umu.sePublications
Change search
Refine search result
1 - 37 of 37
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Bergström, Erik
    et al.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Dahlqvist, Rune
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    [Do better next time]2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 8, p. 527-Article in journal (Other academic)
  • 2. Bergström, Erik
    et al.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Dahlqvist, Rune
    Birgander, Slunga Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    [Criticism against a prioritization project in Vasterbotten. Serious prioritization work requires knowledge and open ethical principles]2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 3, p. 126-127Article in journal (Other academic)
  • 3.
    Claesson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jansson, Jan-Håkan
    Lindahl, B
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burell, G
    Asplund, Kjell
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Mattsson, Cecilia
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Cognitive-behavioural stress management does not improve biological cardiovascular risk indicators in women with ischaemic heart disease: a randomized-controlled trial.2006In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 260, no 4, p. 320-331Article in journal (Refereed)
  • 4.
    Claesson, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nasic, Salmir
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Åström, Monica
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Asplund, Kjell
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Burell, Gunilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Women's hearts - stress management for women with ischemic heart disease: explanatory analyses of a randomized controlled trial.2005In: Journal of Cardiopulmonary Rehabilitation (JCR), ISSN 0883-9212, E-ISSN 1539-0691, Vol. 25, no 2, p. 93-102Article in journal (Refereed)
  • 5.
    Eskilsson, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Malmberg Gavelin, Hanna
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Stigsdotter Neely, Anna
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre.
    Aerobic training for improved memory in patients with stress-related exhaustion: a randomized controlled trial2017In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 17, no 1, article id 322Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with stress-related exhaustion suffer from cognitive impairments, which often remain after psychological treatment or work place interventions. It is important to find effective treatments that can address this problem. Therefore, the aim of this study was to investigate the effects on cognitive performance and psychological variables of a 12-week aerobic training program performed at a moderate-vigorous intensity for patients with exhaustion disorder who participated in a multimodal rehabilitation program.

    METHODS: In this open-label, parallel, randomized and controlled trial, 88 patients diagnosed with exhaustion disorder participated in a 24-week multimodal rehabilitation program. After 12 weeks in the program the patients were randomized to either a 12-week aerobic training intervention or to a control group with no additional training. Primary outcome measure was cognitive function, and secondary outcome measures were psychological health variables and aerobic capacity.

    RESULTS: In total, 51% patients in the aerobic training group and 78% patients in the control group completed the intervention period. The aerobic training group significantly improved in maximal oxygen uptake and episodic memory performance. No additional improvement in burnout, depression or anxiety was observed in the aerobic group compared with controls.

    CONCLUSION: Aerobic training at a moderate-vigorous intensity within a multimodal rehabilitation program for patients with exhaustion disorder facilitated episodic memory. A future challenge would be the clinical implementation of aerobic training and methods to increase feasibility in this patient group.

    TRIAL REGISTRATION: ClinicalTrials.gov: NCT03073772 . Retrospectively registered 21 February 2017.

  • 6.
    Lind, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn K
    Ohlin, Ann-Kristin
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Thrombomodulin as a marker for bleeding complications during warfarin treatment.2009In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 169, no 13, p. 1210-1215Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The major adverse effect of warfarin treatment is hemorrhage. Several risk factors for bleeding complications are also risk factors for thromboembolic events, making the clinical decision to initiate or withhold anticoagulant treatment difficult. Specific markers that solely identify patients at high risk of bleeding would have great clinical impact. This study aimed to test if thrombomodulin (TM) concentrations were associated with bleeding complications, cardiovascular events, or mortality in long-term anticoagulant-treated patients. METHODS: In a longitudinal cohort study we followed up 719 patients receiving warfarin treatment for a mean duration of 4.2 years. All bleeding complications causing hospitalization were registered and classified. Soluble TM antigen (sTM) concentration in plasma was measured with an enzyme-linked immunosorbent assay method. RESULTS: During the follow-up time, 113 clinically relevant bleeding events and 73 major bleeding events occurred. Increased concentration of sTM was associated with both clinically relevant bleeding and major bleeding events after adjustment for age. In the multivariable models, hazard ratios for the highest tertiles compared with the lowest were 2.29 (95% confidence interval, 1.35-3.89) and 2.33 (95% confidence interval, 1.21-4.48), respectively. No association between sTM concentration and nonfatal ischemic cardiovascular events or all-cause mortality was found. CONCLUSIONS: Increased levels of sTM are associated with bleeding complications during warfarin treatment but not with cardiovascular events or all-cause mortality. Soluble TM antigen concentration has potential as a new specific marker to identify patients at high risk of bleeding during warfarin treatment.

  • 7.
    Lind, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn K
    Department of Clinical Chemistry, Örebro University Hospital, Örebro, Sweden.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Cystatin C and creatinine as markers of bleeding and mortality during oral anticoagulant treatment2012Manuscript (preprint) (Other academic)
  • 8.
    Lind, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn K
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Von Willebrand factor predicts major bleeding and mortality during oral anticoagulant treatment2012In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 271, no 3, p. 239-246Article in journal (Refereed)
    Abstract [en]

    Aims.  Oral anticoagulation (OAC), predominantly with warfarin, is an effective treatment to prevent thromboembolic events. Serious bleeding is a frequent and feared treatment complication. In this longitudinal cohort study of OAC-treated patients, we aimed to evaluate the relationship between von Willebrand factor (VWF) levels and risk of bleeding complications, cardiovascular mortality and all-cause mortality.

