Air quality and morbidity : concentration-response relationship for Sweden

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Импульсное зондирование при исследовании импедансных свойств биосегментов

Тез. докл. Междунар. науч.-техн. конф. (науч. чтения, посвящ. П. О. Сухому), Гомель, 4-6 июля. 2002 г

Long-term stability in obsessive thoughts and compulsive behavior in the general population: a longitudinal study in Sweden

OBJECTIVE: Obsessive thoughts and compulsive behavior and their related disorder Obsessive-Compulsive Disorder (OCD) commonly occur in the general population. Clinical populations indicate a high level of stability, although there are few longitudinal studies in the general population. The recommended drug treatments are SSRIs/TCAs. However, there are few long-term follow up studies. The goal of this study was to 1) examine the occurrence and stability of obsessions, compulsions, and OCD in a longitudinal population-based survey, 2) investigate the use of SSRI and TCA and the potential effect on symptoms. METHODS: A ten-year longitudinal general population in Stockholm was used (2000 and 2010, n = 5650) Obsessional washing, checking, intrusive unpleasant thoughts and the level of suffering due to these symptoms were measured by self-report. Information on use of SSRIs and TCAs by these individuals was obtained from registers. Stability was examined using contingency tables and multinomial logistic regression. RESULTS: At baseline, 2.1, 11.7 and 11.9% reported obsessional washing, checking and intrusive thoughts. A total of 5% reported considerable suffering from these (i.e. OCD). Based on psychiatric interview only 0.4% had OCD. Ten years later a quarter of OCD cases were still classified as having OCD, one quarter reported any obsessive or compulsive symptom and half were classified as symptom-free. Treatment receipt was low and controlling for medication did not change the stability. CONCLUSION: Obsessive thoughts and compulsive behavior are common and stable. While this group is potentially undertreated, there is no indication that those treated display a different pattern of recovery

Interactions between Glutathione S-Transferase P1, Tumor Necrosis Factor, and Traffic-Related Air Pollution for Development of Childhood Allergic Disease

BACKGROUND: Air pollutants may induce airway inflammation and sensitization due to generation of reactive oxygen species. The genetic background to these mechanisms could be important effect modifiers. OBJECTIVE: Our goal was to assess interactions between exposure to air pollution and single nucleotide polymorphisms (SNPs) in the beta2-adrenergic receptor (ADRB2), glutathione S-transferase P1 (GSTP1), and tumor necrosis factor (TNF) genes for development of childhood allergic disease. METHODS: In a birth cohort originally of 4,089 children, we assessed air pollution from local traffic using nitrogen oxides (traffic NO(x)) as an indicator based on emission databases and dispersion modeling and estimated individual exposure through geocoding of home addresses. We measured peak expiratory flow rates and specific IgE for inhalant and food allergens at 4 years of age, and selected children with asthma symptoms up to 4 years of age (n = 542) and controls (n = 542) for genotyping. RESULTS: Interaction effects on allergic sensitization were indicated between several GSTP1 SNPs and traffic NO(x) exposure during the first year of life (p(nominal) < 0.001-0.06). Children with Ile105Val/Val105Val genotypes were at increased risk of sensitization to any allergen when exposed to elevated levels of traffic NO(x) (for a difference between the 5th and 95th percentile of exposure: odds ratio = 2.4; 95% confidence interval, 1.0-5.3). In children with TNF-308 GA/AA genotypes, the GSTP1-NO(x) interaction effect was even more pronounced. We observed no conclusive interaction effects for ADRB2. CONCLUSION: The effect of air pollution from traffic on childhood allergy appears to be modified by GSTP1 and TNF variants, supporting a role of genes controlling the antioxidative system and inflammatory response in allergy

The Swedish Twin Registry in the Third Millennium: An Update

Abstract The Swedish Twin Registry was first established in the late 1950s. Today it includes more than 170,000 twins — in principle all twins born in Sweden since 1886. In this article we describe some ongoing and recently completed projects based on the registry. In particular, we describe recent efforts to screen all twins born between 1959 and 1985, and young twin pairs when they turn 9 and 12 years of age. For these studies, we present initial frequencies of common conditions and exposures

Asthmatics Exhibit Altered Oxylipin Profiles Compared to Healthy Individuals after Subway Air Exposure

Asthma is a chronic inflammatory lung disease that causes significant morbidity and mortality worldwide. Air pollutants such as particulate matter (PM) and oxidants are important factors in causing exacerbations in asthmatics, and the source and composition of pollutants greatly affects pathological implications.This randomized crossover study investigated responses of the respiratory system to Stockholm subway air in asthmatics and healthy individuals. Eicosanoids and other oxylipins were quantified in the distal lung to provide a measure of shifts in lipid mediators in association with exposure to subway air relative to ambient air.Sixty-four oxylipins representing the cyclooxygenase (COX), lipoxygenase (LOX) and cytochrome P450 (CYP) metabolic pathways were screened using liquid chromatography-tandem mass spectrometry (LC-MS/MS) of bronchoalveolar lavage (BAL)-fluid. Validations through immunocytochemistry staining of BAL-cells were performed for 15-LOX-1, COX-1, COX-2 and peroxisome proliferator-activated receptor gamma (PPARγ). Multivariate statistics were employed to interrogate acquired oxylipin and immunocytochemistry data in combination with patient clinical information.Asthmatics and healthy individuals exhibited divergent oxylipin profiles following exposure to ambient and subway air. Significant changes were observed in 8 metabolites of linoleic- and α-linolenic acid synthesized via the 15-LOX pathway, and of the COX product prostaglandin E(2) (PGE(2)). Oxylipin levels were increased in healthy individuals following exposure to subway air, whereas asthmatics evidenced decreases or no change.Several of the altered oxylipins have known or suspected bronchoprotective or anti-inflammatory effects, suggesting a possible reduced anti-inflammatory response in asthmatics following exposure to subway air. These observations may have ramifications for sensitive subpopulations in urban areas

