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1.	Bossini-Castillo, Lara, et al. (author) A replication study confirms the association of TNFSF4 (OX40L) polymorphisms with systemic sclerosis in a large European cohort 2011 In: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 70:4, s. 638-641 Journal article (peer-reviewed)abstract Objectives The aim of this study was to confirm the influence of TNFSF4 polymorphisms on systemic sclerosis (SSc) susceptibility and phenotypic features. Methods A total of 8 European populations of Caucasian ancestry were included, comprising 3014 patients with SSc and 3125 healthy controls. Four genetic variants of TNFSF4 gene promoter (rs1234314, rs844644, rs844648 and rs12039904) were selected as genetic markers. Results A pooled analysis revealed the association of rs1234314 and rs12039904 polymorphisms with SSc (OR 1.15, 95% CI 1.02 to 1.31; OR 1.18, 95% CI 1.08 to 1.29, respectively). Significant association of the four tested variants with patients with limited cutaneous SSc (lcSSc) was revealed (rs1234314 OR 1.22, 95% CI 1.07 to 1.38; rs844644 OR 0.91, 95% CI 0.83 to 0.99; rs844648 OR 1.10, 95% CI 1.01 to 1.20 and rs12039904 OR 1.20, 95% CI 1.09 to 1.33). Association of rs1234314, rs844648 and rs12039904 minor alleles with patients positive for anti-centromere antibodies (ACA) remained significant (OR 1.23, 95% CI 1.10 to 1.37; OR 1.12, 95% CI 1.01 to 1.25; OR 1.22, 95% CI 1.07 to 1.38, respectively). Haplotype analysis confirmed a protective haplotype associated with SSc, lcSSc and ACA positive subgroups (OR 0.88, 95% CI 0.82 to 0.96; OR 0.88, 95% CI 0.80 to 0.96; OR 0.86, 95% CI 0.77 to 0.97, respectively) and revealed a new risk haplotype associated with the same groups of patients (OR 1.14, 95% CI 1.03 to 1.26; OR 1.20, 95% CI 1.08 to 1.35; OR 1.23, 95% CI 1.07 to 1.42, respectively). Conclusions The data confirm the influence of TNFSF4 polymorphisms in SSc genetic susceptibility, especially in subsets of patients positive for lcSSc and ACA.
2.	Zamora, Juan Carlos, et al. (author) Considerations and consequences of allowing DNA sequence data as types of fungal taxa 2018 In: IMA Fungus. - : INT MYCOLOGICAL ASSOC. - 2210-6340 .- 2210-6359. ; 9:1, s. 167-185 Journal article (peer-reviewed)abstract Nomenclatural type definitions are one of the most important concepts in biological nomenclature. Being physical objects that can be re-studied by other researchers, types permanently link taxonomy (an artificial agreement to classify biological diversity) with nomenclature (an artificial agreement to name biological diversity). Two proposals to amend the International Code of Nomenclature for algae, fungi, and plants (ICN), allowing DNA sequences alone (of any region and extent) to serve as types of taxon names for voucherless fungi (mainly putative taxa from environmental DNA sequences), have been submitted to be voted on at the 11th International Mycological Congress (Puerto Rico, July 2018). We consider various genetic processes affecting the distribution of alleles among taxa and find that alleles may not consistently and uniquely represent the species within which they are contained. Should the proposals be accepted, the meaning of nomenclatural types would change in a fundamental way from physical objects as sources of data to the data themselves. Such changes are conducive to irreproducible science, the potential typification on artefactual data, and massive creation of names with low information content, ultimately causing nomenclatural instability and unnecessary work for future researchers that would stall future explorations of fungal diversity. We conclude that the acceptance of DNA sequences alone as types of names of taxa, under the terms used in the current proposals, is unnecessary and would not solve the problem of naming putative taxa known only from DNA sequences in a scientifically defensible way. As an alternative, we highlight the use of formulas for naming putative taxa (candidate taxa) that do not require any modification of the ICN.
3.	Bossini-Castillo, Lara, et al. (author) Confirmation of association of the macrophage migration inhibitory factor gene with systemic sclerosis in a large European population. 2011 In: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; 50, s. 1976-1981 Journal article (peer-reviewed)abstract Objectives. The aim of this study was to confirm the implication of macrophage migration inhibitory factor (MIF) gene in SSc susceptibility or clinical phenotypes in a large European population.Methods. A total of 3800 SSc patients and 4282 healthy controls of white Caucasian ancestry from eight different European countries were included in the study. The MIF -173 single nucleotide polymorphism (SNP) was selected as genetic marker and genotyped using Taqman 5' allelic discrimination assay.Results. The MIF -173 SNP showed association with SSc [P = 0.04, odds ratio (OR) = 1.10, 95% CI 1.00, 1.19]. Analysis of the MIF -173 polymorphism according to SSc clinical phenotype revealed that the frequency of the -173C allele was significantly higher in the dcSSc group compared with controls (P = 5.30E-03, OR = 1.21, 95% CI 1.07, 1.38). Conversely, the frequency of the MIF -173C allele was significantly underrepresented in the lcSSc group compared with dcSSc patients, supporting previous findings [(P = 0.04, OR = 0.86, 95% CI 0.75, 0.99); meta-analysis including previous results (P = 0.005, OR = 0.83, 95% CI 0.73, 0.94)].Conclusion. Our results confirm the role of MIF -173 promoter polymorphism in SSc, and provide evidence of a strong association with the dcSSc subgroup of patients. Hence, the MIF -173 variant is confirmed as a promising clinical phenotype genetic marker.
4.	Gorlova, Olga, et al. (author) Identification of Novel Genetic Markers Associated with Clinical Phenotypes of Systemic Sclerosis through a Genome-Wide Association Strategy 2011 In: PLoS Genetics. - : Public Library of Science (PLoS). - 1553-7404. ; 7:7 Journal article (peer-reviewed)abstract The aim of this study was to determine, through a genome-wide association study (GWAS), the genetic components contributing to different clinical sub-phenotypes of systemic sclerosis (SSc). We considered limited (IcSSc) and diffuse (dcSSc) cutaneous involvement, and the relationships with presence of the SSc-specific auto-antibodies, anti-centromere (ACA), and anti-topoisomerase I (ATA). Four GWAS cohorts, comprising 2,296 SSc patients and 5,171 healthy controls, were meta-analyzed looking for associations in the selected subgroups. Eighteen polymorphisms were further tested in nine independent cohorts comprising an additional 3,175 SSc patients and 4,971 controls. Conditional analysis for associated SNPs in the HLA region was performed to explore their independent association in antibody subgroups. Overall analysis showed that non-HLA polymorphism rs11642873 in IRF8 gene to be associated at GWAS level with lcSSc (P = 2.32x10(-12), OR = 0.75). Also, rs12540874 in GRB10 gene (P = 1.27 x 10(-6), OR = 1.15) and rs11047102 in SOX5 gene (P = 1.39x10(-7), OR = 1.36) showed a suggestive association with lcSSc and ACA subgroups respectively. In the HLA region, we observed highly associated allelic combinations in the HLA-DQB1 locus with ACA (P = 1.79x10(-61), OR = 2.48), in the HLA-DPA1/B1 loci with ATA (P = 4.57x10(-76), OR = 8.84), and in NOTCH4 with ACA P = 8.84x10(-21), OR = 0.55) and ATA (P = 1.14x10(-8), OR = 0.54). We have identified three new non-HLA genes (IRF8, GRB10, and SOX5) associated with SSc clinical and autoantibody subgroups. Within the HLA region, HLA-DQB1, HLA-DPA1/B1, and NOTCH4 associations with SSc are likely confined to specific auto-antibodies. These data emphasize the differential genetic components of subphenotypes of SSc.
