| 1. |
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| 2. |
- Alves Dias, Joana, et al.
(författare)
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Low-grade inflammation, oxidative stress and risk of invasive post-menopausal breast cancer - A nested case-control study from the Malmö diet and cancer cohort
- 2016
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Although cancer promotes inflammation, the role of inflammation in tumor-genesis is less well established. The aim was to examine if low-grade inflammation is related to post-menopausal breast cancer risk, and if obesity modifies this association. Methods; In the Malmo Diet and Cancer cohort, a nested case-control study was defined among 8,513 women free of cancer and aged 55.73 years at baseline (1991.96); 459 were diagnosed with invasive breast cancer during follow-up (until December 31st, 2010). In laboratory analyses of blood from 446 cases, and 885 controls (matched on age and date of blood sampling) we examined systemic inflammation markers: oxidized (ox)-LDL, interleukin (IL)- 1β, IL-6, IL-8, tumor necrosis factor (TNF)-α, white blood cells, lymphocytes and neutrophils. Odds ratios (OR) and 95% confidence intervals (CI) for breast cancer risk was calculated using multivariable conditional logistic regression. Results: Inverse associations with breast cancer were seen in fully-adjusted models, for 2nd and 3rd tertiles of ox-LDL, OR (95% CI): 0.65 (0.47.0.90), 0.63 (0.45.0.89) respectively, p-trend = 0.01; and for the 3rd tertile of TNF-α, 0.65 (0.43.0.99), p-trend = 0.04. In contrast, those in the highest IL-1β category had higher risk, 1.71 (1.05.2.79), p-trend = 0.01. Obesity did not modify associations between inflammation biomarkers and breast cancer. Conclusion; Our study does not suggest that low-grade inflammation increase the risk of post-menopausal breast cancer.
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| 3. |
- Alves Dias, Joana, et al.
(författare)
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Plasma variation and reproducibility of oxidized LDL-cholesterol and low-grade inflammation biomarkers among participants of the Malmö Diet and Cancer cohort
- 2016
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Ingår i: Biomarkers. - 1354-750X. ; 21:6, s. 562-571
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Tidskriftsartikel (refereegranskat)abstract
- Context: Large epidemiological studies often collect non-fasting samples, although the reliability of biomarkers may be uncertain. Objective: To explore the reliability and reproducibility of a single measurement of selected biomarkers in a sub-sample of the Malmö Diet and Cancer cohort. Methods: We estimated single- and average-measures intraclass correlation coefficients (ICC) for oxidized (ox)-LDL, interleukin (IL)-1β, IL-6, IL-8 and TNF-α. Results: Single-measures ICC in non-fasting samples of ox-LDL, IL-1β, IL-6, IL-8 and TNF-α were the following: 0.85, 0.71, 0.61, 0.78 and 0.66 for men, and 0.67, 0.81, 0.87, 0.69 and 0.81 for women. Biomarkers at non-fasting and fasting samples were highly correlated (all r > 0.80). Conclusions: The observed ICC suggest that most of the examined biomarkers (non-fasting blood) would allow meaningful analysis in epidemiological studies.
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| 4. |
- Appelgren Engström, Heléne, 1968-, et al.
(författare)
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Associations between heteronormative information, parental support and stress among same-sex mothers in Sweden-A web survey
- 2021
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Ingår i: Nursing Open. - : WILEY. - 2054-1058.
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate same-sex mothers' self-assessed experiences of forming a family, and the association between heteronormative information, parental support and parenting stress. Design: A quantitative, cross-sectional study. Methods: In a web survey conducted in Sweden in 2019, same-sex mothers (N = 146) with a child aged 1-3 years answered questions about their experiences of forming a family through assisted reproduction and questions about parenting stress. Descriptive statistics describes the process of forming a family. Pearson's correlation analyses and independent sample t tests were used to test hypotheses about heteronormative information, parental support and parenting stress. Results: Same-sex mothers experienced going through assisted reproduction treatment as stressful, and parental groups as not being supportive. Heteronormative information correlated with both lower perceived parental support and higher perceived parenting stress. Non-birth mothers experienced less acknowledgement and support than birthmothers.
