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  • 1.
    Abong'o, Deborah
    et al.
    University of Nairobi, Kenya.
    Wandiga, Shem
    University of Nairobi, Kenya.
    Jumba, Isaac
    University of Nairobi, Kenya.
    Madadi, Vincent
    University of Nairobi, Kenya.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Impacts of pesticides on human health and environment in the River Nyando catchment, Kenya2014In: International Journal of Humanities, Arts, Medicine and Sciences, ISSN 2348-0521, Vol. 2, no 3, p. 1-14Article in journal (Other academic)
    Abstract [en]

    The population of the River Nyando catchment largely relies on rain fed agriculture for their subsistence.

    Important crops grown include cereals, cash crops fruits and vegetables. Farming is one of the contributors of pollution to Lake Victoria. Organophosphates and other banned organochlorine pesticides such as lindane, aldrin and dieldrin were used by farmers. The pesticides transport was by storm water run-off and air drift into the lake. Environmental risk assessment background information was collected through questionnaire and interviews of farmers to determine knowledge and safe use of pesticides. Fourteen pesticides were identified as commonly used of which four are toxic to bees and five to birds. The farmers identified declines in the number of pollinating insects, the disappearance of Red-billed Oxpecker (Buphagus erythrorthynchus) and wild bird’s fatalities. The general knowledge among farmers about chemicals risks, safety, and chronic illnesses was low. Activities that increases environmental awareness and safety of pesticides should be initiated by the agrochemical firms and government.

  • 2.
    Ainsbury, Elizabeth A.
    et al.
    Publ Hlth England, England.
    Samaga, Daniel
    Bundesamt Strahlenschutz, Germany.
    Della Monaca, Sara
    Ist Super Sanita, Italy.
    Marrale, Maurizio
    Univ Palermo, Italy; Univ Palermo, Italy.
    Bassinet, Celine
    Inst Radioprotect and Surete Nucl, France.
    Burbidge, Christopher I.
    Environm Protect Agcy, Ireland.
    Correcher, Virgilio
    Ctr Moncloa, Spain.
    Discher, Michael
    Univ Salzburg, Austria.
    Eakins, Jon
    Publ Hlth England, England.
    Fattibene, Paola
    Ist Super Sanita, Italy.
    Guclu, Inci
    Turkish Atom Energy Commiss, Turkey.
    Higueras, Manuel
    Basque Ctr Appl Math, Spain.
    Lund, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Maltar-Strmecki, Nadica
    Rudjer Boskovic Inst, Croatia.
    McKeever, Stephen
    Oklahoma State Univ, OK 74078 USA.
    Raaf, Christopher L.
    Lund Univ, Sweden.
    Sholom, Sergey
    Oklahoma State Univ, OK 74078 USA.
    Veronese, Ivan
    Univ Milan, Italy; Natl Inst Nucl Phys, Italy.
    Wieser, Albrecht
    Helmholtz Zentrum Munchen, Germany.
    Woda, Clemens
    Helmholtz Zentrum Munchen, Germany.
    Trompier, Francois
    Inst Radioprotect and Surete Nucl, France.
    UNCERTAINTY ON RADIATION DOSES ESTIMATED BY BIOLOGICAL AND RETROSPECTIVE PHYSICAL METHODS2018In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 178, no 4, p. 382-404Article in journal (Refereed)
    Abstract [en]

    Biological and physical retrospective dosimetry are recognised as key techniques to provide individual estimates of dose following unplanned exposures to ionising radiation. Whilst there has been a relatively large amount of recent development in the biological and physical procedures, development of statistical analysis techniques has failed to keep pace. The aim of this paper is to review the current state of the art in uncertainty analysis techniques across the EURADOS Working Group 10-Retrospective dosimetry members, to give concrete examples of implementation of the techniques recommended in the international standards, and to further promote the use of Monte Carlo techniques to support characterisation of uncertainties. It is concluded that sufficient techniques are available and in use by most laboratories for acute, whole body exposures to highly penetrating radiation, but further work will be required to ensure that statistical analysis is always wholly sufficient for the more complex exposure scenarios.

  • 3.
    Alkner, Björn A.
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine. Reg Jonkoping Cty, Linkoping, Sweden.
    Norrbrand, Lena
    KTH Royal Institute Technology, Sweden.
    Tesch, Per A.
    Karolinska Institute, Sweden.
    Neuromuscular Adaptations Following 90 Days Bed Rest With or Without Resistance Exercise2016In: AEROSPACE MEDICINE AND HUMAN PERFORMANCE, ISSN 2375-6314, Vol. 87, no 7, p. 610-617Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This study examined the effects of long-term bed rest with or without a concurrent resistance exercise protocol on different muscle function indices of the knee extensors and their influence on previously shown atrophy, neural impairment, and slow-to-fast phenotype shift. METHODS: Nine men underwent 90 d of bed rest only (BR), while eight men in addition performed maximal supine squats every third day (BRE). Before and at day 1 and 5 following bed rest, surface quadriceps electromyographic (EMG) activity was measured during a sustained (60-s) submaximal isometric action and rate of force development (RFD) was assessed during a maximal isometric action, both in the supine squat position. Maximal torque was measured during isokinetic knee extensions at different angular velocities before and after (day 2 and 11) bed rest. RESULTS: EMG amplitude at a fixed submaximal load increased in BR, but not in BRE. The increase in amplitude during the sustained action was elevated in BR but not in BRE. RFD decreased in BR; this effect was attenuated day 1 and normalized day 5 in BRE. RFD expressed relative to maximal force was maintained in both groups. Angle-specific torque decreased equally for all velocities in BR. The decrease in isokinetic strength was attenuated day 2 in BRE. DISCUSSION: Phenotype changes were not reflected in muscle function measurements, probably because they were overridden by the effects of atrophy and neural adaptation. The protective effect of resistance exercise was more pronounced in tasks similar to the training action, inferring great impact of neural mechanisms.

  • 4.
    Alkner, Björn
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Orthopaedics, Eksjö, Region Jönköping County, Linköping, Sweden.
    Bring, Daniel K- I
    Division of Orthopedics and Biotechnology, Clintec, Karolinska Institutet, Stockholm, Sweden.
    Muscle Activation During Gravity-Independent Resistance Exercise Compared to Common Exercises2019In: Aerospace Medicine and Human Performance, ISSN 2375-6314, E-ISSN 2375-6322, Vol. 90, no 6, p. 506-512Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim was to study quadriceps muscle activation during resistance exercise using a flywheel device, developed as a gravity-independent resistance exercise device to be used during spaceflight, compared with traditional strength training exercises. METHODS: Eight healthy men experienced in resistance exercise performed the following exercises in random order: flywheel leg press (FW), knee extension isokinetic dynamometry (ID), barbell front squat (FS), weight stack leg press (LP), and weight stack knee extension (KE). They accomplished eight repetitions of coupled concentric and eccentric actions with simultaneous recordings of surface electromyography (EMG) from the three superficial quadriceps muscles and knee angles using electrogoniometry. Maximal voluntary contraction (MVC) in knee extension was performed before and after these measurements. RESULTS: EMG averaged across muscles and angles and normalized to MVC was 99/76% in FW, 48/41% FS, 65/47% LP, 81/52% KE, and 93/84% ID in concentric/eccentric phases, respectively. FW and ID showed higher mean EMG activity than LP and FS concentrically and higher than all other exercises eccentrically. No difference in activity between FW and ID was found. Pre- and post-MVC torque was comparable. DISCUSSION: Quadriceps muscle activation was superior in FW and ID exercises compared to the other exercises. The difference was most pronounced in the eccentric phase, but even concentric activation was lower in traditional closed chain exercises. This data supports that FW is an effective training tool and should be considered when designing strength training programs for spaceflights and on Earth.

  • 5.
    Arapovic-Johansson, B.
    et al.
    Karolinska Institute, Sweden.
    Wåhlin, Charlotte
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Karolinska Institute, Sweden.
    Kwak, L.
    Karolinska Institute, Sweden.
    Björklund, C.
    Karolinska Institute, Sweden.
    Jensen, I.
    Karolinska Institute, Sweden.
    Work-related stress assessed by a text message single-item stress question2017In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 67, no 8, p. 601-608Article in journal (Refereed)
    Abstract [en]

    Background Given the prevalence of work stress-related ill-health in the Western world, it is important to find cost-effective, easy-to-use and valid measures which can be used both in research and in practice. Aims To examine the validity and reliability of the single-item stress question (SISQ), distributed weekly by short message service (SMS) and used for measurement of work-related stress. Methods The convergent validity was assessed through associations between the SISQ and subscales of the Job Demand-Control-Support model, the Effort-Reward Imbalance model and scales measuring depression, exhaustion and sleep. The predictive validity was assessed using SISQ data collected through SMS. The reliability was analysed by the test-retest procedure. Results Correlations between the SISQ and all the subscales except for job strain and esteem reward were significant, ranging from -0.186 to 0.627. The SISQ could also predict sick leave, depression and exhaustion at 12-month follow-up. The analysis on reliability revealed a satisfactory stability with a weighted kappa between 0.804 and 0.868. Conclusions The SISQ, administered through SMS, can be used for the screening of stress levels in a working population.

  • 6.
    Arlinger, Stig
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences.
    Hörsel och hörselskador i arbetslivet: Kunskapssammanställning2013Report (Refereed)
    Abstract [sv]

    Rapporten baserar sig på sammanställning av publicerade artiklar i vetenskapliga tidskrifter med tyngdpunkt på perioden från år 2000. Vissa äldre publikationer har också inkluderats när de har haft innehåll av betydelse för rapporten. Sökning har främst skett i databaserna PubMed och Google Scholar samt i referenslistor från identifierade relevanta arbeten. Söktermer har varit noise, hearing, noise-induced hearing loss, TTS, PTS, tinnitus, impulse noise, solvent, vibration i olika kombinationer.

