • Ingår i: The Complement System. - New York, NY : Humana Press. - 9781071610152 - 9781071610169 - 9781071610183 ; , s. 33-41
  • Bokkapitel (refereegranskat)abstract
    • Accurate determination of complement component C1q is hampered by the fact that C1q is an immune complex binding protein. Consequently, immunochemical techniques which rely on immune complex formation in fluid phase such as nephelometry and turbidimetry tend to give results which differ from those obtained by, for example, ELISA and other solid phase-based assays. In this chapter, we discuss the pros and cons of different techniques for the quantification of C1q and present a comprehensive protocol for a newly developed magnetic bead-based sandwich immunoassay which has replaced nephelometry in our complement diagnostic laboratory at the University Hospital in Uppsala.
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31.
  • Svenungsson, Elisabet, et al. (författare)
  • Complement deposition, C4d, on platelets is associated with vascular events in systemic lupus erythematosus
  • 2020
  • Ingår i: Rheumatology. - : Oxford University Press. - 1462-0324 .- 1462-0332. ; 59:11, s. 3264-3274
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. Complement components, including C4d, can be found on activated platelets, a process associated with vascular disease in SLE. We investigated whether platelet C4d (PC4d) adds additional value to traditional and known lupus-associated risk factors when identifying SLE patients with vascular disease. Methods. This cross-sectional study included 308 well-characterized SLE patients and 308 matched general population controls. PC4d deposition was analysed using flow cytometry. Values >95% of controls were considered as PC4d positive (+). aPL were determined by Luminex, and the LA test was performed by DRVVT. History of vascular disease (composite and as separate outcomes) was defined at inclusion. Results. SLE patients had increased PC4d deposition as compared with population controls (50 vs 5%, P < 0.0001). PC4d+ positively associated with any vascular events, and separately with venous and cerebrovascular events, and also with all investigated aPL profiles. The association for any vascular event remained statistically significant after adjustment for traditional and SLE-associated risk factors (odds ratio: 2.3, 95% CI: 1.3, 4.3, P = 0.008). Compared with patients negative for both PC4d and LA, patients with double positivity were more likely to have vascular disease (odds ratio: 12.3, 95% CI: 5.4, 29.3; attributable proportion due to interaction 0.8, 95% CI: 0.4, 1.1) Conclusion. PC4d+ is associated with vascular events in SLE, independently of traditional and SLE-associated risk factors. Concurrent presence of PC4d and LA seem to interact to further increase the odds for vascular events. Prospective studies should examine whether the aPL/PC4d combination can improve prediction of vascular events in SLE and/or APS.
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32.
  • Tjernberg, Anna Rockert, et al. (författare)
  • Celiac disease and complement activation in response to Streptococcus pneumoniae
  • 2020
  • Ingår i: European Journal of Pediatrics. - : Springer. - 0340-6199 .- 1432-1076. ; 179:1, s. 133-140
  • Tidskriftsartikel (refereegranskat)abstract
    • Individuals with celiac disease (CD) are at increased risk of invasive pneumococcal disease (IPD). The aim of this study was to explore whether the complement response to Streptococcus pneumoniae differed according to CD status, and could serve as an explanation for the excess risk of IPD in CD. Twenty-two children with CD and 18 controls, born 1999-2008, were included at Kalmar County Hospital, Sweden. The degree of complement activation was evaluated by comparing levels of activation products C3a and sC5b-9 in plasma incubated for 30 min with Streptococcus pneumoniae and in non-incubated plasma. Complement analyses were performed with enzyme-linked immunosorbent assay (ELISA). Pneumococcal stimulation caused a statistically significant increase in C3a as well as sC5b-9 in both children with CD and controls but there was no difference in response between the groups. After incubation, C3a increased on average 4.6 times and sC5b-9 22 times in both the CD and the control group (p = 0.497 and p = 0.724 respectively). Conclusion: Complement response to Streptococcus pneumoniae seems to be similar in children with and without CD and is thus unlikely to contribute to the increased susceptibility to invasive pneumococcal disease in CD.
