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- Olofsson, Erika, et al.
(författare)
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Association of depressive disorders and dementia with mortality among older people with hip fracture
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hip fracture (HF) is a significant cause of mortality among older people. Almost half of the patients with HF have dementia, which increases the mortality risk further. Cognitive impairment is associated with depressive disorders (DDs) and both dementia and DDs are independent risk factors for poor outcome after HF. However, most studies that evaluate mortality risk after HF separate these conditions.AIMS: To investigate whether dementia with depressive disorders (DDwD) affects the mortality risk at 12, 24, and 36 months after HF among older people.METHODS: Patients with acute HF (n = 404) were included in this retrospective analysis of two randomized controlled trials performed in orthopedic and geriatric departments. Depressive symptoms were assessed using the Geriatric Depression Scale and cognitive function was assessed using the Mini-Mental State Examination. A consultant geriatrician made final depressive disorder and dementia diagnoses using the Diagnostic and Statistical Manual of Mental Disorders criteria, with support from assessments and medical records. The 12-, 24- and 36-month mortality after HF was analyzed using logistic regression models adjusted for covariates.RESULTS: In analyses adjusted for age, sex, comorbidity, pre-fracture walking ability, and fracture type, patients with DDwD had increased mortality risks at 12 [odds ratio (OR) 4.67, 95% confidence interval (CI) 1.75-12.51], 24 (OR 3.61, 95% CI 1.71-7.60), and 36 (OR 4.53, 95% CI 2.24-9.14) months. Similar results were obtained for patients with dementia, but not depressive disorders, alone.CONCLUSION: DDwD is an important risk factor for increased mortality at 12, 24, and 36 months after HF among older people. Routinely assessments after HF for cognitive- and depressive disorders could identify patients at risk for increased mortality, and enable early interventions.TRIAL REGISTRATION: RCT2: International Standard Randomized Controlled Trial Number Register, trial registration number: ISRCTN15738119.
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| 3. |
- Bergh, Johan, et al.
(författare)
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Effekter av ett förändrat klimat på skogen och implikationer för skogsbruket : Bilaga B 19, Arbetsrapport 34
- 2007
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Ingår i: Sverige inför klimatförändringarna. - : Fritzes. ; , s. 1-71
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Bokkapitel (populärvet., debatt m.m.)abstract
- Att klimatet kan komma att förändras påverkar svenskt skogsbruk. Skogen har i sig en direkt inverkan på klimatet samtidigt som skogsbruket kan behöva anpassas till de nya förhållandena. Ett osäkert klimat sätter brukandet av skogen i ett nytt läge som vi inte har någon tidigare erfarenhet av. Scenarier för framtida klimatutveckling är behäftade med stor osäkerhet och de förväntade effekterna på skogen blir således ännu mer osäkra. Trots detta kan man ändå förutsäga några sannolika huvuddrag i effekterna på den svenska skogen vid ett framtida ändrat klimat. En ökad potential för biomassaproduktion kan förväntas, liksom ökade möjligheter att använda nya arter i skogsbruket. Samtidigt ökar sannolikt risken för vissa typer av skador.Att väga eventuella fördelar i form av ökad produktion och ökade möjligheter i trädslagsval mot ökade risker för skador är viktigt för att ge samhället ett helhetsperspektiv och för att en större grupp ska ha möjlighet att ta till sig frågan. Det är också viktigt att i största möjliga mån kvantifiera eller ge ramarna i ekonomiska termer för hur det förändrade klimatet kan tänkas påverka skogsbruket. Vidare kan det vara styrande för prioritering av fortsatta forskningsarbeten och riskbedömning och för att prioritera åtgärder. Därför har vi försökt utifrån befintlig kunskap idag, konstruera en Tabell över den ekonomiska betydelsen och forskningsbarheten för olika risk/ämnesområden (se Tabell 17 sidan 39). De kanske största effekterna av ett förändrat klimat på ekonomin inom skogsbruket skulle vara om vi lyckas utnyttja den ökade produktionspotentialen. Det förutsätter att vi kan bemästra de negativa effekterna i första hand av en ökad risk för vindfällning, skadeangrepp från insekter och svampar. Mot bakgrund av skogsbrukets stora betydelse som naturresurs och industriell bas, så finner vi att det är viktigt att vi står rustade inför en framtid med såväl ökade hot som nya möjligheter.I denna skrift försöker vi beskriva och analysera tänkbara effekter av ett förändrat klimat på skogen och bedömt deras implikationer för produktionsskogsbruket. Andra aspekter än produktionsaspekter på skogsbruket har inte behandlats. Analysen sker i fyra steg. Vi inleder med att, så långt nuvarande kunskapsläge tillåter, kvantifiera effekterna på den skogliga primärproduktionen – tillväxten i skogen. I ett andra steg omsätts dessa effekter till effekter på produktionsekonomin i ett bestånd. Därefter analyseras tänkbara effekter på risken för stormfällning i skogen. I ett sista steg breddas diskussionen till en något mera spekulativ bild av tänkbara effekter på skogsbrukets ekonomi.
