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| 2. |
- Marklinder, Ingela, 1959-, et al.
(författare)
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A Structural Equation Model Demonstrating the Relationship between Food Safety Background, Knowledge, Attitudes and Behaviour among Swedish Students
- 2022
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Ingår i: Foods. - : MDPI. - 2304-8158. ; 11:11
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Tidskriftsartikel (refereegranskat)abstract
- Traditionally, food safety knowledge has been seen as a factor in improving food safety behaviour. However, the relationship between knowledge and behavior is complex. The aim of the present study was to investigate self-reported data from 408 university students regarding food safety background, knowledge, attitudes, and behaviour using Structural Equation Model (SEM) to examine the influence of different factors on food safety behaviour. The SEM was applied to four factors derived from the data: Background, Knowledge, Attitude and Behaviour. The novelty of this current investigation is the inclusion of the Background factor (genus; experience of cooking and handling different food items; experience of a food safety education course; the foremost sources of food safety knowledge). The factors were constructed from variables with sufficient factor loadings and set up in a predetermined structure confirmed to be valid in previous studies. The results, demonstrated as regression coefficients between factors, confirm that the Background factor strongly influenced Knowledge (0.842). The Knowledge factor, in turn, strongly affected Attitude (0.605), while it did not directly affect Behaviour (0.301) in the same way as Attitude. Attitude had a stronger influence on Behaviour (0.438) than Knowledge. Thus, the Attitude factor seemed to play a mediating role between Knowledge and Behaviour. This indicates that students ' attitudes towards the importance of food safety may have an impact on their food safety behavior, which should have implications for the development of food safety education. This warrants further investigation and practical development.
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| 3. |
- Marklinder, Ingela, 1959-, et al.
(författare)
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Food safety knowledge, sources thereof and self-reported behaviour among university students in Sweden
- 2020
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Ingår i: Food Control. - : Elsevier. - 0956-7135 .- 1873-7129. ; 113
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Tidskriftsartikel (refereegranskat)abstract
- International studies have noted shortcomings in food safety knowledge and behaviour among university students. In general students do not constitute a pronounced risk group but there are wider implications. In a foreseeable future some of them will become pregnant and a majority will be responsible for vulnerable groups in their near environment. A crucial question exists, therefore, about their food safety knowledge and safe food handling practices.The aim of this study is to investigate food safety knowledge, sources thereof and self-reported food safety behavior among university students in Sweden.A quantitative study design using a web-based questionnaire was chosen as the data collection method. The questionnaire was distributed through social media and e-mail.Among the 606 respondents from 24 Swedish universities 80% were 18-30 years and 78% were women. The average number of correct answers on the knowledge questions was 7.61 out of 12 (63.4%). The foremost source of food safety knowledge was "Family and friends" (45%). Just 21.1% reported Food safety education as a source, although 35.6% had experience of a course in food hygiene/safety and/or microbiology. Respondents who reported "Family and friends" to be the foremost food safety source of knowledge also got a significantly lower rate of correct answers. Students who estimated their food safety knowledge to be good also had more correct answers. Experience of food safety education at secondary school/university/working place/polytechnic school significantly correlated with more correct answers on the knowledge questions and indicated a safer self-reported behaviour. Those with fewer correct answers also reported more unfavourable behaviours. The present study indicates that education promotes more optimal behaviors. The authors would suggest a more systematic food safety education at younger ages.
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| 4. |
- Järhult, Josef D., et al.