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| 5. |
- Appelgren Engström, Heléne, 1968-
(författare)
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Family formation in two-mother families : Experiences of parental support in antenatal and child health care in Sweden
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim with the thesis was to examine same-sex mothers experiences of forming a family, pregnancy, parenthood and parental support from professionals in antenatal and child health care. An additional purpose was to explore professionals' experiences of meeting and supporting families with two mothers.The results are based on four articles (three studies). The project started with exploratory semi-structured interviews (n = 20) with mothers in same-sex relationships who had children with the help of assisted reproduction at a Swedish clinic. Thereafter, a web survey was designed based on the results from the first sub-study. The survey, as well as a survey on perceived parenting stress (SPSQ), was answered by 146 mothers in same-sex relationships. Finally, focus groups were held with professionals (n = 13) in antenatal and child health care with experience of meeting and supporting families with two mothers.The results showed that the mothers in same-sex relationships experienced the process of forming a family as a stressful journey in a heteronormative world, and that they lacked psychological / emotional support (Articles I, III). The results also showed that the mothers strived for equal parenthood and that they lacked professional support (Articles II, III).Furthermore, the results showed that the non-birth mother experienced a lower degree of acknowledgement from antenatal and child health care than the mother who gave birth, and a lower degree of support from antenatal care but no difference in the experience of support from child health care. The mothers also experienced a low degree of parenting stress (Article III).Professionals strived for an open approach in meeting new parents. They met well-prepared mothers who planned for equal parenting. Professionals expressed that they either gave equal support to all parents, or that they provided tailored support to same-sex mothers (Article IV).The thesis contributes with an in-depth understanding and increased knowledge about mothers in same-sex relationships' experience of family formation as well as their experience of treatment and support from professionals in antenatal and child health care. Furthermore, it also shows professionals' experiences of meeting and supporting families with two mothers.
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| 6. |
- Appelgren Engström, Heléne, 1968-, et al.
(författare)
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Mothers in Same-Sex Relationships Describe the Process of Forming a Family as a Stressful Journey in a Heteronormative World : A Swedish Grounded Theory Study
- 2018
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Ingår i: Maternal and Child Health Journal. - : Springer. - 1092-7875 .- 1573-6628. ; 22:10, s. 1444-1450
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to gain insight into how women in same-sex relationships experience the process of forming a family through the use of assisted reproduction technique (ART), from planning the pregnancy to parenthood, and their experience of parental support from healthcare professionals. Methods The participants were 20 women in a same-sex relationship who had conceived through ART at a Swedish clinic. Semi-structured interviews including open questions about pregnancy, parenthood and support from healthcare professionals were conducted. The interviews were tape-recorded and transcribed verbatim. The data were analysed according to grounded theory. Results The core category, A stressful journey through a heteronormative world, emerged from the analysis, as did three subcategories: A journey fraught with difficulties and decisions; The nuclear family as the norm; and A need for psychological support. Same-sex parents expressed a need for more information about how to access ART in Sweden. Both the healthcare organization and treatment were perceived as heteronormative. In particular, these women lacked psychological support during the demanding process of utilizing a sperm donor to conceive. Conclusions for Practice Professionals in antenatal care should undergo mandatory cultural competency training to ensure cultural sensitivity and the provision of updated information, tailored brochures and early parental support for families with same-sex parents. All parents need guidance and support from competent, caring personnel throughout the entire process of forming a family.
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| 7. |
- Appelgren Engström, Heléne, 1968-, et al.
(författare)
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Mothers in same‐sex relationships—Striving for equal parenthood: : A grounded theory study
- 2019
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Ingår i: JOURNAL OF CLINICAL NURSING. - : Wiley Online library. - 0962-1067 .- 1365-2702. ; 28:19-20, s. 3700-3709
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Tidskriftsartikel (refereegranskat)abstract
- To get a deeper understanding of how mothers in same-sex relationships think and reason about their parenthood in terms of gender equality, and how they experience early parental support from child healthcare professionals. Background: There is an increasing amount of research on how women in same-sex relationships experience healthcare services when forming a family. Yet there is limited knowledge of what kind of early parental support these women may request. Design: Grounded theory. Follows guidelines for qualitative research (COREQ). Method: Twenty women ranging from 25 to 42 years of age participated in semi-structured interviews. Data collection and analysis took place in parallel, as recommended in grounded theory methodology. Results: The results are described by the core category Same-sex mothers request professional support to achieve equal parenthood, which includes five categories: (a) equality in everyday life, (b) diversity in mother and child attachment, (c) justification of the family structure, (d) ambivalent thoughts about their child's future and (e) a special need for networking and request for professional support. These findings provide a deeper understanding of how same-sex mothers experience their parenthood and the parental support that is offered. Conclusion: Child healthcare professionals need to be sensitive and recognise both mothers as equal parents and offer early parenting groups where two-mother families feel included and supported. Relevance to clinical practice: Healthcare professionals need to be aware of diverse family formations and meet each parent as a unique individual without heteronormative assumptions. Same-sex mothers must be treated as equal parents and acknowledged as mothers. Healthcare professionals should offer inclusive and supportive parental groups to same-sex families. They should also inform and support nonbirth mothers about the possibility to breastfeed.