    Methods and results.  A total of 719 patients receiving warfarin treatment were observed for a mean duration of 4.2 years. All bleeding complications causing hospitalization were registered and classified into clinically relevant bleeding (CRB) and major bleeding. Ischaemic stroke, peripheral arterial embolism, myocardial infarction, and death were also recorded. We identified 113 cases of CRB and 73 of major bleeding. In total, 161 deaths occurred during follow-up with cardiovascular disease identified as the cause of death in 110 patients. Patients in the highest tertile of VWF had a significantly increased risk of bleeding complications: hazard ratio (HR) 2.53 (95% CI 1.41-4.56) for major bleeding and HR 2.19 (95% CI 1.38-3.48) for CRB. VWF, expressed either in tertiles or as a continuous variable, showed a significant association with cardiovascular mortality (HR 1.68, 95% CI 1.40-2.01) and all-cause mortality (HR 1.77, 95% CI 1.52-2.05). In multivariate Cox regression analysis, the findings remained significant after adjusting for age, high-sensitivity C-reactive protein and creatinine.

    Conclusions.  Patients with high levels of VWF had an increased risk of bleeding complications, cardiovascular mortality and all-cause mortality during OAC treatment. Our findings imply that the use of VWF as a risk marker for thromboembolic events is complicated by the association of VWF with bleeding complications.

  • 9.
    Lind, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    D-dimer predicts major bleeding, cardiovascular events and all-cause mortality during warfarin treatment2014In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 47, no 7-8, p. 570-573Article in journal (Refereed)
    Abstract [en]

    Objectives: Previous studies have shown that biomarkers in blood plasma can predict bleeding complications during anticoagulant treatment as well as thromboembolic events and may improve existing risk stratification schemes in patients on or considered for oral anticoagulant treatment. The aim of this study was to investigate if levels of D-dimer, tissue plasminogen activator (tPA) and its complex with plasminogen inhibitor type 1 (tPA/PAI-1 complex) can predict major bleedings, cardiovascular events and all-cause mortality in patients with warfarin treatment.

    Design and methods: In a longitudinal cohort study, 719 patients on oral anticoagulant treatment were followed for a total of 3001 treatment years. Major bleeding, stroke, arterial emboli, myocardial infarction and death were recorded and classified. Blood samples collected at baseline were analyzed for D-dimer, tPA, and tPA/PAI-1 complex.

    Results: In multivariate Cox regression analysis, high levels of D-dimer were associated with major bleeding (HR 1.27 per SD; 95% CI: 1.01-1.60), cardiovascular events (HR 1.23 per SD; 95% CI: 1.05-1.45) and all-cause mortality (HR 1.25 per SD; 95% CI: 1.06-1.47). Neither tPA nor the tPA/PAI-1 complex was associated with major bleeding, cardiovascular events or all-cause mortality.

    Conclusion: We conclude that high levels of D-dimer predict major bleeding, cardiovascular events and all-cause mortality during warfarin treatment. (C) 2014 The Canadian Society of Clinical Chemists. 

  • 10.
    Lind, Marcus
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Jansson, Jan-Håkan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nilsson, Torbjörn K.
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry.
    Järvholm, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Cystatin C and creatinine as markers of bleeding complications, cardiovascular events and mortality during oral anticoagulant treatment2013In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 132, no 2, p. E77-E82Article in journal (Refereed)
    Abstract [en]

    Introduction: Impaired kidney function has been linked to both ischemic events as well as bleeding complications in several clinical conditions. Our aim was to investigate if cystatin C, creatinine and calculated glomerular filtration rate (eGFR) were related to future risk of bleeding complications, cardiovascular events or all-cause mortality during oral anticoagulant treatment.

    Materials and methods: In a cohort study, 719 patients on long-term vitamin K antagonist (VKA) treatment were followed for a mean of 4.2 years. Blood sampling was taken at inclusion and patients were followed prospectively. Cystatin C and creatinine were analysed and eGFR was calculated. All medical records were reviewed. Major bleeding events, myocardial infarctions, strokes, arterial emboli, and deaths were recorded and classified.

    Results: After adjustment for age, no association between cystatin C, creatinine or eGFR and major bleeding was found. Cystatin C was independently associated with cardiovascular events (hazard ratio 1.50 (95% CI: 1.27-1.77)) and all-cause mortality (hazard ratio 1.62 (95% CI: 1.38-1.90)). Creatinine was only associated with all-cause mortality, while eGFR was not associated with any of the outcomes.

    Conclusions: Our findings underscore the superiority of cystatin C as a marker of cardiovascular risk compared to creatinine or eGFR. VKA-treated patients with increased cystatin C levels should be considered to be at an increased risk of cardiovascular events, and not bleeding complications.

