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  • 1.
    Helgesson, Magnus
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.
    Pettersson, Emma
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden..
    Lindsäter, Elin
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, SE-17177 Stockholm, Sweden.;Acad Primary Care Ctr, Stockholm, Sweden..
    Taipale, Heidi
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland.;Univ Eastern Finland, Sch Pharm, Kuopio, Finland..
    Tanskanen, Antti
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.;Univ Eastern Finland, Niuvanniemi Hosp, Dept Forens Psychiat, Kuopio, Finland..
    Mittendorfer-Rutz, Ellenor
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden..
    Cullen, Alexis E.
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.;Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England..
    Trajectories of work disability among individuals with anxiety-, mood/affective-, or stress-related disorders in a primary healthcare setting2024In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 24, no 1, article id 623Article in journal (Refereed)
    Abstract [en]

    Background

    Anxiety-, mood/affective-, or stress-related disorders affect up to one-third of individuals during their lives and often impact their ability to work. This study aimed to delineate trajectories of work disability (WD) among individuals diagnosed with anxiety-, mood/affective-, or stress-related disorder in primary healthcare and to examine associations between trajectory group membership and sociodemographic, clinical, and clinical-related factors.

    Methods

    The study population included working-age individuals, aged 22–62 years, living in Stockholm County, Sweden, who experienced a new episode of any anxiety-, mood/affective, or stress-related disorder in primary healthcare in 2017 (N = 11,304). Data were obtained from Swedish national and regional registers and were linked using pseudonymised unique personal identification numbers. The primary outcome was days with WD (sum of sickness absence and disability pension days) during the three years before and three years after a diagnosis of anxiety-, mood/affective-, or stress-related disorders in primary healthcare. A zero-inflated Poisson group-based trajectory model was used to identify groups of individuals with similar patterns of WD over the study period, with a multinomial logistic regression used to examine associations of sociodemographic, clinical, and clinical-related factors with trajectory group membership.

    Results

    Four distinct trajectory groups were found, high increasing (5.1%), with high levels, from 16 to 80 days of WD in six-monthly intervals during follow-up, peak (11.1%), with a peak in WD, up to 32 days of WD, around the time of the diagnosis, low increasing (12.8%), with an increase in days of WD from 4 to 22 during the study period, and constant low (71.1%), with almost no WD over the study period. In multinomial regression models, diagnostic category, psychotropic medication use, a diagnosis of a psychiatric disorder within secondary healthcare, age at diagnosis, and occupation were associated with WD trajectory groups.

    Conclusions

    Around two-thirds of individuals treated for a new episode of any anxiety-, mood/affective-, or stress-related disorder in primary healthcare have an excellent prognosis regarding WD. Several sociodemographic and clinical characteristics were associated with group membership; these factors could identify individuals at risk of long-term welfare dependency and who might benefit from interventions to promote a return to work.

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  • 2.
    Klockar, Erika
    et al.
    Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, Falun, Sweden..
    Kylen, Maya
    Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, Falun, Sweden.;Lund Univ, Dept Hlth Sci, Lund, Sweden..
    McCarthy, Linnea
    Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, Falun, Sweden..
    von Koch, Lena
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Karolinska Univ Hosp, Theme Neuro, Stockholm, Sweden..
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, Falun, Sweden..
    Jones, Fiona
    Kingston Univ, Fac Hlth & Social Care Sci, London, England.;St Georges Univ London, London, England..
    Elf, Marie
    Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, Falun, Sweden..
    The Swedish Stroke Self-Efficacy Questionnaire: translation and cross-cultural adaptation2024In: Journal of Patient-Reported Outcomes, E-ISSN 2509-8020, Vol. 8, no 1, article id 55Article in journal (Refereed)
    Abstract [en]

    Objective To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) from English to Swedish and to evaluate psychometric properties of the questionnaire.Methods A cross-sectional study design, where the translation followed a process including initial translation, synthesis, backward translation, expert committee, and pretest. Content validity was assessed using Content validity index (CVI). Psychometric assessments included floor-ceiling effects and internal consistency.Results Language and cultural congruence were achieved, and content validity index scores were high (0.923-1). The psychometric evaluations provided acceptable outcomes concerning internal consistency, with Cronbach's alpha scores for the total scale (0.902), the activities subscale (0.861) and the self-management subscale (0.818) respectively. Ceiling effects were evident, but no floor effects.Conclusion This study found the Swedish version of the SSEQ promising as a tool for assessment of self-efficacy in a Swedish stroke care setting, although further psychometric assessments are recommended in future studies.

