1001. |
- Marchi, Mattia, et al.
(författare)
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Experience of discrimination during COVID-19 pandemic : the impact of public health measures and psychological distress among refugees and other migrants in Europe
- 2022
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.
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1002. |
- Markström, Carina, 1975-, et al.
(författare)
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Konsensus och personifierade konflikter : problembeskrivningar av äldreomsorg i svensk dagspress
- 2011
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Ingår i: Sociologisk forskning. - Stockholm : Sveriges sociologförbund. - 0038-0342 .- 2002-066X. ; 48:1, s. 5-23
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Tidskriftsartikel (refereegranskat)abstract
- Consensus and personified conflicts: Representations of elderly care issues in Swedish newspapers Elderly care issues are commonly framed in public discourse. In mass media the representations of such issues are influenced by media logic. The purpose of this paper is to describe and analyse how elderly care issues were represented in three Swedish newspapers during the first half of 2007. How were the problems characterized? How were different actors characterized and which roles were they assigned? How are conflicts of interests described? Finally, we aim to discuss how media contribute to an understanding of the complexity of elderly care as a whole. Taken together, the articles do not provide a coherent picture. However, costs, quality of care and demographic issues were common themes. The elderly were commonly represented in personal narratives about. problems that occurred when they needed elderly care. The elderly in the future are projected as more active and demanding than the elderly today. The care workers were active voices in discussions about working conditions, but absent in discussions about their education and professional identity, which was an issue commonly advocated by politicians. Many issues were represented as conflicts between the individual elderly and the care system or between care workers and their employers. More elaborated discussions about how to prioritize between different needs and demands were rare. This can be seen as examples of how the media tends to use personification, simplification and polarization as means to tell interesting stories.
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1003. |
- Marmstål Hammar, Lena, et al.
(författare)
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The care of and communication with older people from the perspective of student nurses. A mixed method study.
- 2017
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 52, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Undergraduate nurse education needs to prepare student nurses to meet the demands and to have the necessary communication skills for caring for an increasing older population. The challenges involve how best to support and empower student nurses to learn the communication skills needed to care for older people.OBJECTIVE: The aim of this study was to investigate student nurses' views on the care of and communication with older people.DESIGN: A descriptive study with a mixed-method approach was conducted.METHODS: Quantitative and qualitative data were collected from a questionnaire completed by third-year Swedish student nurses in 2015.RESULTS: The student nurses reported positive attitudes to the care of and communication with older people. The findings focus on the central aspects related to relationship building, techniques for communication and external prerequisites.CONCLUSIONS: Despite positive attitudes, student nurses had a limited view of communication with older people. Educators need to increase student nurses' capacity to communicate effectively with older people. Educational interventions to improve and evaluate the communication competency of nurses and student nurses are needed.
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1004. |
- Masoumi, Davoud, et al.
(författare)
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Mapping Children’s Actions in the Scaffolding Process Using Interactive Whiteboard
- 2023
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Ingår i: Early Childhood Education Journal. - : Springer Science and Business Media B.V.. - 1082-3301 .- 1573-1707.
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to examine children’s actions in relation to the preschool teacher’s scaffolding action in a context where an interactive whiteboard (IWB) is used. Over five months, 22 children aged between 4 and 6 years old, along with their five preschool teachers, were video observed. The study of these teaching moments has provided a rich seam of evidence that details the ways children act in relation to their teacher’s scaffolding. The results show that children manifest 12 distinct actions including: Giving short responses, Approaching the IWB to engage in the teaching activities; Explaining, Experimenting; Smiling and laughing; Pointing and showing; Working together; Challenging each other; Solving a problem; Using language in meaningful contexts; Expressing emotions; and Comparing the similarities and differences. By mapping children’s actions in the scaffolding process, which are often undermined or ignored in the existing research, the findings of this study have expanded and deepened our understanding of the scaffolding process and the notion of scaffolding itself. The findings, further, exemplify how just providing support can contribute to early childhood education, since early interventions, such as the ways preschool teachers scaffold children’s actions, are particularly crucial for children’s learning and development. © 2023, The Author(s).
