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| 2. |
- Thompson, Paul M., et al.
(författare)
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The ENIGMA Consortium : large-scale collaborative analyses of neuroimaging and genetic data
- 2014
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Ingår i: BRAIN IMAGING BEHAV. - : Springer Science and Business Media LLC. - 1931-7557 .- 1931-7565. ; 8:2, s. 153-182
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Tidskriftsartikel (refereegranskat)abstract
- The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium is a collaborative network of researchers working together on a range of large-scale studies that integrate data from 70 institutions worldwide. Organized into Working Groups that tackle questions in neuroscience, genetics, and medicine, ENIGMA studies have analyzed neuroimaging data from over 12,826 subjects. In addition, data from 12,171 individuals were provided by the CHARGE consortium for replication of findings, in a total of 24,997 subjects. By meta-analyzing results from many sites, ENIGMA has detected factors that affect the brain that no individual site could detect on its own, and that require larger numbers of subjects than any individual neuroimaging study has currently collected. ENIGMA's first project was a genome-wide association study identifying common variants in the genome associated with hippocampal volume or intracranial volume. Continuing work is exploring genetic associations with subcortical volumes (ENIGMA2) and white matter microstructure (ENIGMA-DTI). Working groups also focus on understanding how schizophrenia, bipolar illness, major depression and attention deficit/hyperactivity disorder (ADHD) affect the brain. We review the current progress of the ENIGMA Consortium, along with challenges and unexpected discoveries made on the way.
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| 4. |
- Baker, Ulrika, et al.
(författare)
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Unpredictability dictates quality of maternal and newborn care provision in rural Tanzania : A qualitative study of health workers' perspectives
- 2017
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health workers are the key to realising the potential of improved quality of care for mothers and newborns in the weak health systems of Sub Saharan Africa. Their perspectives are fundamental to understand the effectiveness of existing improvement programs and to identify ways to strengthen future initiatives. The objective of this study was therefore to examine health worker perspectives of the conditions for maternal and newborn care provision and their perceptions of what constitutes good quality of care in rural Tanzanian health facilities. Methods: In February 2014, we conducted 17 in-depth interviews with different cadres of health workers providing maternal and newborn care in 14 rural health facilities in Tandahimba district, south-eastern Tanzania. These facilities included one district hospital, three health centres and ten dispensaries. Interviews were conducted in Swahili, transcribed verbatim and translated into English. A grounded theory approach was used to guide the analysis, the output of which was one core category, four main categories and several sub-categories. Results: `It is like rain' was identified as the core category, delineating unpredictability as the common denominator for all aspects of maternal and newborn care provision. It implies that conditions such as mothers' access to and utilisation of health care are unreliable; that availability of resources is uncertain and that health workers have to help and try to balance the situation. Quality of care was perceived to vary as a consequence of these conditions. Health workers stressed the importance of predictability, of `things going as intended', as a sign of good quality care. Conclusions: Unpredictability emerged as a fundamental condition for maternal and newborn care provision, an important determinant and characteristic of quality in this study. We believe that this finding is also relevant for other areas of care in the same setting and may be an important defining factor of a weak health system. Increasing predictability within health services, and focusing on the experience of health workers within these, should be prioritised in order to achieve better quality of care for mothers and newborns.
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| 5. |
- Diaz, Sandra, et al.
(författare)
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Hyperpolarized (3)He apparent diffusion coefficient MRI of the lung: Reproducibility and volume dependency in healthy volunteers and patients with emphysema.
- 2008
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Ingår i: Journal of Magnetic Resonance Imaging. - : Wiley. - 1522-2586 .- 1053-1807. ; 27, s. 763-770
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To measure the apparent diffusion coefficient (ADC) of hyperpolarized (HP) (3)He gas using diffusion weighted MRI in healthy volunteers and patients with emphysema and examine the reproducibility and volume dependency. MATERIALS AND METHODS: A total of eight healthy volunteers and 16 patients with emphysema were examined after inhalation of HP (3)He gas mixed with nitrogen (N(2)) during breathhold starting from functional residual capacity (FRC) in supine position. Coronal diffusion-sensitized MR images were acquired. Each subject was imaged on three separate days over a seven-day period and received two different volumes (6% and 15% of total lung capacity [TLC]) of HP (3)He each day. ADC maps and histograms were calculated. The mean and standard deviation (SD) of the ADC at different days and volumes were compared. RESULTS: The reproducibility of the mean ADC and SD over several days was good in both healthy volunteers and patients (SD range of 0.003-0.013 cm(2)/second and 0.001-0.009 cm(2)/second at 6% and 15% of TLC for healthy volunteers, and a SD range of 0.001-0.041 cm(2)/second and 0.001-0.011 cm(2)/second, respectively, for patients). A minor but significant increase in mean ADC with increased inhaled gas volume was observed in both groups. CONCLUSION: Mean ADC and SD of HP (3)He MRI is reproducible and discriminates well between healthy controls and patients with emphysema at the higher gas volume. This method is robust and may be useful to gain new insights into the pathophysiology and course of emphysema. J. Magn. Reson. Imaging 2008. (c) 2008 Wiley-Liss, Inc.
