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1.	Andersson, Ulf, 1985-, et al. (författare) Clinical reasoning in the emergency medical services: an integrative review 2019 Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. Tidskriftsartikel (refereegranskat)abstract Abstract: Clinical reasoning is the process of gathering and understanding information conducted by clinicians in the emergency medical services (EMS) so as to make informed decisions. Research on clinical reasoning spans several disciplines, but a comprehensive view of the process is lacking. To our knowledge, no review of clinical reasoning in the EMS has been conducted.Aim: The aim was to investigate the nature, deployment, and factors influencing EMS clinicians’ clinical reasoning by means of a review.Method: Data was collected through searches in electronic databases, networking among research teams ,colleagues and friends, “grey literature,” and through ancestry searches. A total of 38 articles were deemed eligible for inclusion and were analyzed using descriptive thematic analysis. The analysis resulted in an overarching finding -namely, the importance for EMS clinicians to adjust for perceived control in unpredictable situations. Within this finding, 3 themes emerged in terms of EMS clinicians’ clinical reasoning: (1) maintaining a holistic view of the patient; (2) keeping an open mind; and (3) improving through criticism. Seven subthemes subsequently emerged from these three themes.Results: This review showed that EMS clinicians’ clinical reasoning begins with the information that they are given about a patient. Based on this information, clinicians calculate the best route to the patient and which equipment to use, and they also assess potential risks. They need to be constantly aware of what is happening on the scene and with the patient and strive to control the situation. This striving also enables EMS clinicians to work safely and effectively in relation to the patient, their relatives, other clinicians, associated organizations, and the wider community. A lack of contextually appropriate guidelines results in the need for creativity and forces EMS clinicians to use “workarounds” to solve issues beyond the scope of the guidelines available. In addition, they often lack organizational support and fear repercussions such as litigation, unemployment, or blame by their EMS or healthcare organization or by patients and relatives.Conclusion: Clinical reasoning is influenced by several factors. Further research is needed to determine which influencing factors can be addressed through interventions to minimize their impact on patient outcomes.
2.	Andersson, Ulf, 1985-, et al. (författare) Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study 2023 Ingår i: Paramedicine. - : Sage Publications. - 2753-6386 .- 2753-6386. Tidskriftsartikel (refereegranskat)abstract IntroductionClinical reasoning (CR) among healthcare professionals working in emergency medical services (EMS) who focus on ambulance care is a vital part of ensuring timely and safe patient care. The EMS environment continually fluctuates, so clinicians constantly need to adapt to new situations. Organizational support is described as important for CR, but overall, research on organizational influences for CR in an EMS context is lacking. An increased understanding of these influencing factors can assist in the development of EMS by strengthening CR among clinicians. Therefore, the purpose of this study was to investigate the organizational factors influencing EMS clinicians’ CR.MethodsUsing a qualitative single case study design, an EMS organization in southwestern Sweden was explored. Data were collected from participant observations of patient encounters, individual and group interviews with clinicians and organizational representatives, and organizational document audits. Data were analyzed using qualitative content analysis and triangulation of data sources.ResultsThe results revealed several organizational influencing factors. Collaboration and information sharing internally and externally were emphasized as essential components influencing CR. Additionally, the structure for the clinicians’ ‘room for action’ appeared confused and created uncertainties for CR related to decision mandates.ConclusionThe conclusion is that organizational factors do play an important role in clinicians’ CR. Moreover, the EMS community needs to develop suitable forums for discussing and developing these influencing factors across organizational hierarchies. Finally, clarification is needed on clinicians’ ‘room for action’ within their own organization but also with possible collaborators.
3.	Andersson, Ulf, 1985-, et al. (författare) Situation awareness in Sweden’s emergency medical services : a goal-directed task analysis 2023 Ingår i: Discover Health Systems. - 2731-7501. ; 2 Tidskriftsartikel (refereegranskat)abstract Situation awareness is knowing what is going on in the situation. Clinicians working in the emergency medical services (EMS) encounter numerous situations in various conditions, and to be able to provide efficient and patient safe care they need to understand what is going on and possible projections of the current situation. The design of this study encompassed a Goal-Directed Task analysis where situation awareness information requirements were mapped in relation to goals related to various aspects of the EMS mission. A group of 30 EMS subject matter experts were recruited and answered a web-based survey in three rounds related to what they though themselves or a colleague might need to achieve situation awareness related to the specific goals of various situations. The answers were analysed using content analysis and descriptive statistics. Answers reached consensus at a predetermined level of 75%. Those who reached consensus were entered into the final goal-directed task analysis protocol. The findings presented that EMS clinicians must rely on their own, or their colleagues prior experience or knowledge to achieve situation awareness. This suggests that individual expertise plays a crucial role in developing situation awareness. There also seems to be limited support for situation awareness from organizational guidelines. Furthermore, achieving situation awareness also involves collaborative efforts from the individuals involved in the situation. These findings could add to the foundation for further investigation in this area which could contribute to the development of strategies and tools to enhance situation awareness among EMS clinicians, ultimately improving patient care and safety.
4.	Andersson, Henrik, 1968-, et al. (författare) Simulation in Virtual World to Promote Communication 2018 Ingår i: Pre-hospital care- Education and training of ambulance professionals. - Noordwijkerhout, The Netherlands. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Introduction Communication between ambulance professionals and patients is essential for understanding the patient's lifeworld (Wireklint Sundström & Dahlberg 2010). Simultaneously, communication is challenging to teach and learn within the framework of specific courses. However, simulation in virtual worlds can support the development of new skills such as communication (Combs, Sokolowski & Banks 2016). AimThe aim of this work was to design a simulation-based platform for communication training among ambulance nurse students (ANS). MethodsA qualitative action research approach was used (Coghlan & Casey 2001). Second Life® (SL) was selected since it was an existing virtual world. SL is a web-based flexible three-dimensional platform that allows customization. Interaction and communication with other virtual people can be done through avatars in real time (Hodge, Collins & Giordano 2011). Three ANS and five teachers participated, none of the participants had prior experience of SL. Observations and interviews were used as data and analysed using thematic analysis. Results The participants’ experiences generated three themes: Understanding the virtual worldIt was easy to interact and communicate with other virtual people. However, it took time to feel comfortable to navigate in SL. Technological challengesOne challenge was related to audio-visual problems e.g. not compatible headset, interfering echoes and that the image was distorted at times, which made it difficult to act and move the avatar. Another challenge was associated with the 3D modelling e.g. the capability to use of coordinates, positioning, object dimensioning and the fact that accidental deletions could not be restored. A third challenges that influenced the communication was the difficulty of visualizing clinically relevant care measures such as diagnostic examinations or drug treatment. Finally, there was a challenge to customize the avatars to look like ambulance professionals or a severely ill patient. Learning through avatars Learning through avatars requires that the participants take responsibility for delivering a convincing performance. Immersion was limited since actions do not take place from a first-person viewpoint. There is a need that the scenario is based on realistic conditions e.g. interiors, equipment, clothing, avatar appearance and behaviour. Conclusion The present system is not suitable for training of medical assessment. Teachers who are considering using virtual worlds in the training for future ambulance professionals should note that an appropriate design is crucial for how the simulation is experienced.
5.	Axelsson, Christer, et al. (författare) The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting 2016 Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 31:3, s. 272-277 Tidskriftsartikel (refereegranskat)abstract There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter.All patients in the Municipality of Gothenburg (Sweden) with a positive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey.In all, 696 patients fulfilled the inclusion criteria. Their mean age was 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had “true pathogens” in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms and signs.The EMS nurse suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes versus three hours and 21 minutes among the remaining patients (P =.0006). The corresponding figures for cases with “true pathogens” were one hour and 19 minutes versus three hours and 15 minutes (P =.009).Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in six percent of cases. Regardless of whether or not patients with true pathogens were isolated, a suspicion of sepsis by the EMS clinician at the scene was associated with a shorter delay to the start of antibiotic treatment.