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33.
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34.
  • Ahlqvist, Kerstin, et al. (författare)
  • The Association of Self-Reported Generalized Joint Hypermobility with pelvic girdle pain during pregnancy : a retrospective cohort study
  • 2020
  • Ingår i: BMC Musculoskeletal Disorders. - : BMC. - 1471-2474. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Pelvic girdle pain (PGP) is common during pregnancy but the causes remain poorly understood. Generalized joint hypermobility (GJH) is an inherited trait, with joint mobility beyond normal limits and is assumed to be related with PGP. The aim of this project was to study the association between self-reported GJH and the presence of PGP during pregnancy. Methods In this cohort study, 4884 Swedish-speaking women were consecutively recruited at their first visit for registration in the national antenatal screening programme in Sweden. We used the five-part questionnaire (5PQ) to assess GJH and pain drawings to identify PGP. Our primary outcome was the presence of PGP during the entire pregnancy and secondary outcomes were PGP in each trimesters. We tested the associations with logistic regression analysis, and adjusted for age and ethnicity. Results In all,2455 (50.3%) women responded to both questionnaires. The prevalence of self-reported GJH was 28.7%. A higher proportion of women with GJH than women without GJH reported PGP during the entire pregnancy (47.9% vs. 41.0%), particularly in trimester 1 (31.6% vs. 22.0%). Thus, women with GJH also had higher odds of PGP during the entire pregnancy (adjusted odds ratio (aOR) 1.27: 95% CI 1.11-1.47) and in trimester 1 (aOR 1.54: 95% CI 1.20-1.96), but the associations were not statistically significant in trimester 2 (aOR 1.24: 95% CI 0.82-1.88) or trimester 3 (aOR 1.20: 95% CI 0.99-1.45). The odds of PGP in pregnancy increased with increasing numbers of positive answers to the 5PQ (pfor linear trend < 0.001) for the entire pregnancy and in trimester 1 (pfor linear trend < 0.001), but not in trimesters 2 or 3 (p = 0.13 andp = 0.06, respectively). Conclusions Compared to women with normal joint mobility, women with GJH had higher odds of reporting PGP during pregnancy and the odds increased with number of positive responses to the 5PQ. The associations were present in trimester 1 but did not reach statistical significance in trimester 2 and 3.
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35.
  • Allbrand, Marianne, 1958- (författare)
  • Gene expression of inflammatory markers and growth factors in placenta in relation to maternal obesity and foetal and postnatal growth
  • 2020
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Maternal obesity is a growing health problem, that contributes to obstetrical complications in pregnancy, as well as neonatal morbidity and mortality. The placenta serves for gas and nutrient exchange between the mother and the foetus, and obesity may influence and modify placental growth and function. The aims of this thesis were to investigate associations between maternal obesity without associated morbidity and gene expression of inflammatory markers and growth factors in the placenta, as well as offspring birth weight and postnatal growth. Study I and III were designed as matched case-control studies including 32 obese women with an early pregnancy body mass index (BMI) ≥ 35.0 kg/m2, study II was an experimental study examining twelve placentas of normal weight women, and study IV was a cohort study including 109 obese women with a BMI ≥ 34.5 kg/m2. In studies I-IV analyses of gene expression were performed and in study III additionally cord blood concentrations were determined. No difference was found in the occurrence of placental gene expression of inflammatory markers or growth factors between obese and normal weight women, nor did the sampling site in placentas of normal weight women influence gene expression of these markers, except for leptin gene (LEP) and insulin receptor gene (INSR) expression. Ghrelin gene (GHRL) and LEP expression, as well as cord blood ghrelin and adiponectin levels, was not altered in maternal obesity, and a negatively U-shaped relationship between LEP expression and infant birth weight (BW) z-scores was observed in the placentas of obese women.In conclusion, no statistically significant difference in gene expressions of inflammatory markers and growth factors in the placenta between severely obese and normal weight women was found. These results are in contrast with earlier studies and could be due to the fact that we examined mainly healthy obese women. The correlations we found between gene expression of leptin in the placenta and the birth weight of the infants warrants further studies.
