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  • 1.
    Anderzén, I
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Arnetz, B
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    The impact of a prospective survey-based workplace intervention program on employee health, biologic stress markers, and organizational productivity.2005In: J Occup Environ Med, ISSN 1076-2752, Vol. 47, no 7, p. 671-82Article in journal (Refereed)
  • 2.
    Anderzén, Ingrid
    et al.
    Karolinska Institute, Department of Public Health Sciences, Division of Psychosocial Factors and Health.
    Arnetz, Bengt
    bNational Institute for Psychosocial Factors and Health, Stockholm, Sweden.
    Psychophysiological reactions to international adjustment: Results from a controlled, longitudinal study1999In: Psychotherapy and Psychosomatics, ISSN 0033-3190, E-ISSN 1423-0348, Vol. 68, no 2, p. 67-75Article in journal (Refereed)
    Abstract [en]

    Background: This controlled prospective study examines psychophysiological reactions in employees during their first and second year abroad to identify individual as well as work-related factors predictive of positive adjustment. Methods: Employees (n = 47) relocating from Sweden to a foreign country on a work-related assignment were followed. The subjects completed a questionnaire before relocation and after 1 and 2 years abroad. Blood samples were collected for determination of the stressor-related hormones prolactin, cortisol and testosterone. A matched non-moving reference group of employees (n = 35) responded to the questionnaire at similar time periods, and also provided blood samples. Results: During the years abroad, the expatriate employees experienced increased psychosocial stress as well as negative adjustment as reflected in circulating levels of prolactin and testosterone, worse mental well-being and worsening subjective work environment, as compared with the non-moving group. The greatest change occurred during the first year. Individual factors such as social support, internal locus of control, self-esteem and sense of coherence modified the stress response and predicted employees’ ability to adjust to foreign assignments. Negative changes in the psychosocial work environment explained to a large degree the decrease in work adjustment during the first year and these findings were also reflected in physiological stress indicators. Conclusions: The study emphasises the importance for multinational organisations to look at these individual characteristics before sending employees abroad. They also need to get more involved in supporting employees to manage stressors characteristic of the first year of foreign work.

  • 3.
    Arble, Eamonn
    et al.
    Wayne State Univ, Dept Psychol, 71 W Warren Ave, Detroit, MI 48202 USA..
    Arnetz, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Michigan State Univ, Coll Human Med, Dept Family Med, 788 Serv Rd,Rm B106D, E Lansing, MI 48824 USA.
    A Model of First-responder Coping: An Approach/Avoidance Bifurcation2017In: Stress and Health, ISSN 1532-3005, E-ISSN 1532-2998, Vol. 33, no 3, p. 223-232Article in journal (Refereed)
    Abstract [en]

    The work of first responders is fraught with numerous stressors, ranging from potentially traumatic critical incidents to institutional strains. The severity and pervasiveness of these difficulties prompt a necessary consideration of the coping methods employed by first responders. The present study developed an empirical model of first-responder coping strategies, based upon a nationally representative survey sample of 6240 first responders. Participants were drawn from Swedish first responders in the following occupations: coast guard, customs control, military, emergency medical services, fire department and police services. In the final model, exposure to stress related to well-being through several indirect paths that in sum accounted for the original direct relationship between these constructs. These several indirect paths were classified theoretically as either approach or avoidance coping behaviours or subsequent health outcomes. In general, approach coping behaviours were related to better well-being; and avoidance was related to a decrease in the outcome. The size of the present sample, as well as the diverse nature of the included first responders, suggests that the resulting model may offer a unique insight into potentially adaptive pathways for first-responder coping.

  • 4. Arfken, CL
    et al.
    Jamil, H
    Arnetz, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Marijuana and non-medical prescription drug use among immigrant Arab Americans2012In: New Iraqi Med, Vol. 8, p. 7-13Article in journal (Refereed)
  • 5. Arfken, Cynthia L
    et al.
    Arnetz, Bengt B
    2.Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI, USA.
    Fakhouri, Monty
    Ventimiglia, Matthew J
    Jamil, Hikmet
    Alcohol use among Arab Americans: what is the prevalence?2011In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 13, no 4, p. 713-718Article in journal (Refereed)
    Abstract [en]

    Information is limited on alcohol use among Arab Americans. The purpose of this study was to describe and analyze the alcohol use pattern among Arab Americans by reviewing existing surveys using an acculturation model. Secondary data analysis. Nationally, English-speaking immigrant Arab Americans reported lower rates of lifetime alcohol use (50.8%), past month use (26.4%) and binge drinking (10%) than the White majority group. In a state survey, self-identified English-speaking Arab Americans were less likely to report past month use (45.6%) than the White majority group but reported similar rate of binge drinking (17.0%). Locally, lifetime drinking was reported by 46.2% of the immigrants but only 13.4% of refugees fleeing war. Few databases are available to estimate alcohol use pattern among Arab Americans; the limited data suggest a drinking pattern consistent with acculturation. However, the potential influence of other factors is unknown and needs to be investigated.

