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2.
  • Israelsson, Johan, et al. (författare)
  • Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
  • 2017
  • Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
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3.
  • Larsson, C. L., et al. (författare)
  • Strengthening the Reporting of Observational Studies in Epidemiology - nutritional epidemiology (STROBE-nut) : An extension of the STROBE statement
  • 2016
  • Ingår i: Nutrition Bulletin. - : Wiley. - 1471-9827 .- 1467-3010. ; 13:6
  • Tidskriftsartikel (refereegranskat)abstract
    • Concerns have been raised about the quality of reporting in nutritional epidemiology. Research reporting guidelines such as the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement can improve quality of reporting in observational studies. Herein, we propose recommendations for reporting nutritional epidemiology and dietary assessment research by extending the STROBE statement into Strengthening the Reporting of Observational Studies in Epidemiology - Nutritional Epidemiology (STROBE-nut). Recommendations for the reporting of nutritional epidemiology and dietary assessment research were developed following a systematic and consultative process, co-ordinated by a multidisciplinary group of 21 experts. Consensus on reporting guidelines was reached through a three-round Delphi consultation process with 53 external experts. In total, 24 recommendations for nutritional epidemiology were added to the STROBE checklist. When used appropriately, reporting guidelines for nutritional epidemiology can contribute to improve reporting of observational studies with a focus on diet and health.
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4.
  • Larsson, Per-Olof, 1948, et al. (författare)
  • Arbetslinje för alla?
  • 2011
  • Ingår i: Motala & Vadstena Tidning 29 Juni 2011.
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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5.
  • Karlsson-Tuula, Marie, 1961- (författare)
  • Rekonstruktion av företag inom insolvenslagstiftningens ramar : en jämförande studie av svensk och amerikansk insolvensrätt
  • 2001
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Insolvency law is the rooth of commercial and financial law because it obliges the legislator to chose. There is not enough money to go round so the law must chose who to pay. The law must always decide who is to bear the risk so there is always a winner and a loser. The insolvency law has been at the policy agenda in many countries in the last years. In France, Germany, Italy, Japan and other countries have the legal frameworks changed from liquidation procedures to reorganization business. The legal situation in Sweden has also changed from compositions to reorganization business, lagen om företagsrekonstruktion. The key issues are to encourage the formal proceeding by enlarging the debtors control of the business and by inroads creditors rights, in which case the proceeding is pro-debtor.This dissertation compares Swedish and American Bankruptcy Codes with respect to similarities and differences at macro- and micro perspectives. Chapter 11 Reorganization Business in America provides a corporate rehabilitation model, which has been used in other countries. The dissertation also compares the use of the concepts of - the purpose, - the function and - the direction of Swedish and American Bankruptcy Laws in order to establish whether the law is pro-debtor or pro-creditor. The key indicators of whether the rescue proceeding is pro-debtor or pro-creditor include; - How easy it is to enter the rescue proceeding. Debtor's incentives to commence proceeding, freeze on executions and liquidation petitions, impact on security, impact on title of finance, impact on set-off and netting, impact on contract rescissions and lease forfeitures. Disclaimer and abandonment, ability to replace the management, financing of the rescue, scope of the rehabilitation plan. It is argued that the optimal bankruptcy law can be achieved if the law purpose, the function and the law direction relate to each other in Sweden, in both reorganization business and in the liquidation code and it also compared with the American Bankruptcy Code. According to my opinion this is important both in a national and international context.The dissertation also deals with debtor's contract in an insolvency situation in reorganization business and in liquidation. Swedish Laws are compared to the American Bankruptcy Code and point out similarities and differences. In the American Bankruptcy Code there is a special section 365 § BC dealing with executory contract, this section is nearly the same for both the reorganization- and liquidationproceedings. The contracts must be unperformed which means the obligation of both the bankrupt and the other party in the contract are so far unperformed that the failure of either to complete performance would constitute a material breach excusing the performance of the other. If the contract is unperformed the debtor has the possibility to chose if the contracts shall be assumed, assumed and assigned or rejected. Section 365 § BC requires the court to consider whether assumption of the contract in question will further be needed in either rehabilitation or liquidation of the bankruptcy estate. The court reviews the financial impact of the estate and if it is benefiting becoming administratively obligated to perform. The court also review if is best to breach the contract. In Sweden we have different sections which regulate the situation. One section in our reorganization law, lagen om företagsrekonstruktion, we also have two special sections in the law of Sale of Goods, which deals with contract when a debtor became insolvent or file for reorganization business. But we don't have any section in our liquidation law, konkurslagstiftningen, which in my opinion is very strange. We also have a problem with the legislation about swaps and netting which are regulated in a special law, lagen om handel med finansiella intrument. Particular attention is given to the advantages and disadvantages of the existing rules in Swedish legal system compared with 365 § in American Bankruptcy Code. From a national point of view such section should preferably include all types of contract in only one section which is nearly the same as the American model of section 365 §.
