| 41. |
- Magnusson, Lennart, et al.
(författare)
-
Extended safety and support systems for people with dementia living at home
- 2014
-
Ingår i: Journal of Assistive Technologies. - : Emerald Group Publishing Limited. - 1754-9450 .- 2042-8723. ; 8:4, s. 188-206
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose– The purpose of this paper is to highlight the complexity surrounding the implementation of advanced electronic tracking, communication and emergency response technologies, namely, an extended safety and support (ESS) system for people with dementia (pwd) living at home. Results are presented from a Swedish demonstration study (2011-2012) conducted in 24 municipalities.Design/methodology/approach– It is a descriptive intervention study with a pre-post test design. Questionnaires were administered to pwd, carers and professionals at the outset and eight months later. ESS logging data were analyzed.Findings– ESS usage rates varied widely. A total of 650 alerts were triggered, mainly when the pwd was outdoors. Activities were reduced amongst pwd, most likely due to a progression of their disease. Carers noted that pwd were more independent than previously on those occasions when they engaged in outdoor activities. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers. In total, 50 per cent of carers felt it was justified to equip their relative with an ESS without their explicit consent, compared to one in eight staff.Research limitations/implications– A limitation is the amount of missing data and high drop- out rates. Researchers should recruit pwd earlier in their illness trajectory. A mixed-methods approach to data collection is advisable.Practical implications– Carers played a crucial role in the adoption of ESS. Staff training/supervision about assistive devices and services is recommended.Social implications– Overall, use of ESS for pwd living at home was not an ethical problem.Originality/value– The study included key stakeholder groups and a detailed ethical analysis was conducted.
|
|
| 42. |
- Mosallanezhad, Z., et al.
(författare)
-
A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
- 2017
-
Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 70, s. 123-129
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chisquare tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results: The measurement model yielded a reasonable fit to the data, chi(2) = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037-0.058. The model fit for the conceptual model was acceptable; chi(2) = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074-0.093. SES itself was not a direct predictor of HS (beta = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (beta = 0.31, p < 0.001) or I (beta = 0.57, p < 0.001). Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. (C) 2017 Elsevier B.V. All rights reserved.
|
|
| 43. |
|
|
| 44. |
- Snögren, Maria, et al.
(författare)
-
Psychometric evaluation of a short-form version of the Swedish "Attitudes to and Knowledge of Oral Health" questionnaire
- 2022
-
Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare professionals' attitudes to and knowledge of oral health are fundamental to providing good oral health care to older adults. One instrument that assesses healthcare professionals' attitudes to and knowledge of oral health in a Swedish context is the "Attitudes to and Knowledge of Oral health" (AKO) questionnaire. Two of the three item-groups of the AKO have previously been validated in a Swedish context. However, it is crucial that all three item-groups are validated, and beneficial to design a shorter, easy-to-use questionnaire for healthcare professionals while maintaining adequate integrity of its reliability and validity. Therefore, the present study aims to develop a short-form version of AKO and to secure its psychometric properties. Methods Psychometric evaluation with Classical Test Theory and Item Response Theory to validate and shorten AKO with 611 healthcare professionals from a population of 1159 working in a municipality in an urban area in western Sweden. Results Of the original 16 items in the AKO, 13 were shown to warrant retention in the abbreviated/shortened form. These showed acceptable validity and reliability for assessing healthcare professionals' attitudes to and knowledge of oral health. Conclusion This validated short-form version of AKO shows acceptable validity and reliability after being reduced to 13 items, structured in a 3-part scale. The items are consistent with the total scale, indicating that the internal consistency is acceptable. Future studies should be performed to evaluate AKO in other groups of healthcare professionals, across cultures, languages, and so on, to investigate its use and strengthen its validity and reliability.
|
|
| 45. |
- Hedna, Khedidja, 1978, et al.