6.	Bombarda, F., et al. (författare) Runaway electron beam control 2019 Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 61:1 Tidskriftsartikel (refereegranskat)
7.	Bremer, Anders, Docent, 1957-, et al. (författare) Translation and further validation of a global rating scale for the assessment of clinical competence in prehospital emergency care 2020 Ingår i: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 47:August, s. 1-8 Tidskriftsartikel (refereegranskat)abstract Global rating scales are useful to assess clinical competence at a general level based on specific word dimensions. The aim of this study was to translate and culturally adapt the Paramedic Global Rating Scale, and to contribute validity evidence and instrument usefulness in training results and clinical competence assessments of students undergoing training to become ambulance nurses and paramedics at Swedish and Finnish universities. The study included translation, expert review and inter-rater reliability (IRR) tests. The scale was translated and culturally adapted to clinical and educational settings in both countries. A content validity index (CVI) was calculated using eight experts. IRR tests were performed with five registered nurses working as university lecturers, and with six clinicians working as ambulance nurses. They individually rated the same simulated ambulance assignment. Based on the ratings IRR was calculated with intra-class correlation (ICC). The scale showed excellent CVI for items and scale. The ICC indicated substantial agreement in the group of lecturers and a high degree of agree- ment in the group of clinicians. This study provides validity evidence for a Swedish version of the scale, sup- porting its use in measuring clinical competence among students undergoing training to become ambulance nurses and paramedics.
8.	Eriksson, Frida, 1986, et al. (författare) Interpretative and predictive modelling of Joint European Torus collisionality scans 2019 Ingår i: Plasma Physics and Controlled Fusion. - : Institute of Physics Publishing (IOPP). - 0741-3335 .- 1361-6587. ; 61:11 Tidskriftsartikel (refereegranskat)abstract Transport modelling of Joint European Torus (JET) dimensionless collisionality scaling experiments in various operational scenarios is presented. Interpretative simulations at a fixed radial position are combined with predictive JETTO simulations of temperatures and densities, using the TGLF transport model. The model includes electromagnetic effects and collisions as well as (E)over-right-arrow x (b)over-right-arrow shear in Miller geometry. Focus is on particle transport and the role of the neutral beam injection (NBI) particle source for the density peaking. The experimental 3-point collisionality scans include L-mode, and H-mode (D and H and higher beta D plasma) plasmas in a total of 12 discharges. Experimental results presented in (Tala et al 2017 44th EPS Conf.) indicate that for the H-mode scans, the NBI particle source plays an important role for the density peaking, whereas for the L-mode scan, the influence of the particle source is small. In general, both the interpretative and predictive transport simulations support the experimental conclusions on the role of the NBI particle source for the 12 JET discharges.
9.	Falchenberg, Åsa, et al. (författare) Evidence-based guidelines for comprehensive assessment in pre-hospital and hospital emergency care 2018 Ingår i: Presented at the 3rd Global Conference on Emergency Nursing and Trauma Care, Noordwijkerhout, Netherlands, October 4-6, 2018. Konferensbidrag (refereegranskat)
10.	Fuxelius, Hans-Henrik, 1968- (författare) Methods and Applications in Comparative Bacterial Genomics 2007 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Comparative studies of bacterial genomes, now counting in the hundreds, generate massive amounts of information. In order to support a systematic and efficient approach to genomic analyses, a database driven system with graphic visualization of genomic properties was developed - GenComp. The software was applied to studies of obligate intracellular bacteria. In all studies, ORFs were extracted and grouped into ORF-families. Based on gene order synteny, orthologous clusters of core genes and variable spacer ORFs were identified and extracted for alignments and computation of substitution frequencies. The software was applied to the genomes of six Chlamydia trachomatis strains to identify the most rapidly evolving genes. Five genes were chosen for genotyping, and close to a 3-fold higher discrimination capacity was achieved than that of serotypes. With GenComp as the backbone, a massive comparative analysis were performed on the variable gene set in the Rickettsiaceae, which includes Rickettsia prowazekii and Orientia tsutsugamushi, the agents of epidemic and scrub typhus, respectively. O. tsutsugamushi has the most exceptional bacterial genome identified to date; the 2.2 Mb genome is 200-fold more repeated than the 1.1 Mb R. prowazekii genome due to an extensive proliferation of conjugative type IV secretion systems and associated genes. GenComp identified 688 core genes that are conserved across 7 closely related Rickettsia genomes along with a set of 469 variably present genes with homologs in other species. The analysis indicates that up to 70% of the extensively degraded and variably present genes represent mobile genetic elements and genes putatively acquired by horizontal gene transfer. This explains the paradox of the high pseudogene load in the small Rickettsia genomes. This study demonstrates that GenComp provides an efficient system for pseudogene identification and may help distinguish genes from spurious ORFs in the many pan-genome sequencing projects going on worldwide.
11.	Gustavsson, Carolina, et al. (författare) Cerebrospinal fluid levels of insulin, leptin, and agouti-related protein in relation to BMI in pregnant women 2016 Ingår i: Obesity. - : Wiley. - 1930-7381. ; 24:6, s. 1299-1304 Tidskriftsartikel (refereegranskat)abstract ObjectiveDuring pregnancy, metabolic interactions must be adapted, though neuroendocrine mechanisms for increased food intake are poorly understood. The objective of this study was to characterize differences in insulin, leptin, and agouti-related protein (AgRP) levels in serum and cerebrospinal fluid (CSF) in pregnant women with normal weight (NW) and pregnant women with overweight (OW) or obesity (OB). Placenta as a source for increased peripheral AgRP levels during pregnancy was also investigated. MethodsWomen were recruited at admission for elective cesarean section. Insulin, AgRP, and leptin were measured in serum and CSF from 30 NW, 25 OW, and 21 OB at term. Serum during pregnancy and placenta at term were collected for further AgRP analysis. ResultsImmunohistology showed placental production of AgRP and serum AgRP levels increased throughout pregnancy. CSF AgRP, leptin, and insulin levels were higher in OW and OB than NW. Serum leptin and insulin levels were higher and AgRP lower in OB than NW. ConclusionsHigh serum AgRP levels might protect from the suppressive effects of leptin during pregnancy. Pregnant women with OB and OW might further be protected from the suppressive effect of leptin by high CSF AgRP levels. Evidence was found, for the first time, of human placental AgRP production mirrored by levels in the circulation.
12.	Hedsten, Karin, 1964, et al. (författare) MEMS-based VCSEL beam steering using replicated polymer diffractive lens 2008 Ingår i: Sensors and Actuators, A: Physical. - : Elsevier BV. - 0924-4247 .- 1873-3069. ; 142:1, s. 336-345 Tidskriftsartikel (refereegranskat)abstract Abstract. This paper describes a fully integrated micro-optical system, in which dynamic angular control of the beam from a VCSEL (vertical cavity surface emitting laser) is realized by laterally moving a collimat¬ing diffractive lens in the light path. The lens is mounted on a translatable silicon stage, which consists of a frame with an opening for the light to traverse the lens and electro-statically driven comb actuators, by which the lateral movement is achieved. Devices implementing both 1D and 2D scanning have been fabricated and evaluated. Integration of the lens onto the translatable silicon stage is done using a newly developed fabrication process based on hot embossing of an amorphous fluorocarbon polymer. This fabrication process relies on a reversed-order protocol, where the structuring of the optical element precedes the silicon microstructuring. Assembly and packaging of the VCSEL-MOEMS system, using LTCC (low temperature cofired ceramic) technique, is also demonstrated. Optical evaluation of the system and beam steering function shows significant beam deflection for a relatively low driving voltage (~70 V).
