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- Villa, Luisa L., et al.
(författare)
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Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions
- 2007
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Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 356:19, s. 1915-1927
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Human papillomavirus types 16 (HPV-16) and 18 (HPV-18) cause approximately 70% of cervical cancers worldwide. A phase 3 trial was conducted to evaluate a quadrivalent vaccine against HPV types 6, 11, 16, and 18 (HPV-6/11/16/18) for the prevention of high-grade cervical lesions associated with HPV-16 and HPV-18. METHODS: In this randomized, double-blind trial, we assigned 12,167 women between the ages of 15 and 26 years to receive three doses of either HPV-6/11/16/18 vaccine or placebo, administered at day 1, month 2, and month 6. The primary analysis was performed for a per-protocol susceptible population that included 5305 women in the vaccine group and 5260 in the placebo group who had no virologic evidence of infection with HPV-16 or HPV-18 through 1 month after the third dose (month 7). The primary composite end point was cervical intraepithelial neoplasia grade 2 or 3, adenocarcinoma in situ, or cervical cancer related to HPV-16 or HPV-18. RESULTS: Subjects were followed for an average of 3 years after receiving the first dose of vaccine or placebo. Vaccine efficacy for the prevention of the primary composite end point was 98% (95.89% confidence interval [CI], 86 to 100) in the per-protocol susceptible population and 44% (95% CI, 26 to 58) in an intention-to-treat population of all women who had undergone randomization (those with or without previous infection). The estimated vaccine efficacy against all high-grade cervical lesions, regardless of causal HPV type, in this intention-to-treat population was 17% (95% CI, 1 to 31). CONCLUSIONS: In young women who had not been previously infected with HPV-16 or HPV-18, those in the vaccine group had a significantly lower occurrence of high-grade cervical intraepithelial neoplasia related to HPV-16 or HPV-18 than did those in the placebo group.
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| 2. |
- Rauhala, A S, et al.
(författare)
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Which factors are associated with COVID-19 infection incidence in care services for older people in Nordic countries? : A cross-sectional survey
- 2022
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905.
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate the differences between Sweden, Denmark, Finland and Norway regarding residential/home care units' and frontline managers' background factors, the resources allocated and measures taken during the initial phases of the COVID-19 pandemic, and whether and how these differences were associated with COVID-19 among older people in residential/home units.Methods: Register- and survey-based data. Responses from managers in municipal and private residential/home units. Number of municipal COVID-19 cases from national registries. Multilevel logistic multivariate regression analysis with presence of COVID-19 among older people in residential/home units as the outcome variable.Results: The proportions of residential/home units with client COVID-19 cases, mid-March-April 2020 were Denmark 22.7%, Finland 9.0%, Norway 9.7% and Sweden 38.8%, most cases found in clusters. The proportions were similar among employees. Client likelihood of having COVID-19 was six-fold higher if the employees had COVID-19. Mean client cases per residential/home unit were Denmark 0.78, Finland 0.46, Norway 0.22 and Sweden 1.23. For the same municipal infection incidence class, Sweden's mean client infection levels were three-fold those of other countries. The regression analysis variables country, municipal COVID-19 incidence proportion, and care type were associated with client cases at p <= .001. Compared with Denmark, the odds ratios (ORs) for Sweden, Norway and Finland were 1.86, 0.41 and 0.35 respectively. The variable difficulties in preventive testing had an OR of 1.56, p <= .05.Conclusions: Municipal COVID-19 incidence, employee cases, and the lack of testing resources somewhat explained the confirmed COVID-19 cases among older people in residential/home units. A two- to five-fold unexplained inter-country difference in ORs in the multivariate analyses was notable. The level of protection of vulnerable older clients in municipal and private residential/home units differed between the included countries.
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| 6. |
- Lunde, J., et al.
(författare)
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Ion-dispersion and rapid electron fluctuations in the cusp : a case study
- 2008
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Ingår i: Annales Geophysicae. - 0992-7689 .- 1432-0576. ; 26:8, s. 2485-2502
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Tidskriftsartikel (refereegranskat)abstract
- We present results from co-ordinated measurements with the low altitude REIMEI satellite and the ESR (EISCAT Svalbard Radar), together with other ground-based instruments carried out in February 2006. The results mainly relate to the dayside cusp where clear signatures of so-called ion-dispersion are seen in the satellite data. The cusp ion-dispersion is important for helping to understand the temporal and spatial structure of magnetopause reconnection. Whenever a satellite crosses boundaries of flux tubes or convection cells, cusp structures such as ion-dispersion will always be encountered. In our case we observed 3 distinct steps in the ion energy, but it includes at least 2 more steps as well, which we interpret as temporal features in relation to pulsed reconnection at the magnetopause. In addition, fast variations of the electron flux and energy occurring during these events have been studied in detail. The variations of the electron population, if interpreted as structures crossed by the REIMEI satellite, would map near the magnetopause to similar features as observed previously with the Cluster satellites. These were explained as Alfven waves originating from an X-line of magnetic reconnection.
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| 12. |
- Frøiland, Christina T., et al.