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36.
  • Allbrand, Marianne, 1958-, et al. (författare)
  • Gene expression of leptin, leptin receptor isoforms and inflammatory cytokines in placentas of obese women : Associations to birth weight and fetal sex
  • 2022
  • Ingår i: Placenta. - : Elsevier. - 0143-4004 .- 1532-3102. ; 117, s. 64-71
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Leptin signaling in placentas of obese women may influence fetal growth and may be dependent on fetal sex. The aim of this study was to investigate placental gene expression of leptin, its receptor and inflammatory cytokines in obese mothers in relation to offspring birth weight and sex.METHODS: In total, 109 placental tissue samples from severely obese women (body mass index in first trimester ≥35 kg/m2) giving birth vaginally at term to a healthy child were included. Quantitative real-time PCR was used for the analysis of leptin (LEP), its receptor LEPR with two splice variants, interleukin (IL)1B, chemokine (C-X-C motif) ligand 8 (CXCL8), tumour necrosis factor (TNF), IL6, IL10, hypoxia-inducible factor 1-alpha (HIF1A) and insulin receptor (INSR). The subjects were divided into three groups based on LEP expression percentiles (<25th percentile; 25-75th percentile and >75th percentile).RESULTS: A reverse U-shaped association between LEP expression and birth weight z-scores was found (R2 = 0.075, p = 0.005). Placental LEPRb expression was downregulated (p = 0.034) in those with highest LEP expression. Female infants had higher birth weight z-scores than males (0.58 (-1.49-2.88) vs 0.21 (-1.50-2.93), p = 0.020) and their placental LEPRb expression was upregulated (p = 0.047). The associations between expression of different genes differed by sex.DISCUSSION: A reverse U-shaped relationship between placental LEP expression and offspring birth weight z-scores was found together with sexual dimorphism in LEPRb expression indicating a complex regulation of fetal growth by placental leptin signaling in maternal obesity.
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37.
  • Andersson, Anna, et al. (författare)
  • Molecular changes among non-volatile disinfection by-products between drinking water treatment and consumer taps
  • 2021
  • Ingår i: Environmental Science. - : Royal Society of Chemistry. - 2053-1400 .- 2053-1419. ; 7:12, s. 2335-2345
  • Tidskriftsartikel (refereegranskat)abstract
    • The formation of disinfection by-products (DBPs) during drinking water treatment has been associated with various health concerns but the total DBP exposure is still unknown. In this study, molecular level non-target analysis by Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) was used to study non-volatile DBPs, and how their composition changes during water distribution in four drinking water treatment plants (DWTPs) in Sweden using different types of raw water and disinfection processes. The largest portion of tap water DBP compositions were detected also at the DWTPs, highlighting that these DBP formulae were rather stable and contribute to human DBP exposure. Yet the number of detected DBPs decreased 14-48% between drinking water treatment and consumer taps in the three plants in which no mixing of water from other DWTPs in the distribution system occurred showing active DBP processing in the water distribution network. While considerable amounts of bromine-containing DBPs were detected upon chemical disinfection in some DWTPs, few of them were detected in the tap water samples, likely due to debromination by hydrolytic reactions. The overall fewer non-volatile DBPs detected in tap waters, along with changed distribution among chlorine and bromine DBPs, demonstrate that DBP mixtures are highly dynamic and that DBP measurements at DWTPs do not adequately reflect exposure at the point-of-use. Clearly, more knowledge about changes of DBP mixtures through the distribution system is needed to improve DBP exposure assessments.
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38.