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| 8. |
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| 9. |
- Appelgren Engström, Heléne, 1968-, et al.
(författare)
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Professionals' experiences of supporting two-mother families in antenatal and child health care in Sweden
- 2022
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Ingår i: Scandinavian Journal of Caring Sciences. - : WILEY. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- Background In Sweden, antenatal and child health care are offered free of charge to all expectant and new parents. Professionals in antenatal and child health care play an important role in supporting parents. Previous research shows that same-sex mothers face heteronormative assumptions and insufficient support during their transition to parenthood. Objective To explore professionals' experiences of supporting two-mother families in antenatal and child health care. Method A qualitative method with focus group discussions was used. An interview guide was followed, and the discussions were held online. The data was analysed according to inductive content analysis. Settings and participants The participants were midwives (n = 8) and nurses (n = 5) in antenatal and child health care from different parts of Sweden. Participants were recruited through the coordinating midwives and child health care nurses in the different regions. Findings One main category was identified: Striving to be open-minded in supporting same-sex mothers. Health care professionals described meeting well-prepared mothers, with an equal commitment between each other, and mothers on guard against heteronormative views. Professionals provided support through empowerment by creating a safe environment and aiming at providing equal support to all parents or tailored support to same-sex mothers. Mothers described handling challenges, as a balancing act to acknowledge both mothers. Struggling with documents and communication and a lack of information were other challenges to be handled. Professionals reflected on their own professional competence and expressed that knowledge acquired through education, experience and personal interest all contributed to their competence. Conclusions Forms and documentation need to be updated to be gender neutral to be including to a variety of family constelleations. Health care professionals need time to reflect on norms and challenges to better support both mothers in a two-mother family.
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| 10. |
- Bergström, Gunnel, et al.
(författare)
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Proteolytic modification of pig and rat liver pyruvate kinase including the phosphorylatable site
- 1978
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Ingår i: Biochimica et Biophysica Acta. - 0006-3002 .- 1878-2434. ; 532:2, s. 259-267
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Tidskriftsartikel (refereegranskat)abstract
- The phosphorylated or phosphate-accepting site of pyruvate kinase from pig and rat liver was removed without inactivation by incubation with subtilisin. At different time intervals the subtilisin was inactivated with phenylmethylsulfonyl fluoride and the amount of remaining phosphorylatable or phosphorylated sites of pyruvate kinase estimated by incubation with an excess of [32P]-ATP and protein kinase. It was found that to get the same rate of modification the subtilisin concentration required to modify unphosphorylated pyruvate kinase was approximately ten times higher than that used for removal of the phosphorylated site of phosphorylated site of phosphorylated enzyme. It was shown that the proteolytically-modified pyruvate kinase had an increased apparent Km for phosphoenolpyruvate without a change in V, when compared to unmodified unphosphorylated and phosphorylated pyruvate kinase. The removal of the phosphorylated site was not associated with loss of the allosteric sites for ATP and Fru-1,6-P2. The possibility that phosphorylation of the pyruvate kinase increases its degradation rate in vivo is briefly discussed.
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| 11. |
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| 12. |
- Berntsson, John, et al.
(författare)
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Plasma Natriuretic Peptides and Incidence of Subtypes of Ischemic Stroke.
- 2014
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 37:6, s. 444-450
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: Natriuretic peptides predict poor outcomes in cardiovascular disease. However, the knowledge of their relationship to stroke is limited and prospective studies from the general population are few. The purpose of this study was to explore the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and midregional pro-atrial natriuretic peptide (MR-proANP) plasma levels and the risk for ischemic stroke and its subtypes. Methods: NT-proBNP and MR-proANP were measured in fasting blood samples from 4,862 subjects (40.2% men, mean age 57.5 ± 6.0 years) without cardiovascular disease from the Malmö Diet and Cancer Study, a prospective, population-based study in Sweden. Incidence of ischemic stroke was monitored over a mean follow-up of 14.9 ± 3.0 years. Stroke cases were etiologically classified according to the TOAST classification. Cox proportional-hazards regression was used to study the incidence of stroke in relationship to NT-proBNP and MR-proANP. Results: During follow-up, 227 had a first-ever ischemic stroke (large-artery atherosclerosis, n = 35; cardioembolic stroke, n = 44; small-artery occlusion, n = 80; undetermined cause, n = 68). In the age- and sex-adjusted model, only NT-proBNP was associated with total ischemic stroke. This association was completely explained by an increased incidence of cardioembolic stroke. Adjusted for cardiovascular risk factors (age, sex, hypertension, diabetes, smoking, body mass index and low-density lipoprotein cholesterol), the hazard ratios (HRs, 95% confidence interval, 95% CI) for cardioembolic stroke were 1.00 (reference), 1.42 (0.34-6.00), 2.79 (0.77-10.12) and 5.64 (1.66-19.20), respectively, for the 1st, 2nd, 3rd and 4th quartiles of NT-proBNP. The corresponding HRs (95% CIs) for quartiles of MR-proANP were 1.00 (reference), 1.83 (0.55-6.14), 1.20 (0.33-4.34) and 3.96 (1.31-11.99), respectively. In total, 335 (6.9%) subjects were diagnosed with atrial fibrillation during follow-up. Among the cardioembolic stroke cases, 30% were diagnosed with atrial fibrillation before the stroke event and another 36% within 6 months after the stroke. Of the cardioembolic stroke cases with atrial fibrillation, 59% were in the top quartile of NT-proBNP, 69% in the top quartile of MR-proANP and 79% were either in the top quartile of NT-proBNP or in the top quartile of MR-proANP. Conclusion: High plasma levels of NT-proBNP and MR-proANP are associated with a substantially increased risk of cardioembolic stroke, but not with other subtypes of ischemic stroke. The results suggest that assessment of stroke risk, including electrocardiography, is warranted in subjects with high NT-proBNP or MR-proANP. © 2014 S. Karger AG, Basel.