(författare)
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Environmental levels of the antiviral oseltamivir induce development of resistance mutation H274Y in influenza A/H1N1 virus in mallards
- 2011
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Ingår i: PLOS ONE. - San Francisco, CA : Public Library of Science (PLoS). - 1932-6203. ; 6:9
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Tidskriftsartikel (refereegranskat)abstract
- Oseltamivir (Tamiflu®) is the most widely used drug against influenza infections and is extensively stockpiled worldwide as part of pandemic preparedness plans. However, resistance is a growing problem and in 2008-2009, seasonal human influenza A/H1N1 virus strains in most parts of the world carried the mutation H274Y in the neuraminidase gene which causes resistance to the drug. The active metabolite of oseltamivir, oseltamivir carboxylate (OC), is poorly degraded in sewage treatment plants and surface water and has been detected in aquatic environments where the natural influenza reservoir, dabbling ducks, can be exposed to the substance. To assess if resistance can develop under these circumstances, we infected mallards with influenza A/H1N1 virus and exposed the birds to 80 ng/L, 1 µg/L and 80 µg/L of OC through their sole water source. By sequencing the neuraminidase gene from fecal samples, we found that H274Y occurred at 1 µg/L of OC and rapidly dominated the viral population at 80 µg/L. IC₅₀ for OC was increased from 2-4 nM in wild-type viruses to 400-700 nM in H274Y mutants as measured by a neuraminidase inhibition assay. This is consistent with the decrease in sensitivity to OC that has been noted among human clinical isolates carrying H274Y. Environmental OC levels have been measured to 58-293 ng/L during seasonal outbreaks and are expected to reach µg/L-levels during pandemics. Thus, resistance could be induced in influenza viruses circulating among wild ducks. As influenza viruses can cross species barriers, oseltamivir resistance could spread to human-adapted strains with pandemic potential disabling oseltamivir, a cornerstone in pandemic preparedness planning. We propose surveillance in wild birds as a measure to understand the resistance situation in nature and to monitor it over time. Strategies to lower environmental levels of OC include improved sewage treatment and, more importantly, a prudent use of antivirals.
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| 5. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Evaluation of skin reactions during proton beam radiotherapy – Patient-reported versus clinician-reported
- 2021
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Ingår i: Technical Innovations and Patient Support in Radiation Oncology. - : Elsevier Ireland Ltd. - 2405-6324. ; 19, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Skin reaction is a common side-effect of radiotherapy and often only assessed as clinician-reported outcome (CRO). The aim was to examine and compare patient-reported outcome (PRO) of skin reactions with CRO for signs of acute skin reactions for patients with primary brain tumour receiving proton beam radiotherapy (PBT). A further aim was to explore patients’ experiences of the skin reactions. Methods: Acute skin reactions were assessed one week after start of treatment, mid-treatment and end of treatment among 253 patients with primary brain tumour who underwent PBT. PRO skin reactions were assessed with the RSAS and CRO according to the RTOG scale. Fleiss’ kappa was performed to measure the inter-rater agreement of the assessments of skin reactions. Results: The results showed a discrepancy between PRO and CRO acute skin reactions. Radiation dose was associated with increased skin reactions, but no correlations were seen for age, gender, education, occupation, other treatment or smoking. There was a poor agreement between patients and clinicians (κ = −0.016) one week after the start of PBT, poor (κ = −0.045) to (κ = 0.396) moderate agreement at mid treatment and poor (κ = −0.010) to (κ = 0.296) moderate agreement at end of treatment. Generally, patients’ symptom distress toward skin reactions was low at all time points. Conclusion: The poor agreement between PRO and CRO shows that the patient needs to be involved in assessments of skin reactions for a more complete understanding of skin reactions due to PBT. This may also improve patient experience regarding involvement in their own care. © 2021 The Author(s)
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| 6. |
- Sjövall, K., et al.
