| 11. |
- Schollin Ask, Lina, et al.
(författare)
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Receiving early information and trusting Swedish child health centre nurses increased parents' willingness to vaccinate against rotavirus infections
- 2017
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 106:8, s. 1309-1316
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Rotavirus vaccines are effective against severe infections, but have a modest impact on mortality in high-income countries. Parental knowledge and attitudes towards vaccines are crucial for high vaccination coverage. This study aimed to identify why parents refused to let their infant have the vaccination or were unsure. Methods: This cross-sectional study was based on 1,063 questionnaires completed by the parents of newborn children in 2014. Stepwise logistic regression was used to identify the main predictors. Results: Most (81%) parents intended to vaccinate their child against the rotavirus, while 19% were unwilling or uncertain. Parents with less education and children up to five weeks of age were more likely to be unwilling or uncertain about vaccinating their child. Factors associated with a refusal or uncertainty about vaccinating were not having enough information about the vaccine, no intention of accepting other vaccines, paying little heed to the child health nurses' recommendations, thinking that the rotavirus was not a serious illness and not believing that the vaccine provided protection against serious forms of gastroenteritis. Conclusion: Early information, extra information for parents with less education and close positive relationships between parents and child health nurses were important factors in high rotavirus vaccination rates.
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| 12. |
- Sjögren, Eva, et al.
(författare)
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Parental conceptions of the rotawirus vaccine during implementation in Stockholm: A phenomenographic study
- 2017
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 21:4, s. 476-487
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Tidskriftsartikel (refereegranskat)abstract
- In 2014, Stockholm became the first Swedish county to introduce the rotavirus vaccine, which is given from as early as six weeks of age. The aim of this study was to describe parental conceptions of rotavirus infection and vaccination during its implementation as part of the child immunization program, as their support is vital for any new vaccine. The study followed a descriptive, qualitative design with a phenomenographic approach. Ten in-depth interviews with parents were conducted in Stockholm County, transcribed and analyzed to describe qualitatively different conceptions of rotavirus infection and vaccination. Four main categories were identified: to vaccinate without doubt, hesitant to vaccinate, risky to vaccinate, and unnecessary to vaccinate. All the parents had in common the desire to protect their children from suffering, either by vaccinating their child in order to avoid rotavirus infection or by not vaccinating their child because of concerns about the side effects. It is important that child health-care professionals understand the variations of conceptions that influence the parents' decisions and that these conceptions may differ considerably. Individualized parental information about rotavirus infection and vaccination would help to achieve a successful implementation of the vaccination program.
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| 13. |
- Viklund, Gunnel, et al.
(författare)
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Assessment of an empowerment education programme. : A randomized study in teenagers with diabetes
- 2007
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 24:5, s. 550-556
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To determine the effects of an empowerment programme on glycaemic control and empowerment, and to study the role of parental involvement. Methods: The wait-list design is a randomized controlled trial lasting for 6 months, after which the control group participate in the same education programme as the intervention group. After 6 months, data from the two groups are analysed together (pre/post). Thirty-two teenagers with Type 1 diabetes (12-17 years) completed an empowerment group education programme, meeting weekly for 6 weeks. They were also offered an extra meeting together with their parents, which resulted in three groups: together with parents, only parents and no parent involvement at all. HbA1c was measured before intervention and after 6, 12, 18 and 24 months, and empowerment before, and 6 and 12 months after. Results: HbA1c and empowerment were similar in the intervention group and the control group 6 months after intervention. In pre/post analysis, HbA1c was significantly higher 6 and 12 months after intervention in teenagers > 14 years (from 8.4% to 9.3%; P < 0.05 to 9.6%; P < 0.01), but returned to baseline 18 months after the programme. In teenagers ≤ 14 years of age, HbA1c did not change during the study. The teenagers felt more ready for changes after the programme than before (3.9 sd = 0.5 to 4.1 sd = 0.5; P < 0.05). In the teenagers in the group that involved their parents, there was a significant decrease in HbA1c 12 and 24 months after intervention, from 8.9% (sd = 1.1) to 7.6% (sd = 1.3; P < 0.05, confidence interval 0.37, 2.26). Conclusion: This empowerment programme for teenagers with diabetes showed no positive glycaemic or empowerment effects. Empowerment programmes for diabetic teenagers in early and middle adolescence should include parental involvement.
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| 14. |
- Wang, Ning, et al.