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| 13. |
- Ek, Pia, et al.
(författare)
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Comparative kinetic studies on the L-type pyruvate kinase from rat liver and the enzyme phosphorylated by cyclic 3´, 5´-AMP-stimulated protein kinase
- 1976
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Ingår i: Biochimica et Biophysica Acta. - 0006-3002 .- 1878-2434. ; 429:2, s. 374-382
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Tidskriftsartikel (refereegranskat)abstract
- The kinetics of rat liver L-type pyruvate kinase (EC 2.7.1.40), phosphorylated with cyclic AMP-stimulated protein kinase from the same source, and the unphosphorylated enzyme have been compared. The effects of pH and various concentrations of substrates, Mg2+, K+ and modifiers were studied. In the absence of fructose 1, 6-diphosphate at pH 7.3, the phosphorylated pyruvate kinase appeared to have a lower affinity for phosphoenolpyruvate (K0.5=0.8 mM) than the unphosphorylated enzyme (K0.5=0.3 mM). The enzyme activity vs. phosphoenolpyruvate concentration curve was more sigmoidal for the phosphorylated enzyme with a Hill coefficient of 2.6 compared to 1.6 for the unphosphorylated enzyme. Fructose 1, 6-diphosphate increased the apparent affinity of both enzyme forms for phosphoenolpyruvate. At saturating concentrations of this activator, the kinetics of both enzyme forms were transformed to approximately the same hyperbolic curve, with a Hill coefficient of 1.0 and K0.5 of about 0.04 mM for phosphoenolpyruvate. The apparent affinity of the enzyme for fructose 1, 6-diphosphate was high at 0.2 mM phosphoenolpyruvate with a K0.5=0.06 muM for the unphosphorylated pyruvate kinase and 0.13 muM for the phosphorylated enzyme. However, in the presence of 0.5 mM alanine plus 1.5 mM ATP, a higher fructose 1, 6-diphosphate concentration was needed for activation, with K0.5 of 0.4 muM for the unphosphorylated enzyme and of 1.4 muM for the phosphorylated enzyme. The results obtained strongly indicate that phosphorylation of pyruvate kinase may also inhibit the enzyme in vivo. Such an inhibition should be important during gluconeogenesis.
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| 14. |
- Engström, Elisabet, et al.
(författare)
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Auditory event-related potentials and mismatch negativity in children with hearing loss using hearing aids or cochlear implants : A three-year follow-up study
- 2021
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 140
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The primary aim was to examine how event-related potentials (ERPs) and mismatch negativity (MMN) change and develop over time among children with hearing loss (HL) using hearing aids (HAs) or cochlear implants (CIs). Children with normal hearing (NH) were tested as a reference group.Methods: This three-year follow-up study included 13 children with sensorineural HL (SNHL); 7 children using bilateral HAs and 6 children using CIs; and 10 children with NH as a reference group. ERPs were recorded at baseline and after three years. At time for the original study the children were approximately 5-8 years old and at the follow-up study 8-11 years old. ERP recordings and data processing were identical in both sessions. A standard stimulus alternated with five different deviants (gap, intensity, pitch, location and duration), presented in a pseudorandom sequence, thus following the multi-feature paradigm, Optimum-1. MMN was calculated from the average ERP of each deviant minus the standard stimuli. Repeated measures ANOVA was used for the statistical analyses and the results were based on samples within a specific time interval; 80-224 ms.Results: There was a statistically significant difference in the obligatory responses between the NH and HA groups at baseline, but this difference disappeared after three years in our follow-up study. The children with HA also showed a significant difference in mean ERP at baseline compared to follow-up, and significant differences between the deviants at follow-up but not at baseline. This suggests an improvement over time among the children with HAs. On the other hand, the children with CIs did not differ from the NH children at baseline, but after three years their mean ERP was significantly lower compared to both the children with HA and NH, indicating a reduced development of the central auditory system in this age span among the children with CIs. Regarding MMN, there was an interaction between the duration deviant and time for the children with HA, also indicating a possible improvement over time among the HA children.Conclusions: This three-year follow-up study shows neurophysiological differences between children with HL and children with NH. The results suggest a delay in the central auditory processing among the HA children compared to children with NH, but a possible catch-up, over time, and this potential may be worth to be utilized. Regarding the CI children, similar improvement in this age span is missing, meaning there are differences between the subgroups of children with HL, i.e. the children with HAs vs. CIs. The results highlight the importance of distinguishing between subgroups of children with HL in further research.