(författare)
-
Clinical relevance of alerts from a decision support system, PHARAO, for drug safety assessment in the older adults
- 2019
-
Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1, s. 164-
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundPHARAO is a decision support system developed to evaluate the risk for a set of either common or serious side-effects resulting from a combination of pharmacodynamic effects from a patient's medications. The objective of this study was to investigate the validity of the risk scores for the common side-effects generated by PHARAO in older patients.MethodsSide-effects included were sedation, constipation, orthostatic symptoms, anticholinergic and serotonergic effects. The alerts generated by PHARAO were tested in 745 persons 65years old. Dispensed prescriptions retrieved from the Swedish prescribed drug register were used to generate the pharmacological risk scores of patients' medications. Symptoms possibly related to side-effects were extracted from medical records data.ResultsThe PHARAO system generated 776 alerts, most often for the risk of anticholinergic symptoms. The total specificity estimates of the PHARAO system were 0.95, 0.89 and 0.78 for high, intermediate and low risk alerts, respectively. The corresponding sensitivity estimates were between 0.12 and 0.37. The negative predictive value was 0.90 and the positive predictive value ranged between 0.20-0.25.ConclusionsThe PHARAO system had a high specificity and negative predictive value to detect symptoms possibly associated with the of patients' medications, while the sensitivity and positive predictive value were low. The PHARAO system has the potential to minimise the risk of over-alerts in combination with a drug-drug interaction alert system, but should be used in connection with a medical evaluation of the patient.
|
|
| 46. |
- Gustafson, Deborah R.
(författare)
-
Adipose Tissue Complexities in Dyslipidemias
- 2019
-
Ingår i: Dyslipidemia. - London : IntechOpen. - 9781839680045 - 9781839680038 - 9781839680052 ; , s. 1-22
-
Bokkapitel (refereegranskat)abstract
- Adipose tissue is the largest organ in the human body and, in excess, contributes to dyslipidemias and the dysregulation of other vascular and metabolic processes. Adipose tissue is heterogeneous, comprised of several cell types based on morphology, cellular age, and endocrine and paracrine function. Adipose tissue depots are also regional, primarily due to sex differences and genetic variation. Adipose tissue is also characterized as subcutaneous vs. visceral. In addition, fatty deposits exist outside of adipose tissue, such as those surrounding the heart, or as infiltration of skeletal muscle. This review focuses on adipose tissue and its contribution to dyslipidemias. Dyslipidemias are defined as circulating blood lipid levels that are too high or altered. Lipids include both traditional and nontraditional species. Leaving aside traditional definitions, adipose tissue contributes to dyslipidemias in a myriad of ways. To address a small portion of this topic, we reviewed (a) adipose tissue location and cell types, (b) body composition, (c) endocrine adipose, (d) the fat-brain axis, and (e) genetic susceptibility. The influence of these complex aspects of adipose tissue on dyslipidemias and human health, illustrating that, once again, that adipose tissue is a quintessential, multifunctional tissue of the human body, will be summarized.
|
|
| 47. |
- Spreco, Armin, et al.
(författare)
-
Nowcasting (Short-Term Forecasting) of COVID-19 Hospitalizations Using Syndromic Healthcare Data, Sweden, 2020
- 2022
-
Ingår i: Emerging Infectious Diseases. - : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 28:3, s. 564-571
-
Tidskriftsartikel (refereegranskat)abstract
- We report on local nowcasting (short-term forecasting) of coronavirus disease (COVID-19) hospitalizations based on syndromic (symptom) data recorded in regular healthcare routines in Östergötland County (population ≈465,000), Sweden, early in the pandemic, when broad laboratory testing was unavailable. Daily nowcasts were supplied to the local healthcare management based on analyses of the time lag between telenursing calls with the chief complaints (cough by adult or fever by adult) and COVID-19 hospitalization. The complaint cough by adult showed satisfactory performance (Pearson correlation coefficient r>0.80; mean absolute percentage error <20%) in nowcasting the incidence of daily COVID-19 hospitalizations 14 days in advance until the incidence decreased to <1.5/100,000 population, whereas the corresponding performance for fever by adult was unsatisfactory. Our results support local nowcasting of hospitalizations on the basis of symptom data recorded in routine healthcare during the initial stage of a pandemic. © 2022 Centers for Disease Control and Prevention (CDC). All rights reserved.
|
|
| 48. |
- Arabpour, Mohammad, et al.