5.	López-Isac, Elena, et al. (author) Brief Report : IRF4 Newly Identified as a Common Susceptibility Locus for Systemic Sclerosis and Rheumatoid Arthritis in a Cross-Disease Meta-Analysis of Genome-Wide Association Studies 2016 In: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 68:9, s. 2338-2344 Journal article (peer-reviewed)abstract Objective: Systemic sclerosis (SSc) and rheumatoid arthritis (RA) are autoimmune diseases that have similar clinical and immunologic characteristics. To date, several shared SSc–RA genetic loci have been identified independently. The aim of the current study was to systematically search for new common SSc–RA loci through an interdisease meta–genome-wide association (meta-GWAS) strategy. Methods: The study was designed as a meta-analysis combining GWAS data sets of patients with SSc and patients with RA, using a strategy that allowed identification of loci with both same-direction and opposite-direction allelic effects. The top single-nucleotide polymorphisms were followed up in independent SSc and RA case–control cohorts. This allowed an increase in the sample size to a total of 8,830 patients with SSc, 16,870 patients with RA, and 43,393 healthy controls. Results: This cross-disease meta-analysis of the GWAS data sets identified several loci with nominal association signals (P < 5 × 10−6) that also showed evidence of association in the disease-specific GWAS scans. These loci included several genomic regions not previously reported as shared loci, as well as several risk factors that were previously found to be associated with both diseases. Follow-up analyses of the putatively new SSc–RA loci identified IRF4 as a shared risk factor for these 2 diseases (Pcombined = 3.29 × 10−12). Analysis of the biologic relevance of the known SSc–RA shared loci identified the type I interferon and interleukin-12 signaling pathways as the main common etiologic factors. Conclusion: This study identified a novel shared locus, IRF4, for the risk of SSc and RA, and highlighted the usefulness of a cross-disease GWAS meta-analysis strategy in the identification of common risk loci.
6.	Olofsson, Jonas K., et al. (author) Long-term episodic memory decline is associated with olfactory deficits only in carriers of ApoE-є4 2016 In: Neuropsychologia. - : Elsevier BV. - 0028-3932 .- 1873-3514. ; 85, s. 1-9 Journal article (peer-reviewed)abstract The ɛ4 allele of the Apolipoprotein E gene is a genetic risk factor for late-onset dementia of the Alzheimers' type (DAT), which is characterized by loss of both episodic memoryand olfactory functions. Little is known about the possible role of ɛ4 in the association between ongoing episodic memory decline and olfactory deficits in the general population, but such information is relevant in determining the relevance of olfaction as a marker of DAT risk. The present study was based on a large, population-based sample (n=1087, aged 45–90 years, of which 324 were ɛ4-carriers). Episodic memory change rates were established using data collected every 5 years for a 10–20 year interval leading up to an olfactory assessment using the Scandinavian Odor Identification Test at the last wave of data collection. Participants were classified according to whether or not their episodic memory ability declined more rapidly than the age-typical norm (by >1SD). Our main result is that only in ɛ4-carriers was episodic memory decline associated with odor identification impairment. In individuals without ɛ4, odor identification was unrelated to episodic memory decline status. Follow-up analyses indicated that this moderation by ɛ4 was due to the olfactory nature of the identification test, and that the effect was not caused by 63 individuals with dementia. Our results suggest that the ɛ4 determines the functional association between ongoing episodic memory decline and olfaction. These findings are consistent with the notion that ɛ4-carriers with DAT, compared to non-carriers, display a cortical atrophy pattern that is more focused on mediotemporal lobe regions supporting olfactory and episodic memory functions. Olfactory and memory assessments might provide complementary information on mediotemporal atrophy prior to clinical dementia onset, but the ɛ4 should be considered when using olfactory assessment as an early-stage indicator.
7.	Oudin, Anna, et al. (author) Traffic-Related Air Pollution and Dementia Incidence in Northern Sweden : A Longitudinal Study 2016 In: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 124:3, s. 306-312 Journal article (peer-reviewed)abstract BACKGROUND: Exposure to ambient air pollution is suspected to cause cognitive effects, but a prospective cohort is needed to study exposure to air pollution at the home address and the incidence of dementia.OBJECTIVES: We aimed to assess the association between long-term exposure to traffic-related air pollution and dementia incidence in a major city in northern Sweden.METHODS: Data on dementia incidence over a 15-year period were obtained from the longitudinal Betula study. Traffic air pollution exposure was assessed with a Land Use Regression Model with a spatial resolution of 50 m x 50 m. Annual mean nitrogen oxide levels at the residential address of the participants at baseline (the start of follow-up) was used as a marker for long-term exposure to air pollution.RESULTS: Out of 1806 participants at baseline, 191 were diagnosed with Alzheimer's disease during follow-up, and 111 were diagnosed with vascular dementia. Participants in the highest exposure group were more likely to be diagnosed with dementia (Alzheimer's disease or vascular dementia), with a Hazard Ratio (HR) of 1.43 (95% Confidence Interval (CI): 0.998, 2.05 for the highest versus lowest quartile). The estimates were similar for Alzheimer's disease (HR 1.38) and vascular dementia (HR 1.47). The HR for dementia associated for the third quartile versus the lowest quartile was 1.48 (95% CI: 1.03, 2.11). A sub-analysis that excluded a younger sample that had been re-tested after only 5 years of follow-up suggested stronger associations with exposure than in the full cohort (HR = 1.71; 95% CI: 1.08, 2.73 for the highest versus lowest quartile).CONCLUSIONS: If the associations we observed are causal, then air pollution from traffic might be an important risk factor for vascular dementia and Alzheimer's disease.
8.	Andersson, John, et al. (author) PM2.5 exposure and olfactory functions 2022 In: International Journal of Environmental Health Research. - : Taylor & Francis Group. - 0960-3123 .- 1369-1619. ; 32:11, s. 2484-2495 Journal article (peer-reviewed)abstract Growing evidence indicates that air pollution can negatively impact cognitive functions. The olfactory system is interesting in this context as it is directly exposed to pollutants and also associated with cognitive functions. The aim of this study was to investigate long- and short-term PM2.5 exposure in association with olfactory functions. Scores from odor tests were obtained from the Betula project - a longitudinal cohort study. Estimates of annual mean PM2.5 concentrations at the participants' residential address were obtained from a dispersion-model. Daily mean PM2.5 concentrations were obtained from a measuring station close to the test location. We found a positive association between long-term PM2.5 exposure and odor identification, i.e. exposure was associated with a better ability to identify odors. We also found an interaction effect between PM2.5 and age on odor identification. We found no associations between any PM2.5 exposure and odor detection or between short-term PM2.5 exposure and olfactory functions.
9.	Azfar, Hossain Syed, et al. (author) Cardiovascular Disease and Mental Distress Among Ethnic Groups in Kyrgyzstan 2021 In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9 Journal article (peer-reviewed)abstract The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress.Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress.Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups.Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
10.	Cain, William S., et al. (author) Independence of odor Quality and Absolute Sensitivity in a Study of Aging 2008 In: Chemosensory Perception. - : Springer. - 1936-5802 .- 1936-5810. ; 1, s. 24-33 Journal article (peer-reviewed)abstract Young, middle-aged, and senior subjects performed tasks designed to examine whether odor quality discrimination varies independently of sensitivity. One task entailed detection of 2-heptanone and the others AB-X discrimination of quality for sets of 2-heptanone and homologues or 2-heptanone and non-ketones. Subjects sought to discriminate either at intensity-matched concentrations far above threshold, but fixed across subjects, or at levels adjusted to neutralize differences in sensitivity. The young and middle-aged groups manifested the same absolute sensitivity, but the senior group poorer sensitivity. Performance in quality discrimination, however, declined progressively. Performance lacked an association with absolute sensitivity, no matter how examined. These data, in conjunction with converging findings from patients with neurological damage, studies of brain imaging, and the relation between concentration and quality discrimination in younger persons, suggest largely independent processing of odor quality and intensity.
11.	Claeson, Anna-Sara, et al. (author) The role of perceived pollution and health risk perception in annoyance and health symptoms : a population-based study of odorous air pollution 2013 In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 86:3, s. 367-374 Journal article (peer-reviewed)abstract OBJECTIVES: Health effects associated with air pollution at exposure levels below toxicity may not be directly related to level of exposure, but rather mediated by perception of the air pollution and by top-down processing (e.g., beliefs that the exposure is hazardous). The aim of the study was to test a model that describes interrelations between odorous air pollution at non-toxic exposure levels, perceived pollution, health risk perception, annoyance and health symptoms.METHODS: A population-based questionnaire study was conducted in a Swedish community of residents living near a biofuel facility that emitted odorous substances. Individuals aged 18-75 years were selected at random for participation (n = 1,118); 722 (65 %) agreed to participate. Path analyses were performed to test the validity of the model.RESULTS: The data support a model proposing that exposure level does not directly influence annoyance and symptoms, and that these relations instead are mediated by perceived pollution and health risk perception.CONCLUSIONS: Perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms in odorous environments at non-toxic levels of exposure.
