| 1. |
- Ahlgren, Kerstin M., et al.
(författare)
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Increased IL-17A secretion in response to Candida albicans in autoimmune polyendocrine syndrome type 1 and its animal model
- 2011
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Ingår i: European Journal of Immunology. - : Wiley. - 0014-2980 .- 1521-4141. ; 41:1, s. 235-245
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Tidskriftsartikel (refereegranskat)abstract
- Autoimmune polyendocrine syndrome type 1 (APS-1) is a multiorgan autoimmune disease caused by mutations in the autoimmune regulator (AIRE) gene. Chronic mucocutaneous candidiasis, hypoparathyroidism and adrenal failure are hallmarks of the disease. The critical mechanisms causing chronic mucocutaneous candidiasis in APS-1 patients have not been identified although autoantibodies to cytokines are implicated in the pathogenesis. To investigate whether the Th reactivity to Candida albicans (C. albicans) and other stimuli was altered, we isolated PBMC from APS-1 patients and matched healthy controls. The Th17 pathway was upregulated in response to C. albicans in APS-1 patients, whereas the IL-22 secretion was reduced. Autoantibodies against IL-22, IL-17A and IL-17F were detected in sera from APS-1 patients by immunoprecipitation. In addition, Aire-deficient (Aire(0/0) ) mice were much more susceptible than Aire(+/+) mice to mucosal candidiasis and C. albicans-induced Th17- and Th1-cell responses were increased in Aire(0/0) mice. Thus an excessive IL-17A reactivity towards C. albicans was observed in APS-1 patients and Aire(0/0) mice.
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| 2. |
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| 3. |
- Asplund, Sofia, et al.
(författare)
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Experiences of being a manager in the municipal sector in rural northern Sweden
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this study was to describe experiences of being a manager in the municipal sector in rural northern Sweden.METHODS: Semi-structured interviews were performed with 15 managers working in the municipal sector. The interviews were subjected to inductive qualitative content analysis.RESULTS: The managers' experiences were interpreted in the main theme, Striving for stability on shaky ground. They struggled within slimmed-down organizations with substitute shortages and reduced means. They expressed being burdened by conflicting demands, a work overload, work conflicts and a requirement to be present. They had to endure the negative consequences of working in small municipalities, and handling health and family life impairments. The managers expressed the importance of being strengthened by inner and outer resources, such as being motivated, having social support and finding strategies to cope. They also expressed benefits of working in small municipalities, such as great opportunities to influence and efficiency in decision-making.CONCLUSION: This study illuminates managers' adverse psychosocial working conditions, insights into working in a small municipality in the rural context and also the importance of organizational support. Future studies could focus on applying adapted workplace support interventions among managers in the municipal sector in rural northern Sweden.
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| 4. |
- Asplund, Sofia, et al.
(författare)
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Experiences of work-related stress among highly stressed municipal employees in rural northern Sweden
- 2022
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. METHODS: We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. RESULTS: Under the main theme of Suffering Through Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. CONCLUSION: Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both health and family lives of employees, and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization.
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| 5. |
- Asplund, Sofia, et al.
(författare)
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Organizational and psychosocial environmental work factors associated with self-rated exhaustion disorder among municipal employees in rural northern Sweden
- 2023
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 75:4, s. 1215-1229
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Tidskriftsartikel (refereegranskat)abstract
- Background: Research indicates that good organizational and psychosocial environments are vital to well-functioning workplaces and employee health. Working in the municipal sector and in the rural context may contribute to more health problems, poorer organizational and psychosocial work environments, and higher sick-leave rates.Objective: The aim of this study was to explore organizational and psychosocial environmental work factors among municipal employees with or without self-rated exhaustion disorder (s-ED) in rural northern Sweden.Methods: The Modern Work Life Questionnaire and the Self-Rated Exhaustion Disorder Scale were used among 1093 municipal employees.Results: The results showed that there were significant differences between the s-ED and the non-s-ED group in all but one of the organizational and psychosocial environmental work factors. Various demands, i.e. quantitative, emotional, intellectual, and IT demands were some factors associated with the s-ED group. Social support, resources, and time for work and reflection were some factors associated with the non-s-ED group. Both the s-ED and the non-s-ED groups assessed significantly higher emotional demands and less resources compared to national reference values.Conclusion: Findings from this study are relevant to a better understanding what organizational and psychosocial work environmental work factor the employer need to pay extra attention to. Addressing risk and protective factors in the work environment could tribute to promote occupational well-being, preventing exhaustion disorder and long-term sick leave among municipal employees in rural northern Sweden.
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| 6. |
- Asplund, Sofia, et al.
