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  • 1.
    Aagaard, Hanne
    et al.
    Lovisenberg Diaconal University College, Oslo, Norway.
    Hall, ElisabethO.C.
    Health, Aarhus University, Aarhus, Denmark; Faculty of Health Sciences and Nursing University of Faroe Islands, Torshavn, Faroe Islands.
    Audulv, Åsa
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Ludvigsen, Mette S.
    Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Westergren, Thomas
    Department of Public Health, University of Stavanger, Norway; Department of Nursing Science, University of Agder, Norway.
    Fegran, Liv
    Department of Nursing Science, University of Agder, Norway.
    Parents’ experiences of transitioning to home with a very-low-birthweight infant: a meta-ethnography2023Ingår i: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 29, nr 3, s. 444-452Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Medical-technological advances and neurodevelopmental care have improved the survival of extremely- and very-low-birthweight infants born before 32 weeks' gestation. After months in neonatal care, the infants are discharged, and parents exited but full of anxiety. This review is designed as a meta-ethnography, addressing parents' discharge experiences to comprehend the synthesised research, which includes 12 eligible studies. From the analysis, we constructed three themes: ‘approaching discharge with both uncertainty and confidence’; ‘discharge as a longed-for though disordering turning point’; and ‘facing joys, worries and multiple challenges when at home’. The overarching interpretation was ‘discharge as double-edged sword’. We conclude that bringing home very-low-birthweight infants is a joyful event, yet parents also experience discharge as never-endingly worrying, as a time filled with challenges to which parents must adapt and as necessitating continuous support from knowledgeable providers.

  • 2. Aaghabali, M.
    et al.
    Akbari, S.
    Friedland, S.
    Markström, Klas
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för matematik och matematisk statistik.
    Tajfirouz, Z.
    Upper bounds on the number of perfect matchings and directed 2-factors in graphs with given number of vertices and edges2015Ingår i: European journal of combinatorics (Print), ISSN 0195-6698, E-ISSN 1095-9971, Vol. 45, s. 132-144Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    We give an upper bound on the number of perfect matchings in simple graphs with a given number of vertices and edges. We apply this result to give an upper bound on the number of 2-factors in a directed complete bipartite balanced graph on 2n vertices. The upper bound is sharp for even n. For odd n we state a conjecture on a sharp upper bound.

  • 3.
    Aalberg, Carmen
    et al.
    Wageningen UR.
    Eckerberg, Katarina
    Umeå universitet, Samhällsvetenskapliga fakulteten, Statsvetenskapliga institutionen.
    Governance patterns and performance of regional strategies in peri-urban areas: comparative analysis of seven cases in Europe and Chine2011Rapport (Övrigt vetenskapligt)
    Abstract [en]

    This report examines how different regional and local governance patterns and specific spatial planning strategies impact on peri-urban land use in Rural Urban regions. It draws from seven regional case studies, presenting a diverse mix of strategies ranging from protecting biodiversity and agricultural land, creating recreation and tourism opportunities to reducing pressure from building and infrastructure development. To study the means of influence or power an analytical framework of ‘policy arrangement’ was employed (Tatenhove et al, 2000): specifying rules of the game, resources, coalitions and discourses. Both government and nongovernment actors such as environmental groups or developers can form coalitions, adopt rules, employ resources and develop discourses to influence policies and developments in urban regions. The analytical and assessment frameworks defined by regional researchers and practitioners helped to organize the case study data and to evaluate both processes and outcomes of governance in peri-urban areas. The outcomes are represented in a summarized way for each strategy and region.

    The report provides examples of unsustainable developments in peri-urban regions and how certain strategies helped to counteract these, and emphasizes the importance of recognizing peri-urban areas as a policy field in its own right.

    A sustainable spread of land use over the Rural Urban region requires regional authorities whose jurisdiction covers the Rural Urban region and who have the appropriate mix of policy means of influence and relative power over lower level authorities. Under the current predominant discourse of ‘sustainable’ development largely being equal to economic development, the outcome of sustainability concerns depends on urban areas taking financial responsibility for the inclusion of common good interests such as ecosystem services, cultural heritage and social and environmental justice into the periurban areas. Recommendations for policy makers at different levels conclude the report.

  • 4.
    Aalbers, Carmen B. E. M.
    et al.
    Governance Team, Wageningen University and Research/Alterra, Wageningen, Netherlands.
    Eckerberg, Katarina
    Umeå universitet, Samhällsvetenskapliga fakulteten, Statsvetenskapliga institutionen.
    Governance and sustainability of peri-urban areas: a comparative analysis of the PLUREL case studies2013Ingår i: Peri-urban futures: scenarios and models for land use change in Europe / [ed] Kjell Nilsson; Stephan Pauleit; Simon Bell; Carmen Aalbers; Thomas A. Sick Nielsen, Springer Berlin/Heidelberg, 2013, s. 341-371Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Home  Peri-urban futures: Scenarios and models for land use change in Europe  ChapterGovernance and Sustainability of Peri-Urban Areas: A Comparative Analysis of the PLUREL Case StudiesCarmen B. E. M. Aalbers & Katarina Eckerberg ChapterFirst Online: 01 January 20122144 Accesses2 Citations2 AltmetricAbstractThis chapter examines the analyses and strategies presented for each of the case studies in Chaps. 4, 6, 7, 8, 9, 10 and 11 and presents a comparison in order to draw out the main findings which may provide possible solutions for policy makers working in other regions. As explained in Chap. 1, there are a range of particular policy challenges in the urban fringe. The policies of several adjacent municipalities or local authorities may be combined and managed by an indirectly elected regional authority, while different national and EU-level sectoral and regional policies frequently interfere with each other in such areas. Problems of implementation deficits with sector-based strategies are commonplace following institutional fragmentation, calling for increased co-ordination and better integration mechanisms (Tatenhove et al. 2000).

  • 5. Aalbers, R
    et al.
    Backer, V
    Kava, T T K
    Omenaas, E R
    Sandström, Thomas
    Umeå universitet, Medicinsk fakultet, Folkhälsa och klinisk medicin, Lungmedicin.
    Jorup, C
    Welte, T
    Adjustable maintenance dosing with budesonide/formoterol compared with fixed-dose salmeterol/fluticasone in moderate to severe asthma.2004Ingår i: Current Medical Research and Opinion, ISSN 0300-7995, E-ISSN 1473-4877, Vol. 20, nr 2, s. 225-40Artikel i tidskrift (Refereegranskat)
  • 6.
    Aalto, Sirpa
    et al.
    Faculty of Humanities, University of Oulu, Finland.
    Lehtola, Veli-Pekka
    Giellagas Institute, University of Oulu, Finland.
    The Sami Representations Reflecting the Multi-Ethnic North of the Saga Literature2017Ingår i: Journal of Northern Studies, ISSN 1654-5915, E-ISSN 2004-4658, Vol. 11, nr 2, s. 7-30Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article focuses on contextualizing the Sami (finnar) representations in Old Norse saga literature. The purpose is to show that the Sami representations reflect multi-layered Old Norse textual and oral traditions, and complex interaction between the Sami and the Norwegians in the Middle Ages. The stereotypes of the Sami tell us more about the society that created them than about real, historical events. We can be sure that behind them lie very mundane phenomena such as trade and marriages.