    Fokus avseende hörselskador har traditionellt varit inriktat på hörselnedsättning, den försämrade känslighet som ofta men inte alltid är den uppenbara konsekvensen av en skada på hörselorganet. Men senare års forskning har visat att skador kan uppstå utan påtaglig påverkan på hörtrösklarna men i form av tinnitus, överkänslighet för starka ljud, förvrängd ljudupplevelse av olika slag, försämrad förmåga att uppfatta tal i svåra lyssningsmiljöer etc. Det har därför varit angeläget att lyfta fram dessa vidare aspekter på hörselskada.

    Många arbetsmiljöer domineras av en relativt kontinuerlig ljudnivå, men ibland förekommer också impulsbuller, d.v.s. ljudtoppar med kortvariga mycket höga ljudnivåer. Nya metoder som föreslagits för att mäta och säkrare värdera hörselskaderiskerna vid exponering för impulsbuller beskrivs också i rapporten.

    Följderna av bullerexponering på en individs hörsel beror inte alltid enbart på bullerexponeringen utan kan påverkas av andra faktorer. Dessa kan vara relaterade till arbetsmiljön men också till egenskaper hos den exponerade individen och kan därför behöva beaktas i skaderiskbedömningar.

    Djurförsök ha påvisat möjligheten att med farmakologiska medel minimera bullerskada efter en exponering och också att åtminstone delvis återskapa hörselfunktionen efter en bullerskada. Strävan är naturligtvis att kunna överföra denna kunskap och metodik till människa, men ännu återstår mycket arbete innan sådan behandling är tillgänglig.

  • 7.
    Aronsson, Gunnar
    et al.
    University of Stockholm, Sweden.
    Theorell, Tores
    University of Stockholm, Sweden; Karolinska Institute, Sweden.
    Grape, Tom
    Health Care Centre, Sweden.
    Hammarstrom, Anne
    University of Umeå, Sweden.
    Högstedt, Christer
    Karolinska Institute, Sweden.
    Marteinsdottir, Ina
    Linköping University, Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Skoog, Ingmar
    University of Gothenburg, Sweden.
    Traskman-Bendz, Lil
    Lund University, Sweden.
    Hall, Charlotte
    Swedish Council Health Technology Assessment, Sweden.
    A systematic review including meta-analysis of work environment and burnout symptoms2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 264Article, review/survey (Refereed)
    Abstract [en]

    Background: Practitioners and decision makers in the medical and insurance systems need knowledge on the relationship between work exposures and burnout. Many burnout studies -original as well as reviews-restricted their analyses to emotional exhaustion or did not report results on cynicism, personal accomplishment or global burnout. To meet this need we carried out this review and meta-analyses with the aim to provide systematically graded evidence for associations between working conditions and near-future development of burnout symptoms. Methods: A wide range of work exposure factors was screened. Inclusion criteria were: 1) Study performed in Europe, North America, Australia and New Zealand 1990-2013. 2) Prospective or comparable case control design. 3) Assessments of exposure (work) and outcome at baseline and at least once again during follow up 1-5 years later. Twenty-five articles met the predefined relevance and quality criteria. The GRADE-system with its 4-grade evidence scale was used. Results: Most of the 25 studies focused emotional exhaustion, fewer cynicism and still fewer personal accomplishment. Moderately strong evidence (grade 3) was concluded for the association between job control and reduced emotional exhaustion and between low workplace support and increased emotional exhaustion. Limited evidence (grade 2) was found for the associations between workplace justice, demands, high work load, low reward, low supervisor support, low co-worker support, job insecurity and change in emotional exhaustion. Cynicism was associated with most of these work factors. Reduced personal accomplishment was only associated with low reward. There were few prospective studies with sufficient quality on adverse chemical, biological and physical factors and burnout. Conclusion: While high levels of job support and workplace justice were protective for emotional exhaustion, high demands, low job control, high work load, low reward and job insecurity increased the risk for developing exhaustion. Our approach with a wide range of work exposure factors analysed in relation to the separate dimensions of burnout expanded the knowledge of associations, evidence as well as research needs. The potential of organizational interventions is illustrated by the findings that burnout symptoms are strongly influenced by structural factors such as job demands, support and the possibility to exert control.

  • 8.
    Back, A.
    et al.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    von Thiele Schwarz, U.
    Karolinska Institute, Sweden.
    Richter, A.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Hasson, H.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Walking the tightrope-perspectives on local politicians role in implementing a national social care policy on evidence-based practice2016In: INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS, ISSN 1752-4458, Vol. 10, article id 75Article in journal (Refereed)
    Abstract [en]

    Background: Despite national policy recommending evidence-based practice (EBP), its application in social care has been limited. While local politicians can affect the process, little is known about their knowledge, attitudes and roles regarding EBP. The aim here is twofold: to explore the role of local politicians in the implementation of EBP in social care from both their own and a management perspective; and to examine factors politicians perceive as affecting their decisions and actions concerning the implementation of EBP policy. Methods: Local politicians (N = 13) and managers (N = 22) in social care were interviewed. Qualitative thematic analysis with both inductive and deductive codes was used. Results: Politicians were rather uninformed regarding EBP and national policy. The factors limiting their actions were, beside the lack of awareness, lack of ability to question existing working methods, and a need for support in the steering of EBP. Thus, personal interest played a significant part in what role the politicians assumed. This resulted in some politicians taking a more active role in steering EBP while others were not involved. From the managers perspective, a more active steering by politicians was desired. Setting budget and objectives, as well as active follow-up of work processes and outcomes, were identified as means to affect the implementation of EBP. However, the politicians seemed unaware of the facilitating effects of these actions. Conclusions: Local politicians had a possibility to facilitate the implementation of EBP, but their role was unclear. Personal interest played a big part in determining what role was taken. The results imply that social care politicians might need support in the development of their steering of EBP. Moving the responsibility for EBP facilitation upwards in the political structure could be an important step in developing EBP in social care.

  • 9.
    Bidleman, Terry
    et al.
    Umeå University, Sweden.
    Kurt-Karakus, Perihan
    Bahcesehir University, Istanbul, Turkey.
    Armitage, James
    University of Toronto, Ontario, Canada.
    Brown, Tanya
    University of Victoria, British Columbia, Canada.
    Danon Schaffer, Monica
    University of British Columbia, Vancouver, Canada.
    Helm, Paul
    Ontario Ministry of the Environment, Toronto, Canada.
    Hung, Haley
    Meteorological Services Canada .
    Jantunen, Liisa
    Environment Canada.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Li, Yi-Fan
    Environment, Canada.
    Loock, Daniela
    Royal Military College of Canada.
    Luttmer, Carol
    Royal Military College of Canada.
    Ma, Jianmin
    Lanzhou University, Peoples Republic of China.
    Macdonald, Robie
    Fisheries and Oceans, Canada.
    Mackay, Don
    Trent University, Peterborough, Ontario, Canada.
    Reid, Liisa
    Trent University, Peterborough, Ontario, Canada.
    Reimer, Ken
    Royal Military College of Canada.
    Chapter 2: Properties, sources, global fate and transport2013In: Canadian Arctic Contaminants Assessment Report III 2013: Persistent Organic Pollutants in Canada’ s North / [ed] Derek Muir, Perihan Kurt-Karakus and Peter Stow, Ottawa: Northern Contaminants Program, Aboriginal Affairs and Northern Development Canada , 2013, p. 19-146Chapter in book (Refereed)
    Abstract [en]

    Part II of the second Canadian Arctic Contaminants Assessment Report (CACAR-II) began with a section on “Physicochemical Properties of Persistent Organic Pollutants”, which identified key physicochemical (pchem) properties, provided the rationale for their measurement or prediction and tabulated literature citations for chemicals that are of concern to the NCP (Bidleman et al. 2003). The section also discussed temperature dependence of pchem properties and their applications to describing partitioning in the physical environment.

    There is, and will continue to be, emphasis on predictive approaches to screening chemicals for persistence, bioaccumulation and toxic (PB&T)properties, as well as long-range atmospheric transport (LRAT) potential (Brown and Wania 2008, Czub et al. 2008, Fenner et al. 2005, Gouin andWania 2007, Howard and Muir 2010, Klasmeier et al. 2006, Matthies et al. 2009, Muir and Howard 2006). This has created the need for determining pchem properties of new and emerging chemicals of concern.

    Predicting gas exchange cycles of legacy persistent organic pollutants (POPs) and new and emerging chemicals of concern places a high demand on the accuracy of pchem properties, particularly the air/water partition coefficient, KAW. Hexachlorocyclohexanes (HCHs) in Arctic Ocean surface waters are close to air-water equilibrium, with excursions toward net volatilization or deposition that vary with location and season (Hargrave et al. 1993, Jantunen et al. 2008a, Lohmann et al. 2009, Su et al. 2006, Wong et al. 2011) while hexachlorobenzene (HCB) (Lohmann et al. 2009, Su et al. 2006, Wong et al. 2011) and some current use pesticides (CUPs) (Wong et al. 2011) are undergoing net deposition. The predicted Arctic Contamination Potential (ACP) for persistent organic chemicals is strongly influenced by ice cover due to its effect on air-water gas exchange (Meyer and Wania 2007).

    Many advances have taken place and numerous papers have been published since CACAR-II, which present new measurements and predictions of pchem properties. This section does not attempt to provide a comprehensive review of the field, or to compile pchem properties from the many studies. The approach taken is to highlight the reports which are most relevant to polar science, particularly in areas of improving reliability of pchem properties for POPs, improving experimental techniques and comparing predictive methods. The section ends with a discussion of polyparameter linear free energy relationships (pp-LFERs), which goes beyond partitioning descriptions based on single pchem properties by taking into account specific chemical interactions that can take place in airsurface and water-surface exchange processes. A detailed list of chemical names and nomenclature are provided in the Glossary.

  • 10.
    Borgestig, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    The impact of gaze-based assistive technology on daily activities in children with severe physical impairments2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Aim: The aim of the thesis was to investigate the impact of gaze-based assistive technology on daily activities in children with severe physical impairments and without speech. The objectives were to develop and pilot a gaze-based assistive technology intervention (GAT intervention) at home and in school for these children and to understand its impact on daily activities as experienced by their parents.

