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- Sigurbergsdottir, Adalbjorg Yr, et al.
(författare)
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Disease associations with monoclonal gammopathy of undetermined significance can only be evaluated using screened cohorts: results from the population-based iStopMM study
- 2023
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Ingår i: REVISTA CHILENA DE LITERATURA. - 0718-2295. ; :108, s. 3392-3398
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Tidskriftsartikel (refereegranskat)abstract
- Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic precursor condition that precedes multiple myeloma and related disorders but has also been associated with other medical conditions. Since systematic screening is not recommended, MGUS is typically diagnosed due to underlying diseases and most cases are not diagnosed. Most previous studies on MGUS disease associations have been based on clinical cohorts, possibly resulting in selection bias. Here we estimate this selection bias by comparing clinically diagnosed and screened individuals with MGUS with re-gards to demographics, laboratory features, and comorbidities. A total of 75,422 participants in the Iceland Screens, Treats, or Prevents Multiple Myeloma (iStopMM) study were screened for MGUS by serum protein electrophoresis, immunofixation and free light chain assay (clinicaltrials gov. Identifier: NCT03327597). We identified 3,352 individuals with MGUS, whereof 240 had previously been clinically diagnosed (clinical MGUS), and crosslinked our data with large, nationwide registries for information on comorbidities. Those with clinical MGUS were more likely to have at least one comorbidity (odds ratio=2.24; 95% confidence interval: 1.30-4.19), and on average had more comorbidities than the screened MGUS group (3.23 vs. 2.36, mean difference 0.68; 95% confidence interval: 0.46-0.90). They were also more likely to have rheumato-logical disease, neurological disease, chronic kidney disease, liver disease, heart failure, or endocrine disorders. These findings indicate that individuals with clinical MGUS have more comorbidities than the general MGUS population and that previous studies have been affected by significant selection bias. Our findings highlight the importance of screening data when studying biological and epidemiological implications of MGUS.
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- Sigurðardóttir, Sigríður Margrét, et al.
(författare)
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Principals' Preparation and Professional Development in Nordic Countries
- 2023
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Ingår i: Education and Democracy in the Nordic Countries. - Cham : Springer. - 9783031331947 - 9783031331954 ; , s. 153-172
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Bokkapitel (refereegranskat)abstract
- Principals in Nordic countries face increasing and changing demands in their work that have transformed the expectations of their knowledge and skills. This transformation has focused on the need for high-quality preparation programmes and continuous professional development opportunities for principals. In this chapter, we investigate and compare principal preparation and professional development in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. We reflect on the variation in professional development opportunities across the Nordic countries and discuss how professional development for novice and in-post school principals might be organised in the future. A cross-case study is applied, making use of document analysis to find, select, appraise and synthesise data and policy documents, legislation and current research. A range of similarities and differences between the Nordic countries that concern both formal expectations, required education for becoming a principal and possibilities for continuous professional development were identified. With many governing levels and a changing society, it seems that professional development is historically and nationally situated rather than being a strategic incitement to use, keep and build competence. Preparation and continuous development for principals in the Nordic countries vary both between and within countries. This is a concern for principals, as well as the national and local authorities responsible for their preparation and continuous professional development.
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