  • 11.
    Malmberg Gavelin, Hanna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lisbeth, Slunga Järvholm
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stigsdotter Neely, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Karlstad University.
    Effects of a process-based cognitive training intervention for patients with stress-related exhaustion2015In: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 18, no 5, p. 578-588Article in journal (Refereed)
    Abstract [en]

    Stress-related exhaustion has been linked to a pattern of selective cognitive impairments, mainly affecting executive functioning, attention and episodic memory. Little is known about potential treatments of these cognitive deficits. The purpose of the present study was to evaluate the effects of a process-based cognitive training intervention, designed to target the specific cognitive impairments associated with stress-related exhaustion. To this end, patients diagnosed with exhaustion disorder (ED) were randomized to either a multimodal stress rehabilitation program with the addition of a process-based cognitive training intervention (training group, n = 27) or a treatment-as-usual control condition, consisting of multimodal stress rehabilitation with no additional training (control group, n = 32). Treatment effects were evaluated through an extensive cognitive test battery, assessing both near- and far transfer effects, as well as self-report forms regarding subjective cognitive complaints and burnout levels. Results showed pronounced training-related improvements on the criterion updating task (p < 0.001). Further, evidence was found of selective near transfer effects to updating (p = 0.01) and episodic memory (p = 0.04). Also, the trained group reported less subjective memory complaints (p = 0.02) and levels of burnout decreased for both groups, but more so for the trained group (p = 0.04), following the intervention. These findings suggest that process-based cognitive training may be a viable method to address the cognitive impairments associated with ED.

  • 12.
    Malmberg Gavelin, Hanna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stigsdotter Neely, Anna
    Karlstad University.
    Effects of a process-based cognitive training intervention for patients with stress-related exhaustion: a randomized clinical trial2015In: International Convention of Psychological Science, Amsterdam, 2015Conference paper (Other academic)
    Abstract [en]

    The present study evaluated whether a computerized process-based cognitive training program improves cognitive function in patients with stress-related exhaustion (n=59). Results showed training effects that were generalizable beyond the specific training tasks, suggesting that cognitive training may be a viable part of the rehabilitation of stress-related exhaustion.

  • 13.
    Malmberg Gavelin, Hanna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark..
    Josefsson, Maria
    Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).
    Stigsdotter Neely, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden..
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO – a randomized clinical trial2018In: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 21, no 4, p. 279-291Article in journal (Refereed)
    Abstract [en]

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47) or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.

  • 14.
    Malmberg Gavelin, Hanna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Stigsdotter Neely, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.
    Andersson, Micael
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Boraxbekk, Carl-Johan
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.
    Neural activation in stress-related exhaustion: cross-sectional observations and interventional effects2017In: Psychiatry Research: Neuroimaging, ISSN 0925-4927, E-ISSN 1872-7506, Vol. 269, p. 17-25Article in journal (Refereed)
    Abstract [en]

    The primary purpose of this study was to investigate the association between burnout and neural activation during working memory processing in patients with stress-related exhaustion. Additionally, we investigated the neural effects of cognitive training as part of stress rehabilitation. Fifty-five patients with clinical diagnosis of exhaustion disorder were administered the n-back task during fMRI scanning at baseline. Ten patients completed a 12-week cognitive training intervention, as an addition to stress rehabilitation. Eleven patients served as a treatment-as-usual control group. At baseline, burnout level was positively associated with neural activation in the rostral prefrontal cortex, the posterior parietal cortex and the striatum, primarily in the 2-back condition. Following stress rehabilitation, the striatal activity decreased as a function of improved levels of burnout. No significant association between burnout level and working memory performance was found, however, our findings indicate that frontostriatal neural responses related to working memory were modulated by burnout severity. We suggest that patients with high levels of burnout need to recruit additional cognitive resources to uphold task performance. Following cognitive training, increased neural activation was observed during 3-back in working memory-related regions, including the striatum, however, low sample size limits any firm conclusions.

  • 15.
    Norlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reuterwall, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Höög, Jonas
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Work situation and self-perceived economic situation as predictors of change in burnout: a prospective general population-based cohort study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, no 329, p. 1-9Article in journal (Other academic)
    Abstract [en]

    Background: Sick leave rates due to mental and behavioural disorders have increased in Sweden during the last decades. The aim of this prospective study was to investigate changes in the level of burnout in a working subset of the general population and to identify how such changes relate to changes in work situation and self-perceived economic situation.

    Methods: A cohort of 1000 persons from a subset of the 2004 northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) general population survey was followed over a five-year period (2004–2009). In total, 623 persons (323 women and 300 men) were included in the analysis. Burnout levels were measured at baseline and follow-up using the Shirom Melamed Burnout Questionnaire. Risk factors were assessed at both measuring points.

    Results: In the whole study cohort, a small (−0.15) but statistically significant reduction in burnout level was found. No differences in change of burnout were found between men and women. Constant strain at work, an increased risk of unemployment, and a perceived worsening of economic situation during the study time period were related to an increased burnout level. An accumulation of these risk factors was associated with increased burnout level.

    Conclusions: Risk factors in work situation and self-perceived economy are related to changes in burnout level, and special attention should be directed towards persons exposed to multiple risk factors.

  • 16.
    Norlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reuterwall, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Höög, Jonas
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Work situation and self-perceived economic situation as predictors of change in burnout - a prospective general population-based cohort study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 329Article in journal (Refereed)
    Abstract [en]

    Background: Sick leave rates due to mental and behavioural disorders have increased in Sweden during the last decades. The aim of this prospective study was to investigate changes in the level of burnout in a working subset of the general population and to identify how such changes relate to changes in work situation and self-perceived economic situation. Methods: A cohort of 1000 persons from a subset of the 2004 northern Sweden MONICA (Multinational Monitoring of Trends and Determinants in Cardiovascular Disease) general population survey was followed over a five-year period (2004-2009). In total, 623 persons (323 women and 300 men) were included in the analysis. Burnout levels were measured at baseline and follow-up using the Shirom Melamed Burnout Questionnaire. Risk factors were assessed at both measuring points. Results: In the whole study cohort, a small (-0.15) but statistically significant reduction in burnout level was found. No differences in change of burnout were found between men and women. Constant strain at work, an increased risk of unemployment, and a perceived worsening of economic situation during the study time period were related to an increased burnout level. An accumulation of these risk factors was associated with increased burnout level. Conclusions: Risk factors in work situation and self-perceived economy are related to changes in burnout level, and special attention should be directed towards persons exposed to multiple risk factors.