    Methods: Study I was a pilot study in which the basic components that were developed for the intervention were evaluated for students with physical impairments. The study aimed at improving the use of computers as assistive technology (AT) in school. Based on the findings in Study I, the GAT intervention was developed. The GAT intervention aimed at implementing gaze-based AT in daily activities. It consisted of two parts; having access to gaze-based AT and having access to services from a multi professional communication team during nine to ten months. Studies II-IV concerned gazebased AT for children with severe physical impairments without speech who participated in the GAT intervention. The participants were ten children (ages 1-15) (Studies II, III), and their parents (Study IV). Studies II and III had longitudinal designs and children were followed during 15-20 months with repeated measurements before, after and at follow-up. In Study II children’s repertoire of computer activities, extent of use, and goal attainment with gaze-based AT was evaluated, as well as parents’ satisfaction with the AT and with services. In Study III children’s eye gaze performance when using gaze-based AT was examined. In Study IV, parents were interviewed twice with the aim of  exploring their experiences of children’s gaze-based AT use in daily life. In Study IV a hermeneutical approach was used.

    Results: The findings of Study I showed that the basic components of intervention improved the use of computers in school. Study II showed an increased repertoire of computer activities with the gazebased AT, maintained use in daily activities for all at follow up, and that all children attained goals for gaze-based AT use in daily activities. Parents were satisfied with the gaze-based AT, and with the services in the GAT intervention. In study III, nine children improved in eye gaze performance over time when using the gaze-based AT in daily activities. Study IV revealed that children’s gaze-based AT usage in daily activities made a difference to parents since the children demonstrated agency, and showed their personality and competencies by using gaze-based AT, and for the parents this opened up infinite possibilities for the child to do and learn things. Overall, children’s gaze-based AT usage provided parents with hope of a future in which their children could develop and have influence in life.

    Conclusions: This thesis shows that these children with severe physical impairments and without speech acquired sufficient gaze control skills to use gaze-based AT for daily activities in the home and at school. The gaze-based AT had a positive impact on performing activities, for example, play activities and communication- and interaction-related activities. For the parents, children’s gaze-based AT usage made a difference since it shaped a hope of a better future for their children, where they can develop and gain influence in their future life. Furthermore, the children continued to perform daily activities with gaze-based AT over time. This finding suggests that key persons were provided with sufficient knowledge and skills to support children in maintained use of gaze-based AT after withdrawal of the services provided in the GAT intervention.

    List of papers
    1. Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
    Open this publication in new window or tab >>Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
    2013 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 463-470Article in journal (Refereed) Published
    Abstract [en]

    Objective: The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Methods: Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers opinions of goal setting were collected at follow-up. Results: The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. Discussion: The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2013
    Keywords
    Assistive technology, children with disabilities, goal setting, intervention, self-help devices
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-102984 (URN)10.3109/11038128.2013.837506 (DOI)000328280300008 ()
    Note

    Funding Agencies|Swedish Research Council||Swedish Institute of Assistive Technology||Norrbacka-Eugeniastiftelsen||

    Available from: 2014-01-09 Created: 2014-01-09 Last updated: 2017-12-06
    2. Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
    Open this publication in new window or tab >>Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
    Show others...
    2017 (English)In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed) Published
    Abstract [en]

    Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

    Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

    Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

    Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2017
    Keywords
    Cerebral palsy, computer activities, eye-tracking technology, goal achievement, self-help devices
    National Category
    Occupational Health and Environmental Health Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-123300 (URN)10.3109/17518423.2015.1132281 (DOI)000399489800003 ()26930111 (PubMedID)
    Note

    Funding agencies|Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

    At the time for thesis presentation publication was in status: Manuscript.

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2018-01-10Bibliographically approved
    3. Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
    Open this publication in new window or tab >>Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
    Show others...
    2016 (English)In: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 28, no 2, p. 93-102Article in journal (Refereed) Published
    Abstract [en]

    Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with an AB design was conducted on ten children (aged 1–15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9–11 months, and after 15–20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15–20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

    Keywords
    assistive devices, computer access, physical disability
    National Category
    Pediatrics Psychology (excluding Applied Psychology)
    Identifiers
    urn:nbn:se:liu:diva-123301 (URN)10.1080/10400435.2015.1092182 (DOI)000376031400004 ()26496529 (PubMedID)
    Note

    Funding agencies: Swedish Research Council; Stiftelsen Sunnerdahls Handikappfond; Jimmy Dahlstens Fond

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2018-03-17Bibliographically approved
    4. Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
    Open this publication in new window or tab >>Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
    2017 (English)In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed) Published
    Abstract [en]

    This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

    Place, publisher, year, edition, pages
    Taylor & Francis, 2017
    Keywords
    Activities in daily life, cerebral palsy, eye tracking controlled system, self-help devices, parental hope, qualitative
    National Category
    Occupational Health and Environmental Health Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-123302 (URN)10.1080/17518423.2016.1211769 (DOI)000406527400008 ()
    Note

    Funding agencies: Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

    Available from: 2015-12-10 Created: 2015-12-10 Last updated: 2019-06-28Bibliographically approved
  • 11.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Rytterström, Patrik
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 5, p. 301-308Article in journal (Refereed)
    Abstract [en]

    This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

  • 12.
    Borgestig, Maria
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Sandqvist, Jan
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Ahlsten, Gunnar
    Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
    Falkmer, Torbjorn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Occupational Therapy & Social Work, Curtin University, Perth, WA, Australia; School of Occupational Therapy, La Trobe University, Melbourne, Victoria, Australia.
    Hemmingsson, Helena
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 3, p. 129-141Article in journal (Refereed)
    Abstract [en]

    Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

    Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

    Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

    Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

  • 13.
    Bornman, Riana
    et al.
    University of Pretoria, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Bouwman, Henk
    Northwest University, South Africa.
    Household behavioural responses following successful IRS malaria control: Challenges for health education and intervention strategies.2012Conference paper (Other academic)
    Abstract [en]

    Control of malaria remains one of the world’s chief current public health challenges, particularly in sub-Saharan Africa where malaria is still responsible for 10% of the total disease burden. Mothers, guardians and caregivers of children play a vital role in the prevention, early detection and management of malaria. The general and daily priorities of caregivers living in a malarial area are not well understood, particularly as they have to balance competing social, economic and health constraints. A better understanding of household behaviour with respect to health education is imperative for the reduction of malaria incidence and the success of malaria control strategies. The investigation compared the relative importance assigned by female caregivers in communities under a successful vertically-managed malaria control programme to malaria awareness on the one hand and to social and economic concerns on the other.

     

    We conducted interviews with 156 caregivers of children using both open-ended and closed fixed-answer questions. The adult female responsible for the day-to-day care of the children was interviewed 1) in two malarial villages subject to annual indoor residual spraying (IRS) a total of 120 persons (60 in each village), and 2) 36 in a reference non-sprayed village.

     

    The mean income was between 27-56% of the national mean, indicating a community under considerable pressure. Male parents were often absent due to work commitments. Unemployment, poverty, crime, and lack of clean water were the main, unprompted, threats, but malaria was volunteered by none. Only when malaria was prompted (caregivers had good knowledge of malaria), did its concern rise to 52% and 38% in the IRS-sprayed villages.

     

    Malaria was not a prominent conscious concern and this apparent discrepancy between actual daily and potential future threats significantly increases the difficulty of mobilising communities for preventive action regarding potential threats. Integrated Vector Management (IVM), a multi-sector (central or local government, together with communities) horizontal control program, may be particularly difficult to implement in communities such as these above. Any changes to this effective system will therefore have to take exceptional care not to impact on the effectiveness other than to improve it. Considerations should be given to study the needs requirements of the caregiver as a crucial component of rural community life as their ‘buy-in’ to any new measures will be crucial for success. Our findings should be considered in malaria control strategies, rural policy development, climate change adaptation, and communication strategies.

  • 14.
    Bornman, Riana
    et al.
    University of Pretoria, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Sereda, Barbara
    Agricultural Research Council, South Africa.
    Bouwman, Henk
    Norethwest University, South Africa.
    DDT in Brest Milk: Intake, Risk, Lactation Duration, and Effect of Gender.2012Conference paper (Other academic)
    Abstract [en]

    DDT is annually applied indoors of every dwelling at 64-128 g DDT for malaria vector control. We studied 163 breast milk samples from three DDT-sprayed villages and one reference village in South Africa for the presence and levels of DDT. Mean ?DDT levels in breast milk from the DDT-sprayed villages were 18, 11, and 9.5 mg/kg mf (milk fat) (1.4 mg/kg mf reference village). Primipara mothers from DDT-sprayed villages had significantly higher levels ?DDT in their milk. The highest DDT level in breast milk ever reported from South Africa was detected (5.2 mg/l wm (whole milk) and 140 mg/kg mf). The Maximum Residue Limit (MRL) in milk and Provisional Tolerable Daily Intake (PTDI) for DDT by infants were significantly exceeded in DDT-sprayed villages (maximum exceeded the MRL 310 times, and the PTDI 99 times). The differences between villages indicated differences in exposure and uptake due to application, substrate, and/or culture. The duration of completed lactation was similar for all four villages and DDT exposure had no effect on the duration. There were indications (not significant) that first-born female infants drank milk with higher ?DDT levels than first-born male infants and vice versa for multipara male and female infants. These patterns were evident in each of the DDT-spayed villages, suggesting gender involvement on levels of DDT in breast milk. In view of the high levels recorded, effective measures to reduce DDT exposure are urgently needed, over and above the need to find suitable, safe, and sustainable alternatives.

  • 15.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Bornman, Riana
    University of Pretoria, South Africa.
    van den Berg, Henk
    Wageningen University, The Netherlands.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    DDT: Fifty years since silent spring2013In: Late lessons from early warnings: science, precaution, innovation, Copenhagen: European Environment Agency , 2013, , p. 291p. 272-291Chapter in book (Other academic)
    Abstract [en]

    'There was a strange stillness. The birds for example — where had they gone? Many people spoke about them, puzzled and disturbed. The feeding stations in the backyards were deserted. The few birds seen anywhere were moribund: they trembled violently and could not fly. It was a spring without voices ... only silence lay over the fields and woods and marsh.'

    The book Silent Spring by Rachel Carson is mainly about the impacts of chemicals (in particular in particular dichlorodiphenyltrichlorethane also known as DDT) on the environment and human health. Indeed, the close association between humans and birds remains very apt. Representing the only two warm-blooded groups of life on Earth, mammals and birds share the same environments and threats.