13.	Maurin Söderholm, Hanna, et al. (författare) Research challenges in prehospital care : the need for a simulation-based prehospital research laboratory 2019 Ingår i: Advances in Simulation. - : BioMed Central. - 2059-0628 .- 2059-0628. ; 4:3, s. 1-6 Tidskriftsartikel (refereegranskat)abstract There is a need for improved research in the field of prehospital care. At the same time, there are many barriers in prehospital research due to the complex context, posing unique challenges for research, development, and evaluation. The present paper argues for the potential of simulation for prehospital research, e.g., through the development of an advanced simulation-based prehospital research laboratory. However, the prehospital context is different from other healthcare areas, which implies special requirements for the design of this type of laboratory, in terms of simulation width (including the entire prehospital work process) and depth (level of scenario detail). A set of features pertaining to simulation width, scenario depth, equipment, and personnel and competence are proposed. Close tailoring between these features and the prehospital research problems and context presents great potential to improve and further prehospital research.
14.	Nordanstig, Joakim, et al. (författare) Mortality with Paclitaxel-Coated Devices in Peripheral Artery Disease. 2020 Ingår i: The New England journal of medicine. - : Massachusetts Medical Society. - 1533-4406 .- 0028-4793. ; 383, s. 2538-46 Tidskriftsartikel (refereegranskat)abstract The results of a recent meta-analysis aroused concern about an increased risk of death associated with the use of paclitaxel-coated angioplasty balloons and stents in lower-limb endovascular interventions for symptomatic peripheral artery disease.We conducted an unplanned interim analysis of data from a multicenter, randomized, open-label, registry-based clinical trial. At the time of the analysis, 2289 patients had been randomly assigned to treatment with drug-coated devices (the drug-coated-device group, 1149 patients) or treatment with uncoated devices (the uncoated-device group, 1140 patients). Randomization was stratified according to disease severity on the basis of whether patients had chronic limb-threatening ischemia (1480 patients) or intermittent claudication (809 patients). The single end point for this interim analysis was all-cause mortality.No patients were lost to follow-up. Paclitaxel was used as the coating agent for all the drug-coated devices. During a mean follow-up of 2.49 years, 574 patients died, including 293 patients (25.5%) in the drug-coated-device group and 281 patients (24.6%) in the uncoated-device group (hazard ratio, 1.06; 95% confidence interval, 0.92 to 1.22). At 1 year, all-cause mortality was 10.2% (117 patients) in the drug-coated-device group and 9.9% (113 patients) in the uncoated-device group. During the entire follow-up period, there was no significant difference in the incidence of death between the treatment groups among patients with chronic limb-threatening ischemia (33.4% [249 patients] in the drug-coated-device group and 33.1% [243 patients] in the uncoated-device group) or among those with intermittent claudication (10.9% [44 patients] and 9.4% [38 patients], respectively).In this randomized trial in which patients with peripheral artery disease received treatment with paclitaxel-coated or uncoated endovascular devices, the results of an unplanned interim analysis of all-cause mortality did not show a difference between the groups in the incidence of death during 1 to 4 years of follow-up. (Funded by the Swedish Research Council and others; ClinicalTrials.gov number, NCT02051088.).
15.	Olander, Agnes, et al. (författare) Assessment of patients with suspected sepsis in the ambulance services : a qualitative interview study 2021 Ingår i: BMC Emergency Medicine. - : BioMed Central. - 1471-227X. ; 21 Tidskriftsartikel (refereegranskat)abstract Background: The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Early identification, care and treatment are vital for patients with sepsis to avoid adverse outcomes. However, knowledge about how patients with sepsis are assessed in ambulance services (AS) by AC is limited. Therefore, the aim of this study was to explore the meaning of ACs’ lived experiences in assessing patients suspected of having sepsis.Methods: A descriptive design with a qualitative approach was used. Fourteen ACs from three Swedish ambulance organizations participated in dyadic and individual semistructured interviews. A thematic analysis based on descriptive phenomenology was performed.Results: AC experiences were grouped into four themes: (1) being influenced by previous experience; (2) searching for clues to the severity of the patient’s condition; (3) feeling confident when signs and symptoms were obvious; and (4) needing health-care professionals for support and consultation.Conclusions: This study indicates that several factors are important to assessments. ACs needed to engage in an ongoing search for information, discuss the cases with colleagues and reconsider the assessment throughout the entire ambulance mission. A reflective and open stance based on professional knowledge could contribute to recognizing patients with sepsis.
16.	Olander, Agnes, et al. (författare) Lived experiences of the onset of sepsis 2022 Ingår i: The 4th International NCCS & EACS Conference April 27th – 28th 2022 at Mälardalen University, Sweden. Konferensbidrag (refereegranskat)
17.	Olander, Agnes, et al. (författare) Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study 2023 Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press (CUP). - 1049-023X .- 1945-1938. ; 38:2, s. 160-167 Tidskriftsartikel (refereegranskat)abstract Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
18.	Olander, Agnes, et al. (författare) Prehospital characteristics among patients with sepsis: a comparison between patients with or without adverse outcome 2019 Ingår i: Bmc Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 19:1 Tidskriftsartikel (refereegranskat)abstract Background The prehospital care of patients with sepsis are commonly performed by the emergency medical services. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients with sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse prognosis. Therefore, early identification of patients with sepsis is important, and more information about the prehospital characteristics that can be used to identify these patients is needed. Based on this lack of information, the objectives of this study were to investigate the prehospital characteristics that are identified while patients with sepsis are being transported to the hospital by the emergency medical services, and to compare these values to those of the patients with and without adverse outcomes during their hospital stays. Methods This was a retrospective observational study. The patients' electronic health records were reviewed and selected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an emergency department by the emergency medical services. Data were collected on demographics, prehospital characteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit, and analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital characteristics for predicting or development of adverse outcome were analysed. Results In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing patients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care were found to be associated with an adverse outcome. Conclusions The findings suggests that patients having a decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient prognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with sepsis early and improve their long-term outcomes. However further research is required to predict limit values of saturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients with sepsis.
19.	Rosén, Christoffer, 1986, et al. (författare) Increased Levels of Chitotriosidase and YKL-40 in Cerebrospinal Fluid from Patients with Alzheimer's Disease. 2014 Ingår i: Dementia and geriatric cognitive disorders extra. - : S. Karger AG. - 1664-5464. ; 4:2, s. 297-304 Tidskriftsartikel (refereegranskat)abstract The cerebrospinal fluid (CSF) biomarkers total tau, abnormally phosphorylated tau and amyloid β 1-42 are strongly associated with Alzheimer's disease (AD). Apart from the pathologic hallmarks that these biomarkers represent, other processes such as inflammation and microglial activation are present in the brains of patients with AD. New biomarkers related to these processes could be valuable for the diagnosis and follow-up of AD patients and for the evaluation of inflammation-related pathologies.