12.	David Carmona, F., et al. (author) Association of a non-synonymous functional variant of the ITGAM gene with systemic sclerosis 2011 In: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 70:11, s. 203-2050 Journal article (other academic/artistic)
13.	Ekström, Ingrid, et al. (author) Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion 2017 In: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 65:6, s. 1238-1243 Journal article (peer-reviewed)abstract ObjectivesTo determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period.DesignProspective cohort study.SettingBetula Study, Umeå, Sweden.ParticipantsA population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774).MeasurementsOlfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade.ResultsWithin the 10-year follow-up, 411 of 1,774 (23.2%) participants had died. In a Cox model, the association between higher SOIT score and lower mortality was significant (hazard ratio (HR) = 0.74 per point interval, 95% confidence interval (CI) = 0.71-0.77, P < .001). The effect was attenuated, but remained significant, after controlling for age, sex, education, and health-related and cognitive variables (HR = 0.92, 95% CI = 0.87-0.97, P = .001). The association between SOIT score and mortality was retained after controlling for dementia conversion before death (HR = 0.92, 95% CI = 0.87-0.97, P = .001). Similar results were obtained for self-reported olfactory dysfunction.ConclusionPoor odor identification and poor self-reported olfactory function are associated with greater likelihood of future mortality. Dementia does not attenuate the association between olfactory loss and mortality, suggesting that olfactory loss might mark deteriorating health, irrespective of dementia.
14.	Ekström, Ingrid, 1988-, et al. (author) Subjective Olfactory Loss in Older Adults Concurs with Long-Term Odor Identification Decline 2019 In: Chemical Senses. - Oxford : Oxford University Press (OUP). - 0379-864X .- 1464-3553. ; 44:2, s. 105-112 Journal article (peer-reviewed)abstract Olfactory impairments may provide early indications of future health outcomes in older adults. Thus, an important question concerns whether these impairments can be self-assessed. Previous findings of cross-sectional studies indicate low correlations between self-reported olfactory function and objective olfactory performance. On the other hand, subjective olfactory impairments predict future dementia and mortality in longitudinal settings. No previous study has assessed the relationship between subjectively and objectively measured decline in olfaction over time. Based on data for 903 older adults derived from the Betula Study, a Swedish population-based prospective study, we tested whether rate-of-change in odor identification could be predicted from subjective olfactory decline over a time span of 10 years during which subjective and objective odor functions were assessed on 2 or 3 test occasions. Indeed, we found that participants who experienced subjective olfactory decline over the study period also had significantly steeper rates of decline in odor identification, even after adjusting for demographic, cognitive, and genetic factors that previously have been associated with performance in odor identification. This association was, however, not present in a subsample with baseline cognitive impairment. We interpret these results as evidence that when asked about whether they have an olfactory impairment or not, older persons are assessing intraindividual olfactory changes, rather than interindividual differences. Our results indicate that subjective olfactory loss reflects objective olfactory decline in cognitively intact older adults. This association might be harnessed to predict health outcomes and highlights the need to develop effective olfactory self-assessments.
15.	Enkvist, Hampus, et al. (author) Stress, mental ill-health and functional somatic syndromes in incident and chronic sleep disturbance in a general adult population 2023 In: Health Psychology and Behavioral Medicine. - : Taylor & Francis. - 2164-2850. ; 11:1 Journal article (peer-reviewed)abstract Objective: Sleep disturbance may constitute health problems for the afflicted individual, but documentation of its chronicity is sparse. The objective was to investigate the extent to which incident and chronic sleep disturbance are associated with stress, mental ill-health and functional somatic syndromes.Design: This was a prospective, longitudinal study with 3-year interval between two assessments (T1 and T2), with a population-based sample forming groups with incident sleep disturbance (disturbance only at T2; n = 303), chronic sleep disturbance (disturbance at T1 and T2; n = 343) and without sleep disturbance (neither at T1 nor T2; n = 1421). Questionnaire data were used at T2 of physician-based diagnosis of anxiety disorder, depression, exhaustion syndrome, and functional somatic syndrome as well as of degree of stress, burnout, anxiety and depression.Results: Significant associations were found between chronic sleep disturbance and all four diagnoses (odds ratios = 1.74–2.19), whereas incident sleep disturbance was associated only with exhaustion syndrome and depression (odds ratios = 2.18–2.37). Degree of stress, burnout, anxiety and depression increased significantly from the referents to incident and chronic sleep disturbance, in that order (eta2 = 0.083–0.166), except for the two latter groups not differing in depression.Conclusion: The findings imply that healthcare professionals should be observant regarding various conditions of, apart from stress, mental ill-health and functional somatic syndromes in patients who present themselves with sleep disturbance, and in particular chronic disturbance.
16.	Eriksson, Jeanette, et al. (author) Längre arbetsliv : om samverkan mellan företagshälsovård och personalavdelningar inom norrländska kommuner och landsting 2014 Reports (other academic/artistic)
17.	Frick, Inga-Maria, et al. (author) Constitutive and Inflammation-Dependent Antimicrobial Peptides Produced by Epithelium Are Differentially Processed and Inactivated by the Commensal Finegoldia magna and the Pathogen Streptococcus pyogenes. 2011 In: Journal of immunology. - : The American Association of Immunologists. - 1550-6606 .- 0022-1767. ; 187, s. 4300-4309 Journal article (peer-reviewed)abstract Epithelial linings serve as physical barriers and produce antimicrobial peptides (AMPs) to maintain host integrity. Examples are the bactericidal proteins midkine (MK) and BRAK/CXCL14 that are constitutively produced in the skin epidermal layer, where the anaerobic Gram-positive coccoid commensal Finegoldia magna resides. Consequently, this bacterium is likely to encounter both MK and BRAK/CXCL14, making these molecules possible threats to its habitat. In this study, we show that MK expression is upregulated during inflammation, concomitant with a strong downregulation of BRAK/CXCL14, resulting in changed antibacterial conditions. MK, BRAK/CXCL14, and the inflammation-dependent antimicrobial β-defensins human β-defensin (hBD)-2 and hBD-3 all showed bactericidal activity against both F. magna and the virulent pathogen Streptococcus pyogenes at similar concentrations. SufA, a released protease of F. magna, degraded MK and BRAK/CXCL14 but not hBD-2 nor hBD-3. Cleavage was seen at lysine and arginine residues, amino acids characteristic of AMPs. Intermediate SufA-degraded fragments of MK and BRAK/CXCL14 showed stronger bactericidal activity against S. pyogenes than F. magna, thus promoting survival of the latter. In contrast, the cysteine-protease SpeB of S. pyogenes rapidly degraded all AMPs investigated. The proteins FAF and SIC, released by F. magna and S. pyogenes, respectively, neutralized the antibacterial activity of MK and BRAK/CXCL14, protein FAF being the most efficient. Quantitation and colocalization by immunoelectron microscopy demonstrated significant levels and interactions of the molecules in in vivo and ex vivo samples. The findings reflect strategies used by a permanently residing commensal and a virulent pathogen, the latter operating during the limited time course of invasive disease.
18.	Höglund, Per, 1969-, et al. (author) Impact of group interventions on stress and sleep problems in primary care Other publication (other academic/artistic)abstract Objectives: The majority of patients who seek help for stress and sleep problems do so in primary health care in Sweden. However, the resources for psychological treatment are limited. The aim of this study was to assess the effectiveness of a low-intensity student-led group interventions, applying cognitive behavioral therapy (CBT) with an indicated prevention approach in primary care for recovery and reducing symptoms of stress and sleep disturbance.Methods: Using a quasi-experimental design, interventions were conducted for stress (n=274, mean age=38 years, 75% women) and sleep (n=106, mean age=44 years, 56% women) problems in consecutively recruited primary care patients. These were compared with a control group (n=221, mean age=45 years, 91% women) recruited via social media. The interventions were CBT-based psychoeducative group interventions that consisted of four 90-min sessions and led by psychology students. Assessment was completed at pre- and post-intervention and at 3-month follow-up. Main outcome measures were the 10-item Perceived Stress Scale and the Shirom-Melamed Burnout Questionnaire for the stress intervention, and the Karolinska Sleep Questionnaire for the sleep intervention. The Hospital Anxiety and Depression Scale and the 15-item Patient Health Questionnaire were used to assess anxiety, depression and somatization as secondary outcome measures for both interventions. Analysis of covariance (pre- vs post-intervention) and reliable change index (pre-intervention vs three-month follow-up) were applied.Results: Statistically significant, but small effects of improved health in comparison to the control group were found on stress and burnout (η2=.021-.030) in the stress intervention, and on sleep (η2=.017) in the sleep intervention. The proportion of patients in the stress intervention with a reliable improvement at three-month follow-up was 28% for stress and 59% for burnout, and 0% and 33%, respectively, for the control group. Among those with a reliable improvement in burnout, 31% also met a recovery criterion (<4.0). In the sleep intervention, 25% of the patients showed a reliable improvement in sleep and 61% in burnout, and 6% and 33%, respectively, for the control group. The effects of the stress intervention were statistically significant, but small on anxiety and depression (η2=.021-.047), as were the effects of the sleep intervention on stress and burnout (η2=.017-.026). Conclusion: The results suggest that psychology students can effectively provide a low-intensity group-delivered CBT intervention for patients exhibiting symptoms of stress, burnout and sleep disturbance in routine general medical practice, offering promising opportunities for scalability expansion. Although the average treatment effects were small, a substantial proportion of the patients showed reliable improvement or recovery at 3-month follow-up. This suggests that the interventions decrease the prevalence of burnout and sleep disturbance or improve the well-being of individuals experiencing mental distress.