  • 17.
    Norlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reuterwall, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Höög, Jonas
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burnout, working conditions and gender: results from the northern Sweden MONICA Study2010In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 10, no 326Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sick-leave because of mental and behavioural disorders has increased considerably in Sweden since the late nineties, and especially in women. The aim of this study was to assess the level of burnout in the general working population in northern Sweden and analyse it's relation to working conditions and gender.

    METHODS: In this cross-sectional study the survey from the MONICA-study (Monitoring of Trends and Determinants in Cardiovascular Disease) in northern Sweden 2004 was used. A burnout instrument, the Shirom Melamed Burnout Questionnaire (SMBQ), was incorporated in the original survey which was sent to a random sample of 2500 individuals with a response rate of 76%. After including only actively working people, aged 25-64 years, our study population consisted of 1000 participants (497 women and 503 men). ANOVA and multiple linear regression models were used.

    RESULTS: The prevalence of a high level of burnout (SMBQ >4.0) was 13%. Women had a higher level of burnout than men with the most pronounced difference in the age group 35-44 years. In both sexes the level of burnout decreased with age. Demand and control at work, and job insecurity were related to burnout. In women the level of education, socioeconomic position, work object, and working varying hours were of importance. Interaction effects were found between sex and work object, and sex and working hours. In a multiple regression analysis almost half of the gender difference could be explained by work related and life situational factors.

    CONCLUSIONS: Working life conditions contributed to the level of burnout in this actively working sample from the general population in northern Sweden. Especially in women, socioeconomic position was associated with burnout. The high level of burnout in women compared to men was partly explained by more unfavourable working conditions and life situational factors. Efforts to level out gender differences in burnout should probably focus on improving both working and socioeconomic conditions for women.

  • 18.
    Norlund, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Reuterwall, Christina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Research and Development Department, Jämtland County Council, Östersund, Sweden.
    Höög, Jonas
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Edlund, Curt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Work related factors and sick leave after rehabilitation in burnout patients: experiences from the REST-project2011In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    Introduction The aim of this study was to investigate the impact of psychosocial working conditions and coping strategies at work on change in sick leave level for patients on long-term sick leave due to burnout.

    Methods A cohort sample of patients (n = 117) on long-term sick leave due to burnout was analyzed. The patients answered a questionnaire at baseline and sick leave information was collected from the Swedish Social Insurance Agency at baseline and at follow-up 2 years later. Two groups were formed depending on whether the patients had "improved" and reduced their sick leave level (56%) or if the sick leave level was "unchanged" (44%) at follow-up. The association between change in sick leave and predictors measuring psychosocial working conditions and coping strategies at work were analyzed using logistic regression.

    Results The predictor, low control at work, was associated with unchanged sick leave at follow-up. When background characteristics were taken into account, usage of covert coping towards supervisors and covert coping towards workmates, respectively, also predicted unchanged sick leave level. High overcommitment was of borderline significance and associated with a reduced sick leave level at follow-up.

    Conclusions Patients with burnout who have experienced low control at work and used covert coping towards supervisors and/or workmates have a higher risk of not reducing their sick leave after rehabilitation. The workplace may contribute to a reduction of sick leave lengths with a more flexible work environment and improvement in communication strategies for employees and supervisors.

  • 19.
    Pettersson-Strömbäck, Anita
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bodin Danielsson, Christina
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Öhrn, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Harder, Mette
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Wahlström, Viktoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slutrapport från AKTIKON-PROJEKTET i Örnsköldsviks kommun: Arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö – en kontrollerad studie i Örnsköldsviks kommun2018Report (Other academic)
    Abstract [sv]

    Projektet Aktivitetsbaserat Kontor (AktiKon) har följt och utvärderat en förändringsprocess i Örnsköldsviks kommun där tjänstemännen i kommunen flyttade från cellkontor till antingen ett aktivitetsbaserat kontor (AB-kontor) eller ett cellkontor. Syftet med forskningsprojektet var att studera effekter på arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö och kunna jämföra med fortsatt arbete i cellkontor. Mätningar med enkäter, fokusgruppsintervjuer, gåturer och observationer utfördes 6 mån före flytt och 6 respektive 18 månader efter flytt. Individuella intervjuer av personer med upplevd funktionsnedsättning utfördes ca 10 månader efter flytt. Rörelsemätningar utfördes vid fem olika tillfällen under flyttprocessen.

    I denna rapport har vi valt att redovisa enkätresultat från anställda som vi har kunnat följa över tid, d.v.s. individer där vi har resultat från enkät besvarad före flytt och från minst ett tillfälle efter flytt. Den ursprungliga studiepopulationen som studerades med denna metod bestod från början av 374 anställda och vid den sista uppföljningen, 18 månader efter flytt, av 152 anställda i AB-kontoret och 63 i cellkontoret. De två grupperna som flyttade till olika kontorsmiljöer var inte helt jämförbara. Exempelvis var det fler män och chefer som flyttade till AB-kontoret och yrkesgrupperna var inte heller lika, men alla som ingick i projektet var tjänstemän inom samma kommun.