20.	Wallin, Kim, Doktorand, 1978-, et al. (författare) The Emergency Care Competence Needed for Police Patrol Officers According to the Experts 2022 Ingår i: Nordic Journal of Studies in Policing. - : Scandinavian University Press / Universitetsforlaget AS. - 2703-7045. ; 9:1, s. 1-15 Tidskriftsartikel (refereegranskat)abstract Police patrol officers (PPOs) face different types of encounters with acutely ill and injured people as first responders. The study aim was to explore and describe the emergency care competence needed for Swedish PPOs. The study had an exploratory design, and the data was collected using the Delphi technique from 43 experts in Sweden: police program educators (n=10), police authority instructors (n=11), and PPOs (n= 22). The results generated an understanding of emergency care competence that is relevant for PPOs. Basic assessment and basic life support measures for traumatic injuries and cardiac arrest (e.g., airway management, cardiopulmonary resuscitation (CPR), and hemorrhage control) received the highest levels of agreement among the experts, whereas more advanced assessments (taking care of people suffering from mental/medical illness or with drug/alcohol abuse) received lower levels of agreement. These results provide support for educators at the police programs and for the police authority in preparing PPOs to perform relevant out-of-hospital emergency care.
21.	Öhman, May-Britt, 1966-, et al. (författare) Sámi Land Free University : An invitation to centre Indigenous Peoples expertise and knowledge in an online open access university 2023 Konferensbidrag (refereegranskat)abstract This roundtable aims at presenting what the platform Sámi Land Free University (SFU) has achieved so far and to invite to a conversation on what SFU may achieve in the practice of decolonising research and education, while inviting interested to join forces for courses and joint or shared research over the colonial borders.Over the last four decades, Indigenous Studies (IS) has been developed as an academic discipline within several settler colonial states and within colonial academia, the strongest presence in North America, Australia and Aotearoa/New Zealand. So far Sweden is lagging behind. Yet, IS mainly turns the gaze towards the Indigenous peoples, while to achieve decolonization and long term sustainability, as well as good relations, there is a need for a 180 degrees shift in vision. What if there were several universities that centre Indigenous knowledges and expertise, as point of departure, while researching and teaching for the benefit of all?In 2015, the SFU [www.samelandsfriauniversitet.com ] was created by Lule and Forest Sámi, Dr May-Britt Ӧhman with a vision and challenge of the mind to include the Sámi community and international Indigenous collaborations, having its base on the Swedish side of Sábme. SFU has co-hosted symposia and workshops. We now envision moving on, producing free to access online educational content, inviting earlier and new collaborators. Methods adopted are supra-disciplinary, giving voice to academics, artists, and practitioners of Indigenous ways of knowing and being, while also inviting other scientific methods. Commentator: Kim TallBear, Univ of Alberta, Faculty of Native Studies1 May-Britt Öhman, Lule and Forest Sámi, with Tornedalian heritage, SábmeCentre for Multidisciplinary Studies on Racism, Uppsala UniversityExperiences from the last 7 years with the platform Sámi Land Free University – what has it done for my – and others – thinking and acting?Introductory presentation on how the Sámi Land Free University came about as a website in 2015, followed by a Facebook page, a youtube channel, and some of the activities that has taken place, as well as some thoughts on possibilities to move ahead.There are so far very little opportunities for Sámi to study our own history, culture, traditions, epistemologies at universities in Sweden. There are even less opportunities to have a place in academia for Sámi who are open with their Sámi identity. Hence, there is a need for a place to gather, to develop courses, and proposed ways to make this happen, as the (settler colonial) academia so far gives very little space to Sámi perspectives in Sweden. Yet, Swedish legislation states that the Sámi are a people, with rights, and that Sámi history, culture and tradition shall be taught to pupils in school and secondary school.Furthermore, at universities, there is almost no teaching on Indigenous peoples culture, history, traditions, around the world, while the settler colonial perspectives are taught in all university courses.Thus, there is a need for a Sámi university, on Swedish side of Sábme, that will provide both Sámi and other Indigenous peoples history, traditions, culture, expertise, perspectives - the question is mainly how to organize this.2 Frances Wyld, Martu woman (Aboriginal People of the Pilbara region of Australia) living on Kaurna land, Dr of CommunicationJustice and Society, University of South AustraliaAll good thing are wild and free: the wild winds that carried me to Sámi Land Free University.NAISA introduced me to the international cross fertilization of ideas within Indigenous research and education, specifically it created the opportunity to collaborate with Sámi Land Free University as an Australian Aboriginal scholar. The collaboration has included 6 visits to Sweden and Sápmi for symposia and workshops, publications, and freelance work on a climate change and Indigenous sustainability project. I am a storyteller; I write in the moment inspired by nature. I watch the news reporting on the damage done by wild winds on the weekend. The reporter is in front of a house where a tree has fallen onto it, the house is on my road. At the same time, through my open door, I hear the whine of the chainsaw cutting into this majestic ghost gum tree. Only weeks ago, I was riding my bicycle along the same road with a wild sense of freedom as my birds, the Rainbow Lorikeets who live in the avenue of trees, flew alongside me. Sámi Land Free University has given me the same sense of freedom to work as a decolonising scholar within Critical Indigenous Studies, gaining international perspectives and walking on two lands that are both rich is stories. The collaboration has given me opportunities, and now in the spirit of reciprocity, I lend my skills as a curriculum developer to create content for this grassroots university in another land inhabited by Indigenous people who have much in common with my own people, with knowledges to share for a sustainable future.3 Anna Kajsa Aira and Laila Susanna Kuhmunen, Jokkmokk in collaboration with Alma Linke NilsenDuv gábdde - Du gákti - Din kolt – Your Sámi dressWe are Sámi artisans, duojár. Anna Kajsa makes handicraft – duodje - in the Lule Sámi tradition, Jokkmokk area. Laila Susanna works within the North Sámi duodji tradition of the Karesuando area. We both live in Jokkmokk/Jåhkåmåhkke, a Sámi metropolis. Sámi heritage is passed down from generation to generation.The traditional Sámi dress – gábbde/gákti/kolt - reveals one’s geographical area and is an important link to one’s roots and history. Many Sámi now reclaim their culture by wanting to wear the dress, but there is a gap of one generation in the transmission of knowledge about how to make them. Our project “your Sámi dress” is about providing this knowledge, both by making the gábbde for children and young people, for rent, and through making a digital platform with instructions and advice. It is just as important to be able to wear your gábbde as it is to handle it respectfully. While there is a university in Sweden for textiles and fashion, there is no such for Sámi culture. We think maybe our work could find a place within the SFU, and thereby receive more support. 4 Henrik Andersson and Hampus Andersson, Gällivare Forest Sámi villageExperiences of and reflections on the needs for education and higher education for and about Sámi reindeer herdersReindeer husbandry is carried out on Sámi territories, on almost 50 percent of the territories of the colonial state of Sweden. It is is a tradition – a way of life – as well as a basis for livelihood, income, since several hundred of years. It is acknowledged as a national interest, to be protected, since 1987.Yet, the knowledge and expertise of reindeer herding is mainly passed within the families. Learning demands spending time together with the older generations, from early childhood. As the school system requests pupils to be in school, this often come into conflict with the need to learn. Furthermore, for a reindeer herder, there are an increasing set of other skills than the actual herding – which is complex enough- that are of importance; economics, law, animal health, and one’s own history and culture etc. In school, secondary school, and at universities, there are no opportunities to study reindeer herding with the other skills thereto related. Another aspect of the education system’s lack of teaching on reindeer and reindeer herding, is that when persons within the reindeer herding meet with all parts of society – health care, police, teachers, social care, etc, they have to carry the burden of constantly educating them, and also facing discrimination and racism. Henrik , 42 years old, and Hampus , 20 years old, are two generations reindeer herders within the Gällivare Forest Sámi village, Flakaberg group. They will share their experiences and reflect on the need for education and higher education for Sámi reindeer herders. 5 Susanne Spik and Gun Aira, Jåhkåmåkke in collaboration with Alma Linke NilsenLule Sámi culture and language on university level ? Experiences, reflections and ideas Gun Aira is a Lule Sámi teacher and Susanne Spik, is an entrepreneur and innovator. Both live in Jåhkåmåhkke, and are active within reindeer herding. Both have attended university – teacher’s education- at a Swedish university, in the 1980s. The Lule Sámi language and culture origin in the Lule River valley. Due to the by the Swedish state forced relocation of several North Sámi families, from the Karesuando area during in the 20th century, along with fierce Swedification politics, both the language and culture have become sidestepped. While there is a Lule Sámi centre on Norwegian side, there is no such on the Swedish. In general, there is vastly more support to Sámi culture and language in Norway, than in Sweden. We will present our experiences, reflections and ideas on how SFU could be of use to promote Lule Sámi language and culture, and wish to develop this with the others and the audience.
