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  • 1. Edner, A
    et al.
    Katz-Salamon, M
    Lagercrantz, H
    Ericson, Mats
    KTH, School of Technology and Health (STH), Ergonomics.
    Milerad, J
    Heart rate variability in infants with apparent life-threatening events.2000In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 89, no 11, p. 1326-9Article in journal (Refereed)
    Abstract [en]

    Heart rate variability (HRV) is often used as an index of sympatho-vagal balance. A decreased HRV has been observed in patients with central hypoventilation and in infants who have later succumbed to sudden infant death syndrome (SIDS). The aim of the present study was to investigate whether HRV is altered in infants with apparent life-threatening events (ALTE), a group with an increased risk of SIDS. Fifty infants with ALTE were compared with 50 age- and sex-matched controls. ECG was recorded overnight in all infants. Two sequences of RR intervals free of artefacts were selected from each sleep state and spectral analysis of RR variability was performed. The mean and SD of RR and the low (LFPow) and high (HFPow) frequency power were analysed. In active sleep (AS) the LF/HF ratio was lower in ALTE infants, but no differences were seen in either the LFPow or the HFPow. In quiet sleep (QS), however, ALTE infants had higher SD-RR (p = 0.006), greater HFPow (p = 0.02) and VLFPow (very low frequency power, p = 0.02) than the control infants. The same results were seen when the two sleep states were combined for analysis, ALTE infants had higher SD-RR (p = 0.004), HFPow (p = 0.006) and VLFPow (p = 0.04). Conclusion: The different HRV pattern in ALTE infants compared to healthy controls suggests an altered autonomic control.

  • 2.
    Halldin, Peter
    et al.
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Jakobsson, Lotta
    Chalmers tekniska högskola School of Mechanical Engineering. Institutionen för tillämpad mekanik. .
    Brolin, Karin
    Chalmers tekniska högskola School of Mechanical Engineering. Institutionen för tillämpad mekanik. .
    Palmertz, Camilla
    Kleiven, Svein
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    von Holst, Hans
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Investigations of Conditions that Affect Neck Compression-Flexion Injuries Using Numerical Techniques2000In: Stapp Car Crash Journal, ISSN 1532-8546Article in journal (Refereed)
  • 3.
    Larsson, Tore J
    et al.
    KTH, School of Technology and Health (STH), Centres, Centre for Health and Building, CHB.
    Bråfelt, Olle
    IPSO Classification&Control AB, Sweden.
    Risk control in the shipping industry: Relevant applications for the prevention of accidents2000In: Safety Science Monitor, ISSN 1443-8844, Vol. 4, no 1Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION

    The shipping industry is in a way the first global industry. It is the link between nations and continents. The establishment of international co-operation and conventions has therefore a long history in the shipping industry.

    The public, as well as others who use shipping services have the right to expect that the ship they board or which carries their cargo is safe and within the context of the voyage, seaworthy and otherwise fit for the purpose. Seafarers too have the right to expect that their ship is safe and they will not be exposed to danger or unacceptably high levels of risk.

    There are many stakeholders in marine transportation safety. The industry is highly regulated with prescriptive requirements to ensure well-designed and constructed ships. Many operational procedures and training or certification requirements have been researched and mandated to ensure safe operations.

    It has always been recognised that the best way of improving safety at sea is by developing international regulations that are followed by all shipping nations and from the mid 19th century onwards a number of such treaties were adopted.

    In 1948 United Nations established the International Maritime Organisation (IMO). The first task was to adopt a new version of the International Convention for the Safety of Life at Sea (SOLAS), the most important of all treaties dealing with maritime safety. This was achieved in 1960 and IMO then turned its attention to such matters as facilitation of maritime traffic, load lines, and the carriage of dangerous goods.

    But although safety was and remains IMO's most important responsibility, a new problem was emerging - pollution. Pollution prevention was part of IMO's original mandate but in the late 1960´s a number of tanker accidents resulted in further action being taken. As an example, recent changes to the convention will make it necessary for all new tankers to be fitted with double-hulls or a design that provides equivalent cargo protection in the event of a collision or grounding. These changes are also applied to existing tankers when they reach 25 years of age.

    For certain maritime segments, the International Safety Management (ISM) Code has just come into force. For others it will enter into force soon and further insure quality of operations. State agencies i. e.

    Maritime Directorates, mariners, pilots, those involved with maritime control or advisement systems, as ISSUE 1 2000 VOL 42 well as operating companies, classification societies, and many others have interests in developing a practical system that contributes to better working environment and safer operations.

    The shipping industry has shown that free market forces can provide efficient cheap transport and it does this through a complex web of contracts and agreements. However, as ships increase in size, cargoes become more complex and ferries run even faster, the risk of disruption following an incident become correspondingly greater.

