| 1. |
- Zahed, Hana, et al.
(author)
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Epidemiology of 40 blood biomarkers of one-carbon metabolism, vitamin status, inflammation, and renal and endothelial function among cancer-free older adults
- 2021
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In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 11:1
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Journal article (peer-reviewed)abstract
- Imbalances of blood biomarkers are associated with disease, and biomarkers may also vary non-pathologically across population groups. We described variation in concentrations of biomarkers of one-carbon metabolism, vitamin status, inflammation including tryptophan metabolism, and endothelial and renal function among cancer-free older adults. We analyzed 5167 cancer-free controls aged 40–80 years from 20 cohorts in the Lung Cancer Cohort Consortium (LC3). Centralized biochemical analyses of 40 biomarkers in plasma or serum were performed. We fit multivariable linear mixed effects models to quantify variation in standardized biomarker log-concentrations across four factors: age, sex, smoking status, and body mass index (BMI). Differences in most biomarkers across most factors were small, with 93% (186/200) of analyses showing an estimated difference lower than 0.25 standard-deviations, although most were statistically significant due to large sample size. The largest difference was for creatinine by sex, which was − 0.91 standard-deviations lower in women than men (95%CI − 0.98; − 0.84). The largest difference by age was for total cysteine (0.40 standard-deviation increase per 10-year increase, 95%CI 0.36; 0.43), and by BMI was for C-reactive protein (0.38 standard-deviation increase per 5-kg/m2 increase, 95%CI 0.34; 0.41). For 31 of 40 markers, the mean difference between current and never smokers was larger than between former and never smokers. A statistically significant (p < 0.05) association with time since smoking cessation was observed for 8 markers, including C-reactive protein, kynurenine, choline, and total homocysteine. We conclude that most blood biomarkers show small variations across demographic characteristics. Patterns by smoking status point to normalization of multiple physiological processes after smoking cessation.
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| 3. |
- Rydenfält, Christofer, et al.
(author)
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Exploring Local Initiatives to Improve the Work Environment : A Qualitative Survey in Swedish Home Care Practice
- 2021
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In: Home Health Care Management & Practice. - : SAGE Publications. - 1084-8223 .- 1552-6739. ; 33:3, s. 154-161
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Journal article (peer-reviewed)abstract
- Home care for the elderly constitutes a large and growing part of the social welfare system. Though, home care work is associated with a number of work environment-related challenges, including an increased risk for injuries, musculoskeletal disorders, high levels of sick leave and staff turnover, as well as stress and high workload, research is sparse. The present study explores local initiatives to improve the work environment initiated by the home care organizations themselves, and asks whether or not these initiatives affected gender equality. A qualitative web survey was sent to Swedish home care organizations, with open questions about change initiatives intended to have a positive effect on the work environment. There is an impressive amount of local work environment-related change initiatives going on. 80 categories of change initiatives were identified in answers from 178 units. However, these change initiatives were seldom evaluated or made accessible to stakeholders outside the organization. Main themes were concerned with work organization, digitalization, and planning, which largely follows trends in society (ie, digitalization, teamwork), rather than the actual needs identified by research (eg, musculoskeletal disorders). Despite apparent gender-related challenges, little of the work was associated with gender equality. The results indicates that there is a huge learning potential as the identified initiatives can serve as inspiration for others. However, to fully take advantage of these type of initiatives, more systematic evaluations are required.
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| 4. |
- Rydenfält, Christofer, et al.
(author)
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Picking low hanging fruit–A scoping review of work environment related interventions in the home care sector
- 2020
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In: Home Health Care Services Quarterly. - : Routledge. - 0162-1424 .- 1545-0856. ; 39:4, s. 223-237
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Journal article (peer-reviewed)abstract
- Home care for elderly people is an important part of the social welfare system. The sector employs many people, especially women, and work environment issues are common. This review explores the scientific literature on organizational interventions that target the home care work environment. Altogether, 16 studies of varying quality met the inclusion criteria. The interventions identified involved organizational change, education and training, digitalization and scheduling. Many interventions were concerned with changing specific behaviors or with introducing new technology rather than tackling complex issues such as sick leave, stress or gender inequality. Employee participation increased the likelihood of success.