22.	2018 Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:9 Tidskriftsartikel (refereegranskat)
23.	2018 Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:1 Forskningsöversikt (refereegranskat)
24.	Adman, Per, et al. (författare) 171 forskare: ”Vi vuxna bör också klimatprotestera” 2019 Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447. Tidskriftsartikel (populärvet., debatt m.m.)abstract DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
25.	Ahlgren, Erika, et al. (författare) Association between Plasma Homocysteine Levels and Neuronal Injury in HIV Infection 2016 Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:7 Tidskriftsartikel (refereegranskat)abstract Objective To investigate the role of homocysteine in neuronal injury in HIV infection. Methods Using a cross-sectional design and archived samples, we compared concentrations of plasma homocysteine and cerebrospinal fluid (CSF) neurofilament light protein (NFL), a sensitive marker of neuronal injury, in 83 HIV-1-infected subjects without antiretroviral treatment. We also analyzed plasma vitamin B12, serum folate, CSF, and plasma HIV RNA, the immune activation marker neopterin in CSF and serum, and albumin ratio as a marker of blood-brain barrier integrity. Twenty-two subjects provided a second sample median of 12.5 months after antiretroviral treatment initiation. Results A significant correlation was found between plasma homocysteine and CSF NFL concentrations in untreated individuals (r = 0.52, p < 0.0001). As expected, there was a significant inverse correlation between homocysteine and B12 (r = -0.41, p < 0.001) and folate (r = -0.40, p = < 0.001) levels. In a multiple linear regression analysis homocysteine stood out as an independent predictor of CSF NFL in HIV-1-infected individuals. The correlation of plasma homocysteine and CSF NFL was also present in the group receiving antiretroviral therapy (r = 0.51, p = 0.016). Conclusion A correlation between plasma homocysteine and axonal injury, as measured by CSF NFL, was found in both untreated and treated HIV. While this study is not able to prove a causal link, homocysteine and functional B12/folate deficiency appear to play a role in neural injury in HIV-infected individuals.
26.	An improved model for the accurate calculation of parallel heat fluxes at the JET bulk tungsten outer divertor 2018 Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:10 Tidskriftsartikel (refereegranskat)
27.	Andersson, Anneli, 1992-, et al. (författare) Adverse Pregnancy Outcomes in Women Diagnosed with ADHD : A Population-Based Register Study Annan publikation (övrigt vetenskapligt/konstnärligt)
28.	Andersson, Anneli, 1992-, et al. (författare) Attention-deficit/hyperactivity disorder and smoking habits in pregnant women 2020 Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 15:6 Tidskriftsartikel (refereegranskat)abstract Background: Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women with ADHD may therefore show elevated rates of smoking during pregnancy.Aims: To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway.Methods: Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy.Results: In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway.Conclusions: Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.
29.	Andersson, Anneli, 1992-, et al. (författare) Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder 2023 Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 325, s. 817-823 Tidskriftsartikel (refereegranskat)abstract Background: Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.Methods: We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.Results: A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.Limitations: There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.Conclusions: ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.
30.	Andersson, Anneli, 1992-, et al. (författare) Depression and Anxiety Disorders During the Postpartum Period – in Women Diagnosed with ADHD Annan publikation (övrigt vetenskapligt/konstnärligt)
31.	Andersson, Anneli, 1992-, et al. (författare) Genetic overlap between ADHD and externalizing, internalizing and neurodevelopmental disorder symptoms : a systematic review and meta-analysis 2018 Ingår i: Behavior Genetics. - : Springer. - 0001-8244 .- 1573-3297. ; 48:6, s. 455-456 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder (Wilens, Biederman & Spencer 2002) and affects approximately 5% of children (Polanczyk, de Lima, Horta, Biederman & Rohde 2007). About half of those diagnosed in childhood continue to have the diagnosis and symptoms in adulthood (Kessler et al. 2006). The co-occurrence of ADHD with other psychiatric disorder symptoms (Burt et al. 2001; Cole et al. 2009; Polderman et al. 2014) has been suggested to be partly explained by a shared genetic vulnerability (Polderman et al. 2014). However, the strength of the genetic overlap is currently unclear. Also, no study has examined whether the genetic correlations differs between age groups (childhood versus adulthood), by rater (self-report, other informant, combined (parent-teacher, parent-twin, teacher-twin)), or by type of psychiatric disorder symptoms (externalizing, internalizing, neu-rodevelopmental). To address this gap, we conducted a systematic literature search to identify relevant twin studies, in PubMed, PsycINFO, and EMBASE. A total of 31 articles were identified and included in the present study. The pooled estimates showed that the comorbidity between ADHD and diverse psychiatric disorder symptoms were explained by shared genetic effectsrg= 0.50 (0.43–0.56). A similar shared genetic overlap between ADHD and psychiatric disorder symptoms was observed in both childhood rg= 0.51(0.42–0.61) and adulthood rg= 0.47 (0.40–0.53). Similar results werealso found for self-reports rg= 0.49 (0.42–0.55), other informants rg= 0.50 (0.40–0.60), and combined raters rg= 0.51 (0.30–0.69). Further, the strength of the genetic correlations of ADHD with the externalizing rg= 0.49 (0.39–0.59), internalizing rg= 0.55 (0.40–0.68) and neurodevelopmental rg= 0.47 (0.40–0.53) spectrums were similar in magnitude. These findings emphasize the presence of a shared genetic liability between ADHD and externalizing, internalizing and neurodevelopmental disorder symptoms, independent of age and rater.ReferencesBurt, S. A., Krueger, R. F., McGue, M., Iacono, W. G. (2001).Sources of covariation among attention-deficit/hyperactivity disorder,oppositional defiant disorder, and conduct disorder: the importance ofshared environment.Journal of Abnormal Psychology, 4, 516–525.Cole, J., Ball, H. A., Martin, N. C., Scourfield, J., McGuffin, P.(2009). Genetic overlap between measures of hyperactivity/inatten-tion and mood in children and adolescents.J Am Acad Child AdolescPsychiatry48, 1094–1101.Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C.K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik,K., Spencer, T., Ustun, T. B., Walters, E. E., Zaslavsky, A. M. (2006).The prevalence and correlates of adult ADHD in the United States:results from the National Comorbidity Survey Replication.Am JPsychiatry, 163, 716–723.Polanczyk, G., de Lima, M. S., Horta, B. L., Biederman, J., Rohde,L. A. (2007). The worldwide prevalence of ADHD: a systematicreview and metaregression analysis.Am J Psychiatry, 164, 942-8.Polderman, T. J., Hoekstra, R. A., Posthuma, D., Larsson, H.(2014). The co-occurrence of autistic and ADHD dimensions inadults: an etiological study in 17,770 twins.Transl Psychiatry2014;4: e435.Wilens, T. E., Biederman, J., Spencer, T. J. (2002). Attentiondeficit/hyperactivity disorder across the lifespan.Annual Review Med53:113–131.