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| 6. |
- Diaz, Sandra, et al.
(författare)
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Progression of Emphysema in a 12-month Hyperpolarized (3)He-MRI Study Lacunarity Analysis Provided a More Sensitive Measure than Standard ADC Analysis(1).
- 2009
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Ingår i: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 16:6, s. 700-707
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE AND OBJECTIVES: Inhaled hyperpolarized (3)He magnetic resonance (MR) imaging has been used to measure alveolar size in patients with emphysema. The aim of this study was to test the hypothesis that (3)He MR images could be used to develop a biomarker of emphysema progression. MATERIALS AND METHODS: Twelve healthy controls and 18 patients with emphysema (eight current smokers, 10 ex-smokers) were imaged at baseline and 6 and 12 months. An additional nine subjects with alpha-1 antitrypsin deficiency (four with emphysema, six without symptoms) were also imaged at baseline and at 6 months. Each subject was imaged at two lung volumes: functional residual capacity (FRC) and FRC plus 15% of total lung capacity. Means and standard deviations of apparent diffusion coefficients (ADCs) were calculated from coronal images of the entire lung and correlated with pulmonary function test results. The lacunarity hypothesis was tested and calculated from the data using a range of 2x2 x 2 to 6x6 x 6 voxels, and the average was calculated. RESULTS: There was no change in the mean ADC at either lung volume in any subject over the 6- or 12-month period. FRC and residual volume increased over the 12 months, suggesting air trapping. The lacunarity of images collected at FRC increased at 6 and 12 months in smokers only (P=.063 and P=.023, respectively). CONCLUSIONS: The mean ADC calculated from MR images of the lungs with helium was not sufficiently sensitive to detect changes over a 12-month period. However, lacunarity captured more of the spatial information in the images and detected emphysema progress in the smokers.
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| 7. |
- Diaz, Sandra, et al.
(författare)
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Validity of apparent diffusion coefficient hyperpolarized He-3-MRI using MSCT and pulmonary function tests as references
- 2009
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Ingår i: European Journal of Radiology. - : Elsevier BV. - 1872-7727 .- 0720-048X. ; 71:2, s. 257-263
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare apparent diffusion coefficient (ADC) measurements from hyperpolarized (HP) helium (He-3)-magnetic resonance imaging (MRI) with quantitative data from multislice Computed Tomography (CT) (MSCT) of the whole lungs and pulmonary function tests (PFT). Materials and methods: Twenty-seven subjects, 22 with established emphysema and 5 with preclinical emphysema defined by PFT criteria, were examined with Hp He-3-MRI and MSCT. Mean age was 55 (+/- 12) years, 18 female and 9 male. Mean ADC from He-3-MRI was compared with emphysema index (EI), 15th percentile and mean lung density (MLD) values from MSCT. Both mean ADC and MSCT data were compared to PFT, especially percent of predicted diffusing capacity of carbon monoxide (%predicted DLCO), using Pearson's correlation test. Results: Mean ADC and standard deviation values were 0.392 +/- 0.119 cm(2)/s for the established emphysema group and 0.216 +/- 0.046 for the pre-clinical emphysema group. MSCT values for the established emphysema group and pre-clinical emphysema group were: EI (%) 11 +/- 12 and 0.4 +/- 0.6, respectively; 15th percentile (Hounsfield Units (HU)), -956 +/- 25 and -933 +/- 13, respectively and MLD (HU) -877 +/- 20 and -863 +/- 15, respectively. Correlations between mean ADC and El and 15th percentile were both r=0.90 and for MLD r=0.59. There was higher correlation between mean ADC and %predicted DLCO (r=0.90) than between El and %predicted DLCO (r=0.76). Conclusion: Hp He-3-MRI correlates well with density measurements from MSCT and agrees better than MSCT with %predicted DLCO which is the PFT most related to emphysema. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
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| 8. |
- Djukanovic, Ingrid, et al.