(författare)
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Selective IgA deficiency in autoimmune diseases
- 2011
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Ingår i: Molecular Medicine. - Baltimore, Md. : Johns Hopkins University Press. - 1076-1551 .- 1528-3658. ; 17:11-12, s. 1383-
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Forskningsöversikt (refereegranskat)abstract
- Selective IgA deficiency (IgAD) is the most common primary immunodeficiency in Caucasians. It has previously been suggested to be associated with a variety of concomitant autoimmune diseases. In this review, we present data on the prevalence of IgAD in patients with Graves' disease (GD), systemic lupus erythematosus (SLE), type 1 diabetes (T1D), celiac disease (CD), myasthenia gravis (MG) and rheumatoid arthritis (RA) based both on our own, recent, large scale screening results and literature data. Genetic factors are important for the development of both IgAD and various autoimmune disorders, including GD, SLE, T1D, CD, MG and RA, and a strong association with the MHC region has been reported. In addition, non-MHC genes, such as IFIH1 and CLEC16A, are also associated with the development of IgAD and some of the above diseases. This indicates a possible common genetic background. In this review, we present suggestive evidence for a shared genetic predisposition between these disorders.
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| 15. |
- Örtqvist, Eva
(författare)
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The importance of immunological, genetic and clinical factors for beta cell function in childhood diabetes
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Type I diabetes is caused by environmentally initiated, progressive autoimmune destruction of pancreatic beta cells in genetically susceptible individuals, which results in insulin deficiency and hyperglycemia. At diagnosis, about 10-20 % of beta cells remain, but after insulin therapy is started, a period with regained secretive capacity follows. This period, called the clinical remission, offers an opportunity to arrest beta cell destruction by intervention with immune-modulation, antioxidant treatment and beta cell rest. Diabetes risk is strongly influenced by age-related genetic factors, and diabetes-specific autoantibodies can be found already before diagnosis. Although, extensive data on genetic and immunological factors which influence the process exist, uncertainty remains concerning the complicated combined effect, of genetic, immunological and clinical influences, that befall the growing child who develops type I diabetes. The aims of our studies were: To investigate prevalence of GAD65Ab with a new radioimmunoassay; to study immunological, genetic and clinical factors which influence the duration of the clinical remission and rate of progression of beta cell destruction in newly onset childhood diabetes; to study evolution and species-specificity of GAD65Ab; and to evaluate the effect of initial diazoxide treatment on residual endogenous insulin secretion. We have studied, in total, 330 children, with newly diagnosed type 1 diabetes, and a reference group of 119 healthy children. 56 children were randomized to either diazoxide or placebo for the first 3 months of diabetes and followed for two years. Insulin secretion was evaluated indirect as duration of clinical remission, or as fasting- and breakfast-stimulated C-peptide. Autoantibodies were analyzed by radioimmunoassay (GAD65Ab, GAD65Ab epitopes and IA-2Ab) and indirect immunofluorescence (ICA) and HLA-DQ and -DR haplotypes were analyzed by PCR-techniques. In conclusion we have found: Higher prevalence and index levels of GAD65Ab in female than male patients and a positive age-correlation of GAD65Ab in boys; Age- and gender-dependent divergence in the duration of the clinical remission and also dependence on ICA; HLA-DQ- and GAD65Ab-influences on the rate of change in beta cell function, with the fastest loss of endogenous insulin secretion in DQ2-positive individuals with GAD65Ab; Maturation of the humoral immunity towards GAD65, with a change from preference for rodent GAD65 to human GAD65 during the first year after diagnosis; and, although a 50% reduction in C-peptide secretion was achieved during treatment with diazoxide, the subsequent effect on residual insulin secretion was of shorter duration in children than in adults. We propose, that the increased risk for a faster reduction in beta cell function in HLA-DQ2 positive patients, with GAD65Ab, should be taken into consideration when new intervention protocols are planned. The fact, that male and female patients differ in their physiological response to growth also needs to be accounted for. The high rate of adverse effects for diazoxide and the short term effect achieved, prompt the development of new beta cell-specific inhibiting drugs, which may also be tried in pre-diabetic individuals. The time, when autoimmune markers have revealed that a process involving beta cell destruction is started, and during the first months of clinical disease (when preservation of remaining beta cells may be possible), is an important window of opportunity for intervention. Still, many questions remain to be answered until we find the optimal screening procedures and intervention strategies that are safe and effective in large groups of children.