32.	Andersson, Agnes, et al. (författare) Headache Before and After Endoscopic Transsphenoidal Pituitary Tumor Surgery: A Prospective Study 2022 Ingår i: Journal of Neurological Surgery Part B-Skull Base. - : Georg Thieme Verlag KG. - 2193-6331 .- 2193-634X. ; 83:suppl. 2 Tidskriftsartikel (refereegranskat)abstract Objective Headache is a common symptom among patients with pituitary tumors, as it is in the general population. The aim of the study was to investigate headache as a symptom in patients with pituitary tumors before and 6 months after endoscopic transsphenoidal surgery (TSS). Design This is a prospective observational cohort study. Setting This study was conducted at university tertiary referral hospital. Participants A total of 110 adult patients underwent endoscopic TSS for pituitary tumors. Main Outcome Measures The Migraine Disability Assessment (MIDAS) questionnaire was used before and 6 months after surgery for the assessment of headache. Clinical variables with potential influence on headache were analyzed. Results Sixty-eight (62%) patients experienced headaches at least once during the 3 months before surgery. Thirty (27%) patients reported disabling headache before surgery, with younger age being an independent associated factor ( p <0.001). In patients with disabling headache before surgery, the median (interquartile range) MIDAS score improved from 78 (27-168) to 16 (2-145; p =0.049), headache frequency decreased from 45 (20-81) to 14 (4-35) days ( p =0.009), and headache intensity decreased from 6 (5-8) to 5 (4-7) ( p =0.011) after surgery. In total, 16 of the 30 (53%) patients reported a clinically relevant improvement and five (17%) a clinically relevant worsening. Four (5%) patients developed new disabling headache. No predictor for postoperative improvement of headache was identified. Conclusion In this prospective study, the results show that disabling headache improves following endoscopic TSS in a subset of patients with pituitary tumors. However, no predictive factors for improvement could be identified.
33.	Andersson, Anneli, 1992- (författare) How is ADHD associated with comorbidities and health related outcomes? : The role of familial factors and ADHD during pregnancy 2021 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by impaired attention and hyperactivity/impulsivity. ADHD is associated with several comorbidities and health-related outcomes. However, it is uncertain whether ADHD is more strongly associated with certain disorder domains, and whether ADHD-related comorbidities and health-related outcomes is important to consider during pregnancy. Aims: To expand the knowledge regarding the genetic overlap between ADHD and other psychiatric disorder symptoms, and to increase the awareness and understanding related to ADHD in women, with a focus on adverse health behaviors, mental health problems, and pregnancy outcomes. Methods: The present thesis includes one systematic review and metaanalysis (Study I), and three studies based on population-based register data from Sweden (Study II, III, and IV), and Norway (Study II).Results: Individuals with ADHD have an increased liability to meet criteria for externalizing, internalizing and neurodevelopmental disordersymptoms, and these co-occurrences are partly due to shared genetic risks. Further, ADHD is an important risk factor to consider before, during and after pregnancy, as ADHD increases the risk of smoking during pregnancy, mental health problems postpartum, and adverse pregnancy outcomes.Conclusions: The genetic overlaps between ADHD and other psychiatric disorder symptoms were similar across disorder dimensions. Further, results demonstrated that ADHD is an important risk factor to consider in women surrounding pregnancy. These findings point towards the importance of recognizing that women diagnosed with ADHD need to be prioritized and allowed more attention and support by the healthcare system, specifically during their fertile years.
34.	Andersson, Anneli, 1992-, et al. (författare) Research Review : The strength of the genetic overlap between ADHD and other psychiatric symptoms - a systematic review and meta-analysis 2020 Ingår i: Journal of Child Psychology and Psychiatry. - : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 61:11, s. 1173-1183 Forskningsöversikt (refereegranskat)abstract Background: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with other psychiatric disorders. Twin studies have established that these co-occurrences are in part due to shared genetic risks. However, the strength of these genetic overlaps and the potential heterogeneity accounted for by type of psychiatric symptoms, age, and methods of assessment remain unclear. We conducted a systematic review to fill this gap.Methods: We searched PubMed, PsycINFO, Embase, and Web of Science until March 07, 2019. Genetic correlations (r(g)) were used as effect size measures.Results: A total of 31 independent studies fulfilled the inclusion criteria. The pooled estimates showed that the associations between ADHD and other psychiatric symptoms were partly explained by shared genetic factors, with a pooled genetic correlation of 0.50, 95% confidence interval: 0.46-0.60. The genetic correlations (r(g)) between ADHD and externalizing (r(g) = .49 [0.37-0.61]), internalizing (r(g) = .50 [0.39-0.69]), and neurodevelopmental (r(g) = .56 [0.47-0.66]) symptoms were similar in magnitude. The genetic correlations in childhood and adulthood werer(g) = .53 (0.43-0.63) andr(g) = .51 (0.44-0.56), respectively. For methods of assessment, the genetic correlations were also similar in strength, self-reportsr(g) = .52 (0.47-0.58), other informantsr(g) = .55 (0.41-0.69), and combined ratersr(g) = .50 (0.33-0.65).Conclusions: These findings indicate that the co-occurrence of externalizing, internalizing, and neurodevelopmental disorder symptoms in individuals with ADHD symptoms in part is due to a shared genetic risk.
35.	Andersson, Henrik, 1968-, et al. (författare) Acute coronary syndrome in relation to the occurrence of associated symptoms : A quantitative study in prehospital emergency care. 2017 Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 33, s. 43-47 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION: Acute chest pain is a common symptom among prehospital emergency care patients. Therefore, it is crucial that ambulance nurses (ANs) have the ability to identify symptoms and assess patients suffering from acute coronary syndrome (ACS). The aim of this study is to explore the occurrence of dyspnoea and nausea and/or vomiting in the prehospital phase of a suspected ACS and the associations with patients' outcome.METHODS: This study has a quantitative design based on data from hospital records and from a previous interventional study (randomised controlled trial) including five Emergency Medical Service (EMS) systems in western Sweden in the years 2008-2010.RESULTS: In all, 1836 patients were included in the interventional study. Dyspnoea was reported in 38% and nausea and/or vomiting in 26% of patients. The risk of death within one year increased with the presence of dyspnoea. The presence of nausea and/or vomiting increased the likelihood of a final diagnosis of acute myocardial infarction (AMI).CONCLUSION: This study shows that dyspnoea, nausea and/or vomiting increase the risk of death and serious diagnosis among ACS patients. This means that dyspnoea, nausea and/or vomiting should influence the ANs' assessment and that special education in cardiovascular nursing is required.
36.	Andersson, Henrik, 1968-, et al. (författare) Competency requirements for the assessment of patients with mental illness in somatic emergency care : A modified Delphi study from the nurses’ perspective 2020 Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 40:3, s. 162-170 Tidskriftsartikel (refereegranskat)abstract Patients suffering from mental illness are vulnerable, and they do not always have access to proper emergency care. The aim of this study was to identify competency requirements for the assessment of patients with mental illness by soliciting the views of emergency care nurses. A modified Delphi method comprising four rounds was used. Data were collected in Sweden between October 2018 and March 2019. The data were analyzed using content analysis and descriptive statistics. The panel of experts reached the highest level of consensus regarding basic medical knowledge: the capability to listen and show respect to the patient are essential competency requirements when assessing patients with mental illness in emergency care. Awareness of these competency requirements will enhance teaching and training of emergency care nurses.
