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  • 951.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Anders
    Kungliga Tekniska Högskolan.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Repetitive low energy impacts on alpine ski helmets2014In: Science and Skiing VI / [ed] Erich Muller, Josef Kroll, Stefan Lindinger, Meyer & Meyer Sport, 2014, p. 323-329Chapter in book (Refereed)
  • 952.
    Swarén, Mikael
    et al.
    KTH ; Swedish Olympic Academy.
    Fredrik, Hillergren
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Larsson, Andreas
    SkateCoach AB.
    Björklund, Glenn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Swedish Sports Confederation.
    Key performance indicators of ice hockey sprint performance2018In: Journal of Sports Sciences: BASES Conference 2018 – Programme and Abstracts, Routledge, 2018, Vol. 36 (S1), p. 1-94Conference paper (Refereed)
    Abstract [en]

    Ice hockey is a physical demanding sport with high intensity and repetitive start and stop movements. Hence, players need to have excellent physical condition and ice skating skills with good acceleration and sprint capacities. However, little biomechanical research has been conducted on elite ice hockey players to analyse applicable key performance indicators of skating acceleration and short sprint performance. The aim of the study was to collect plantar forces data of elite ice hockey players during short sprints in order to analyse and identify plausible performance indicators. With institutional ethics approval, twelve professional male ice hockey players, (Age 22.8 ± 5.2 years, height 185.6 ± 5.0 cm, weight 86.9 ± 6.2 kg) from the Swedish Hockey League participated in the study. Following an individual warm up, each player performed three maximal sprints (18.4 m) from a stationary position, with three minutes of rest between each sprint. Sprint time was collected with timing gates (Brower Timing system, USA). The best trial for each player was chosen for further analysis. Plantar forces were collected at 100 Hz with pressure insoles (Novel GmbH, Germany), placed in both skates (Buckeridge et al., 2015, PLOS ONE, 10, 5). Analyses were made for stride rate, symmetry left-right, contact time, force production and impulse. Only the step frequency, 3.35 ± 0.38 strides/s was correlated to skating performance (r = -0.6, P < 0.05). For the second to seventh step, the mean contact time was 0.26 ± 0.04 s, the mean force was 844 ± 152 N and the mean peak force was 1335 ± 224 N. The mean impulse was 230 ± 52 Ns and the group showed greater force production for the left leg compared to the right leg −2.07 ± 9.08 %. The present study is the first study to analyse plantar forces on professional ice hockey players. The significance of stride rate is in line with previous research (Renaud et al., 2017, Sports Engineering, 20, 255–266) whereas the plantar force production is higher, compared to findings by Buckeridge et al. (2015). This is likely explained by the use of higher skilled players in the present study. Still, plantar force production is not significant for performance which points to the importance of skating kinematics and/or shear forces. Hence, the combination of kinetics and 3D kinematics on ice is important to enhance the knowledge about skating performance of elite ice hockey players as well as developing a kinetic measurement system to measure shear forces in combination with plantar forces.

  • 953.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Anders
    Royal Institute of Technology, Stockholm, Sweden.
    Repeated Low Impacts: Alpine Ski Helmets2013In: Proceedings for Congress of the International Society for Skiing Safety, 2013Conference paper (Refereed)
  • 954.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Mechanics, Royal Institute of Technology, Stockholm, Sweden.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Anders
    Department of Mechanics, Royal Institute of Technology, Stockholm, Sweden.
    Repeated low impacts in alpine ski helmets2013In: Sports Technology, ISSN 1934-6182, E-ISSN 1934-6190, Vol. 6, no 1, p. 43-52Article in journal (Refereed)
    Abstract [en]

    Alpine ski race helmets are subjected to multiple impacts during a race caused by the skiers hitting the gates on their way down the course. This study investigated the difference between expanded polystyrene (EPS) and expanded polypropylene (EPP) cores in alpine ski race helmets when subjected to repetitive violence, caused by alpine slalom gates. A special test rig was developed where a rotating slalom pole impacted the helmets with a velocity of 13.3 m·s− 1. All helmets (six EPS and six EPP) were attached to a headform, monitored with a triaxial accelerometer at the center of mass. Each helmet sustained 1000 impacts and acceleration data were collected around every 200 impacts. No significant differences were observed between the first hit and after 1000 hits for either the EPS or the EPP helmets. However, the total group mean acceleration and mean peak acceleration were 15% and 16% higher, respectively, for the EPS series compared with the EPP series. Also, all EPS helmets showed cracked cores after 1000 impacts compared with 1 cracked EPP core. Findings suggest that EPP cores might be more suitable for absorbing multiple low impacts caused by alpine gates and that repeated violence is a relevant parameter to consider when constructing alpine ski race helmets.

  • 955.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Anders
    KTH Mechanics,, Royal Institute of Technology, Stockholm, Sweden.
    Repetitive Low Impacts on Alpine Ski Helmets2013In: Proceedings for the 6th International Congress on Science and Skiing / [ed] Erich Mueller, Josef Kröll, Stefan Josef Lindinger, Jurgen Pfusterschmied, Thomas Stöggl, 2013, p. 22-Conference paper (Refereed)
  • 956.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Mechanics, Royal Institute of Technology, Stockholm, Sweden .
    Karlöf, L.
    Swix Sport AS, Frysajv. 40, Oslo, Norway .
    Holmberg, Hans-Christer
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Swedish Olympic Committee, Stockholm, Sweden.
    Eriksson, A
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Mechanics, Royal Institute of Technology, Stockholm, Sweden .
    Validation of test setup to evaluate glide performance in skis2014In: Sports Technology, ISSN 1934-6182, E-ISSN 1934-6190, Vol. 7, no 1-2, p. 89-97Article in journal (Refereed)
    Abstract [en]

    Although today's ski waxing chemicals and micro-machining techniques of the ski base are highly sophisticated, objective procedures for testing and verification of the results have not yet been developed and evaluation is based on comparison of subjective experience. The purpose of the present study was thus to compare different setups for testing the glide of cross-country skis. Two differently waxed ski pairs were tested for glide inside a ski tunnel. Inertial measurement units (IMUs) were attached to each ski; instantaneous velocities monitored by three different speed-traps; the velocities during the acceleration phase determined by Doppler radar. Kinetic, potential and total energy, giving the energy dissipation, were calculated for four representative trials during the acceleration phase. No reliable data were obtained from the IMUs due to high drift. The mean maximal velocity for the two ski pairs were 6.97, s = 0.09 and 6.70, s = 0.09 m·s − 1, respectively. Higher differences between the skis were identified during the retardation phase compared to the acceleration phase. The mean difference between the velocities determined by the speed-trap and Doppler radar was 0.6, s = 1%, demonstrating that the latter provides accurate data for evaluation of gliding characteristics and performance. However, theoretical confirmation of the friction coefficient, on the basis of data provided by Doppler radar and energy calculations requires exact measurements of the inclination and topography of the track in question. © 2015 Taylor & Francis.

  • 957.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Larsson, Oscar
    Björklund, Glenn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Using telecasting to identify key performance indicators in alpine skiing and evaluate the inter-analyst reliability of alpine ski coaches2016Conference paper (Refereed)
    Abstract [en]

