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  • Aare, Magnus, et al. (författare)
  • Injuries from motorcycle- and moped crashes in Sweden from 1987 to 1999.
  • 2003
  • Ingår i: Injury control and safety promotion. - 1566-0974. ; 10:3, s. 131-8
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this paper is to study injuries from motorcycle and moped crashes in Sweden from 1987 to 1999. Databases at the National Board for Health and Welfare and codes from both ICD9 and ICD10 systems were used, including patterns of age, gender, E-code and type of injury. Length of hospital stay, type of injuries and trends over time was evaluated. To get a more detailed picture of the age distribution, type of vehicle used and number of killed, data from the Swedish National Road Administration were also used. In Sweden, 27,122 individuals received in-patient care due to motorcycle and moped injuries between 1987 and 1999. The motorcycle and moped injury rate was reduced in the second half of the studied period and so were the total days of treatment per year. Males had eight times the incidence of injuries compared to females. Riders under the age of 26 and in particular those at an age of 15 had the highest incidence rate. Head injuries were the most frequent diagnosis, followed by fractures to the lower limbs. Concussion was the most frequent head injury. Focal and diffuse brain injuries combined showed the same frequency as concussion. It is concluded that more preventative strategies must be presented before the injury rate can be reduced.
  • Aare, Sudhakar, et al. (författare)
  • Effects of corticosteroids in the development of limb muscle weakness in a porcine intensive care unit model
  • 2013
  • Ingår i: Physiological Genomics. - 1094-8341 .- 1531-2267. ; 45:8, s. 312-320
  • Tidskriftsartikel (refereegranskat)abstract
    • Severe muscle wasting is a debilitating condition in critically ill intensive care unit (ICU) patients, characterized by general muscle weakness and dysfunction, resulting in a prolonged mobilization, delayed weaning from the ventilator and a decreased quality of life post-ICU. The mechanisms underlying limbmuscle weakness in ICU patients are complex and involve the impact of primary disease, but also factors common to critically ill ICU patients such as sepsis, mechanical ventilation (MV), immobilization and systemic administration of corticosteroids (CS).  These factors may have additive negative effects on skeletal muscle structure and function, but their respective role alone remain unknown. The primary aim of this study was to examine how CS administration potentiates ventilator and immobilization-related limb muscle dysfunction at the gene level. Comparing biceps femoris gene expression in pigs exposed to MV and CS for five days with only MV pigs for the same duration of time showed a distinct deregulation of 186 genes using microarray. Surprisingly, the decreased force-generation capacity at the single muscle fiber reported in response to the addition of CS administration in mechanically ventilated and immobilized pigs was not associated with an additional up-regulation of proteolytic pathways. On the other hand, an altered expression of genes regulating kinase activity, cell cycle, transcription, channel regulation, oxidative stress response , cytoskeletal, sarcomeric and heat shock protein as well as protein synthesis at the translational level appear to play an additive deleterious role for the  limb muscle weakness in immobilized ICU patients. 
  • Aare, Sudhakar, et al. (författare)
  • Mechanisms underlying the sparing of masticatory versus limb muscle function in an experimental critical illness model
  • 2011
  • Ingår i: Physiological Genomics. - 1094-8341 .- 1531-2267. ; 43:24, s. 1334-1350
  • Tidskriftsartikel (refereegranskat)abstract
    • Acute quadriplegic myopathy (AQM) is a common debilitating acquired disorder in critically ill intensive care unit (ICU) patients which is characterized by tetraplegia/generalized weakness of limb and trunk muscles. Masticatory muscles, on the other hand, are typically spared or less affected, yet the mechanisms underlying this striking muscle-specific difference remain unknown. This study aims to evaluate physiological parameters and the gene expression profiles of masticatory and limb muscles exposed to factors suggested to trigger AQM, such as mechanical ventilation, immobilization, neuromuscular blocking agents (NMBA), corticosteroids (CS) and sepsis for five days by using a unique porcine model mimicking the ICU conditions. Single muscle fiber cross-sectional area and force-generating capacity, i.e., maximum force normalized to fiber cross-sectional area (specific force), revealed maintained masseter single muscle fiber cross-sectional area and specific-force after five days exposure to all triggering factors. This is in sharp contrast to observations in limb and trunk muscles, showing a dramatic decline in specific force in response to five days exposure to the triggering factors. Significant differences in gene expression were observed between craniofacial and limb muscles, indicating a highly complex and muscle specific response involving transcription and growth factors, heat shock proteins, matrix metalloproteinase inhibitor, oxidative stress responsive elements and sarcomeric proteins underlying the relative sparing of cranial versus spinal nerve innervated muscles during exposure to the ICU intervention.
  • Aarne, Päivikki, et al. (författare)
  • Parent-rated socio-emotional development in children with language impairment in comparison with typically developed children
  • 2014
  • Ingår i: European Journal of Developmental Psychology. - 1740-5629. ; 11:3, s. 279-291
  • Tidskriftsartikel (refereegranskat)abstract
    • Children with language impairment (LI) and children with typical development (TD) were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version SECDI) and Greenspan Socio Emotional Growth Chart (GSEGC). The aim was to investigate socio-emotional and language development in children with LI and TD with respect to possible differential patterns and relations between the groups. The results highlight a clear association between language and socio-emotional development. Children with LI were rated similar to young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development: the use of linguistic symbols as well as related areas such as symbol play and symbolic mental ability. The results are discussed in light of presumable background factors and possible consequences for children or sub-groups of children with LI.
  • Aarne, Päivikki (författare)
  • Self and other : socio-emotional aspects of development in children with language impairment
  • 2015
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • The thesis comprises four studies that focus on young children with language impairment (LI). The research focus was different aspects of socio-emotional development. In Study I visual check back behaviors were investigated in ten pre-school-aged children with LI and in two groups of children with typical development (TD); ten children that were matched with regard to age (AMC) and ten children matched with regard to language level (LMC). Play setting situations were designed to elicit the target behaviors of shared attention, intention and emotion. The children with lower language level (LI and LMC) gave visual check back significantly more seldom than children with a higher language level (AMC). In Study II, the association between communication and language level, and socio-emotional level was investigated by parent ratings. Pre-school-aged children with LI and children with TD were assessed by their respective parents using The MacArthur Communicative Development Inventories (Swedish version (SECDI) and Greenspan Socio Emotional Growth Chart, (GSEGC). An association between language and socio-emotional development was found. Children with LI were rated similar to the young language-matched children with TD, but significantly lower relative to age-matched TD children, particularly concerning symbolic stages of development. In Study III, a case study, the capacity to mentalize was explored in a primary-school-aged boy with a history of LI. In play situations, the child was presented story stems that he could complete by play actions or verbally. The mentalizing capacity was analyzed with respect to the organization and the content of his responses, as well as his observable behavior in the situation. The child had difficulties in affect regulation, i.e. self-oriented mentalizing, and his other-oriented mentalizing was limited as well. In Study IV, parental stress and the parents’ perception of their child’s behavioral as well as communication and language difficulties were investigated by Swedish Parenthood Stress Questionnaire (SPSQ), Swedish version of Strengths and Difficulties Questionnaire (SDQ-Swe) and the Swedish version of MacArthur Communicative Developmental Inventories (SECDI), in three groups of pre-school-aged children: children with LI, children with more extensive communication difficulties and suspected ASD (COM), and children with TD. Parental experience of stress differed significantly between the groups on total and specific aspects of stress. A significant association was found between parental stress and children’s behavioral difficulties in the total group, but not in the clinical groups. Parental stress and children’s communication and language difficulties were associated in the group COM with extensive communication difficulties.
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