    Carson's claim that she lived in 'an era dominated by industry, in which the right to make a dollar at whatever cost is seldom challenged' still resonates strongly with the problems that societies face all over the world. One chapter heading, 'The obligation to endure', derived from the French biologist and philosopher Jean Rostand's famous observation that, 'the obligation to endure gives us the right to know'. United States President John F. Kennedy responded to the challenge posed by Carson by investigating DDT, leading to its complete ban in the US. The ban was followed by a range of institutions and regulations concerned with environmental issues in the US and elsewhere, driven by public demand for knowledge and protection.

    DDT was the primary tool used in the first global malaria eradication programme during the 1950s and 1960s. The insecticide is sprayed on the inner walls and ceilings of houses. Malaria has been successfully eliminated from many regions but remains endemic in large parts of the world. DDT remains one of the 12 insecticides — and the only organochlorine compound — currently recommended by the World Health Organization (WHO), and under the Stockholm Convention on Persistent Organic Pollutants, countries may continue to use DDT. Global annual use of DDT for disease vector control is estimated at more than 5 000 tonnes.

    It is clear that the social conscience awakened by Rachel Carson 50 years ago gave momentum to a groundswell of actions and interventions that are slowly but steadily making inroads at myriad levels. Chapter 17 of her book, 'The other road' reminds the reader of the opportunities that should have been seized much earlier. With more than 10 % of bird species worldwide now threatened in one way or another, it is clear that we missed early warnings or failed to act on them. Will we continue to miss signposts to 'other roads'? Are our obligations to endure met by our rights to know? As Carson said 50 years ago: 'The choice, after all, is ours to make.'

  • 16.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    Bornman, Riana
    University of Pretoria, South Africa.
    The paradox of the effectiveness or IRS insecticides (including DDT) and its impactson human health: What can we fix if it isn’t broken?2012Conference paper (Other academic)
  • 17.
    Bouwman, Henk
    et al.
    North-Wast University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Sereda, Barbara
    Plant Protection Research Institute, South Africa.
    Bornman, Rianna
    University of Pretoria, South Africa.
    DDT IN BREAST MILK: INTAKE, GENDER, AND DURATION OF LACTATION2011Conference paper (Other academic)
  • 18.
    Bouwman, Henk
    et al.
    Northwest Univerfsity, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, the Netherlands.
    DDT used in malaria control: It is now time for precaution.2011Conference paper (Other academic)
  • 19.
    Bouwman, Henk
    et al.
    Northwest University, South AFrica.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, the Netherlands.
    The paradox of DDT used in malaria control: It is now time for precaution.2012Conference paper (Other academic)
  • 20.
    Bouwman, Henk
    et al.
    Northwest University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies.
    van den Berg, Henk
    Wageningen University, South Africa.
    Bornman, Riana
    University of Pretoria, South Africa.
    Is precaution the way to manage the paradox of DDT use in malaria control?2012Conference paper (Other academic)
  • 21.
    Bouwman, Henk
    et al.
    North-West University, Potchefstroom, South Africa.
    van den Berg, Henk
    Wageningen University, Wageningen, the Netherlands.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Letter: DDT Paradox: Bouwman et al. Respond2011In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 119, no 10, p. A424-A425Article in journal (Other academic)
    Abstract [en]

    n/a

  • 22.
    Bouwman, Hindrik
    et al.
    North-West University, South Africa.
    Kylin, Henrik
    Linköping University, Department of Thematic Studies, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Bornman, Riana
    University of PRetoria, South Africa.
    ENVIRONMENTAL AND HUMAN HEALTH CONSEQUENCES OF DDT USED IN SOUTH AFRICAFOR MALARIA CONTROL2016In: Organohalogen Compounds, ISSN 1026-4892, Vol. 78, p. 1015-1017, article id 2.4001Article in journal (Refereed)
  • 23.
    Bouwman, Hindrik
    et al.
    North-West University, South Africa.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Bornman, Riana
    University of Pretoria, South Africa.
    Is Indoor Residual Spraying broken and what should be fixed?2015In: Proceedings of the 7th International Toxicology Symposium in Africa, 2015, p. 2-3Conference paper (Refereed)
    Abstract [en]

    Indoor residual spraying (IRS) has been and is still a very successful method to controlmalaria. We are concerned that not enough research attention is given to improvingIRS and that most funding goes towards modern but seemingly still ineffectualmethods. We believe that there is ample scope for improving IRS, while reducinginsecticide exposure

  • 24.
    Bouwman, Hindrik
    et al.
    North West University, South Africa .
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Sereda, Barbara
    Plant Protect Research Institute, South Africa .
    Bornman, Riana
    University of Pretoria, South Africa .
    High levels of DDT in breast milk: Intake, risk, lactation duration, and involvement of gender2012In: Environmental Pollution, ISSN 0269-7491, E-ISSN 1873-6424, Vol. 170, p. 63-70Article in journal (Refereed)
    Abstract [en]

    We investigated presence and levels of DDT in 163 breast milk samples from four South African villages where, in three of them, malaria is controlled with DDT-sprayed indoors. Mean Sigma DDT levels in breast milk were 18, 11, and 9.5 mg/kg mf (milk fat) from the three DDT-sprayed villages, respectively, including the highest Sigma DDT level ever reported for breast milk from South Africa (140 mg/kg mf). Understanding the causes for these differences would be informative for exposure reduction intervention. The Provisional Tolerable Daily Intake (PTDI) for DDT by infants, and the Maximum Residue Limit (MRL) were significantly exceeded. DDT had no effect on duration of lactation. There were indications (not significant) from DDT-sprayed villages that first-born female infants drink milk with more Sigma DDT than first-born male infants, and vice versa for multipara male and female infants, suggesting gender involvement on levels of DDT in breast milk - requiring further investigation.

  • 25.
    Cotgreave, Ian
    et al.
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Ghavanini, Ali Alavian
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Alfaro-Moreno, Ernesto
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Bergman, Åke
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Cederbrant, Karin
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Forsby, Anna
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Förare, Jonas
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Gustafsson, Åke
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Hellmond, Heike
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Lindberg, Johan
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Lupu, Diana
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Norinder, Ulf
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Rüegg, Joelle
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Tang, Mandy
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Öberg, Mattias
    Swedish Toxicology Sciences Research Center, Södertälje, Sweden.
    Kylin, Henrik
    Linköping University, The Tema Institute, Tema Environmental Change. Linköping University, Faculty of Arts and Sciences.
    Andersson, Patrik
    Department of Chemistry, Umeå University, Sweden.
    Zhang, Jin
    Department of Chemistry, Umeå University, Sweden.
    Bergdahl, Ingvar
    Department of Public Health and Clinical Medicine, Umeå University, Swetox.
    Jakobsson, Kristina
    Department of Public Health and Community Medicine, University of Gothenburg, Swetox.
    Lindh, Christian
    Division of Occupational and Environmental Medicine, Lund University.
    Demeneix, Barbara
    UMR CNRS/ MNHN 7221 Muséum National d'Histoire Naturelle, Paris France.
    Knudsen, Lisbeth
    Department of Public Health, Section of Occupational and Environmental Health, University of Copenhagen, Copenhagen Denmark.
    Pyriproxifen and microcephaly: an investigation of potential ties to the ongoing "Zika epidemic"2016Report (Other academic)
    Abstract [en]

    As part of the Swetox mission to react to emerging concerns in chemical health and environmental safety, a preliminary litterature investigation was undertaken to gather all readily available scientific information on PPF with respect to safety assessment, in order to better understand potential links between chemical exposure and the devopment of microcephaly in affected areas. Therefore the contents of the report do not constitute an attempt at either questioning the use of existing regulatory data in the manner prescribed by international regulatory proceedures, or as a new risk assessment, based on the scientific information and concepts discussed. Here we report our findings, with particular emphasis on exisiting regulatory information, potential for lack of translation of results from regulatory animal testing to humans, lack of human exposure data and suggestions on plausible mode(s) of action of PPF in human neurodevelopmental adversities such as microcephaly.

  • 26.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Arbetslivsinriktad rehabilitering2010In: Arbets- och Miljömedicin - en lärobok om hälsa och miljö / [ed] Christer Edling, Gunnar Nordberg, Maria Albin, Monica Nordberg, Lund: Studentlitteratur , 2010, 3, p. 117-130Chapter in book (Other academic)
    Abstract [sv]

    Arbets- och miljömedicin

    – en lärobok om hälsa och miljö

    Läroboken i arbets- och miljömedicin tar upp dagsaktuella frågor och ger förslag på hantering av arbets- och miljömedicinska ärenden.

    Detta är den svenska lärobok som försöker samla hela det stora kunskapsområdet inom arbets- och miljömedicin. Med hänsyn till dynamiken inom området har i denna 3:e upplaga skett en uppdatering, förnyelse och komplettering. Den har fem nyskrivna kapitel: Arbets- och miljörelaterade hudsjukdomar – särskilt kontakteksem och prevention, Belastningsrelaterade sjukdomar, Ersättning vid arbetsskada, Företagshälsovård samt Luftföroreningar, global klimatpåverkan och hälsa. Liksom tidigare ges epidemiologi och toxikologi ett stort utrymme då dessa redskap utgör grunden för riskbedömning och riskkommunikation. Handläggning av arbets- och miljömedicinska larm presenteras som ett exempel på riskkommunikation. I särskilda kapitel behandlas psykosociala frågor och arbetsorganisation, hjärt-kärlsjukdomar samt arbetslivsinriktad rehabilitering. Kemiska hälsorisker är fortfarande aktuella och fordrar ofta miljöövervakning i form av biologiska exponeringsmarkörer och markörer för biologisk effekt, ex. genetiska förändringar. Miljöns påverkan på foster, reproduktion och cancer beskrivs, liksom miljörelaterade luftvägssjukdomar. Traditionella områden som buller, vibrationer, bekämpningsmedel, livsmedel och matförgiftning behandlas också. Översiktligt diskuteras aktuella arbets- och miljömedicinska frågor som klorering och hälsa, perfluorerade ämnen, nanomaterial och effekter av arbetslöshet. Ett särskilt kapitel ägnas åt etiska frågor inom arbets- och miljömedicin.