    ntroduction The most frequently used analysis method in alpine skiing is video footage. However, using video footage to identifying key performance indicators (KPIs) and other characteristics are difficult as each coach analyzes video footage in a subjective manner, which decreases the reliability of the analyses. Even though alpine skiing is a “closed sport”, without any external disturbing moments, each race is unique therefore never identical. It is thus difficult for coaches to know the validity and reliability of their analyses as the majority of the video footage of alpine skiers is captured during training, not racing. A large number of analyzed races with high reliability could therefore facilitate to identify KPIs in alpine skiing. The purpose of this study was to use the standardized typical error to explore the possibility to use telecasting to analyze performance and skiing characteristics in world cup slalom races. Method Standard telecasting footage (25 fps) from four different WC-races (eight runs) was used for analyzing turn times for eleven skiers (nine males and two females). The footage was analyzed at three separate situations, by two different alpine World Cup coaches and one video analyst. Turn time was defined as boot passage of the gate and all video analyses were made in DartFish ProSuite 6. Typical error (TE) was calculated by; TE=σ_diff/√(N_obs ) The standardized typical error (STE) was calculated by; TE= TE/√(((n_1-1)^2 σ_1^2+(n_2-1)^2 σ_2^2 ) /((n_1+n_2-2))-TE^2 ) The index described by Hopkins [1] was used for evaluating the influence of the STE. Results The mean turn time for the male skiers was 0.83 ± 0.18 s, with a coefficient of variation of 22%. The mean turn time for the two female skiers was 0.85 ± 0.19 s and the coefficient of variation was 22%. The TE between the different analyses was 0.03 s and the STE was 0.14. The results provide a detailed analysis of gate-to-gate times for each skier. Discussion The TE value of 0.03 s is most likely due to the 25 fps telecasting footage, where each frame is 0.04 s. The analysts must therefore choose one frame if the point of interest is between two frames. Hence, TE will presumably decrease with increase framerate. As the STE < 0.2, the disagreement between the different analysts can be considered as trivial [1, 2]. We here show how the STE can be used to identify inter-analyst reliability of alpine skiing video analyses. Furthermore, the presented method provides a robust, cheap and effective method to objectively analyze skiing performance and identifying plausible key performance indicators in alpine skiing. References 1. Hopkins, W., Reliability from consecutive pairs of trials (Excel spreadsheet). A new view of statistics, 2000. 2. Liu, H., et al., Inter-operator reliability of live football match statistics from OPTA Sportsdata. International Journal of Performance Analysis in Sport, 2013. 13(3): p. 803-821.

  • 958.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Larsson, Oscar
    Ultimate Performance AB, Uppsala.
    Björklund, Glenn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Using telecasting to identify turn times in alpine skiing2016Conference paper (Refereed)
    Abstract [en]

    Alpine skiing can be considered as a “closed sport” where each athlete is alone in the course without any external disturbing moments. However, each alpine race is unique therefore never identical. In addition, the condition of the course is constantly changing as each skier makes new tracks in the snow. Identifying key performance indicators (KPI) and other characteristics are therefore difficult. The most frequently used analysis method in alpine skiing is video footage. However, it is not always possible for coaches to cover a complete course as they can be several kilometers long as e.g. downhill skiing. The purpose of this study was thus to explore the possibility to use telecasting to analyze performance and skiing characteristics in world cup slalom races to identify possible KPI.

  • 959.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. KTH.
    Soehnlein, Quirin
    Holmberg, Martin
    Stöggl, Thomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Salzburg University, Department of Sport Science and Kinesiology.
    Björklund, Glenn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Using 3D motion capture to analyze ice-hockey shooting technique on ice2015Conference paper (Refereed)
  • 960.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stöggl, Thomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kalmendal, Christian
    Björklund, Glenn
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    How do custom made insoles affect the pressure distribution under the feet in alpine skiing?2016Conference paper (Refereed)
    Abstract [en]

    Introduction Elite alpine skiers frequently adjust insoles, boots and skis to optimize skiing performance. There are numerous different constructions of custom made insoles. However, nobody has, to the authors’ knowledge, investigated the mechanisms behind a plausible performance increase. The purpose of the study was therefore to investigate the potential difference in pressure distribution under the feet when skiing with regular insoles compared to custom made insoles. Method A pre-study investigated differently constructed insoles and their possible effects on the pressure distribution under the feet. One test subject performed different squat and fly-wheel exercises with six differently constructed insoles. Kinetics and 3D-kinematics were collected to identify possible differences. One insole construction, with a flat bottom and a semi-soft upper layer, was thereafter chosen to be used for field tests. Nine professional skiers, including both race skiers and full time ski instructors, were recruited for the field tests. Each skier performed in a randomized order, three runs with a standard insole and three runs with a custom made insole. Plantar pressure under the feet was measured with the Pedar Mobile System at 100 Hz, for eight consecutive carving turns. The skiers were instructed to have the smallest possible time difference between all runs. The three runs for each situation were synchronized and the mean total, forefoot and midfoot pressure distributions were calculated. Results The pre-study results show that the pressure distribution between foot and insole and between insole and ski-boot depends on the insole construction. The mean time for all 54 runs was 26.62 ± 2.41 s and the mean individual time difference between the fastest and the slowest runs was 0.62 ± 0.33 s. All skiers showed large individual differences in percentage of “used” area under the feet, between the two types of insoles (5-80%). When skiing with the custom made insole, the total mean difference in percentage usage of the forefoot was -17 ± 19% and 8 ± 12% for the midfoot. Discussion The results show that the pressure distribution under the feet depends on the type of insole. However, the effect of a custom made insole is very individual. Hence, when performing studies of skiing kinetics and/or equipment, it is of vast importance that all subjects use similarly constructed custom made insoles. It can also be hypothesized that e.g., different canting angles of the ski-boot, affect the skier differently depending on the type of insole. Our suggestion is therefore to perform measurements to optimize the insoles before investigating and optimizing canting angles. The results also show that custom made insoles can assist the skier to utilize different areas of the foot. However, future studies are needed to investigate whether the decreased usage of the forefoot affects the overall aggressiveness of the setup and whether custom made insoles have a positive effect on skiing performance.

  • 961.
    Swarén, Mikael
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Royal Institute of Technology, Stockholm.
    Stöggl, Thomas
    University of Salzburg, Salzburg, Austria.
    Supej, Matej
    University of Lubljana, Lubljana, Slovenia.
    Eriksson, Anders
    Royal Institute of Technology, Stockholm.
    Usage and validation of a tracking system to monitor position and velocity during cross-country skiing2016In: International Journal of Performance Analysis in Sport, ISSN 1474-8185, E-ISSN 1474-8185, Vol. 16, no 2, p. 769-785Article in journal (Refereed)
    Abstract [en]

    For the first time, we investigate here the possibility of using a real-time locating system (RTLS) to track cross-country skiers during a competition. For validation, three RTLS tags were attached to the antenna of a real-time kinematics global navigation satellite system (RTK GNSS) carried by a skier, skiing the course at three different intensities. In addition, RTLS data were collected from 70 racers during a FIS cross-country skiing sprint race. Spline interpolations were fitted to the RTLS data. In comparison to the RTK GNSS, the spline models for the three RTLS tags overestimated the mean skiing velocity by 5% and 2% at low and medium intensities, respectively, with no difference between the two systems during high intensity. The corresponding overestimations of the peak velocity at skiing intensities were 15%, 10% and 8%, respectively. A decimated sampling frequency for the RTLS data from 50 Hz to 0.5 Hz resulted in lower typical mean errors for the x-(0.53 m vs. 1.40 m), y-(0.31 m vs. 1.36 m) and z-axis (0.10 m vs. 0.20 m). The spline models based on 0.5 Hz and 1 Hz RTLS data overestimated the finishing times by on average of 0.5 s and 0.3 s, respectively. If a sufficient number of locators is utilized and the number of tags simultaneously recorded is limited, this RTLS can track cross-country skiers accurately. In conclusion, a low RTLS sampling frequency in combination with a spline model offer considerable potential for analyzing performance during cross-country sprint skiing.

  • 962.
    Säfsten, Pär
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    BVC Sjuksköterskors erfarenheter av hälsosamtal med familjer i fråga om risk för övervikt hos barn. Intervjustudie 2017.2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 963.
    Säll, Anna-Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hälsorelaterad livskvalitet vid kranskärlssjukdomHjärtinfarkt och livskvalitet i Gävleborgs län2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 964.
    Säll, Anna-Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jämställdhetsintegrering och hälsa i fem svenska landsbygdskommuner.: En studie med mixad metod.2019Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 965.
    Söderberg, Eva
    et al.
    University of Stockholm.
    Nyhlén, Sara
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Giritli Nygren, Katarina
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    The place of girls?: Collective memory work in the study of portrayals of rural girlhood in Swedish child and youth literature2018In: Visual Encounters in the Study of Rural Childhoods, Rutgers University Press, 2018, p. 109-122Chapter in book (Other academic)
  • 966.
    Söderberg Lejonfrid, Marie
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Grön Rehabilitering: – en multimodal rehabilitering i restorativ naturmiljö som arbetslivsinriktad och medicinsk rehabilitering vid stressrelaterad ohälsa.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 967.
    Söderlind, Vicky
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjuksköterskans upplevelse och erfarenhet av att vårda patienter som genomgår immunterapi: En empirisk studie med semistrukturerad intervjuguide2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 968.
    Tegström, Sandra
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Frykland, Tove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Att vårda ett svårt sjukt barn: Sjuksköterskans roll i den palliativa omvårdnaden2013Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 969.
    Tengberg, Martin
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Medarbetartrivsel i förändringsprocesser: Hur påverkas mellanledare och medarbetare som arbetar med bostödjandes’ trivsel på arbetsplatsen, när det sker en större förändring av arbetsmetoderna i organisationen?2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 970.
    Tersing, Linda
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svenska elevhälsoteams erfarenheter kring hälsofrämjande arbete: fokus på samverkan och nätverk.2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 971.
    Tesch, Per
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Pozzo, M.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Ainegren, Mats
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Swarén, Mikael
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Linnehan, R. M.
    Astronaut Office, National Aeronautics and Space Administration, Johnson Space Center, Houston, TX, United States .
    Cardiovascular responses to rowing on a novel ergometer designed for both resistance and aerobic training in space2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 5, p. 516-521Article in journal (Refereed)
    Abstract [en]