    De som flyttade till AB-kontoret upplevde den nya kontorsmiljön som estetiskt tilltalande och luftkvaliteten god. De som flyttade till nya cellkontor hade utifrån kvalitativa intervjuer inte en lika positiv uppfattning vad gäller kontorets design och inredning.

    Arbetsbelastningen och olika typer av krav såg lika ut över tid för respektive grupp. Det var vid 18 månader efter flytt ingen skillnad jämfört med före flytt i hälsofrämjande arbetsfaktorer undersökta med WEMS-instrumentet (Work Experience Measurement Scale) för de som flyttat till AB-kontor. Det var inte heller någon skillnad över tid i jämförelse med de som flyttat till cellkontor. Datorstödet upplevdes mycket positivt av de som flyttade till AB-kontoret och de blev något mer nöjda än de som flyttade till cellkontor. Det fanns i AB-kontoret inte någon säker skillnad i upplevelse av samarbete mellan olika arbetsgrupper eller inom hela organisationen vid 18 månader efter flytt jämfört med utgångsläget och inte heller någon säker skillnad över tid jämfört med cellkontoret. De som flyttade till AB-kontor rapporterade efter flytten en ökad störning av ljud och besvär av bristande avskildhet. Man upplevde i genomsnitt en lägre produktivitet i AB-kontoret efter flytt och det fanns en skillnad mellan de två kontorstyperna över tid.

    Cheferna var generellt nöjda med att arbeta i AB-kontor och de upplevde inte någon minskad produktivitet vid övergång till AB-kontor. I genomsnitt blev det emellertid en minskad nöjdhet med kontorets utformning i gruppen som flyttade till AB-kontor. Nöjdheten med AB-kontoret varierade beroende på yrke och typ av arbetsuppgifter. De som hade mycket enskilt och koncentrationskrävande datorarbete upplevde mindre nöjdhet efter flytt och angav att de helst ville arbeta i cellkontor om de fick välja. De som arbetade mycket i grupp, behövde vara idérika och ofta diskuterade med kollegor föredrog att arbeta i AB-kontor. Bland dem som helst ville arbeta i cellkontor fanns det en ökad förekomst av problem med stress, långvarig utmattning och psykiska besvär.

    Det framkom ökade problem med koncentrationen hos de som flyttade till AB-kontor. Det fanns däremot inga säkra skillnader över tid mellan grupperna vad gäller skattning av allmän hälsa och förekomst av andra typer av besvär.

    Redan före flytten hade båda grupperna tillgång till höj- och sänkbara bord och det var vanligt att arbeta stående under en rätt stor del av arbetsdagen. Efter flytten ökade tiden i gående och antal steg något i AB-kontoret jämfört med cellkontoret. I AB-kontoret fanns tillgång till gå-band, men dessa användes endast av ett fåtal anställda. Den centralt belägna öppna trappan var omtyckt och användes mycket.

    Sammanfattningsvis visar studien att nöjdhet, preferens och produktivitet i AB-kontor varierar mycket beroende på vilka arbetsuppgifter man har. AB-kontoret fungerar särskilt bra för personer med ledningsuppdrag. För att AB-kontoret ska kunna fungera bra även för personer med funktionsnedsättning måste det finnas system för att fånga upp individuella problem och möjliggöra anpassningar vid behov. Detta gäller särskilt vid psykiska besvär och kognitiva svårigheter. Det är angeläget att det i AB-kontoret finns tillgång till stödytor och resurser i tillräcklig omfattning för alla de olika arbetsuppgifter som ska utföras.

    En viktig erfarenhet i projektet är betydelsen av att kunna beskriva den kontext som förändringen sker i. Genom att göra en processutvärdering har det funnits möjlighet att på ett adekvat sätt tolka och förstå de effekter som framkom vid övergång till AB-kontor.

    Framgångsfaktorer vid övergång till AB-kontor är noggrann kartläggning och analys före flytt, samverkan, delaktighet, överenskomna regler och förhållningssätt, och övergripande rutiner som inkluderar hela kontoret för det fortsatta arbetsmiljöarbetet.

  • 20.
    Pettersson-Strömbäck, Anita
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Managers and coworkes perceptions of activity based work: a sub study of the aktikon project2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, p. S149-S149Article in journal (Other academic)
  • 21.
    Slunga, Lisbeth
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Clinical chemistry. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Serum lipoprotein(a) in relation to ischemic heart disease and associated risk factors1993Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Lipoprotein(a) (Lp(a)) consists of an LDL-like particle and the specific protein apo(a), which is very similar to plasminogen. Apo(a) contains repeated kringle structures and a serine protease domain, which cannot be activated by t-PA. Lp(a) is considered to be a predictor for atherosclerotic disease. It has been found incorporated in atherosclerotic plaques and inhibits in vitro fibrinolysis.

    Lp(a) was determined in 1527 randomly selected individuals participating in the Northern Sweden WHO-MONICA project. A weak but significant relation between Lp(a) and increasing age was found. Menopausal status was the strongest independent predictor of Lp(a) level in women. Fibrinogen was independently related to Lp(a) in both sexes. Only a minor fraction of Lp(a) variance could be explained for in a multiple regression model, which is in agreement with the contention that Lp(a) is highly genetically determined.