(författare)
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Evaluating patient reported outcomes and experiences in a novel proton beam clinic : challenges, activities, and outcomes of the ProtonCare project
- 2023
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Ingår i: BMC Cancer. - : Springer Nature. - 1471-2407 .- 1471-2407. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ProtonCare Study Group (PCSG) was formed with the purpose to develop and implement a framework for evaluation of proton beam therapy (PBT) and the related care at a novel clinic (Skandionkliniken), based on patient reported data.METHOD: A logic model framework was used to describe the process of development and implementation of a structured plan for evaluation of PBT for all diagnoses based on patient reported data. After the mission for the project was determined, meetings with networks and stakeholders were facilitated by PCSG to identify assumptions, resources, challenges, activities, outputs, outcomes, and outcome indicators. RESULT: This paper presents the challenges and accomplishments PCSG made so far. We describe required resources, activities, and accomplished results. The long-term outcomes that were outlined as a result of the process are two; 1) Improved knowledge about health outcomes of patients that are considered for PBT and 2) The findings will serve as a base for clinical decisions when patients are referred for PBT. CONCLUSION: Using the logical model framework proved useful in planning and managing the ProtonCare project. As a result, the work of PCSG has so far resulted in long-lasting outcomes that creates a base for future evaluation of patients' perspective in radiotherapy treatment in general and in PBT especially. Our experiences can be useful for other research groups facing similar challenges. Continuing research on patients´ perspective is a central part in ongoing and future research. Collaboration, cooperation, and coordination between research groups/networks from different disciplines are a significant part of the work aiming to determine the more precise role of PBT in future treatment options.
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| 7. |
- Gillman, Anna, et al.
(författare)
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Oseltamivir-Resistant Influenza A (H1N1) Virus Strain with an H274Y Mutation in Neuraminidase Persists without Drug Pressure in Infected Mallards
- 2015
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Ingår i: Applied and Environmental Microbiology. - : American Society for Microbiology. - 0099-2240 .- 1098-5336. ; 81:7, s. 2378-2383
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Tidskriftsartikel (refereegranskat)abstract
- Influenza A virus (IAV) has its natural reservoir in wild waterfowl, and emerging human IAVs often contain gene segments from avian viruses. The active drug metabolite of oseltamivir (oseltamivir carboxylate [OC]), stockpiled as Tamiflu for influenza pandemic preparedness, is not removed by conventional sewage treatment and has been detected in river water. There, it may exert evolutionary pressure on avian IAV in waterfowl, resulting in the development of resistant viral variants. A resistant avian IAV can circulate among wild birds only if resistance does not restrict viral fitness and if the resistant virus can persist without continuous drug pressure. In this in vivo mallard (Anas platyrhynchos) study, we tested whether an OC-resistant avian IAV (H1N1) strain with an H274Y mutation in the neuraminidase (NA-H274Y) could retain resistance while drug pressure was gradually removed. Successively infected mallards were exposed to decreasing levels of OC, and fecal samples were analyzed for the neuraminidase sequence and phenotypic resistance. No reversion to wild-type virus was observed during the experiment, which included 17 days of viral transmission among 10 ducks exposed to OC concentrations below resistance induction levels. We conclude that resistance in avian IAV that is induced by exposure of the natural host to OC can persist in the absence of the drug. Thus, there is a risk that human-pathogenic IAVs that evolve from IAVs circulating among wild birds may contain resistance mutations. An oseltamivir-resistant pandemic IAV would pose a substantial public health threat. Therefore, our observations underscore the need for prudent oseltamivir use, upgraded sewage treatment, and surveillance for resistant IAVs in wild birds.
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| 8. |
- Isehed, Catrine, et al.
(författare)
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Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri-implantitis : A randomized controlled trial
- 2016
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Ingår i: Journal of Clinical Periodontology. - Hoboken, USA : Wiley-Blackwell Publishing Inc.. - 0303-6979 .- 1600-051X. ; 43:10, s. 863-873
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This randomized clinical trial aimed at comparing radiological, clinical and microbial effects of surgical treatment of peri-implantitis alone or in combination with enamel matrix derivative (EMD).Methods: Twenty-six subjects were treated with open flap debridement and decontamination of the implant surfaces with gauze and saline preceding adjunctive EMD or no EMD. Bone level (BL) change was primary outcome and secondary outcomes were changes in pocket depth (PD), plaque, pus, bleeding and the microbiota of the peri-implant biofilm analyzed by the Human Oral Microbe Identification Microarray over a time period of 12 months.Results: In multivariate modelling, increased marginal BL at implant site was significantly associated with EMD, the number of osseous walls in the peri-implant bone defect and a Gram+/aerobic microbial flora, whereas reduced BL was associated with a Gram-/anaerobic microbial flora and presence of bleeding and pus, with a cross-validated predictive capacity (Q(2) ) of 36.4%. Similar, but statistically non-significant, trends were seen for BL, PD, plaque, pus and bleeding in univariate analysis.Conclusion: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.