  • Arvidsson, Inger, et al. (författare)
  • Should I stay or should I go? Associations between occupational factors, signs of exhaustion and the intention to change workplace among swedish principals
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:10, s. 1-20
  • Tidskriftsartikel (refereegranskat)abstract
    • A high turnover among principals may disrupt the continuity of leadership and negatively affect teachers and, by extension, the students. The aim was to investigate to what extent various work environment factors and signs of exhaustion were associated with reported intentions to change workplace among principals working in compulsory schools. A web-based questionnaire was administered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of the associations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, and the intention to change workplace, using Generalized Estimating Equations models. Part II involved 631 principals who participated in both surveys. The patterns of intended and actual changes of workplace across two years were described, together with associated changes of occupational factors and signs of exhaustion. Supportive management was associated with an intention to stay, while demanding role conflicts and the feeling of being squeezed between management and co-workers (buffer-function) were associated with the intention to change workplace. The principals who intended to change their workplace reported more signs of exhaustion. To increase retention among principals, systematic efforts are probably needed at the national, municipal, and local level, in order to improve their working conditions.
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39.
  • Arvidsson, Inger, et al. (författare)
  • Should I stay or should I go? Associations between occupational factors, signs of exhaustion and the intention to change workplace among swedish principals
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI Multidisciplinary Digital Publishing Institute. - 1661-7827 .- 1660-4601. ; 18:10, s. 1-20
  • Tidskriftsartikel (refereegranskat)abstract
    • A high turnover among principals may disrupt the continuity of leadership and negatively affect teachers and, by extension, the students. The aim was to investigate to what extent various work environment factors and signs of exhaustion were associated with reported intentions to change workplace among principals working in compulsory schools. A web-based questionnaire was administered twice, in 2018 and in 2019. Part I of the study involved cross-sectional analyses of the associations 2018 (n = 984) and 2019 (n = 884) between occupational factors, signs of exhaustion, and the intention to change workplace, using Generalized Estimating Equations models. Part II involved 631 principals who participated in both surveys. The patterns of intended and actual changes of workplace across two years were described, together with associated changes of occupational factors and signs of exhaustion. Supportive management was associated with an intention to stay, while demanding role conflicts and the feeling of being squeezed between management and co-workers (buffer-function) were associated with the intention to change workplace. The principals who intended to change their workplace reported more signs of exhaustion. To increase retention among principals, systematic efforts are probably needed at the national, municipal, and local level, in order to improve their working conditions.
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40.
  • Bjuhr, Marie (författare)
  • Being active in working life at older ages
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of the thesis was to examine factors associated with (Study 1), predictors (Study II), and experiences (Study III) involved with being active in working life after the expected retirement age and the experiences of exiting working life before the expected retirement age (Study IV). In Studies I and II, a quantitative approach was used, with data derived from the Swedish National Study on Aging and Care (SNAC). In Studies III and IV, a qualitative approach was used, with data collected through semi-structured interviews. The results from Studies I and II revealed that being active in working life at age 66 was associated with being male, having a university education, working in a highly skilled occupation, having light physical activity at work, or having no more than one diagnosed disease. Being male (Studies I and II), having a university education (only in Study I) or working in a highly skilled occupation (only in Study II) were associated with being active in working life at age 72. The results from Studies III and IV revealed that from an individual perspective, health was a prominent aspect in either remaining in or exiting from working life. Staying active in working life increased feelings of vitality; the innermost dimension of health. Favorable working conditions could be beneficial to cognitive and physical health as well as to social well-being and a sense of meaningfulness. In contrast, strenuous working conditions contributed to the deterioration of health and pushed people at older ages toward an early exit from working life. The present results confirm the complexity regarding the predictors for being active in working life at older ages. The results add knowledge regarding how health in overall life and staying active in or exiting from working life at older ages can be experienced from a subjective perspective. With a successive increase in statutory retirement ages, the focus on the possibilities for healthy aging through being active in working life at older ages needs to be increased.
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41.
  • Blomberg, Anders, et al. (författare)
  • Chronic Airflow Limitation, Emphysema and Impaired Diffusing Capacity in Relation to Smoking Habits in a Swedish Middle-Aged Population.