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  • 3.
    Lostelius, Petra V.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Reg Västmanland Uppsala Univ, Västmanland Hosp Västerås, Ctr Clin Res, Västerås, Sweden; Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden; Clin Pain Rehabil Västmanland, Reg Västmanland, Västerås, Sweden.
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Dalarna Univ, Sch Hlth & Welf, Falun, Sweden.
    Thors Adolfsson, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland.
    Söderlund, Anne
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden..
    Revenäs, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden; Västerås Hosp Reg Vastmanland, Orthoped Clin, Västerås, Sweden.
    Zakrisson, Ann-Britt
    Örebro Univ, Fac Med & Hlth, Univ Hlth Care Res Ctr, Örebro, Sweden..
    Mattebo, Magdalena
    Mälardalen Univ, Sch Hlth Care & Social Welf, Västerås, Sweden..
    Identification of health-related problems in youth: a mixed methods feasibility study evaluating the Youth Health Report System2024In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 24, no 1, article id 64Article in journal (Refereed)
    Abstract [en]

    Background

    Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study.

    Methods

    This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16–23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants’ quantitative Youth Health Report System data were analyzed for descriptive statistics.

    Results

    Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility.

    Conclusions

    The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.

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  • 4.
    Normand, Claude L.
    et al.
    Univ Quebec Outaouais, Dept Psychoeduc & Psychol, Gatineau, PQ, Canada..
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Dalarna Univ, Sch Hlth & Welf, Falun, Sweden.
    Alfredsson Ågren, Kristin
    Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden..
    Heitplatz, Vanessa N.
    TU Dortmund Univ, Social Res Ctr, Dortmund, Germany.;TU Dortmund Univ, Rehabil Technol, Dortmund, Germany..
    Chadwick, Darren D.
    Liverpool John Moores Univ, Sch Psychol, Liverpool, Merseyside, England..
    Johansson, Stefan
    Royal Inst Technol, Sch Elect Engn & Comp Sci, Dept Media Technol & Interact Design, KTH, Stockholm, Sweden.;Lund Univ, Fac Engn, Dept Design Studies, Certec,LTH, Lund, Sweden..
    "Mum Helps Me When the Internet Messes Up... ": Accessibility of eHealth Services for People with Intellectual Disability2024In: Universal Access in Human-Computer Interaction: 18th International Conference, UAHCI 2024, Held as Part of the 26th HCI International Conference, HCII 2024, Washington, DC, USA, June 29 – July 4, 2024, Proceedings, Part II / [ed] Margherita Antona; Constantine Stephanidis, Cham: Springer, 2024, p. 213-230Conference paper (Refereed)
    Abstract [en]

    Many services have become digitized in society, including health services. Although there are many advantages to eHealth services, some segments of the population cannot reap those benefits.

    Objectives: This study aimed to: 1-describe how people with intellectual disability use the internet in Sweden; and 2-understand the nature of the contextual and personal barriers these users face-when trying to access eHealth services in particular.

    Methods: Data from the nationwide survey "Swedes with Impairment and the Internet 2021" (SMFOI-21) were extracted for a subsample of 154 people with self-declared intellectual disability.