19.	Höglund, Per, et al. (author) Risk factors for insomnia and burnout : a longitudinal population-based cohort study 2023 In: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:4, s. 798-812 Journal article (peer-reviewed)abstract Insomnia and burnout are highly prevalent in the general population, calling for understanding of its causes. Taking a broad approach, the aim of this study was to determine various mental and somatic risk factors for development of insomnia and burnout and stratifying for sex and age group. Questionnaire data were used from a Swedish population-based sample aged 18–79 years, from which cohorts without insomnia (n = 1702) and without burnout (n = 1972) at baseline were followed-up after 3 years. Self-reports of eight mental and somatic conditions at baseline were used as independent variables in logistic regression analyses to predict development of insomnia and burnout at 3-year follow-up. All eight studied conditions were significant risk factors for development of both insomnia (odds ratio, OR = 1.62–2.73) and burnout (OR = 2.20–3.21). Burnout and poor self-rated health had the highest ORs for insomnia, and poor self-rated health, anxiety and somatic symptoms had the highest ORs for burnout. The ORs were generally similar between men and women, whereas age groups tended to differ in some of the risk factors. The study highlights the importance of a broad assessment of both mental and somatic conditions in the prevention of insomnia and burnout.
20.	Josefsson, Maria, et al. (author) APOE-epsilon 4 effects on longitudinal decline in olfactory and non-olfactory cognitive abilities in middle-aged and old adults 2017 In: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7 Journal article (peer-reviewed)abstract Characterizing aging-related decline trajectories in mental abilities, and relationships of the epsilon 4 allele of the Apolipoprotein gene, helps to identify individuals at high risk for dementia. However, longitudinal changes in olfactory and non-olfactory cognitive abilities have not been investigated in relation to the epsilon 4 allele. In the present study, participants from a large population-based study (657 middle-aged and 556 old) were tested over 10 years on their performance on an odor identification task and three non-olfactory cognitive tasks; MMSE, episodic memory, and semantic memory. Our key finding is that in middle-aged participants, odor identification declined twice as fast for epsilon 4/4 homozygotes, compared to non-carriers. However, in old participants, the epsilon 4/4 homozygotes showed an impaired odor identification ability, but they declined at a similar rate as the non-carriers. Furthermore, in old participants all assessments displayed aging-related declines, but exaggerated declines in epsilon 4-carriers were found only in MMSE and episodic memory assessments. In sum, we present evidence that odor identification ability starts to decline already in middle-aged, and that carriers of epsilon 4/4, who are at highest risk of developing dementia, decline twice as fast. Our results may have implications for use of odor identification assessment in detection of early-stage dementia.
21.	Larsson, Kjerstin, et al. (author) A group-based patient education programme for high-anxiety patients with Crohn's disease or ulcerative colitis 2003 In: Scandinavian Journal of Gastroenterology. - 1502-7708. ; 38, s. 763-769 Journal article (peer-reviewed)
22.	Larsson, Maria, et al. (author) Loss of Olfactory Function Predicts Mortality Irrespective of Dementia Conversion : 10-year follow-up of an age-varied sample 2016 In: Chemical Senses. - : Oxford University Press (OUP). - 0379-864X .- 1464-3553. ; 41:9, s. e111-e288 Journal article (peer-reviewed)abstract The objective of this study was to examine the association between performance in odor identification and future mortality in a community cohort of adults aged between 40 and 90 years. We assessed olfactory performance with a 13-item-version of the Scandinavian Odor Identification Test (SOIT). The results showed that during follow-up (mean=9.4 years, standard deviation=2.23), 411 of 1774 (23.2%) participants died. In a Cox model, the association between higher SOIT score and mortality was highly significant (hazard ratio [HR]=0.74, per point interval, 95% confidence interval [CI]=0.71–0.77, p<0.001). The effect was attenuated, but remained significant after controlling for age, sex, education, and health and cognitive variables that were also associated with an increased risk of mortality (HR=0.92, 95% CI=0.87–0.97, p=0.001). Controlling for dementia conversion prior to death did not attenuate the association between SOIT score and mortality (HR=0.92, 95% CI=0.87–0.97, p=0.001). Similar results were obtained for olfactory sensitivity as assessed by self-report. Overall, the present findings show that poor odor identification performance is associated with an increased likelihood of future mortality in middle-aged and older adults, after controlling for social, cognitive, and medical risk factors. Most importantly, controlling for the development of dementia did not attenuate the association between odor identification and mortality, suggesting that olfactory decline might mark deteriorating health also irrespective of dementia.
23.	Lind, Nina, 1989-, et al. (author) Coping and social support in asthma and allergy: the Vasterbotten Environmental Health Study 2015 In: Journal of Asthma. - : Informa UK Limited. - 0277-0903 .- 1532-4303. ; 52:6, s. 622-629 Journal article (peer-reviewed)abstract Objectives: Asthma and allergy are stressful conditions that require coping strategies and social support to reduce stress and enhance health-promoting behavior. However, research is limited regarding coping and social support in asthma and allergy. The aim was to better understand the use of different coping strategies and perceived social support in low and high severity (exacerbation frequency) of asthma and allergy. Methods: Population-based data were used to provide ratings of coping strategies (Study I) and social support (Study II) from 124 and 94 participants, respectively, with asthma and/or allergy, categorized as low or high in severity. Problem-and emotion-focused coping strategies were assessed as well as emotional, instrumental and informative social support from seven sources. Results: Study I showed that avoiding certain environments (problem-based coping) and trying to accept one's situation (emotion-based) were the most commonly used coping strategies. These behaviors did not differ due to severity. Study II showed that more emotional than instrumental and informative support was perceived. The highest rated support sources were the partner, family members and the healthcare system. More social support was reported in low asthma/allergy severity compared to high asthma/allergy severity. Conclusion: The most commonly used coping strategies in the population of persons with these four types of asthma and allergy are avoiding certain environments and trying to accept one's situation. More emotional support than instrumental and informative is perceived to be received, and most of the support is received from one's partner and other family members and least from authorities and patient associations/support groups.
24.	Lind, Nina, et al. (author) Psychological distress in asthma and allergy : the Västerbotten Environmental Health Study 2014 In: Psychology, Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 19:3, s. 316-323 Journal article (peer-reviewed)abstract With the aim to better understand the association between asthma/allergy and psychological distress, it was hypothesized that levels of stress, exhaustion, anxiety, depression, and health worries for environmental pollution would be higher in allergic asthma, allergic rhinitis, and atopic dermatitis than in non-allergic asthma and in referents without asthma or allergy. Taking part in the population-based Vasterbotten Environmental Health Study (aged 18-79years), 76 respondents reported a physician-based diagnosis of allergic asthma, 86 reported non-allergic asthma, 190 reported allergic rhinitis, and 46 reported atopic dermatitis as the only form of asthma/allergy. A group of 2876 respondents without an asthma/allergy diagnosis constituted as referents. The participants responded to the Perceived Stress Scale, the Shirom-Melamed Burnout Questionnaire, the Hospital Anxiety and Depression Scale, and the Environmental Pollution subscale of the Modern Health Worries Scale. Levels of stress, exhaustion, and anxiety were higher in allergic asthma and atopic dermatitis than in non-allergic asthma, allergic rhinitis, and among referents, and there was a strong tendency of such group differences for depression and health worries. The results imply that stress reduction and treatment of negative affect may in certain cases be fruitful interventions in patients with atopy.