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| 15. |
- Engström, Elisabet, et al.
(författare)
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Computer-assisted reading intervention for children with hearing impairment using cochlear implants : Effects on auditory event-related potentials and mismatch negativity
- 2020
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 137
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary aim was to find out whether a computer-assisted reading intervention program with a phonic approach can affect event-related (ERPs) and mismatch negativity (MMN) in hearing impaired (HI) children using cochlear implants (CIs).METHODS: This study involved a test group of 15 HI children with CIs and a control group of 14 normal hearing (NH) children. The children were 4 years and 10 months to 8 years and 1 month old. ERPs were recorded immediately before and after 4 weeks of training with a computer-assisted reading intervention, GraphoGame. A multi-feature paradigm, Optimum-1, was used, i.e. a standard stimulus alternated with five different deviants: gap intensity, pitch, location and duration. MMN was calculated from the mean amplitude ERP of each deviant minus the standard stimulus response in a specific time interval, 80 - 224 ms. Repeated measures ANOVA was used for the statistical analysis.RESULTS: The results did not show any significant changes with the computerassisted training in the ERPs and MMNs among the HI children with CIs. The presence of both MMN and a positive mismatch response (pMMR), which might reflect an immaturity, complicates interpreting the results in this age group. Individually, there was a mix of MMNs and pMMRs among all participants, pre and post training, and the change of each deviant after intervention was not predictable.CONCLUSIONS: There are no significant changes in ERP or MMN after intervention, however lack of significances must be interpreted with caution. Besides the presence of both MMNs and pMMRs, only modest changes are to be expected on an individual basis and small samples hinder making statistical conclusions regarding the training's effects. The study contributes to some more descriptive pieces of ERPs and MMNs among the HI children with CIs. The issues of MMN and pMMR are highlighted.
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| 16. |
- Engström, Elisabet, et al.
(författare)
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Computer-assisted reading intervention for children with sensorineural hearing loss using hearing aids : Effects on auditory event-related potentials and mismatch negativity
- 2019
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Ingår i: International Journal of Pediatric Otorhinolaryngology. - : Elsevier. - 0165-5876 .- 1872-8464. ; 117, s. 17-25
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary aim was to investigate whether computer-assisted reading intervention somehow can affect event-related potentials (ERP) and mismatch negativity (MMN) in hearing impaired (HI) children with hearing aids (HAs) and normal hearing (NH) children.METHODS: The study included 15 HI children with sensorineural hearing loss (SNHL) using bilateral HAs and 14 NH children as a reference group; all children between the ages of 5 and 8. A multi-feature MMN-paradigm, Optimum-1, with a standard stimulus alternating with 5 different deviants was used. ERPs were recorded pre and post intervention, i.e. one month of repeatedly computer-assisted training (GraphoGame). MMN was calculated from the average ERP of each deviant minus standard. Data were based on samples within a specific time interval, 80-224 ms, and repeated measures ANOVA was used to analyze possible interactions.RESULTS: There was a significant difference between groups before training, though, the mean obligatory responses or MMN was not statistically significantly different before versus after training, neither among the NH nor the HI children. Further, the HI children did generally achieve lower levels in GraphoGame compared to the NH children. Altogether, our findings indicate differences between the groups and that training may affect the neurophysiological processing in the brain, gaining the HI children. Both MMN and positive mismatch response (pMMR) were seen among both the HA and NH children, irrespective to deviant type. Individually, changes of the MMN and pMMR after training seem unpredictable.CONCLUSION: There are statistically significant differences in both the obligatory responses in ERP and the MMNs between the NH and HI groups before the computer-assisted training. Though, these differences disappear after the intervention. This suggests possible training effects regarding the central auditory processing among the HI children.