    Results: Findings reveal that people with intellectual disability used the internet predominantly for entertainment purposes. Challenges arose in more complex online activities, like internet searches, logging into eHealth services, booking medical appointments, and financial transactions. Participants relied on support from family, guardians or staff to read, write, create and memorise passwords, understand content, or solve technical problems encountered. They expressed a desire to engage more independently in the digital society but faced barriers due to the cognitive requirements of using apps and the internet as designed by computer scientists, difficulties in navigating complex online processes, such as eHealth services, and a lack of accessible infrastructure. Conclusion: This research underscores the importance of improved accessibility, simplified interfaces, clearer instructions, and a supportive ecosystem to enhance their digital inclusion. It is a matter of people with intellectual disability being afforded equal rights to access health services.

  • 5.
    Pettersson, Linda
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna.
    Johansson, Stefan
    School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden.
    Demmelmaier, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation.
    von Koch, Lena
    Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Gulliksen, Jan
    School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, Stockholm, Sweden.
    Hedvall, Per-Olof
    Certec, Department of Design Sciences, Lund University, Lund, Sweden.
    Gummesson, Karl
    Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden.
    Gustavsson, Catharina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Center for Clinical Research Dalarna. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation.
    Disability digital divide — Accessibility of eHealth before compared to during the COVID-19 pandemic among people with and without impairment: a repeated cross-sectional surveyManuscript (preprint) (Other academic)
  • 6.
    Reine, Ieva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Riga Stradins Univ, Stat Unit, Riga, Latvia.
    Mikelsone, Madara
    Riga Stradins Univ, Stat Unit, Riga, Latvia..
    Tomsone, Signe
    Riga Stradins Univ, Fac Rehabil, Riga, Latvia..
    Guomundsson, Helgi
    Univ Iceland, Social Sci Res Inst, Reykjavik, Iceland..
    Ivanovs, Andrejs
    Riga Stradins Univ, Stat Unit, Riga, Latvia..
    Guomundsson, Halldor S.
    Univ Iceland, Fac Social Work, Reykjavik, Iceland..
    Koroleva, Ilze
    Riga Stradins Univ, Stat Unit, Riga, Latvia.;Latvia Univ, Inst Philosophy & Sociol, Riga, Latvia..
    Unraveling the dynamics of loneliness in the Baltic-Nordic region: a comparative analysis in the wake of COVID-192024In: Frontiers in Public Health, E-ISSN 2296-2565, Vol. 12, article id 1360285Article in journal (Refereed)
    Abstract [en]

    Introduction The primary aim of this study is to thoroughly investigate the prevalence and determinants of loneliness among older adults in the Baltic-Nordic region. Utilizing high-quality data sources and employing a methodologically rigorous approach, the study endeavors to enhance our understanding of how loneliness manifests and varies across different cultural and socio-economic contexts within these regions. By identifying key factors influencing loneliness, including demographic, social, and economic variables, the research seeks to contribute significantly to the existing body of knowledge on loneliness and inform targeted public health strategies and interventions tailored to the unique needs of older adults in the Baltic and Nordic countries.Material and methods This research, centered on older adults aged 67 and above within the Baltic-Nordic region, draws upon data from the Survey of Health, Ageing and Retirement in Europe (SHARE), specifically its eighth wave conducted between June and August 2020. The demographic analysis of this study covers a diverse sample of 5,313 participants from the Baltic and Nordic regions. Specifically, the sample includes 2,377 participants from Nordic countries, namely Sweden, Denmark, and Finland, and 2,936 from the Baltic countries of Estonia, Latvia, and Lithuania. The investigation extends to the financial well-being of households, involving an analysis of 3,925 individuals, with 1,748 from Nordic countries and 2,177 from Baltic countries. Although Iceland is categorized as a Nordic country, the analysis within this study is conducted separately due to the unavailability of SHARE data for this region. Instead, the HL20 study, focusing on the health and well-being of the older adult population in Iceland, contributes data for 1,033 respondents. This methodological distinction allows for a comprehensive understanding of regional differences, highlighting the importance of specialized approaches to examine the intricate dynamics of loneliness and well-being across the Baltic-Nordic region.Results The study reveals significant regional variations in loneliness among older adults during the COVID-19 outbreak, with the Baltic countries (Estonia, Latvia, Lithuania) reporting a lower prevalence of loneliness compared to the Nordic countries (Sweden, Denmark, Finland). Iceland, while grouped with the Nordic countries, was analysed separately. Employment emerges as a key factor in reducing loneliness across all regions, suggesting the benefits of social interactions and structured routines. Gender and marital status significantly influence loneliness, with notable disparities in the Baltic region and smaller gaps in the Nordic countries, reflecting the impact of societal and cultural norms. Additionally, educational attainment and health status show varied associations with loneliness, highlighting the complex interplay of individual and societal factors in these regions.