    Lp(a) was determined in 1571 patients investigated with coronary angiography because of suspected severe coronary artery disease (CAD). Patients with proven CAD at elective angiography had significantly higher Lp(a) than patients without significant CAD or healthy controls. Lp(a) was found to be an independent discriminator of CAD in both sexes.

    HLA-DR genotype 13 or 17 was found more frequently in 30 male patients with angiographic CAD at young age (< 50 years) than in 30 age matched controls. These genotypes were common in patients with high Lp(a) levels, which indicates that Lp(a) may be related to immunological processes.

    The reaction of Lp(a) was investigated in 32 patients with acute myocardial infarction (AMI). Lp(a) increased during the first week, but the response was comparatively weak. Individual Lp(a) responses were heterogeneous and no correlations to infarct size or changes in the acute phase proteins were found.

    In a randomized cross-over study on 36 hypercholesterolaemic patients treated with simvastatin/placebo during 12+12 weeks Lp(a) did not change significantly, but patients with high Lp(a) levels at baseline tended to develop further increased Lp(a).

    To conclude, Lp(a) was found to be an independent predictor of angiographic CAD in both men and women. Lp(a) levels are primarily genetically determined and only a small fraction of Lp(a) variance could be explained by other factors in this study. Lp(a) may be related to HLA DR types and immunological processes involved in atherosclerotic disease. Lp(a) increased slightly during the first week of AMI, but was not related to changes in the acute-phase proteins. The effective LDL-lowering agent simvastatin did not influence Lp(a) significantly.

  • 22.
    Sonntag-Öström, Elisabet
    et al.
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Dolling, Ann
    Sveriges lantbruksuniversitet.
    Lundell, Ylva
    Sveriges lantbruksuniversitet.
    Nilsson, Leif
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Can rehabilitation in boreal forests help recovery from exhaustion disorder?: the randomised clinical trial ForRest2015In: Scandinavian Journal of Forest Research, ISSN 0282-7581, E-ISSN 1651-1891, Vol. 30, no 8, p. 732-748Article in journal (Refereed)
    Abstract [en]

    Modern society is faced with increasing incidence of mental and behavioural disorders. The objective of this study was to evaluate whether visits to boreal forests can be utilised for rehabilitation from exhaustion disorder (ED). This randomised controlled trial comprised of a forest rehabilitation group (n = 35) and a waiting list group (control group) (n = 43) with subsequent cognitive behavioural rehabilitation (CBR) for all participants in both groups. The recovery from ED was compared between the forest rehabilitation and the control group at baseline, after the forest rehabilitation (3 months), and at the end of the CBR (1 year). Both groups had enhanced recovery from ED after the 3-month intervention period and at the end of the CBR (1 year), and there were no significant differences between the groups in terms of psychological health measures. Mental state, attention capacity and preferences for different forest environments were studied during the forest visits. Mental state was improved, but it showed some seasonal differences. A significant effect on attention capacity was found for single forest visits, but there was no effect found for the rehabilitation period as a whole. The most popular forest environments contained easily accessible, open and bright settings with visible water and/or shelter. Forest rehabilitation did not enhance the recovery from ED compared to the control group, but the participants’ well-being was improved after single forest visits.

  • 23.
    Sonntag-Öström, Elisabet
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Arctic Research Centre at Umeå University.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lundell, Ylva
    Dolling, Ann
    Wiklund, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Karlsson, Marcus
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Carlberg, Bo
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Restorative effects of visits to urban and forest environments in patients with exhaustion disorder2014In: Urban Forestry & Urban Greening, ISSN 1618-8667, E-ISSN 1610-8167, Vol. 13, no 2, p. 344-354Article in journal (Refereed)
    Abstract [en]

    This experimental study investigated differences in perceived restorativeness, mood, attention capacity and physiological reactions when visiting city and forest environments. Twenty female patients diagnosed with exhaustion disorder visited three different forest environments and one city environment in randomized order. They performed a standardized 90-min test procedure in each of these environments. Evaluation of the environments and psychological effects in mood were studied with self-administered questionnaires. Attention capacity was studied with Necker Cube Pattern Control task. Physiological responses were measured with regularly scheduled controls of heart rate and blood pressure, and a single test of heart rate recovery. Visits to the forest environments were perceived as significantly more restorative, enhancing mood and attention capacity compared to the city. This also applies to the results of heart rate and to some extent to the results of the diastolic blood pressure. The results from this experimental study support our hypothesis that short visits to forest environments enhance both psychological and physiological recovery and that visits to forest environments are likely to be beneficial when suffering from exhaustion disorder. 

  • 24.
    Sonntag-Öström, Elisabet
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lundell, Ylva
    Brännström, Rigmor
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dolling, Ann
    Can the boreal forest be used for rehabilitation and recovery from stress-related exhaustion? A pilot study.2011In: Scandinavian Journal of Forest Research, ISSN 0282-7581, E-ISSN 1651-1891, Vol. 26, no 3, p. 245-256Article in journal (Refereed)
    Abstract [en]

    It has been suggested that humans suffering from mental exhaustion recover better in environments that do not demand directed attention. Hence, we hypothesized that forests have restorative effects and examined whether the boreal forest in northern Sweden can be used for rehabilitation from stress-related exhaustion in a pilot study. Six participants suffering from stress-related exhaustion were offered visits twice a week, for 11 weeks, in six different forest settings: pine forest, mixed forest, spruce forest, forest by the lake, the forest with a small stream and rock outcrops. The participants chose one forest setting prior to each visit, and the mental state of each participant was evaluated before and after each visit. Interviews focusing on the experience of the forest were conducted after the 22 visits. Solitude and forest settings with light were identified as positive factors for recovery. Despite the limited amount of data, the results showed that the forest visits had significant positive effects on the participants' mental state. The interviews also indicated that the concept is suitable for use in larger randomized studies and that it is important to provide various forest settings to meet individual preferences of the participants and to offer the possibility of solitude.