(författare)
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Exploring mentorship practices in clinical education in nursing homes : A qualitative mixed-methods study
- 2022
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:7-8, s. 895-908
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore registered nurses' mentorship practices of first-year nursing students in nursing home placements.Background: Enabling nursing students to develop professional competence through clinical placements relies heavily on registered nurses' mentorship practices. Despite renewed interest in nursing homes as an important clinical placement setting, studies are scarce on registered nurses' mentorship practices in this context.Design: An exploratory, qualitative mixed-methods design.Methods: The data consisted of 126 h' observation of two registered nurse mentor-student dyads, supplemented by in-depth interviews (n = 12) with registered nurse mentors. The data were collected in three Norwegian nursing homes and analysed using content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used to report the findings.Results: The registered nurses' mentorship practices of first-year nursing students in nursing home clinical placement were characterised by (1) variability and uncertainty in pedagogical supervisory approaches, (2) lack of management support and engagement of staff members in supervision, (3) lack of supervisory continuity and (4) a peripheral role in formal assessment discussions.Conclusions: A marginal nursing home context, alongside a mismatch between registered nurses' roles and first-year students' learning objectives, introduces considerable vulnerability that impedes effective mentorship practices. Targeted efforts to enhance mentorship practices in nursing homes are warranted to promote full use of the learning potential in this context. Developing and testing educational interventions is necessary to effectively enhance registered nurses' pedagogical competence, alongside engagement and support from nurse managers and nurse educators.Relevance to clinical practice: This study provides insight into barriers to effective mentorship practices of first-year nursing students in nursing home placements. These barriers warrant attention from nursing home managers and nurse education institutions towards improvements that enhance effective mentorship practices vital for students' learning, professional growth and future recruitment to care for older people.
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| 13. |
- Gregersen, Ida, et al.
(författare)
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Legumain in Acute Coronary Syndromes : A Substudy of the PLATO (Platelet Inhibition and Patient Outcomes) Trial
- 2020
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Ingår i: Journal of the American Heart Association. - : WILEY. - 2047-9980. ; 9:17
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The cysteine protease legumain is increased in patients with atherosclerosis, but its causal role in atherogenesis and cardiovascular disease is still unclear. The aim of the study was to investigate the association of legumain with clinical outcome in a large cohort of patients with acute coronary syndrome. METHODS AND RESULTS : Serum levels of legumain were analyzed in 4883 patients with acute coronary syndrome from a substudy of the PLATO (Platelet Inhibition and Patient Outcomes) trial. Levels were analyzed at admission and after 1 month follow-up. Associations between legumain and a composite of cardiovascular death, spontaneous myocardial infarction or stroke, and its individual components were assessed by multivariable Cox regression analyses. At baseline, a 50% increase in legumain level was associated with a hazard ratio (HR) of 1.13 (95% CI, 1.04-1.21),P=0.0018, for the primary composite end point, adjusted for randomized treatment. The association remained significant after adjustment for important clinical and demographic variables (HR, 1.10; 95% CI, 1.02-1.19;P=0.013) but not in the fully adjusted model. Legumain levels at 1 month were not associated with the composite end point but were negatively associated with stroke (HR, 0.62; 95% CI, 0.44-0.88;P=0.0069), including in the fully adjusted model (HR, 0.57; 95% CI, 0.37-0.88;P=0.0114). CONCLUSIONS: Baseline legumain was associated with the primary outcome in patients with acute coronary syndrome, but not in the fully adjusted model. The association between high levels of legumain at 1 month and decreased occurrence of stroke could be of interest from a mechanistic point of view, illustrating the potential dual role of legumain during atherogenesis and acute coronary syndrome. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00391872.
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- Lunde Hermansson, Anna, 1987, et al.
(författare)
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Strong economic incentives of ship scrubbers promoting pollution
- 2024
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Ingår i: Nature Sustainability. - Göteborg : IVL Svenska Miljöinstitutet. - 2398-9629. ; In Press
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Tidskriftsartikel (refereegranskat)abstract
- In response to stricter regulations on ship air emissions, many shipowners have installed exhaust gas cleaning systems, known as scrubbers, allowing for use of cheap residual heavy fuel oil. Scrubbers produce large volumes of acidic and polluted water that is discharged to the sea. Due to environmental concerns, the use of scrubbers is being discussed within the International Maritime Organization. Real-world simulations of global scrubber-vessel activity, applying actual fuel costs and expenses related to scrubber operations, show that 51% of the global scrubber-fitted fleet reached economic break even by the end of 2022, with a surplus of €4.7 billion in 2019 euros. Within five years after installation, more than 95% of the ships with the most common scrubber systems reach break even. However, the marine ecotoxicity damage cost, from scrubber water discharge in the Baltic Sea Area 2014–2022, amounts to >€680 million in 2019 euros, showing that private economic interests come at the expense of marine environmental damage.
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| 17. |
- Tedner, S. G., et al.
(författare)
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Maternal sensitization during pregnancy
- 2018
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Ingår i: Allergy. European Journal of Allergy and Clinical Immunology. - : WILEY. - 0105-4538 .- 1398-9995. ; 73:Suppl. 105, s. 694-694
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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