(författare)
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Association between depressive symptoms and age, sex, loneliness and treatment among older people in Sweden
- 2015
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Ingår i: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 19:6, s. 560-568
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to examine the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex among older people (65–80 years) and to investigate to what extent those who report depressive symptoms had visited a health care professional and/or used antidepressant medication.Method: A cross-sectional study was conducted in a Swedish sample randomized from the total population in the age group 65–80 years (n = 6659). Chi square tests and logistic regression analyses were conducted.Results: The data showed that 9.8% (n = 653) reported depressive symptoms and 27.5% reported feelings of loneliness. More men than women reported depressive symptoms, and the largest proportion was found among men in the age group 75–80 years. An association between the odds to have a depressive disorder and loneliness was found which, however, decreased with increasing age. Of those with depressive symptoms a low proportion had visited a psychologist (2.9%) or a welfare officer (4.2%), and one in four reported that they use antidepressant medication. Of those who reported depressive symptoms, 29% considered that they had needed medical care during the last three months but had refrained from seeking, and the most common reason for that was negative experience from previous visits.Conclusion: Contrary to findings in most of the studies, depressive symptoms were not more prevalent among women. The result highlights the importance of detecting depressive symptoms and loneliness in older people and to offer adequate treatment in order to increase their well-being.
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| 9. |
- Djukanovic, Ingrid
(författare)
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Depression in late life-prevalence and preventive intervention
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundDepression in older people often goes undetected but has severe consequences on physical health, functioning and quality of life. As the aging population is growing, mental ill-health already is and will continue to be an important public health problem. There is a need for adequate strategies to meet this challenge.Aims(1) To investigate the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex in a random Swedish sample in the age group 65-80 years, and to investigate to what extent those scoring ≥ 8 in the depression dimension of the Hospital Anxiety and Depression Scale (HAD) had visited health care professionals and/ or used antidepressive medication.(2) To evaluate the effect of group discussions, in which structured reminiscence and a Problem Based Method (PBM) were used, on depressive symptoms, Quality of Life (QoL) and Self-Rated Health (SRH) among older people.(3) To describe the individual´s experiences of the year before and the time after retirement.(4) To evaluate the factorial structure of the HAD in a general older population 65-80 years and to examine the possible presence of differential item functioning (DIF) related to sex.ResultMore men than women reported depressive symptoms, few were offered psychological treatment and a quarter used antidepressant medication. Depressive symptoms were associated with loneliness and this association decreased with increasing age. Participation in group discussions resulted in a decrease in depressive symptoms and an increase in QoL and SRH. Both expectations and fears were experienced the year before and the time after retirement.The psychometric evaluation of the HAD showed a two-factorial structure and invariance regarding sex.ConclusionThe result highlights the importance of detecting depressive symptoms and loneliness in older people and offer adequate treatment. Transition into retirement should receive more attention both from a health care and organizational perspective. Group discussions with structured reminiscence and PBM as a nursing intervention, seem to be a promising method to prevent depressive symptoms in older people, but further research is needed. The HAD can be recommended to assess anxiety and depression among a general population 65-80 years old.
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| 10. |
- Djukanovic, Ingrid, et al.
(författare)
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Experiences of the transition intoretirement : An interview study
- 2016
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Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 36:4, s. 224-232
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Tidskriftsartikel (refereegranskat)abstract
- Retirement is one of the most important transitions in a person's life, which also might affect health and well-being. Adjustment to a life as retiree does not follow a uniform pattern, which emphasizes the importance of an individual perspective. This article uses transition theory as a theoretical perspective. In-depth interviews were conducted with 13 individuals newly retired, focusing on experiences from the last year of work and the time after retirement. Content analysis was used to analyze data. Two themes emerged: ‘become aware of’ and ‘become adapted to’. Nine subthemes describe the individual experiences reflecting positive expectations and outcomes but also feelings of grief and disconnectedness and fears about loss of social network and identity. Transition into retirement should receive more attention from a nursing perspective since experiences such as, for example, grief, disconnectedness and loss of identity if unaddressed could lead to an unhealthy transition.
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