    The ultimate goal of the article is therefore to reveal the multi-ethnic North that provided the background for the saga sources, a North whose history is not as homogeneous as sources suggest and quite unlike the modified version which found its way into the histories of nation states. The literary conventions of sagas are not just imaginary tales—their use in various contexts can reveal something essential in otherwise schematic images or configurations. Even researchers of the sagas have certain personal conceptions of what the “real” lives of the Sami were like at the time, and how the sagas depict this. In fact, they participate in a continuum of saga literature that generates representations of the Sami in history.

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  • 7. Aarseth, Espen
    et al.
    Bean, Anthony M.
    Boonen, Huub
    Carras, Michelle Colder
    Coulson, Mark
    Das, Dimitri
    Deleuze, Jory
    Dunkels, Elza
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för tillämpad utbildningsvetenskap.
    Edman, Johan
    Ferguson, Christopher J.
    Haagsma, Maria C.
    Bergmark, Karin Helmersson
    Hussain, Zaheer
    Jansz, Jeroen
    Kardefelt-Winther, Daniel
    Kutner, Lawrence
    Markey, Patrick
    Nielsen, Rune Kristian Lundedal
    Prause, Nicole
    Przybylski, Andrew
    Quandt, Thorsten
    Schimmenti, Adriano
    Starcevic, Vladan
    Stutman, Gabrielle
    Van Looy, Jan
    Van Rooij, Antonius J.
    Scholars' open debate paper on the World Health Organization ICD-11 Gaming Disorder proposal2017Ingår i: Journal of Behavioral Addictions, ISSN 2062-5871, E-ISSN 2063-5303, Vol. 6, nr 3, s. 267-270Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Concerns about problematic gaming behaviors deserve our full attention. However, we claim that it is far from clear that these problems can or should be attributed to a new disorder. The empirical basis for a Gaming Disorder proposal, such as in the new ICD-11, suffers from fundamental issues. Our main concerns are the low quality of the research base, the fact that the current operationalization leans too heavily on substance use and gambling criteria, and the lack of consensus on symptomatology and assessment of problematic gaming. The act of formalizing this disorder, even as a proposal, has negative medical, scientific, public-health, societal, and human rights fallout that should be considered. Of particular concern are moral panics around the harm of video gaming. They might result in premature application of diagnosis in the medical community and the treatment of abundant false-positive cases, especially for children and adolescents. Second, research will be locked into a confirmatory approach, rather than an exploration of the boundaries of normal versus pathological. Third, the healthy majority of gamers will be affected negatively. We expect that the premature inclusion of Gaming Disorder as a diagnosis in ICD-11 will cause significant stigma to the millions of children who play video games as a part of a normal, healthy life. At this point, suggesting formal diagnoses and categories is premature: the ICD-11 proposal for Gaming Disorder should be removed to avoid a waste of public health resources as well as to avoid causing harm to healthy video gamers around the world.

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  • 8. Aarts, Clara
    et al.
    Hörnell, Agneta
    Umeå universitet.
    Kylberg, Elisabeth
    Hofvander, Yngve
    Gebre-Medhin, Mehari
    Breastfeeding patterns in relation to thumb sucking and pacifier use.1999Ingår i: Pediatrics, ISSN 1098-4275, Vol. 104, nr 4, s. e50-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:The primary aim was to assess, the association of the quantity and quality of dietary fat intake from 6 to 12 months of age and serum lipids at 12 months.Subjects/Methods:Three hundred healthy term Swedish infants were recruited in a longitudinal prospective study at the age of 6 months; 276 remained in the study at 12 months. Food records and anthropometric data were collected monthly from 6 to 12 months; serum lipids were analysed at 6 and 12 months.Results:Swedish infants had a total fat intake within the Nordic recommendations, but intake of polyunsaturated fatty acids (PUFA) was low (5.6 percent of total energy (E%)) and intake of saturated fatty acids (SAFA) was high (15.1 E%). Higher PUFA intake was associated with lower total serum cholesterol (TC, B=-0.13, P=0.003), lower low-density-lipoprotein cholesterol (LDL-C, B=-0.12, P=0.004) and apolipoprotein B (B=-0.03) (P=0.034) in girls but not in boys. When data from the present study were compared to data from similar studies in Finland and Iceland, it appears that the quality of the dietary fat has greater impact on serum lipid levels than the quantity of fat in the diet.Conclusions:Higher PUFA and lower SAFA intakes may reduce TC and LDL-C early in life, particularly in girls. Further, with respect to lowering serum lipid concentrations in early childhood it seems appropriate to set focus on fat quality rather than the quantity.Sponsorships:Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning (Formas), Swedish Research Council, Medicine, Stiftelsen Oskar Foundation, Sven Jerring Foundation, Samariten Foundation, Stiftelsen Goljes minne and Semper AB.European Journal of Clinical Nutrition advance online publication, 20 June 2007; doi:10.1038/sj.ejcn.1602824.

  • 9. Aarts, Clara
    et al.
    Kylberg, Elisabeth
    Hörnell, Agneta
    Umeå universitet.
    Hofvander, Yngve
    Gebre-Medhin, Mehari
    Greiner, T
    How exclusive is exclusive breastfeeding? A comparison of data since birth with current status data.2000Ingår i: Int J Epidemiol, ISSN 0300-5771, Vol. 29, nr 6, s. 1041-6Artikel i tidskrift (Refereegranskat)
  • 10. Aartsen, Marja
    et al.
    Beland, Daniel
    Edmondson, Ricca
    Ginn, Jay
    Komp, Kathrin
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Nilsson, Magnus
    Perek-Bialas, Jolanta
    Sorensen, Penny
    Weicht, Bernhard
    Ageing in the light of crises: Economic crisis, demographic change, and the search for meaning2012Rapport (Övrigt vetenskapligt)
  • 11.
    Aartsen, Marja
    et al.
    Social Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
    Komp, Kathrin
    Umeå universitet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    The future of greying Europe: Conclusion2013Ingår i: Old age in Europe: A textbook of gerontology / [ed] Komp, K., & Aartsen, M., Dordrecht: Springer Netherlands, 2013, s. 131-136Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Although Europe’s population is greying, the future of Europe does not look grey. What can be learned from this book is that old age is not necessarily characterized by frailty and decline, but instead can be a time of self-fulfillment, activity, and social participation. Moreover, we now know that population ageing does not need to threaten extant social and welfare state-related institutions, but instead opens up potentials for restructuring and reinvention. Life expectancy is longer than ever before and living conditions that enhance healthy ageing have very much improved. New technologies and Information and Communication Technologies may assist older people to stay in their homes longer. The growing possibilities to reach a good old age may have given rise to what is sometimes called ‘a silver economy’: an economy with all kinds of new products and services, particularly aimed at the growing share of healthy and wealthy senior citizens. The greying of Europe might, thus, ultimately lead us into a bright and colourful future.