  • 4.
    Larsson, Tore J
    et al.
    KTH, School of Technology and Health (STH), Centres, Centre for Health and Building, CHB.
    Hale, Andrew R
    Aspects of risk assessment, control and prevention2000In: Safety Science Monitor, ISSN 1443-8844, Vol. 4, no 1Article in journal (Refereed)
    Abstract [en]

    The contributions to this Worklife 2000 workshop and special issue of the Safety Science Monitor touch upon several aspects crucial to safety management. The perspectives and concepts presented are from areas which include, but are not specifically dedicated to, occupational health and safety. Safety at work, however, represents the prime target area of the workshop and the discussion initiated here, and hopefully continuing through the year on this site, should be seen as an attempt to seek the potential of initiatives, approaches and applications in non-occupational areas to the management of safety at work.

    These comments are not meant to be exhaustive to the theme of the workshop, but rather to provide some perspectives from the target area of work-related risks.

  • 5. Reichard, P
    et al.
    Jensen-Urstad, K
    Ericson, Mats
    KTH, School of Technology and Health (STH), Ergonomics.
    Jensen-Urstad, M
    Lindblad, L E
    Autonomic neuropathy--a complication less pronounced in patients with Type 1 diabetes mellitus who have lower blood glucose levels.2000In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 17, no 12, p. 860-6Article in journal (Refereed)
    Abstract [en]

    AIMS: Autonomic neuropathy is a serious diabetic complication, probably contributing to the death of many young people with Type 1 diabetes mellitus. It is often not diagnosed.

    METHODS: Patients with Type 1 diabetes from the Stockholm Diabetes Intervention Study were investigated with power spectral analysis (n = 88), heart rate and blood pressure reactions to tilting (n = 66), and heart rate variability during deep breathing (n = 70) a mean of 11.4 years after randomization to intensified conventional treatment (ICT) or standard treatment (ST), the treatment groups similar with regard to age, duration of diabetes and metabolic control at baseline (HbA1c 9.4 (1.3)%, mean (SD)). Blood glucose levels (mean of 29 HbA1c values) during the 10 years were lower in the patients from the ICT group (7.2 (0.6) vs. 8.3 (1.0)%, P = 0.001).

    RESULTS: Heart rate variability (HRV) in the high frequency range (P = 0.034), the expiration-inspiration ratio (P = 0.020), and the brake index during tilt (P = 0.044) were lower in the ST group, indicating more pronounced parasympathetic insufficiency. Systolic blood pressure fell by 10 (16) mmHg in the ST group, and by 2.5 (15) mmHg in the ICT group 8 min after rising from the supine to a 70 degrees upright position (P = 0.034). A decreased autonomic function was associated with age and higher HbA1c.

    CONCLUSION: Better autonomic nerve function is associated with lower HbA1c and lower age which were both the same in the intensively and the conventionally treatment groups at baseline. After a mean of 11.4 years autonomic function was better in the intensively treated group.

  • 6.
    Sundblad, Patrik
    et al.
    KTH, School of Technology and Health (STH), Environmental Physiology (Closed 20130701).
    Haruna, Y
    Tedner, B
    Linnarsson, D
    Short-term cardiovascular responses to rapid whole-body tilting during exercise.2000In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 81, no 4, p. 259-270Article in journal (Refereed)
    Abstract [en]

    Our objective was to characterize the responses of heart rate (HR) and arterial blood pressure (BP) to changes in posture during concomitant dynamic leg exercise. Ten men performed dynamic leg exercise at 50, 100, and 150 W and were rapidly and repeatedly tilted between supine (0 degrees ) and upright (80 degrees ) positions at 2-min intervals. Continuous recordings of BP and HR were made, and changes in central blood volume were estimated from transthoracic impedance. Short-lasting increases in BP were observed immediately upon tilting from the upright to the supine position (down-tilt), averaging +18 mmHg (50 W) to +31 mmHg (150 W), and there were equally short-lasting decreases in BP, ranging from -26 to -38 mmHg upon tilting from supine to upright (up-tilt). These components occurred for all pressure parameters (systolic, mean, diastolic, and pulse pressures). We propose that these transients reflect mainly tilt-induced changes in total peripheral resistance resulting from decreases and increases of the efficiency of the venous muscle pump. After 3-4 s (down-tilt) and 7-11 s (up-tilt) there were large HR transients in a direction opposite to the pressure transients. These HR transients were larger during the down-tilt (-15 to -26 beats. min(-1)) than during the up-tilt (+13 to +17 beats. min(-1)), and increased in amplitude with work intensity during the down-tilt. The tilt-induced HR fluctuations could be modelled as a basically linear function of an arterial baroreflex input from a site half-way between the heart and the carotid sinus, and with varying contributions of fast vagal and slow sympathetic HR responses resulting in attenuated tachycardic responses to hypotensive stimuli during exercise.