  • 6.
    Arnetz, B
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Subjective indicators as a gauge for improving organizational well-being. An attempt to apply the cognitive activation theory to organizations.2005In: Psychoneuroendocrinology, ISSN 0306-4530, Vol. 30, no 10, p. 1022-6Article in journal (Refereed)
  • 7.
    Arnetz, B
    et al.
    Uppsala University.
    Arnetz, J
    Uppsala University.
    Psychosocial factors and musculoskeletal symptoms in a high-tech work environment.1992In: Arbete och Hälsa, no 17, p. 28-30Article in journal (Other scientific)
  • 8.
    Arnetz, B
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Arnetz, J
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Johansson, A-M
    Rundquist, A
    Patienternas syn på hälso- och sjukvården. Vad berättar klagomål till Patientnämnden?2001Report (Other (popular scientific, debate etc.))
  • 9.
    Arnetz, B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Fjellner, B
    Stress responsiveness in patients with psoriasis2007In: British Journal of Dermatology, ISSN 0007-0963, E-ISSN 1365-2133, ISSN 0007-0963, Vol. 156, no 2, p. 388-Article in journal (Refereed)
  • 10.
    Arnetz, Bengt B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Broadbridge, Carissa L
    Ghosh, Samiran
    Longitudinal determinants of energy levels in knowledge workers2014In: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 56, no 1, p. 79-85Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Increasingly, workers in the service, welfare, and health care sectors suffer adverse effects (ie, depression, burnout, etc) of "low-energy syndromes." Less is known about energy-based outcomes among knowledge workers. This study aimed to identify determinants of self-rated energy in knowledge workers and examine how these determinants change over time.

    METHODS: In collaboration with a large union and employer federation, 317 knowledge workers in Sweden responded to the health and productivity survey three times.

    RESULTS: At each assessment, worry, satisfaction with eating habits, and work-effectiveness were predictive of energy levels; however, only work-effectiveness covaried with energy over time.

    CONCLUSIONS: This study suggests that perceived work-effectiveness is an important factor in preventing knowledge workers from experiencing "low-energy syndromes." Lifestyle factors also play a role. Therefore, multifaceted interventions for increasing energy are needed.

  • 11.
    Arnetz, Bengt B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Broadbridge, Carissa L
    Jamil, Hikmet
    Lumley, Mark A
    Pole, Nnamdi
    Barkho, Evone
    Fakhouri, Monty
    Talia, Yousif Rofa
    Arnetz, Judith E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees2014In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 6, p. 1055-1061Article in journal (Refereed)
    Abstract [en]

    Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.

  • 12.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Ekman, RolfUppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Stress in Health and Disease2006Collection (editor) (Other academic)
    Abstract [en]

    This first book to address the most urgent issues combines a solid research approach with applied individual and stress issues. It focuses on our latest knowledge of various causes of stress and its neuro-cognitive and biological implications. World-renowned authors cover all perspectives: societal, individual, organ and molecular level.

  • 13.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Frenzel, L.
    Åkerstedt, T.
    Lisspers, Jan
    The brief fatigue syndrome scale: validation and utilization in fatigue recovery studies2008In: Fatigue Science for Human Health / [ed] Y. Watanabe, B. Evengård, B.H. Natelson, L. A. Jason and H. Kuratsune, Tokyo: Springer , 2008, p. 55-66Chapter in book (Other academic)
  • 14.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Michigan State Univ, E Lansing, USA; Umea Univ, Umea, Sweden.
    Lewalski, Philip
    Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA..
    Arnetz, Judy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Michigan State Univ, E Lansing, USA; Umea Univ, Umea, Sweden.
    Breejen, Karen
    Michigan State Univ, Coll Human Med, Dept Family Med, E Lansing, MI 48824 USA..
    Przyklenk, Karin
    Wayne State Univ, Sch Med, Dept Emergency Med, Detroit, MI USA.;Wayne State Univ, Sch Med, Cardiovasc Res Inst, Detroit, MI USA.;Wayne State Univ, Sch Med, Dept Physiol, Detroit, MI 48201 USA..
    Examining self-reported and biological stress and near misses among Emergency Medicine residents: a single-centre cross-sectional assessment in the USA2017In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, no 8, article id e016479Article in journal (Refereed)
    Abstract [en]