  • 12.
    Aas, Kirsti
    et al.
    Consultant Urological Surgeon and Associate Professor, Akershus University Hospital, Norway; Faculty of Medicine, University of Oslo, Norway.
    Sherif, Amir
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi. Consultant Urological Surgeon and Associate Professor, Norrlands University Hospital, Umeå, Sweden.
    Long-term patient follow-up should be routinely implemented in radiotherapy units to detect late adverse effects after cancer treatment2023Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 58, s. 30-31Artikel i tidskrift (Övrigt vetenskapligt)
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  • 13.
    Aas, Marit
    et al.
    Oslo universitet.
    Törnsen, Monika
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för skolledarutveckling.
    Norske og svenske skolelederprogram: en sammenligning2016Ingår i: Bedre Skole, ISSN 0802-183X, nr 2, s. 56-61Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [no]

    De nasjonale lederprogrammene i Sverige og Norge blir sammenlignet ved hjelp av et forskningsbasert internasjonalt rammeverk for hva som kjennetegner god ledelse. Målet er å undersøke om og i hvilken grad de nordiske programmene er influert av internasjonal forskning om profesjonsutvikling av skoleledere. Noen områder for videreutvikling av de nordiske lederprogrammene blir foreslått.

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  • 14.
    Aas, Marit
    et al.
    Oslo universitet.
    Törnsén, Monika
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för skolledarutveckling.
    Examining Norwegian and Swedish Leadership training programs in light of international research2016Ingår i: Nordic Studies in Education, ISSN 1891-5914, E-ISSN 1891-5949, Vol. 36, nr 2, s. 173-187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article examines and compares principal training programs in Sweden and Norway, the two Nordic countries with national leadership programs for already active school leaders. To investigate the knowledge base and design of the programs we draw on two research-derived tools about successful professional learning programs for school leaders. Based on the examinations, we suggest that the programs reflect international research both in terms of content and process factors. In addition, we identify topics and issues, such as balancing democratic participation with managerial decision-making, which can be characterized as making up a Nordic profile.

  • 15.
    Aas, Marit
    et al.
    Department of Teacher Education, School Research, University of Oslo, Norway.
    Törnsén, Monika
    Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för skolledarutveckling.
    Nordic studies in education - Special issue: Educational leadership in nordic countries2016Ingår i: Nordic Studies in Education, ISSN 1891-5914, E-ISSN 1891-5949, Vol. 36, nr 2, s. 81-85Artikel i tidskrift (Övrigt vetenskapligt)
  • 16.
    Aasa, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi. Norrlandsklinikens hälsocentral, Umeå, Sweden.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial2015Ingår i: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 45, nr 2, s. 77-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.

  • 17.
    Aasa, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Hellqvist, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain2011Konferensbidrag (Refereegranskat)
  • 18.
    Aasa, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi. Norrlandskliniken, Umeå.
    Lundström, Lena
    Pain Rehabilitation, Norrlands University Hospital, Umeå.
    Papacosta, Daniel
    Norrlandskliniken, Umeå.
    Sandlund, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Do we see the same movement impairments?: the inter-rater reliability of movement tests for experienced and novice physiotherapists2014Ingår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, nr 16, s. 173-182, artikel-id 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.

  • 19.
    Aasa, Björn
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Sandlund, Jonas
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Rudolfsson, Thomas
    Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
    Aasa, Ulrika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Acuity of goal-directed arm movements and movement control: evaluation of differences between patients with persistent neck/shoulder pain and healthy controls2022Ingår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 24, nr 1, s. 47-55Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.

    Methods: Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.

    Results: Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.

    Conclusions: This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.

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  • 20.
    Aasa, Ulrika
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Idrottsmedicin. Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Kirurgi.
    Ambulance Work: Relationships between occupational demands, individual characteristics and health-related outcomes2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Although musculoskeletal disorders (MSDs) and other health complaints are an occupational problem for ambulance personnel, there is a lack of knowledge regarding work-related factors associated with MSDs and other health complaints. The overall aim of this thesis was to investigate the relationships between occupational demands, individual characteristics and health-related outcomes among ambulance personnel.

    A random sample of 234 female and 953 male ambulance personnel participated in a national questionnaire survey on work-related factors, and musculoskeletal and other health complaints. Physical demands was associated with activity limitation due to neck-shoulder and low-back complaints among the female personnel. Among the male personnel, physical demands was associated with low-back complaints and activity limitation due to low-back complaints. Psychological demands was significantly associated with neck-shoulder complaints, sleeping problems, headache and stomach symptoms among both female and male ambulance personnel. Worry about work conditions was associated with musculoskeletal disorders and sleeping problems, headache and stomach symptoms.

    A local sample of 26 ambulance personnel was followed during a 24-hour work shift and for the next two work-free days. Subjective stress- and energy levels, and cortisol levels were measured at regular intervals, and heart rate was registered continuously by electrocardiogram (ECG). Autonomic reactivity to standardized tests before (pre-work) and at the end of the work shift (post-work) was also investigated. For the whole group, baseline values of heart rate were higher pre-work than post-work, but autonomic reactivity did not differ. Increased reactivity to the mental test, modest deviation in heart rate variability (HRV) pattern during the late night hours at work and higher morning cortisol values during work than during leisure time were observed in personnel with many health complaints, but not among their co-workers without or with few complaints. Ambulance personnel with many health complaints also reported higher psychological demands and tended to be more worried about work conditions.

    Heart rate (HR), lactate level (LL) and perceived exertion (RPE) were investigated in 17 female and 48 male ambulance personnel during a simulated standardized work task “carry a loaded stretcher”. The ambulance personnel had to carry the loaded stretcher (920 N) up and down three flights of stairs twice. The high physiological strain (HR, LL, RPE) for the male, and near or at maximal strain for the female ambulance personnel, implied the importance to identify what kind of physical capacity is most important for ambulance personnel. Therefore, the explained variance of developed fatigue by tests of cardiorespiratory capacity, muscular strength and endurance, and coordination was investigated. The results showed that VO2max and isometric back endurance were important predictors for development of fatigue when carrying a loaded stretcher.

    The influence of body size on the relationships between maximal strength and functional performance was investigated in a methodological study. The results confirm that the assessment of physical performance could be confounded by the body weight. Therefore, the models for explaining development of fatigue when carrying the loaded stretcher were adjusted for height and weight. Including height in the models significantly increased the explained variance of accumulated lactate among female, but not among male personnel. Lactate levels were higher among short compared to tall female personnel. Weight had no effect on any of the models.

    In conclusion, the national survey showed that self-reported physical demands was a risk factor of having MSDs, and that self-reported psychological demands and worry about work were important risk factors of having MSDs and other health complaints. Stress monitoring of ambulance personnel during work and leisure time showed that physiological and subjective stress markers did not show any differences between the 24-hour ambulance work shift and leisure time afterwards. However, ambulance personnel with many health complaints had certain physiological changes during the work shift in comparison with the next two work-free days. The physiological and subjective responses during carrying a loaded stretcher, especially among the female ambulance personnel, showed that female and male ambulance personnel could be exposed to internal exposures at different levels when performing the same work task. A better understanding of the relationships between occupational demands and health-related outcomes require further studies on age- and gender matched groups in long-term perspective studies.