    Background: Astronauts are required to perform both resistance and aerobic exercise while in orbit. This study assessed the aerobic energy yield and related physiological measurements using a nongravity dependent flywheel device designed for both resistance and aerobic exercise (RAD) in space. Methods: Eight physically active men and women performed all-out rowing on the RAD. For comparison, exercise was also carried out employing a commercially available rowing ergometer (C2). Results: Peak oxygen uptake during exercise using RAD and C2 averaged 3.11 ± 0.49 and 3.18 ± 0.50 L · min-1 respectively. Similarly, peak plasma lactate concentration (9.6 vs. 11.2 mmol · L-1), heart rate (183 vs. 184 bpm), and rate of perceived exertion (15.8 vs. 16.0) were comparable across exercise using the two devices. Discussion: Collectively, the results suggest that this novel exercise modality offers cardiovascular and metabolic responses, and thus aerobic exercise stimulus that is equally effective as that evoked by established technology for indoor rowing. Given the need for physiologically sound and highly effective exercise countermeasures that features small mass and envelope, and allows for resistance and aerobic exercise in a single apparatus, we believe this novel hardware should be considered for use in space. © by the Aerospace Medical Association, Alexandria, VA.

  • 972.
    Tettli, Daniel
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Det sociala stödets betydelse i arbetslivet: - en studie av svenska arbetstagare i Norge2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 973.
    Thomson, Hilary
    et al.
    MRC, Social & Publ Hlth Sci Unit, Glasgow G12 8RZ, Lanark, Scotland .
    Thomas, Sian
    MRC, Social & Publ Hlth Sci Unit, Glasgow G12 8RZ, Lanark, Scotland .
    Sellström, Eva
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Petticrew, Mark
    London Sch Hyg & Trop Med, Fac Publ Hlth & Policy, Dept Social & Environm Hlth Res, London WC1, England.
    Housing improvements for health and associated socio-economic outcomes2013In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 2, p. Art. No. CD008657-Article, review/survey (Refereed)
    Abstract [en]

    Background The well established links between poor housing and poor health indicate that housing improvement may be an important mechanism through which public investment can lead to health improvement. Intervention studies which have assessed the health impacts of housing improvements are an important data resource to test assumptions about the potential for health improvement. Evaluations may not detect long term health impacts due to limited follow-up periods. Impacts on socio-economic determinants of health may be a valuable proxy indication of the potential for longer term health impacts. Objectives To assess the health and social impacts on residents following improvements to the physical fabric of housing. Search methods Twenty seven academic and grey literature bibliographic databases were searched for housing intervention studies from 1887 to July 2012 (ASSIA; Avery Index; CAB Abstracts; The Campbell Library; CINAHL; The Cochrane Library; COPAC; DH-DATA: Health Admin; EMBASE; Geobase; Global Health; IBSS; ICONDA; MEDLINE; MEDLINE In-Process & Other Non-Indexed Citations; NTIS; PAIS; PLANEX; PsycINFO; RIBA; SCIE; Sociological Abstracts; Social Science Citations Index; Science Citations Index expanded; SIGLE; SPECTR). Twelve Scandinavian grey literature and policy databases (Libris; SveMed+; Libris uppsok; DIVA; Artikelsok; NORART; DEFF; AKF; DSI; SBI; Statens Institut for Folkesundhed; Social.dk) and 23 relevant websites were searched. In addition, a request to topic experts was issued for details of relevant studies. Searches were not restricted by language or publication status. Selection criteria Studies which assessed change in any health outcome following housing improvement were included. This included experimental studies and uncontrolled studies. Cross-sectional studies were excluded as correlations are not able to shed light on changes in outcomes. Studies reporting only socio-economic outcomes or indirect measures of health, such as health service use, were excluded. All housing improvements which involved a physical improvement to the fabric of the house were included. Excluded interventions were improvements to mobile homes; modifications for mobility or medical reasons; air quality; lead removal; radon exposure reduction; allergen reduction or removal; and furniture or equipment. Where an improvement included one of these in addition to an included intervention the study was included in the review. Studies were not excluded on the basis of date, location, or language. Data collection and analysis Studies were independently screened and critically appraised by two review authors. Study quality was assessed using the risk of bias tool and the Hamilton tool to accommodate non-experimental and uncontrolled studies. Health and socio-economic impact data were extracted by one review author and checked by a second review author. Studies were grouped according to broad intervention categories, date, and context before synthesis. Where possible, standardized effect estimates were calculated and statistically pooled. Where meta-analysis was not appropriate the data were tabulated and synthesized narratively following a cross-study examination of reported impacts and study characteristics. Qualitative data were summarized using a logic model to map reported impacts and links to health impacts; quantitative data were incorporated into the model. Main results Thirty-nine studies which reported quantitative or qualitative data, or both, were included in the review. Thirty-three quantitative studies were identified. This included five randomised controlled trials (RCTs) and 10 non-experimental studies of warmth improvements, 12 non-experimental studies of rehousing or retrofitting, three non-experimental studies of provision of basic improvements in low or mIddle Income countries (LMIC), and three non-experimental historical studies of rehousing from slums. Fourteen quantitative studies (42.4%) were assessed to be poor quality and were not included in the synthesis. Twelve studies reporting qualitative data were identified. These were studies of warmth improvements (n = 7) and rehousing (n = 5). Three qualitative studies were excluded from the synthesis due to lack of clarity of methods. Six of the included qualitative studies also reported quantitative data which was included in the review. Very little quantitative synthesis was possible as the data were not amenable tometa-analysis. This was largely due to extreme heterogeneity both methodologically as well as because of variations in the intervention, samples, context, and outcome; these variations remained even following grouping of interventions and outcomes. In addition, few studies reported data that were amenable to calculation of standardized effect sizes. The data were synthesised narratively. Data from studies of warmth and energy efficiency interventions suggested that improvements in general health, respiratory health, and mental health are possible. Studies which targeted those with inadequate warmth and existing chronic respiratory disease were most likely to report health improvement. Impacts following housing-led neighbourhood renewal were less clear; these interventions targeted areas rather than individual households in most need. Two poorer quality LMIC studies reported unclear or small health improvements. One better quality study of rehousing from slums (pre-1960) reported some improvement in mental health. There were few reports of adverse health impacts following housing improvement. A small number of studies gathered data on social and socioeconomic impacts associated with housing improvement. Warmth improvements were associated with increased usable space, increased privacy, and improved social relationships; absences from work or school due to illness were also reduced. Very few studies reported differential impacts relevant to equity issues, and what data were reported were not amenable to synthesis. Authors' conclusions Housing investment which improves thermal comfort in the home can lead to health improvements, especially where the improvements are targeted at those with inadequate warmth and those with chronic respiratory disease. The health impacts of programmes which deliver improvements across areas and do not target according to levels of individual need were less clear, but reported impacts at an area level may conceal health improvements for those with the greatest potential to benefit. Best available evidence indicates that housing which is an appropriate size for the householders and is affordable to heat is linked to improved health and may promote improved social relationships within and beyond the household. In addition, there is some suggestion that provision of adequate, affordable warmth may reduce absences from school or work. While many of the interventions were targeted at low income groups, a near absence of reporting differential impacts prevented analysis of the potential for housing improvement to impact on social and economic inequalities.