    Objectives To examine the relationship between perceived and biological stress and near misses among Emergency Medicine residents. Design Self-rated stress and stress biomarkers were assessed in residents in Emergency Medicine before and after a day shift. The supervising physicians and residents reported numbers of near misses. Setting The study took place in the Emergency Department of a large trauma 1 centre, located in Detroit, USA. Participants Residents in Emergency Medicine volunteered to participate. The sample consisted of 32 residents, with complete data on 28 subjects. Residents' supervising physicians assessed the clinical performance of each resident. Primary and secondary outcome measures Participants' preshift and postshift stress, biological stress (salivary cortisol, plasma interleukin-6, tumour necrosis factor-alpha (TNF-alpha) and high-sensitivity C-reactive protein), residents' and supervisors' reports of near misses, number of critically ill and patients with trauma seen during the shift. Results Residents' self-reported stress increased from an average preshift level of 2.79 of 10 (SD 1.81) to a postshift level of 5.82 (2.13) (p<0.001). Residents cared for an average of 2.32 (1.52) critically ill patients and 0.68 (1.06) patients with trauma. Residents reported a total of 7 near misses, compared with 11 reported by the supervising physicians. After controlling for baseline work-related exhaustion, residents that cared for more patients with trauma and had higher levels of TNF-a reported a higher frequency of near misses (R-2=0.72; p=0.001). Residents' preshift ratings of how stressful they expected the shift to be were related to the supervising physicians' ratings of residents' near misses during the shift. Conclusion Residents' own ratings of near misses were associated with residents' TNF-alpha, a biomarker of systemic inflammation and the number of patients with trauma seen during the shift. In contrast, supervisor reports on residents' near misses were related only to the residents' preshift expectations of how stressful the shift would be.

  • 15.
    Arnetz, Bengt B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Templin, Thomas
    Saudi, Waleed
    Jamil, Hikmet
    Obstructive sleep apnea, posttraumatic stress disorder, and health in immigrants2012In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 74, no 8, p. 824-831Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States.

    METHODS: A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health.

    RESULTS: The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH.

    CONCLUSIONS: Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.

  • 16.
    Arnetz, Bengt B
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Ventimiglia, Matthew
    Beech, Pamela
    DeMarinis, Valerie
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, The Social Sciences of Religion, Psychology of Religions.
    Lökk, Johan
    Arnetz, Judith E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Spiritual values and practices in the workplace and employee stress and mental well-being2013In: Journal of Management, Spirituality and Religion, ISSN 1476-6086, E-ISSN 1942-258X, Vol. 10, no 3, p. 271-281Article in journal (Refereed)
    Abstract [en]

    Objective:

    To determine whether employees’ spiritual values and practicesin the workplace attenuate occupational stress and work-related exhaustion,and promote mental well-being.

    Methods:

    Participants (N = 649) completedvalidated measures of mental well-being, occupational stress, and workrelatedexhaustion, as well as two newly developed measures of individualspiritual values and practices in the workplace.

    Results:

    Factor analysis confirmedthat spirituality items belonged to two separate constructs. In logisticregression models, the Spiritual Values in the Workplace scale was positivelyassociated with mental well-being and low occupational stress. Thespiritual practices at work scale was positively associated with low workrelatedexhaustion.

    Conclusions:

    Employee spiritual values and practices, aswell as workplace acceptance of such practices, appear to promote mentalwell-being and attenuate stress.

  • 17.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Wiholm, Clairy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Wang, Shinan
    Slatcher, Rich
    Lumley, Mark
    Hytter, Anders
    Sandmark, Helen
    Shi, Weisong
    Real-Time Ecologically-Valid Assessment of Cognitive and Cardiovascular Load in Real-Life in Mid-Career Female Managers2013In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 75, no 3, p. A100-A100Article in journal (Other academic)
  • 18.
    Arnetz, Bengt B.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Åkerstedt, Torbjörn
    Hillert, Lena
    Lowden, Arne
    Kuster, Niels
    Wiholm, Clairy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    The Effects of 884 MHz GSM Wireless Communication Signals on Self-reported Symptoms and Sleep: An Experimental Provocation Study2007In: PIERS online, ISSN 1931-7360, Vol. 3, no 7, p. 1148-1150Article in journal (Refereed)
    Abstract [en]

