| 1. |
- Conradi, Nils, 1950, et al.
(author)
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First-trimester diagnosis of juvenile neuronal ceroid lipofuscinosis by demonstration of fingerprint inclusions in chorionic villi.
- 1989
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In: Prenatal diagnosis. - 0197-3851. ; 9:4, s. 283-7
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Journal article (peer-reviewed)abstract
- One of the most common hereditary, progressive encephalopathies in children--juvenile neuronal ceroid lipofuscinosis (NCL)--lacks methods for carrier detection and prenatal diagnosis. A transcervical chorionic villus biopsy was performed at 9 completed weeks in a fetus at high risk of this disease. The syncytiotrophoblast of the chorionic villi contained fingerprint inclusions similar to those observed in various cells from children with this disease. Together with previous reports of second-trimester diagnosis in a case with late-infantile NCL (MacLeod et al., 1984, 1985), the presence of typical inclusions in placental tissue sampled at term in the infantile NCL (Rapola et al., 1987) and the lack of pathological alterations in one fetus at high risk of juvenile NCL and without clinical and morphological signs of disease at the age of 15 months (Kohlschutter et al., 1989), our findings strongly indicate that an early prenatal diagnosis of (juvenile) NCL is possible.
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| 2. |
- Engel, Jörgen, 1942, et al.
(author)
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Neonatal herpes simplex virus type 1 brain infection affects the development of sensorimotor gating in rats.
- 2000
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In: Brain research. - 0006-8993. ; 863:1-2, s. 233-40
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Journal article (peer-reviewed)abstract
- The effect of neonatal brain infection of herpes simplex virus type 1 (HSV-1) on the development of sensorimotor function in the rat was investigated using an acoustic startle paradigm. Intracerebral inoculation of HSV-1 at day 2 after birth, but not at day 4, caused a significant delay in the development of prepulse inhibition of acoustic startle. A decrease in prepulse inhibition was shown at 37, 46 and 58 days of age in these rats compared to control rats. No evidence was obtained for other behavioural dysfunctions such as differences in sensorimotor reactivity, sensorimotor response habituation, spontaneous locomotor activity, rearing activity or stereotyped behaviour. Prepulse inhibition of acoustic startle is an accepted model of sensorimotor gating in the CNS, a function which has been shown diminished in schizophrenic persons. The present results suggest that early viral infections during a neurone-susceptible period may contribute to the development of this deficit.
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| 3. |
- Eriksson, Erik, 1977, et al.
(author)
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Post-New Public Management in Public Healthcare: Recycled, Hybridized, Paradigmatic?
- 2019
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In: British Academy of Management (BAM) 2019 Conference. - : British Academy of Management.
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Conference paper (peer-reviewed)abstract
- New Public Management (NPM) is increasingly used pejoratively and claimed unfit for the complex challenges in contemporary societies, for example aging population structures and, as a result, increased number of cancer patients. Consequently, post-NPM gains increased attention. Drawing from a longitudinal case in Swedish cancer care, the present article seeks to pinpoint post-NPM in public healthcare practice. It is revealed that some post-NPM aspects are recycled by combining traditional public administration (pre-NPM) and NPM aspects: the former’s re-professionalisation is combined with the latter’s foci on performance measures, decentralisation, and accountability. Other post-NPM aspects are hybridizing typical NPM aspects with new (post-NPM) aspects: for instance, customer-focus is taken further to include the patient’s active participation in co-designing services, and standardization is reinterpreted to concern meeting-places rather than efficiency. Yet other aspects are replacing NPM shortcomings: for instance, trust is replacing control, and a systems approach is replacing the intra-organisational focus
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| 4. |
- Ghatnekar, Ola, et al.
(author)
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Direct hospital resource utilization and costs of treating patients with multiple myeloma in Southwest Sweden: a 5-year retrospective analysis.