  • 974.
    Tiitinen Mekhail, Kirsi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sträven efter stabilitet i livsvillkor som nybliven pappa i en mångkulturell förort:erfarenheter efter ett utökat föräldrastödprogram.2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 975.
    Tjulin, Åsa
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    What is fair? International perspectives on equity in work and health2018In: NU2018: Det akademiska lärarskapet, 2018Conference paper (Refereed)
    Abstract [sv]

    WHAT IS FAIR? INTERNATIONAL PERSPECTIVES ON EQUITY IN WORK AND HEALTH Åsa Tjulin (asa.tjulin@miun.se) Det är titlen på den distanskurs (7,5 hp) som Mittuniversitetet, Mälardalens Högskola och University of Waterloo (Kanada) skapar tillsammans. Vi vill skapa interaktion mellan svenska och kanadensiska studenter inom ämnesområdet arbetsliv och hälsa. Vi har bildat en partnerskapsmodell där kursen är vår gemensamma plattform. Varje läsosäte antar sina egna studenter. Vi har en baktanke med det som jag gärna berättar mer om. Jag kan ge dig en teaser: University of Waterloo är erkänt ett av de största lärosäten i Kanada som ger onlineutbildningar. Deras stödresurser är enorma i jämförelse vad vi i Sverige är vana vid. Vi har en egen OnlineConsultant knuten till projektet. Den personen ger feedback på allt från våra lärandemål till hur vi pedagogiskt kan genomföra kursen och vilka onlineverktyg som passar bäst till våra idéer. Jag vill gärna dejta dig som är intresserad av och kanske har egen erfarenhet av att bedriva ditt akademiska lärarskap inom ramen för internationella kurser/utbildning. Det jag kan berätta för dig handlar om hur idén till den här kursen föddes, hur den förädlats, vilka samverkansstrategier vi använder oss av och vad vi vill med kursen och med vårt partnerskap. Vi har även fått initieringsbidrag från STINT för att förverkliga vår idé. Blir du nyfiken? Jag hoppas det! Nästa steg som jag funderar på är om vi kan söka forskningsmedel för att studera vår aktivitet. Kanske kan vi bidra till att belysa både fallgropar och framgångsfaktorer för hur internationella kursers online/på distans inom vårt ämnesområde fungerar i praxis. Har du idéer eller erfarenehet om detta? Eller har jag väckt din nyfikenhet? Kom och träffa mig! Vi ses, hälsar Åsa Tjulin

  • 976.
    Tjulin, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hagqvist, Emma
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eriksson, Andrea
    Kungliga Tekniska Högskolan.
    Landstad, Bodil
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Prerequisites and hindrance in a health-promoting leadership educational intervention: - learning experinces from first line public sector managers2018In: Implementing health promotion in the life course: - user involvement in practice and research / [ed] Siw Tone Innstrand, Geir Arild Espnes, Bjarne Bruun Jensen, Rapportserie Senter for helsefremmende forskning , 2018Conference paper (Refereed)
  • 977.
    Tjulin, Åsa
    et al.
    Division of Public Health Sciences, School of Health, Care and Social Welfare, Malardalens University, Sweden .
    Mussner, Ulrika
    Division of Community Medicine, Department of Medical and Health Sciences, Linkoping University, Sweden .
    Selander, John
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ekberg, Kerstin
    National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linkoping University, Sweden .
    Learning Experiences in Return to Work Among Workplace Actors2015In: International Journal of Disability Mangement Research, ISSN 1833-8550, E-ISSN 1834-4887, Vol. 10, article id e1Article in journal (Refereed)
    Abstract [en]

    Purpose: The objective of this article was to investigate how individual learning emerges among workplace actors during the return-to-work process, and whether the prerequisites for collective learning at the workplace are present and managed by the actors. Learning in this context is viewed as a change in the preconceptions, experience or competence of the individual as a result of interactions in the workplace due to the return-to-work process. Method: A qualitative method was used, consisting of open-ended interviews with 19 individuals across 11 workplaces in the public and private sector. Inductive content analysis was performed. Results: The key findings from this study are that individual learning emerges in the return-to-work process due to previous experience, communication with other workplace actors, or insights into what works for the individual. However, the individual learning that occurs in the return-to-work process is not carried over into workplace learning due to barriers in understanding the needs and opportunities that may be present in the process. Conclusion: Our findings suggest that individual learning occurs within social practices through social interaction between the actors involved (workers on sickness absence supervisors and colleagues) and individual experiences. A greater knowledge of the factors that contribute to workplace learning could facilitate biopsychosocial and ecological return-to-work interventions, which allow workplace actors to draw on previous experiences from one return-to-work process to another.

  • 978.
    Toivanen, Susanna
    et al.
    CHESS, Stockholms universitet.
    Harter Griep, Rosane
    Fundação Oswaldo Cruz.
    Mellner, Christin
    Stockholms universitet.
    Nordenmark, Mikael
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eloranta, Sandra
    Krolinska institutet.
    Hospitalization due to stroke or myocardial infarction – are there any differences between self-employed individuals and employees?2016Conference paper (Refereed)
    Abstract [en]

    The aim was to examine hospitalization due to stroke and acute myocardial infarction, respectively, and to analyze differences between the self-employed and paid employees in the same industries. Data and methods: Data from Statistics Sweden's population register (2003) was linked to National Board of Health and Welfare’s hospital admission register and cause of death register (2004-2008). More than 4.7 million people (7% self-employed) were included in the analyses. Individuals were classified on the basis of their occupational status as self-employed persons or employees. The self-employed were further classified as sole proprietors or limited liability company owners according to the legal form of self-employment. Based on the Swedish Standard Industrial Classification (SNI 2002) eight industries were distinguished. Diagnoses of hospitalization were classified as stroke (intracerebral hemorrhage I61, cerebral infarction I63, and unspecified acute cerebrovascular disease I64) and acute myocardial infarction (I21) based on the international classification of diseases (ICD-10). Stroke and Myocardial Infarction (MI) hospitalization incidence rate ratios (IRR) and 95% confidence intervals (CI) were estimated using negative binomial regression models adjusted for pre-specified potential confounding covariates. Effect modification by occupational status, industrial sector, and gender was investigated with two and three-way interaction terms. 

  • 979.
    Toivanen, Susanna
    et al.
    CHESS, Stockholms universitet.
    Harter Griep, Rosane
    Mellner, Christine
    Nordenmark, Mikael
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eloranta, S
    Sjukhusinläggningar till följd av akuta hjärt-kärlsjukdomar: finns det skillnader mellan egenföretagare och anställda inom samma bransch?2016In: Book of abstracts - FALF 2016, Östersund: Mittuniversitetet , 2016, p. 42-43Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Både bättre och sämre hälsa har tidigare rapporterats hos egenföretagare jämfört med anställda. Egenföretagare rapporterar oftast bättre livs- och arbetstillfredsställelse trots att de arbetar mer, tar kortare semester, är mer sällan sjukskrivna och oftare sjuknärvarande än anställda. Företagsform och bransch påverkar egenföretagares dödsrisk, även i jämförelse med anställda. Vad gäller sjukhusinläggningar till följd av akuta hjärt- kärlsjukdomar är kunskapen om skillnader mellan egenföretagare och anställda begränsad. Syftet var att undersöka sjukhusinläggningar till följd av akut hjärtinfarkt och stroke, var för sig, och analysera skillnader mellan egenföretagare och anställda inom samma branscher. Data och metod: Data från Statistiska centralbyråns befolkningsregister (2003) länkades till Socialstyrelsens patientregister och dödsorsaksregister (2004-2008). Drygt 4,7 miljoner individer (7 % egenföretagare) ingick i studien. Individer klassificerades utifrån yrkesställning som anställda, egenföretagare eller egenföretagare med aktiebolag. Utifrån Standard för svensk näringsgrensindelning (SNI 2002) klassificerades åtta branscher.

    Diagnos för sjukhusinläggning klassificerades som akut hjärtinfarkt (I21) och stroke (I61 intracerebral blödning; I63 cerebral infarkt; I64 ospecificerad akut cerebrovaskulär sjukdom) utifrån internationell klassificering av diagnoser (ICD-10). Sjukhusinläggningstal (incidens rate ratio, IRR med 95 % konfidensintervall, KI) estimerades med multipel Negative Binomial regressionsanalys. Två- och trevägsinteraktioner testades mellan yrkesställning, bransch och kön. Resultat: Risken för sjukhusinläggning till följd av akut hjärtinfarkt (IRR 0,92; KI 0,85-0,99) var signifikant lägre bland egenföretagare med aktiebolag jämfört med anställda, och högre i de flesta branscher (IRR 1,15 – 1,25) jämfört med jordbruk, skogsbruk och fiske (JSF). Förhöjd risk för sjukhusinläggning till följd av stroke fanns i samtliga branscher (IRR 1,19 – 1,48) jämfört med JSF, däremot fanns inga skillnader utifrån yrkesställning. Tvåvägsinteraktionen mellan yrkesställning och bransch var signifikant för hjärtinfarkt (p=0,0019). Jämfört med anställda hade egenföretagare förhöjd risk för sjukhusinläggning inom handel, restaurang och transport (IRR 1,22; KI 1,09-1,38) samt lägre risk inom JSF (IRR 0,81; KI 0,68-0,97) och i icke specificerade branscher (IRR 0,79; KI 0,67- 0,93).