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  • 7.
    Taipale, Heidi
    et al.
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.;Niuvanniemi Hosp, Kuopio, Finland.;Univ Eastern Finland, Sch Pharm, Kuopio, Finland..
    Bergström, Jakob
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden..
    Gèmes, Katalin
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden..
    Tanskanen, Antti
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.;Niuvanniemi Hosp, Kuopio, Finland..
    Ekselius, Lisa
    Uppsala University, WoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan).
    Mittendorfer-Rutz, Ellenor
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden..
    Helgesson, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, SE-17177 Stockholm, Sweden.
    Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes2024In: JAMA Network Open, E-ISSN 2574-3805, Vol. 7, no 3, article id e242859Article in journal (Refereed)
    Abstract [en]

    Importance  Individuals with attention-deficit/hyperactivity disorder (ADHD) often have comorbid psychiatric conditions. Relatively little is known about how specific ADHD medications are associated with overall treatment outcomes among these patients.

    Objective  To investigate the association of the use of specific ADHD medications with hospitalization outcomes and work disability among adolescents and adults with ADHD.

    Design, Setting, and Participants  This nationwide register-based cohort study identified individuals (aged 16-65 years) with ADHD from Swedish nationwide registers of inpatient health care, specialized outpatient health care, sickness absence, and disability pension during the years 2006 to 2021. Data analysis was performed from November 2022 to August 2023.

    Exposure  Use of specific ADHD medications.

    Main Outcomes and Measures  The main outcome measure was psychiatric hospitalization, and secondary outcomes were suicide attempt and/or death by suicide, nonpsychiatric hospitalization, and work disability (ie, sickness absence or disability pension). The risk of outcomes between use vs nonuse periods of ADHD medications was compared in a within-individual design, where a person acts as their own control, and was analyzed with stratified Cox models.

    Results  A total of 221 714 persons with ADHD were included in the study cohort (mean [SD] age, 25.0 [11.2] years; 120 968 male individuals [54.6%]). Methylphenidate was the most commonly used ADHD medication (151 837 individuals [68.5%]), followed by lisdexamphetamine (78 106 individuals [35.2%]) during the follow-up (mean [SD], 7.0 [4.7] years). The following medications were associated with a decreased risk of psychiatric hospitalization: amphetamine (adjusted hazard ratio [aHR], 0.74; 95% CI, 0.61-0.90), lisdexamphetamine (aHR, 0.80; 95% CI, 0.78-0.82), ADHD drug polytherapy (aHR, 0.85; 95% CI, 0.82-0.88), dexamphetamine (aHR, 0.88; 95% CI, 0.83-0.94), and methylphenidate (aHR, 0.93; 95% CI, 0.92-0.95). No associations were found for modafinil, atomoxetine, clonidine, and guanfacine. Decreased risk of suicidal behavior was associated with the use of dexamphetamine (aHR, 0.69; 95% CI, 0.53-0.89), lisdexamphetamine (aHR, 0.76; 95% CI, 0.68-0.84), and methylphenidate (aHR, 0.92; 95% CI, 0.86-0.98). None of the medications was associated with increased risk of nonpsychiatric hospitalization; instead, use of amphetamine, lisdexamphetamine, polytherapy, dexamphetamine, methylphenidate, and atomoxetine were associated with decreased risk of nonpsychiatric hospitalization. The results regarding work disability were significant only for the use of atomoxetine (aHR, 0.89; 95% CI, 0.82-0.97), especially among adolescents and young adults aged 16 to 29 years, (aHR, 0.82; 95% CI, 0.73-0.92).