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| 5. |
- Harvey, Nicholas C., et al.
(author)
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Sarcopenia Definitions as Predictors of Fracture Risk Independent of FRAX®, Falls, and BMD in the Osteoporotic Fractures in Men (MrOS) Study : A Meta-Analysis
- 2021
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In: Journal of Bone and Mineral Research. - : Wiley. - 0884-0431 .- 1523-4681. ; 36:7, s. 1235-1244
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Journal article (peer-reviewed)abstract
- Dual-energy X-ray absorptiometry (DXA)-derived appendicular lean mass/height2 (ALM/ht2) is the most commonly used estimate of muscle mass in the assessment of sarcopenia, but its predictive value for fracture is substantially attenuated by femoral neck (fn) bone mineral density (BMD). We investigated predictive value of 11 sarcopenia definitions for incident fracture, independent of fnBMD, fracture risk assessment tool (FRAX®) probability, and prior falls, using an extension of Poisson regression in US, Sweden, and Hong Kong Osteoporois Fractures in Men Study (MrOS) cohorts. Definitions tested were those of Baumgartner and Delmonico (ALM/ht2 only), Morley, the International Working Group on Sarcopenia, European Working Group on Sarcopenia in Older People (EWGSOP1 and 2), Asian Working Group on Sarcopenia, Foundation for the National Institutes of Health (FNIH) 1 and 2 (using ALM/body mass index [BMI], incorporating muscle strength and/or physical performance measures plus ALM/ht2), and Sarcopenia Definitions and Outcomes Consortium (gait speed and grip strength). Associations were adjusted for age and time since baseline and reported as hazard ratio (HR) for first incident fracture, here major osteoporotic fracture (MOF; clinical vertebral, hip, distal forearm, proximal humerus). Further analyses adjusted additionally for FRAX-MOF probability (n = 7531; calculated ± fnBMD), prior falls (y/n), or fnBMD T-score. Results were synthesized by meta-analysis. In 5660 men in USA, 2764 Sweden and 1987 Hong Kong (mean ages 73.5, 75.4, and 72.4 years, respectively), sarcopenia prevalence ranged from 0.5% to 35%. Sarcopenia status, by all definitions except those of FNIH, was associated with incident MOF (HR = 1.39 to 2.07). Associations were robust to adjustment for prior falls or FRAX probability (without fnBMD); adjustment for fnBMD T-score attenuated associations. EWGSOP2 severe sarcopenia (incorporating chair stand time, gait speed, and grip strength plus ALM) was most predictive, albeit at low prevalence, and appeared only modestly influenced by inclusion of fnBMD. In conclusion, the predictive value for fracture of sarcopenia definitions based on ALM is reduced by adjustment for fnBMD but strengthened by additional inclusion of physical performance measures.
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| 6. |
- Johansson, Gerd, et al.
