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| 2. |
- Håkansson, Anders, et al.
(författare)
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Treatment seeking for gambling disorder in nationwide register data – observations around a major shift in legislation
- 2024
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Ingår i: Frontiers in Public Health. - 2296-2565. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment seeking for gambling disorder is known to be low and there has been a lack of longitudinal research regarding treatment opportunities. The present study aimed to assess possible changes in treatment uptake after a formal introduction of gambling disorder in social services and health care legislations, by using register data, including patient characteristics with respect to socio-demographics and comorbidities. Methods: Nationwide register data were collected for the years 2005–2019, describing diagnoses in specialized out-patient health care and in in-patient hospital care. Numbers and characteristics of patients with gambling disorder were followed longitudinally. Also, a new legislation for treatment by public institutions was introduced in 2018, and data were compared for the years before and after the shift in legislation, both nationally, for each of the three major urban regions, and for the rest of the country. Comparisons were made with respect to concurrent mental health comorbidities, age and gender. Results: The number of out-patient gambling disorder diagnoses increased over time, but without any significant step changes around the shift in legislation. Over time, patients were younger, became more likely to have gambling disorder as their primary diagnosis, and less likely to have mental health comorbidities, whereas gender distribution did not change. Among the smaller group of patients diagnosed in in-patient settings, mental health comorbidity increased over time. Despite gradual changes over time, no changes in demographics were seen around the actual shift in legislation, although the psychiatric comorbidity appeared to increase after this change. Conclusion: After the introduction of gambling disorder in the responsibility of social services and health care settings in Sweden, the number of patients diagnosed with gambling disorder increased only modestly. Likely, further implementation of gambling disorder treatment is required in the health care services. Also, longer longitudinal studies are needed in order to understand to what extent patients not seeking health care treatment are received by municipal social services or remain outside the treatment system.
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- Karlsson, Anna-Carin, et al.
(författare)
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Ethical challenges in residential care facilities during COVID-19 : leaders’ perspective
- 2024
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Person-centred care is based on ethical principles, and it is regarded as high-quality care. Care of older persons should embrace person-centredness. During the pandemic, older persons were highlighted as a vulnerable group at risk of developing serious illness and/or suffering death from COVID-19. Several pandemic-related measures were introduced in residential care facilities (RCFs) to reduce this risk, which influenced the possibilities to lead and provide a person-centred care.Aim: This study’s aim was to explore ethical challenges in relation to person-centredness during the COVID-19 pandemic, from the perspective of leaders in RCFs.Research design: The study had a qualitative descriptive design.Participants and research context: Semi-structured interviews were conducted with 26 leaders working in RCFs in Sweden. Data were analysed using conventional content analysis.Ethical considerations: The study was approved by the Swedish Ethical Review Authority. The participants received oral and written information about the study and gave written consent. The study was conducted in accordance with the Declaration of Helsinki.Findings: The overarching ethical challenge was Having to disregard the individual needs of the person in order to protect the group and society. This included (a) Protecting the group versus promoting the older person’s autonomy; (b) Being forced to lead care based on uncertainty instead of evidence; (c) Striving to provide dignified care but lacking opportunities; and (d) Going far beyond ordinary duty and endangering one’s own and the staff’s health.Discussion: The ethical challenges meant being torn between the person’s individual needs and protecting the group and society, with clashing ethical principles as a consequence.Conclusions: The leaders faced ethical situations resulting in undignified and compromised person-centred care, which has implications for stakeholders and management who need to address the work conditions in RCFs.
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- Karlsson, Anna-Karin, et al.