    Conclusions and Relevance  In this nationwide cohort study of adolescents and adults with ADHD, the use of ADHD medication was associated with fewer hospitalizations for both psychiatric and nonpsychiatric morbidity and lower suicidal behavior.

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  • 8.
    Tondel, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nordqvist, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Helgesson, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden..
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    COVID-19: incidence and mortality in Sweden comparing all foreign-born to all Swedish-born individuals in different occupations in an unvaccinated cohort of year 20202024In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 81, no 3, p. 136-141Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim was to analyse the incidence and mortality of COVID-19 in immigrants compared with Swedish born in inpatients and outpatient registers, respectively.

    Methods

    The study population included all persons 20-88 years of age living in Sweden, 31 December 2019, including 1 676 516 foreign-born persons and 6 037 151 Swedish-born persons. The outcome was clinical cases of COVID-19 with a positive PCR test (ICD-10 U07.01) or without a positive PCR test (U07.2) from 1 January to 31 December 2020. Persons 20-64 years of age were classified with occupational titles according to the Swedish Standard Classification of Occupations. Residing municipality of each individual was coded according to the Swedish Association of Local Authorities. Relative risks (RR) were calculated by sex in 5 years age bands using Swedish born as reference. Age-adjusted RRs (adj RR) with 95% CIs were calculated in a Poisson regression model. Rural municipalities were used as the reference category.

    Results

    Foreign born had consistently higher RRs in COVID-19, regardless of sex, with a peak in 50-69 years of age. Foreign born had a higher RR of death in COVID-19 above 50 years and 40 years of age in women and men, respectively. Among occupations, male drivers had the highest adj RR 4.37 (95% CI 3.45 to 5.54) and 5.09 (4.26 to 6.07) in outpatients and inpatients, respectively (U07.1). Persons living in commuting municipalities did not show any consistent increased risk for COVID-19.

    Conclusion

    Foreign born have a higher risk of COVID-19 compared with Swedish-born individuals at any age and occupation before vaccination began in 2021.

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  • 9.
    Vejby, Sölvi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Eriksson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Haematology. Department of Medical Sciences, Uppsala University, Sweden.
    Nordin, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Johansson, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Department of Immunology, Genetics and Pathology, Uppsala University, Sweden.
    Är det möjligt att öka mängden fysisk aktivitet hos patienter som isolerats på grund av hematopoetisk stamcellstransplantation med hjälp av en omvårdnadsinsats? En förstudie2021In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 42, no 1, p. 18-27Article in journal (Other academic)
  • 10.
    Vikmoen, Olav
    et al.
    Norwegian Sch Sport Sci, Dept Phys Performance, POB 4014, N-0806 Oslo, Norway..
    Strandberg, Emelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vassbakk Svindland, Karianne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Henriksson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Mazzoni, Anne-Sophie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Johansson, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Jönsson, Janniz
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Karakatsanis, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery. Uppsala Univ Hosp, Dept Surg, Sect Breast Surg, Uppsala, Sweden..
    Annebäck, Matilda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Kudren, David
    Soder Sjukhuset, Dept Oncol, Stockholm, Sweden..
    Lindman, Henrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    Warnberg, Fredrik
    Gothenburg Univ, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Surg, Gothenburg, Sweden..
    Berntsen, Sveinung
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway..
    Demmelmaier, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway..
    Nordin, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Raastad, Truls
    Norwegian Sch Sport Sci, Dept Phys Performance, POB 4014, N-0806 Oslo, Norway.;Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway..
    Effects of heavy-load strength training during (neo-)adjuvant chemotherapy on muscle strength, muscle fiber size, myonuclei, and satellite cells in women with breast cancer2024In: The FASEB Journal, ISSN 0892-6638, E-ISSN 1530-6860, Vol. 38, no 13, article id e23784Article in journal (Refereed)
    Abstract [en]