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  • 21.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Barnekow-Bergkvist, Margareta
    Angquist, Karl-Axel
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Relationships between work-related factors and disorders in the neck-shoulder and low-back region among female and male ambulance personnel.2005Ingår i: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 47, nr 6, s. 481-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This cross-sectional study on a random sample of 1,500 ambulance personnel investigated the relationships between self-reported work-related physical and psychosocial factors, worry about work conditions, and musculoskeletal disorders among female and male ambulance personnel. Three different outcomes, complaints, activity limitation, and sick leave, for the neck-shoulder and low-back region, respectively, were chosen. Among the female personnel, physical demands was significantly associated with activity limitation in the neck-shoulder (OR 4.13) and low-back region (OR 2.17), and psychological demands with neck-shoulder (OR 2.37) and low-back (OR 2.28) complaints. Among the male personnel, physical demands was significantly associated with low-back complaints (OR 1.41) and activity limitation (OR 1.62). Psychological demands and lack of social support were significantly associated with neck-shoulder complaints (OR 1.86 and OR 1.58, respectively) and activity limitation (OR 3.46 and OR 1.71) as well as activity limitation due to low-back complaints (OR 2.22 and OR 1.63). Worry about work conditions was independently associated with activity limitation due to low-back complaints among the female (OR 5.28), and to both neck-shoulder and low-back complaints (OR 1.79 and OR 2.04, respectively) and activity limitation (OR 2.32 and OR 1.95) among the male personnel. In conclusion, the association patterns between physical and psychological demands and MSDs suggest opportunities for intervention.

  • 22.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Bengtsson, Victor
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för fysioterapi.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Öhberg, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik.
    Variability of lumbar spinal alignment among power- and weightlifters during the deadlift and barbell back squat2022Ingår i: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 21, nr 6, s. 707-717Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of the study were to evaluate the relative and absolute variability of upper (T11-L2) and lower (L2-S2) lumbar spinal alignment in power- and weightlifters during the deadlift and back squat exercises, and to compare this alignment between the two lifting groups. Twenty-four competitive powerlifters (n = 14) and weightlifters (n = 10) performed three repetitions of the deadlift and the back squat exercises using a load equivalent to 70% of their respective one-repetition maximum. The main outcome measures were the three-dimensional lumbar spinal alignment for start position, minimum and maximum angle of their spinal alignment, and range of motion measured using inertial measurement units. Relative intra-trial reliability was calculated using the two-way random model intraclass correlation coefficient (ICC) and absolute reliability with minimal detectable change (MDC). The ICC ranged between 0.69 and 0.99 and the MDC between 1 degrees-8 degrees for the deadlift. Corresponding figures for the squat were 0.78-0.99 and 1 degrees-6 degrees. In all participants during both exercises, spinal adjustments were made in both thoracolumbar and lumbopelvic areas in all three dimensions. In conclusion, when performing three repetitions of the deadlift and the squat, lumbar spinal alignment of the lifters did not change much between repetitions and did not differ significantly between power- and weightlifters.

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  • 23.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Samhällsvetenskapliga fakulteten, Idrottshögskolan vid Umeå universitet.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Umeå universitet, Samhällsvetenskapliga fakulteten, Idrottshögskolan vid Umeå universitet.
    A descriptive analysis of functional impairments and patho-anatomical findings in eight powerlifters2020Ingår i: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 60, nr 4, s. 582-593Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Low back pain (LBP) is a common pain problem in powerlifters. There is a lack of evidence to guide powerlifters and health-care professionals in understanding the role of powerlifting in the development of LBP and treatment of injuries in powerlifters. This study aimed to describe functional impairments and patho-anatomical findings in eight powerlifters with and without LBP. METHODS: First, four powerlifters with LBP were recruited. Each powerlifter was then matched with a pain-free lifter (Control) by age, Body Mass Index and competition weight class. They all performed physical performance tests and were examined with magnetic resonance imaging. Four weeks prior to the examination the powerlifters also recorded training load. Powerlifters with LBP were also examined by a physiotherapist in order to define their pain and impairments. RESULTS: The four male powerlifters with LBP had a nociceptive pain associated with non-ideal squatting technique, higher flexibility in their lumbar spine than in their hips and patho-anatomical findings such as degenerated discs (four), spondylolysis (one) and spinal stenosis (one). However, the controls also showed similar functional impairments and patho-anatomical findings. CONCLUSIONS: Powerlifters with and without LBP show similar functional impairments and patho-anatomical findings. However, powerlifters' LBP seems associated with pain during movement and loading of the lumbar spine. The association and causation between specific functional impairments, patho-anatomical findings and LBP in powerlifters has to be further investigated in studies including more participants.

  • 24.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Aasa, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Krafttag ska stoppa styrkelyftarnas skador2015Ingår i: Svensk idrottsforskning, ISSN 1103-4629, nr 4, s. 29-31Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 25.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Idrottsmedicin.
    Brulin, Christine
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Ängquist, Karl-Axel
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Barnekow-Bergkvist, Margareta
    Work-related psychosocial factors, worry about work conditions and health complaints among female and male ambulance personnel.2005Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, nr 3, s. 251-258Artikel i tidskrift (Refereegranskat)
  • 26.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Jaric, S
    Barnekow-Bergkvist, M
    Johansson, H
    Muscle strength assessment from functional performance tests: role of body size2003Ingår i: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 17, nr 4, s. 664-670Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to test the hypothesis that the body size plays an important role in assessment of muscle ability to exert force by standard functional performance tests. Twenty-one male students were tested on maximal isometric lift, one leg rising, vertical jump, and box lift tests, and the maximal isokinetic strength of hip and knee extensors was also recorded. When indices of the 4 functional performance tests were related to the strength of each of the 2 leg extensor muscle groups, only maximal isometric lift demonstrated positive correlation with knee extensors strength. When muscle strength was corrected for body mass, however, the aforementioned relationship became insignificant, but the 1 leg rising performance demonstrated a positive relationship with knee extensor strength. In addition, maximal isometric lift and 1 leg rising test performance provided positive and negative correlation, respectively, with body mass. The obtained findings were in line with the effects of scale applied on the tested performance. We generally conclude that the assessment of muscle capability to exert force based on some standard functional performance tests could be confounded by the body size effect.

  • 27.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik. Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Jensen, Bente R
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Sandfeld, Jesper
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Richter, Hans
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Lyskov, Eugene
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Crenshaw, Albert
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    The impact of object size and precision demands on fatigue during computer mouse use2011Ingår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, nr 3, s. 118-127Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Prolonged computer use, especially if fatigue ensues, is associated with visual and musculoskeletal symptoms. The aim was to determine the time-course of perceived fatigue in the wrist, forearm, shoulder and eyes during a 60-min mouse task (painting rectangles), and whether object size and/or mouse use demands were of infl uence. Also, we investigated performance (number of rectangles painted), and whether perceived fatigue was paralleled by local muscle fatigue or tissue oxygenation.

    Ten women performed the task for three conditions (crossover design). At condition 1, rectangles were 45 25 mm, square paint cursor size 1.3 1.3 mm, and mouse – pointer movement ratio 1:26. At condition 2, the same cursor size and mouse – pointer movement ratio was used, but rectangles were smaller. At condition 3, the smaller rectangles were used, but the cursor size was also smaller and mouse – pointer movement ratio was 1:8. The results showed increased self-reported fatigue over time, with the observed increase greater for the eyes, but no change in physiological responses. Condition 2 resulted in higher performance and increased eye fatigue. Perceived fatigue in the muscles or physiological responses did not differ between conditions. In conclusion, computer work tasks imposing high visual and motor demands, and with high performance, seemed to have an infl uence on eye fatigue.

