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- Broberg, Anders G, 1950, et al.
(author)
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Stöd till barn som bevittnat våld mot mamma - Resultat från en nationell utvärdering
- 2011
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Reports (other academic/artistic)abstract
- Barn som bevittnar våld mot en förälder som de är beroende av för sitt välbefinnande utsätts för en form av våld. Barn behöver – i synnerhet under den tidiga barndomen – föräldrar som prioriterar barnets behov framför sina egna. När barnets ena förälder – eller någon annan som bor med familjen – slår eller förgriper sig på den andra föräldern blir barnet känslomässigt övergivet och skyddslöst. Barn kan bevittna våld mot en primär omsorgsgivare under kortare eller längre peri-oder i sitt liv, men ofta innebär det ett liv begränsat av olika typer av makt, övergrepp och förtryck. Sådana upplevelser medför en ökad risk för att barnet utvecklar problem såsom posttraumatisk stress, depression, beteendeproblem och problem med sociala relationer – både inom familjen och med kamrater. Sedan 2007 är socialtjänstens ansvar, för att barn som bevittnat våld får det stöd och den hjälp de behöver, förtydligat i Socialtjänstlagen. Det viktigaste stödet för barn som bevittnat våld mot sin mamma är skydd från fortsatt utsatthet. Internationellt sett är den vanligaste formen av stöd till barn, utöver sådant skydd, samtal i grupp. Det finns dock stora skillnader mellan vilka mål programmen är tänkta att uppnå, vilket medför att utvärderingsstudier använder varierande mått för att bedöma vad som är ett ”lyckat utfall”. Detta försvårar i sin tur jämförelser av utvärde-ringar av dessa program. I Sverige är den vanligaste typen av insats fortfarande indivi-duella samtal, även om gruppverksamheter för barn har blivit vanligare de senaste 10 åren. Kunskapen om effekterna av de metoder som utvecklats inom och utom social-tjänsten för att stödja barn som bevittnat våld mot mamma är fortfarande begränsad internationellt och i Sverige är den i stort sett obefintlig. Göteborgs universitet fick 2008 i uppdrag av Socialstyrelsen att utvärdera effekten av insatser riktade till barn som bevittnat våld mot sin mamma. Syftet med utvärderingen var att studera förändringar i barns hälsa och välbefinnande efter stödinsatser, med ut-gångspunkt i mammors och barns beskrivningar.
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| 4. |
- Holme, I., et al.
(author)
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Lipoprotein predictors of cardiovascular events in statin-treated patients with coronary heart disease. Insights from the Incremental Decrease in End-points through Aggressive Lipid-lowering Trial (IDEAL)
- 2008
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In: Annals of Medicine. - : Informa UK Limited. - 0785-3890 .- 1365-2060. ; 40:6, s. 456-464
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Journal article (peer-reviewed)abstract
- Background. Few studies have looked into the ability of measurements of apolipoprotein B (apoB) and apolipoprotein A-1 (apoA-1) or apoB/apoA-1 to predict new coronary heart disease (CHD) events in patients with CHD on statin treatment. Aims. In the IDEAL trial, to compare lipoprotein components to predict CHD events and to what degree differences in those parameters could explain the observed outcome. Methods. We compared the ability of treatment with atorvastatin 80 mg/day to that of simvastatin 20-40 mg/day to prevent CHD events in patients with CHD and used Cox regression models to study the relationships between on-treatment levels of lipoprotein components to subsequent major coronary events (MCE). Findings. Variables related to low-density lipoprotein cholesterol (LDL-C) carried more predictive information than those related to high-density lipoprotein cholesterol (HDL-C), but LDL-C was less predictive than both non-HDL-C and apoB. The ratio of apoB to apoA-1 was most strongly related to MCE. However, for estimating differences in relative risk reduction between the treatment groups, apoB and non-HDL-C were the strongest predictors. Interpretation. The on-treatment level of apoB/apoA-1 was the strongest predictor of MCE in the pooled patient population, whereas apoB and non-HDL-C were best able to explain the difference in outcome between treatment groups. Measurements of apoB and apoA-1 should be more widely available for routine clinical assessments. © 2008 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).
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| 5. |
- Kirchhof, Paulus, et al.
(author)
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Comprehensive risk reduction in patients with atrial fibrillation : emerging diagnostic and therapeutic options - a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference
- 2012
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In: Europace. - : Oxford University Press (OUP). - 1099-5129 .- 1532-2092. ; 14:1, s. 8-27
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Research review (peer-reviewed)abstract
- While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper covers four chapters: (i) risk factors and risk markers for AF; (ii) pathophysiological classification of AF; (iii) relevance of monitored AF duration for AF-related outcomes; and (iv) perspectives and needs for implementing better antithrombotic therapy. Relevant published literature for each section is covered, and suggestions for the improvement of management in each area are put forward. Combined, the propositions formulate a perspective to implement comprehensive management in AF.
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| 7. |
- Olausson, E, et al.
(author)
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Diffuse myocardial fibrosis associates with incident ventricular arrhythmia in implantable cardioverter defibrillator recipients
- 2023
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In: medRxiv : the preprint server for health sciences. - : Cold Spring Harbor Laboratory.
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Journal article (other academic/artistic)abstract
- BackgroundDiffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a vulnerable phenotype and associate with life threatening ventricular arrhythmias more than focal myocardial fibrosis. This principle remains important because 1) risk stratification for implantable cardioverter defibrillators (ICD) remains challenging, and 2) DMF may respond to current or emerging medical therapies (reversible substrate).ObjectivesTo evaluate the association between quantified by ECV in myocardium without focal fibrosis by late gadolinium enhancement (LGE) with time from ICD implantation to 1) appropriate shock, or 2) shock or anti-tachycardia pacing.MethodsAmong patients referred for cardiovascular magnetic resonance (CMR) without congenital disease, hypertrophic cardiomyopathy, or amyloidosis who received ICDs (n=215), we used Cox regression to associate ECV with incident ICD therapy.ResultsAfter a median of 2.9 (IQR 1.5-4.2) years, 25 surviving patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV ranged from 20.2% to 39.4%. No patient with ECV<25% experienced an ICD shock. ECV associated with both endpoints, e.g., hazard ratio 2.17 (95%CI 1.17-4.00) for every 5% increase in ECV, p=0.014 in a stepwise model for ICD shock adjusting for ICD indication, age, smoking, atrial fibrillation, and myocardial infarction, whereas focal fibrosis by LGE and global longitudinal strain (GLS) did not.ConclusionsDMF measured by ECV associates with ventricular arrhythmias requiring ICD therapy in a dose-response fashion, even adjusting for potential confounding variables, focal fibrosis by LGE, and GLS. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.Condensed AbstractAnalogous to heart failure and mortality outcomes, diffuse myocardial fibrosis (DMF) quantified by extracellular volume (ECV) may represent a more vulnerable phenotype for life-threatening ventricular arrhythmia than focal myocardial fibrosis. In patients referred for cardiovascular magnetic resonance, we identified 215 subsequently receiving implantable cardioverter defibrillators (ICD). After a median of 2.9 (IQR 1.5-4.2) years, 25 patients experienced ICD shock and 44 experienced shock or anti-tachycardia pacing. ECV associated with ICD therapy in Cox regression models. Focal fibrosis variables or global longitudinal strain did not. ECV-based risk stratification and DMF representing a therapeutic target to prevent ventricular arrhythmia warrant further investigation.
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