| 871. |
- Toots, Annika, et al.
(författare)
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Effects of exercise on cognitive function in older people with dementia : a randomized controlled trial
- 2017
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Ingår i: Journal of alzheimers disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 60:1, s. 323-332
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. Objectives: To investigate effects of exercise on cognitive function in people with dementia. Method: The Umea a Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umea, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean MiniMental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale -Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months. Results: Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707). Conclusion: A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.
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| 872. |
- Toots, Annika, et al.
(författare)
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The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes : A Randomized Controlled Trial
- 2019
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier. - 1525-8610 .- 1538-9375. ; 20:7, s. 835-842
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate exercise effects on falls in people with dementia living in nursing homes, and whether effects were dependent on sex, dementia type, or improvement in balance. A further aim was to describe the occurrence of fall-related injuries.DESIGN: A cluster-randomized controlled trial.SETTING AND PARTICIPANTS: The Umeå Dementia and Exercise study was set in 16 nursing homes in Umeå, Sweden and included 141 women and 45 men, a mean age of 85 years, and with a mean Mini-Mental State Examination score of 15.INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity; each conducted 2-3 times per week for 4 months.MEASURES: Falls and fall-related injuries were followed for 12 months (after intervention completion) by blinded review of medical records. Injuries were classified according to severity.RESULTS: During follow-up, 118(67%) of the participants fell 473 times in total. At the interim 6-month follow-up, the incidence rate was 2.7 and 2.8 falls per person-year in exercise and control group, respectively, and at 12-month follow-up 3.0 and 3.2 falls per person-year, respectively. Negative binomial regression analyses indicated no difference in fall rate between groups at 6 or 12 months (incidence rate ratio 0.9, 95% confidence interval (CI) 0.5-1.7, P = .838 and incidence rate ratio 0.9, 95% CI 0.5-1.6, P = .782, respectively). No differences in exercise effects were found according to sex, dementia type, or improvement in balance. Participants in the exercise group were less likely to sustain moderate/serious fall-related injuries at 12-month follow-up (odds ratio 0.31, 95% CI 0.10-0.94, P = .039).CONCLUSIONS/IMPLICATIONS: In older people with dementia living in nursing homes, a high-intensity functional exercise program alone did not prevent falls when compared with an attention control group. In high-risk populations, in which multimorbidity and polypharmacy are common, a multifactorial fall-prevention approach may be required. Encouraging effects on fall-related injuries were observed, which merits future investigations.
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| 873. |
- Toots, Annika, et al.
(författare)
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Usual gait speed independently predicts mortality in very old people : a population-based study
- 2013
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 14:7, s. 529.e1-529.e6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In older people, usual gait speed has been shown to independently predict mortality; however, less is known about whether usual gait speed is as informative in very old populations, in which prevalence of multimorbidity and disability is high. The aim of this study was to investigate if usual gait speed can independently predict all-cause mortality in very old people, and whether the prediction is influenced by dementia disorder, dependency in activities of daily living (ADL), or use of walking aids in the gait speed test.Design: Prospective cohort study. Setting: Population-based study in northern Sweden and Finland (the Umea 85+/GERDA Study).Participants: A total of 772 participants with a mean age of 89.6 years, 70% women, 33% with dementia disorders, 54% with ADL dependency, and 39% living in residential care facilities.Measurements: Usual gait speed assessed over 2.4 meters and mortality followed-up for 5 years. Results: The mean +/- SD gait speed was 0.52 +/- 0.21 m/s for the 620 (80%) participants able to complete the gait speed test. Cox proportional hazard regression analyses adjusted for potential confounders were performed. Compared with the fastest gait speed group (>= 0.64 m/s), the hazard ratio for mortality was for the following groups: unable = 2.27 (P < .001), <= 0.36 m/s = 1.97 (P = .001), 0.37 to 0.49 m/s = 1.99 (P < .001), 0.50 to 0.63 m/s = 1.11 (P = .604). No interaction effects were found between gait speed and age, sex, dementia disorder, dependency in ADLs, or use of walking aids.Conclusion: Among people aged 85 or older, including people dependent in ADLs and with dementia disorders, usual gait speed was an independent predictor of 5-year all-cause mortality. Inability to complete the gait test or gait speeds slower than 0.5 m/s appears to be associated with higher mortality risk. Gait speed might be a useful clinical indicator of health status among very old people.
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| 874. |
- Toots, Annika, et al.
(författare)
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Walking aids moderate exercise effects on gait speed in people with dementia : a randomized controlled trial
- 2017
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 18:3, s. 227-233
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate the effects of exercise on gait speed, when tested using walking aids and without, and whether effects differed according to amount of support in the test.DESIGN: A cluster-randomized controlled trial.SETTING: The Umeå Dementia and Exercise (UMDEX) study was set in 16 nursing homes in Umeå, Sweden.PARTICIPANTS: One hundred forty-one women and 45 men (mean age 85 years) with dementia, of whom 145 (78%) habitually used walking aids.INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity.MEASUREMENTS: Blinded assessors measured 4-m usual gait speed with walking aids if any gait speed (GS), and without walking aids and with minimum amount of support, at baseline, 4 months (on intervention completion), and 7 months.RESULTS: Linear mixed models showed no between-group effect in either gait speed test at 4 or 7 months. In interaction analyses exercise effects differed significantly between participants who walked unsupported compared with when walking aids or minimum support was used. Positive between-group exercise effects on gait speed (m/s) were found in subgroups that walked unsupported at 4 and 7 months (GS: 0.07, P = .009 and 0.13, P < .001; and GS test without walking aids: 0.05, P = .011 and 0.07, P = .029, respectively).CONCLUSIONS: In people with dementia living in nursing homes exercise had positive effects on gait when tested unsupported compared with when walking aids or minimum support was used. The study suggests that the use of walking aids in gait speed tests may conceal exercise effects.
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| 875. |
- Trope, C., et al.
(författare)
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Human malignant melanoma heterotransplanted to nude mice
- 1981
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Ingår i: Neoplasma. ; 28:5, s. 585-591
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Tidskriftsartikel (refereegranskat)abstract
- Five different human malignant melanoma were heterotransplanted subcutaneously to nude mice. When small tissue pieces were used 3 out of 5 tumors grew. Subcutaneous injections of suspended tumor cells were also made, but all failed to take. Metastatic or infiltrative growth was never seen in the mice observed for up to 2.5 months. The successful grafts largely retained the original morphological features. The three successfully transplanted tumors could all be serially transfered with 100% tumor take. In one case passage time was reduced from 40 days to 15 days. As measured with 3H-thymidine incorporation the proliferation rate increased during the passages. These changes might be due to a selection of more rapidly growing tumor cells in the nudes.
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| 876. |
- Tunon, Håkan, et al.
(författare)
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Grattis Moder Jord!
- 2010
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Ingår i: Svenska Dagbladet/Brännpunkt. ; 22 april 2010
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 877. |
- Tuominen, Rainer, et al.
(författare)
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Investigation of a putative melanoma susceptibility locus at chromosome 3q29
- 2014
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Ingår i: Cancer Genetics. - : Elsevier. - 2210-7762 .- 2210-7770. ; 207:3, s. 70-74
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Tidskriftsartikel (refereegranskat)abstract
- Malignant melanoma, the most fatal form of skin cancer, is currently increasing in incidence in many populations. Approximately 10% of all cases occur in families with an inherited predisposition for melanoma. In Sweden, only a minor portion of such melanoma families carry a mutation in the known melanoma gene CDKN2A, and there is a need to identify additional melanoma susceptibility genes. In a recently performed genome-wide linkage screen, novel loci with suggestive evidence of linkage to melanoma were detected. In this study, we have further analyzed one region on chromosome 3q29. In all, 89 affected and 15 nonaffected family members from 42 melanoma-prone families were genotyped for 34 genetic markers. In a pooled linkage analysis of all 42 families, we detected significant evidence of linkage, with a maximum heterogeneity logarithm of odds (HLOD) score of 3.1 with 83% of the families contributing to the linkage score. The minimum critical region of linkage (defined by a 1LOD score support interval) maps to chromosome 3q29, spans 3.5 Mb of genomic sequence, and harbors 44 identified genes. Sequence variants within this region have previously been associated with cancer susceptibility. This study reports the presence of a putative novel melanoma susceptibility locus in the Swedish population, a finding that needs to be replicated in an independent study on other individuals with familial melanoma. Sequencing of genes in the region may identify novel melanoma-associated mutations.
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| 878. |
- Turunen Olsson, Pernilla, et al.
(författare)
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“It’s all connected!” : Nursing students’ experiences of an integrated case seminar
- 2016
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Ingår i: Innovations in Education and Teaching International. - : Routledge. - 1470-3300 .- 1470-3297. ; 53:2, s. 203-214
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally, nursing students learn medical subjects and nursing separately, which makes it difficult to develop an integrated understanding. This study aimed to explore nursing students’ experiences of participating in a case seminar integrating medical and nursing sciences and if, and how, it contributed to their learning. A case seminar divided into a ‘laboratory session’ and a ‘follow-up session’ was developed. The case seminar was evaluated by group interviews and an open-ended questionnaire. Forty-four third-year nursing students agreed to participate. Themes of motivation, authenticity, professional development, collaboration and integration were identified. The case seminars help nursing students to integrate medical science with nursing science, which supports them in their professional development and role as registered nurses.
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| 879. |
- Ujvari, Beata, et al.
(författare)
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Low genetic diversity threatens imminent extinction for the Hungarian meadow viper (Vipera ursinii rakosiensis)
- 2002
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Ingår i: Biological Conservation. - 1873-2917. ; 105:1, s. 127-130
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Tidskriftsartikel (refereegranskat)abstract
- Meadow vipers (Vipera ursinii) are small venomous snakes whose range in Hungary has been greatly fragmented by anthropogenic habitat disturbance (especially, agriculture). We obtained DNA from a total of eight Hungarian snakes. Genetic variability at the major histocompatibility (Mhc) class I loci was much lower for these snakes than for specimens from two large Ukrainian populations. Within two Hungarian populations for which we had multiple individuals, band-sharing indices were 100 and 84.6% (versus 63.3 and 57% for the Ukraine populations). The Ukrainian snakes also displayed more RFLP fragments than the Hungarian vipers (mean 13.7 versus 9.0, respectively). In combination with reports of birth deformities, chromosomal abnormalities and low juvenile survival, these data strongly suggest that the Hungarian vipers are experiencing inbreeding depression. Genetic diversity is still present in the Hungarian vipers but among rather than within populations. Given the very low numbers of animals, the only feasible strategy to increase the genetic diversity and to save the Hungarian vipers from extinction is to implement a captive breeding program based on genetically screened animals. (C) 2002 Elsevier Science Ltd. All rights reserved.
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| 880. |
- Vallon-Christersson, J, et al.
(författare)
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Functional analysis of BRCA1 C-terminal missense mutations identified in breast and ovarian cancer families
- 2001
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Ingår i: Human Molecular Genetics. - : Oxford University Press (OUP). - 0964-6906 .- 1460-2083. ; 10:4, s. 60-353
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Tidskriftsartikel (refereegranskat)abstract
- Germline mutations in the breast and ovarian cancer susceptibility gene BRCA1 are responsible for the majority of cases involving hereditary breast and ovarian cancer. Whereas all truncating mutations are considered as functionally deleterious, most of the missense variants identified to date cannot be readily distinguished as either disease-associated mutations or benign polymorphisms. The C-terminal domain of BRCA1 displays an intrinsic transactivation activity, and mutations linked to disease predisposition have been shown to confer loss of such activity in yeast and mammalian cells. In an attempt to clarify the functional importance of the BRCA1 C-terminus as a transcription activator in cancer predisposition, we have characterized the effect of C-terminal germline variants identified in Scandinavian breast and ovarian cancer families. Missense variants A1669S, C1697R, R1699W, R1699Q, A1708E, S1715R and G1738E and a truncating mutation, W1837X, were characterized using yeast- and mammalian-based transcription assays. In addition, four additional missense variants (V1665M, D1692N, S1715N and D1733G) and one in-frame deletion (V1688del) were included in the study. Our findings demonstrate that transactivation activity may reflect a tumor-suppressing function of BRCA1 and further support the role of BRCA1 missense mutations in disease predisposition. We also report a discrepancy between results from yeast- and mammalian-based assays, indicating that it may not be possible to unambiguously characterize variants with the yeast assay alone. We show that transcription-based assays can aid in the characterization of deleterious mutations in the C-terminal part of BRCA1 and may form the basis of a functional assay.
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