  • 980.
    Toivanen, Susanna
    et al.
    CHESS, Stockholms universitet.
    Härter Griep, Rosane
    Stockholm University/Karolinska Institutet ; Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil.
    Mellner, Christin
    Stockholms universitet.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Eloranta, Sandra
    Scandinavian Development Services, Stockholm, Sweden.
    Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden2016In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 73, no 9, p. 627-636Article in journal (Refereed)
    Abstract [en]

    Objectives: Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data. Methods:A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18–100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004–2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders. Results: Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13–15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11–20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17–23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries. Conclusions: Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.

  • 981.
    Toivanen, Susanna
    et al.
    Centre for Health Equity Studies, Stockholm University, Karolinska Institutet, Sweden.
    Mellner, Christin
    Department of Psychology, Stockholm University, Sweden.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Self-Employed Persons in Sweden - Mortality Differentials by Industrial Sector and Enterprise Legal Form: A Five-Year Follow-Up Study2015In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 58, no 1, p. 21-32Article in journal (Refereed)
    Abstract [en]

    Objectives

    This study investigated mortality differentials between self-employed persons in Sweden, considering industrial sector, enterprise characteristics and socio-demographic factors.

    Methods

    Data on 321,274 self-employed persons were obtained from population registers in Sweden. Cox proportional hazards models were used to compare all-cause and cause-specific mortality rate ratios by industrial sector and enterprise legal form, adjusted for confounders.

    Results

    All-cause mortality was 10–32% higher in self-employed persons in Manufacturing and Mining, Trade and Communication, and Not Specified and Other sectors than in Agriculture, Forestry, and Fishing. Mortality from cardiovascular disease was 23% higher in Trade and Communication, and from neoplasms 17–51% higher in Manufacturing and Mining, Not Specified, and Other. Mortality from suicide was 45–60% lower in Personal and Cultural Services, and in Not Specified. Mortality was 8–16% higher in sole proprietorship than limited partnership.

    Conclusions

    Further research of working conditions is warranted, considering industry and enterprise legal form. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.

  • 982.
    Toivanen, Susanna
    et al.
    Derpartment of Public Health Sciences, Stockholm University.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Arbete och ojämlikhet i hälsa i vuxenlivet2018In: Den orättvisa hälsan: Om socioekonomiska skillnader i hälsa och livslängd, Stockholm: Liber, 2018, 2, p. 335-360Chapter in book (Refereed)
  • 983.
    Tolvanen, Liisa
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Patient´s experiences with social support during weight-regain after bariatric surgery: A qualitative study2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
  • 984.
    Torsdatter Markussen, Lisa
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Stress och återhämtning i arbetet: - En enkätundersökning av anställda i servicebranschen i Finlands huvudstadsregion2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 985.
    Trappe, S
    et al.
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Hayes, A
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Galpin, L
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Kaminsky, L
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Jemiolo, B
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Fink, W
    Ball State Univ, Human Performance Lab, Muncie, IN 47306 USA. .
    Trappe, T
    Human Performance Laboratory, Ball State Univ., Muncie, IN 47306, United States.
    Jansson, Anna
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gustafsson, T
    Department of Laboratory Medicine, Clinical Physiology Karolinska Instutet, Stockholm, Sweden.
    Tesch, Per
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    New Records In Aerobic Power Among Octogenarian Lifelong Endurance Athletes2013In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 114, no 1, p. 3-10Article in journal (Refereed)
    Abstract [en]

    New records in aerobic power among octogenarian lifelong endurance athletes. J Appl Physiol 114: 3-10, 2013. First published October 11, 2012; doi:10.1152/japplphysiol.01107.2012.-We examined whole body aerobic capacity and myocellular markers of oxidative metabolism in lifelong endurance athletes [n = 9, 81 ± 1 yr, 68 ± 3 kg, body mass index (BMI) = 23 ± 1 kg/m2] and age-matched, healthy, untrained men (n = 6; 82 ± 1 y, 77 ± 5 kg, BMI = 26 ± 1 kg/m2). The endurance athletes were cross-country skiers, including a former Olympic champion and several national/regional champions, with a history of aerobic exercise and participation in endurance events throughout their lives. Each subject performed a maximal cycle test to assess aerobic capacity (VO2max). Subjects had a resting vastus lateralis muscle biopsy to assess oxidative enzymes (citrate synthase and βHAD) and molecular (mRNA) targets associated with mitochondrial biogenesis [peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) and mitochondrial transcription factor A (Tfam)]. The octogenarian athletes had a higher (P < 0.05) absolute (2.6 ± 0.1 vs. 1.6 ± 0.1 l/min) and relative (38 ± 1 vs. 21 ± 1 ml·kg-1·min-1) VO2max, ventilation (79 ± 3 vs. 64 ± 7 l/min), heart rate (160 ± 5 vs. 146 ± 8 beats per minute), and final workload (182 ± 4 vs. 131 ± 14 W). Skeletal muscle oxidative enzymes were 54% (citrate synthase) and 42% (βHAD) higher (P < 0.05) in the octogenarian athletes. Likewise, basal PGC-1α and Tfam mRNA were 135% and 80% greater (P < 0.05) in the octogenarian athletes. To our knowledge, the VO2max of the lifelong endurance athletes is the highest recorded in humans >80 yr of age and comparable to nonendurance trained men 40 years younger. The superior cardiovascular and skeletal muscle health profile of the octogenarian athletes provides a large functional reserve above the aerobic frailty threshold and is associated with lower risk for disability and mortality. © 2013 the American Physiological Society.

  • 986.
    Tredal, Ingrid
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alcohol use among abused and non-abused older persons aged 60-84 years: An European study2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 987.
    Tredal, Ingrid
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Soares, Joaquim J. F.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sundin, Örjan
    Mid Sweden University, Faculty of Human Sciences, Department of Psychology.
    Viitasara, Eija Riitta
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Melchiorre, MG
    Scientific Technological Area, Socio Economic Research Centre, Italian National Institute of Health and Science on Aging, Ancona, Italy .
    Torres-Gonzales, F
    Network of Biomedical Research on Mental Health Centers, University of Granada, Granada, Spain .
    Stankunas, M
    Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania .
    Lindert, J
    Department of Public Health Sciences, Protestant University of Applied Sciences, Ludwigsburg, Germany .
    Ioannidi-Kapolou, E
    Department of Sociology, National School of Public Health, Athens, Greece.
    Barros, H
    Department of Hygiene and Epidemiology, University of Porto, Medical School, Porto, Portugal.
    Alcohol use among abused and non-abused older persons aged 60-84 years: A European study2013In: Drugs: education prevention and policy, ISSN 0968-7637, E-ISSN 1465-3370, Vol. 20, no 2, p. 96-109Article in journal (Refereed)
    Abstract [en]

    Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression).

    Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60–84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with bivariate/multivariate methods.

    Findings: Psychologically abused elders were more often alcohol users than non-users (21.7% vs. 16.3%) and the opposite regarding financially abused elders (4.8% vs. 3.5%). Psychologically abused elders also had more often three or more drinks containing alcohol in a drinking day (21.1% vs. 16.1%) and six or more drinks on one occasion (24.5% vs. 18.3%). Psychological abuse, demographics/socio-economics (e.g. education), smoking and leisure activities were positively associated alcohol use, and being from certain countries (e.g. Italy), age (e.g. 80–84 years), depression and financial abuse negatively.

    Conclusions: Across countries, 64.2% of the elders were drinkers. Some variables (e.g. psychological abuse) were positively related to alcohol use and others (e.g. depression) negatively. Many of the elders were exposed to abuse. Our findings may be useful to prevent/manage drinking and abuse among elders. However, alcohol use was influenced by various factors that need to be further elucidated, particularly the relation between abuse and drinking.