  • 27.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Eklund, Mona
    Lunds universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Kunskapsbaserade åtgärder för att främja arbetsförmåga och återgång i arbete2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Hensing, Lund: Studentlitteratur AB, 2015, 1, p. 219-233Chapter in book (Other academic)
  • 28.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Eklund, Mona
    Lunds universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Perspektiv på arbetsförmåga2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Mensing, Lund: Studentlitteratur AB, 2015, 1, p. 19-31Chapter in book (Other academic)
  • 29.
    Ekberg, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Erlandsson, Lena-Karin
    Lunds universitet, Institutionen för hälsovetenskaper.
    Lättare psykisk ohälsa2015In: Återgång i arbete: processer, bedömningar, åtgärder / [ed] Kerstin Ekberg, Mona Eklund, Gunnel Hensing, Lund: Studentlitteratur AB, 2015, 1, p. 111-128Chapter in book (Other academic)
  • 30.
    Ericsson, Maria
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Jensen, Per
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Domestication and ontogeny effects on the stress response inyoung chickens (Gallus gallus)2016In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 6, article id 6_35818Article in journal (Refereed)
    Abstract [en]

    Domestication is thought to increase stress tolerance. The connection between stressor exposure,glucocorticoids and behavioural responses has been studied in adults, where domestication effectsare evident. Early stress exposure may induce detrimental effects both in short-and long term.Previous research has reported a lack of glucocorticoid response in newly hatched chickens (Gallusgallus), whereas others have found opposite results. Hence it remains unclear whether the HPA-axis isfunctional from hatch, and if domestication has affected the early post-hatch ontogeny of the stressresponse. Our aims were to investigate the early ontogeny of the HPA-axis and characterize behaviouraland hormonal stress responses in ancestral Red Junglefowl and in two domestic layer strains. Plasmacorticosteone and behavioural responses before and after physical restraint was measured on dayone, nine, 16 and 23 post hatch. The results showed significant increases of corticosterone after stressin all three breeds at all the different ages. The HPA-response decreased with age and was lower inRed Junglefowl. Behavioural responses also decreased with age, and tended to be stronger in RedJunglefowl. In summary, the HPA-axis is reactive from day one, and domestication may have affectedits development and reactivity, alongside with related behaviour responses.

  • 31.
    Fagerlind Ståhl, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Smith, Peter
    Inst Work and Hlth, Canada; Univ Toronto, Canada; Monash Univ, Australia.
    Longitudinal association between psychological demands and burnout for employees experiencing a high versus a low degree of job resources2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 915Article in journal (Refereed)
    Abstract [en]

    Background: Exhaustion and burnout are common causes for sickness absence. This study examines the relationship between psychological demands and burnout over time, and if environmental support modifies the longitudinal relationship between psychological demands and burnout at baseline, with burnout measured 2 years subsequently. Methods: A questionnaire was sent to employees in seven Swedish organizations in 2010-2012 with follow-up after 2 years, n = 1722 responded (64%). Linear regressions were used to examine the associations between burnout and psychological demands at baseline and burnout at follow-up. Stratified regression models examined if relationships between burnout and psychological demands at baseline on burnout at follow-up differed for employees in supportive versus unsupportive work environments. Results: Burnout and psychological demands at baseline were associated with burnout at follow-up, after adjustment for study covariates. No significant differences were observed between estimates for psychological demands and burnout among respondents in supportive work environments versus those in unsupportive work environments. Conclusions: This study shows that high demands are associated with greater risk of burnout, regardless of level of other work supports. This has implications for prevention of sick leave due to burnout and for rehabilitation, where demands such as work pace, workload and conflicting demands at work may need to be reduced.

  • 32.
    Flodin, Ulf
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Rolander, B.
    Jonkoping Univ, Sweden; Futurum, Sweden.
    Lofgren, H.
    Ryhov Hosp, Sweden.
    Krapi, Blerim
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Nyqvist, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Wåhlin, Charlotte
    Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Unit of Intervention and Implementation Research, Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Risk factors for neck pain among forklift truck operators: a retrospective cohort study2018In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, article id 44Article in journal (Refereed)
    Abstract [en]

    Background

    No previous research has been performed into neck pain among forklift operators. This is a common complaint among these workers, who number around 150,000 in Sweden and six million in Europe. The aim of the study was to examine long-term exposure to unnatural neck positions among forklift operators as a risk factor for neck pain.

    Methods

    A retrospective cohort study was conducted of all eligible employees at a high-level warehouse. Forklift operators and office workers answered an 18-page questionnaire comprising questions about joint pain, work tasks, work postures and year of start for all items. By using person years in the exposed and less-exposed groups before start of neck pain we were able to calculate Incident Rate ratios for various exposures.

    Results

    Forty nine percent of the forklift operators reported having experienced neck pain compared to 30 % of office workers. Being a forklift operator was associated with an increased risk of neck pain (OR = 5.1, 95% CI 1.4–18.2). Holding the head in an unnatural position resulted in significantly increased risks for neck pain, irrespective of type of position. The risks for neck pain remained after taking other ergonomic exposures and psychosocial aspects into consideration.

    Conclusions

    This is the first published study showing that forklift operators have an increased risk of neck pain. The results are therefore of significance for improving work schedules, the adjustment of work tasks for these workers and the design of the vehicles.

  • 33.
    Fornander, Louise
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Upper Airway Mucosal Inflammation: Proteomic Studies after Exposure to Irritants and Microbial Agents2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    People are, in their daily lives, exposed to a number of airborne foreign compounds that do not normally affect the body. However, depending on the nature of these compounds, dose and duration of exposure, various airway symptoms may arise. Early symptoms are often manifested as upper airway mucosal inflammation which generates changes in protein composition in the airway lining fluid.

    This thesis aims at identifying, understanding mechanisms and characterizing protein alterations in the upper airway mucosa that can be used as potential new biomarkers for inflammation in the mucosa. The protein composition in the mucosa was studied by sampling of nasal lavage fluid that was further analyzed with a proteomic approach using twodimensional gel electrophoresis and mass spectrometry. Additionally, by studying factors on site through environmental examination, health questionnaires and biological analyses, we have tried to understand the background to these protein alterations and their impact on health.

    Respiratory symptoms from the upper airways are common among people who are exposed to irritative and microbial agents. This thesis have focused on personnel in swimming pool facilities exposed to trichloramine, metal industry workers exposed to metalworking fluids, employees working in damp and moldy buildings and infants diagnosed with respiratory syncytial virus infection. The common denominator in these four studies is that the subjects experience upper airway mucosal inflammation, which is manifested as cough, rhinitis, phlegm etc. In the three occupational studies, the symptoms were work related. Notably, a high prevalence of perceived mucosal symptoms was shown despite the relatively low levels of airborne irritants revealed by the environmental examination. Protein profiling verified an ongoing inflammatory response by identification of several proteins that displayed altered levels. Interestingly, innate immune proteins dominated and four protein alterations occurred in most of the studies; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin. Similarly, these proteins were also found in nasal fluid from children with virus infection and in addition a truncated form of SPLUNC1 and two other S100 proteins (S100A7-like 2 and S100A16), not previously found in nasal secretion, were identified.

    Altogether, the results indicate the potential use of a proteomic approach for identifying new biomarkers for the upper respiratory tract at an early stage in the disease process after exposure to irritant and microbial agents. The results indicate an effect on the innate immunity system and the proteins; SPLUNC1, protein S100A8 and S100A9 and alpha-1-antitrypsin are especially promising new biomarkers. Moreover, further studies of these proteins may help us to understand the molecular mechanisms involved in irritant-induced airway inflammation.

    List of papers
    1. Innate immunity proteins and a new truncated form of SPLUNC1 in nasopharyngeal aspirates from infants with respiratory syncytial virus infection
    Open this publication in new window or tab >>Innate immunity proteins and a new truncated form of SPLUNC1 in nasopharyngeal aspirates from infants with respiratory syncytial virus infection
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    2011 (English)In: PROTEOMICS CLINICAL APPLICATIONS, ISSN 1862-8346, Vol. 5, no 9-10, p. 513-522Article in journal (Refereed) Published
    Abstract [en]

    Purpose: Respiratory syncytial virus (RSV) is the most common cause of severe respiratory tract infection in infants. The aim was to identify host defence components in nasopharyngeal aspirate (NPA) from infants with RSV infection and to study the expression of the novel 25 kDa innate immunity protein SPLUNC1. less thanbrgreater than less thanbrgreater thanExperimental design: NPAs from infants were analyzed with 2-DE and MS in a pilot study. The levels of SPLUNC1 were analyzed with immunoblotting in 47 NPAs, admitted for RSV diagnosis. less thanbrgreater than less thanbrgreater thanResults: Totally, 35 proteins were identified in NPA, including several innate immunity proteins such as group X phospholipase A(2), different S100 proteins and SPLUNC1. In addition, a new truncated 15 kDa form of SPLUNC1 was identified that was detected in about 50% of the aspirates admitted for RSV diagnosis. RSV-positive boys had significantly less 25 kDa SPLUNC1 than RSV-negative boys while there were no significant differences among girls. less thanbrgreater than less thanbrgreater thanConclusions and clinical relevance: Several important innate immunity proteins were identified in NPA. Notably, a new truncated form of the newly suggested anti-bacterial protein SPLUNC1 was found. It is possible that a decrease in SPLUNC1 in the upper airways may increase the risk for severe pneumonia in boys.

    Place, publisher, year, edition, pages
    Wiley-VCH Verlag Berlin, 2011
    Keywords
    MS, Nasopharynx, PLUNC, Respiratory syncytial virus, Two-dimensional gel electrophoresis
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72142 (URN)10.1002/prca.201100016 (DOI)000296418400005 ()
    Note
    Funding Agencies|The Research Council of South East Sweden|FORSS-36761- 8505|Available from: 2011-11-18 Created: 2011-11-18 Last updated: 2015-04-23
    2. Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids
    Open this publication in new window or tab >>Airway irritation among indoor swimming pool personnel: trichloramine exposure, exhaled NO and protein profiling of nasal lavage fluids
    2013 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 5, p. 571-580Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    Occurrence of airway irritation among indoor swimming pool personnel was investigated. The aims of this study were to assess trichloramine exposure levels and exhaled nitric oxide in relation to the prevalence of airway symptoms in swimming pool facilities and to determine protein effects in the upper respiratory tract.