  • 28.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Kalezic, Nebojsa
    Lyskov, Eugene
    Ängquist, Karl-Axel
    Barnekow-Bergkvist, Margareta
    Stress monitoring of ambulance personnel during work and leisure time.Manuskript (Övrigt vetenskapligt)
  • 29. Aasa, Ulrika
    et al.
    Kalezic, Nebojsa
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Lyskov, Eugene
    Ängquist, Karl-Axel
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Barnekow-Bergkvist, Margareta
    Stress monitoring of ambulance personnel during work and leisure time.2006Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 80, nr 1, s. 51-59Artikel i tidskrift (Refereegranskat)
  • 30.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Lundell, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Aasa, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. Norrlandskliniken, Umeå, Sweden.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not: A Longitudinal Study2015Ingår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, nr 24, s. 1926-1933Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.

    OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.

    SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.

    METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.

    RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.

    CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.

    LEVEL OF EVIDENCE: 3.

  • 31.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Lundell, Sara
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Barnekow-Bergkvist, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Jansson, Eva
    Westerståhl, Maria
    The Swedish physical activity and fitness cohort born in 1958 - dropout analysis and overview at 36-year follow-up2017Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, nr 4, s. 418-429Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The main aim of the Swedish physical activity and fitness cohort study (SPAF-1958) was to describe physical fitness, physical activity, health, and lifestyle across part of the lifespan, and to assess the influences on these factors from the environment, personal factors, and genetics. There is inevitable dropout from longitudinal studies, and it may be systematic. The aim of this first paper of the second follow-up of SPAF-1958 was to provide a dropout analysis to consider to what extent the participants, at 52 years of age, remain a representative sample of the original adolescent study population. Additional aims were to provide an overview of the study protocol and the ongoing study population. Ongoing study participants in SPAF born in 1958 were, at the second follow-up at the age of 52, still representative of the study cohort in terms of sex, adolescent geographical area, upper secondary school program, adolescent body composition, muscular strength, and muscular endurance. However, a higher physical activity and, among women, a higher aerobic capacity in adolescence decreased the risk for dropout. It is important when interpreting results from longitudinal studies to adjust for the systematic dropout that could bias the conclusions drawn from the results.

  • 32.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Paulin, Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Madison, Guy
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Correspondence between physical self-concept and participation in, and fitness change after, bi-weekly body conditioning classes in sedentary women2017Ingår i: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 31, nr 2, s. 451-461Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aims of the study were (1) to investigate the effects of participation in low impact body conditioning classes on physical fitness in sedentary women at different ages and (2) to examine the correspondence between physical self-concept and participation in, and fitness change after, the participation. Ninety-two sedentary women (mean age 44.2 years) participated in 11-weeks of bi-weekly classes that included cardiovascular, strength, core, endurance and mobility exercises, all performed in synchrony with music. Cardiorespiratory fitness, maximal lifting strength, mobility and balance tests were performed pre- and post the exercise period and the short-form Physical Self-Description Questionnaire (PSDQ-S) was completed. Zero-order Spearman correlation analyses showed that women who rated the PSDQ-S dimension Sport competence higher participated in a larger number of sessions (rs=0.24, p=0.040). At post-tests, all participants had increased their balance, the participants aged 20-34 years had increased their lifting strength, and the participants aged 35-65 years had increased their cardiorespiratory fitness and mobility. Most PSDQ-S dimensions did not affect performance change, but the perception of being physically active was related to increased cardiovascular fitness. We conclude that women with a sedentary lifestyle who wish to increase their physical capacity benefit from music exercise and that inquiries about perceived sport competence and physical activity can improve recommendations made by strength and conditioning professionals.

  • 33.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå Centrum för idrottsvetenskap.
    Svartholm, Ivar
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Andersson, Fredrik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Berglund, Lars
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Samhällsvetenskapliga fakulteten, Umeå Centrum för idrottsvetenskap.
    Injuries among weightlifters and powerlifters: a systematic review2017Ingår i: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, nr 4, s. 211-219Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two growing sports.

    Objective The purpose of this study was to systematically review the literature regarding various definitions of injuries used, injury localisation, the prevalence and incidence of injuries and the associated risk factors for injuries in weightlifting and powerlifting.

    Design Systematic review.

    Data sources Five databases, PubMed, MEDLINE, SPORTDiscus, Scopus and Web of Science, were searched between 9 March and 6 April 2015.

    Eligibility criteria for selecting studies Studies assessing injury incidence and prevalence in Olympic weightlifting and powerlifting were included. The Quality assessment tool for observational cohort and cross-sectional studies was used to assess methodological quality.

    Results 9 studies were included in the review. Injury was defined fairly consistently across studies. Most studies were of low methodological quality. The spine, shoulder and the knee were the most common injury localisations in both sports. The injury incidence in weightlifting was 2.4–3.3 injuries/1000 hours of training and 1.0–4.4 injuries/1000 hours of training in powerlifting. Only one retrospective study had analysed possible risk factors.

    Summary/conclusions The risk of injury in both sports were similar to other non-contact sports also requiring strength/power, but low compared to contact sports. The severity of injuries differed in the included studies. Since little has been studied regarding possible risk factors to injuries, further research is therefore warranted to explain why athletes get injured and how to prevent injuries.

    Trial registration number PROSPERO CRD42015014805.

  • 34.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Barnekow-Bergkvist, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Jansson, Eva
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Hälsoresan till medelåldern2011Ingår i: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, nr 2, s. 4s. 40-43Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [sv]

    Vad är viktigast för att få en god hälsa som vuxen? Sedan 1974 har vi följt samma personer från 16 års ålder in i medelåldern och studerat deras hälsa från flera olika synvinklar. Nu pågår den tredje mätomgången.

  • 35.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Wiitavaara, Birgitta
    Högskolan i Gävle.
    Personalens hälsa och arbetsmiljö2009Ingår i: Prehospital akutsjukvård / [ed] Björn-Ove Suserud och Leif Svensson, Stockholm: Liber, 2009, s. 33-38Kapitel i bok, del av antologi (Övrig (populärvetenskap, debatt, mm))
  • 36.
    Aasa, Ulrika
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Sjukgymnastik.
    Ängquist, Karl-Axel
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Barnekow-Bergkvist, Margareta
    The effects of a 1-year physical exercise programme on development of fatigue during a simulated ambulance work task.2008Ingår i: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 51, nr 8, s. 1179-94Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to evaluate the effects of individually prescribed physical exercise programmes on development of fatigue during the carrying of a loaded stretcher up and down the stairs. Nineteen ambulance personnel performed the training for 1 year. Testing occurred before and after 1 year of the training. Both the training group (n = 19) and the control group (n = 15) were assessed for physical capacity and lactate concentration in blood and ratings of perceived exertion during carrying a stretcher on the stairs. When comparisons were made between those who had been training three times/week for 1 year and the control group, lactate concentration was significantly decreased. In conclusion, markers of fatigue during stretcher carrying can be reduced by the use of individually prescribed physical exercise programmes.

  • 37. Aazh, Hashir
    et al.
    Knipper, Marlies
    Danesh, Ali A.
    Cavanna, Andrea E.
    Andersson, Linus
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Paulin, Johan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Schecklmann, Martin
    Heinonen-Guzejev, Marja
    Moore, Brian C. J.
    Insights from the Third International Conference on Hyperacusis: Causes, Evaluation, Diagnosis, and Treatment2018Ingår i: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 20, nr 95, s. 162-170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities. 