    In the current study we assessed possible effects of prolonged (3 hours) exposure to 884 MHz GSM wireless communication signals on self-reported symptoms, cognitive function, and electroencephalographically (EEG) recorded sleep. The study group consisted of 36 women and 35 men. Twenty-two women and sixteen men reported symptoms they specifically related to mobile phone use (SG). The rest of the participants reported no mobile phone-related symptoms (NG). Potential participants volunteering for the study were evaluated by physicians, including some biochemical assessments, to rule out medical conditions that could interfere with study variables of interest. Once selected, participants spent three different sessions in the laboratory. The habituation session was followed by two subsequent sessions. In these subsequent sessions, subjects were either exposed to sham exposure (sham) or 884 MHz GSM wireless communication signals for 3 hours (an average of 1.4 W/kg including periods of DTX and Non-DTX. Exposure directed to the left hemisphere). Data was collected before, during and following the exposure/sham sessions. Data collected included self-reported symptoms, including headache, cognitive function, mood, and electroencephalographic recordings. During actual exposure, as compared to sham exposure, sleep initiated one hour after exposure was affected. There was a prolonged latency to reach the first cycle of deep sleep (stage 3). The amount of stage 4 sleep was also decreased in exposed subjects. NG subjects reported more headaches during exposures vs. sham exposure. Neither group (SG and NG) was able to detect the true exposure status more frequently than by chance alone. The study indicates that during laboratory exposure to 884 MHz wireless signals, components of sleep, believed to be important for recovery from daily wear and tear, are adversely affected. Moreover, participants that otherwise have no self-reported symptoms related to mobile phone use, appear to have more headaches during actual radiofrequency exposure as compared to sham exposure. However, subjects were not able to detect the true exposure status more often than would have been expected by statistical chance alone. Additional self-reported findings, biochemical, performance and electrophysiological data are currently being analyzed. Possible health implications from the findings will also be further explored.

  • 19.
    Arnetz, Bengt
    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, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , CEOS.
    Blomkvist, Vanja
    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, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , CEOS.
    Leadership, Mental Health, and Organizational Efficacy in Health Care Organizations: Psychosocial Predictors of Healthy Organizational Development Based on Prospective Data from Four Different Organizations2007In: Psychotherapy and Psychosomatics, ISSN 0033-3190, E-ISSN 1423-0348, Vol. 76, no 4, p. 242-248Article in journal (Refereed)
    Abstract [en]

    Background: Only a few studies of psychosocial determinants of employee health and organizational development have been prospective, involving more than one organization and applying standardized assessment tools. This limits the ability of providing evidence-based guidance as how to carry out healthy organizational transformations. Methods: A total of 6,000 employees responded twice to a validated psychosocial-leadership questionnaire within a 2-year period. The assessment focused on changes over time in the three outcome measures - mental health, efficacy, and leadership, determined to be important indicators of a healthy organization. Changes within and between organization were assessed statistically using regular t tests and general linear modeling. Results: There were major differences between organizations in psychosocial measures, both at the baseline and over time. At the organizational level, changes between study periods in management performance feedback, participatory management, and work tempo were the most consistent predictors of improvements over time in the three outcome measures. Conclusions: Performance feedback and participatory management might be two common predictors of healthy workplaces. Some of the psychosocial determinants of healthy organizations suggested in previous research might not be universally valid. It is suggested that future research should to a larger degree make use of multiple departments and organizations in studies of psychosocial determinants of healthy organizations.

  • 20.
    Arnetz, Bengt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Drutchas, Alexis
    Sokol, Robert
    Kruger, Michael
    Jamil, Hikmet
    1991 Gulf War exposures and adverse birth outcomes2013In: U.S. Army Medical Department journal, ISSN 1524-0436, p. 58-65Article in journal (Refereed)
    Abstract [en]