- 2008
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In: Clinical Therapeutics. - : Elsevier BV. - 0149-2918. ; 30:9, s. 1704-1713
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Journal article (peer-reviewed)abstract
- BACKGROUND: Approximately 570 patients are diagnosed with multiple myeloma (MM) in Sweden each year. Few studies have estimated the cost of treatment for these patients. OBJECTIVE: The purpose of this study was to retrospectively investigate the direct hospital resource utilization and costs associated with the treatment of patients with MM in southwest Sweden. METHODS: Patients aged > or =18 years who initiated first-line chemotherapy in the year 2001 at hospitals in southwestern Sweden were included in this retrospective chart review. Direct hospital-based resources and their corresponding costs (year-2006 euros) for each patient were calculated until the patient's death, or until December 31, 2005. Costs for outpatient and terminal stage care related to MM were not included. RESULTS: Ninety-four patients were included; 20 were still alive at study completion. Mean age at diagnosis was 76 years and patients were followed for a mean of 32.7 months; 55% were males and 74% had at least 1 comorbidity. First-, second-, and third-line treatment lasted a mean of 24.3, 5.8, and 2.6 months, and included 2.8, 2.6, and 3.1 chemotherapy drugs per patient, respectively. Of the 80 patients who received first-line chemotherapy, 72 were prescribed melphalan and 55 patients received a combination of melphalan and prednisone, as recommended by Swedish treatment guidelines. The mean total cost per patient was euro88,199, or euro2770 per patient-month. Therapy-induced and comorbidity-related events constituted 42% of total costs, as much as autologous stem-cell transplantation and inpatient care together. Chemotherapy, bisphosphonate, and blood cell-enhancement drugs each amounted to only 2% of total costs, but chemotherapy drugs increased from euro29/month in first-line therapy to euro453/month in third-line therapy. CONCLUSIONS: The cost of treating Swedish patients with MM varied greatly between individuals but, overall, chemotherapy drugs constituted only a minor part of the total monthly cost (2%), whereas costs for inpatient stays and therapy-induced adverse events or comorbidity-related events accounted for 35% and42%, respectively. There was no significant differencein monthly cost between treatment lines.
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| 5. |
- Hellström, Andreas, 1972, et al.
(author)
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A Physician-Led, Learning-Driven Approach to Regional Development of 23 Cancer Pathways in Sweden
- 2014
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In: Organizing for Sustainable Effectiveness. - 2045-0613 .- 2045-0605. - 9781784410353 - 9781784410346 ; 4, s. 101-131
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Book chapter (other academic/artistic)abstract
- Purpose This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.Design/methodology/approach The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.Findings The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.Originality/value Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.
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| 6. |
- Hellström, Andreas, 1972, et al.
(author)
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Co-designing a social innovation to better support people affected by cancer: A user-driven integration of societal resources
- 2018
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In: XXII IRSPM Annual Conference 2018.
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Conference paper (peer-reviewed)abstract
- The House of Power opened on February 8th, 2018 – the first Swedish support centre for people affected by cancer. The centre is located in the city of Borås (a mid-size Swedish municipality) with a 300 square meters venue to provide emotional, social, and practical support for people affected by cancer. The House of Power is a social innovation project initiated, driven, and designed by people affected by cancer. It is the result of a collaboration between patients, relatives, local hospital, primary care, municipality, Social insurance agency, Employment agency, academia, local businesses, and civil society. All of these actors are often involved in people’s life event of getting a cancer diagnosis, but the resources are fragmented and badly fitted for the person affected by cancer. With the ambition to act as a platform for relevant resources, The House of Power builds on the logic of user-driven resource integration. This work has been nominated for the Swedish Design Award 2018 in the category sustainable development. In this paper, we describe the design process and highlight some key learnings for the open and distributed co-creation process of this social innovation.
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| 7. |
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| 8. |
- Sjöstrand, Johan, 1936, et al.