(author)
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Hemtjänstpersonalens arbetsmiljö och hälsa i fyra skånska kommuner
- 2021
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Reports (other academic/artistic)abstract
- I denna rapport presentas resultaten från en arbetsmiljöenkät som genomförts ihemtjänsten i fyra skånska kommuner (2 landsortskommuner, 1 medelstor stad, 1 storstad). Enkäten syftade till att brett kartlägga hemtjänstpersonalens arbetsmiljö, hälsa och välmående och är en del av det fyraåriga forskningsprojektet ”Att skapa en bättre arbetsmiljö i hemtjänsten - participativt förändringsarbete i praktiken”. Projektet har finansierats av Forskningsrådet för hälsa, arbetsliv och välfärd (FORTE).Totalt svarade 114 personer varav 99 var kvinnor, 14 män och en person som inte angivit kön på enkäten. Andelen av hemtjänstpersonalen som svarade på enkäten var 73%. Personerna svarade på frågor om övergripande arbetssituation inklusive ergonomiska förhållanden och psykosocial arbetsmiljö och om hälsa.De allra flesta (mer än 90%) uppgav att de trivs med sitt arbete och sin arbetsplats. De angav också att stämningen var god, att de kände en gemenskap på arbetsplatsen och upplevde ett stort stöd från sina arbetskamrater, vilket medför att de har möjlighet att få råd och att lära av andra. En majoritet uppgav att de också hade ett gott stöd från närmaste chef. Däremot upplevde de att de ganska sällan fick uppskattning eller belöning för sitt arbete. Det kan också noteras att två tredjedelar av deltagarna kände att de ville arbeta kvar på nuvarande arbetsplats om fem år.Hemtjänstpersonalen lyfter i sina enkätsvar främst fram tre problem i arbetet;bristen på vikarier, att tiden att ägna sig åt varje omsorgstagare är för kort samt att antalet omsorgstagare som varje person ska besöka under en vecka är för stort.Bristen på tid hos omsorgstagarna medför bl.a. att de inte hinner sköta andrakringuppgifter, att tiden att förflytta sig mellan olika omsorgstagare äts upp ochnågon tid för att kunna varva ner finns inte. Möjligen kan denna brist på mikropauser i vardagen bidra till både ökad stress och fysisk belastning.Av samtliga undersökningsdeltagare angav mer än hälften i sina enkätsvar attnuvarande arbete hade gjort deras hälsa något eller mycket sämre. Förekomsten av besvär från muskler och leder var anmärkningsvärt hög jämfört med andra yrkesgrupper och även jämfört med tidigare studier av personal inom hemtjänst. Det var särskilt vanligt med besvär från rygg och armbågar/händer.För bedömning av indikation för utmattning har tre olika instrument använts.Dessa visar att en fjärdedel till en tredjedel av de hemstjänstanställda rapporterarstress och/eller utmattningsreaktioner på en nivå som indikerar risk för utmattningssyndrom eller annan relaterad psykisk ohälsa om deras situation blir långvarig.Sammanfattningsvis anser vi att de positiva sociala aspekterna av arbetsmiljön iform av trivsel på arbetsplatsen, god gemenskap med stöd från både ledning ochkollegor betyder att bilden av hemtjänsten som en oattraktiv arbetsplats inte är entydig. Det finns resurser i organisationen och bland personalen som det går attbygga vidare på.Vad gäller individens fysiska och psykologiska arbetsmiljö ser vi dock ett antalutmaningar i form av hög fysisk belastning och risk för stress och utmattning. Allt detta måste åtgärdas för att öka attraktionen för yrket och minska riskerna för arbetsskador och sjukskrivning. Även om organisatoriska förändringar och användning av tekniska hjälpmedel i vissa fall kan minska problemen så måste det anställas fler personer för att personalen ska kunna ge omsorgstagarna den vård- och omsorg de behöver. För att fler personer ska välja att arbeta inom hemtjänst krävs också förbättrade anställningsförhållanden som tillsvidareanställning, förbättrade löneförmåner, möjlighet till fortbildning, en arbetsmiljö som inte påverkar hälsan negativt och möjlighet att påverka hur arbetet utförs.
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| 8. |
- Persson, Johanna, et al.
(author)
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Digitalization and mobile work in home care nursing – how does it work in everyday practice?
- 2021
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Conference paper (peer-reviewed)abstract
- In this study we explore what digitally supported, mobile work in home care nursing may look like in practice. The results show that there is a large degree of self-determination among the nurses when it comes to organizing their work and that the digital systems can lead to an increased complexity. The diverse environment encountered in home care (as compared to the more standardized hospital environment) accentuates that digitalization has many sides to it and cannot be treated as a generic homogeneous entity regardless of context and task.
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