    We studied 1991 Gulf War (GW)-related environmental exposures and adverse birth outcomes in Iraqis. A random cross-sectional sample of 307 Iraqi families that immigrated to the United States responded to a structured interview covering socioeconomics, lifestyle, environmental exposures, and birth outcome. Data per each family was collected either from the man or the woman in the respective family. The respondents were divided into those that resided in Iraq during and following the GW (post-GW, n=185) and those that had left before (pre-GW, n=122). The primary outcome was lifetime prevalence of adverse birth outcomes, ie, congenital anomalies, stillbirth, low birth weight, and preterm delivery and its relationship to GW exposures. Mean number of adverse birth outcomes increased from 3.43 (SD=2.11) in the pre-GW to 4.63 (SD=2.63) in the post-GW group (P<.001). Mean chemical (Ch) and nonchemical (NCh) environmental exposure scores increased from pre-GW scores of 0.38 units (SD=1.76) and 0.43 (SD=1.86), respectively, to post-GW scores of 5.65 units (SD=6.23) and 7.26 (SD=5.67), P<.001 between groups for both exposures. There was a significant dose-response relationship between Ch environmental exposure (P=.001), but not NCh exposure, and number of adverse birth outcomes. Exposure to burning oil pits and mustard gas increased the risks for specific adverse birth outcomes by 2 to 4 times. Results indicate that Gulf War Ch, but not NCh exposures are related to adverse birth outcomes. Pregnancies in women with a history of war exposures might benefit from more intensive observation.

  • 21.
    Arnetz, Bengt
    et al.
    Wayne State University School of Medicine, Family Medicine, Detroit, MI.
    Sokol, Robert
    Drutchas, Alexis
    Kruger, Michael
    Jamil, Hikmet
    1991 Gulf War exposures and pregnancy outcomes: a retrospective study of Iraqi immigrants2012In: American Journal of Obstetrics and Gynecology, ISSN 0002-9378, E-ISSN 1097-6868, Vol. 206, no 1 S, p. 261-262Article in journal (Refereed)
    Abstract [en]

    We studied 1991 Gulf War (GW)-related environmental exposures and adverse birth outcomes in Iraqis. A random cross-sectional sample of 307 Iraqi families that immigrated to the United States responded to a structured interview covering socioeconomics, lifestyle, environmental exposures, and birth outcome. Data per each family was collected either from the man or the woman in the respective family. The respondents were divided into those that resided in Iraq during and following the GW (post-GW, n=185) and those that had left before (pre-GW, n=122). The primary outcome was lifetime prevalence of adverse birth outcomes, ie, congenital anomalies, stillbirth, low birth weight, and preterm delivery and its relationship to GW exposures. Mean number of adverse birth outcomes increased from 3.43 (SD=2.11) in the pre-GW to 4.63 (SD=2.63) in the post-GW group (P<.001). Mean chemical (Ch) and nonchemical (NCh) environmental exposure scores increased from pre-GW scores of 0.38 units (SD=1.76) and 0.43 (SD=1.86), respectively, to post-GW scores of 5.65 units (SD=6.23) and 7.26 (SD=5.67), P<.001 between groups for both exposures. There was a significant dose-response relationship between Ch environmental exposure (P=.001), but not NCh exposure, and number of adverse birth outcomes. Exposure to burning oil pits and mustard gas increased the risks for specific adverse birth outcomes by 2 to 4 times. Results indicate that Gulf War Ch, but not NCh exposures are related to adverse birth outcomes. Pregnancies in women with a history of war exposures might benefit from more intensive observation.

  • 22.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Gender differences in patient perceptions of involvement in myocardial infarction care2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 3, p. 174-181Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Gender differences in the clinical presentation, treatment and outcomes of myocardial infarction (MI) have been demonstrated. However, few studies have examined gender differences in patients' perceptions of involvement in MI care, and whether differing levels of involvement might be associated with gender differences in treatment and outcome. AIM: To examine possible gender differences in MI patients' perceptions of their involvement during hospitalization. METHODS: Questionnaire study conducted in 2005-2006 among MI patients under the age of 75 at eleven hospitals. Patient ratings of their involvement during hospitalization were analyzed for age-stratified gender differences. RESULTS: Younger (<70 years of age) female MI patients placed significantly more value on shared decision-making than younger (<70) men. More than one third of patients would have liked to be more involved in their care during hospitalization and discharge planning, with women significantly more dissatisfied than men. Significantly fewer younger female patients discussed secondary preventive lifestyle changes with cardiology staff prior to hospital discharge. CONCLUSION: Significant age-specific gender differences exist in MI patient ratings of, and satisfaction with, involvement during hospitalization. Further study is needed regarding the possible role of involvement in the recognized gender differences in the treatment and outcomes of MI.

  • 23.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Staff views and behaviour regarding patient involvement in myocardial infarction care: development and evaluation of a questionnaire2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 1, p. 27-35Article in journal (Refereed)
    Abstract [en]

    BACKGROUND

    Healthcare legislation in several nations now dictates the responsibility of health care professionals to involve patients in decisions concerning care and treatment. However, few studies have examined the impact of patient involvement on the work of health care professionals. A better understanding of staff views and behaviour might enhance patient involvement.