  • 988.
    Turtiainen, Aino
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Skadeprofil hos finska damfotbollspere i division ett och två2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 989.
    Tymko, Michael M.
    et al.
    Univ British Columbia, Sch Hlth & Exercise Sci, Ctr Heart Lung & Vasc Hlth, Kelowna, BC, Canada.
    Tremblay, Joshua C.
    Queens Univ, Sch Kinesiol & Hlth Studies, Cardiovasc Stress Response Lab, Kingston, ON, Canada.
    Steinback, Craig D.
    Univ Alberta, Fac Phys Educ & Recreat, Edmonton, AB, Canada.
    Moore, Jonathan P.
    Bangor Univ, Extremes Res Grp, Sch Sport Hlth & Exercise Sci, Bangor, Gwynedd, Wales.
    Hansen, Alex B.
    Univ British Columbia, Sch Hlth & Exercise Sci, Ctr Heart Lung & Vasc Hlth, Kelowna, BC, Canada.
    Patrician, Alexander
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Howe, Connor A.
    Univ British Columbia, Sch Hlth & Exercise Sci, Ctr Heart Lung & Vasc Hlth, Kelowna, BC, Canada.
    Hoiland, Ryan L.
    Univ British Columbia, Sch Hlth & Exercise Sci, Ctr Heart Lung & Vasc Hlth, Kelowna, BC, Canada.
    Green, Daniel J.
    Univ Western Australia, Sch Sports Sci Exercise & Hlth, Crawley, WA, Australia; Liverpool John Moores Univ, Res Inst Sport & Exercise Sci, Liverpool, Merseyside, England.
    Ainslie, Philip N.
    Univ British Columbia, Sch Hlth & Exercise Sci, Ctr Heart Lung & Vasc Hlth, Kelowna, BC, Canada.
    UBC-Nepal Expedition: acute alterations in sympathetic nervous activity do not influence brachial artery endothelial function at sea level and high altitude2017In: Journal of applied physiology, ISSN 8750-7587, E-ISSN 1522-1601, Vol. 123, no 5, p. 1386-1396Article in journal (Refereed)
    Abstract [en]

    Evidence indicates that increases in sympathetic nervous activity (SNA), and acclimatization to high altitude (HA), may reduce endothelial function as assessed by brachial artery flow-mediated dilatation (FMD); however, it is unclear whether such changes in FMD are due to direct vascular constraint, or consequential altered hemodynamics (e.g., shear stress) associated with increased SNA as a consequence of exposure to HA. We hypothesized that 1) at rest, SNA would be elevated and FMD would be reduced at HA compared with sea-level (SL);and 2) at SL and HA, FMD would be reduced when SNA was acutely increased, and elevated when SNA was acutely decreased. Using a novel, randomized experimental design, brachial artery FMD was assessed at SL (344 m) and HA (5,050 m) in 14 participants during mild lower-body negative pressure (LBNP; -10 mmHg) and lower-body positive pressure (LBPP; -10 mmHg). Blood pressure (finger photoplethysmography), heart rate (electrocardiogram), oxygen saturation (pulse oximetry), and brachial artery blood flow and shear rate (Duplex ultrasound) were recorded during LBNP, control, and LBPP trials. Muscle SNA was recorded (via microneurography) in a subset of participants (n = 5). Our findings were 1) at rest, SNA was elevated (P < 0.01), and absolute FMD was reduced (P = 0.024), but relative FMD remained unaltered (P = 0.061), at HA compared with SL; and 2) despite significantly altering SNA with LBNP (+60.3 +/- 25.5%) and LBPP (-37.2 +/- 12.7%) (P < 0.01), FMD was unaltered at SL (P = 0.448) and HA (P = 0.537). These data indicate that acute and mild changes in SNA do not directly influence brachial artery FMD at SL or HA.

  • 990.
    Tågestad, Erika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ungdomars upplevelse av idrotten i skolan2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 991.
    Udo, Camilla
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Health Care Sciences Post Graduate School Karolinska Institute Stockholm Sweden .
    Melin-Johansson, Christina
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Henoch, Ingela
    Institute of Health and Care Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
    Axelsson, Bertil
    Department of General Surgery Östersund Hospital Östersund Sweden .
    Danielson, Ella
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Institute of Health and Care Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden .
    Surgical nurses’ attitudes towards caring for patients dying of cancer: a pilot study of an educational intervention on existential issues2014In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 23, no 4, p. 426-440Article in journal (Refereed)
    Abstract [en]

    This is a randomised controlled pilot study using a mixed methods design. The overall aim was to test an educational intervention on existential issues and to describe surgical nurses' perceived attitudes towards caring for patients dying of cancer. Specific aims were to examine whether the educational intervention consisting of lectures and reflective discussions, affects nurses' perceived confidence in communication and to explore nurses' experiences and reflections on existential issues after participating in the intervention. Forty-two nurses from three surgical wards at one hospital were randomly assigned to an intervention or control group. Nurses in both groups completed a questionnaire at equivalent time intervals: at baseline before the educational intervention, directly after the intervention, and 3 and 6 months later. Eleven face-to-face interviews were conducted with nurses directly after the intervention and 6 months later. Significant short-term and long-term changes were reported. Main results concerned the significant long-term effects regarding nurses' increased confidence and decreased powerlessness in communication, and their increased feelings of value when caring for a dying patient. In addition, nurses described enhanced awareness and increased reflection. Results indicate that an understanding of the patient's situation, derived from enhanced awareness and increased reflection, precedes changes in attitudes towards communication.

  • 992.
    Uljevic, Ognjen
    et al.
    University of Split; Faculty of Kinesiology; Split; Croatia.
    Pehar, Miran
    University of Mostar; Faculty of Natural Sciences Mathematics and Education; Mostar; Bosnia and Herzegovina.
    Pojskic, Haris
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Spasic, Miodrag
    University of Split, Faculty of Kinesiology, Split, Croatia.
    Sekulic, Damir
    Faculty of Kinesiology, University of Split, Croatia.
    A Total Sample Vs. Playing-Position Approach To Identifying Relationships Between Different Agility Components In Basketball2017In: 11th International Conference on Kinanthropology: Sport and Quality of Life, Brno, Czech Republic, 2017, Vol. 11, p. 55-Conference paper (Refereed)
    Abstract [en]

    Purpose: Non-planned agility (reactive agility - RAG), and pre-planned agility (change of direction speed- CODS) are important determinants of success in basketball. However, the association between these two conditioning capacities in high-level basketball players is rarely evidenced. The aim of this investigation was to evaluate the relationship between basketball-specific CODS and RAG in the total sample, and separately for three main playing positions in the game of basketball (i.e. guards, forwards and centers).

    Methods: The sample comprised 106 national/international-level male basketball players (age:21.9±3.5 years; body height: 195.1±7.9 cm; body mass: 90.1±10.0 kg), divided according to their playing positions in game (guards, N = 49; forwards, N = 22; centers, N = 35). The variables included body mass, body height, and body fat percentage; as well as basketball-specific CODS and -RAG. The reliability of CODS and RAG was evidenced by intra-class-coefficients (ICC). Differences among positions were established by one-way analysis of variance, consecutive post-hoc analyses, and effect size differences (η2). Finally, the relationship between variables was established by means of Pearson’s moment correlation coefficient (r), which was calculated for the total sample, and then separately for each playing position.

    Results: The intra-session reliability was somewhat higher for CODS, than for RAG (ICC: 0.81 and 0.76, respectively). The centers were tallest (F: 67.75, p < 0.01; η2: 0. 57), and heaviest (F: 39.01, p < 0.01,η2: 0.44), followed by forwards. The guards and forwards achieved better results than centers in CODS(F: 5.19, p < 0.01; η2: 0.09), and RAG (F: 3.85, p < 0.05; E η2: 0.07). When observed for the total sample, the CODS and RAG shared 49% of common variance (r: 0.70). When calculated for playing positions, the highest correlation between CODS and RAG was evidenced for centers (r: 0.81), then for forwards(r: 0.71), and guards (r: 0.51).

    Conclusion: Relatively strong correlations between CODS and RAG among forwards and centers implies the possibility of simultaneous strength and conditioning of these capacities for these two playing positions. Meanwhile, because of the small common variance, separate training for RAG and CODS is warranted for guards. The study highlights the necessity of a position-specific approach to evidencing determinants of sport-specific conditioning qualities for high-level players.