25.	Lindahl, Bernt, et al. (author) Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk 2020 In: European Journal of Preventive Cardiology. - : Sage Publications. - 2047-4873 .- 2047-4881. ; 27:2, s. 209-215 Journal article (peer-reviewed)abstract Aims: Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors.Methods: Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated.Results: About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results.Conclusions: Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.
26.	Nordin Fredrikson, Gunilla, et al. (author) Involvement of the CD1d-NKT cell pathway in neointima formation after vascular injury. 2007 In: Circulation Research. - : Lippincott Williams & Wilkins. - 0009-7330 .- 1524-4571. ; 101, s. e83-e89 Journal article (peer-reviewed)
27.	Nordin, Jonas, et al. (author) Hästar, härar och hus : Förläggandet av den svenska stormaktstidens planschverk 2023 In: Boghistorie i Skandinavien. - 9788772197081 - 9788775972241 ; , s. 169-199 Book chapter (peer-reviewed)
28.	Nordin, Maria, 1967-, et al. (author) Coping strategies, social support and responsibility in chemical intolerance 2010 In: Journal of Clinical Nursing. - : Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 19:15/16, s. 2162-2173 Journal article (peer-reviewed)abstract Aims and objectives. To study coping strategies, social support and responsibility for improvement in chemical intolerance (CI). Background. Limited knowledge of CI among health professionals and lay persons places demands on the chemically intolerant individual’s coping strategies and perception of social support and ability to take responsibility for improvement. However, there is sparse literature on these issues in CI. Design. A cross-sectional, questionnaire-based, quasi-experimental study. Method. Fifty-nine persons with mild, 92 with moderate and 31 with severe CI participated by rating (i) usage and effectiveness of six problem- and six emotion-focused coping strategies, (ii) emotional, instrumental and informative support provided by various sources and (iii) society’s and the inflicted individual’s responsibility for improvement. Results. The participants reported that the most commonly used and effective coping strategies were avoiding odorous/pungent environments and asking persons to limit their use of odorous/pungent substances (problem-focused strategies) as well as accepting the situation and reprioritising (emotion-focused strategies). High intolerance severity was associated with problemfocused coping strategies and relatively low intolerance with emotion-focused strategies. More emotional than instrumental and informative support was perceived, predominantly from the partner and other family members. Responsibility attributed to society was also found to increase from mild to moderate/severe intolerance. Conclusions. Certain coping strategies are more commonly used and perceived as more effective than others in CI. However, intolerance severity plays a role regarding both coping strategies and responsibility. Emotional support appears to be the most available type of support.
29.	Nordin, Maria, et al. (author) Is there a bidirectional relationship between sleep and asthma and allergy in a general population? 2016 In: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 85, s. 75-76 Journal article (other academic/artistic)
30.	Nordin, Maria, et al. (author) Psychometric evaluation and normative data for the Karolinska Sleep Questionnaire 2013 In: Sleep and Biological Rhythms. - Hoboken : Springer Science and Business Media LLC. - 1446-9235 .- 1479-8425. ; 11:4, s. 216-226 Journal article (peer-reviewed)abstract The study objective was to validate the Karolinska Sleep Questionnaire with regard to dimensionality, internal consistency, and construct and criterion validity. Another objective was to provide normative data. Data from the cross-sectional Vasterbotten Environmental Health Study in Sweden were used. The 3406 participants in this study, 18 to 79 years old, constituted a random sample stratified for age and sex. Along with the Karolinska Sleep Questionnaire, the participants responded to the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessing construct validity. Factor analyses of the questions in the Karolinska Sleep Questionnaire that relate to nocturnal sleep revealed the dimensions sleep quality, non-restorative sleep, and sleep apnea. A separate factor analysis on the questions regarding day time sleepiness revealed a sleepiness dimension. The sleep quality, non-restorative sleep, and sleepiness dimensions showed approximate normal distributions, whereas the distribution for sleep apnea was positively skewed. All dimensions showed good internal consistency. Satisfactory construct validity was found for all dimensions. Using the DSM-IV criteria of insomnia, relevant questions in the Karolinska Sleep Questionnaire were combined into an index of nocturnal symptoms of insomnia as were questions of sleep apnea. Prevalences of insomnia and sleep apnea correspond well to those of other studies, indicating good criterion validity. The favorable psychometric properties of the dimensions and indexes from the Karolinska Sleep Questionnaire suggest their use for assessing sleep quality, non-restorative sleep, sleep apnea, sleepiness and nocturnal symptoms of insomnia.
31.	Nordin, Maria, et al. (author) Psychometric evaluation and normative data of the Swedish version of the 10-item perceived stress scale 2013 In: Scandinavian Journal of Psychology. - : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 54:6, s. 502-507 Journal article (peer-reviewed)abstract The perceived stress scale (PSS) has been translated to several languages and validated in many cultures. The longer 14-item version (PSS-14), has been translated to Swedish and validated for Swedish use. However, the Swedish version of the shorter 10-item version (PSS-10) has not been validated before. Therefore, the aim of this study was to evaluate the Swedish version of the PSS-10 with regard to reliability and validity, and to provide normative data. Data from 3,406 individuals who took part in the Vasterbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79years, and stratified for age and sex. They responded to the Swedish version of the PSS-10 as well as to the hospital anxiety and depression scale, and the Shirom Melamed burnout questionnaire for assessment of construct validity. The results show that the PSS-10 provides approximately normally distributed data, has good internal reliability (Cronbach's alpha 0.84), and has good construct validity with anxiety (r=0.68), depression (r=0.57), and mental/physical exhaustion (r=0.71). The favorable psychometric properties of the Swedish version of the PSS-10 suggest use of the instrument for assessing perceived stress in Swedish and similar populations.
32.	Nordin, Maria, et al. (author) Self-rated health and its bidirectional relationship with burnout, sleep quality and somatic symptoms in a general adult population 2024 In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 24:1 Journal article (peer-reviewed)abstract The aim of this study was to investigate how self-rated health (SRH) reflects ongoing ill-health and how SRH is associated with previous ill-health and/or predicts future ill-health such as burnout, disturbed sleep, and somatic symptoms. The study used two waves from the population-based Västerbotten Environmental and Health Study in which 2 336 adult persons participated by answering a questionnaire at two time points three years apart. Hierarchical and logistic regression analyses were conducted, thus treating all variables both continuously (degree) and categorically (case). The analyses were performed both cross-sectionally and longitudinally. The results showed bidirectionality between suboptimal SRH and burnout, disturbed sleep and somatic severity caseness. Moreover, degree of poor SRH was more likely to occur simultaneously to high degrees of burnout and somatic severity than to degree of poor sleep quality. Also, caseness of burnout, disturbed sleep and somatic severity increased the risk of simultaneous suboptimal SRH. Finally, the results showed that degree of burnout three years earlier, predicted degree of poor SRH, and that degree of poor SRH predicted degree of sleep three years later. In conclusion, in a population-based, normal adult sample there is a bidirectional relationship between suboptimal SRH and caseness of burnout, disturbed sleep quality and somatic symptoms, but not between degree of these symptoms. The results can have implications for health care meeting patients complaining about poor general health.
33.	Nordin, Maria, et al. (author) Sleep and sleepiness in environmental intolerances : a population-based study 2016 In: Sleep Medicine. - : Elsevier BV. - 1389-9457 .- 1878-5506. ; 24, s. 1-9 Journal article (peer-reviewed)abstract Background: About one fourth of the general population report environmental intolerance (El) to odorous/pungent chemicals, certain buildings, electromagnetic fields (EMFs), and/or sounds. EI sufferers show various clinical features, of which sleep disturbance is one. Sleep disturbance is common also in the general population, but it is not known whether the disturbance is more prominent in EI sufferers than in individuals who do not experience EI. Therefore, El was compared on various sleep aspects with referents without El. Methods: A population-based sample of 3406 individuals, aged 18-79 years, was recruited from Northern Sweden. Sleep quality, non-restorative sleep, daytime sleepiness, obstructive breathing, and nocturnal insomnia were assessed with the Karolinska Sleep Questionnaire. Single questions assessed time slept, amount of hours of needed sleep, and extent of enough time slept. Results: All four EI groups, compared to the referents, reported significantly poorer sleep quality, more non-restorative sleep, more daytime sleepiness, more obstructive breathing and higher prevalence of nocturnal insomnia than the referents. Nocturnal insomnia was an important factor for El groups attributing their most prevalent symptoms to chemicals and sounds, irrespective of distress and certain syndromes. None of the EI groups differed significantly from the referents on time slept, but reported needing more sleep time (the EMF-intolerance group showing only a tendency), and all four groups reported to perceive enough sleep to a significantly lesser extent. Conclusion: Sleep disturbance and daytime sleepiness are more common in individuals reporting El compared to normal referents. Moreover, nocturnal insomnia is an important symptom in its own right in various types of EI. This evokes the question of whether or not sleep therapy may attenuate the severity of the El.