(författare)
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SustAinimal Grazing Living Lab–a survey of grazing management on dairy farms in northern Sweden
- 2024
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Ingår i: Acta Agriculturae Scandinavica - Section B. - : Taylor and Francis Ltd.. - 0906-4710 .- 1651-1913. ; 74:1, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- A survey was conducted on 302 Sweden dairy farms (response rate 98%) to identify grazing and grassland management strategies and main challenges to grazing in northern Sweden. The most common grazing strategy on all dairy farms was continuous grazing (59%) followed by rotational grazing (45%), while organic dairy farms preferentially adopted rotational grazing (69%). The main challenges reported in grazing dairy cows on temporary grasslands on conventional farms were trampling damage and seasonal variations in grass growth, while for organic dairy farmers, the primary challenge was weed control. Only a few farms had grazing on semi-natural grasslands. Future sustainable grazing should focus on optimising grazing strategy in relation to on-farm grazing locations and nutrient supply for high-yielding dairy cows.
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| 6. |
- Karlsson, Anna-Malin, 1969-
(författare)
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Skriften och samhället
- 2024. - 3
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Ingår i: Sociolingvistik. - Stockholm : Liber. - 9789147149377 ; , s. 227-237
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Karlsson, Anna, et al.
(författare)
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Regional forest green infrastructure planning and collaborative governance: A case study from southern Sweden
- 2024
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Ingår i: Environmental Science and Policy. - 1462-9011 .- 1873-6416. ; 160
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Tidskriftsartikel (refereegranskat)abstract
- Green Infrastructure (GI) is a strategically planned network delivering and enhancing diverse ecosystem services whilst preventing further biodiversity loss. Although not mandatory for EU members to implement GI, it is increasingly advocated as a tool for landscape planning. In 2016, the Swedish Government mandated the County Administrative Boards (CABs) to design regional GI plans using a collaborative process. This study explored the GI collaborative process in the region of Scania in southern Sweden, focusing on forest as an important component of Swedish landscapes. We interviewed 14 different stakeholders who participated in the process, and analysed the preconditions, inner workings and outcomes of collaborative GI planning. Despite remarkably different expectations, the perceived outcomes were consistent. Most stakeholders perceived the process as mainly informational rather than deliberative and, in general, use of the GI plan was limited. Despite successful finalisation of the plan, collaboration as a long-term process has not been achieved, which may limit the realisation of activities that foster GI. Scania's GI planning illustrates the defects of top-down approaches with insufficient resources, failing to address the stakeholders' trust and positioning. A lack of inclusivity and deliberation undermine the legitimacy of collaborative processes, discrediting the very concept of GI in Sweden. Our analysis indicates that a genuine collaborative process and a long-term commitment to implementing GI is unachievable without sustained and substantial governmental funding, capacity development at the lead agency, thorough consideration of prehistory, and targeted measures to increase trust among stakeholders.
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| 8. |
- Karlsson, Anna, 1985-, et al.
(författare)
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The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy – the TABANETOC trial: study protocol for a randomized clinical multicenter trial
- 2024
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Ingår i: Acta Oncologica. - Uppsala : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 580-585
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tinzaparin, a low-molecular weight heparin (LMWH), has shown anti-neoplastic properties in animal models and in in vitro studies of human cancer cell lines. The reduction of CA-125 levels during neoadjuvant chemotherapy (NACT) in patients with epithelial ovarian cancer (EOC) co-varies with the prognosis; the larger the decrease in CA-125, the better the prognosis.Purpose: This study aims to evaluate the potential anti-neoplastic effects of tinzaparin by investigating changes in serum CA-125 levels in advanced EOC patients who receive NACT.Material and methods: This is an open randomized multicenter pilot trial. Forty patients with EOC selected to receive NACT will be randomized 1:1 to receive daily addition of tinzaparin or no tinzaparin. The processing and treatment of the patients will otherwise follow the recommendations in the Swedish National Guidelines for Ovarian Cancer. Before every cycle of chemotherapy, preoperatively, and 3 weeks after the last cycle of chemotherapy, a panel of biomarkers, including CA-125, will be measured.Patients: Inclusion criteria are women aged 18 years or older, World Health Organization performance status 0–1, histologically confirmed high-grade serous, endometrioid or clear cell EOC, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV. In addition, a CA-125 level of ≥ 250 kIE/L at diagnosis. Exclusion criteria are contraindications to LMWH, ongoing or recent treatment with unfractionated heparin, LMWH, warfarin or non-vitamin K antagonist oral anticoagulants.Interpretation: This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC.