    Methods

    The presence of airway symptoms related to work was examined in 146 individuals working at 46 indoor swimming pool facilities. Levels of trichloramine, as well as exhaled nitric oxide, were measured in five facilities with high prevalence of airway irritation and four facilities with no airway irritation among the personnel. Nasal lavage fluid was collected, and protein profiles were determined by a proteomic approach.

    Results

    17 % of the swimming pool personnel reported airway symptoms related to work. The levels of trichloramine in the swimming pool facilities ranged from 0.04 to 0.36 mg/m3. There was no covariance between trichloramine levels, exhaled nitric oxide and prevalence of airway symptoms. Protein profiling of the nasal lavage fluid showed that the levels alpha-1-antitrypsin and lactoferrin were significantly higher, and S100-A8 was significantly lower in swimming pool personnel.

    Conclusions

    This study confirms the occurrence of airway irritation among indoor swimming pool personnel. Our results indicate altered levels of innate immunity proteins in the upper airways that may pose as potential biomarkers. However, swimming pool facilities with high prevalence of airway irritation could not be explained by higher trichloramine exposure levels. Further studies are needed to clarify the environmental factors in indoor swimming pools that cause airway problems and affect the immune system.

    Place, publisher, year, edition, pages
    Springer, 2013
    Keywords
    Innate immunity, Occupational medicine, roteomics, Upper respiratory tract
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-86713 (URN)10.1007/s00420-012-0790-4 (DOI)000320394300008 ()22729567 (PubMedID)
    Available from: 2012-12-25 Created: 2012-12-25 Last updated: 2017-12-06Bibliographically approved
    3. Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids
    Open this publication in new window or tab >>Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids
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    2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 12, p. e83089-Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF) and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions.

    METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde) generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach.

    RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms.

    CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

    Place, publisher, year, edition, pages
    Public Library of Science, 2013
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-103739 (URN)10.1371/journal.pone.0083089 (DOI)000329325200035 ()24391738 (PubMedID)
    Available from: 2014-01-24 Created: 2014-01-24 Last updated: 2019-02-11Bibliographically approved
    4. Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated to moldy and damp buildings
    Open this publication in new window or tab >>Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated to moldy and damp buildings
    Show others...
    2016 (English)In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 26, no 5, p. 743-754Article in journal (Refereed) Published
    Abstract [en]

    Upper airway irritation is common among individuals working in moldy and damp buildings. The aim was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 exposed subjects and 13 controls. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increa e of protein S100-A8 and decrease of SPLUNC1 in subjects from one workplace while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared to healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separate when the dampness is associated with the presence of molds.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2016
    Keywords
    Sick building syndrome, proteomics, nasal mucosa, SPLUNC1, alpha-1-antitrypsin, protein S100-A8
    National Category
    Occupational Health and Environmental Health Infectious Medicine
    Identifiers
    urn:nbn:se:liu:diva-117339 (URN)10.1111/ina.12257 (DOI)000387348500009 ()
    Note

    Funding agencies: Research Council of South East Sweden [FORSS-222751, FORSS-389061]; Cancer and Allergy Foundation [150441]

    Available from: 2015-04-23 Created: 2015-04-23 Last updated: 2018-01-11Bibliographically approved
  • 34.
    Govorov, Igor
    et al.
    Karolinska Inst, Sweden.
    Bremme, Katarina
    Karolinska Inst, Sweden.
    Lindahl, Tomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Holmstrom, Margareta
    Karolinska Univ, Sweden.
    Komlichenko, Eduard
    Almazov Natl Med Res Ctr, Russia.
    Chaireti, Roza
    Karolinska Inst, Sweden.
    Mints, Miriam
    Karolinska Inst, Sweden.
    Thrombin generation during a regular menstrual cycle in women with von Willebrand disease2018In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 17467Article in journal (Refereed)
    Abstract [en]

    Fluctuations of the sex steroids during the menstrual cycle might significantly influence hemostasis. This association, derived from a number of the observations on healthy women, is yet to be described in females affected by bleeding disorders. The aim of the current study was to assess the changes in hemostatic variables in women with vWD during two phases of the menstrual cycle (follicular and luteal) and to compare it with healthy controls. The study group included 12 vWD-affected females with regular menstrual cycle, with none of them being prescribed any hormonal treatment. The control group consisted of 102 healthy females, matched for age and BMI. Within the vWD group FVIII and FX were both significantly higher during follicular phase than in luteal phase (p=0.013 and p=0.033 respectively). AT, FII, FVII and FX were higher in women with vWD, compared with controls during both phases of the menstrual cycle (pamp;lt;0.0005, pamp;lt;0.0005, p=0.001 and pamp;lt;0.0005). In women with vWD, lag time and time to peak were prolonged during both phases of the menstrual cycle(pamp;lt;0.0005), while peak thrombin concentration was reduced (p=0.003 and p=0.002 during follicular and luteal phase respectively) compared to healthy peers. Lower levels of FVIII and FX during luteal phase may predispose women to the development of the menorrhagia - common complication of vWD. Women with vWD need more time to reach the peak thrombin concentration, while the latter still remains less than in healthy women. Higher levels of AT in vWD-affected females, compared to controls, may also contribute to the existing bleeding tendency in this cohort.

  • 35.
    Graff, Pal
    et al.
    Orebro Univ, Sweden; Natl Inst Occupat Hlth STAMI, Norway.
    Bryngelsson, Ing-Liss
    Orebro Univ, Sweden.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Flodin, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Adult onset asthma in non-allergic women working in dampness damaged buildings: A retrospective cohort study2019In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 62, no 4, p. 357-363Article in journal (Refereed)
    Abstract [en]

    Background There is still no consensus about the association between working in dampness-damaged buildings and new onset of asthma among adults. The purpose of this study was to assess asthma in the staff of two psychiatric clinics where some premises were suffering from dampness. Methods A 20-year retrospective cohort study was performed using questionnaires. Results Incidence rate ratios (IRR) for asthma were non-significantly elevated (IRR = 2.3) among exposed individuals. The risk was greater among females (IRR = 3.5, 95% CI 1.0-16). IRR for non-atopic women was 8.8 (95% CI 1.4-196). Adjusting for smoking habits weakened the risks marginally (IRR = 7.3, 95% CI 1.1-167). The number of male participants was too low to draw conclusion regarding the risk for men. Conclusion The results suggest that working in dampness-damaged buildings might be a possible health hazard. This finding is most pronounced in non-atopic females.

  • 36.
    Graff, Pål
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine.
    Elmsjo, Lisa
    Eksjo Industrial Health Care Unit.
    Bjorkander, Janne
    Ryhov City Hospital.
    Flodin, Ulf
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Occupational and Environmental Medicine. Östergötlands Läns Landsting, Centre for Medicine, Occupational and Environmental Medicine Centre.
    Occupational rhinitis caused by tolyltriazole in metalworking fluids2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 5, p. 403-404Article in journal (Other academic)
    Abstract [en]

    Objectives: Exposure to metalworking fluids is known to cause mucous membrane inflammation of the airways. In this case report, the authors attempted to identify responsible components in the metalworking fluids for the rhinitis of an exposed patient.

    Methods: The patient underwent two provocation tests. The first provocation was performed with the different metalworking fluids used in the factory, and the second was done double blind for some of the components in the metalworking fluids. The patient was asked to quantify her symptoms before, immediately after, 24 hours after, and finally 96 hours after the exposure.

    Results: The patient reacted to tolyltriazole with rhinitis and headache. These symptoms started about 8 hours after the exposure and persisted for 24 hours.

    Conclusion: The double-blind provocation exposure to the components of the metalworking fluids showed that the patient reacted to the corrosion inhibitor tolyltriazole. To the authors knowledge, no such reaction to tolyltriazole in the airways has previously been reported.

  • 37.
    Hedlund, Louise
    et al.
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Whittle, Rosemary
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Jensen, Per
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Effects of commercial hatchery processing on short- and long-term stress responses in laying hens2019In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 2367Article in journal (Refereed)
    Abstract [en]

    In commercial egg production, chicks are exposed to a potentially stressful procedure during their first day of life. Here, we investigated how this procedure affects the chickens in a short-as well as long-term perspective by conducting two behaviour tests and measuring corticosterone (CORT) and sex hormone levels at different time points. These results were compared with a group of control chickens from the same hatchery and incubator that did not go through the commercial hatchery routine. Chickens were continuously weighed, egg production data was collected and feather scoring was performed. We found that chicks have a significant increase in CORT during the hatchery process, which implies they are exposed to stress. During first weeks of life, these chicks were more fearful, had a higher CORT reactivity during restraint and weighed more than control chicks. Later in life, hatchery treated chickens had more feather damages and injuries on combs and wattles, a faster onset of egg laying and higher levels of estradiol. We conclude that processing at the commercial hatchery was a stressful event with short-and long-term effects on behaviour and stress reactivity, and potentially also positive effects on production. The results are relevant for a large number of individuals, since the chicken is by far the globally most common farm animal.

  • 38.
    Hedman, Anna
    et al.
    Karolinska Inst, Sweden.
    Breithaupt, Lauren
    Karolinska Inst, Sweden; George Mason Univ, VA 22030 USA.
    Hubel, Christopher
    Karolinska Inst, Sweden; Kings Coll London, England.
    Thornton, Laura M.
    Univ N Carolina, NC 27599 USA.
    Tillander, Annika
    Linköping University, Department of Computer and Information Science, The Division of Statistics and Machine Learning. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Norring, Claes
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Birgegard, Andreas
    Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Larsson, Henrik
    Karolinska Inst, Sweden; Orebro Univ, Sweden.
    Ludvigsson, Jonas F.
    Karolinska Inst, Sweden; Orebro Univ Hosp, Sweden.
    Savendahl, Lars
    Karolinska Inst, Sweden.
    Almqvist, Catarina
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Bulik, Cynthia M.
    Karolinska Inst, Sweden; Univ N Carolina, NC 27599 USA; Univ N Carolina, NC 27515 USA.
    Bidirectional relationship between eating disorders and autoimmune diseases2019In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, no 7, p. 803-812Article in journal (Refereed)
    Abstract [en]

    Background Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases. Methods In this nationwide population-based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs. Results We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal-related autoimmune diseases such as, celiac disease and Crohns disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED. Conclusions The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.