  • 993.
    Uthman, Muhammed Mubashir B.
    et al.
    Univ Ilorin, Fac Clin Sci, Dept Epidemiol & Community Hlth, Coll Hlth Sci, Ilorin, Nigeria.
    Uthman, Olalekan A.
    Univ Warwick, Warwick Med Sch, CAHRD, Warwick, England.
    Yahaya, Ismail
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Interventions for the prevention of mycobacterium avium complex in adults and children with HIV2013In: Cochrane Database of Systematic Reviews, ISSN 1469-493X, E-ISSN 1469-493X, no 4, p. Art. no. CD007191-Article, review/survey (Refereed)
    Abstract [en]

    Background Mycobacterium avium complex (MAC) infection is a common complication of advanced acquired immunodeficiency syndrome (AIDS) disease and is an independent predictor of mortality and shortened survival. Objectives To determine the effectiveness and safety of interventions aimed at preventing MAC infection in adults and children with HIV infection. Search methods We searched MEDLINE, EMBASE, and The Cochrane Library (search date December 2012). Selection criteria Randomised controlled trials comparing different strategies for preventing MAC infection in HIV-infected individuals. Data collection and analysis Two reviewers independently assessed trial eligibility and quality, and extracted data. Where data were incomplete or unclear, a third reviewer resolved conflicts and/or trial authors were contacted for further details. Development of MAC infection and survival were compared using risk ratios (RR) and 95% confidence intervals (CI). The quality of evidence has been assessed using the GRADE methodology. Main results Eight studies met the inclusion criteria. Placebo-controlled trials There was no statistically significant difference between clofazimine and no treatment groups in the number of patients that developed MAC infection (RR 1.01; 95% CI 0.37 to 2.80). Rifabutin (one study; RR 0.48; 95% CI 0.35 to 0.67), azithromycin (three studies; RR 0.37; 95% CI 0.19 to 0.74) and clarithromycin (one study; RR 0.35; 95% CI 0.21 to 0.58) were more effective than placebo in preventing the development of MAC infection. There was no statistically significant difference between those treated with clofazimine (one study; RR 0.98; 95% CI 0.41 to 2.32), rifabutin (one study RR 0.91; 95% CI 0.78 to 1.05), azithromycin (three studies, pooled RR 0.96; 95% CI 0.69 to 1.32) and placebo in number of reported deaths. One study found that the risk of death was reduced by 22% in patients treated with clarithromycin compared to those treated with placebo (RR 0.78; 95% CI 0.64 to 0.96). Monotherapy vs. monotherapy Patients treated with clarithromycin (RR 0.60; 95% CI 0.41 to 0.89) and azithromycin (RR 0.60; 95% CI 0.40 to 0.89) were 40% less likely to develop MAC infection than those treated with rifabutin. There was no statistically significant difference between those treated with clarithromycin (RR 0.98; 95% CI 0.83 to 1.15), azithromycin (RR 0.98; 95% CI 0.77 to 1.24) and rifabutin in the number of reported deaths Combination therapy versus monotherapy There was no statistically significant difference between patients treated with a combination of rifabutin and clarithromycin and those treated with clarithromycin alone (RR 0.74; 95% CI 0.46 to 1.20); and those treated with combination of rifabutin and azithromycin and those treated with azithromycin alone (RR 0.59; 95% CI 1.03). Patients treated with a combination of rifabutin plus clarithromycin were 56% less likely to develop MAC infection than those treated with rifabutin alone (RR 0.44; 95% CI 0.29 to 0.69). Patients treated with a combination of rifabutin plus azithromycin were 65% less likely to develop MAC infection than those treated with rifabutin alone (RR 0.35; 95% CI 0.21 to 0.59). There was no statistically significant difference in the number of reported deaths in all the four different comparisons of prophylactic agents. Authors' conclusions Based on limited data, azithromycin or clarithromycin appeared to be a prophylactic agent of choice for MAC infection. Further studies are needed, especially direct comparison of clarithromycin and azithromycin. In additions, studies that will compare different doses and regimens are needed.

  • 994.
    van Vliet, Marja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Integrative Medicine in the Dutch healthcare system: prerequisites and tools for implementation2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Integrative Medicine (IM) is a care approach that focuses on the overall well-being and healing process of patients rather than solely on their disease. IM educates and empowers people to be active players in their own care, emphasizes the therapeutic relationship, and makes use of all appropriate evidence-based approaches. The health-oriented foundations of IM are in line with the recently posed concept that describes health as ”the ability to adapt and to self-manage”. Due to the shared underpinnings of both IM and the new concept of health, incorporation of this new concept of health may serve as a facilitator for the development and implementation of IM. From a practical viewpoint, working from an integrative care approach requires specific competences from healthcare providers, such as socio-communicative and self-reflective skills, and reflexivity towards a holistic perspective on health. Previous studies have shown that a Mind-Body Medicine (MBM) course can potentially foster these competences among future healthcare providers. This thesis intended to gain increased insight into the prerequisites and tools for implementation of IM. Therefore, in the first part it aimed to explore the attitudes and practice of IM among Dutch nurses and the support for the new dynamic concept of health as ”the ability to adapt and to self-manage” among main stakeholders within the Dutch healthcare community. Furthermore, in the second part it aimed to evaluate the possibilities of an MBM course among medical and nursing students as a tool to foster an integrative care approach.

    Methods Both quantitative and qualitative research designs were used. Attitudes and practice of IM were assessed in a semi-structured survey study among 355 Dutch nurses (study I). Support for the new concept of health was explored in a mixed method study, where in the first step data from interviews and focus-groups among 140 stakeholders were investigated by use of manifest content analysis, and in the second step a cross-sectional survey was performed among 1938 stakeholders to verify the findings of the first step (study II). The MBM course was evaluated by a controlled, quasi-experimental intervention study (74 participants / 61 controls among medical students and 47 participants / 64 controls among nursing students) in which validated questionnaires were used (study III). Furthermore, in-depth interviews with 11 medical and 15 nursing students were employed and analysed by a Phenomenological Hermeneutical method to obtain an in-depth understanding of the meaning of the MBM course for the participants (study IV).

    Findings Study I showed an overall positive attitude towards IM among nurses. Patient-centeredness and a focus on individuals’ own resources and responsibility to promote health met the most support among both nurses and other stakeholders. These elements were considered to be the main positive aspects of the new dynamic concept of health among stakeholders as well (study II). Use of evidence-based and safe complementary therapies and a healing environment received some support from the nurses, but lack of knowledge and lack of evidence seems to hinder further incorporation in the current healthcare practice (study I). Additionally, study II revealed that health was perceived to comprise six dimensions: bodily functions, mental functions & perception, spiritual / existential dimension, quality of life, social and societal participation and daily functioning. In line with patients, nurses had a more broad conception of health in comparison to other healthcare professionals. Study III showed long-term beneficial effects of the MBM course on two dimensions of empathy (personal distress and empathic concern) among medical students, and on perceived stress and empathy (personal distress) among nursing students. Study IV brought forth that the MBM course can be understood as a pathway to inner awareness and a support to connecting with others as well as the outside world. The following themes were identified: “ability to be more present”, “an increased perception and awareness of self”, and “connecting on a deeper level with others”.

    Conclusion It can be concluded from the results in the first explorative part of this thesis that the observed positive attitudes and perceptions among healthcare professionals toward IM and the newly proposed health concept can serve as important facilitators for further implementation of IM within the Dutch healthcare system. Furthermore, the increased ability to deal with stress, improved empathic abilities and more openness toward different perspectives on health and new treatment options among medical and nursing students following a MBM course, as reported in the second part of this thesis, suggest that this course might be a suitable tool to foster an integrative care approach among future healthcare professionals.

  • 995.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Louis Bolk Institute, the Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Busch, Martine
    van Praag Institute, Utrecht, The Netherlands.
    Meijer, Judith E M
    The Netherlands Foundation Health Centers, National Information and Knowledge Center for Integrative Medicine, Netherlands.
    von Rosenstiel, Inès A
    Slotervaart Hospital, National Information and Knowledge Center for Integrative Medicine, Netherlands .
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute, the Netherlands.
    Attitudes, Beliefs, and Practices of Integrative Medicine Among Nurses in the Netherlands2015In: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, Vol. 33, no 2, p. 110-121Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study assessed the attitude, beliefs, and practices of integrative medicine (IM) among nurses in the Netherlands.