(författare)
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Self-rated exhaustion disorder and associated health-related factors among municipal employees in rural areas of northern Sweden
- 2021
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; , s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study among municipal employees in rural areas of northern Sweden were to assess the prevalence of self-rated exhaustion disorder (s-ED), describe plausible between-group differences in self-reported health-related factors among employees with or without s-ED, and identify health-related factors associated with s-ED.METHODS: In a cross-sectional study, data were collected from 1093 municipal employees (76.1% women) in two rural areas using an instrument measuring s-ED and health variables drawn from the Modern Worklife Questionnaire (MWQ), the Perceived Stress Scale (PSS), and the National Board of Health and Welfare's questions about physical activity. Comparisons were made between an s-ED and a non-s-ED group. Health-related factors associated with s-ED were identified through a logistic regression.RESULTS: Self-rated exhaustion disorder was reported by 21.5% of the participants. Health-related factors associated with s-ED were cognitive problems, sleep problems, depressive symptoms, high stress, poor self-rated health, and stomach problems. There was no statistically significant difference in the prevalence of participants who met the criteria of physical activity among s-ED and non-s-ED group.CONCLUSION: Findings from this study suggest that s-ED is more common among municipal employees in rural areas than in other working populations in Sweden. Several health-related factors were associated with s-ED. Regular use of a self-rated instrument in evaluating the organizational and social work environment can identify people at risk of developing exhaustion disorder and requiring long-term sick leave.
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| 7. |
- Asplund, Sofia, 1982-
(författare)
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Work-related stress among municipal employees in rural northern Sweden
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Many rural municipalities in Sweden are facing challenges like depopulation, decreased economy, and difficulties in recruiting staff. Living and working in rural areas may involve adverse working conditions and higher risks of ill-health. Work is generally good for employee health, but various physical and psychosocial aspects of work can also be hazards and cause work-related stress, health problems, reduced productivity, and long-term sick leave. Leadership by managers in the organisation is important for the work environment, work performance, and occupational health of employees. The Swedish municipal sector employs almost 20% of employees in the labour market, where school, preschool and care of older people are the dominating areas. Previous research has shown that there are adverse psychosocial working conditions in Swedish municipal organisations. The municipal sector has the highest rate of long-term sick leave compared to other sectors in the labour market, mainly due to stress-related disorders, such as exhaustion disorder (ED). Therefore, it is important to focus on organisational and psychosocial work environments, work-related stress, and health in the municipal sector of rural northern Sweden.Aim: The overall aim was to explore organisational and psychosocial work environments, work-related stress, and health among municipal employees in rural northern Sweden.Methods: Both quantitative and qualitative methods were used to collect data. Study I and II had a quantitative approach, a cross-sectional design, and used a questionnaire for collecting data. Participants were employees (n =1093) in the municipal sector in two municipalities in rural northern Sweden. The questionnaire was constructed to contain instruments measuring the organisational and psychosocial work environments, perceived stress, self-rated exhaustion disorder (s-ED), and physical activity. Quantitative data were analysed using logistic regression in Study I, and partial least squares regression in Study II. Studies III and IV had a qualitative approach. In Study III, semi-structured individual interviews were conducted with 15 municipal employees with high self-reported stress. In Study IV, semi-structured individual interviews were conducted with 15 managers at different levels in the municipal sector. All qualitative data were analysed using inductive qualitative content analysis.Results: In Study I, results showed that 21.5 % of the municipal employees reported s-ED.Cognitive problems, sleep problems,depressiveivsymptoms, high stress, poor self-rated health, and stomach problems were the health-related factors most strongly associated with s-ED. In Study II, results showed that there were significant differences between the s-ED and the non–s-ED group in all but one of the 32 organisational and psychosocial environmental work factors. Various demands—i.e., quantitative, emotional, intellectual—and work conflicts were important factors associated with s-ED. Social support, resources, and time for work and reflection were important factors associated with non–s-ED. Findings from Study III showed that the employees with high self-reported stress experienced feelings of suffering through endless chaos when they worked in an organisation with high demands and low resources, control, and support. They also experienced feelings of insufficiency, and negative effects on health and family life. Findings from Study IV showed that managers in the municipal sector experienced feelings of striving for stability on shaky ground. They struggled inside slimmed-down organisations with a substitute shortage and reduced means, were burdened by conflicting demands, and experienced health and family life impairments. Managers expressed the importance of motivation, social support, and coping strategies.Conclusion: This thesis illuminates adverse psychosocial working conditions among municipal employees in two municipalities in the rural context of northern Sweden, where a stressful work environment, s-ED and health impairments are relatively common.It also provides important insights of municipal employee’s experiences of work-related stress, the importance of acknowledging suffering, and managers’ experiences of working in municipal organisations with shrinking resources, as in addition to a work–family imbalance. It seems important that organisations in the municipal sector have supportive and effective leadership, and allow employees control over their work. Furthermore, it seems important that various demands are balanced by sufficient resources; such as staff, social support, and economic resources in order to prevent work-related stress. Findings from this thesis can contribute to future interventions, aiming to prevent work-related stress and improve occupational well-being and work performance. They also have value for development work in municipal organisations.
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| 8. |
- Baecklund, Eva, 1956-, et al.
