| 41. |
- Glerup, Mia, et al.
(författare)
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Longterm Outcomes of Temporomandibular Joints in Juvenile Idiopathic Arthritis : 17 Years of Followup of a Nordic Juvenile Idiopathic Arthritis Cohort
- 2020
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Ingår i: Journal of Rheumatology. - : J RHEUMATOL PUBL CO. - 0315-162X .- 1499-2752. ; 47:5, s. 730-738
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the prevalence of orofacial symptoms, dysfunctions, and deformities of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) 17 years after disease onset.Methods: Drawn from a prospective, population-based Nordic JIA cohort with disease onset from 1997 to 2000, 420 consecutive cases were eligible for orofacial evaluation of TMJ involvement. The followup visit included demographic data, a standardized clinical orofacial examination, and full-face cone-beam computed tomography (CBCT). For comparison, 200 age-matched healthy controls were used.Results: Of 420 eligible participants with JIA, 265 (63%) were included (mean age 23.5 +/- 4.2 yrs) and completed a standardized clinical orofacial examination. Of these, 245 had a full-face CBCT performed. At least 1 orofacial symptom was reported by 33%. Compared to controls, the JIA group significantly more often reported TMJ pain, TMJ morning stiffness, and limitation on chewing. Further, among participants reporting complaints, the number of symptoms was also higher in JIA. The mean maximal incisal opening was lower in the JIA group (p < 0.001), and TMJ pain on palpation was more frequent. Condylar deformities and/or erosions were observed in 61% as assessed by CBCT, showing bilateral changes in about 70%. Risk factors of condylar deformities were orofacial dysfunction or biologic treatment; enthesitis-related arthritis was protective.Conclusion: This study of the longterm consequences of TMJ involvement in a population-based JIA cohort reports persistence of comprehensive symptoms, dysfunctions, and damage of the TMJ into adulthood. We suggest interdisciplinary followup of JIA patients also in adulthood.
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| 42. |
- Helldeen, D., et al.
(författare)
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Climate change and child health: a scoping review and an expanded conceptual framework
- 2021
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Ingår i: Lancet Planetary Health. - : Elsevier. - 2542-5196. ; 26, s. 9-9
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Tidskriftsartikel (refereegranskat)abstract
- Climate change can have detrimental effects on child health and wellbeing. Despite the imperative for a fuller understanding of how climate change affects child health and wellbeing, a systematic approach and focus solely on children (aged <18 years) has been lacking. In this Scoping Review, we did a literature search on the impacts of climate change on child health from January, 2000, to June, 2019. The included studies explicitly linked an alteration of an exposure to a risk factor for child health to climate change or climate variability. In total, 2970 original articles, reviews, and other documents were identified, of which 371 were analysed. Employing an expanded framework, our analysis showed that the effects of climate change on child health act through direct and indirect pathways, with implications for determinants of child health as well as morbidity and mortality from a range of diseases. This understanding can be further enhanced by using a broader range of research methods, studying overlooked populations and geographical regions, investigating the costs and benefits of mitigation and adaptation for child health, and considering the position of climate change and child health within the UN Sustainable Development Goals. Present and future generations of children bear and will continue to bear an unacceptably high disease burden from climate change.
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| 43. |
- Helldén, Daniel, et al.
(författare)
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Climate change adaptation across the life-course - from pregnancy to adolescence – it’s time to advance the field of climate change and child health
- 2023
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Ingår i: Environmental Research. Health. - : Institute of Physics (IOP). - 2752-5309. ; 1:2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Children are bearing and will continue to bear a high burden from climate change, through directand indirect pathways. Climate change adaptation interventions are essential to limit the currentand projected impacts of climate change on child health. However, the perspective of children andtheir health with regards to adaptation in research and policy is limited. Ensuring that adaptationinterventions are context specific, consider interrelated barriers to implementation and leverageexisting structures including multisectoral collaboration is vital. Further, a life-course perspectiveon child health and well-being could serve as a template for tailoring adaptation interventions tothe specific vulnerabilities and needs of specific development periods of the child. A meaningfulengagement of children and young persons in the design and implementation of adaptationinterventions is essential to increase effectiveness and uptake. With climate change effectingmillions of children worldwide, it is high time to put child health at the center of adaptation.
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| 44. |
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| 45. |
- Herrmann, Alina, et al.