    Objective: The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis.

    Topics covered: The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis.

    Conclusions: Implications for research and clinical practice are summarised.

  • 38. Abafe, Ovokeroye A.
    et al.
    Späth, Jana
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Fick, Jerker
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Jansson, Stina
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen.
    Buckley, Chris
    Stark, Annegret
    Pietruschka, Bjoern
    Martincigh, Bice S.
    LC-MS/MS determination of antiretroviral drugs in influents and effluents from wastewater treatment plants in KwaZulu-Natal, South Africa2018Ingår i: Chemosphere, ISSN 0045-6535, E-ISSN 1879-1298, Vol. 200, s. 660-670Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    South Africa has the largest occurrence of the human immune deficiency virus (HIV) in the world but has also implemented the largest antiretroviral (ARV) treatment programme. It was therefore of interest to determine the presence and concentrations of commonly used antiretroviral drugs (ARVDs) and, also, to determine the capabilities of wastewater treatment plants (WWTPs) for removing ARVDs. To this end, a surrogate standard based LC-MS/MS method was optimized and applied for the detection of thirteen ARVDs used in the treatment and management of HIV/acquired immune deficiency syndrome (HIV/AIDS) in two major and one modular WWTP in the eThekwini Municipality in KwaZulu-Natal, South Africa. The method was validated and the detection limits fell within the range of 2–20 ng L−1. The analytical recoveries for the ARVDs were mainly greater than 50% with acceptable relative standard deviations. The concentration values ranged from <LOD – 53000 ng L−1 (influent), <LOD – 34000 ng L−1 (effluent) in a decentralized wastewater treatment facility (DEWATS); <LOD – 24000 ng L−1 (influent), <LOD – 33000 ng L−1 (effluent) in Northern WWTP and 61–34000 ng L−1 (influent), <LOD – 20000 ng L−1 (effluent) in Phoenix WWTP. Whilst abacavir, lamivudine and zidovudine were almost completely removed from the effluents, atazanavir, efavirenz, lopinavir and nevirapine persisted in the effluents from all three WWTPs. To estimate the ecotoxicological risks associated with the discharge of ARVDs, a countrywide survey focussing on the occurrence of ARVDs in WWTPs, surface and fresh water bodies, and aquatic organisms, is necessary.

  • 39. Abalaka, J. L.
    et al.
    Ottosson, Ulf
    Tende, Talatu
    Larson, Keith W.
    Rock Firefinch Lagonosticta sanguinodorsalis in the Mandara Mountains, north-east Nigeria: a new subspecies?2010Ingår i: African Bird Club Bulletin, ISSN 1352-481X, Vol. 17, nr 2, s. 210-211Artikel i tidskrift (Refereegranskat)
    Abstract [fr]

    L’Amarante des rochers Lagonosticta sanguinodorsalis dans les Monts Mandara, Nigeria du sud-est: une nouvelle sous-espèce ? Nous fournissons une description d’un mâle et d’une femelle, ainsi que desphotos d’un mâle, d’un amarante capturé dans les Monts Mandara, au nord-est du Nigeria. Le plumage et le cri de cet amarante sont identiques à ceux de l’Amarante des rochers Lagonosticta sanguinodorsalis, une espèce précédemment rapportée de la zone, excepté que le mâle n’a pas la couronne grise typique de l’espèce. Des travaux supplémentaires sur le terrain sont nécessaires pour déterminer s’il agit d’un individu aberrant ou d’une population de l’Amarante des rochers morphologiquement distincte.

  • 40. Abat, F
    et al.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. Alfredson Tendon Clinic Inc, Umeå, Sweden; Pure Sports Medicine Clinic, ISEH, UCLH, London, UK.
    Cucchiarini, M
    Madry, H
    Marmotti, A
    Mouton, C
    Oliveira, J M
    Pereira, H
    Peretti, G M
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Stephen, J
    van Bergen, C J A
    de Girolamo, L
    Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II2018Ingår i: Journal of experimental orthopaedics, ISSN 2197-1153, Vol. 5, nr 38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The treatment of painful chronic tendinopathy is challenging. Multiple non-invasive and tendon-invasive methods are used. When traditional non-invasive treatments fail, the injections of platelet-rich plasma autologous blood or cortisone have become increasingly favored. However, there is little scientific evidence from human studies supporting injection treatment. As the last resort, intra- or peritendinous open or endoscopic surgery are employed even though these also show varying results. This ESSKA basic science committee current concepts review follows the first part on the biology, biomechanics and anatomy of tendinopathies, to provide a comprehensive overview of the latest treatment options for tendinopathy as reported in the literature.

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  • 41.
    Abat, F.
    et al.
    Department of Orthopaedic Sports Medicine, ReSport Clinic, Passeig Fabra i Puig 47, Barcelona, Spain.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Idrottsmedicin. Alfredson Tendon Clinic Inc, Umeå, Sweden; Pure Sports Medicine Clinic, ISEH, UCLH, London, United Kingdom.
    Cucchiarini, M.
    Molecular Biology, Center of Experimental Orthopaedics, Saarland University Medical Center, Kirrbergerstr Bldg 37, Homburg/Saar, Germany.
    Madry, H.
    Lehrstuhl für Experimentelle Orthopädie und Arthroseforschung, Universität des Saarlandes, Gebäude 37, Kirrbergerstr 1, Homburg, Germany.
    Marmotti, A.
    Department of Orthopaedics and Traumatology, San Luigi Gonzaga Hospital, Orbassano, University of Turin, Turin, Italy.
    Mouton, C.
    Department of Orthopedic Surgery, Clinique d’Eich-Centre Hospitalier de Luxembourg, 76, rue d’Eich, Luxembourg, Luxembourg.
    Oliveira, J.M.
    3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Zona Industrial da Gandra, GMR, Barco, Portugal; ICVS/3B’s - PT Government Associate Laboratory, Braga, Guimarães, Portugal.
    Pereira, H.
    3B’s Research Group University of Minho, ICVS/3B’s–PT Government Associate Laboratory, Braga, Guimarães, Portugal; Orthopedic Department Centro Hospitalar Póvoa de Varzim, Vila do Conde, Portugal; Ripoll y De Prado Sports Clinic – FIFA Medical Centre of Excellence, Madrid, Murcia, Spain.
    Peretti, G.M.
    IRCCS Istituto Ortopedico Galeazzi, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
    Romero-Rodriguez, D.
    Department of Physical Therapy and Sports Rehabilitation, ReSport Clinic Barcelona, Barcelona, Spain; EUSES Sports Science, University of Girona, Girona, Spain.
    Spang, Christoph
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB), Anatomi.
    Stephen, J.
    Fortius Clinic, 17 Fitzhardinge St, London, United Kingdom; The Biomechanics Group, Department of Mechanical Engineering, Imperial College, London, United Kingdom.
    van Bergen, C.J.A.
    Department of Orthopedic Surgery, Amphia Hospital Breda, Breda, Netherlands.
    de Girolamo, L.
    Orthopaedic Biotechnology Laboratory, Galeazzi Orthopaedic Institute, Milan, Italy.
    Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and anexercise-based approach2017Ingår i: Journal of Experimental Orthopaedics, E-ISSN 2197-1153, Vol. 4, nr 1, artikel-id 18Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Chronic tendinopathies represent a major problem in the clinical practice of sports orthopaedic surgeons, sports doctors and other health professionals involved in the treatment of athletes and patients that perform repetitive actions. The lack of consensus relative to the diagnostic tools and treatment modalities represents a management dilemma for these professionals. With this review, the purpose of the ESSKA Basic Science Committee is to establish guidelines for understanding, diagnosing and treating this complex pathology.