34.	Nordin, Maria, et al. (author) Young women's mental health in northern Sweden 2016 In: International Journal of Behavioral Medicine. - : Springer. - 1070-5503 .- 1532-7558. ; 23, s. S3-S3 Journal article (other academic/artistic)
35.	Nordin, Steven, 1960-, et al. (author) Associations between emotional support and cardiovascular risk factors and subclinical atherosclerosis in middle-age 2023 In: Psychology and Health. - : Routledge. - 0887-0446 .- 1476-8321. Journal article (peer-reviewed)abstract Objective: To test the hypothesis of low emotional support being associated with lifestyle and biomedical cardiovascular disease (CVD) risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults.Methods and measures: Cross-sectional data were obtained from participants aged 40–60 years who had one or more conventional CVD risk factor. They underwent assessment based on questionnaires, clinical examination, blood sampling, and carotid ultrasound of plaque formation and carotid intima-media wall thickness (cIMT). Based on the Interview Schedule for Social Interaction, the participants were categorised as either low in emotional support (n = 884) or as a referent (n = 2570). Logistic regression analyses were conducted to study the associations.Results: Logistic regression analyses showed that low emotional support was significantly associated with smoking, alcohol consumption and physical inactivity (OR = 1.53 − 1.94), estimated risk of CVD morbidity and mortality (OR = 1.56 − 1.68), and plaque formation (OR = 1.39). No significant associations were found regarding biomedical CVD risk factors or cIMT.Conclusion: The findings suggest that low social support is associated with lifestyle CVD risk factors, estimated risk of CVD morbidity and mortality, and subclinical atherosclerosis in middle-aged healthy adults, encouraging causal evaluation with longitudinal data investigating an impact of emotional support on mechanisms underlying CVD.
36.	Nordin, Steven, et al. (author) Miljökänslighet – den osynliga folksjukdomen : ett detektivarbete kring orsakerna till miljörelaterad överkänslighet 2012 In: Byggnadsrelaterad ohälsa i Kvarkenregionen. - Vasa : Yrkeshögskolan Novia. - 9789525839364 ; , s. 30-43 Book chapter (other academic/artistic)abstract När man besöker en annan persons hem känner man den vaga lukten av möbler, textilier, matlagning och olika ämnen som många av oss använder – parfymer, rengöringsmedel eller hårprodukter. Efter en stunds vistelse i bostaden registrerar de fl esta människor inte längre lukterna. Men för vissa personer går det precis tvärtom; lukterna försvinner inte utan blir i stället skarpare. De blir allt mer distinkta, till och med påträngande. Någon kanske försöker föra en konversation, men obehaget gör att man inte kan koncentrera sig vad den andra har att säga. I värsta fall drabbas man av huvudvärk, yrsel och andra symptom som gör tillvaron närmast outhärdlig. För en överkänslig person kan vardagen vara fylld av sådana här situationer. Men hur kommer det sig att endast vissa personer drabbas av miljökänslighet?
37.	Nordin, Steven, et al. (author) Psychometric evaluation and normative data for a Swedish version of the Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale 2013 In: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 54:2, s. 112-117 Journal article (peer-reviewed)abstract The lack of an available Swedish version of the Patient Health Questionnaire 15-Item Somatic Symptom Severity Scale (PHQ-15) motivated the present psychometric evaluation of such a version as well as providing normative data for the PHQ-15. Data from 3,406 individuals who took part in the Vasterbotten Environmental Health Study in Sweden were used. The respondents constitute a random sample, aged 18 to 79years, stratified for age and sex. They responded to a Swedish translation of the PHQ-15 as well as the Hospital Anxiety and Depression Scale, the Perceived Stress Scale, and the Shirom Melamed Burnout Questionnaire for assessment of convergent validity. The distribution of PHQ-15 scores was positively skewed and mesokurtic in shape, and the internal consistency of the PHQ-15 was satisfactory. Correlation coefficients between PHQ-15 score and the measures of anxiety, depression, stress and mental/physical exhaustion indicate satisfactory validity. Normative data for PHQ-15 scores as well as for categories of somatic symptom severity are provided. The favorable psychometric properties of the Swedish version of the PHQ-15 suggest use of this instrument for quantification of somatization in Swedish and similar populations, and has the advantage of available normative data.
38.	Nordin, Susanna, et al. (author) The physical environment, activity and interaction in residential care facilities for older people: a comparative case study 2017 In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:4, s. 727-738 Journal article (peer-reviewed)abstract The physical environment is of particular importance for supporting activities and interactions among older people living in residential care facilities (RCFs) who spend most of their time inside the facility. More knowledge is needed regarding the complex relationships between older people and environmental aspects in long-term care. The present study aimed to explore how the physical environment influences resident activities and interactions at two RCFs by using a mixed-method approach. Environmental assessments were conducted via the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM), and resident activities, interactions and locations were assessed through an adapted version of the Dementia Care Mapping (DCM). The Observed Emotion Rating Scale (OERS) was used to assess residents’ affective states. Field notes and walk-along interviews were also used. Findings indicate that the design of the physical environment influenced the residents’ activities and interactions. Private apartments and dining areas showed high environmental quality at both RCFs, whereas the overall layout had lower quality. Safety was highly supported. Despite high environmental quality in general, several factors restricted resident activities. To optimise care for older people, the design process must clearly focus on accessible environments that provide options for residents to use the facility independently.
39.	Nummelin, Tuomas, et al. (author) Forest futures by Swedish students : developing a mind mapping method for data collection 2017 In: Scandinavian Journal of Forest Research. - Oslo : Taylor & Francis. - 0282-7581 .- 1651-1891. ; 32:8, s. 807-817 Journal article (peer-reviewed)abstract Forests are an important natural resource in Sweden. They are used for multiple purposes, for example, providing economic returns from timber harvest, conservation of biodiversity, provision of wild berries and mushrooms and recreational benefits. People's perceptions of forests and forest use are currently under transformation due to drivers like globalization and urbanization. The aim of this study was to analyse in particular Swedish university student's visions of future forests using a newly developed survey method based on mind mapping. An online survey with mind map technique was used to collect data from university students in Umeå, northern Sweden. The study focused on features of forests, products derived from forests and activities in forests. The results indicate that students regard ecological, social and economic aspects of forests as important for future forests and the use of them. In particular, the role of non-wood forest products, like berries and mushrooms, as well as recreational features of forests were central to many of the students. The multitude of different visions suggests that forest management decisions of today, directing the future of forests, need to consider the multiple use of forests to be able to satisfy forest preferences also of younger generations.
40.	Näslund, Ulf, et al. (author) Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) : a pragmatic, open-label, randomised controlled trial 2019 In: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 393:10167, s. 133-142 Journal article (peer-reviewed)abstract BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.
41.	Olofsson, Jonas K., et al. (author) ApoE-e4 Mediates the Association Between Episodic Memory Decline and Olfactory Identification Deficit 2015 In: Chemical Senses. - 0379-864X .- 1464-3553. ; 40:7, s. 667-667 Journal article (other academic/artistic)
42.	Oudin, Anna, et al. (author) Is long-term exposure to air pollution associated with episodic memory? : a longitudinal study from northern Sweden 2017 In: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 7 Journal article (peer-reviewed)abstract Associations between long-term exposure to ambient air pollution and cognitive function have been observed in a few longitudinal studies. Our aim was to investigate the association between long-term exposure to air pollution and episodic memory, a marker of early cognitive decline. We used data from the Betula study in Northern Sweden, and included participants 60 to 85 of age at inclusion, 1,469 persons in total. The participants were followed for up to 22 years, five years apart between 1988 and 2010. A composite of five tasks was used as a measure of episodic memory measure (EMM), and the five-year change in EMM score (ΔEMM) was calculated such that a participant could contribute with up to four measurement pairs. A Land Use Regression Model was used to estimate cumulative annual mean of NOx at the residential address of the participants (a marker for long-term exposure to traffic-related air pollution). There did not seem to be any association between exposure to traffic air pollution and episodic memory change, with a ΔEMM estimate of per 1 µg/m3 increase in NOx of 0.01 (95% Confidence Interval: -0.02,0.03). This is in contrast to a growing body of evidence suggesting associations between air pollution and cognitive function.