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| 16. |
- Örtqvist, Maria, et al.
(författare)
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Reliability of a new instrument for measuring plantarflexor muscle strength
- 2007
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 88:9, s. 1164-1170
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test the reliability of a new muscle strength testing instrument (the Strength Measuring Chair [SMC]) designed to quantify isometric strength in the lower extremities, and to determine the agreement between the SMC and an isokinetic dynamometer (Biodex). Design: Isometric strength tests were performed in plantar-flexors with 2 different knee positions (60 degrees, 30 degrees). Measurements were taken at 3 different sessions. Setting: Strength testing laboratory. Participants: Twenty-three able-bodied adults and 15 able-bodied children. Interventions: Not applicable. Main Outcome Measure: Isometric plantarflexor strength. Results: The reliability of isometric strength measurements of plantarflexors taken in the SMC was excellent for both the adult and children groups (intraclass correlation coefficient range,.84-.87). A Bland-Altman 95% limit of agreement test showed no systematic variation in 3 of the 4 SMC test observations; systematic variation was only observed in the adult group at a knee position of 30 degrees. There was no systematic difference in the adult group between the SMC and the isokinetic dynamometer, but there was a systematic variation in the children's group. Conclusions: The SMC reliably measured isometric plantarflexor strength in the tested populations.
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| 17. |
- Örtqvist, Pernilla, et al.
(författare)
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Phenylglycine as a Novel P2 Scaffold in Hepatitis C Virus NS3 Protease Inhibitors
- 2007
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Ingår i: Bioorganic & Medicinal Chemistry. - : Elsevier BV. - 0968-0896 .- 1464-3391. ; 15:3, s. 1448-1474
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Tidskriftsartikel (refereegranskat)abstract
- Molecular modeling and inhibitory potencies of tetrapeptide protease inhibitors of HCV NS3 proposed phenylglycine as a new promising P2 residue. The results suggest that phenylglycine might be capable of interacting with the NS3 (protease-helicase/NTPase) in ways not possible for the common P2 proline-based inhibitors. Thus, a series of tripeptides, both linear and macrocyclic, based on p-hydroxy-phenylglycine in the P2 position were prepared and their inhibitory effect determined. When the p-hydroxy group was replaced by methoxy, isoquinolin-, or quinolinyloxy functions, inhibitors with improved potencies were obtained. The P2 phenylglycine-based inhibitors were further optimized by C-terminal extension to acyl sulfonamides and by P1–P3 cyclization, which gave products with inhibition constants in the nanomolar range (75 nM).
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| 18. |
- Örtqvist, Pernilla, et al.
(författare)
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Structure-activity relationships of HCV NS3 protease inhibitors evaluated on the drug-resistant variants A156T and D168V
- 2010
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Ingår i: Antiviral Therapy. - 1359-6535 .- 2040-2058. ; 15:6, s. 841-852
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: HCV infections are a serious threat to public health. An important drug target is the NS3 protease, for which several inhibitors are in clinical trials. Because of the high mutation rate of the virus, resistance against any HCV-specific drug is likely to become a substantial problem. Structure-activity data for the major resistant variants are therefore needed to guide future designs of protease inhibitors. METHODS: The inhibitory potency of tripeptide NS3 protease inhibitors, with either a P2 proline or phenylglycine, in combination with different P3 and P1-P1' groups, was assessed in enzyme activity assays using the full-length NS3 protein with known resistance-conferring substitutions A156T or D168V. The results obtained from these variants were compared with the inhibition of the wild-type enzyme. Molecular modelling was used to rationalize the biochemical results. RESULTS: Inhibitors combining the P2 proline and P1 (1R,2S)-1-amino-2-vinylcyclopropyl-carboxylic acid (vinylACCA) lost much of their potency on the resistant variants. Exchange of the P2 proline for phenylglycine yielded inhibitors that were equipotent on the wild-type and on the A156T and D168V variants. The same result was obtained from the combination of either the P2 residue with a norvaline or an aromatic scaffold in the P1 position. CONCLUSIONS: The combination of a substituted P2 proline and P1 vinylACCA appears to be the main problem behind the observed resistance. Molecular modelling suggests an enforced change in binding conformation for the P2 proline-based inhibitors, whereas the phenylglycine-based inhibitors retained their wild-type binding conformation in the substituted forms of the enzyme.
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| 19. |
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