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1005. |
- Matić, Teodora, et al.
(författare)
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Unsupervised Learning from Motion Sensor Data to Assess the Condition of Patients with Parkinson’s Disease
- 2019
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Ingår i: AIME 2019. - Cham : Springer. - 9783030216429 - 9783030216412 ; , s. 420-424
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Konferensbidrag (refereegranskat)abstract
- Parkinson’s disease (PD) is a chronic neurodegenerative disorder that predominantly affects the patient’s motor system, resulting in muscle rigidity, bradykinesia, tremor, and postural instability. As the disease slowly progresses, the symptoms worsen, and regular monitoring is required to adjust the treatment accordingly. The objective evaluation of the patient’s condition is sometimes rather difficult and automated systems based on various sensors could be helpful to the physicians. The data in this paper come from a clinical study of 19 advanced PD patients with motor fluctuations. The measurements used come from the motion sensors the patients wore during the study. The paper presents an unsupervised learning approach applied on this data with the aim of checking whether sensor data alone can indicate the patient’s motor state. The rationale for the unsupervised approach is that there was significant inter-physician disagreement on the patient’s condition (target value for supervised machine learning). The input to clustering came from sensor data alone. The resulting clusters were matched against the physicians’ estimates showing relatively good agreement.
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1006. |
- Matsushita, Kunihiro, et al.
(författare)
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Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate
- 2012
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Ingår i: Journal of the American Medical Association (JAMA). - : American Medical Association (AMA). - 0098-7484 .- 1538-3598. ; 307:18, s. 1941-51
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk implications in diverse settings is lacking.OBJECTIVE: To evaluate risk implications of estimated GFR using the CKD-EPI equation compared with the MDRD Study equation in populations with a broad range of demographic and clinical characteristics.DESIGN, SETTING, AND PARTICIPANTS: A meta-analysis of data from 1.1 million adults (aged ≥ 18 years) from 25 general population cohorts, 7 high-risk cohorts (of vascular disease), and 13 CKD cohorts. Data transfer and analyses were conducted between March 2011 and March 2012.MAIN OUTCOME MEASURES: All-cause mortality (84,482 deaths from 40 cohorts), cardiovascular mortality (22,176 events from 28 cohorts), and end-stage renal disease (ESRD) (7644 events from 21 cohorts) during 9.4 million person-years of follow-up; the median of mean follow-up time across cohorts was 7.4 years (interquartile range, 4.2-10.5 years).RESULTS: Estimated GFR was classified into 6 categories (≥90, 60-89, 45-59, 30-44, 15-29, and <15 mL/min/1.73 m(2)) by both equations. Compared with the MDRD Study equation, 24.4% and 0.6% of participants from general population cohorts were reclassified to a higher and lower estimated GFR category, respectively, by the CKD-EPI equation, and the prevalence of CKD stages 3 to 5 (estimated GFR <60 mL/min/1.73 m(2)) was reduced from 8.7% to 6.3%. In estimated GFR of 45 to 59 mL/min/1.73 m(2) by the MDRD Study equation, 34.7% of participants were reclassified to estimated GFR of 60 to 89 mL/min/1.73 m(2) by the CKD-EPI equation and had lower incidence rates (per 1000 person-years) for the outcomes of interest (9.9 vs 34.5 for all-cause mortality, 2.7 vs 13.0 for cardiovascular mortality, and 0.5 vs 0.8 for ESRD) compared with those not reclassified. The corresponding adjusted hazard ratios were 0.80 (95% CI, 0.74-0.86) for all-cause mortality, 0.73 (95% CI, 0.65-0.82) for cardiovascular mortality, and 0.49 (95% CI, 0.27-0.88) for ESRD. Similar findings were observed in other estimated GFR categories by the MDRD Study equation. Net reclassification improvement based on estimated GFR categories was significantly positive for all outcomes (range, 0.06-0.13; all P < .001). Net reclassification improvement was similarly positive in most subgroups defined by age (<65 years and ≥65 years), sex, race/ethnicity (white, Asian, and black), and presence or absence of diabetes and hypertension. The results in the high-risk and CKD cohorts were largely consistent with the general population cohorts.CONCLUSION: The CKD-EPI equation classified fewer individuals as having CKD and more accurately categorized the risk for mortality and ESRD than did the MDRD Study equation across a broad range of populations.