43.	Oudin, Anna, et al. (author) Traffic-Related Air Pollution as a Risk Factor for Dementia : No Clear Modifying Effects of APOEɛ4 in the Betula Cohort 2019 In: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 71:3, s. 733-740 Journal article (peer-reviewed)abstract It is widely known that the apolipoprotein E (APOE) ɛ4 allele imposes a higher risk for Alzheimer’s disease (AD). Recent evidence suggests that exposure to air pollution is also a risk factor for AD, and results from a few studies indicate that the effect of air pollution on cognitive function and dementia is stronger in APOE ɛ4 carriers than in non-carriers. Air pollution and interaction with APOE ɛ4 on AD risk thus merits further attention. We studied dementia incidence over a 15-year period from the longitudinal Betula study in Northern Sweden. As a marker for long-term exposure to traffic-related air pollution, we used modelled annual mean nitrogen oxide levels at the residential address of the participants at start of follow-up. Nitrogen oxide correlate well with fine particulate air pollution levels in the study area. We had full data on air pollution, incidence of AD and vascular dementia (VaD), APOE ɛ4 carrier status, and relevant confounding factors for 1,567 participants. As expected, air pollution was rather clearly associated with dementia incidence. However, there was no evidence for a modifying effect by APOE ɛ4 on the association (p-value for interaction > 0.30 for both total dementia (AD+VaD) and AD). The results from this study do not imply that adverse effects of air pollution on dementia incidence is limited to, or stronger in, APOE ɛ4 carriers than in the total population.
44.	Oudin, Anna, et al. (author) Traffic-Related air pollution as a risk factor for dementia : no clear modifying effects of apoe ɛ4 in the betula cohort 2021 In: Alzheimer's disease and air pollution. - Amsterdam : IOS Press. - 2210-5727. - 9781643681597 - 9781643681580 ; , s. 357-364 Book chapter (peer-reviewed)abstract It is widely known that the apolipoprotein E (APOE) ε4 allele imposes a higher risk for Alzheimer's disease (AD). Recent evidence suggests that exposure to air pollution is also a risk factor for AD, and results from a few studies indicate that the effect of air pollution on cognitive function and dementia is stronger in APOE ε4 carriers than in non-carriers. Air pollution and interaction with APOE ε4 on AD risk thus merits further attention. We studied dementia incidence over a 15-year period from the longitudinal Betula study in Northern Sweden. As a marker for long-term exposure to traffic-related air pollution, we used modelled annual mean nitrogen oxide levels at the residential address of the participants at start of follow-up. Nitrogen oxide correlate well with fine particulate air pollution levels in the study area. We had full data on air pollution, incidence of AD and vascular dementia (VaD), APOE ε4 carrier status, and relevant confounding factors for 1,567 participants. As expected, air pollution was rather clearly associated with dementia incidence. However, there was no evidence for a modifying effect by APOE ε4 on the association (p-value for interaction > 0.30 for both total dementia (AD+VaD) and AD). The results from this study do not imply that adverse effects of air pollution on dementia incidence is limited to, or stronger in, APOE ε4 carriers than in the total population.
45.	Palmquist, Eva, 1977-, et al. (author) Coping and social support in environmental intolerance Other publication (other academic/artistic)abstract Purpose: Environmental intolerance (EI) is a broad term encompassing several conditions characterized by unspecific symptom patterns attributed to certain environmental exposure, such as odorous/pungent chemicals, electromagnetic fields (EMFs) and sounds. Limited documentation of the role of coping strategies and social support in these EIs motivated the present study of (i) combinations of coping strategies and social support in high and low intolerance severity at baseline, and (ii) combinations of coping strategies and social support at baseline that are associated with recovery from EI at follow-up, three years later.Methods: The study used cross-sectional and longitudinal data from the Västerbotten Environmental Health Study in Sweden, which is a large questionnaire-based survey. Individuals with EI attributed to chemicals, EMFs or sounds were identified through self-report (n=301 at baseline, n=213 at follow-up). The extent of use of four problem- and four emotion-focused strategies were assessed as well as perceived emotional, instrumental and informative support from seven sources.Results: The low and high intolerance severity groups differed as a function of relatively high problem-focused coping and instrumental support compared to lower reported levels of informational support, emotion-focused coping and emotional support. The groups not recovering and recovering from EI differed as a function of relatively high instrumental support and problem-focused coping compared to lower reported levels of informational support, emotional support and emotion-focused coping.Conclusions: The combination of coping strategies and perceived social support seem to be important in recovering from EI, for which emotion-focused coping, emotional and informational support seem to enhance recovery.
46.	Paulin, Johan, et al. (author) Associations between hyperacusis and psychosocial work factors in the general population 2019 In: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 92:1, s. 59-65 Journal article (peer-reviewed)abstract Purpose: We investigated the association between hyperacusis and aspects of psychosocial work environment in a general population. The objectives were to investigate (1) prevalence and characteristics (among age, sex, access to social support at home, education, smoking, physical exercise, and perceived general health) of hyperacusis in a general working population and (2) associations between hyperacusis and psychosocial factors in the work environment. The psychosocial work aspects included effort, reward, overcommitment, worry, and social and emotional support.Methods: Using data from a sample stratified for age and sex from the Österbotten Environmental Health Study in Finland, currently employed participants with self-reported hyperacusis and referents were compared on questionnaire instruments quantifying six aspects of their psychosocial work environment.Results: Among 856 currently employed participants, 47 constituted a hyperacusis group and 809 a reference group. The hyperacusis group scored significantly higher than the referents on worry at work, social support at work, and reward at work, but not on emotional support at work, work overcommitment, or effort at work. About 40% of the hyperacusis group scored on the upper quartile of the three former work environment factors, with odds ratios ranging from 1.91 to 2.56.Conclusions: The results suggest that worrying about aspects at work, perceiving low social support, and not perceiving being rewarded at work are associated with hyperacusis.