(författare)
-
ADP-ribosylating adjuvant reveals plasticity in cDC1 cells that drive mucosal Th17 cell development and protection against influenza virus infection
- 2022
-
Ingår i: Mucosal Immunology. - : Elsevier BV. - 1933-0219. ; 15:4, s. 745-761
-
Tidskriftsartikel (refereegranskat)abstract
- Migratory dendritic cells expressing CD103 are the targets for mucosal vaccines. These belong to either of two lineage-restricted subsets, cDC1 or cDC2 cells, which have been linked to priming of functionally distinct CD4 T cells. However, recent studies have identified plasticity in cDC2 cells with overlapping functions with cDC1 cells, while the converse has not been reported. We genetically engineered a vaccine adjuvant platform that targeted the cholera toxin A1 (CTA1) ADP-ribosylating enzyme to CD103(+) cDC1 and cDC2 cells using a single-chain antibody (scFv) to CD103. Unexpectedly, intranasal immunization with the CTA1-svFcCD103 adjuvant modified cDC1 cells to effectively prime Th17 cells, a function previously limited to cDC2 cells. In fact, cDC2 cells were dispensible, while cDC1 cells, lacking in Batf3-/- mice, were critical. Following intranasal immunizations isolated cDC1 cells from mLN exclusively promoted Rorgt(+) T cells and IL-17, IL-21, and IL-22 production. Strong CD8 T cell responses through antigen cross presentation by cDC1 cells were also observed. Single-cell RNAseq analysis revealed upregulation of Th17-promoting gene signatures in sorted cDC1 cells. Gene expression in isolated cDC2 cells was largely unaffected. Our finding represents a major shift of paradigm as we have documented functional plasticity in cDC1 cells.
|
|
| 49. |
|
|
| 50. |
- Malmgren, Linnea
(författare)
-
Kidney Function During Ageing and its Association with Bone Mass, Fracture and Mortality
- 2020
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Osteoporosis and osteoporosis related fractures are a major health care challenge both in Sweden and globally. The cost and suffering from osteoporosis are expected to increase since the population of elderly is increasing. Bone health can be affected by altered mineral homeostasis, which in its turn can be affected by reduced kidney function. However, the course of age-related decline in kidney function and its association to osteoporosis andfracture in the very elderly need further investigation since longitudinal data are scarce. Therefore, this thesis has two main aims; 1) to investigate kidney function during ageing and 2) its association to bone health in a cohort ofelderly women.Data was collected through the Malmö Osteoporosis Prospective Risk Assessment (OPRA) cohort, a prospective cohort of 1044 community dwelling women, all aged 75 and followed for ten years with reinvestigations at age 80and 85. Data on BMD, fracture and blood biochemistry was available at all three time points.Estimated kidney function greatly depends on which marker and study equation is used. The discrepancies are to such an extent that could affect whether a person is diagnosed with chronic kidney disease (CKD) or not, of particular importance in the elderly. Only women with the worst kidney function, corresponding to CKD stage 3b-5, had continuously increased mortality risk. This indicates that an age-dependent CKD definition would be of valuein elderly women.Kidney function in elderly women was associated with markers of mineral homeostasis, bone loss and BMD, but the effect size was relatively small compared to other risk factors. Also, fracture risk was increased only in womenwith mild-moderate reduction of kidney function (CKD stage 3a) and not in women with the worst kidney function (CKD stage 3b-5). Low BMD was associated with increased fracture risk independent of kidney function. Havingboth reduced kidney function and osteoporosis could present an additional risk increase.In conclusion, estimated kidney function in elderly women greatly depends on method of estimation and the results advocate for an age-adapted CKD definition. Maintaining adequate kidney function is important formaintaining bone health, although in old age it is probable that the effect size of any single specific risk factor is smaller compared with younger individuals.
|
|
