| 220821. |
- Sparring, V., et al.
(författare)
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Changing healthcare utilization patterns in diabetes mellitus : case-control studies 1 year and 8 years after diagnosis
- 2012
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 29:6, s. 784-791
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Tidskriftsartikel (refereegranskat)abstract
- Aims To describe healthcare utilization patterns in young and middle-aged patients with diabetes 1 year and 8 years after diagnosis and to compare with the general population at two time points, 16 years apart. Methods Four cohorts with disease duration of 1 year or 8 years were selected from the Diabetes Incidence Study in Sweden, which registers all incident cases of diabetes in the 15- to 34-year age group. Control subjects were selected from the population register matched by age, sex and county of residence. A postal questionnaire was sent to the 1983 and 1992 cohorts in 1991 and 1993, and to the 1999 and 2008 cohorts in 2007 and 2009. Nine hundred and thirteen patients with diabetes and 1679 control subjects responded. Results One year after diagnosis, 49% of patients with diabetes in the 1992 cohort compared with 4.2% in the 2008 cohort reported visits to departments of internal medicine and endocrinology. A similar pattern was seen 8 years after diagnosis. The use of day care was 45 times higher among patients with diabetes compared with control subjects. Utilization of outpatient hospital care was higher among patients with diabetes compared with control subjects, even when excluding visits to diabetes clinics. Conclusions Excess use of health care among patients with diabetes remained 16 years after the first follow-up. Utilization patterns were stable, except for a major decrease in inpatient care 1 year after diagnosis and an increase in day care 8 years after diagnosis. Observed changes probably reflect successive reforming of diabetes care in Sweden.
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| 220822. |
- Sparring, Vibeke, et al.
(författare)
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Diabetes duration and health-related quality of life in individuals with onset of diabetes in the age group 15-34 years - a Swedish population-based study using EQ-5D
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 377-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Diabetes with onset in younger ages affects both length of life and health status due to debilitating and life-threatening long-term complications. In addition, episodes and fear of hypoglycaemia and of long-term consequences may have a substantial impact on health status. This study aims to describe and analyse health-related quality of life (HRQoL) in individuals with onset of diabetes at the age of 15-34 years and with a disease duration of 1, 8, 15 and 24 years compared with control individuals matched for age, sex and county of residence. Methods: Cross-sectional study of 839 individuals with diabetes and 1564 control individuals. Data on socioeconomic status and HRQoL using EQ-5D were collected by a postal questionnaire. Insulin treatment was self-reported by 94% of the patients, the majority most likely being type 1. Results: Individuals with diabetes reported lower HRQoL, with a significantly lower mean EQ VAS score in all cohorts of disease duration compared with control individuals for both men and women, and with a significantly lower EQ-5D(index) for women, but not for men, 15 years (0.76, p = 0.022) and 24 years (0.77, p = 0.016) after diagnosis compared with corresponding control individuals. Newly diagnosed individuals with diabetes reported significantly more problems compared with the control individuals in the dimension usual activities (women: 13.2% vs. 4.0%, p = 0.048; men: 11.4% vs. 4.1%, p = 0.033). In the other dimensions, differences between individuals with diabetes and control individuals were found 15 and 24 years after diagnosis: for women in the dimensions mobility, self-care, usual activities and pain/discomfort and for men in the dimension mobility. Multivariable regression analysis showed that diabetes duration, being a woman, having a lower education and not being married or cohabiting had a negative impact on HRQoL. Conclusions: Our study confirms the negative impact of diabetes on HRQoL and that the difference to control individuals increased by disease duration for women with diabetes. The small difference one year after diagnosis could imply a good management of diabetes care and a relatively quick adaptation. Our results also indicate that gender differences still exist in Sweden, despite modern diabetes treatment and management in Sweden.
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| 220823. |
- Sparrman, Anna, 1965-, et al.
(författare)
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Archives and children’s cultural heritage
- 2023
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Ingår i: Archives and records. - : Taylor & Francis. - 2325-7962 .- 2325-7989.
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Tidskriftsartikel (refereegranskat)abstract
- In this explorative and collectively written paper, researchers and archivists from the research project Children’s cultural heritage — the visual voices of the archive ponder, wrestle with, confront, and dig deeper into what it means to preserve and include children’s own voices in archives. The authors acknowledge that child-produced cultural objects are historical landmarks and significant parts of national heritage. The article raises questions about where and how the ‘doing’ of what is here called children’s cultural heritage takes place, what it means to archive from children’s perspectives, and what aspects of children are saved during these preservation and archival management processes. To collect, preserve and provide access to heritage might empower and affirm individuals and subordinated groups of people who have not been seen or heard in the historical past, in the present, or in future pasts. Children, as a category, is one such subordinated group in heritage contexts. Adults therefore have a responsibility to empower children by strengthening their position towards other social groups, towards society and the heritage domain. This article provides insights into the challenges that heritage establishments face in taking children’s cultural heritage seriously.
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| 220824. |
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| 220825. |
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| 220826. |
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| 220827. |
- Sparrman, Viktor, et al.
