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- Bergh, Camilla, et al.
(författare)
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Increased risk of revision in patients with non-traumatic femoral head necrosis.
- 2014
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 85:1, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose Previous studies of patients who have undergone total hip arthroplasty (THA) due to femoral head necrosis (FHN) have shown an increased risk of revision compared to cases with primary osteoarthritis (POA), but recent studies have suggested that this procedure is not associated with poor outcome. We compared the risk of revision after operation with THA due to FHN or POA in the Nordic Arthroplasty Register Association (NARA) database including Denmark, Finland, Norway, and Sweden. Patients and methods 427,806 THAs performed between 1995 and 2011 were included. The relative risk of revision for any reason, for aseptic loosening, dislocation, deep infection, and periprosthetic fracture was studied before and after adjustment for covariates using Cox regression models. Results 416,217 hips with POA (mean age 69 (SD 10), 59% females) and 11,589 with FHN (mean age 65 (SD 16), 58% females) were registered. The mean follow-up was 6.3 (SD 4.3) years. After 2 years of observation, 1.7% in the POA group and 3.0% in the FHN group had been revised. The corresponding proportions after 16 years of observation were 4.2% and 6.1%, respectively. The 16-year survival in the 2 groups was 86% (95% CI: 86-86) and 77% (CI: 74-80). After adjusting for covariates, the relative risk (RR) of revision for any reason was higher in patients with FHN for both periods studied (up to 2 years: RR = 1.44, 95% CI: 1.34-1.54; p < 0.001; and 2-16 years: RR = 1.25, 1.14-1.38; p < 0.001). Interpretation Patients with FHN had an overall increased risk of revision. This increased risk persisted over the entire period of observation and covered more or less all of the 4 most common reasons for revision.
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- Dale, Håvard, et al.
(författare)
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Increasing risk of prosthetic joint infection after total hip arthroplasty.
- 2012
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Ingår i: Acta orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 83:5, s. 449-58
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The study was based on the Nordic Arthroplasty Register Association (NARA) dataset. 432,168 primary THAs from 1995 to 2009 were included (Denmark: 83,853, Finland 78,106, Norway 88,455, and Sweden 181,754). Adjusted survival analyses were performed using Cox regression models with revision due to infection as the endpoint. The effect of risk factors such as the year of surgery, age, sex, diagnosis, type of prosthesis, and fixation were assessed. Results 2,778 (0.6%) of the primary THAs were revised due to infection. Compared to the period 1995-1999, the relative risk (with 95% CI) of revision due to infection was 1.1 (1.0-1.2) in 2000-2004 and 1.6 (1.4-1.7) in 2005-2009. Adjusted cumulative 5-year revision rates due to infection were 0.46% (0.42-0.50) in 1995-1999, 0.54% (0.50-0.58) in 2000-2004, and 0.71% (0.66-0.76) in 2005-2009. The entire increase in risk of revision due to infection was within 1 year of primary surgery, and most notably in the first 3 months. The risk of revision due to infection increased in all 4 countries. Risk factors for revision due to infection were male sex, hybrid fixation, cement without antibiotics, and THA performed due to inflammatory disease, hip fracture, or femoral head necrosis. None of these risk factors increased in incidence during the study period. Interpretation We found increased relative risk of revision and increased cumulative 5-year revision rates due to infection after primary THA during the period 1995-2009. No change in risk factors in the NARA dataset could explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA.
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- Höyer, Hans Christian, et al.
(författare)
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Control and Trust in Local School Governance
- 2014
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Ingår i: School Boards in the Governance Process. - Dordrecht : Springer Berlin/Heidelberg. ; , s. 101-115
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Bokkapitel (refereegranskat)abstract
- External school inspection and state supervision represent key instruments in many European countries for improving the quality of education. Although some countries, such as England, France, and the Netherlands, have a long tradition of school inspectorates, other countries such as Sweden only recently reintroduced a school inspection system (Johansson O, Holmgren M, Nihlfors E, Moos L, Skedsmo G, Paulsen JM, Risku M, Local Decisions under Central Watch – a new Nordic quality assurance system. In: Moos L (ed) Transnational influences on values and practices in Nordic educational leadership – is there a Nordic model? Springer, Dordrecht, 2013). In Denmark, the relationship between the state and the municipalities is conducted through a public governance contract. For example, subject matter aims that used to be very broad and loose at this level were supplemented with clear aims that were developed into shared aims from 2006 onwards. Moreover, a state supervision system was introduced to standardize the quality assurance procedure. In a similar vein, Norway conducted a national quality assurance system in 2006, paired with national achievement testing systems, to chart and publish the results and a state supervision system. In contrast to Sweden, the local governance level – municipalities – in Denmark and Norway is the target of state supervision; thus, inspection and control are more loosely coupled with schools and principals at the “street level.” In Finland, the National Board of Education conducts national evaluations, and this state agency is also responsible for the national evaluation of learning outcomes. Notably, in this respect, Finland deviates from the international stream of state quality assurance and inspection, not at least linked to the political system’s resistance to ranking schools and municipalities and the external publication of performance indicators.