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| 9. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Development and initial psychometric evaluation of a radiotherapy-related symptom assessment tool, based on data from patients with brain tumours undergoing proton beam therapy
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:3, s. 796-804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently, no available tool easily and effectively measures both the frequency, intensity and distress of symptoms among patients receiving radiotherapy. A core symptom set (fatigue, insomnia, pain, appetite loss, cognitive problems, anxiety, nausea, depression, constipation, diarrhoea and skin reaction) has been identified and assessed across oncology research to better understand the pattern of symptoms and treatment side effects.Aim: The aim was to develop a tool measuring the multiple‐symptom experience in patients undergoing radiotherapy and evaluate its psychometric properties (validity, reliability and responsiveness).Design: This study has a prospective, longitudinal and quantitative design.Methods: We developed a patient‐reported outcome questionnaire, the Radiotherapy‐Related Symptoms Assessment Scale to assess the frequency, intensity and distress associated with symptoms. Patients (n = 175) with brain tumours undergoing proton beam therapy completed the Radiotherapy‐Related Symptoms Assessment Scale and the health‐related quality of life questionnaire (EORTC QLQ‐C30) during treatment. We assessed the validity, reliability and responsiveness of the Radiotherapy‐Related Symptoms Assessment Scale and evaluated the validity against QLQ‐C30.Results: There were significant questionnaire–questionnaire correlations regarding selected items, primarily fatigue, insomnia and pain, indicating satisfactory criterion‐related validity. The Radiotherapy‐Related Symptoms Assessment Scale had fair to good retest reliability.Conclusion: The Radiotherapy‐Related Symptoms Assessment Scale is a valid instrument for assessing symptom intensity and distress in patients with brain tumour undergoing PBT, with psychometric properties within the expected range. The Radiotherapy‐Related Symptoms Assessment Scale provides nurses with substantial information on symptom experience but requires little effort from the patient. Additional studies are required to further assess the psychometric properties in patients with different cancer diagnoses receiving conventional radiotherapy.
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| 10. |
- Sofrata, Abier H, et al.
(författare)
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Strong antibacterial effect of miswak against oral microorganisms associated with periodontitis and caries.
- 2008
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Ingår i: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 79:8, s. 1474-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The chewing stick (miswak) is used for oral hygiene in many parts of the world. In addition to the mechanical removal of plaque, an antibacterial effect has been postulated; however, tests of miswak extract from Salvadora persica (Arak) disclosed only low to moderate antibacterial effects. This may be attributable to the extraction process. Our aim was to test in vitro the antibacterial effect of miswak pieces, without extraction, on bacteria implicated in the etiology of periodontitis and caries. METHODS: Miswak pieces were standardized by size and weight (0.07 and 0.14 g) and tested against Streptococcus mutans, Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and, as a reference, Haemophilus influenzae. The miswak pieces were tested in two ways: embedded in the agar plate or suspended above the agar plate. RESULTS: The inhibitory effect was most pronounced on P. gingivalis, A. actinomycetemcomitans, and H. influenzae, less on S. mutans, and least on L. acidophilus. Suspended miswak had comparable or stronger effects than miswak embedded in agar. The 0.14-g suspended miswak exhibited significantly greater inhibition on A. actinomycetemcomitans and H. influenzae than the 0.14-g miswak embedded in agar (P<0.01 and P<0.001, respectively). CONCLUSIONS: Miswak embedded in agar or suspended above the agar plate had strong antibacterial effects against all bacteria tested. The antibacterial effect of suspended miswak pieces suggests the presence of volatile active antibacterial compounds.
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