    To investigate the effects of heavy-load strength training during (neo-)adjuvant chemotherapy in women with breast cancer on muscle strength, body composition, muscle fiber size, satellite cells, and myonuclei. Women with stage I-III breast cancer were randomly assigned to a strength training group (ST, n = 23) performing supervised heavy-load strength training twice a week during chemotherapy, or a usual care control group (CON, n = 17). Muscle strength and body composition were measured and biopsies from m. vastus lateralis collected before the first cycle of chemotherapy (T0) and after chemotherapy and training (T1). Muscle strength increased significantly more in ST than in CON in chest-press (ST: +10 +/- 8%, p < .001, CON: -3 +/- 5%, p = .023) and leg-press (ST: +11 +/- 8%, p < .001, CON: +3 +/- 6%, p = .137). Both groups reduced fat-free mass (ST: -4.9 +/- 4.0%, p < .001, CON: -5.2 +/- 4.9%, p = .004), and increased fat mass (ST: +15.3 +/- 16.5%, p < .001, CON: +16.3 +/- 19.8%, p = .015) with no significant differences between groups. No significant changes from T0 to T1 and no significant differences between groups were observed in muscle fiber size. For myonuclei per fiber a non-statistically significant increase in CON and a non-statistically significant decrease in ST in type I fibers tended (p = .053) to be different between groups. Satellite cells tended to decrease in ST (type I: -14 +/- 36%, p = .097, type II: -9 +/- 55%, p = .084), with no changes in CON and no differences between groups. Strength training during chemotherapy improved muscle strength but did not significantly affect body composition, muscle fiber size, numbers of satellite cells, and myonuclei compared to usual care.