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1007. |
- Matsushita, Kunihiro, et al.
(författare)
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Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes : a collaborative meta-analysis of individual participant data
- 2015
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Ingår i: LANCET DIABETES & ENDOCRINOLOGY. - 2213-8587. ; 3:7, s. 514-525
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Tidskriftsartikel (refereegranskat)abstract
- Background The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-analytic approach. Methods We meta-analysed individual-level data for 637 315 individuals without a history of cardiovascular disease from 24 cohorts (median follow-up 4.2-19.0 years) included in the Chronic Kidney Disease Prognosis Consortium. We assessed C statistic difference and reclassification improvement for cardiovascular mortality and fatal and non-fatal cases of coronary heart disease, stroke, and heart failure in a 5 year timeframe, contrasting prediction models for traditional risk factors with and without creatinine-based eGFR, albuminuria (either albumin-to-creatinine ratio [ACR] or semi-quantitative dipstick proteinuria), or both. Findings The addition of eGFR and ACR significantly improved the discrimination of cardiovascular outcomes beyond traditional risk factors in general populations, but the improvement was greater with ACR than with eGFR, and more evident for cardiovascular mortality (C statistic difference 0.0139 [95% CI 0.0105- 0.0174] for ACR and 0.0065 [0.0042-0.0088] for eGFR) and heart failure (0.0196 [0.0108-0.0284] and 0.0109 [0.0059-0.0159]) than for coronary disease (0.0048 [0.0029-0.0067] and 0.0036 [0.0019-0.0054]) and stroke (0.0105 [0.0058-0.0151]and 0.0036 [0.0004-0.0069]). Dipstick proteinuria showed smaller improvement than ACR. The discrimination improvement with eGFR or ACR was especially evident in individuals with diabetes or hypertension, but remained significant with ACR for cardiovascular mortality and heart failure in those without either of these disorders. In individuals with chronic kidney disease, the combination of eGFR and ACR for risk discrimination outperformed most single traditional predictors; the C statistic for cardiovascular mortality fell by 0.0227 (0.0158-0.0296) after omission of eGFR and ACR compared with less than 0.007 for any single modifiable traditional predictor. Interpretation Creatinine-based eGFR and albuminuria should be taken into account for cardiovascular prediction, especially when these measures are already assessed for clinical purpose or if cardiovascular mortality and heart failure are outcomes of interest. ACR could have particularly broad implications for cardiovascular prediction. In populations with chronic kidney disease, the simultaneous assessment of eGFR and ACR could facilitate improved classification of cardiovascular risk, supporting current guidelines for chronic kidney disease. Our results lend some support to also incorporating eGFR and ACR into assessments of cardiovascular risk in the general population.
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1008. |
- Matsushita, Kunihiro, et al.
(författare)
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Measures of chronic kidney disease and risk of incident peripheral artery disease : a collaborative meta-analysis of individual participant data.