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6.
  • Gummesson, Christina, et al. (författare)
  • Entrustable professional activities (EPAs) for undergraduate medical education : development and exploration of social validity
  • 2023
  • Ingår i: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders.Aim: The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs.Method and material: In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed.Results: Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’.Conclusion: Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.
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7.
  • Rinnström, Daniel, 1982-, et al. (författare)
  • Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta : association with systolic blood pressure in the high normal range
  • 2016
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 37, s. 369-369
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Arterial hypertension is common in adults with repaired coarctation of the aorta (CoA). The associations between the diagnosis of hypertension, actual blood pressure, other factors affecting left ventricular overload, and left ventricular hypertrophy (LVH) are not yet fully explored in this population. Material and results: From the national register for congenital heart disease, 506 adult patients (>= 18 years old) with previous repair of CoA were identified (37.0% female, mean age 35.7 +/- 13.8 years, with an average of 26.8 +/- 12.4 years post repair). Echocardiographic data were available for all patients, and showed LVH in 114 (22.5%) of these. Systolic blood pressure (SBP) (mm Hg) (OR 1.02, CI 1.01-1.04), aortic valve disease, (OR 2.17, CI 1.33-3.53), age (years) (OR 1.03, CI 1.01-1.05), diagnosis of arterial hypertension (OR 3.02, CI 1.81-5.02), and sex (female) (OR 0.41, CI 0.24-0.72) were independently associated with LVH. There was an association with LVH at SBP within the upper reference limits [ 130, 140] mm Hg (OR 2.23, CI 1.05-4.73) that further increased for SBP > 140 mm Hg (OR 8.02, CI 3.76-17.12). Conclusions: LVH is common post repair of CoA and is associated with SBP even below the currently recommended target level. Lower target levels may therefore become justified in this population. ORCID Id: 0000-0003-0976-6910
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8.
  • Özel, Faith, et al. (författare)
  • Exploring gender dysphoria and related outcomes in a prospective cohort study: protocol for the Swedish Gender Dysphoria Study (SKDS)
  • 2023
  • Ingår i: Bmj Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction There has been a drastic increase in the reported number of people seeking help for gender dysphoria in many countries over the last two decades. Yet, our knowledge of gender dysphoria and related outcomes is restricted due to the lack of high-quality studies employing comprehensive approaches. This longitudinal study aims to enhance our knowledge of gender dysphoria; different aspects will be scrutinised, focusing primarily on the psychosocial and mental health outcomes, prognostic markers and, secondarily, on the underlying mechanisms for its origin. Methods and analysis The Swedish Gender Dysphoria Study is an ongoing multicentre longitudinal cohort study with 501 registered participants with gender dysphoria who are 15 years old or older. Participants at different phases of their clinical evaluation process can enter the study, and the expected follow-up duration is three years. The study also includes a comparison group of 458 age- and county-matched individuals without gender dysphoria. Data on the core outcomes of the study, which are gender incongruence and experienced gender dysphoria, body satisfaction and satisfaction with gender-affirming treatments, as well as other relevant outcomes, including mental health, social functioning and life satisfaction, are collected via web surveys. Two different research visits, before and after starting on gender-affirming hormonal treatment (if applicable), are planned to collect respective biological and cognitive measures. Data analysis will be performed using appropriate biostatistical methods. A power analysis showed that the current sample size is big enough to analyse continuous and categorical outcomes, and participant recruitment will continue until December 2022. Ethics and dissemination The ethical permission for this study was obtained from the Local Ethical Review Board in Uppsala, Sweden. Results of the study will be presented at national and international conferences and published in peer-reviewed journals. Dissemination will also be implemented through the Swedish Gender Dysphoria Study network in Sweden.
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9.
  • Kirvalidze, Mariam, et al. (författare)
  • Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
  • 2024
  • Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 1365-2796 .- 0954-6820. ; 295:6, s. 804-824
  • Tidskriftsartikel (refereegranskat)abstract
    • Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
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