(författare)
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The Role of Health in Households' Balancing Act for Lifestyles Compatible with the Paris Agreement : Qualitative Results from Mannheim, Germany
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:4
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Tidskriftsartikel (refereegranskat)abstract
- Household lifestyles are the main drivers of climate change. Climate change mitigation measures directed to households often have substantial health co-benefits. The European mixed-methods study HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) investigates households' preferences for reducing greenhouse gas emissions and particularly researches the role of information on health co-benefits in households' decision making. The results presented in this study are derived from 18 qualitative interviews, conducted with a subsample of households from Mannheim, Germany. The in-depth interviews were transcribed verbatim, analyzed with a qualitative content analysis, supported by NVivo software. They showed that, in order to reduce their greenhouse gas emission in a way compatible with the 1.5 °C goal, households have to undertake a difficult balancing act, considering factors from the individual sphere, such as health co-benefits, as well as from the public sphere, such as (climate) policies. Shared responsibility and equity are important aspects of households. In conclusion, health is an important factor in households' decision making. However, information policies about health co-benefits need to go along with structural policy measures, in order to support households effectively in the implementation of healthy and climate-friendly lifestyles, especially in sectors where behavior change is difficult, like the mobility sector.
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| 46. |
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| 47. |
- Jaensson, Maria, 1967-, et al.
(författare)
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Evaluation of postoperative recovery in day surgery patients using a mobile phone application : a multicentre randomized trial
- 2017
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Ingår i: British Journal of Anaesthesia. - : Oxford University Press. - 0007-0912 .- 1471-6771. ; 119:5, s. 1030-1038
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.
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| 48. |
- Jaensson, Maria, 1967-, et al.
(författare)
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Gender differences in risk factors for airway symptoms following tracheal intubation
- 2012
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Ingår i: Acta Anaesthesiologica Scandinavica. - Hoboken, USA : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 56:10, s. 1306-1313
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Tidskriftsartikel (refereegranskat)abstract
- Background: A common complaint after endotracheal intubation is sore throat and hoarseness. The aim of this study was to describe gender differences and independent risk factors in the development of post-operative sore throat and hoarseness after endotracheal intubation in adults.Methods: This prospective cross-sectional observational study was conducted at a university hospital in Sweden. A total of 495 patients were included (203 men and 292 women) and enrolled from a total of eight different surgical departments. Outcome variables were post-operative sore throat and hoarseness evaluated post-operatively in the post-anaesthesia care unit. A total of 31 variables were recorded which described the intubation process, intraoperative factors as well as the extubation process. Bivariate and multivariate analyses were performed.Results: The overall incidence of post-operative sore throat was 35% and hoarseness 59%. The results show different predictors for men and women in the development of airway symptoms. The main risk factor for developing sore throat in men was intubation by personnel with Conclusion: Post-operative sore throat and hoarseness result from several factors, and the cause of these symptoms are multifactorial and differs by gender. Identification of these factors pre-operatively may increase awareness among anaesthesia personnel and possibly reduce the incidence of these minor but distressing symptoms.
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| 49. |
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| 50. |
- Jaensson, Maria, 1967-, et al.
(författare)
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Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway : a prospective study
- 2014
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Ingår i: BMC Anesthesiology. - : BioMed Central. - 1471-2253 .- 1471-2253. ; 14:56
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective. Postoperative sore throat and hoarseness are common minor complications following airway manipulation. This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway (LMA) and endotracheal tube (ETT).Methods. A total of 112 men and 185 women were included during a four month period. All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat, its location and hoarseness. If the patients had any symptom, they were followed-up at 48, 72 and 96 hours until the symptoms resolved. Results. There was no significant gender difference in postoperative sore throat (POST) and postoperative hoarseness (PH) when analyzing both airway devices together. The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA (32% vs. 19%, p= 0.012) and 57% vs. 33% (p< 0.001) respectively. Significantly more women than men had POST after an LMA (26% vs. 6%, p=0.004). No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA. More patients located their pain below the larynx after an ETT vs. an LMA (24% vs. 4%). Pain above the larynx was more common after an LMA than an ETT (52 % vs. 37 %).Conclusions. In a clinical setting where women are intubated with a smaller size ETT than men, there were no significant differences in POST or PH between genders. Additionally, more women than men have POST when an LMA is used. Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery.
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