    AIM

    The aim of this study was to develop and validate a questionnaire for measuring views and behaviour regarding patient involvement among physicians and nursing staff caring for patients with myocardial infarction.

    METHODS

    Focus groups among cardiology staff provided the basis for the construction of the questionnaire. Questionnaire validity and reliability were evaluated in a small pilot study and a larger cross-sectional study among cardiology staff at twelve Swedish hospitals.

    RESULTS

    The questionnaire demonstrated good validity and reliability, with two factors measuring staff views and four measuring behaviour.

    CONCLUSION

    The questionnaire appears to be a useful tool for evaluating the perceptions and behaviour of physicians and nursing staff regarding patient involvement in myocardial infarction care. Use of this questionnaire may provide insight regarding areas of staff-patient interaction that need improvement, as well as implications of patient involvement for the work of each professional group on cardiology wards.

  • 24.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Physicians' and nurses' perceptions of patient involvement in myocardial infarction care2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no 2, p. 113-120Article in journal (Refereed)
    Abstract [en]

    Background: Patients' involvement in their healthcare has been associated with better health outcomes. However, few studies have examined whether patient involvement affects the work of healthcare professionals. A better understanding of professionals' views and behaviour is necessary for improving clinical practice and optimizing patient involvement. Aim: To measure perceptions and behaviour regarding patient involvement among physicians and nursing staff caring for patients with acute myocardial infarction. Methods: A questionnaire study conducted in 2005 among cardiology staff at twelve Swedish hospitals. The questionnaire included six scales measuring staff views and behaviour. Results: Physicians, registered nurses, and practical nurses did not differ significantly in their views of patient involvement, but did differ significantly in behaviour (p<.001). All three groups felt that an actively involved patient enriched their work, at the same time increasing their work load and taking time from other tasks. Physicians discussed daily activities and lifestyle changes with myocardial infarction patients before hospital discharge to a greater extent than nursing staff (p<.001). Conclusion: Physicians and registered nurses viewed time constraints as a hinder for patient involvement, while practical nurses felt unsure in communicating with patients. Considering these organizational and professional issues may improve patient involvement and health outcomes in myocardial infarction care. (C) 2007 European Society of Cardiology. Published by Elsevier B.V All rights reserved.

  • 25.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lindahl, Bertil
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Spångberg, Kalle
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Wallentin, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , UCR-Uppsala Clinical Research Center.
    Wang, Yun
    Ager, Joel
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Is patient involvement during hospitalization for acute myocardial infarction associated with post-discharge treatment outcome?: an exploratory study2010In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 13, no 3, p. 298-311Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether patient involvement during hospitalization for acute myocardial infarction (MI) was associated with health and behavioural outcomes 6–10 weeks after hospital discharge.

    Background Patient involvement has been associated with improved health outcomes in chronic disease, but less research has focused on the effects of patient involvement in acute conditions, such as MI.

    Design Self-administered questionnaire study. Questionnaire results were run against medical outcome data in a national database of cardiac patients.

    Setting and participants Cardiac patients (n = 591) on their first follow-up visit after hospitalization for MI at 11 Swedish hospitals.

    Main outcome measures Patient ratings of three questionnaire scales related to involvement; cardiovascular symptoms, medication compliance, participation in cardiac rehabilitation, and achievement of secondary preventive goals.

    Results More positive patient ratings of involvement were significantly associated with fewer cardiovascular symptoms 6–10 weeks after hospital discharge. In contrast, patients who attended cardiac rehabilitation and achieved the goals for smoking cessation and systolic blood pressure were significantly less satisfied with their involvement. No association was found between involvement ratings and medication compliance.

    Conclusion This study represents a first attempt to examine associations between patient involvement in the acute phase of illness and short-term health outcomes. Some significant associations between involvement and health and behavioural outcomes after acute MI were found. However, higher involvement ratings were not consistently associated with more desirable outcomes, and involvement during hospitalization was not associated with MI patient health and behaviour 6–10 weeks after hospital discharge to the extent hypothesized.

  • 26.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Zhdanova, Ludmila S.
    Elsouhag, Dalia
    Lichtenberg, Peter
    Luborsky, Mark R.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Organizational Climate Determinants of Resident Safety Culture in Nursing Homes2011In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 51, no 6, p. 739-749Article in journal (Refereed)
    Abstract [en]

    Purpose of the Study: In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes. Design and Methods: Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures. Results: The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05). Implications: Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.