  • 2024
  • Ingår i: Annals of the American Thoracic Society. - 2329-6933 .- 2325-6621.
  • Tidskriftsartikel (refereegranskat)abstract
    • RATIONALE: Chronic obstructive pulmonary disease (COPD) includes respiratory symptoms and chronic airflow limitation (CAL). In some cases, emphysema and impaired diffusing capacity for carbon monoxide (DLCO) are present, but characteristics and symptoms vary with smoking exposure.OBJECTIVES: To study the prevalence of CAL, emphysema and impaired DLCO in relation to smoking and respiratory symptoms in a middle-aged population.METHODS: We investigated 28,746 randomly invited individuals (52% women) aged 50-64 years across six Swedish sites. We performed spirometry, DLCO, high-resolution computed tomography (HRCT) and asked for smoking habits and respiratory symptoms. CAL was defined as post-bronchodilator forced expiratory volume in 1 second divided by forced expiratory volume (FEV1/FVC)<0.7.RESULTS: The overall prevalence was for CAL 8.8%, for impaired DLCO (DLCOCONCLUSIONS: In this large population-based study of middle-aged people, CAL and impaired DLCO were associated with common respiratory symptoms. Self-reported asthma was not associated with CAL in never-smokers. Our findings suggest that CAL in never-smokers signifies a separate clinical phenotype that may be monitored and, possibly, treated differently from smoking-related COPD. This article is open access and distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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42.
  • Bonde, J. P. E., et al. (författare)
  • COVID-19-related hospital admission in spouses of partners in at-risk occupations
  • 2023
  • Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 49:3, s. 193-200
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective This study aimed to quantify the risk of COVID-19-related hospital admission in spouses living with partners in at-risk occupations in Denmark during 2020-21.Methods Within a registry-based cohort of all Danish employees (N=2 451 542), we identified cohabiting couples, in which at least one member (spouse) held a job that according to a job exposure matrix entailed low risk of occupational exposure to SARS-CoV-2 (N=192 807 employees, 316 COVID-19 hospital admissions). Risk of COVID-19-related hospital admission in such spouses was assessed according to whether their partners were in jobs with low, intermediate or high risk for infection. Overall and sex-specific incidence rate ratios (IRR) of COVID-19-related hospital admission were computed by Poisson regression with adjustment for relevant covariates.Results The risk of COVID-19-related hospital admission was increased among spouses with partners in highrisk occupations [adjusted IRR (IRRadj)1.59, 95% confidence interval (CI) 1.1-2.2], but not intermediate-risk occupations (IRRadj 0.97 95% 0.8-1.3). IRR for having a partner in a high-risk job was elevated during the first three pandemic waves but not in the fourth (IRRadj 0.48 95% CI 0.2-1.5). Sex did not modify the risk of hospital admission.Conclusions SARS-CoV-2 transmission at the workplace may pose an increased risk of severe COVID-19 among spouses in low-risk jobs living with partners in high-risk jobs, which emphasizes the need for preventive measures at the workplace in future outbreaks of epidemic contagious disease. When available, effective vaccines seem essential.
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43.
  • Bonde, J. P. E., et al. (författare)
  • Occupational risk of COVID-19 across pandemic waves: a two-year national follow-up study of hospital admissions
  • 2022
  • Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 48:8, s. 672-677
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Assuming that preventive measures to mitigate viral transmission of SARS-CoV-2 at the workplace may have been improved in the course of the COVID-19 pandemic, we examined the occupational risk of COVID-19 related hospital admission across the four pandemic waves in Denmark between week 8, 2020, and week 50, 2021. Methods The study included 4416 cases of COVID-19 related hospital admissions among 2.4 million Danish employees aged 20-69 with follow-up in 2020 through 2021. At-risk industrial sectors and a reference population were defined a priory by a job-exposure matrix on occupational risk for COVID-19. Incidence rate ratios (IRR) and potential effect modification by pandemic wave were computed with Poisson regression adjusted for demographic, social and health factors including completed COVID-19 vaccination. Results We observed an overall elevated relative risk in four of six at-risk industrial sectors, but the pandemic wave only modified the risk among healthcare employees, where the excess risk from a high initial level declined to background levels during the latest waves in models not adjusting for COVID-19 vaccination. In social care, education and transport, the elevated risk was not modified by pandemic wave. Conclusion Danish healthcare employees were to some extent protected against occupational transmission of SARS-CoV-2 during the two last pandemic waves even though the absolute risk conferred by occupation may not have been eliminated. Early vaccination of this group seems not to be the only explanation. The risk in other sectors remained elevated indicating a need to revisit preventive measures.