47.	Pettersson-Strömbäck, Anita, 1965-, et al. (author) Slutrapport från AKTIKON-PROJEKTET i Örnsköldsviks kommun : Arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö – en kontrollerad studie i Örnsköldsviks kommun 2018 Reports (other academic/artistic)abstract Projektet Aktivitetsbaserat Kontor (AktiKon) har följt och utvärderat en förändringsprocess i Örnsköldsviks kommun där tjänstemännen i kommunen flyttade från cellkontor till antingen ett aktivitetsbaserat kontor (AB-kontor) eller ett cellkontor. Syftet med forskningsprojektet var att studera effekter på arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö och kunna jämföra med fortsatt arbete i cellkontor. Mätningar med enkäter, fokusgruppsintervjuer, gåturer och observationer utfördes 6 mån före flytt och 6 respektive 18 månader efter flytt. Individuella intervjuer av personer med upplevd funktionsnedsättning utfördes ca 10 månader efter flytt. Rörelsemätningar utfördes vid fem olika tillfällen under flyttprocessen.I denna rapport har vi valt att redovisa enkätresultat från anställda som vi har kunnat följa över tid, d.v.s. individer där vi har resultat från enkät besvarad före flytt och från minst ett tillfälle efter flytt. Den ursprungliga studiepopulationen som studerades med denna metod bestod från början av 374 anställda och vid den sista uppföljningen, 18 månader efter flytt, av 152 anställda i AB-kontoret och 63 i cellkontoret. De två grupperna som flyttade till olika kontorsmiljöer var inte helt jämförbara. Exempelvis var det fler män och chefer som flyttade till AB-kontoret och yrkesgrupperna var inte heller lika, men alla som ingick i projektet var tjänstemän inom samma kommun.De som flyttade till AB-kontoret upplevde den nya kontorsmiljön som estetiskt tilltalande och luftkvaliteten god. De som flyttade till nya cellkontor hade utifrån kvalitativa intervjuer inte en lika positiv uppfattning vad gäller kontorets design och inredning.Arbetsbelastningen och olika typer av krav såg lika ut över tid för respektive grupp. Det var vid 18 månader efter flytt ingen skillnad jämfört med före flytt i hälsofrämjande arbetsfaktorer undersökta med WEMS-instrumentet (Work Experience Measurement Scale) för de som flyttat till AB-kontor. Det var inte heller någon skillnad över tid i jämförelse med de som flyttat till cellkontor. Datorstödet upplevdes mycket positivt av de som flyttade till AB-kontoret och de blev något mer nöjda än de som flyttade till cellkontor. Det fanns i AB-kontoret inte någon säker skillnad i upplevelse av samarbete mellan olika arbetsgrupper eller inom hela organisationen vid 18 månader efter flytt jämfört med utgångsläget och inte heller någon säker skillnad över tid jämfört med cellkontoret. De som flyttade till AB-kontor rapporterade efter flytten en ökad störning av ljud och besvär av bristande avskildhet. Man upplevde i genomsnitt en lägre produktivitet i AB-kontoret efter flytt och det fanns en skillnad mellan de två kontorstyperna över tid.Cheferna var generellt nöjda med att arbeta i AB-kontor och de upplevde inte någon minskad produktivitet vid övergång till AB-kontor. I genomsnitt blev det emellertid en minskad nöjdhet med kontorets utformning i gruppen som flyttade till AB-kontor. Nöjdheten med AB-kontoret varierade beroende på yrke och typ av arbetsuppgifter. De som hade mycket enskilt och koncentrationskrävande datorarbete upplevde mindre nöjdhet efter flytt och angav att de helst ville arbeta i cellkontor om de fick välja. De som arbetade mycket i grupp, behövde vara idérika och ofta diskuterade med kollegor föredrog att arbeta i AB-kontor. Bland dem som helst ville arbeta i cellkontor fanns det en ökad förekomst av problem med stress, långvarig utmattning och psykiska besvär.Det framkom ökade problem med koncentrationen hos de som flyttade till AB-kontor. Det fanns däremot inga säkra skillnader över tid mellan grupperna vad gäller skattning av allmän hälsa och förekomst av andra typer av besvär.Redan före flytten hade båda grupperna tillgång till höj- och sänkbara bord och det var vanligt att arbeta stående under en rätt stor del av arbetsdagen. Efter flytten ökade tiden i gående och antal steg något i AB-kontoret jämfört med cellkontoret. I AB-kontoret fanns tillgång till gå-band, men dessa användes endast av ett fåtal anställda. Den centralt belägna öppna trappan var omtyckt och användes mycket.Sammanfattningsvis visar studien att nöjdhet, preferens och produktivitet i AB-kontor varierar mycket beroende på vilka arbetsuppgifter man har. AB-kontoret fungerar särskilt bra för personer med ledningsuppdrag. För att AB-kontoret ska kunna fungera bra även för personer med funktionsnedsättning måste det finnas system för att fånga upp individuella problem och möjliggöra anpassningar vid behov. Detta gäller särskilt vid psykiska besvär och kognitiva svårigheter. Det är angeläget att det i AB-kontoret finns tillgång till stödytor och resurser i tillräcklig omfattning för alla de olika arbetsuppgifter som ska utföras.En viktig erfarenhet i projektet är betydelsen av att kunna beskriva den kontext som förändringen sker i. Genom att göra en processutvärdering har det funnits möjlighet att på ett adekvat sätt tolka och förstå de effekter som framkom vid övergång till AB-kontor.Framgångsfaktorer vid övergång till AB-kontor är noggrann kartläggning och analys före flytt, samverkan, delaktighet, överenskomna regler och förhållningssätt, och övergripande rutiner som inkluderar hela kontoret för det fortsatta arbetsmiljöarbetet.
48.	Rollborn, Niclas, et al. (author) Good Agreement Between Hba1c Analyzed Using Capillary Electrophoresis, HPLC, Immunological and Enzymatic Methods 2019 In: Journal of Diabetes, Metabolism and its Complications. ; 1:1, s. 1-7 Journal article (peer-reviewed)abstract Purpose: Hemoglobin A1c (HbA1c) is an essential marker for assessment of glycemic control in diabetes patients. The aim of this study was to evaluate the agreement between different HbA1c methods.Methodology: We used blood samples to compare HbA1c results analyzed with Capillarys 3 Tera, Roche Tina-Quant HbA1c Gen 3, BioRad Variant II Turbo (3 sites), Mono S® and Abbott Architect enzymatic method. The comparisons were made as paired instrument comparisons with Capillarys 3 Tera.Results: The linear correlations between the HbA1c methods were as follows:Cobas 6000 = 0.982 x Capillarys 3 Tera + 0.975, R² = 0.994;Architect c8000 = 0.982 x Capillarys 3 Tera + 1.064, R² = 0.994; Mono S® = 0.916 x Capillarys 3 Tera + 3.397, R² = 0.965;BioRad Variant II Turbo = 0.923 x Capillarys 3 Tera + 4.062, R² = 0.990; Tosoh G8 = 0.963 x Capillarys 3 Tera + 3.895, R² = 0.996.Conclusions: The different instrument platforms showed the best agreement in the 50-70 mmol/mol interval. Above and below this range the methods separated into 2 groups, one consisting of Capillarys 3 Tera, Roche Tina-Quant and Abbott enzymatic method and the other group consisting of BioRad Variant II Turbo, Tosoh G8 and Mono S®.
49.	Ström, Åsa, et al. (author) Involvement of the CD1d-Natural killer T cell pathway in neointima formation after vascular injury 2007 In: CIRCULATION RESEARCH. - 0009-7330. ; 101:8 Journal article (peer-reviewed)abstract Recent studies have established that the immune system plays an important role in the development of atherosclerosis. However, its role in regulating the arterial response to mechanical injury is less well studied. Arterial injury is associated with local accumulation of antibodies, and mice lacking functional T and B cells exhibit increased neointima formation, indicating that adaptive immune responses to neoantigens in the damaged tissue modulate the vascular repair process. To study the role of lipid antigen presentation in the arterial response to injury, we analyzed neointima formation in mice deficient in the lipid antigen-presenting molecule CD1d using a carotid collar model. As compared with control mice, neointima formation was reduced by >60% (P<0.01) in CD1d-/- mice. Moreover, carotid injury of wild-type C57BL/6 mice was associated with expansion of CD1d-restricted natural killer T cells in the spleen and accumulation of natural killer T cells in the periadventitial space of injured arteries. The results suggest that presentation of lipid antigens through the CD1d-natural killer T cell pathway modulates vascular repair responses.
50.	Sundström, Anna, 1979-, et al. (author) Construct validation and normative data for different versions of the Shirom-Melamed burnout questionnaire/measure in a Swedish population sample 2023 In: Stress and Health. - : John Wiley & Sons. - 1532-3005 .- 1532-2998. ; 39:3, s. 499-515 Journal article (peer-reviewed)abstract The overall aim of the present study was to examine the construct validity of different versions of the Shirom-Melamed Burnout Questionnaire/Measure (SMBQ/M) suggested in previous work, as well as to provide normative data for a large population-based sample in Sweden with a broad range in age. Cross-sectional data from the Västerbotten Environmental Health Study in Sweden were used. The 3406 participants (56% women) in this study, aged 18–79 years, constituted a random sample stratified for age and sex. Participants responded to a questionnaire including the 4-factor 22-item version of the SMBM as well as background questions and a number of validated questionnaire instruments assessing for example, sleep disturbance, depression, anxiety, perceived stress, and somatic symptoms. The dimensionality of different versions of the SMBM were examined with confirmatory factor analysis. A modified 4-factor 19-item model of the SMBM provided good model-fit, and two 2-factor models (11-item and 6-item) provided excellent model fit. The relationships to relevant psychological constructs provided support for convergent validity for the suggested versions of the SMBM. Finally, normative data were obtained for a broad age group for the different versions. In conclusion, we suggest that for assessing the core of the burnout construct in terms of emotional and physical exhaustion and cognitive weariness, the SMBM-11 or SMBM-6 for repeated measures, are to be used. For a broader assessment of burnout incorporating both symptoms and information about the process of exhaustion via the subscales of listlessness and tension, we recommend the use of the modified 4-factor SMBM-19.

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