37.	Andersson, Henrik, 1968, et al. (författare) Management of Everyday Work in Emergency Departments – an Exploratory Study with Swedish Managers 2014 Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 22:4, s. 190-196 Tidskriftsartikel (refereegranskat)abstract Introduction: Through their formal mandate, position and authority, managers are responsible for managing everyday work in Emergency Departments (EDs) as well as striving for excellence and dealing with the individual needs of practitioners and patients. The aim of the present study is to explore managers’ experiences of managing everyday work in Swedish EDs. Method: A qualitative and exploratory design has been used in this study. Seven managers were interviewed at two EDs. Data was analysed using qualitative content analysis with focus on latent content. Results: Managers experience everyday work in the ED as lifesaving work. One of the characteristics of their approach to everyday work is their capability for rapidly identifying patients with life-threatening conditions and for treating them accordingly. The practitioners are on stand-by in order to deal with unexpected situations. This implies having to spend time waiting for the physicians’ decisions. Management is characterised by a command and control approach. The managers experience difficulties in meeting the expectations of their staff. They strive to be proactive but instead they become reactive since the prevailing medical, bureaucratic and production-orientated systems constrain them. Conclusion: The managers demonstrate full compliance with the organisational systems. This threatens to reduce their freedom of action and influences the way they perform their managerial duties within and outside the EDs.
38.	Andersson, Henrik, et al. (författare) Nudges and Threats: Soft vs Hard Incentives for Tax Compliance 2021 Annan publikation (övrigt vetenskapligt/konstnärligt)abstract We study what induces delinquent taxpayers to pay their taxes due. We use high quality administrative data from the Swedish Tax Agency. We find a strong effect of the standard enforcement regime: a threat of having the debt handed over to the Enforcement Agency increases payments by roughly 10 percentage points. When including actual enforcement, payment increases by around 20 percentage points compared to those who do not risk enforcement. In a field experiment, we compare these effects of standard enforcement to those of much milder nudges, consisting of letters reminding tax delinquents to pay their taxes due. We find that a “pure nudge”, i.e., the inclusion of an extra piece of paper with no valuable information, has an effect of 7-8 percentage points for those who do not risk enforcement upon non-payment. However, the same nudge has no detectable effect for the group at risk of enforcement. Social-norm messages in turn increase payments both for those who risk enforcement and for those who do not, but to a much smaller degree. We also find that a pure nudge works much better for those who receive a physical letter than for those who receive information electronically, while the reaction to the social-norm nudge is significant for those who get the electronic information.
39.	Andersson, Henrik, 1968-, et al. (författare) Nurses competencies in Home health care : An interview study 2017 Ingår i: BMC Nursing. - : Springer. - 1472-6955. ; 16:65 Tidskriftsartikel (refereegranskat)abstract Background: Nurses working in Home health care (HHC) are facing major challenges when more advanced care and treatment are performing in the patient’s home. The aim of this study was to explore how nurses experiencing their competencies in HHC. Methods: This study has a qualitative and explorative design. Ten nurses were interviewed and data were analysed by content analysis.Results: The themes “Being a capable nurse”, “Being a useful nurse” and “Being a subordinate and dependent nurse” were identified. Nurses want to be capable to take care of patients, develop their competencies and perform their duties in the way that are requested. They also want to be useful in their work and providing good and safe HHC. Finally, nurses want to improve the care in HHC with their competencies. Simultaneously, they are subordinate and dependent in the relation with their manager and manager’s interest to encourage nurses’ competence development.Conclusions: Nurses in HHC are responsible for many seriously ill patients and they want to contribute to a good and safe patient care. To maintain patient safety, reduce the risk for burnout and staff turnover as well as to contribute to a sustainable development of the work, strategies for transfer competencies between nurses and efforts for competence development are needed.
40.	Andersson, Henrik, 1968, et al. (författare) Questioning nursing competences in emergency health care. 2009 Ingår i: Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association. - : Elsevier BV. - 1527-2966 .- 0099-1767. ; 35:4, s. 305-11 Tidskriftsartikel (refereegranskat)abstract INTRODUCTION: Medical and technologic developments entail new competence demands in emergency health care, and it follows that head nurses must recognize and create prerequisites, as well as evaluate the competence of registered nurses. The aim of this study is to describe head nurses' conceptions of emergency nursing competence needs and their responsibility for creating prerequisites of competence development in emergency nursing. METHODS: A 24-item questionnaire was sent to all the head nurses (N = 79) of all the existing emergency departments in Sweden. The response rate was 73%, and in the analysis of the data, descriptive statistics were used. RESULTS: According to the head nurses, basic nursing education does not provide sufficient emergency nursing competence. Consequently, there is a need for supplementary formal emergency nursing education. Furthermore, most of the head nurses have inadequate strategies for evaluating competence development, and economic and personnel resources are insufficient to meet the educational needs. A minority of the head nurses consider that they have full responsibility for creating the prerequisites of the competence development of nurses. DISCUSSION: To ensure sufficient nursing competence in emergency health care organizations, there is a need to establish competence demands in emergency nursing and evaluate strategies for competence development. The establishment of a Swedish emergency nurses association would be important for the development of national guidelines of emergency nursing as well as to facilitate the interpretation and concretizing of rules and legislation and to promote questions related to research, development, and education in emergency nursing. With national guidelines and recommendations, the head nurses' responsibilities for the development of nurses' skills would be clarified.
41.	Andersson, Henrik, 1968-, et al. (författare) Simulerings som metod i handledning för att lära sig hantera akuta situationer 2022 Ingår i: Studenthandledning i vårdande verksamhet. Teoretiska utgångspunkter och didaktiska metoder. - Stockholm : Liber. - 9789147140329 ; , s. 208-219 Bokkapitel (övrigt vetenskapligt/konstnärligt)
42.	Andersson, Henrik, 1968-, et al. (författare) The early chain of care in bacteraemia patients: Early suspicion, treatment and survival in prehospital emergency care 2018 Ingår i: American Journal of Emergency Medicine. - : Elsevier BV. - 0735-6757 .- 1532-8171. ; 36:12, s. 2211-2218 Tidskriftsartikel (refereegranskat)abstract Introduction: Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28 days after admission to hospital. Furthermore, the long-term outcome was assessed. Methods: This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records. Results: In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28 days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code "fever, infection" more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p < 0.0001). Conclusion: This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years. (C) 2018 Elsevier Inc. All rights reserved.
43.	Andersson Hagiwara, Magnus, et al. (författare) Measuring participants’ immersion in healthcare simulation : the development of an instrument 2016 Ingår i: Advances in Simulation. - : BioMed Central. - 2059-0628. ; 2016:1 Tidskriftsartikel (refereegranskat)abstract BackgroundImmersion is important for simulation-based education; however, questionnaire-based instruments to measure immersion have some limitations. The aim of the present work is to develop a new instrument to measure immersion among participants in healthcare simulation scenarios.MethodsThe instrument was developed in four phases: trigger identification, content validity scores, inter-rater reliability analysis and comparison with an existing immersion measure instrument. A modified Delphi process was used to develop the instrument and to establish validity and reliability. The expert panel consisted of 10 researchers. All the researchers in the team had previous experience of simulation in the health and/or fire and rescue services as researchers and/or educators and simulation designers. To identify triggers, the panel members independently screened video recordings from simulation scenarios. Here, a trigger is an event in a simulation that is considered a sign of reduced or enhanced immersion among simulation participants.ResultsThe result consists of the Immersion Score Rating Instrument (ISRI). It contains 10 triggers, of which seven indicate reduced and three enhanced immersion. When using ISRI, a rater identifies trigger occurrences and assigns them strength between 1 and 3. The content validity analysis shows that all the 10 triggers meet an acceptable content validity index for items (I-CVI) standard. The inter-rater reliability (IRR) among raters was assessed using a two-way mixed, consistency, average-measures intra-class correlation (ICC). The ICC for the difference between weighted positive and negative triggers was 0.92, which indicates that the raters are in agreement. Comparison with results from an immersion questionnaire mirrors the ISRI results.ConclusionsIn conclusion, we present a novel and non-intrusive instrument for identifying and rating the level of immersion among participants in healthcare simulation scenarios.