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| 9. |
- Karlsson, Anna, et al.
(författare)
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The effect of tinzaparin on biomarkers in FIGO stages III-IV ovarian cancer patients undergoing neoadjuvant chemotherapy - the TABANETOC trial: study protocol for a randomized clinical multicenter trial
- 2024
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Ingår i: ACTA ONCOLOGICA. - : Medical Journals Sweden. - 0284-186X .- 1651-226X. ; 63, s. 580-585
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tinzaparin, a low-molecular weight heparin (LMWH), has shown anti-neoplastic properties in animal models and in in vitro studies of human cancer cell lines. The reduction of CA-125 levels during neoadjuvant chemotherapy (NACT) in patients with epithelial ovarian cancer (EOC) co-varies with the prognosis; the larger the decrease in CA-125, the better the prognosis. Purpose: This study aims to evaluate the potential anti-neoplastic effects of tinzaparin by investigating changes in serum CA-125 levels in advanced EOC patients who receive NACT. Material and methods: This is an open randomized multicenter pilot trial. Forty patients with EOC selected to receive NACT will be randomized 1:1 to receive daily addition of tinzaparin or no tinzaparin. The processing and treatment of the patients will otherwise follow the recommendations in the Swedish National Guidelines for Ovarian Cancer. Before every cycle of chemotherapy, preoperatively, and 3 weeks after the last cycle of chemotherapy, a panel of biomarkers, including CA-125, will be measured. Patients: Inclusion criteria are women aged 18 years or older, World Health Organization performance status 0-1, histologically confirmed high-grade serous, endometrioid or clear cell EOC, International Federation of Gynecology and Obstetrics (FIGO) stages III-IV. In addition, a CA-125 level of >= 250 kIE/L at diagnosis. Exclusion criteria are contraindications to LMWH, ongoing or recent treatment with unfractionated heparin, LMWH, warfarin or non-vitamin K antagonist oral anticoagulants. Interpretation: This study will make an important contribution to the knowledge of the anti-neoplastic effects of tinzaparin in EOC patients and may thus guide the planning of a future study on the impact of tinzaparin on survival in EOC.
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| 10. |
- Rydenman, Karin, 1982, et al.
(författare)
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Antibiotic prescriptions to children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis
- 2024
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Ingår i: Acta Paediatrica, International Journal of Paediatrics. - 0803-5253 .- 1651-2227. ; 113:8, s. 1927-1933
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the rate of dispensed antibiotic prescriptions to children and adolescents with PFAPA and compare this with the rate for children in the general population. Furthermore, to compare dispensed antibiotic prescription rates before and after a diagnosis of PFAPA was established. Methods: Patients aged 0–17 years and diagnosed with PFAPA between 1 January 2006 to 31 October 2017 were included retrospectively. Data on dispensed drug prescriptions were obtained from the Swedish National Prescribed Drug Register. Results: The PFAPA cohort received more antibiotic prescriptions than the general population in all but one of the age groups and time periods that were analysed. The largest difference was seen in 2014–2017 in the youngest age group (0–4 years) when children with PFAPA received 1218 antibiotic prescriptions per 1000 person years compared to 345 in the general population (IRR 3.5; 95% CI 2.8–4.4). The yearly number of antibiotic prescriptions to PFAPA patients was reduced from 2.1 before diagnosis to 0.8 after diagnosis, a reduction of 62%. Conclusion: This study shows higher rates of dispensed antibiotic prescriptions for children with PFAPA than in the general population. The reduction of prescriptions after an established PFAPA diagnosis indicates that antibiotics were previously incorrectly prescribed for PFAPA episodes.
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