(author)
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Morphometric study of the displacement of retinal ganglion cells subserving cones within the human fovea
- 1999
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In: Graefes Archive for Clinical and Experimental Ophthalmology. - 0721-832X. ; 237:12, s. 1014-1023
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Journal article (peer-reviewed)abstract
- Background: A study was carried out to measure the displacement of retinal ganglion cells subserving the cones within the human fovea. Methods: Four human retinas were examined along the nasal or vertical hemi-meridians. Total displacement was estimated by adding the displacement due to fibres of Henle and bipolar cells, measured as the lateral extension of the Henle fibres and of the obliquely running fibre bundles within the inner nuclear layer, respectively. Results: At the foveal border (0.5-0.8 mm or 1.8-2.9 deg eccentricity) the mean offset due to fibres of Henle and mean total lateral displacement was at a maximum of 0.32+/-0.03 mm and 0.37+/-0.03 mm, respectively. A steep decrease of displacement was found outside the foveal border out to an eccentricity of 2.0-2.5 mm. We were able to plot displacement along the vertical meridian in relation to eccentricity with good correlation between three eyes. The data were used to establish different mathematical functions describing the relation between eccentricity and displacement. These functions were applied to previously presented data on densities of retinal ganglion cells and cones. Conclusions: The present estimates of displacement within the human central fovea offer the possibility of analysis of quantitative relations between cones and retinal ganglion cells. Our data provide predictive guidance by establishing that vitreo-retinal procedures causing damage to retinal ganglion cells up to 1 mm from the foveal centre could have implications for loss of information generated within the fovea.
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| 9. |
- Sjöstrand, Johan, 1936, et al.
(author)
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Quantitative estimations of foveal and extra-foveal retinal circuitry in humans
- 1999
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In: Vision Research. - 0042-6989. ; 39:18, s. 2987-2998
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Journal article (peer-reviewed)abstract
- For an understanding of the basis for psychophysical measurement of visual resolution, quantitative morphological studies of retinal neuronal architecture are needed. Here we report on cell densities and retinal ganglion cell:cone ratio (RGC:C) from the foveal border to the peripheral retina (34 degrees eccentricity). Quantitative estimates of RGC and C densities were made using a modified disector method in three vertically sectioned human retinae and were adjusted for RGC displacement. In agreement with our previous data on humans, we found an RGC:C ratio close to 3 at 2-3 degrees eccentricity. Outside the foveal border, the ratio declined to 1.0 at 7.5 degrees eccentricity and to 0.5 at eccentricities larger than 19 degrees. Center-to-center separation of C and RGC in addition to center-to-center separation of estimated 'receptive fields' was calculated at corresponding locations along the superior and inferior hemimeridians. The center-to-center separation of estimated 'receptive fields' was found to be more closely related to resolution thresholds from the fovea to 19 degrees eccentricity than was the separation of RGC and C. On the basis of these quantitative estimates, models for neural circuitry involved in central and peripheral spatial vision can be discussed. (C) 1999 Elsevier Science Ltd. All rights reserved.
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| 10. |
- Söderström, Ann, 1961, et al.
(author)
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Predictive factors and virological response to interferon treatment in children with chronic hepatitis B.
- 2005
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In: Scandinavian journal of infectious diseases. - : Informa UK Limited. - 0036-5548 .- 1651-1980. ; 37:1, s. 40-7
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Journal article (peer-reviewed)abstract
- Further knowledge about factors predicting response to interferon treatment for chronic hepatitis B in children is required, in particular as the benefits of therapy are uncertain. In the present study, baseline characteristics were related to virological and histological responses in 27 children given interferon-alpha for 24 weeks after steroid priming. HBe seroconversion was seen in 8 of 27 HBeAg positive patients and was accompanied by a sustained virological response (SR), with a median 4.1 log HBV DNA reduction. Pretreatment viraemia level was the only baseline parameter associated with SR. After 12 weeks of IFN (mid-treatment), viraemia was significantly reduced in all patients, with a median of 3.0 (range 0.6-5.2) log decline in SR compared with 0.6 (range -0.5-3.6) log decline in non-sustained responders (NSR). HBV DNA levels below 1 million copies/ml at week 12 predicted sustained response with a positive predictive value of 75% and a negative predictive value of 89%. During the latter half of the IFN treatment HBV DNA tended to increase by a mean of 0.4-0.5 log for all patient groups. Flares during IFN treatment were rare or mild as measured by ALT. Pretreatment anti-HBc IgM was associated with liver damage but not with response. Histological inflammation scores were improved in SR. Thus, pretreatment HBV DNA levels were associated with IFN response, and the virological response at week 12 predicts SR and may be useful in the decision to continue or modify therapy.
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