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| 17. |
- Engström, Elisabet
(författare)
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Neurophysiological conditions for hearing in children using hearing aids or cochlear implants : an intervention and follow-up study
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: The four studies in this thesis examine the central auditory pathways in children with hearing loss (HL) through recording event-related potentials (ERP) and mismatch negativity (MMN). The design of the project is partly experimental, and it also includes an intervention part and a follow-up-study after three years. The primary aims were the following: I. Explore whether a multi-feature paradigm (Optimum-1) for eliciting MMN could characterise difficulties in perceiving small sound contrasts in children with HL using their hearing aids (HAs) or cochlear implants (CIs) (Paper I). II. Investigate whether a computer-assisted reading intervention programme with a phonics approach (GraphoGame) could affect ERP and MMN in children with HL using HAs (Paper II) and CIs (Paper III). III. Examine the developmental changes of ERP and MMN over time (three years) among children with HL using HAs or CIs (Paper IV). METHODS: In total, children with HL (n=30) using HAs (n=15) or CIs (n=15), as well as a reference group of children with normal hearing (NH) (n=16), participated. All children were approximately 5–8 years old at baseline (the first ERP recording session), and 8–11 years old at the follow-up after three years. Paper I includes all participants at baseline. Paper II (children with HAs) and Paper III (children with CIs) are the intervention part: one month of repeatedly training with a computer-assisted reading intervention programme with a phonics approach (GraphoGame) and involve two ERP recording sessions: before and after the training. Paper IV comprises the follow-up study after three years and includes all three groups: the children using HAs, the children with CIs, and the children with NH. All studies are based on ERP recordings that, including the data processing, were identical for each of the three sessions. The ERP-recordings followed the multi-feature paradigm, Optimum-1. Thus, a standard stimulus alternated among five different deviants (gap, intensity, pitch, location, and duration), presented in a pseudorandom sequence. MMN was calculated from the average ERP of each deviant minus the standard stimulus. Analysis of variance (ANOVA) was used for the statistical analyses. Paper I served as a model for analyses and interpretations of the results. The results in Paper II–IV were based on samples within a specific time interval: 80–224 ms. The method is non-invasive and safe for the participants. MMN is independent of attention, measured by using an electrode net. Optimum-1 enables short recording sessions. Together, it is a method appropriate for testing children. RESULTS: Paper I demonstrated that the multi-feature paradigm, Optimum-1, could elicit responses in children with HL using their HAs or CIs. Four time windows (TW) were created to structure and facilitate further analyses. TW 2 of 80–220 ms was considered appropriate for the primary test of MMN effects. Overall, the response amplitudes were smaller in the HA group than the NH groups in TW 2. Otherwise, the results could not statistically prove any major differences in discrimination between groups. Paper II established significant differences in the obligatory responses in both ERP and MMN between the NH and HA groups before the computer-assisted training, which disappeared after the intervention. This suggests possible training effects among the children with HAs. This paper also provides a description of MMN and positive mismatch response (pMMR) in all deviants and groups (NH vs HA). Paper III could not statistically demonstrate any computer-assisted training effects detectable with ERPs and MMN among children with CIs. Thus, the results differ from the results regarding children with HAs in Paper II, suggesting that there are differences between these two subgroups of children with HL. The paper also offers a description of MMN and pMMR regarding all deviants in each group (NH vs CI). Paper IV found a significant difference in mean ERP at baseline compared to the time of follow-up three years later in the HA group. This suggests a possible catch-up over time among the children with HAs. On the contrary, the obligatory responses in ERP among the children with CI were significantly lower than both the children with NH and HAs after three years, indicating impaired development of the central auditory system among the children with CIs. There was a high degree of inter-individual variability of both MMNs and pMMRs due to maturational changes in the current age groups. Only small changes were to be expected after training (Paper II and III) and after follow-up (Paper IV), which, together with small sample sizes, may have diminished the ability to demonstrate significant results.
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| 18. |
- Engström, Gunnar, et al.
(författare)
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Marital Dissolution Is Followed by an Increased Incidence of Stroke.