  • 7.
    Sundblad, Patrik
    et al.
    KTH, School of Technology and Health (STH), Environmental Physiology (Closed 20130701).
    Spaak, J
    Linnarsson, D
    Cardiovascular responses to upright and supine exercise in humans after 6 weeks of head-down tilt (-6 degrees).2000In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 83, no 4-5, p. 303-309Article in journal (Refereed)
    Abstract [en]

    Seven healthy men performed steady-state dynamic leg exercise at 50 W in supine and upright postures, before (control) and repeatedly after 42 days of strict head-down tilt (HDT) (-6 degrees) bedrest. Steady-state heart rate (fc), mean arterial blood pressure, cardiac output (Qc), and stroke volume (SV) were recorded. The following data changed significantly from control values. The fc was elevated in both postures at least until 12 days, but not at 32 days after bedrest. Immediately after HDT, SV and Qc were decreased by 25 (SEM 3)% and 19 (SEM 3)% in supine, and by 33 (SEM 5)% and 20 (SEM 3)% in upright postures, respectively. Within 2 days there was a partial recovery of SV in the upright but not in the supine posture. The SV and Qc during supine exercise remained significantly decreased for at least a month. Submaximal oxygen uptake did not change after HDT. We concluded that the cardiovascular response to exercise after prolonged bedrest was impaired for so long that it suggested that structural cardiac changes had developed during the HDT period.

  • 8.
    Sundblad, Patrik
    et al.
    KTH, School of Technology and Health (STH), Environmental Physiology (Closed 20130701).
    Spaak, J
    Linnarsson, D
    Haemodynamic and baroreflex responses to whole-body tilting in exercising men before and after 6 weeks of bedrest.2000In: European Journal of Applied Physiology, ISSN 1439-6319, E-ISSN 1439-6327, Vol. 82, no 5-6, p. 397-406Article in journal (Refereed)
    Abstract [en]

    We sought to determine whether the cardiovascular deconditioning that occurs in exercising men after prolonged (42 days) bedrest in the head-down tilt (HDT) position is primarily related to mechanical changes in the heart or to an impaired arterial-cardiacchronotropic baroreflex. Seven subjects were studied before (C, control) and repeatedly after HDT with rapid tilting between the upright and supine positions during steady-state 50-W dynamic leg exercise. Ventricular interdependence was assumed to be an index of cardiac size; it was assessed on the basis of the initial dip of arterial pulse pressure (PP) induced by a sudden tilt from the upright to the supine position (down-tilt). Arterialcardiac-chronotropic baroreflex sensitivity (ABS) was assessed as the ratio between tilt-induced heart rate transients and the preceding (and reciprocal) transient in arterial pressure. On the first day of recovery, the initial PP dip was -4 (2) mmHg (where 1 mmHg is 0.13 kPa), less than half of the control value; on subsequent recovery days, the initial PP dip was not significantly different from the control value. When tilting from the upright to the supine position, mean ABS ranged from 1.02 to 1.06 bpm/mmHg during three separate control sessions. Tilts in the opposite direction gave lower ABS values because of the more sluggish HR response and ranged from 0.43 to 0.45 bpm/mmHg in the control situations. ABS did not change after HDT. Our results indicate that impairments of the cardiovascular system after long-term bedrest are of haemodynamic rather than baroreflex origin.

  • 9. Tanaka, H
    et al.
    Borres, M
    Thulesius, O
    Tamai, H
    Ericson, Mats O
    KTH, School of Technology and Health (STH), Ergonomics.
    Lindblad, L E
    Blood pressure and cardiovascular autonomic function in healthy children and adolescents.2000In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 137, no 1, p. 63-7Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the relationship between blood pressure levels and cardiovascular autonomic function in adolescents and preadolescents.

    STUDY DESIGN: We measured variability of beat-to-beat arterial pressure and R-R intervals using power spectral analysis in 56 adolescents (aged 13-16 years; mean age, 9.0 +/- 1.4 years) and 71 preadolescents (6-12 years; mean age, 13.5 +/- 1.1 years) in the supine and standing positions.

    RESULTS: Adolescents had higher levels of systolic arterial pressure and lower high-frequency power of RR intervals than preadolescents. Correlation between the basal level of arterial pressure and autonomic function was observed in adolescents but not in preadolescents. In adolescents, multivariate analysis indicated that the basal level of arterial pressure was inversely related with the high-frequency power of RR intervals and positively with the ratio of low-frequency and high-frequency power. No significant relation was found in preadolescents. During standing, adolescents had a more marked increase in diastolic arterial pressure, heart rate, low frequency of R-R intervals, and low frequency of arterial pressure compared with those of preadolescents. Changes in diastolic pressure showed a significant negative correlation with changes in high frequency of R-R intervals.

    CONCLUSION: Cardiovascular autonomic function plays an important role in increasing blood pressure levels associated with increased modulation of vagal tone of the heart after puberty but does not in the preadolescent.

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