(författare)
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Multiple Habitable Phases on Outer Exosolar Worlds
- 2024
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Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 962:1
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Tidskriftsartikel (refereegranskat)abstract
- As stars evolve to higher luminosities during first ascension of the giant branch, previously frozen terrestrial worlds may thaw and host liquid water on their surfaces. Eventually these outer worlds again become uninhabitable due to receiving too much incident light and their water inventory evaporating. Solar-mass stars experience a sudden decrease in luminosity entering the horizontal branch, which could result in a secondary habitable phase for their outer worlds. The outer worlds' time with habitable surface climates is key in evaluating the possibility of extraterrestrial life arising. The times inside the habitable zone (TIHZ) are calculated for outer worlds orbiting between 5 and 45 au around a Sun-like star. By comparing the TIHZ to time estimates for life to arise on Earth, we evaluate whether such outer worlds are promising candidates in the search for extraterrestrial life. We use two different solar evolution models (PARSEC and Dartmouth) and both optimistic and conservative habitable zone (HZ) definitions. Multiple habitable phases are found for each outer world. Outer worlds with orbits as large as Saturn are found to have a secondary habitable phase which exceeds the first in duration. Generally, the time inside the HZ is found to decrease almost monotonically with orbiting distance. Water loss is calculated after the first habitable phase to determine whether a secondary habitable phase is possible. For all orbiting distances the water loss is insufficient to deplete a water inventory equivalent to that of many moons in the outer solar system.
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| 220828. |
- Sparv, David, et al.
(författare)
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The Analgesic Effect of Oxygen in Suspected Acute Myocardial Infarction : A Substudy of the DETO2X-AMI Trial
- 2018
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Ingår i: JACC: Cardiovascular Interventions. - : Elsevier BV. - 1936-8798 .- 1876-7605. ; 39, s. 546-546
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In this substudy of the DETO2X-AMI (An Efficacy and Outcome Study of Supplemental Oxygen Treatment in Patients With Suspected Myocardial Infarction) trial, the authors aimed to assess the analgesic effect of moderate-flow oxygen supplementation in patients with suspected acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) and to study the effect of oxygen supplementation on the use of opiates and sedatives during PCI. Background: Routine oxygen in normoxemic patients with AMI does not provide clinical benefit. However, oxygen may relieve ischemic pain. Methods: Patients were randomly allocated to oxygen or ambient air according to the main study protocol. After PCI, peak level of pain during PCI was measured by the Visual Analogue Scale. The total amount of opiates and sedatives was reported. Results: A total of 622 patients were enrolled: 330 in the oxygen group and 292 in the ambient air group. There was no significant difference in peak level of pain (oxygen 4.0 [1.0 to 6.0] vs. air 3.0 [0.6 to 6.0]; p = 0.37), use of opiates (mg) (oxygen 0.0 [0.0 to 3.0] vs. air 0.0 [0.0 to 3.0]; p = 0.31), or use of sedatives between the groups (median [interquartile range]) (oxygen 2.5 [0.0 to 2.5] vs. air 2.5 [0.0 to 2.5]; p = 0.74). Conclusions: In the present study, the authors did not find any analgesic effect of routine oxygen as compared with ambient air, and no differences in the use of sedatives and opiates during PCI. Our results indicate that moderate-flow oxygen supplementation does not relieve pain in normoxemic patients with suspected AMI undergoing treatment with PCI and should thus not be used for this purpose.
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| 220829. |
- Sparve, Erik, et al.
(författare)
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Prediction and Modeling of Effects on the QTc Interval for Clinical Safety Margin Assessment, Based on Single-Ascending-Dose Study Data with AZD3839
- 2014
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Ingår i: Journal of Pharmacology and Experimental Therapeutics. - : American Society for Pharmacology & Experimental Therapeutics (ASPET). - 0022-3565 .- 1521-0103. ; 350:2, s. 469-478
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Tidskriftsartikel (refereegranskat)abstract
- Corrected QT interval (QTc) prolongation in humans is usually predictable based on results from preclinical findings. This study confirms the signal from preclinical cardiac repolarization models (human ether-a-go-go-related gene, guinea pig monophasic action potential, and dog telemetry) on the clinical effects on the QTc interval. A thorough QT/QTc study is generally required for bioavailable pharmaceutical compounds to determine whether or not a drug shows a QTc effect above a threshold of regulatory interest. However, as demonstrated in this AZD3839 [(S)-1-(2-(difluoromethyl)pyridin-4-yl)-4-fluoro-1-(3-(pyrimidin-5-yl)phenyl)-1H-isoindol-3-amine hemifumarate] single-ascending-dose (SAD) study, high-resolution digital electrocardiogram data, in combination with adequate efficacy biomarker and pharmacokinetic data and nonlinear mixed effects modeling, can provide the basis to safely explore the margins to allow for robust modeling of clinical effect versus the electrophysiological risk marker. We also conclude that a carefully conducted SAD study may provide reliable data for effective early strategic decision making ahead of the thorough QT/QTc study.
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| 220830. |
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