- 2004
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 18:4, s. 318-324
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Many studies have reported lower mortality in married people. The relation between marital status and incidence of haemorrhagic and ischaemic stroke is unclear. It is largely unknown whether the risk of stroke is increased the first years after divorce or death of spouse. <i>Methods:</i> Incidence of first-ever stroke (n = 6,184) was followed over 10 years in a cohort consisting of all 40- to 89-year-old inhabitants (n = 118,134) in the city of Malmö, Sweden. Marital dissolution (i.e. divorce or death of spouse) prior to the date of stroke was compared in a nested case-control design (3,134 initially married stroke cases, 9,402 initially married controls). <i>Results:</i> As compared to the married groups, the incidence of stroke was increased in divorced men and women (RR = 1.23, CI: 1.10–1.39 and RR = 1.26, CI: 1.12–1.41, respectively) and widowed men and women (RR = 1.13, CI: 0.99–1.28 and RR = 1.13, CI: 1.02–1.24, respectively) after adjustments for age, country of birth and socioeconomic indicators. The risk of stroke was not increased in never married men. Marital dissolution was followed by increased risk of stroke, which was significant for men (adjusted odds ratio: 1.23, CI: 1.03–1.5) and borderline significant for women below 65 years of age (odds ratio: 1.45, CI: 0.99–2.14). <i>Conclusion:</i> The incidence of stroke is increased in divorced and widowed individuals. Never married men do not have an increased incidence. The risk of stroke is elevated during the first years after divorce or death of spouse.
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| 19. |
- Engström, Katarina, 1956, et al.
(författare)
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The myxoid/round cell liposarcoma fusion oncogene FUS-DDIT3 and the normal DDIT3 induce a liposarcoma phenotype in transfected human fibrosarcoma cells.
- 2006
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Ingår i: The American journal of pathology. - : Elsevier BV. - 0002-9440 .- 1525-2191. ; 168:5, s. 1642-53
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Tidskriftsartikel (refereegranskat)abstract
- Myxoid/round cell liposarcoma (MLS/RCLS) is the most common subtype of liposarcoma. Most MLS/RCLS carry a t(12;16) translocation, resulting in a FUS-DDIT3 fusion gene. We investigated the role of the FUS-DDIT3 fusion in the development of MLS/RCLS in FUS-DDIT3- and DDIT3-transfected human HT1080 sarcoma cells. Cells expressing FUS-DDIT3 and DDIT3 grew as liposarcomas in severe combined immunodeficient mice and exhibited a capillary network morphology that was similar to networks of MLS/RCLS. Microarray-based comparison of HT1080, the transfected cells, and an MLS/RCLS-derived cell line showed that the FUS-DDIT3- and DDIT3-transfected variants shifted toward an MLS/RCLS-like expression pattern. DDIT3-transfected cells responded in vitro to adipogenic factors by accumulation of fat and transformation to a lipoblast-like morphology. In conclusion, because the fusion oncogene FUS-DDIT3 and the normal DDIT3 induce a liposarcoma phenotype when expressed in a primitive sarcoma cell line, MLS/RCLS may develop from cell types other than preadipocytes. This may explain the preferential occurrence of MLS/RCLS in nonadipose tissues. In addition, development of lipoblasts and the typical MLS/RCLS capillary network could be an effect of the DDIT3 transcription factor partner of the fusion oncogene.
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| 20. |
- Engström, Lorentz, et al.
(författare)
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Pyruvate kinase
- 1987
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Ingår i: The enzymes. - : Elsevier. - 9780121227180 ; , s. 47-75
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Bokkapitel (refereegranskat)
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| 21. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
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Internationally educated nurses' and medical graduates' experiences of getting a license and practicing in Sweden - a qualitative interview study
- 2018
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Ingår i: BMC Medical Education. - : Springer Science and Business Media LLC. - 1472-6920. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Swedish healthcare system has an increased need for nurses and physicians, and the number of International Educated Nurses (IENs) and International Medical Graduates (IMGs) seeking job opportunities and a license to practice in Sweden is rising. This study explored how IENs and IMGs describe their experience of getting a license to practice, their perceptions of working in Sweden and of how their intercultural competence is utilized.METHOD: A qualitative study based on semi-structured interviews with 11 IENs and 11 IMGs. The interviews were conducted between 2015 and 2017. The data were analyzed using qualitative content analysis.RESULTS: Three main themes were identified: 'Getting a license - a different story,' 'The work is familiar, yet a lot is new,' 'Trying to master a new language.' The time to obtain a license to practice and finding a job was shorter for IENs and IMGs coming from European countries than for those from non-European countries. Some of the experiences of getting a license to practice and of entering a new workplace in another country were the same for nurses and physicians. In general, both IENs and IMGs felt welcomed and used their intercultural competence at work. Lack of language skills was regarded as the main problem for both professions, while workplace introduction was shorter for IMGs than for IENs.CONCLUSIONS: Problems related to language and culture are often underestimated, therefore organizations and managers employing IENs and IMGs should provide longer workplace introduction to facilitate the acculturation process. More time-efficient language courses specifically adapted to IENs and IMGs could make the transition easier and shorten the time to obtain a license to practice for both professions.