  • 39.
    Helmfrid, Ingela
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Salihovic, Samira
    Örebro University.
    van Bavel, Bert
    Örebro University.
    Wingren, Gun
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Berglund, Marika
    Karolinska institutet, Stockholm.
    Exposure and body burden of polychlorinated biphenyls (PCB) and metals in a historically contaminated community.2015In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 76, p. 41-8Article in journal (Refereed)
    Abstract [en]

    There are many small villages where environmental contamination is substantial due to historical industrial activities. The aim of the present study was to investigate if long-term or current consumption of local foods, as reported in food frequency questionnaires, co-vary with measured concentrations of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), lead (Pb), cadmium (Cd) and mercury (Hg) in blood, urine and hair from a population living in a historically contaminated village. Blood, urine and hair were provided by men (n=38) and women (n=57), who had participated in a previous case-control study in the contaminated area, and were analyzed for PCB, OCPs, Pb, Cd and Hg. A detailed food frequency questionnaire, used in the previous epidemiological study, was repeated, and up-dated information of life-style, exposure factors and other covariates was collected. Associations between reported consumption of local foods and exposure biomarkers were explored in relation to age, gender, life-style factors and other covariates. A large part of the population in the area reported consumption of local food, and thus, was potentially exposed to the contaminants. Despite the limited number of participants and other weaknesses described, it was possible to link reported consumption of different foods to biomarker concentrations. Reported consumption of local vegetables, forest berries and mushrooms co-varied with urinary Cd, indicating an influence from the contaminated area on the Cd exposure. We found no associations between PCB plasma concentrations with reported consumption of local fish, but with consumption of herring (non-local sea fish) which is typically high in PCB. Pesticide (HCB, p,p'-DDE, trans-nonachlor) exposure was mainly associated with agricultural work and having a private well the first five years of life, but we found no associations between pesticide concentrations in plasma and consumption of local vegetables or fish. Exposure to Hg was associated with consumption of fish, both local and non-local, and Pb exposure was associated with the consumption of game. Overall, the contaminant concentrations measured in blood, urine and hair varied substantially among study participants, but on average, the concentrations were similar to concentrations measured in other groups of the general Swedish population in the same age range. Larger studies are needed to evaluate health risks (and causality) associated with historical environmental contamination.

  • 40.
    Jarvis, Benjamin
    et al.
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Kawalerowicz, Juta
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Valdez, Sarah
    Linköping University, Department of Management and Engineering, The Institute for Analytical Sociology, IAS. Linköping University, Faculty of Arts and Sciences.
    Impact of ancestry categorisations on residential segregation measures using Swedish register data2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, p. 62-65Article in journal (Refereed)
    Abstract [en]

    Aim: Country-of-birth data contained in registers are often aggregated to create broad ancestry group categories. We examine how measures of residential segregation vary according to levels of aggregation. Method: We use Swedish register data to calculate pairwise dissimilarity indices from 1990 to 2012 for ancestry groups defined at four nested levels of aggregation: (1) micro-groups containing 50 categories, (2) meso-groups containing 16 categories, (3) macro-groups containing six categories and (4) a broad Western/non-Western binary. Results: We find variation in segregation levels between ancestry groups that is obscured by data aggregation. Conclusions: This study demonstrates that the practice of aggregating country-of-birth statistics in register data can hinder the ability to identify highly segregated groups and therefore design effective policy to remedy both intergroup and intergenerational inequalities.

  • 41.
    Johansson Capusan, Andrea
    et al.
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine.
    Kuja-Halkola, R.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Viding, E.
    Developmental Risk and Resilience Unit, University College, London UK.
    McCrory, E.
    Developmental Risk and Resilience Unit, University College, London UK.
    Marteinsdottir, Ina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Larsson, H.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden / Department of Medical Sciences, Örebro University, Örebro, Sweden.
    Childhood maltreatment and attention deficit hyperactivity disorder symptoms in adults: a large twin study2016In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, no 12, p. 2637-2646Article in journal (Refereed)
    Abstract [en]

    Background

    Childhood maltreatment (CM) has been associated with increased risk of attention deficit hyperactivity disorder (ADHD) in children and adults. It is, however, unclear whether this association is causal or due to familial confounding.

    Method

    Data from 18 168 adult twins, aged 20–46 years, were drawn from the population-based Swedish twin registry. Retrospective self-ratings of CM (emotional and physical neglect, physical and sexual abuse and witnessing family violence), and self-ratings for DSM-IV ADHD symptoms in adulthood were analysed. Possible familial confounding was investigated using a within twin-pair design based on monozygotic (MZ) and dizygotic (DZ) twins.

    esults

    CM was significantly associated with increased levels of ADHD symptom scores in adults [regression coefficient: 0.40 standard deviations, 95% confidence interval (CI) 0.37–0.43]. Within twin-pair analyses showed attenuated but significant estimates within DZ (0.29, 95% CI 0.21–0.36) and MZ (0.18, 95% CI 0.10–0.25) twin pairs. Similar results emerged for hyperactive/impulsive and inattentive ADHD symptom scores separately in association with CM. We conducted sensitivity analyses for early maltreatment, before age 7, and for abuse and neglect separately, and found similarly reduced estimates in DZ and MZ pairs. Re-traumatization after age 7 did not significantly influence results.

    Conclusions

    CM was significantly associated with increased ADHD symptoms in adults. Associations were partly due to familial confounding, but also consistent with a causal interpretation. Our findings support cognitive neuroscience studies investigating neural pathways through which exposure to CM may influence ADHD. Clinicians treating adults with ADHD should be aware of the association with maltreatment.

  • 42.
    Jonsson, Anna K.
    et al.
    National Board Forens Med, Department Forens Genet and Forens Toxicol, S-58758 Linkoping, Sweden.
    Lövborg, Henrik
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Lohr, Wolfgang
    Umeå University, Sweden.
    Ekman, Bertil
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Rocklov, Joacim
    Umeå University, Sweden; Heidelberg University, Germany.
    Increased Risk of Drug-Induced Hyponatremia during High Temperatures2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 7, article id 827Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the relationship between outdoor temperature in Sweden and the reporting of drug-induced hyponatremia to the Medical Products Agency (MPA). Methods: All individual adverse drug reactions (ADR) reported to MPA from 1 January 2010 to 31 October 2013 of suspected drug-induced hyponatremia and random controls were identified. Reports where the ADR had been assessed as having at least a possible relation to the suspected drug were included. Information on administered drugs, onset date, causality assessment, sodium levels, and the geographical origin of the reports was extracted. A case-crossover design was used to ascertain the association between heat exposure and drug-induced hyponatremia at the individual level, while linear regression was used to study its relationship to sodium concentration in blood. Temperature exposure data were obtained from the nearest observation station to the reported cases. Results: During the study period, 280 reports of hyponatremia were identified. More cases of drug-induced hyponatremia were reported in the warmer season, with a peak in June, while other ADRs showed an opposite annual pattern. The distributed lag non-linear model indicated an increasing odds ratio (OR) with increasing temperature in the warm season with a highest odds ratio, with delays of 1-5 days after heat exposure. A cumulative OR for a lag time of 1 to 3 days was estimated at 2.21 at an average daily temperature of 20 degrees C. The change in sodium per 1 degrees C increase in temperature was estimated to be -0.37 mmol/L (95% CI: -0.02, -0.72). Conclusions: Warm weather appears to increase the risk of drug-induced hyponatremia.

  • 43.
    Jood, Katarina
    et al.
    University of Gothenburg, Sweden; Sahlgrens University Hospital, Sweden.
    Karlsson, Nadine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Medin, Jennie
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Pessah-Rasmussen, Helene
    Lund University, Sweden.
    Wester, Per
    Umeå University, Sweden; Danderyd Hospital, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    The psychosocial work environment is associated with risk of stroke at working age2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 4, p. 367-374Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to explore the relation between the risk of first-ever stroke at working age and psychological work environmental factors. Methods A consecutive multicenter matched 1:2 case control study of acute stroke cases (N=198, age 30-65 years) who had been working full-time at the time of their stroke and 396 sex- and age-matched controls. Stroke cases and controls answered questionnaires on their psychosocial situation during the previous 12 months. The psychosocial work environment was assessed using three different measures: the job control demand model, the effort reward imbalance (ERI) score, and exposures to conflict at work. Results Among 198 stroke cases and 396 controls, job strain [odds ratio (OR) 1.30, 95% confidence interval (95% CI) 1.05-1.62], ERI (OR 1.28, 95% CI 1.01-1.62), and conflict at work (OR 1.75, 95% CI 1.07-2.88) were independent risk factors of stroke in multivariable regression models. Conclusions Adverse psychosocial working conditions during the past 12 months were more frequently observed among stroke cases. Since these factors are presumably modifiable, interventional studies targeting job strain and emotional work environment are warranted.

