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- Christensen, T., et al.
(författare)
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The Nordic governments' responses to the Covid-19 pandemic: A comparative study of variation in governance arrangements and regulatory instruments
- 2023
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Ingår i: Regulation & Governance. - : Wiley. - 1748-5983 .- 1748-5991. ; 17:3, s. 658-676
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Tidskriftsartikel (refereegranskat)abstract
- Government responses to the Covid-19 pandemic in the Nordic states-Denmark, Finland, Iceland, Norway, and Sweden-exhibit similarities and differences. This article investigates the extent to which crisis policymaking diverges from normal policymaking within the Nordic countries and whether variations between the countries are associated with the role of expertise and the level of politicization. Government responses are analyzed in terms of governance arrangements and regulatory instruments. Findings demonstrate some deviation from normal policymaking within and considerable variation between the Nordic countries, as Denmark, Finland, and to some extent Norway exhibit similar patterns with hierarchical command and control governance arrangements, while Iceland, in some instances, resembles the case of Sweden, which has made use of network-based governance. The article shows that the higher the influence of experts, the more likely it is that the governance arrangement will be network-based.
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- Ligthelm, R. J., et al.
(författare)
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Biphasic insulin aspart given thrice daily is as efficacious as a basal-bolus insulin regimen with four daily injections: A randomised open-label parallel group four months comparison in patients with type 2 diabetes
- 2006
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Ingår i: Experimental and Clinical Endocrinology & Diabetes. - : Georg Thieme Verlag KG. - 1439-3646 .- 0947-7349. ; 114:9, s. 511-519
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To show that a thrice daily meal-time biphasic insulin aspart (BIAsp) treatment regimen is as efficacious as a 4 times daily basal-bolus regimen with human isophane insulin (NPH) and insulin aspart (IAsp). Methods: A multinational, randomised, open-label parallel-group trial in 394 patients with type 2 diabetes on a once or twice daily insulin regimen. Patients were randomised 1:1 to BIAsp or IAsp+NPH for 16 weeks. The BIAsp group was treated according to individual needs using BMI as a surrogate index of insulin resistance. Subjects administered BIAsp 70 (BMI < 30 kg/m(2)) or BIAsp 50 (BMI > 30 kg/m(2)) with breakfast and lunch and BIAsp 30 with dinner. The IAsp + NPH group injected IAsp at meals and NPH at bedtime as basal insulin. HbA(lc) levels after 16 weeks were compared between treatments using a predefined non-inferiority criterion of 0.4%. The incidence of BIAsp was non-inferior to that obtained by the IAsp+NPH (intention to treat [ITT]) population: diff, HbA(lc)-0.05%; 95% CI (-0.24; 0.14); per protocol (PP) population: diff, HbA(lc)-0.03%; 95% CI (-0.23; 0.16). Similar improvements in glycaemic control in both groups were confirmed by self-measured 8-point plasma glucose (PG) profiles, average and fasting PG concentrations, and average prandial PG increments. The incidence of adverse events and hypoglycaemic episodes was similar in the two treatment groups. Conclusions: A thrice daily meal-time BIAsp regimen is a suitable alternative to an intensified insulin regimen in people with inadequately controlled type 2 diabetes mellitus, and requires fewer daily injections than a basal-bolus therapy without compromising efficacy and safety.
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- Lynggaard, Line Stensig, et al.
(författare)
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Asparaginase enzyme activity levels and toxicity in childhood acute lymphoblastic leukemia : a NOPHO ALL2008 study
- 2022
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Ingår i: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 6:1, s. 138-147
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Tidskriftsartikel (refereegranskat)abstract
- Asparaginase treatment is a mainstay in contemporary treatment of acute lymphoblastic leukemia (ALL), but substantial asparaginase-related toxicity may lead to jeopardized protocol compliance and compromises survival. We investigated the association between risk of asparaginase-associated toxicities (AspTox) and asparaginase enzyme activity (AEA) levels in 1155 children aged 1.0 to 17.9 years, diagnosed with ALL between July 2008 and March 2016, and treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol. Patients with >= 2 blood samples for AEA measurement drawn 14 +/- 2 days after asparaginase administration were included (6944 trough values). AEA was measurable (or >0 IU/L) in 955 patients, whereas 200 patients (17.3%) had asparaginase inactivation and few AspTox recorded. A time-dependent multiple Cox model of time to any first asparaginase-associated toxicity adjusted for sex and age was used. For patients with measurable AEA, we found a hazard ratio (HR) of 1.17 per 100 IU/L increase in median AEA (95% confidence interval [CI], 0.98-1.41; P = .09). For pancreatitis, thromboembolism, and osteonecrosis, the HRs were 1.40 (95% CI, 1.12-1.75; P = .002), 0.99 (95% CI, 0.70-1.40; P = .96), and 1.36 (95% CI, 1.04-1.77; P = .02) per 100 IU/L increase in median AEA, respectively. No significant decrease in the risk of leukemic relapse was found: HR 0.88 per 100 IU/L increase in AEA (95% CI, 0.66-1.16; P = .35). In conclusion, these results emphasize that overall AspTox and relapse are not associated with AEA levels, yet the risk of pancreatitis and osteonecrosis increases with increasing AEA levels.
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