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| 22. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
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Internationally educated nurses’ descriptions of their access to structural empowerment while working in another country’s health care context
- 2018
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 26:7, s. 866-873
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Tidskriftsartikel (refereegranskat)abstract
- AIM:To examine internationally educated nurses' experiences of empowerment structures using Kanter's theory of structural empowerment.BACKGROUND:There has been an increase in the number of nurses working in other countries worldwide and concerns have been raised regarding their working conditions.METHOD:Semi-structured interviews were conducted with a purposive sample of 11 internationally educated nurses. Directed content analysis was used to analyse the data and Kanter's theory of empowerment was used as a framework.RESULTS:Access to information was generally good. Access to support for their relationship with their managers varied. Regarding access to resources, nurses unfamiliar with clinical leadership found team leadership challenging. Access to in-house learning opportunities were reported as good. Access to informal power was more common than access to formal power.CONCLUSIONS:The findings support Kanter's theory and demonstrate that internationally experienced nurses encountered varying degrees of access to empowering structures. Access to information and formal power was more general and related to the unit. Access to resources, support, opportunities and informal power were related to both the unit and the informants' specific situation as IENs.IMPLICATIONS FOR NURSING MANAGEMENT:Managers need to support IENs when having a team leadership role, facilitate encounters between IENs and ordinary staff, and establishing mentorship for IENs.
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| 23. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
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Job satisfaction and wellbeing among migrant care workers in nursing homes : An integrative review
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:6, s. 3486-3505
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Forskningsöversikt (refereegranskat)abstract
- Aim: To systematically analyse and synthesize studies investigating job satisfaction (including turnover and turnover intention) and wellbeing (physical, social and psychological including work stress, acculturation stress and sick leave) among migrant care workers in nursing homes.Design: An integrated review was conducted.Methods: Joanna Briggs Institute's manual guided the analysis of qualitative data (n = 31). Quantitative data (n = 17) were summarized and integrated with the qualitative findings.Results: Migrants described high job demands, limited control and social support, and stress possibly related to acculturation. Although, compared to natives (born in the country), inconsistent results were reported about wellbeing and job satisfaction, migrant care workers reported enjoying the relational aspects of work and feeling pride when providing care. A satisfying work environment for migrant care workers enables them enjoying working in elderly care with pride.Public Contribution: Help managers to promote an inclusive working life in line with the United Nations Sustainable Development Goal number 8.
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| 24. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
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Preceptors' experiences of supervising internationally educated nurses attending a bridging program: An interview study
- 2023
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Ingår i: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 131
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInternationally educated nurses attending a bridging program must demonstrate clinical competence and meet requirements to apply for a nursing license in Sweden.ObjectivesTo describe preceptors' experiences of supervising internationally educated nurses undergoing clinical practice education during a bridging program.DesignA qualitative descriptive study.SettingsTwo universities offering the 1-year bridging program for nurses with a nursing degree from outside European Union/European Economic Area and Switzerland.ParticipantsFifteen preceptors, all registered nurses, who supervised internationally educated nurses were included.MethodsSemi-structured interviews were performed, and data were analyzed using qualitative content analysis.ResultsSupervising internationally educated nurses was not the same as supervising nursing students and raised feelings of both joy and frustration. Preceptors had to adapt supervision to the student's nursing knowledge and skills. They had to help students communicate in Swedish and form good relationships with other students, patients, and other professionals. Most preceptors requested more information about the student's nurse education, country of education/cultural background, and previous work experiences. Mixed experiences of support from the university, first-line managers, and colleagues were reported.ConclusionsBeing a preceptor for internationally educated nurses is a challenge, and supervision training is important for managing preceptorship. To supervise students based on their level of knowledge and skills, more information must be shared with the preceptor. Encounters with others are of importance in the training, where teamwork and person-centered care must be in focus, both in prior theoretical education and in clinical practice education.
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| 25. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
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The challenges of interviewing internationally educated nurses and doctors in another language than their native language
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Globalization has increased the migration of internationally educated nurses’ (IENs) and International Medical Graduates (IMG) to high-income countries.Objective: To highlight the challenges of interviewing internationally educated nurses and doctors in another language than their native language regarding their working experiences in the Swedish health and social care system.Method: Semi-structured interviews with eleven IENs and eleven IMGs. Data were analyzed with qualitative content analysis.Results: Interviews with non-Swedish trained nurses and doctors provide important information about their working experiences in the host country, even if their language skills in the host country’s language can be poor. However, the data had a less nuanced language, the same word could be used repeatedly, English words were sometimes used when not finding the Swedish words and some questions were difficult for the informants to understand and had to be omitted. Performing the interview, transcribing and analyzing them took more time compared to interviews with native speakers. The informants clearly stated that they wanted the interview to be in Swedish and not in for example English.
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