  • 11.
    Western, Benedikte
    et al.
    Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway..
    Ivarsson, Andreas
    Halmstad Univ, Ctr Res Welf Hlth & Sport, Halmstad, Sweden..
    Vistad, Ingvild
    Univ Bergen, Dept Clin Sci, Bergen, Norway.;Sorlandet Hosp, Dept Obstet & Gynecol, Kristiansand, Norway.;Univ Oslo, Fac Med, Oslo, Norway..
    Demmelmaier, Ingrid
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway.
    Aaronson, Neil K.
    Netherlands Canc Inst, Div Psychosocial Res & Epidemiol, Amsterdam, Netherlands..
    Radcliffe, Gillian
    Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England..
    van Beurden, Marc
    Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Amsterdam, Netherlands..
    Bohus, Martin
    Cent Inst Mental Hlth, Inst Psychiat & Psychosomat Psychotherapy, Mannheim, Germany.;Heidelberg Univ, Heidelberg, Germany.;Univ Antwerp, Fac Hlth Sci, Antwerp, Belgium..
    Courneya, Kerry S.
    Univ Alberta, Fac Kinesiol Sport & Recreat, Edmonton, AB, Canada..
    Daley, Amanda J.
    Loughborough Univ, Ctr Lifestyle Med & Behav CLiMB, Sch Sport Exercise & Hlth Sci, Loughborough, England..
    Galvão, Daniel A.
    Edith Cowan Univ, Exercise Med Res Inst, Joondalup, WA, Australia..
    Garrod, Rachel
    Kings Coll London, Dept Resp Med, London, England..
    Goedendorp, Martine M.
    Univ Groningen, Dept Psychol, Groningen, Netherlands.;Univ Groningen, Univ Med Ctr Groningen, Dept Hlth Psychol, Groningen, Netherlands..
    Griffith, Kathleen A.
    George Washington Univ, Washington, DC USA..
    van Harten, Wim H.
    Netherlands Canc Inst, Div Psychosocial Res & Epidemiol, Amsterdam, Netherlands.;Univ Twente, Enschede, Netherlands..
    Hayes, Sandi C.
    Queensland Univ Technol, Sch Publ Hlth, Inst Hlth & Biomed Innovat, Kelvin Grove, Qld, Australia..
    Herrero-Roman, Fernando
    Fdn GIAFyS Canc, Miranda De Ebro, Spain..
    Hiensch, Anouk E.
    Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands..
    Irwin, Melinda L.
    Yale Sch Publ Hlth, New Haven, CT USA..
    James, Erica
    Univ Newcastle, Sch Med & Publ Hlth, Callaghan, NSW, Australia..
    Kenkhuis, Marlou-Floor
    Radboud Univ Nijmegen, Med Ctr, Dept Med Biosci, Nijmegen, Netherlands..
    Kersten, Marie José
    Univ Amsterdam, Med Ctr, Canc Ctr Amsterdam, Dept Hematol, Amsterdam, Netherlands.;LYMMCARE, Amsterdam, Netherlands..
    Knoop, Hans
    Univ Amsterdam, Dept Med Psychol, Amsterdam UMC, Amsterdam, Netherlands..
    Lucia, Alejandro
    European Univ, Madrid, Spain..
    May, Anne M.
    Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands..
    Mcconnachie, Alex
    Univ Glasgow, Sch Hlth & Wellbeing, Glasgow, Scotland..
    van Mechelen, Willem
    Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Publ & Occupat Hlth, Amsterdam, Netherlands.;Univ Queensland, Fac Hlth & Behav Sci, Sch Human Movement & Nutr Sci, Brisbane, Australia.;Univ Cape Town, Fac Hlth Sci, Dept Human Biol, Cape Town, South Africa.;Univ Coll Dublin, UCD Sch Publ Hlth Physiotherapy & Sports Sci, Dublin, Ireland..
    Mutrie, Nanette
    Univ Edinburgh, Phys Act Hlth Res Ctr, Edinburgh, Scotland..
    Newton, Robert U.
    Edith Cowan Univ, Exercise Med Res Inst, Joondalup, WA, Australia..
    Nollet, Frans
    Amsterdam UMC Locat Univ Amsterdam, Dept Rehabil Med, Amsterdam, Netherlands.;Amsterdam Movement Sci Rehabil & Dev, Amsterdam, Netherlands..
    Oldenburg, Hester S.
    Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Amsterdam, Netherlands..
    Plotnikoff, Ron
    Univ Newcastle, Prior Res Ctr Phys Act & Nutr, Callaghan, NSW, Australia..
    Schmidt, Martina E.
    German Canc Res Ctr, Div Phys Act Prevent & Canc, Heidelberg, Germany.;Natl Ctr Tumor Dis NCT, Heidelberg, Germany..
    Schmitz, Katie H.
    Univ Pittsburgh, Pittsburgh, PA USA..
    Schulz, Karl-Heinz
    Univ Med Ctr Hamburg Eppendorf, Competence Ctr Sports and Exercise Med Athleticum, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Inst Med Psychol, Hamburg, Germany..
    Short, Camille E.
    Univ Melbourne, Melbourne Ctr Behav Change, Melbourne Sch Psychol Sci, Melbourne, Australia.;Univ Melbourne, Melbourne Sch Hlth Sci, Canc & Exercise Recovery Res Grp CanRex, Melbourne, Vic, Australia..
    Sonke, Gabe S.
    Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Amsterdam, Netherlands..
    Steindorf, Karen
    German Canc Res Ctr, Div Phys Act Prevent & Canc, Heidelberg, Germany.;Natl Ctr Tumor Dis NCT, Heidelberg, Germany..
    Stuiver, Martijn M.
    Netherlands Canc Inst, Div Psychosocial Res & Epidemiol, Amsterdam, Netherlands..
    Taaffe, Dennis R.
    Edith Cowan Univ, Exercise Med Res Inst, Joondalup, WA, Australia..
    Thorsen, Lene
    Oslo Univ Hosp, Dept Oncol, Div Canc Med, Natl Advisory Unit Late Effects Canc Treatment, Oslo, Norway.;Oslo Univ Hosp, Dept Clin Serv, Div Canc Med, Oslo, Norway..
    Velthuis, Miranda J.
    Netherlands Comprehens Canc Org IKNL, Utrecht, Netherlands..
    Wenzel, Jennifer
    Sidney Kimmel Comprehens Canc Ctr, Johns Hopkins Sch Nursing, Johns Hopkins Sch Med, Baltimore, MD USA..
    Winters-Stone, Kerri M.
    Oregon Hlth & Sci Univ, Knight Canc Inst, Portland, OR USA..
    Wiskemann, Joachim
    Natl Ctr Tumor Dis NCT Heidelberg, Dept Med Oncol, Heidelberg, Germany.;Heidelberg Univ Clin, Heidelberg, Germany..
    Berntsen, Sveinung
    Univ Agder, Dept Sport Sci & Phys Educ, Kristiansand, Norway..
    Buffart, Laurien M.
    Radboudumc, Dept Physiol, Nijmegen, Netherlands..
    Dropout from exercise trials among cancer survivors: An individual patient data meta-analysis from the POLARIS study2024In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 34, no 2, article id e14575Article in journal (Refereed)
    Abstract [en]