  • 25.
    Sonntag-Öström, Elisabet
    et al.
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lundell, Ylva
    Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, S-901 83 Umeå, Sweden.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fjellman-Wiklund, Annchristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dolling, Ann
    Department of Forest Ecology and Management, Swedish University of Agricultural Sciences, S-901 83 Umeå, Sweden.
    “Nature's effect on my mind”: patients’ qualitative experiences of a forest-based rehabilitation programme2015In: Urban Forestry & Urban Greening, ISSN 1618-8667, E-ISSN 1610-8167, Vol. 14, no 3, p. 607-614Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to investigate the personal experiences and perceived effects on mind from visits to forest environments in a subset of patients with severe exhaustion disorder (ED), who participated in a randomized controlled trial for evaluation of forest-based rehabilitation.

    Participants: A subsample of 19 patients with diagnosed ED, who completed the three-month forest-based rehabilitation programme in the ForRest project, was interviewed. Method: The forest-based rehabilitation consisted of repeated forest visits with the main objective of spending time in rest and solitude in a chosen forest setting. Semi-structured interviews were carried out and analysed using Grounded Theory.

    Result: A core category and five subcategories were set up to describe the patients’ experiences and development during the forest-based rehabilitation. As patients mostly reported that they strove to achieve peace of mind during the forest visits, Striving for serenity was chosen to be the core category. At first the patients were frustrated when left alone with their own thoughts in an unfamiliar forest environment. They gradually became familiar with the forest environments and also found their favourite places where they experienced peace of mind. They were then able to rest and begin reflective thinking about their life situation, which led to ambitions to change it.The preferred forest environments were characterised by openness, light and a good view, and were felt to be undemanding, peaceful and stimulating.

    Conclusion: Visits to the forest provided favourite places for rest, were experienced as restorative, seemed to improved reflection and may have contributed to starting the coping process for these patients. However, forest visits, as the only treatment option, are not sufficient as rehabilitation from severe and long-term ED. We suggest that forest visits should be integrated with cognitive behavioural therapy to further improve the recovery and enhance coping in daily life for these patients.

  • 26.
    Sonntag-Öström, Elisabet
    et al.
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Lundell, Ylva
    Sveriges lantbruksuniversitet.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Slunga Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Dolling, Ann
    Sveriges lantbruksuniversitet.
    "Nature's effect on my mind". Patients' experiences of nature based rehabilitation: a qualitative inquiry.2015In: Urban Forestry & Urban Greening, ISSN 1618-8667, E-ISSN 1610-8167, Vol. 14, no 3, p. 607-14Article in journal (Refereed)
  • 27.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burell, Gunilla
    Knutsson, Anders
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Medicin.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Patients with burnout in relation to gender and a general population2007In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 35, no 5, p. 516-523Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to describe gender differences in patients with burnout and compare these patients with a general population with respect to physical, psychosocial and work variables. Methods: Data were collected from a total of 136 patients (96 women and 40 men, 41,6 ± 7,4 years), diagnosed with stress-related disease and burnout at the Stress Clinic, University Hospital of Umeå. Data on burnout, physical, psychosocial and work characteristics were compared with similar data from a geographical and age-matched population based survey, the 2004 Northern Sweden MONICA study. The survey sample included a total of 573 participants (283 women and 290 men, 40,7 ± 8,5 years). Results: Women with burnout reported a higher rate of impaired awakening, lower job control, greater proportion of unpaid work and worked to a greater extent ``with people'' compared to men. Men with burnout had a more restricted social network and reported working more overtime than women. Patients with burnout reported a higher rate of unemployment, a more restricted social network and higher work demands compared to a general population. Women with burnout reported less emotional support, a more sedentary work situation, high job strain and worked to a greater extent ``with people'' than women from the general population. Conclusions: There are some differences in working conditions and social network between women and men with burnout. Patients with burnout differ from a general population regarding individual and social factors as well as work-related factors.

  • 28.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burell, Gunilla
    Department of Public Health and Caring Sciences, University of Uppsala.
    Steinholtz, Katarina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Edlund, Curt
    Nilsson, Leif
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST - a randomized clinical trial2009In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 16, no 3, p. 294-303Article in journal (Refereed)
    Abstract [en]

    Background

    Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered.

    Purpose

    Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only).

    Method

    In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 ± 7.4 years were allocated to one of the two rehabilitation programs.

    Results

    A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive–compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive–compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive–compulsive symptoms compared to patients in program B.

    Conclusion

    This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.

  • 29.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Birgander, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Lindahl, Bernt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Leif
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Effects of qigong in patients with burnout: a randomized controlled trial2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 9, p. 761-767Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the efficacy of Qigong in rehabilitation for patients with burnout. DESIGN: Prospective, randomized controlled trial. SUBJECTS: Eighty-two patients (68 women and 14 men, mean age 44.3 (standard deviation 9.1) years) diagnosed with burnout.