(författare)
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Anti-cyclic citrullinated peptide antibodies, other common autoantibodies, and smoking as risk factors for lymphoma in patients with rheumatoid arthritis
- 2018
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 47:4, s. 270-275
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Patients with rheumatoid arthritis (RA) are at increased risk of lymphoma. There is no biomarker to indicate future lymphoma risk in RA and it is not known whether factors associated with an increased risk of RA also confer an increased risk of lymphoma. We investigated whether anti-cyclic citrullinated peptide (CCP) antibodies, other autoantibodies, and smoking, are associated with lymphoma development in RA.METHOD: subclasses of anti-CCP antibodies and for 15 antinuclear antibody (ANA)-associated specific autoantibodies. Relative risks were estimated as crude and adjusted odds ratios (adjOR) with 95% confidence intervals (CIs) using logistic regression.RESULTS: We found no association between anti-CCP IgG ≥ 25 units/mL (adjOR 1.4, 95% CI 0.7-2.7), anti-CCP IgG ≥ 500 units/mL (adjOR 1.4, 95% CI 0.7-3.0), anti-CCP Ig of other isotypes, other autoantibodies (adjOR any vs none 0.6, 95% CI 0.3-1.2), or cigarette smoking (adjOR ever vs never 1.1, 95% CI 0.5-2.2) and lymphoma risk among patients with RA.CONCLUSION: In this study, neither anti-CCP antibodies (IgG, IgG1–4, IgM, or IgA), nor other common autoantibodies, nor smoking predicted lymphoma risk in RA
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| 9. |
- Elshafie, Amir, 1970-, et al.
(författare)
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Circulating immune complexes (IC) and IC-induced levels of GM-CSF are increased in sudanese patients with acute visceral Leishmania donovani infection undergoing sodium stibogluconate treatment : implications for disease pathogenesis
- 2007
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Ingår i: Journal of Immunology. - 0022-1767 .- 1550-6606. ; 178:8, s. 5383-5389
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Tidskriftsartikel (refereegranskat)abstract
- Infection with Leishmania donovani is associated with IL-10 as well as with GM-CSF. Immune complexes (IC) exert important functions by stimulation of monocytes/macrophage-mediated production of pro- and anti-inflammatory cytokines in rheumatic diseases. In this investigation, we have explored IC-induced cytokine production during Leishmania infection. Sera from 43 patients with visceral leishmaniasis (VL), 17 patients with post-kala-azar dermal leishmaniasis, and 20 healthy Sudanese controls were precipitated with polyethylene glycol (PEG). The PEG precipitates were added to serum-free PBMC for 20 h,whereupon supernatant levels of IL-1beta, IL-6, IL-10, IL-1 receptor antagonist protein, TNF-alpha, TNF receptor p75, and GM-CSF were investigated using ELISA. Circulating levels of C1q-binding IC were also measured in the serum samples. PEG precipitates from Leishmania-infected patients induced significantly higher levels of GM-CSF (p = 0.0037) and IL-10 (p < 0.0001), as well as of IL-6 (p < 0.0001) and IL-1 receptor antagonist (p = 0.0238) as compared with PEG precipitates from controls. Patients with acute VL as well as VL patients receiving sodium stibogluconate treatment displayed significantly increased levels of PEG precipitate-induced GM-CSF. The induction of GM-CSF by circulating IC was especially prominent in acute VL patients receiving sodium stibogluconate treatment; ANOVA revealed significant interaction between disease activity and treatment for PEG precipitate-induced levels of GM-CSF (disease activity, p = 0.0006; treatment, p = 0.0005; interaction, p = 0.0046). Parallel associations were determined for C1q-binding immune complexes, but not for any cytokine other than GM-CSF. The importance of IC-induced GM-CSF in leishmaniasis warrants further study.
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| 10. |
- Elshafie, Amir I., et al.
(författare)
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Activity and turnover of eosinophil and neutrophil granulocytes are altered in visceral leishmaniasis
- 2011
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Ingår i: International Journal of Parasitology. - : Elsevier BV. - 0020-7519 .- 1879-0135. ; 41:3-4, s. 463-469
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Tidskriftsartikel (refereegranskat)abstract
- Visceral leishmaniasis (VL) is a health issue in Sudan. Our aim was to investigate the involvement of eosinophils and neutrophils in VL by serum and plasma measurements of eosinophil cationic protein (ECP) and myeloperoxidase (MPO) and some key cytokines and chemokines. Blood was collected from 125 VL patients and 181 healthy Sudanese controls from the same rural area. Results showed reduced eosinophil and neutrophil counts in the VL group (P = 0.0001 and P = 0.002, respectively). Serum-ECP levels were higher in the controls (P < 0.0001), while plasma MPO levels were higher in the VL group (P < 0.0001). Levels of IL-5, granulocyte macrophage-colony stimulating factor (GM-CSF) and IL-17 were increased among the VL group (P < 0.0001, P = 0.017 and P = 0.03, respectively), whereas eotaxin and IL-8 levels were reduced (P < 0.0001 and P = 0.002, respectively). Positive correlations were found between IL-8 and ECP/MPO (P < 0.0001). We conclude that eosinophil and neutrophil turnover and activity are increased in subjects in rural areas of Sudan. In VL the turnover was further increased, but the relatively low secretory activity of eosinophils and neutrophils in VL may relate to the reduced production and availability of the chemokines eotaxin and IL-8. The combined assay of ECP and MPO in serum and plasma provides further insight into the mechanisms of eosinophil and neutrophil involvement in disease and constitutes a novel approach to the study of disease processes.
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