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- Kofod, Klaus Kasper, et al.
(författare)
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The School Boards between Power and Influence
- 2014
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Ingår i: School Boards in the Governance Process. - Dordrecht : Springer Science+Business Media B.V.. - 9783319054933 - 9783319054940 ; , s. 117-133
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Bokkapitel (refereegranskat)abstract
- The decentralized Scandinavian school structure with the municipal school committee as a central factor between the municipal council and other school interests gives the school board a central role in the implementation of the centrally decided school legislation from the parliament. Therefore, the central questions in modern Scandinavian schooling are: what are the ways of influence and what power mechanisms are in play throughout the schooling system.The chapter will investigate what power and influence mean in a school board context. We will conduct comparisons across countries and look into which influence and power relations there are between the school committee as the central focal point and the schools’ most important interests. Therefore, we will look at the relations between the board and the national parliamentary level, the superintendent/the municipal administration, the chair of the board, the principals/schools and lastly the parents and the students. These relations between the board and its stakeholders will be analysed in the terms of power and influence in this chapter.
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- Middeldorp, Christel M., et al.
(författare)
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The Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia : design, results and future prospects
- 2019
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 34:3, s. 279-300
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Tidskriftsartikel (refereegranskat)abstract
- The impact of many unfavorable childhood traits or diseases, such as low birth weight and mental disorders, is not limited to childhood and adolescence, as they are also associated with poor outcomes in adulthood, such as cardiovascular disease. Insight into the genetic etiology of childhood and adolescent traits and disorders may therefore provide new perspectives, not only on how to improve wellbeing during childhood, but also how to prevent later adverse outcomes. To achieve the sample sizes required for genetic research, the Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia were established. The majority of the participating cohorts are longitudinal population-based samples, but other cohorts with data on early childhood phenotypes are also involved. Cohorts often have a broad focus and collect(ed) data on various somatic and psychiatric traits as well as environmental factors. Genetic variants have been successfully identified for multiple traits, for example, birth weight, atopic dermatitis, childhood BMI, allergic sensitization, and pubertal growth. Furthermore, the results have shown that genetic factors also partly underlie the association with adult traits. As sample sizes are still increasing, it is expected that future analyses will identify additional variants. This, in combination with the development of innovative statistical methods, will provide detailed insight on the mechanisms underlying the transition from childhood to adult disorders. Both consortia welcome new collaborations. Policies and contact details are available from the corresponding authors of this manuscript and/or the consortium websites.
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- Moos, Lejf, et al.
(författare)
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Control and Trust in Local School Governance
- 2014
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Ingår i: School Boards in the Governance Process. - Dordrecht : Springer. - 9783319054933 - 3319054937 ; , s. 101-115
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Bokkapitel (refereegranskat)
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10. |
- Nihlfors, Elisabet, et al.
(författare)
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Role and Influence of School Boards on Improving Educational Quality
- 2014
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Ingår i: School Boards in the Goverance Process. - Dordrecht : Springer Berlin/Heidelberg. - 9783319054933 ; , s. 135-148
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Bokkapitel (refereegranskat)abstract
- Ensuring educational quality is high on the policy agenda in many countries, especially efforts regarding students’ learning outcomes.In the Nordic countries, local school authorities are in charge of developing systems to assure and enhance school quality. This chapter discusses how members of the school boards perceive their roles, functions, and positions. Based on a survey, we report on the extent to which they are satisfied with student achievements, their expectations towards the work of the superintendent and principals, and their own work related to improving school quality. We examine how the school board members see their own opportunities to influence decisions about school practices and whether the knowledge and capacity in different professional groups are to sufficiently fulfill tasks and responsibilities.In this chapter, we will argue that new governing modes and accountability processes have led to the establishment of new roles and relationships between national authorities and local levels of school governing. One example is quality assurance and the use of quality reports. During the last decade, the focus on establishing systems for quality assurance has intensified. A quality assurance system, in the sense of quality reports, is included in Education Acts in each country. The ways in which reporting and feedback systems are organized differ, but in all Nordic countries quality assurance is an important task for school boards.
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