    METHODS: Basic care was offered to both the intervention and the control group. Patients in the intervention group received basic care and, in addition, performed Qigong twice a week for 12 weeks. Psychological variables, health-related quality of life, perceived relaxation and physical measurements were assessed at baseline and after the intervention period.

    RESULTS: No significant difference in treatment efficacy between the groups was found by either intention-to-treat or per-protocol analyses. Both groups improved significantly over time, with reduced levels of burnout, fatigue, anxiety and depression, and increased dynamic balance and physical capacity. CONCLUSION: In this study, a Qigong intervention twice a week for 12 weeks had no additional effect beyond basic care for patients with burnout.

  • 30.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Järvholm, Lisbeth Slunga
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Effects of rehabilitation programmes for patients on long-term sick leave for burnout: A 3-year follow-up of the REST study.2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 8, p. 684-690Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the long-term effects of two different rehabilitation programmes for patients on long-term sick leave for burnout. Design: Three-year follow-up of a randomized controlled trial with two 1-year group programmes: (A) cognitively oriented behavioural rehabilitation in combination with Qigong; and (B) Qigong alone. Patients: A total of 107 patients with burnout (78 women and 29 men), who all completed the 1-year rehabilitation programme per-protocol, were asked to participate in the follow-up. Methods: At the 3-year follow-up, data on psychological measures, sick leave and use of medication were compared between the programmes. Results: Patients in programme A reported being significantly more recovered from their burnout (p = 0.02), reported lower levels of burnout (p = 0.035), used more cognitive tools learned from the programme (p < 0.001), and had reduced their use of medication for depression (p = 0.002). No significant differences were found between the groups in terms of sick leave rates; both groups had improved. Conclusion: A multimodal rehabilitation including cognitively oriented behavioural rehabilitation and Qigong showed positive effects 3 years after the end of intervention. The results indicate that, for many burnout patients on sick-leave, it takes time to implement cognitive tools and to establish new behaviours.

  • 31.
    Stenlund, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Effects of rehabilitation programs for patients with burnout:: A 3-year follow-up.In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081Article in journal (Refereed)
  • 32. Theorell, Tores
    et al.
    Jood, Katarina
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Vingard, Eva
    Perk, Joep
    Ostergren, Per Olov
    Hall, Charlotte
    A systematic review of studies in the contributions of the work environment to ischaemic heart disease development2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 3, p. 470-477Article, review/survey (Refereed)
    Abstract [en]

    Background: There is need for an updated systematic review of associations between occupational exposures and ischaemic heart disease (IHD), using the GRADE system.

    Methods: Inclusion criteria: (i) publication in English in peer-reviewed journal between 1985 and 2014, (ii) quantified relationship between occupational exposure (psychosocial, organizational, physical and other ergonomic job factors) and IHD outcome, (iii) cohort studies with at least 1000 participants or comparable case-control studies with at least 50 + 50 participants, (iv) assessments of exposure and outcome at baseline as well as at follow-up and (v) gender and age analysis. Relevance and quality were assessed using predefined criteria. Level of evidence was then assessed using the GRADE system. Consistency of findings was examined for a number of confounders. Possible publication bias was discussed.

    Results: Ninety-six articles of high or medium high scientific quality were finally included. There was moderately strong evidence (grade 3 out of 4) for a relationship between job strain and small decision latitude on one hand and IHD incidence on the other hand. Limited evidence (grade 2) was found for iso-strain, pressing work, effort-reward imbalance, low support, lack of justice, lack of skill discretion, insecure employment, night work, long working week and noise in relation to IHD. No difference between men and women with regard to the effect of adverse job conditions on IHD incidence.

    Conclusions: There is scientific evidence that employees, both men and women, who report specific occupational exposures, such as low decision latitude, job strain or noise, have an increased incidence of IHD.

  • 33.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Eskilsson, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Effects of a multicomponent physical activity promoting program on sedentary behavior, physical activity and body measures: a longitudinal study in different office types2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 5, p. 493-504Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office.

    Methods: The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models.

    Results: Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group.

    Conclusions: This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.

  • 34.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Bergman, Frida
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    A longitudinal study of physical activity in different office types2018In: Journal of Physical Activity and Health, ISSN 1543-3080, E-ISSN 1543-5474, Vol. 15, no 10, p. S62-S62Article in journal (Other academic)
  • 35.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Fjellman-Wiklund, Anncristine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Harder, Mette
    Umeå University, Faculty of Science and Technology, Umeå School of Architecture.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Stenlund, Therese
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Implementing a Physical Activity promoting program in a flex-office - a process evaluation with a mixed methods designManuscript (preprint) (Other academic)
  • 36.
    Wahlström, Viktoria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Olsson, David
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Slunga-Järvholm, Lisbeth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Underlying factors explaining sedentary behavior and physical activity among office workers - an exploratory analysisManuscript (preprint) (Other academic)
  • 37.
    Öhman, Lena
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Bergdahl, Jan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Slunga Birgander, Lisbeth
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Occupational and Enviromental Medicine.
    Stigsdotter-Neely, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Cognitive function in outpatients with perceived chronic stress2007In: Scand J Work Environ Health, ISSN 0355-3140, Vol. 33, no 3, p. 223-232Article in journal (Refereed)
1 - 37 of 37
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf