| 11. |
- Adamson, Carly, et al.
(författare)
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Dapagliflozin for Heart Failure According to Body Mass Index : The DELIVER Trial.
- 2022
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 43:41, s. 4406-4417
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Obesity is common and associated with unique phenotypic features in heart failure with preserved ejection fraction (HFpEF). Therefore, understanding the efficacy and safety of new therapies in HFpEF patients with obesity is important. The effects of dapagliflozin were examined according to body mass index (BMI) among patients in the Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure trial. METHODS AND RESULTS: Body mass index was analysed by World Health Organization (WHO) categories and as a continuous variable using restricted cubic splines. Body mass index ranged from 15.2 to 50 kg/m2 with a mean value of 29.8 (standard deviation +/- 6.1) kg/m2. The proportions, by WHO category, were: normal weight 1343 (21.5%); overweight 2073 (33.1%); Class I obesity 1574 (25.2%); Class II obesity 798 (12.8%); and Class III obesity 415 (6.6%). Compared with placebo, dapagliflozin reduced the risk of the primary outcome to a similar extent across these categories: hazard ratio (95% confidence interval): 0.89 (0.69-1.15), 0.87 (0.70-1.08), 0.74 (0.58-0.93), 0.78 (0.57-1.08), and 0.72 (0.47-1.08), respectively (P-interaction = 0.82). The placebo-corrected change in Kansas City Cardiomyopathy Questionnaire total symptom score with dapagliflozin at 8 months was: 0.9 (-1.1, 2.8), 2.5 (0.8, 4.1), 1.9 (-0.1, 3.8), 2.7 (-0.5, 5.8), and 8.6 (4.0, 13.2) points, respectively (P-interaction = 0.03). The placebo-corrected change in weight at 12 months was: -0.88 (-1.28, -0.47), -0.65 (-1.04, -0.26), -1.42 (-1.89, -0.94), -1.17 (-1.94, -0.40), and -2.50 (-4.4, -0.64) kg (P-interaction = 0.002). CONCLUSIONS: Obesity is common in patients with HFpEF and is associated with higher rates of heart failure hospitalization and worse health status. Treatment with dapagliflozin improves cardiovascular outcomes across the spectrum of BMI, leads to greater symptom improvement in patients with obesity, compared with those without, and has the additional benefit of causing modest weight loss.
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| 12. |
- af Winklerfelt Hammarberg, Sandra, et al.
(författare)
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Clinical effectiveness of care managers in collaborative primary health care for patients with depression : 12-and 24-month follow-up of a pragmatic cluster randomized controlled trial
- 2022
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Ingår i: BMC Primary Care. - : Springer Nature. - 2731-4553. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In previous studies, we investigated the effects of a care manager intervention for patients with depression treated in primary health care. At 6 months, care management improved depressive symptoms, remission, return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study was to compare the long-term effectiveness of care management and usual care for primary care patients with depression on depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and 24 months after the start of the intervention. Methods Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control) in the regions of Vastra Gotaland and Dalarna, Sweden. Patients >= 18 years with newly diagnosed mild to moderate depression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed a structured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care manager followed up symptoms and treatment, encouraged behavioral activation, provided education, and communicated with the patient's general practitioner as needed. Patients at control centers received usual care. Adjusted mixed model repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptoms and remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specific questionnaire). Results The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) but not 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differences in remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from the primary care center. Conclusions Patients with depression who had a care manager maintained their 6-month improvements in symptoms at the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients with care managers also had significantly more confidence in primary care and belief in future support than controls.
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| 13. |
- Agredo Chavez, Angelica Maria, et al.