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44.
  • Bonde, Jens Peter Ellekilde, et al. (författare)
  • Occupational risk of COVID-19 related hospital admission in Denmark 2020–2021 : a follow-up study
  • 2023
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 49:1, s. 84-94
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021.Methods: The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression.Results: During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk.Conclusion: Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.
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45.
  • Bonde, J. P. E., et al. (författare)
  • Occupational risk of SARS-CoV-2 infection: a nationwide register-based study of the Danish workforce during the COVID-19 pandemic, 2020-2021
  • 2023
  • Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 80:4, s. 202-208
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveMost earlier studies on occupational risk of COVID-19 covering the entire workforce are based on relatively rare outcomes such as hospital admission and mortality. This study examines the incidence of SARS-CoV-2 infection by occupational group based on real-time PCR (RT-PCR) tests. MethodsThe cohort includes 2.4 million Danish employees, 20-69 years of age. All data were retrieved from public registries. The incidence rate ratios (IRRs) of first-occurring positive RT-PCR test from week 8 of 2020 to week 50 of 2021 were computed by Poisson regression for each four-digit Danish Version of the International Standard Classification of Occupations job code with more than 100 male and 100 female employees (n=205). Occupational groups with low risk of workplace infection according to a job exposure matrix constituted the reference group. Risk estimates were adjusted by demographic, social and health characteristics including household size, completed COVID-19 vaccination, pandemic wave and occupation-specific frequency of testing. ResultsIRRs of SARS-CoV-2 infection were elevated in seven healthcare occupations and 42 occupations in other sectors, mainly social work activities, residential care, education, defence and security, accommodation and transportation. No IRRs exceeded 2.0. The relative risk in healthcare, residential care and defence/security declined across pandemic waves. Decreased IRRs were observed in 12 occupations. DiscussionWe observed a modestly increased risk of SARS-CoV-2 infection among employees in numerous occupations, indicating a large potential for preventive actions. Cautious interpretation of observed risk in specific occupations is needed because of methodological issues inherent in analyses of RT-PCR test results and because of multiple statistical tests.
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46.
  • Carlson, Annelie, et al. (författare)
  • REMAnufactuRing – Key enABLEr to future business (REMARKABLE)
  • 2023
  • Konferensbidrag (refereegranskat)abstract
    • Circularity through remanufacturingRemanufacturing can be described as a process of bringing used products to “like-new” functional state. It is an industrial process whereby products referred as cores are restored to useful life. During this process the core pass through a number of remanufacturing steps, e.g., inspection, disassembly, part replacement/refurbishment, cleaning, reassembly, and testing to ensure it meets the desired product standards’.Remanufacturing involves not only new processes but also necessitates changes in product design, the adoption of new business models, advancements in information management, and the inclusion of sustainability assessments. These assessments ensure that the new designs and circular business models implemented are not only circular but also sustainable. All these aspects form a crucial part of the REMARKABLE project, contributing to the development of a comprehensive remanufacturing ecosystem.The purpose of the REMARKABLE project is to support manufacturers to become more resilient, circular, and sustainable through remanufacturing and contribute to a more efficient use ofresources.Project activities and initial resultsThe REMARKABLE project involves six highly engaged manufacturing companies from a variety of sectors that will collaborate during 2022-2025. At first, workshops have taken place with each company to identify needs, challenges and ambitions. In addition, five student projects have been conducted during spring 2022 along with two study visits at participating companies.Initial company discussions shows that remanufacturing tends to question current business models and generate grounds for circular business models development (e.g. leasing, rental, deposit system). Remanufacturing often also questions the current value network and the actors in it, as remanufacturing flows can generate need of new business relationships whilst maintaining current business models.Remanufacturing poses challenges due to small batch sizes, low automation, and reliance on manual labor. Flexibility and specific capabilities are needed to handle uncertainties, complexity in planning, and ensure efficiency. Tools, methods, and frameworks are necessary to effectively balance all three pillars of sustainability. The development process of remanufacturing systems plays a critical role in achieving sustainability performance which also requires effective information management.Commonly, the products are not adapted for remanufacturing. Within the REMARKABLE project we are investigating how to make the products easier to remanufacture by design. This includes for example aspects of making the product easier to clean and disassemble.