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| 6. |
- Björk, Annette, et al.
(författare)
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A nurse-led lifestyle intervention for adult persons with attention-deficit/hyperactivity disorder (ADHD) in Sweden
- 2020
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis Group. - 0803-9488 .- 1502-4725. ; 74:8, s. 602-612
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Attention-deficit/hyperactivity disorder (ADHD) is associated with lifestyle-related diseases. Therefore, a nurse-led lifestyle intervention including interpersonal relationships, health education and cognitive support was developed to facilitate healthier lifestyle habits.Aim: The aim was to develop a lifestyle intervention and investigate its impact on mental and physical healthMethod: The 52-week intervention included 35 adults with ADHD. In a pre- and post-test design, symptoms of ADHD were measured with the Adult ADHD Self-Report Scale, quality of life was measured with the Adult ADHD Quality of Life scale and mental health was measured with the Hospital Anxiety and Depression scale. Lifestyle habits and dimensions of health were measured by the Lifestyle-Performance-Health Questionnaire and physical fitness was measured by the VO2 Max Test and calculations of waist circumference and body mass index. Result: Post-tests for a group of 25 persons showed positive changes following the intervention regarding weekly physical activity, quality of life and general and mental health. Lifestyle habit support was found to be important. The impact of the intervention should be confirmed in a long-term study with a control group.Conclusion: This intervention may be beneficial and may be implemented in a primary healthcare setting or in other open care units.
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- Blennow, Kristina, et al.
(författare)
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Climate change and the probability of wind damage in two Swedish forests
- 2010
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Ingår i: Forest Ecology and Management. - : Elsevier BV. - 0378-1127 .- 1872-7042. ; 259, s. 818-830
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Tidskriftsartikel (refereegranskat)abstract
- We simulated how possible changes in wind and ground-frost climate and state of the forest due to changes in the future climate may affect the probability of exceeding critical wind speeds expected to cause wind damage within one northern and one southern study area in Sweden, respectively. The topography of the study areas was relatively gentle and the forests were dominated by Norway spruce (Picea abies (L.) Karst.) and Scots pine (Pinus sylvestris L.). Using estimated changes in the net primary production (NPP) due to climate change and assuming a relative change in the site productivity equal to a relative change in NPP, we simulated possible future states of the forest under gradual adjustment of the site index in response to climate change using the model The Forest Time Machine. Global climate change scenarios based on two emission scenarios and one general circulation model were downscaled to the regional level. The modified WINDA model was used to calculate the sensitivity of the forest to wind and the probability of wind damage for individual forest stands for the periods 2011–2041 and 2071–2100 and for a control period 1961–1990. This was done while taking into account effects on stability of the forest from expected changes in the occurrence of ground frost. Increasing sensitivity of the forest to wind was indicated for both study areas when adhering to recommended management rules of today. Adding also a changed wind climate further increased the probability of wind damage. Calculated probabilities of wind damage were generally higher in the southern study area than in the northern one and were explained by differences in wind climate and the state of the forests, for example with respect to tree species composition. The indicated increase in sensitivity of the forest to wind under the current management regime, and possibly increasing windiness, motivate further analysis of the effects of different management options on the probability of wind damage and what modifications of Swedish forest management are possibly warranted.
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| 10. |
- Blennow, Kristina, et al.
(författare)
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Evaluating WINDA : a tool for assessing the probability of wind damage to forest stands
- 2003
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Ingår i: Proceedings of the International Conference Wind Effects on Trees. ; , s. 137-144
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- WINDA is an integrated system of models for calculating the stand-wise probability of wind damage of trees within a landscape (Blennow & Sallnäs, submitted). It integrates a modified version of the dose/response model HWIND (Peltola et al., 1999), the airflow model WASP (Mortensen et al., 1998), and a component for calculating the zero-plane displacement and surface roughness. WINDA uses a GIS for geographical computations. The calculations are made point-wise at exposed stand edges and the results are combined for each stand. The likelihood of damage is calculated using extreme value theory. The mechanistic modelling approach makes WINDA useful for evaluating effects on the probability of wind damage of silvicultural treatments and forestry activities as well as of a changed climate. This paper briefly outlines WINDA and evaluates output by comparing predicted damage with observed damage for two landscapes in southern Sweden.
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