44.	Andersson, Louise, 1979, et al. (författare) Role of EphA4 receptor signaling in thyroid development: regulation of folliculogenesis and propagation of the C-cell lineage. 2011 Ingår i: Endocrinology. - : The Endocrine Society. - 1945-7170 .- 0013-7227. ; 152:3, s. 1154-64 Tidskriftsartikel (refereegranskat)abstract Transcriptome analysis revealed that the tyrosine kinase receptor EphA4 is enriched in the thyroid bud in mouse embryos. We used heterozygous EphA4-EGFP knock-in mice in which enhanced green fluorescent protein (EGFP) replaced the intracellular receptor domain (EphA4(+/EGFP)) to localize EphA4 protein in thyroid primordial tissues. This showed that thyroid progenitors originating in the pharyngeal floor express EphA4 at all embryonic stages and when follicles are formed in late development. Also, the ultimobranchial bodies developed from the pharyngeal pouch endoderm express EphA4, but the ultimobranchial epithelium loses the EGFP signal before it merges with the median thyroid primordium. Embryonic C cells invading the thyroid are exclusively EphA4-negative. EphA4 expression continues in the adult thyroid. EphA4 knock-out mice and EphA4-EGFP homozygous mutants are euthyroid and have a normal thyroid anatomy but display subtle histological alterations regarding number, size, and shape of follicles. Of particular interest, the pattern of follicular abnormality differs between EphA4(-/-) and EphA4(EGFP/EGFP) thyroids. In addition, the number of C cells is reduced by >50% exclusively in animals lacking EphA4 forward signaling (EphA4(EGFP/EGFP)). Heterozygous EphA4 mutants have no apparent thyroid phenotype. We conclude that EphA4 is a novel regulator of thyroid morphogenesis that impacts on postnatal development of the two endocrine cell lineages of the differentiating gland. In this process both EphA4 forward signaling (in the follicular epithelium) and reverse signaling mediated by its cognate ligand(s) (A- and/or B-ephrins expressed in follicular cells and C cells, respectively) are probably functionally important.
45.	Andreasson, Ulf, 1968, et al. (författare) Aspects of beta-amyloid as a biomarker for Alzheimer's disease 2007 Ingår i: Biomarkers in Medicine. - : Future Medicine Ltd. - 1752-0363 .- 1752-0371. ; 1:1, s. 59-78 Forskningsöversikt (refereegranskat)abstract Alzheimer’s disease is an age-related neurodegenerative disorder that results in progressive cognitive impairment and death. The accumulation of β-amyloid (Aβ) in specific brain regions is believed by many to represent the earliest event in the pathogenesis of the disease. Here, we review the key aspects of Aβ as a biomarker for Alzheimer’s disease, including the pathogenicity of Aβ, the possible biological functions of its precursor protein, the Aβ metabolism and homeostasis, the diagnostic performance of different Aβ assays in different settings and the potential usefulness of Aβ as a surrogate marker for treatment efficacy in clinical trials of novel Aβ-targeting drugs against Alzheimer’s disease.
46.	Backlund, Per, 1964-, et al. (författare) Breaking Out of the Bubble Putting Simulation Into Context to Increase Immersion and Performance 2018 Ingår i: Journal Simulation & Gaming. - : Sage Publications. - 1046-8781 .- 1552-826X. ; 49:6, s. 642-660 Tidskriftsartikel (refereegranskat)abstract Objective. Simulation based training with full-size mannequins is a prominent means of training within the healthcare sector. Prehospital missions include all parts of the healthcare process which take place before a patient is handed over to the receiving hospital. This implies that the context for prehospital care is varied and potentially challenging or dangerous in several ways. In this article we present a study which explores immersion and performance by emergency medical services (EMS) professionals in in a training situation which takes the specifics of prehospital interventions into account.Methods. The study was carried out as a field experiment at an ambulance unit. The experiment was designed to compare the differences between two types of medical scenarios: basic and contextualized. We analyzed the levels of immersion throughout the scenarios and then team performance was evaluated by independent experts. Both analyses were made by observing video recordings from multiple camera angles with a custom made analysis tool.Results. Our results show that the contextualization of a medical scenario increases both immersion as measured by the Immersion Score Rating Instrument (ISRI) and team performance as measured by the Global Rating Scale (GRS). The overall ISRI score was higher in the contextualized condition as compared to the basic condition, with an average team wise difference of 2.94 (sd = 1.45). This difference is significant using a paired, two-tailed t-test (p<.001). The GRS score was higher for overall clinical performance in the contextualized scenario with an average team wise difference of 0.83 (sd = 0.83, p=.005).Conclusions. Full-size mannequin simulation based training for EMS professionals may be enhanced by contextualizing the medical scenarios. The main benefits are that the contextualized scenarios better take prehospital medical challenges into account and allow participants to perform better.
47.	Bonanomi, N., et al. (författare) Effects of nitrogen seeding on core ion thermal transport in JET ILW L-mode plasmas 2018 Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:2 Tidskriftsartikel (refereegranskat)
48.	Bonanomi, N., et al. (författare) Light impurity transport in JET ILW L-mode plasmas 2018 Ingår i: Nuclear Fusion. - : IOP Publishing. - 1741-4326 .- 0029-5515. ; 58:3 Tidskriftsartikel (refereegranskat)
49.	Citrin, J., et al. (författare) Tractable flux-driven temperature, density, and rotation profile evolution with the quasilinear gyrokinetic transport model QuaLiKiz 2017 Ingår i: Plasma Physics and Controlled Fusion. - : IOP Publishing. - 1361-6587 .- 0741-3335. ; 59:12 Tidskriftsartikel (refereegranskat)abstract Quasilinear turbulent transport models are a successful tool for prediction of core tokamak plasma profiles in many regimes. Their success hinges on the reproduction of local nonlinear gyrokinetic fluxes. We focus on significant progress in the quasilinear gyrokinetic transport model QuaLiKiz (Bourdelle et al 2016 Plasma Phys. Control. Fusion 58 014036), which employs an approximated solution of the mode structures to significantly speed up computation time compared to full linear gyrokinetic solvers. Optimisation of the dispersion relation solution algorithm within integrated modelling applications leads to flux calculations x 10(6-7) faster than local nonlinear simulations. This allows tractable simulation of flux-driven dynamic profile evolution including all transport channels: ion and electron heat, main particles, impurities, and momentum. Furthermore, QuaLiKiz now includes the impact of rotation and temperature anisotropy induced poloidal asymmetry on heavy impurity transport, important for W-transport applications. Application within the JETTO integrated modelling code results in 1 s of JET plasma simulation within 10 h using 10 CPUs. Simultaneous predictions of core density, temperature, and toroidal rotation profiles for both JET hybrid and baseline experiments are
50.	Danielsson, Henrik, et al. (författare) A Systematic Review of Longitudinal Trajectories of Mental Health Problems in Children with Neurodevelopmental Disabilities 2024 Ingår i: Journal of Developmental and Physical Disabilities. - : Springer. - 1056-263X .- 1573-3580. ; 36, s. 203-242 Forskningsöversikt (refereegranskat)abstract To review the longitudinal trajectories - and the factors influencing their development - of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

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