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  • 42.
    Abat, Ferran
    et al.
    ReSport Clinic Barcelona, Blanquerna-Ramon Llull University School of Health Science, Rosselló, Barcelona, Spain.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Sonosurgery ultrasound-guided arthroscopic shaving for the treatment of patellar tendinopathy when conservative treatment fails2023Ingår i: Anterior knee pain and patellar instability / [ed] Vicente Sanchis-Alfonso, Cham: Springer Nature, 2023, 3, s. 403-413Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Proximal patellar Tendinopathy, commonly denominated as Jumper´s Knee, is widely considered to be a challenge to treat (Abat et al. in J Exp Orthop. 3:34, 2016). The treatment of patellar tendinopathy focuses on reducing if not eliminating the pain and improving function. At present, there are a several distinct treatments oriented to that end, and a “gold-standard” treatment might be in sight. (Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018 Sep 24;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.)

  • 43. Abat, Ferran
    et al.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Campos, Jocelio
    Planells, Gabriel
    Torras, Jordi
    Madruga-Parera, Marc
    Rodriguez-Baeza, Alfonso
    Ultrasound-guided versus blind interventions in patellar tendon lesions: a cadaveric study2021Ingår i: Skeletal Radiology, ISSN 0364-2348, E-ISSN 1432-2161, Vol. 50, nr 5, s. 967-972Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The present study aims to analyze the accuracy of injections aimed to hit the proximal and depth part of the patellar tendon "target point" in patellar tendinopathy, comparing ultrasound-guided or non-ultrasound-guided (blind) injections.

    Methods: A cadaver randomized study was carried out. Injections were performed under ultrasound control, as well as blinded. There were 26 knees from fresh cadavers and injections were placed by 26 practitioners with experience in the use of musculoskeletal ultrasound and injection treatment. Each participant performed 6 ultrasound-guided and 6 blind punctures in different cadaveric specimens. This provided 312 injections that were analyzed in 2 different anatomical cuts, thus providing a database of 624 measurements for statistical analysis.

    Results: Statistically significant differences were observed (p < 0.0001) in the distance from the target point between the ultrasound-guided and the non-guided infiltrations. The "unguided" injections were considered to have been performed on average 10 mm away from the target point compared to the "ultrasound-guided" injections. The ultrasound-guided injections obtained an accuracy of 74.36% while the "non-ultrasound-guided" injections obtained an accuracy of 11.54% (p < 0.0001).

    Conclusion: The use of ultrasound to guide the positioning of injections on the dorsal side of the proximal patellar tendon had a significantly higher accuracy compared to blind injections. The finding provides knowledge of importance for injection treatment.

  • 44.
    Abat, Ferran
    et al.
    Department of Sports Orthopaedic, ReSport Clinic Barcelona, Barcelona, Spain.
    Maffulli, Nicola
    Centre for Sports and Exercise Medicine, Queen Mary University of London Barts and The London School of Medicine, London, United Kingdom.
    Alfredson, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Avdelningen för idrottsmedicin.
    Lopez-Vidriero, E.
    Department of Orthopaedic, International Sports Medicine Clinic and Ibermutuamur Sevilla, Sevilla, Spain.
    Myers, C.
    Complete Physio, Tendon Performance, Sports Medicine Ultrasound Group (SMUG), London, United Kingdom.
    Gomes, S.
    Department of MSK Radiology, Clinica do Dragao Espregueira Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal.
    Chan, O.
    Department of MSK Radiology, BMI London Independent Hospital, London, United Kingdom.
    Clinical utility of diagnostic ultrasound in athletes with tendinopathy (ICL 22)2016Ingår i: Esska instructional course lecture book: Barcelona 2016 / [ed] Roland Becker; Gino M.M.J. Kerkhoffs; Pablo E. Gelber; Matteo Denti; Romain Seil, Springer Berlin/Heidelberg, 2016, s. 217-223Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    Chronic painful tendinopathy is common in elite and recreational athletes and in sedentary subjects; all may have to stop or decrease their level of physical activity [1, 2]. Midportion Achilles tendinopathy and for the younger and heavy loading population also patellar tendinopathy are problematic injuries. However, recent research on innervation patterns histopathology and pain mechanisms in Achilles and patellar tendons has led to an increased knowledge about the chronic painful tendon [3–6].

  • 45. Abbara, Aula
    et al.
    Al-Harbat, Nizar
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Abo-Yahya, Bashar
    El-Amin, Wael
    Hatcher, James
    Gabbar, Omar
    Antimicrobial Drug Resistance among Refugees from Syria, Jordan2017Ingår i: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 23, nr 5, s. 885-886Artikel i tidskrift (Refereegranskat)
  • 46.
    Abbara, Aula
    et al.
    Imperial College, London, United Kingdom.
    Almalla, Mohamed
    American University of Beirut, Beirut, Lebanon.
    AlMasri, Ibrahim
    O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
    AlKabbani, Hussam
    Department of Health and Nutrition Al-Ameen for Humanitarian Support, Gaziantep, Turkey.
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS). Umeå universitet, Medicinska fakulteten, Umeå Centre for Microbial Research (UCMR). Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    El-Amin, Wael
    King's College Hospital London, United Arab Emirates.
    Rajan, Latha
    Tulane University School of Public Health and Tropical Medicine, Tulane University, LA, New Orleans, United States.
    Rahhal, Ibrahim
    Hand in Hand for Aid and Development, Gaziantep, Turkey.
    Alabbas, Mohammad
    Hand in Hand for Aid and Development, Gaziantep, Turkey.
    Sahloul, Zaher
    Department of Pulmonology and Critical Care, University of Illinois, IL, Chicago, United States.
    Tarakji, Ahmad
    Syrian American Medical Society, Washington DC, United States.
    Sparrow, Annie
    Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, New York, United States.
    The challenges of tuberculosis control in protracted conflict: The case of Syria2020Ingår i: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, International Journal of Infectious Diseases, ISSN 1201-9712, Vol. 90, s. 53-59Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objectives: Syria's protracted conflict has resulted in ideal conditions for the transmission of tuberculosis (TB) and the cultivation of drug-resistant strains. This paper compares TB control in Syria before and after the conflict using available data, examines the barriers posed by protracted conflict and those specific to Syria, and discusses what measures can be taken to address the control of TB in Syria.

    Results: Forced mass displacement and systematic violations of humanitarian law have resulted in overcrowding and the destruction of key infrastructure, leading to an increased risk of both drug-sensitive and resistant TB, while restricting the ability to diagnose, trace contacts, treat, and follow-up. Pre-conflict, TB in Syria was officially reported at 22 per 100 000 population; the official figure for 2017 of 19 per 100 000 is likely a vast underestimate given the challenges and barriers to case detection. Limited diagnostics also affect the diagnosis of multidrug- and rifampicin-resistant TB, reported as comprising 8.8% of new diagnoses in 2017.

