| 1. |
- Boysen, Gerhard, et al.
(författare)
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Fransk grammatik
- 1996
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Brännström, Jon, et al.
(författare)
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Gender disparities in the pharmacological treatment of cardiovascular disease and diabetes mellitus in the very old : an epidemiological, cross-sectional survey
- 2011
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Ingår i: Drugs & Aging. - : Springer Science and Business Media LLC. - 1170-229X .- 1179-1969. ; 28:12, s. 993-1005
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There are many reports of disparities in health and medical care both between women and men and between various age groups. In most cases, men receive better treatment than women and young and middle-aged people are privileged compared with the old and the very old. Cardiovascular morbidity and diabetes mellitus are common, increase with age and are often treated extensively with drugs, many of which are known to have significant adverse effects.OBJECTIVE: The aim of the study was to analyse gender differences in the pharmacological treatment of cardiovascular disease and diabetes among very old people.METHODS: The study took the form of an epidemiological, cross-sectional survey. A structured interview was administered during one or more home visits, and data were further retrieved from medical charts and interviews with relatives, healthcare staff and other carers. Home-dwelling people as well as people living in institutional care in six municipalities in the county of Västerbotten, Sweden, in 2005-7 were included in the study. Half of all people aged 85 years, all of those aged 90 years and all of those aged ≥95 years living in the selected municipalities were selected for inclusion in the study. In total, 467 people were included in the present analysis. The main study outcome measures were medical diagnoses and drug use.RESULTS: In total, women were prescribed a larger number of drugs than men (mean 7.2 vs 5.4, p < 0.001). Multiple logistic regression models adjusted for age and other background variables as well as relevant medical diagnoses (hypertension, heart failure) showed strong associations between female sex and prescriptions of thiazide diuretics (odds ratio [OR] 4.4; 95% CI 1.8, 10.8; p = 0.001), potassium-sparing diuretics (OR 3.5; 95% CI 1.4, 8.7; p = 0.006) and diuretics as a whole (OR 1.8; 95% CI 1.1, 2.9; p = 0.021). A similar model, adjusted for angina pectoris, showed that female sex was associated with prescription of short-acting nitroglycerin (OR 3.7; 95% CI 1.6, 8.9; p = 0.003). However, more men had been offered coronary artery surgery (p = 0.001). Of the participants diagnosed with diabetes, 55% of the women and 85% of the men used oral antihyperglycaemic drugs (p = 0.020), whereas no gender difference was seen in prescriptions of insulin.CONCLUSIONS: Significant gender disparities in the prescription of several drugs, such as diuretics, nitroglycerin and oral antihyperglycaemic drugs, were observed in this study of very old people. In most cases, women were prescribed more drugs than men. Men more often had undergone coronary artery surgery. These disparities could only in part be explained by differences in diagnoses and symptoms.
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| 3. |
- Granklint Enochson, Pernilla, 1965-
(författare)
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Om organsystemens organisation och funktion : analys av elevsvar från Sverige och Sydafrika
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna avhandling är att studera svenska och sydafrikanska elevers föreställningar om kroppens byggnad och funktion, samt hur dessa föreställningar påverkar närliggande frågeställningar. Datainsamling har skett genom att flera olika typer av enkäter samt intervjuer använts. Samtliga elever som deltog gick i årskurs nio. Det var 88 elever i den svenska och 166 i den Sydafrikanska datainsamlingen.Resultaten visar att elever har en god förmåga att beskriva matspjälkningssystemet då de beskriver en smörgås väg genom kroppen, och de visar även god förmåga att koppla samman blodsystemet till matspjälkningsorganen för detta scenario. Däremot har eleverna svårigheter att överföra denna kunskap till ett nytt sammanhang då de skulle beskriva en värktabletts väg genom kroppen. Eleverna hade inte fått undervisning om värktablettens väg genom kroppen, så detta var ett nytt sammanhang för dem. Det visade sig vara än svårare för eleverna att koppla samman ytterligare ett organsystem, det vill säga urinorganen, när de skulle beskriva vattnets väg genom kroppen. Trots att urinorganen finns beskrivna i läroboken och eleverna hade fått undervisning om dessa. Det fanns också elever som visade icke vetenskapligt vedertagna modeller och beskrev vattnets väg genom kroppen genom att rita ett rör direkt från halsen till njuren. Dessa elever kunde inte beskriva njuren främsta funktion som är att rena blodet. En liknande studie genomfördes i fem Sydafrikanska skolor och det visade sig att den i Sverige, och i andra europeiska studier, vanliga icke vetenskapliga förklaringen med en direktkoppling mellan matspjälkningsorganen och njurarna var mycket ovanlig bland dessa elever. Nästan hälften av de sydafrikanska eleverna visade istället en föreställning om att vattnet passerar lungorna på sin väg till magsäcken. Det fanns även mindre mängd elever som även ansåg att maten skulle passera lungorna innan magsäcken. När det gäller vattenfrågan har en djupare analys gjorts på 5 av de svenska elevernas enkät- och intervjusvar. Det visade sig att elevernas föreställningar antingen var desamma eller förändrades till en mindre sofistikerad förklaringsmodell mellan enkät och intervjusvar då det gällde vattnets väg genom kroppen, detta skiljer sig från frågeställningen med smörgåsen där intervjun visade på liknande eller bättre resultat.