- 2017
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Ingår i: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 5:9, s. 718-728
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Some evidence suggests that chronic kidney disease is a risk factor for lower-extremity peripheral artery disease. We aimed to quantify the independent and joint associations of two measures of chronic kidney disease (estimated glomerular filtration rate [eGFR] and albuminuria) with the incidence of peripheral artery disease.METHODS: In this collaborative meta-analysis of international cohorts included in the Chronic Kidney Disease Prognosis Consortium (baseline measurements obtained between 1972 and 2014) with baseline measurements of eGFR and albuminuria, at least 1000 participants (this criterion not applied to cohorts exclusively enrolling patients with chronic kidney disease), and at least 50 peripheral artery disease events, we analysed adult participants without peripheral artery disease at baseline at the individual patient level with Cox proportional hazards models to quantify associations of creatinine-based eGFR, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria with the incidence of peripheral artery disease (including hospitalisation with a diagnosis of peripheral artery disease, intermittent claudication, leg revascularisation, and leg amputation). We assessed discrimination improvement through c-statistics.FINDINGS: We analysed 817 084 individuals without a history of peripheral artery disease at baseline from 21 cohorts. 18 261 cases of peripheral artery disease were recorded during follow-up across cohorts (median follow-up was 7·4 years [IQR 5·7-8·9], range 2·0-15·8 years across cohorts). Both chronic kidney disease measures were independently associated with the incidence of peripheral artery disease. Compared with an eGFR of 95 mL/min per 1·73 m(2), adjusted hazard ratios (HRs) for incident study-specific peripheral artery disease was 1·22 (95% CI 1·14-1·30) at an eGFR of 45 mL/min per 1·73 m(2) and 2·06 (1·70-2·48) at an eGFR of 15 mL/min per 1·73 m(2). Compared with an ACR of 5 mg/g, the adjusted HR for incident study-specific peripheral artery disease was 1·50 (1·41-1·59) at an ACR of 30 mg/g and 2·28 (2·12-2·44) at an ACR of 300 mg/g. The adjusted HR at an ACR of 300 mg/g versus 5 mg/g was 3·68 (95% CI 3·00-4·52) for leg amputation. eGFR and albuminuria contributed multiplicatively (eg, adjusted HR 5·76 [4·90-6·77] for incident peripheral artery disease and 10·61 [5·70-19·77] for amputation in eGFR <30 mL/min per 1·73 m(2) plus ACR ≥300 mg/g or dipstick proteinuria 2+ or higher vs eGFR ≥90 mL/min per 1·73 m(2) plus ACR <10 mg/g or dipstick proteinuria negative). Both eGFR and ACR significantly improved peripheral artery disease risk discrimination beyond traditional predictors, with a substantial improvement prediction of amputation with ACR (difference in c-statistic 0·058, 95% CI 0·045-0·070). Patterns were consistent across clinical subgroups.INTERPRETATION: Even mild-to-moderate chronic kidney disease conferred increased risk of incident peripheral artery disease, with a strong association between albuminuria and amputation. Clinical attention should be paid to the development of peripheral artery disease symptoms and signs in people with any stage of chronic kidney disease.FUNDING: American Heart Association, US National Kidney Foundation, and US National Institute of Diabetes and Digestive and Kidney Diseases.
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1009. |
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1010. |
- Mattsson, Karin Tillberg, et al.
(författare)
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Immigrant entrepreneurs and potentials for path creating tourism development in rural Sweden
- 2019
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Ingår i: Tourism Planning & Development. - : Routledge. - 2156-8316 .- 2156-8324. ; 17:4, s. 384-403
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Tidskriftsartikel (refereegranskat)abstract
- This paper investigates the potential of immigrant tourism entrepreneurs to contribute to tourism development and to the goals of regional tourism policy through the creation of new paths of development. Based on qualitative interviews in the county of Gävleborg in Sweden, the paper contributes to understanding the role of immigrant entrepreneurs in the context of public tourism development efforts in a rural region characterized by primary resource based and manufacturing industries. The findings suggest that the strategies and agencies of several immigrant entrepreneurs are in line with the public regional development efforts to achieve new touristic products, growth of foreign visitor numbers and increased co-operation among tourism stakeholders. The paper also highlights the barriers faced by the immigrant entrepreneurs and regional tourism development actors in their efforts to increase professionalization and co-operation among local stakeholders. Finally, we argue that if the potential for immigrant tourism entrepreneurs to contribute with external networks and new knowledge for tourism development should be realised, public efforts to stimulate networking between tourism firms and with other business sectors need to be stable and long term.
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