    Conclusions: The control of TB in Syria requires a multipronged, tailored, and pragmatic approach to improve timely diagnosis, increase detection, stop transmission, and mitigate the risk of drug resistance. Solutions must also consider vulnerable populations such as imprisoned and besieged communities where the risk of drug resistance is particularly high, and must recognize the limitations of national programming. Strengthening capacity to control TB in Syria with particular attention to these factors will positively impact other parallel conditions; this is key as attention turns to post-conflict reconstruction.

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  • 47.
    Abbara, Aula
    et al.
    Department of Infection, Imperial College, St Marys Hospital, London, United Kingdom; Syria Public Health Network, London, United Kingdom.
    Almhawish, Naser
    Assistance Coordination Unit, Gaziantep, Turkey.
    Aladhan, Ibrahim
    Environmental Protection Agency of Syria, Gaziantep, Turkey.
    Alobaid, Redwan
    Assistance Coordination Unit, Gaziantep, Turkey.
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Weaponisation of water2022Ingår i: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 400, nr 10367, s. 1925-1925Artikel i tidskrift (Refereegranskat)
  • 48. Abbara, Aula
    et al.
    Rawson, Timothy M.
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten). Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS). Umeå universitet, Medicinska fakulteten, Umeå Centre for Microbial Research (UCMR).
    El-Amin, Wael
    Hatcher, James
    Tajaldin, Bachir
    Dar, Osman
    Dewachi, Omar
    Abu Sitta, Ghassan
    Uhlin, Bernt Eric
    Umeå universitet, Medicinska fakulteten, Umeå Centre for Microbial Research (UCMR). Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS). Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Sparrow, Annie
    A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict2018Ingår i: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 75, s. 26-33Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Antimicrobial resistance (AMR) in populations experiencing war has yet to be addressed, despite the abundance of contemporary conflicts and the protracted nature of twenty-first century wars, in combination with growing global concern over conflict-associated bacterial pathogens. The example of the Syrian conflict is used to explore the feasibility of using existing global policies on AMR in conditions of extreme conflict. The available literature on AMR and prescribing behaviour in Syria before and since the onset of the conflict in March 2011 was identified. Overall, there is a paucity of rigorous data before and since the onset of conflict in Syria to contextualize the burden of AMR. However, post onset of the conflict, an increasing number of studies conducted in neighbouring countries and Europe have reported AMR in Syrian refugees. High rates of multidrug resistance, particularly Gram-negative organisms, have been noted amongst Syrian refugees when compared with local populations. Conflict impedes many of the safeguards against AMR, creates new drivers, and exacerbates existing ones. Given the apparently high rates of AMR in Syria, in neighbouring countries hosting refugees, and in European countries providing asylum, this requires the World Health Organization and other global health institutions to address the causes, costs, and future considerations of conflict-related AMR as an issue of global governance. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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  • 49. Abbara, Aula
    et al.
    Rawson, Timothy M.
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten). Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS). Umeå universitet, Medicinska fakulteten, Umeå Centre for Microbial Research (UCMR).
    El-Amin, Wael
    Hatcher, James
    Tajaldin, Bachir
    Dar, Osman
    Dewachi, Omar
    Abu Sitta, Ghassan
    Uhlin, Bernt Eric
    Umeå universitet, Medicinska fakulteten, Umeå Centre for Microbial Research (UCMR). Umeå universitet, Medicinska fakulteten, Molekylär Infektionsmedicin, Sverige (MIMS). Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Sparrow, Annie
    Antimicrobial resistance in the context of the Syrian conflict: Drivers before and after the onset of conflict and key recommendations2018Ingår i: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 73, s. 1-6Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Current evidence describing antimicrobial resistance (AMR) in the context of the Syrian conflict is of poor quality and sparse in nature. This paper explores and reports the major drivers of AMR that were present in Syria pre-conflict and those that have emerged since its onset in March 2011. Drivers that existed before the conflict included a lack of enforcement of existing legislation to regulate over-the-counter antibiotics and notification of communicable diseases. This contributed to a number of drivers of AMR after the onset of conflict, and these were also compounded by the exodus of trained staff, the increase in overcrowding and unsanitary conditions, the increase in injuries, and economic sanctions limiting the availability of required laboratory medical materials and equipment. Addressing AMR in this context requires pragmatic, multifaceted action at the local, regional, and international levels to detect and manage potentially high rates of multidrug-resistant infections. Priorities are (1) the development of a competent surveillance system for hospital-acquired infections, (2) antimicrobial stewardship, and (3) the creation of cost-effective and implementable infection control policies. However, it is only by addressing the conflict and immediate cessation of the targeting of health facilities that the rehabilitation of the health system, which is key to addressing AMR in this context, can progress. 

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  • 50.
    Abbara, Aula
    et al.
    Imperial College, London, United Kingdom; Syria Public Health Network, United Kingdom.
    Zakieh, Omar
    Imperial College, London, United Kingdom.
    Rayes, Diana
    Syria Public Health Network, United Kingdom; Johns Hopkins, United States.
    Collin, Simon M.
    Public Health England, United Kingdom.
    Almhawish, Naser
    Assistance Coordination Unit, Turkey.
    Sullivan, Richard
    King's College, London, United Kingdom.
    Aladhan, Ibrahim
    Assistance Coordination Unit, Turkey.
    Tarnas, Maia
    Community Research Initiative, MA, Charlestown, United States.
    Whalen-Browne, Molly
    University of Alberta, Edmonton, Canada.
    Omar, Maryam
    St Bartholomew's Hospital, London, United Kingdom.
    Tarakji, Ahmad
    Syrian American Medical Society, United States.
    Karah, Nabil
    Umeå universitet, Medicinska fakulteten, Institutionen för molekylärbiologi (Medicinska fakulteten).
    Weaponizing water as an instrument of war in Syria: Impact on diarrhoeal disease in Idlib and Aleppo governorates, 2011–20192021Ingår i: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 108, s. 202-208Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Investigate the weaponization of water during the Syrian conflict and the correlation of attacks on water, sanitation, and hygiene (WASH) infrastructure in Idlib and Aleppo governorates with trends in waterborne diseases reported by Early Warning and Response surveillance systems.

    Methods: We reviewed literature and databases to obtain information on attacks on WASH in Aleppo and Idlib governorates between 2011 and 2019. We plotted weekly trends in waterborne diseases from two surveillance systems operational in Aleppo and Idlib governorates between 2015 and early 2020.

    Results: The literature review noted several attacks on water and related infrastructure in both governorates, suggesting that WASH infrastructure was weaponized by state and non-state actors. Most interference with WASH in the Aleppo governorate occurred before 2019 and in the Idlib governorate in the summer of 2020. Other acute diarrhea represented >90% of cases of diarrhea; children under 5 years contributed 50% of cases. There was substantial evidence (p < 0.001) of an overall upward trend in cases of diarrheal disease.

    Conclusions: Though no direct correlation can be drawn between the weaponization of WASH and the burden of waterborne infections due to multiple confounders, this research introduces important concepts on attacks on WASH and their potential impacts on waterborne diseases.

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