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| 4. |
- Granklint Enochson, Pernilla
(författare)
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Om organsystemens organisation och funktion– analys av elevsvar från Sverige och Sydafrika : analys av elevsvar från Sverige och Sydafrika
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna avhandling är att studera svenska och sydafrikanska elevers föreställningar om kroppens byggnad och funktion, samt hur dessa föreställningar påverkar närliggande frågeställningar. Datainsamling har skett genom att flera olika typer av enkäter samt intervjuer använts. Samtliga elever som deltog gick i årskurs nio. Det var 88 elever i den svenska och 166 i den Sydafrikanska datainsamlingen. Resultaten visar att elever har en god förmåga att beskriva matspjälkningssystemet då de beskriver en smörgås väg genom kroppen, och de visar även god förmåga att koppla samman blodsystemet till matspjälkningsorganen för detta scenario. Däremot har eleverna svårigheter att överföra denna kunskap till ett nytt sammanhang då de skulle beskriva en värktabletts väg genom kroppen. Eleverna hade inte fått undervisning om värktablettens väg genom kroppen, så detta var ett nytt sammanhang för dem. Det visade sig vara än svårare för eleverna att koppla samman ytterligare ett organsystem, det vill säga urinorganen, när de skulle beskriva vattnets väg genom kroppen. Trots att urinorganen finns beskrivna i läroboken och eleverna hade fått undervisning om dessa. Det fanns också elever som visade icke vetenskapligt vedertagna modeller och beskrev vattnets väg genom kroppen genom att rita ett rör direkt från halsen till njuren. Dessa elever kunde inte beskriva njuren främsta funktion som är att rena blodet. En liknande studie genomfördes i fem Sydafrikanska skolor och det visade sig att den i Sverige, och i andra europeiska studier, vanliga icke vetenskapliga förklaringen med en direktkoppling mellan matspjälkningsorganen och njurarna var mycket ovanlig bland dessa elever. Nästan hälften av de sydafrikanska eleverna visade istället en föreställning om att vattnet passerar lungorna på sin väg till magsäcken. Det fanns även mindre mängd elever som även ansåg att maten skulle passera lungorna innan magsäcken. När det gäller vattenfrågan har en djupare analys gjorts på 5 av de svenska elevernas enkät- och intervjusvar. Det visade sig att elevernas föreställningar antingen var desamma eller förändrades till en mindre sofistikerad förklaringsmodell mellan enkät och intervjusvar då det gällde vattnets väg genom kroppen, detta skiljer sig från frågeställningen med smörgåsen där intervjun visade på liknande eller bättre resultat.
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| 5. |
- Hornsten, Carl, et al.
(författare)
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The prevalence of stroke and the association between stroke and depression among a very old population
- 2012
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 55:3, s. 555-559
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Tidskriftsartikel (refereegranskat)abstract
- There are few studies comparing those who have had and have not had a stroke among those aged 80 years and over, the very old. The aim of this paper was to investigate the prevalence of stroke and the association between stroke and depression in a very old population. This paper is based on cross-sectional data from a population-based study performed between 2005 and 2007. Half of those aged 85 years, all 90-, and 95-year-olds and older in eight urban and rural municipalities in northern Sweden and Finland were invited to participate. A sample of 601 individuals who participated fully in the study was selected. Data were collected through assessments, structured interviews and investigation of medical charts. A specialist in geriatric medicine determined disease status for depression based on medical records and results from the Geriatric Depression Scale (GDS)-15, the Montgomery A Asberg Depression Rating Scale (MADRS) and the Organic Brain Syndrome (OBS) scale, and for stroke based on medical records and reported disease. The prevalence of stroke was 21.5%. The prevalence of depression was 50.4% among those with stroke compared to 34.3% among those without stroke (OR 1.944, p < 0.001). In a logistic regression model adjusted for several demographic variables, diseases and functional level, stroke was independently associated with depression (OR 1.644, p = 0.038). A large proportion of those with depression, both with and without stroke, were not receiving antidepressant medication. In conclusion, the stroke prevalence was high and stroke showed a strong association with depression among very old people. (c) 2012 Elsevier Ireland Ltd. All rights reserved.
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| 6. |
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| 7. |
- Molander, Lena, 1983-, et al.
(författare)
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Blood pressure change and antihypertensive treatment in old and very old people : evidence of age, sex and cohort effects
- 2013
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Ingår i: Journal of Human Hypertension. - : Nature Publishing Group. - 0950-9240 .- 1476-5527. ; 27:3, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- The epidemiology of blood pressure in very old age has not been thoroughly studied. The objective of this study was to study blood pressure changes throughout old age and changes in blood pressure and antihypertensive drug use from 1981 to 2005. The study includes 1133 blood pressure measurements from two studies carried out in Umea, Sweden. The U70 study (1981-1990) included individuals aged 70-88 and the Umea 85+/GERDA study (2000-2005) covered people aged 85, 90 or >= 95 years. The impact of age, sex and year of investigation on blood pressure was investigated using linear regression. Mean diastolic blood pressure (DBP) decreased by 0.35mmHg (P<0.001) for each year of age. An inverted U-shaped relation was found between age and systolic blood pressure (SBP), with SBP reaching its maximum at 74.5 years. Mean SBP and DBP also decreased over time (SBP by 0.44mmHg per year, P<0.001 and DBP by 0.34mmHg per year, P<0.001). The proportion of participants on antihypertensive drugs increased from 39.0% in 1981 to 69.4% in 2005. In this study of people aged >= 70 years, mean SBP and DBP decreased with higher age and later investigation year. Antihypertensive drug use increased with time, which might partly explain the observed cohort effect.
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| 8. |
- Molander, Lena, 1983-
(författare)
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Blood pressure in advanced age : with focus on epidemiology, cognitive impairment and mortality
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general conception is that blood pressure increases with age, but that diastolic blood pressure (DBP) starts decreasing in the elderly. There are, however, indications that systolic blood pressure (SBP) might also decline in advanced age, but further studies are needed to establish whether this is true. Midlife hypertension is an acknowledged risk factor for mortality and dementia. Some research has, however, suggested more complicated associations between blood pressure and these outcomes in old age, as low blood pressure has been linked to both increased mortality and increased risk of dementia. Research on this subject, especially in very old people (≥85 years of age), is still limited. The purpose of the present thesis was to investigate blood pressure epidemiology in old age and associations between blood pressure and mortality and cognition in very old people. Subjects were mainly derived from the Umeå 85+/GERDA (GErontological Regional DAtabase) study, a study on individuals aged 85 years, 90 years or ≥95 years carried out in northern Sweden and Finland in 2000-2007. For analysis of blood pressure change with age, data from this study were combined with data from the U70 study that was carried out in the city of Umeå, Sweden between 1981-1990 and included individuals aged 70-88 years. Investigations were performed during a home visit in the Umeå 85+/GERDA study and at a geriatric centre in the U70 study. SBP and DBP were measured in the supine position in both studies and pulse pressure (PP) was calculated as SBP-DBP. Main outcome variables were 4-year mortality, Mini-Mental State Examination (MMSE) scores, dementia and blood pressure change with age and over the years. Treatment with antihypertensive drugs was also considered. Blood pressure changes with age and time were investigated using 1133 blood pressure measurements from 705 individuals aged ≥70 years performed between 1981 and 2005. DBP continually decreased with increasing age, whereas SBP and PP increased up to age 74.5 and 80.6 years, respectively, to then start decreasing. Mean SBP and DBP also decreased over the years. The prevalence of treatment with antihypertensive drugs increased during the same period and is probably one explanation for the decrease in blood pressure with time. Blood pressure also decreased in longitudinal analyses of those individuals who participated in more than one data collection. Women had higher SBP and PP than men. The association between blood pressure and 4-year mortality was investigated in a sample of 348 individuals aged ≥85 years. Results indicated a non-linear association between SBP and mortality, i.e. both lower and higher SBP were associated with increased mortality. The lowest mortality risk was associated with an SBP of 164 mmHg (95% confidence interval 154-184 mmHg). The analyses were adjusted for a number of diseases and health factors and thus suggest a negative effect of low SBP on survival, independent of health status. There was no association between DBP or PP and 4-year mortality. The impact of blood pressure on MMSE scores and dementia was investigated both in a cross-section of 575 individuals and longitudinally in two samples including 102 and 205 individuals, respectively, all ≥85 years old. Cross-sectional analysis demonstrated nonlinear associations between SBP and PP and MMSE scores, indicating poorer cognitive function with both low and high blood pressure. The association between DBP and MMSE scores was linear, higher DBP being associated with higher scores. Individuals with dementia had lower blood pressure than those without dementia. Longitudinally, over five years, no association between baseline blood pressure and incident dementia or change in MMSE scores could be demonstrated. Mean blood pressure declined over this time period, and this decline was greater in individuals who developed dementia than in those who remained dementia free. A greater decline in blood pressure was associated with a greater decline in MMSE scores. In conclusion, this study has shown a decrease in both SBP and DBP in advanced age and also that low blood pressure is associated with both increased mortality and poor cognitive function in very old people. These associations might not be fully explained by underlying disease or poor health status; the underlying mechanisms are so far mostly speculative. Very high blood pressure might also remain a risk factor for the mentioned outcomes even in very old age, at least in some people. No association between baseline blood pressure and cognitive decline or incident dementia could be demonstrated, but blood pressure decline was associated with cognitive decline and incident dementia. The direction of this association remains to be determined. Blood pressure also decreased over the years from 1981 to 2005, probably partly due to an increasing prevalence of treatment with antihypertensive drugs.
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| 9. |
- Molander, Lena, 1967-
(författare)
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Les fonctions de l'alternance codique dans les salles d'immersion française au Québec
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present study focusses on the code-switching by teachers and students to English - the L1 of the majority of the students - in six French immersion (L2) classrooms in Quebec, Canada. It is argued that code-switching is a dynamic notion which is given its status as such in interaction: different teachers have different ideas about what constitutes an L1 element in L2 interaction. It is also the various teachers who by their own code-switching and by their choice of feedback after a student code-switch, determine whether code-switching is an acceptable or an unacceptable verbal behaviour in immersion classroom interaction. Using audio-recorded L2 interactions in six immersion classrooms taken from two educational programmes, and applying methods from the fields of conversation analysis, interactional (interpretative) analysis and pragmatic linguistics, the study examines the functions of teachers’ and students’ code-switches. This examination is made in accordance with the type of classroom activity and the type of discourse (didactic and non didactic) during which these code-switches are found and also, in accordance with what kind of teacher or student feedback it receives in these contexts. On an interactional level, the study investigates the production and the interpretation of code-switches in form and meaning focussed sequences. It is demonstrated that these types of sequences -frequent in second language classrooms - contain teacher and student code-switches that are used in both general and more individual functions. These discourse functions are linked to three main uses of code-switching in the French immersion classroom : code-switching for pedagogical/didactic purposes (teachers), for learning related purposes (students) and for communicative (pragmatic) purposes (both teachers and students). It is suggested that code-switching is used for all these three purposes in various degrees in the majority of the classrooms. It is also suggested that the teachers can make use of a code-switch in a certain function - and treat a code-switch by a student in a certain function - in very different ways, not only from one classroom to another but also within the same classroom depending on the circumstances in which the code-switching takes place.
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| 10. |
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