(författare)
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Cracking and Fatigue of Heavy Loaded Prestressed Concrete Bridge in Sweden
- 2022
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Ingår i: IABSE Symposium Prague 2022: Challenges for Existing and Oncoming Structures - Report, International Association for Bridge and Structural Engineering. - Zürich : International Association for Bridge and Structural Engineering. ; , s. 792-799
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Konferensbidrag (refereegranskat)abstract
- A prestressed concrete bridge was built in 1963 with BBRV cables. It has three spans and a total length of 134.8 m. Due to mining activities the bridge was loaded with trucks with a total weight of 90 ton during 2012-2014 and from 2019. Crack development has been monitored manually and from 2020 with strain gauges and LVDTs.Cracks normally vary between 0.1 to 0.3 mm in width and grow in length with time. In November 2020 some of the strain gauges on the concrete showed alarming growth and the bridge was closed for traffic. Additional strain gauges were installed on vertical reinforcement bars and an assessment was carried out of the fatigue capacity of the bridge. It was found that the new strain gauges did not indicate any growth in strain and that the fatigue capacity was sufficient. The bridge could be opened again for traffic after being closed for five weeks. Monitoring drift in the strain gauges and fatigue are discussed.
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| 14. |
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| 15. |
- Altman, Maria, et al.
(författare)
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Prolonged second stage of labor is associated with low Apgar score
- 2015
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Ingår i: European Journal of Epidemiology. - Stockholm : Karolinska Institutet, Dept of Medicine, Solna. - 0393-2990 .- 1573-7284.
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Tidskriftsartikel (refereegranskat)abstract
- There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 minutes. All nulliparous women (n= 32 796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (OR) with 95% confidence intervals (CI). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 minutes <7 and <4. We found that the overall rates of 5 minute Apgar score <7 and <4 were 7.0 and 1.3 per 1000 births, respectively. Compared to women with <1 hour from retracted cervix to birth, adjusted ORs of Apgar score <7 at 5 minutes generally increased with length of second stage of labor: 1-<2 hours: OR 1.78 (95% CI 1.19-2.66); 2- <3 hours: OR 1.66 (1.05-2.62); 3-<4 hours: OR 2.08 (1.29-3.35); and ≥4 hours: OR 2.71 (1.67-4.40). We conclude that prolonged second stage of labor is associated with an increased risk of low 5 minute Apgar score.
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| 16. |
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| 18. |
- Amouzad Mahdiraji, Saeid, et al.
(författare)
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An Optimization Model for the Placement of Mobile Stroke Units
- 2024
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Ingår i: Advanced Research in Technologies, Information, Innovation and Sustainability - 3rd International Conference, ARTIIS 2023, Proceedings. - : Springer. - 1865-0929 .- 1865-0937. - 9783031488573 - 9783031488580 ; 1935 CCIS, s. 297-310
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Konferensbidrag (refereegranskat)abstract
- Mobile Stroke Units (MSUs) are specialized ambulances that can diagnose and treat stroke patients; hence, reducing the time to treatment for stroke patients. Optimal placement of MSUs in a geographic region enables to maximize access to treatment for stroke patients. We contribute a mathematical model to optimally place MSUs in a geographic region. The objective function of the model takes the tradeoff perspective, balancing between the efficiency and equity perspectives for the MSU placement. Solving the optimization problem enables to optimize the placement of MSUs for the chosen tradeoff between the efficiency and equity perspectives. We applied the model to the Blekinge and Kronoberg counties of Sweden to illustrate the applicability of our model. The experimental findings show both the correctness of the suggested model and the benefits of placing MSUs in the considered regions.
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| 19. |
- Andersén, Annelie, 1977-, et al.
(författare)
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Yrkesämnesdidaktik på universitet : Mål, innehåll, arbetssätt och examination
- 2018
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Ingår i: Nordic Journal of Vocational Education and Training. - Linköping : Linköping University Electronic Press. - 2242-458X. ; 8:3, s. 98-123
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to investigate learning goals, content, working methods and examinations in the vocational didactic sections of the vocational teacher education programme. In a case study, a total of forty study guides from one vocational teacher education programme have been analysed in order to answer what central content is highlighted, how the goals are examined, and what course literature is used in vocational subject didactics in a selected vocational teacher education programme at a Swedish university. The aim of the analysis, based on Hiim’s (2010) model, is to find both clearly expressed and more latent elements. The results answer questions on what the subject didactics contain in three different courses. Vocational teacher educators plan their teaching with regard to the goals of vocational subject didactics, but the interpretation of goals varies among different educators and within different vocational subjects. The result also gives some indications of what could be general differences and similarities within and between different didactics teacher groups and/or vocational subjects. The analysis of the study guides also shows that educational background and the form of employment of educators seem to be of importance.
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| 20. |
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