    DESIGN: Subscribers of a Dutch nursing journal were asked to fill in an anonymous, structured, online survey related to the topic under study.

    RESULTS: A total of 355 people responded, of which 37% were familiar with the concept of IM in advance. On completion of the survey, the majority (83%) considered IM as a (very) important innovation in health care. Familiarity (odds ratio = 3.20; 95% confidence interval [1.48, 6.94]) and organization (nursing home compared to hospital (odds ratio = 5.98; 95% confidence interval [1.36, 26.23]) were characteristics associated with a positive attitude toward IM. Between 23% and 46% of respondents encountered obstacles regarding implementation of IM. The main obstacles were lack of support (69% to 78%), means (57% to 85%), and time (63% to 70%).

    CONCLUSIONS: Dutch nurses seem to have relatively positive attitudes and beliefs regarding IM. The outcome of this survey may contribute an increased awareness of the key role that nurses can play in the development and implementation of IM.

  • 996.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A Barrier Opener for Personal Insights: Nursing and Medical Students Experiences of Participating in an Experiential Mind-Body Skills Program2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A98-A99Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to obtain an in-depth understanding on how nursing-, and medical students participating in a Mind-Body Medicine Skills program experienced participation and what the program has meant to them on a personal and a professional level.

    Methods: Based on a qualitative approach, first and second year students were interviewed 3 months after completion of the program. Interviews were analyzed with a qualitative content analysis. As a part of a larger study evaluating the effects on stress, empathy and self-reflection, this qualitative sub-study included 10 nursing students from Mid Sweden University, Sweden, and 10 medical students from University of Utrecht, The Netherlands. The Mind-Body Medicine Skills program was adapted from the program developed at Georgetown University School of Medicine, Washington DC, and included 11 experiential sessions were the students were introduced to different mind-body techniques (mindfulness meditation, guided imagery, bio-feedback etc).

    Results: Data analysis is ongoing and more complete analysis will be presented at the conference. In preliminary analysis an overarching theme has been identified: The Mind-Body Medicine Skills program as a barrier opener of personal insights, and a starting point for a new journey in life. The participants describe how the course have made it possible for them obtain insights about themselves, both by self reflection in relation to experiences and through listening to the stories of the others. It is also described that they currently do not at all times explicitly use the direct techniques, but more separate personalized elements, which they have been able to incorporate in everyday situations: i.e. moments of mindfulness while walking, biking or eating, or taking a moment of breathing and relaxation before dealing with problematic situations with others.

    Conclusion: Participation in the Mind-Body Medicine Skills program can on an individual basis have a deep and profound meaning, stimulating to personal growth.

  • 997.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Effects of a Mind-Body Medicine Skills Program on Perceived Stress, Empathy and Self-Reflection Among Medicine and Nursing Students: A Quantitative Study2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A99-A99Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to implement and quantitatively evaluate the Mind-Body Medicine (MBM) Skills program among Dutch medical and Swedish nursing students.

    Methods: The MBM Skills program was piloted among second year medical students at Utrecht University and first year nursing students at Mid Sweden University in the period 2011–2013. During the course, the participating students learned and practiced Mind-Body techniques such as relaxation, meditation, guided imagery, biofeedback, physical exercise, art, music and movement. The effects of the MBM skills program on perceived stress, empathy, and self-reflection were evaluated by the following validated scales: Perceived Stress Scale, Interpersonal Reactivity Index, and Groningen Reflection Ability Scale. Participating students and controls answer(-ed) the different questionnaires at baseline, at the end of the course, and 6 and 12 months later.

    Results: In total, 55 medical students and 49 nursing students have participated in the MBM skills program. Baseline analysis (age, gender, mind-body experience, perceived stress, four subscales of the IRI, and self-reflection) demonstrated that participating nursing students were significantly older (p<0.001), and had higher scores for empathetic concern (p<0.001) and self-reflection (p=0.001) than participating medical students. Further, baseline analysis showed no significant differences in baseline characteristics between intervention and control group for medical students, except from significantly higher levels of perceived stress among controls (p=0.008). Regarding nursing students, no differences were found between intervention and control group, except from significantly higher scores for empathetic concern among participants (p=0.023).

    Conclusion: We have successfully implemented the MBM Skills program for medical and nursing students. Baseline analysis showed that participants of the course were not a selected group, except from perceived stress among medical students and empathetic concern among nursing students. Data on the effects of the MBM skills program on perceived stress, empathic concern and self-reflection are currently being evaluated and will be presented at the conference.

  • 998.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlan.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlands; National Information and Knowledge Center Integrative Medicine (NIKIM), Amsterdam, the Netherlands.
    Long-term benefits by a mind–body medicine skills course on perceived stress and empathy among medical and nursing students2017In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 39, no 7, p. 710-719Article in journal (Refereed)
    Abstract [en]

    Background: A significant number of medical students suffer from burnout symptoms and reduced empathy. This controlled, quasi-experimental study aimed to investigate whether a mind–body medicine (MBM) skills course could reduce perceived stress and increase empathy and self-reflection in medical and nursing students.

    Methods: The MBM course (consisting of experiential sessions of mind–body techniques and group reflections) was piloted among Dutch medical students and Swedish nursing students. Main outcome variables were perceived stress (PSS), empathy (IRI subscales perspective taking, fantasy, empathic concern, and personal distress), and self-reflection (GRAS). Participating and control students completed questionnaires at baseline, post-intervention, at 6 and 12 months follow-up.

    Results: Seventy-four medical and 47 nursing students participated in the course. Participating medical students showed significantly increased empathic concern [1.42 (95% CI 0.05, 2.78), p = 0.042], increased fantasy [3.24 (95% CI 1.58, 4.90), p < 0.001], and decreased personal distress [−1.73 (95% CI −3.04, −0.35), p = 0.010] compared to controls until 12 months follow-up. Participating nursing students showed significantly decreased levels of perceived stress [−5.09 (95% CI −8.37, −1.82), p = 0.002] and decreased personal distress [−5.01 (95% CI −6.97, −3.06), p < 0.001] compared to controls until 12 months follow-up.

    Conclusions: This study demonstrated long-term beneficial effects of the MBM course on perceived stress and empathy in medical and nursing students.

  • 999.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A Mind Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World2018In: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 5Article in journal (Refereed)
    Abstract [en]

    Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.

  • 1000.
    Vigetun-Haughey, Helena
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Capio St Gorans Hosp, Dept Clin Physiol, Stockholm, Sweden.
    Appelberg, Jonas
    Sundsvall Hosp, Dept Res & Dev, Vasternorrland Cty Council, Sundsvall, Sweden.
    Forsberg, Tomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kaldensjö, Magnus
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Schagatay, Erika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Voluntary apnea evokes diving responses in obstructive sleep apnea patients2015In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 115, no 5, p. 1029-1036Article in journal (Refereed)
    Abstract [en]

    Two potentially protective responses to apnea were studied in obstructive sleep apnea (OSA) patients; the diving response and the increase in Hb concentration [Hb] via spleen contraction. Eight OSA patients and ten healthy controls performed apneas in air (A) and apneas with facial immersion in 15 A degrees C water (FIA) after inspiration and without prior hyperventilation. In each condition, subjects performed three apneas of maximal voluntary duration spaced by 2 min of rest. Cardiorespiratory parameters were measured non-invasively, and venous blood samples for [Hb] analysis were drawn before and after apneas. Mean (SD) apnea durations were similar between groups (NS). In controls, the heart rate (HR) reduction was 10 +/- A 10 % at apnea and 19 +/- A 10 % in FIA (P < 0.05). In OSA patients, however, the fall in HR was the same in both conditions, 13 +/- A 10 and 14 +/- A 8 % for A and FIA, respectively (NS). In controls, the [Hb] increase was the same in A and FIA (2.2 +/- A 2.9 and 2.1 +/- A 2.2 %), while in OSA the [Hb] increase was greater during FIA compared to A (3.3 +/- A 2.2 and 1.4 +/- A 0.9 %; P < 0.05). Apnea induces a diving response and [Hb] increase in both groups. OSA patients did not show the typical training effect of the diving response seen in apnea divers despite their frequent nocturnal apneas. However, they also deviated from normal controls in response pattern; face immersion enhanced the cardiovascular diving response in controls but not in OSA, while the hematological response was enhanced by face immersion only in OSA patients.

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