    Introduction

    The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors.

    Methods

    This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree.

    Results

    Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2, performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment.

    Conclusions

    There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.

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  • 12.
    Yang, Fen
    et al.
    Karolinska Inst, Dept Global Publ Hlth, Solnavagen 1E, S-11365 Stockholm, Sweden.;Dept Global Publ Hlth, Solnavagen 1E, S-11365 Stockholm, Sweden..
    Janszky, Imre
    Karolinska Inst, Dept Global Publ Hlth, Solnavagen 1E, S-11365 Stockholm, Sweden.;Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, Trondheim, Norway..
    Roos, Nathalie
    Karolinska Univ Hosp, Karolinska Inst, Dept Med Solna, Div Clin Epidemiol, Stockholm, Sweden..
    Li, Jiong
    Aarhus Univ Hosp, Dept Clin Med, Dept Clin Epidemiol, Aarhus, Denmark..
    László, Krisztina D.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public health, working life and rehabilitation. Karolinska Inst, Dept Global Publ Hlth, Solnavagen 1E, S-11365 Stockholm, Sweden..
    Prenatal Exposure to Severe Stress and the Risk of Heart Failure Up to Middle-Age2024In: JACC. Heart failure, ISSN 2213-1779, E-ISSN 2213-1787, Vol. 12, no 8, p. 1353-1362Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Prenatal stress is a potential risk factor for cardiovascular disease, but its association with heart failure (HF) is unknown.

    OBJECTIVES The purpose of this study was to investigate whether prenatal stress, defined as maternal bereavement, was associated with HF risk up to middle-age.

    METHODS This cohort study included 6,758,560 live singleton births from the Danish (1973-2016) and the Swedish (1973-2014) Medical Birth Registers. The authors retrieved information on death of the mothers' close family members (partner, older children, parents, and siblings) and offspring's HF (up to 2016 in Denmark and 2020 in Sweden) from nationwide registers. They estimated HRs and 95% CIs for HF in the offspring according to maternal bereavement.

    RESULTS During up to 48 years of follow-up, 4,812 offspring (0.07%) had a diagnosis of HF. Maternal loss of any close family member was not associated with HF in the offspring (adjusted HR: 1.04; 95% CI: 0.88-1.23). However, the most severe forms of bereavement, ie, death of a partner or an older child (adjusted HR: 1.47; 95% CI: 1.06-2.04) and unnatural death of a relative (adjusted HR: 2.77; 95% CI: 1.49-5.17), were associated with increased risks of HF. Congenital heart disease and preterm birth contributed substantially to the association of maternal loss of a partner or older child with HF risk in the offspring.

    CONCLUSIONS Maternal loss of a partner or older child and loss of a close relative caused by unnatural causes the year before or during pregnancy were associated with increased risk of HF in offspring.

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