Allvarlig silikos finns fortfarande i Sverige

Silikos orsakas av kvarts och kan inte botas, bara förebyggas. Vid tidiga tecken på sjukdomen kan avbruten exponering minska risken för att sjukdomen blir allvarlig. Stora insatser gjordes i Sverige för att eliminera sjukdomen under mitten av 1900-talet. Trots detta angavs silikos som bidragande eller underliggande dödsorsak hos 70 män och 1 kvinna mellan 2007 och 2012. Bearbetning av berg i stenindustri eller gruva var de vanligaste arbetsmiljöerna för dessa fall. Alla personer utom tre var födda i Sverige. Studien visar att arbetsmiljön i Sverige fortfarande kan innebära en risk för allvarlig silikos. Risken förebyggs bäst genom noggrann kontroll av dammhalterna.Many measures have been taken in Sweden to eliminate the occurrence of serious silicosis. However, between 1997 and 2013 there were 111 deaths with silicosis as underlying cause, 110 men and 1 woman. In most cases the deceased was rather old; only fourteen persons were below 74 years of age. We have studied the exposure between 2007 and 2012 in the 71 persons who died of silicosis as underlying or contributing cause through medical records. We could find information regarding 48 of them. Ten persons worked in mines, 10 in stone industry, 14 with crushing or blasting of rock, 4 in foundries, 3 were concrete workers and 7 suffered exposure in other industries. The study shows that the measures taken in Sweden have not been sufficient to totally eliminate serious silicosis

Success factors when implementing a structured support model for systematic work environment management in operating departments : A case study from Sweden

Aim The study aimed to investigate how departments in a Swedish hospital worked with a structured support model between the sessions and what they identified as success factors. Background To improve the work environment in a Swedish hospital, a structured support model for systematic work environment management was implemented in operating departments. The structured work starts with sending a web-based, open-ended, anonymous questionnaire to all employees. In response, employees describe how they perceive their work environment 'right now'. Next, a session is held where employees' viewpoints are discussed, and areas of improvement are agreed upon. Action plans are created between the sessions, and the employees start working with their plans with support from their managers. Implementing new models takes time and requires efforts from employees and managers. Method A case study was conducted, including three operating departments within a perioperative organization in a university hospital in Sweden. The participating departments had used the model without interruption during the Covid-19 pandemic 2 years after implementation, and they had created a customized working method. Three first-line managers were interviewed, and 22 action plans, 21 workplace meeting notes and two presentations were analysed using thematic analysis. Results The results are sorted under three main thematic headings: Experience of results and benefits, Marketing and cheering on and Making adjustments and making the model one's own. The results from the action plans and workplace meetings indicated that the employees had discussed problems with cooperation, work organization and how to treat each other. Conclusion Human factors, such as support, encouragement, seeing the benefits, allowing for time and respecting each other can facilitate and contribute to the implementation and success of a new model. Implications for Nursing Management The main finding of the study indicates that with a structured way of working, and with the participation of the employees in the systematic work environment work, the employees contributed with constructive suggestions for improvement. This, in turn, contributed to reducing the workload for first-line managers. In addition, when working with a structured model, deficiencies in the workplace were identified, which triggered an improvement process in the participating hospital departments

First-Line Managers' Experiences of Working with a Structured Support Model for Systematic Work Environment Management

Background: This paper describes the experiences of first-line managers when working with a structured support model for systematic work environment management in their work groups. First-line managers play a key part in influencing the work environment. Methods: In this study, a sample of managers implementing a structured support model, the Stamina model, in Swedish municipalities were interviewed. A total of 31 (n = 31) interviews were conducted at two time points during a one-year period. The collected data were analysed using a qualitative thematic approach. Results: The results showed that managers experienced discomfort when giving the responsibility of working with work environmental issues to employees. However, managers also experienced and were impressed by how well it worked in allowing employees to take on work environmental issues. Managers found that they balanced between being quiescent and, at the same time, actively monitoring progress in the work groups. Conclusions: The results from this study implicate that managers need to be sensitive to the needs and capacity of their work groups. The oracle in Delphi stated know yourself. We conclude: Know your group

Val av inhalator är av stor vikt vid behandling av astma och KOL

There are three main types of inhalers, dry powder inhalers (DPI, single and multidose), metered dose inhalers (pMDI, spray, suspension and solution), and soft mist (SMI). There are major differences in inhalation technique and handling of the different inhaler types. Different inhalers are well suited for different patients and the choice of inhaler may be crucial for the treatment outcome. It is frequently observed that patients have poor inhaler technique and the use of different inhalers, in particular inhaler types, in the same patient increases the risk of handling errors. Careful instructions and follow up on inhaler technique at every visit to the health care center is of utmost importance. In treatment failure, change of inhaler may be considered before change of drugs or dosing. Change of inhaler as a result of a telephone prescriptions is unacceptable and must not happen