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47.
  • Carlsson, Hanna, et al. (författare)
  • Complement activation in individuals with previous subclinical Lyme borreliosis and patients with previous Lyme neuroborreliosis
  • 2020
  • Ingår i: European Journal of Clinical Microbiology and Infectious Diseases. - : Springer. - 0934-9723 .- 1435-4373. ; 39:5, s. 855-862
  • Tidskriftsartikel (refereegranskat)abstract
    • Lyme borreliosis (LB) is caused by Borrelia burgdorferi and infection may lead to not only a large variety of clinical manifestations but also a subclinical outcome. The aim of the present study was to investigate if there is a constitutional difference in complement activation between individuals with previous subclinical Lyme borreliosis (SB) and patients previously diagnosed with Lyme neuroborreliosis (LNB).Lepirudin plasma for activation studies was collected from 60 SB individuals and from 22 patients pre-diagnosed with LNB. The plasma was incubated with live Borrelia spirochetes of two strains (complement sensitive B. garinii Lu59 and complement resistant B. afzelii ACA1).Complement factor C3 was measured in non-activated lepirudin plasma with immune-nephelometry and C3a and sC5b-9 generated during complement activation were measured by enzyme-linked immunosorbent assay.We found that the complement sensitive Lu59 induced higher complement activation than the complement resistant ACA1 when measuring activation products C3a and sC5b-9 in SB and LNB patients, p < 0.0001. No significant difference was found between SB and LNB patients in systemic levels of C3. Furthermore, SB individuals generated a higher activation of C3 cleavage to C3a (C3a/C3 ratio) than LNB patients after activation with ACA1, p < 0.001, but no significant differences were found in response to Lu59. In conclusion, Lu59 induced higher complement activation than ACA1 and individuals with previous SB showed increased generation of C3a compared with patients with previous LNB. In our study population, this mechanism could lead to less elimination of spirochetes in LNB patients and thereby be a factor contributing to the clinical outcome.
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48.
  • Dahlgren, Hedda, et al. (författare)
  • Sexual function in primiparous women : a prospective study
  • 2022
  • Ingår i: International Urogynecology Journal. - : Springer. - 0937-3462 .- 1433-3023. ; 33:6, s. 1567-1582
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION AND HYPOTHESIS: The aim of this prospective study was to examine the impact of sociodemographic, pregnancy and obstetric characteristics on sexual function 12 months postpartum in primiparous women. We hypothesized that sexual function would decrease after childbirth.METHODS: Between 1 October 2014 and 1 October 2017, all nulliparous women in early pregnancy registering for maternity health care in Region Örebro County, Sweden, were invited to participate in this prospective study. A total of 958 women were included. Sexual activity and function were measured at early pregnancy, 8 weeks postpartum and 12 months postpartum using the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The associations between sociodemographic, pregnancy and obstetric characteristics and sexual activity and function from early pregnancy to 12 months postpartum were examined using linear and logistic models based on generalized estimating equations.RESULTS: We found that the prevalence of sexually active women decreased from 98.0% in early pregnancy to 66.7% at 8 weeks postpartum, but increased to 90.0% at 12 months postpartum. Age ≥ 35 years, second-degree perineal tear and current breastfeeding were statistically significant risk factors for sexual inactivity at 12 months postpartum. Poor self-reported health in early pregnancy was statistically significantly associated with decreased sexual function at 12 months postpartum.CONCLUSIONS: A majority of women resumed sexual activity at 8 weeks postpartum and most women at 12 months postpartum; the decrease in sexual function at 12 months postpartum was small and few risk factors were observed.