  • 44.
    Kaiser, Gudrun
    et al.
    Philipps Univ Marburg, Germany.
    Kues, Johanna N.
    Philipps Univ Marburg, Germany.
    Kleinstaeuber, Maria
    Philipps Univ Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Weise, Cornelia
    Philipps Univ Marburg, Germany.
    Methods for coping with premenstrual change: Development and validation of the German Premenstrual Change Coping Inventory2018In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 58, no 9, p. 1062-1079Article in journal (Refereed)
    Abstract [en]

    During the premenstrual phase, psychological and physiological changes can occur, which are associated with different levels of disability. When they appear with Premenstrual Dysphoric Disorder (PMDD), different coping strategies may be used by women to deal with premenstrual changes. Currently no German measure exists for assessing premenstrual symptom-related coping strategies. Therefore, we developed the Premenstrual Change Coping Inventory (PMS-Cope). First, the 33-item questionnaire was tested with an exploratory factor analytic approach (EFA) in a sample of 150 women prospectively diagnosed with PMDD or severe Premenstrual Syndrome from August 2013 until March 2016. The EFA resulted in a 12-item scale with a two-factor structure: "seeking positive affect-inducing activities" and "seeking support"; Cronbach`s alpha of 0.73 and 0.71, respectively, demonstrated good reliability for both factors. Confirmatory factor analysis based on a second sample of 89 women conducted from May 2016 until June 2016 confirmed the two-factor structure. Additionally, a potential third factor "healthcare use behavior" was tested with an EFA. For the three-factor solution, satisfactory Cronbachs alpha values (0.70-0.72) were detected. The PMS-Cope was shown to be a valid, reliable, and economic measure. In future research, cross validations and confirmatory factor analyses with the three-factor solution should be conducted.

  • 45.
    Karlén, Jerker
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Ludvigsson, Johnny
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Hedmark, Max
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Olsen Faresjö, Åshild
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Faresjö, Tomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Early Psychosocial Exposures, Hair Cortisol Levels, and Disease Risk2015In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 135, no 6, p. E1450-E1457Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Early psychosocial exposures are increasingly recognized as being crucial to health throughout life. A possible mechanism could be physiologic dysregulation due to stress. Cortisol in hair is a new biomarker assessing long-term hypothalamic-pituitary-adrenal axis activity. The objective was to investigate whether early-life adverse psychosocial circumstances influence infant cortisol levels in hair and health outcomes in children prospectively until age 10. METHODS: A cohort study in the general community using a questionnaire covering 11 psychosocial items in the family during pregnancy and the cumulative incidence of diagnoses until age 10 years in 1876 children. Cortisol levels in hair were measured by using a radioimmunoassay in those with sufficient hair samples at age 1, yielding a subsample of n = 209. RESULTS: Children with added psychosocial exposures had higher infant cortisol levels in hair (B = 0.40, P less than .0001, adjusted for gender and size for gestational age) in a cumulative manner and were significantly more often affected by 12 of the 14 most common childhood diseases, with a general pattern of increasing odds ratios. CONCLUSIONS: The findings support the model of physiologic dysregulation as a plausible mechanism by which the duration and number of early detrimental psychosocial exposures determine health outcomes. The model indicates that the multiplicity of adversities should be targeted in future interventions and could help to identify children who are at high risk of poor health. Furthermore, given the prolonged nature of exposure to a stressful social environment, the novel biomarker of cortisol in hair could be of major importance.

  • 46.
    Kues, Johanna N.
    et al.
    University of Marburg, Germany.
    Janda, Carolyn
    University of Marburg, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    How to measure the impact of premenstrual symptoms? Development and validation of the German PMS-Impact Questionnaire2016In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 56, no 7, p. 807-826Article in journal (Refereed)
    Abstract [en]

    With 75% of women of reproductive age affected, premenstrual symptoms are very common, ranging from emotional and cognitive to physical symptoms. Premenstrual Syndrome and Premenstrual Dysphoric Disorder can lead to substantial functional interference and psychological distress comparable to that of dysthymic disorders. The assessment of this impact is required as a part of the diagnostic procedure in the DSM-5. In the absence of a specific measure, the authors developed the PMS-Impact Questionnaire. A sample of 101 women reporting severe premenstrual complaints was assessed with the twenty-two items in the questionnaire during their premenstrual phase in an ongoing intervention study at the Philipps-University Marburg from August 2013 until January 2015. An exploratory factor analysis revealed a two-factor solution (labeled Psychological Impact and Functional Impact) with 18 items. A Cronbachs alpha of 0.90 for Psychological Impact and of 0.90 for Functional Impact indicated good reliability. Convergent construct validity was demonstrated by moderate to high correlations with the Pain Disability Index. Low correlations with the Big Five Inventory-10 indicated good divergent validity. The PMS-Impact Questionnaire was found to be a valid, reliable, and an economic measure to assess the impact of premenstrual symptoms. In future research, cross validations and confirmatory factor analyses should be conducted.

  • 47.
    Kumar, Manasi
    et al.
    Univ Nairobi, Kenya; UCL, England.
    Wangari Kuria, Mary
    Univ Nairobi, Kenya.
    Othieno, Caleb Joseph
    Univ Nairobi, Kenya.
    Falkenström, Fredrik
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Improving psychotherapies offered in public hospitals in Nairobi, Kenya: extending practice-based research model for LMICs2018In: International Journal of Mental Health Systems, ISSN 1752-4458, E-ISSN 1752-4458, Vol. 12, article id 76Article in journal (Refereed)
    Abstract [en]

    BackgroundPsychotherapy and mental health services in Nairobis public hospitals are increasing. Rather than prematurely imposing psychotherapy protocols developed in Western countries to Kenya, we argue that first studying psychological interventions as they are practiced may generate understanding of which psychological problems are common, what interventions therapists use, and what seems to be effective in reducing psychiatric problems in a lower and middle income country like Kenya.MethodWe present preliminary findings from a process-outcome study involving 345 patients from two public institutions, Kenyatta National and Mathare National Hospitals. We asked our patients to fill out a brief personal information questionnaire, Clinical Outcomes in Routine Evaluation-Outcome Measure (Evans et al. in Br J Psychiatry 180:51-60, 2002, and the Session Alliance Inventory (Falkenstrom et al. in Psychol Assess 27:169-183, 2015) after each session. We present descriptives for CORE-OM, patient-therapist concordance on the SAI, and using longitudinal mixed-effects model, test change in CORE-OM over time with various therapy and patient factors as predictors in regression analyses.ResultsThe majority of patients who attended the outpatient care clinics were young males. Our regression analysis suggested that patients with depression reported higher initial distress levels (2.75 CORE-OM scores, se=1.11, z=2.48, p=0.013, 95% CI 0.57-4.93) than patients with addictions, anxiety, or psychosis. Older clients improved slower (0.08 CORE-OM scores slower improvement per session per year older age; se=0.03, z=3.02 p=0.003, 95% CI 0.03, 0.14). Female patients reported higher initial distress than men (2.62 CORE-OM scores, se=1.00, z=2.61, p=0.009, 95% CI 0.65, 4.58). However, interns had patients who reported significantly higher initial distress (3.24 CORE-OM points, se=0.90, z=3.60, pamp;lt;0.001, 95% CI 1.48, 5.00), and improved more over time (-1.20 CORE-OM scores per session, se=0.51, z=-2.35, p=0.019, 95% CI -2.20, -0.20) than patients seeing mental health practitioners. The results showed that at average alliance, CORE-OM decreased by 1.74 points per session (se=0.21, pamp;lt;0.001). For each point higher on the SAI at session 2, the CORE-OM decreased by an additional 0.58 points per session (se=0.25, p=0.02).DiscussionOur objective was to study psychotherapies as they are practiced in naturalistic settings. The overall significant finding is that our participants report improvement in their functioning mental health condition and distress reduced as psychotherapy progressed. There were many more male than female participants in our sample; younger patients improved more than older ones; and while interns had patients with higher distress, their patients improved better than those patients attended by professionals.ConclusionsThese are preliminary observations to consider for a larger sample follow-up study. Before changing practices, evaluating the existing practices by mapping clinical outcomes is a helpful route.

  • 48.
    Landén Ludvigsson, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Neck-specific exercise program2015Report (Other academic)
    Abstract [en]

    Description of neck specific exercise program as used by Maria Landén Ludvigsson, Anneli Peolsson, Gunnel Peterson in a randomized study comparing exercise approaches in chronic whiplash “Effects of neck-specific exercise with or without a behavioural approach in addition to prescribed physical activity for individuals with chronic whiplash-associated disorders: a prospective randomised study”

  • 49.
    Leandersson, Per
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center.
    Isocyanates and hydrogen cyanide in fumes from heated proteins and protein-rich foods2019In: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 29, no 2, p. 291-298Article in journal (Refereed)
    Abstract [en]

    Toxic compounds in cooking fumes could cause respiratory problems. In the present study, the formation of isocyanic acid (ICA), methyl isocyanate (MIC), and hydrogen cyanide (HCN) was studied during the heating of proteins or frying of protein-rich foods. Heating was performed in an experimental setup using a tube oven set at 200-500 degrees C and in a kitchen when foods with different protein content were fried at a temperature around 300 degrees C. ICA, MIC, and HCN were all generated when protein or meat was heated. Individual amino acids were also heated, and there was a significant positive correlation between their respective nitrogen content and the formation of the measured compounds. Gas from heated protein or meat also caused carbamylation in albumin. ICA, MIC, and HCN were also present in fumes generated when meat, egg, and halloumi were fried in a kitchen pan. The levels of ICA were here twice that of the Swedish occupational exposure limit. If ICA, MIC, and HCN in fumes from heated protein-rich foods could contribute to the risk of airway dysfunction among those exposed is not clear, but it is important to avoid inhaling frying and grilling fumes and to equip kitchens with good exhaust ventilation.

    The full text will be freely available from 2019-12-12 15:48
  • 50.
    Leijon, Matti
    et al.
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Stark Ekman, Diana
    Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Work and Rehabilitation. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Walter, Lars
    Landstinget i Östergötland; Centre for Public Health Sciences; Folkhälsovetenskapligt centrum.
    Ståhle, Agneta
    Department of Neurobiology, Health Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    Is there a demand for physical activity interventions from health care providers?: Findings from a population survey2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 34Article in journal (Refereed)
    Abstract [en]

    Background: Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to investigate the self-reported physical activity levels of the population and intention to increase physical activity levels, self-perceived need for support, and opinions about the responsibilities of both individuals and health care providers to promote physical activity.

    Methods: A regional public health survey was mailed to 13 440 adults (aged 18-84 years) living in Östergötland County (Sweden) in 2006. The survey was part of the regular effort by the regional Health Authorities.

    Results: About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37%) had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change "right now" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity) more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support.

    Conclusion: These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for their own physical activity levels, but also attribute responsibility for promoting increased physical activity to health care practitioners.

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