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49.
  • Ekberg, EwaCarin, et al. (författare)
  • Diagnostic Criteria for Temporomandibular Disorders - INfORM recommendations : Comprehensive and short-form adaptations for adolescents.
  • 2023
  • Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842. ; 50:11, s. 1167-1180
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for use in adults is in use worldwide. Until now, no version of this instrument for use in adolescents has been proposed.OBJECTIVE: To present comprehensive and short-form adaptations of the adult version of DC/TMD that are appropriate for use with adolescents in clinical and research settings.METHODS: International experts in TMDs and experts in pain psychology participated in a Delphi process to identify ways of adapting the DC/TMD protocol for physical and psychosocial assessment of adolescents.RESULTS: The proposed adaptation defines adolescence as ages 10-19 years. Changes in the physical diagnosis (Axis I) include (i) adapting the language of the Demographics and the Symptom Questionnaires to be developmentally appropriate for adolescents, (ii) adding two general health questionnaires, one for the adolescent patient and one for their caregivers, and (iii) replacing the TMD Pain Screener with the 3Q/TMD questionnaire. Changes in the psychosocial assessment (Axis II) include (i) adapting the language of the Graded Chronic Pain Scale to be developmentally appropriate for adolescents, (ii) adding anxiety and depression assessment that have been validated for adolescents, and (iii) adding three constructs (stress, catastrophizing and sleep disorders) to assess psychosocial functioning in adolescents.CONCLUSION: The recommended DC/TMD, including Axis I and Axis II for adolescents, is appropriate to use in clinical and research settings. This adapted first version for adolescents includes changes in Axis I and Axis II requiring reliability and validity testing in international settings. Official translations of the comprehensive and short-form to different languages according to INfORM requirements will enable a worldwide dissemination and implementation.
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50.
  • Elm, Annika, 1958-, et al. (författare)
  • Academic teachers’ experiences of technology enhanced learning (TEL) in higher education – A Swedish case
  • 2023
  • Ingår i: Cogent Education. - Abingdon : Taylor & Francis. - 2331-186X. ; 10:2
  • Tidskriftsartikel (refereegranskat)abstract
    • This article presents a Swedish study on the potential of technology to transform teaching and learning practices in higher education. Sweden is at the forefront of technological innovation and digitalization and when it comes to technology in education this is not an exception. Technology Enhanced Learning (TEL) has emerged as an important pedagogical aspect within higher education in recent years. The term TEL is used to demonstrate teaching experiences that intend to improve such support. Previous research has recognized bottom-up initiatives from academic staff with specialists in technology often addressed by individual enthusiasts. Also, most internal processes regarding digitalization are identified as top-down initiatives driven by policy rather than influenced teachers. Hence, the main aim of this study is to analyse academic teachers´ experiences with digital technologies that support students’ learning in higher education. To support this aim, following research questions are posed: 1) What factors facilitate TEL in teaching in higher education and why? 2) What factors limit TEL in higher education and why? Focus group interviews with 36 academic teachers from two Swedish universities were conducted. Results show that on the one hand teachers experience both benefits and limitations with TEL. On the other hand, important organisational aspects of using TEL are highlighted. The choices that academic teachers face and give expression to do not appear to be a matter of individual choice or stance in teaching situations. These results have relevance globally for all involved in teaching and learning in higher education. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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