| 1. |
- Al-Adili, Lina, et al.
(författare)
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Self‐reported documentation of goals and outcomes of nutrition care : A cross‐sectional survey study of Scandinavian dietitians
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:2, s. 472-485
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe documentation of goals and outcomes of nutrition care in Electronic Health Records is insufficient making further exploration of this of particular interest. Identifying common features in documentation practice among Scandinavian dietitians might provide information that can support improvement in this area.AimsTo explore the associations between clinical dietitians' self-reported documentation of patients' goals and outcomes and demographic factors, self-reported implementation of the systematic framework the Nutrition Care Process 4th step (NCP) and its associated terminology, and factors associated with the workplace.MethodsData from a cross-sectional study based on a previously tested web-based survey (INIS) disseminated in 2017 to dietitians in Scandinavia (n = 494) was used. Respondents were recruited through e-mail lists, e-newsletters and social media groups for dietitians. Associations between countries regarding the reported documentation of goals and outcomes, implementation levels of the NCP 4th step, demographic information and factors associated with the workplace were measured through Chi-square test. Associations between dependent- and independent variables were measured through logistic regression analysis.ResultsClinically practicing dietitians (n = 347) working in Scandinavia, Sweden (n = 249), Norway (n = 60), Denmark (n = 38), who had completed dietetic education participated. The reported documentation of goals and outcomes from nutrition intervention was highly associated with the reported implementation of NCP 4th step terminology (OR = 5.26; p = 0.009, OR = 3.56; p = 0.003), support from the workplace (OR = 4.0, p < 0.001, OR = 8.89, p < 0.001) and area of practice (OR = 2.02, p = 0.017). Years since completed dietetic training and educational level did not have any significant associations with documentation practice regarding goals and outcomes.ConclusionFindings highlight strong associations between the implementation of the NCP 4th step terminology and the documentation of goals and outcomes. Strategies to support dietitians in using standardized terminology and the development of tools for comprehensive documentation of evaluation of goals and outcome are required.
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| 2. |
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| 3. |
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| 4. |
- Andersson, Lars, et al.
(författare)
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Sprouting capacity from intact root systems of Cirsium arvense and Sonchus arvensis decrease in autumn
- 2013
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Ingår i: Weed research (Print). - : Wiley. - 0043-1737 .- 1365-3180. ; 53:3, s. 183-191
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Tidskriftsartikel (refereegranskat)abstract
- Perennial weeds are often controlled by mechanical means, which aim at stimulating axillary and adventitious buds to sprout. This happens when the apical dominance of the main shoot is removed by defoliation or when the underground system is fragmented. By repeating the measures, the result is a depletion of storage compounds, which weakens the plants and reduces their capacity to grow and reproduce. However, timing is critical. Earlier research has indicated that emergence from fragments of Sonchus arvensis cease during a period in autumn, while the seasonal pattern of sprouting in Cirsium arvense appears to be inconsistent. We studied the emergence pattern of defoliated plants with undisturbed root systems, from late summer to early spring. Potted plants grown outdoors were exhumed at regular intervals, put under forcing conditions for 4weeks, after which shoots above and below soil level were counted and weighed together with the remaining root systems. In both species, the number and weight of emerged shoots decreased during a period in the autumn. In C.arvense, underground shoots were constantly produced during the same period, while fewer underground shoots were present in S.arvensis. For the latter species, apical dominance does not fully explain the effect; thus, endodormancy might be involved. Root weight increased until withering and did not explain the lack of emergence. Our results suggest an impaired sprouting capacity of undisturbed root systems of C.arvense and S.arvensis during SeptemberOctober, which has implications for the timing and method of control of these species.
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| 5. |
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| 6. |
- Berntsson, Shala G., 1964-, et al.
(författare)
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Rapidly increasing off-label use of rituximab in multiple sclerosis in Sweden : Outlier or predecessor?
- 2018
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 138:4, s. 327-331
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Off-label use of rituximab to treat MS patients in Sweden is high, and the need for long-term safety data may not be met. Our objectives were to assess the rate of rituximab prescription in patients with multiple sclerosis in Sweden and, in addition, to evaluate the safety of rituximab in a single centre for patients with multiple sclerosis.MATERIAL AND METHODS: Review of the Swedish MS register was performed to study the number of MS patients treated with rituximab during the last 6 years. Investigation also included a retrospective review of medical files in search for possible side effects/adverse events in all adult patients with MS treated with rituximab at Uppsala University Hospital.RESULTS: Presently, in Sweden the rate of rituximab prescriptions in relation to other annually started of disease- modifying drugs in MS is 53.5%.CONCLUSIONS: The share of MS patients in Sweden who are treated with rituximab is very high, and also rapidly increasing. Taken into account the off-label use, cases with adverse medical conditions that could possibly be related to rituximab use should be reported thoroughly.
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| 7. |
- Bjørnevik, Kjetil, et al.
(författare)
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Negative interaction between smoking and EBV in the risk of multiple sclerosis : The EnvIMS study
- 2017
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 23:7, s. 1018-1024
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Results from previous studies on a possible interaction between smoking and Epstein-Barr virus (EBV) in the risk of multiple sclerosis (MS) are conflicting.OBJECTIVES: To examine the interaction between smoking and infectious mononucleosis (IM) in the risk of MS.METHODS: Within the case-control study on Environmental Factors In Multiple Sclerosis (EnvIMS), 1904 MS patients and 3694 population-based frequency-matched healthy controls from Norway, Italy, and Sweden reported on prior exposure to smoking and history of IM. We examined the interaction between the two exposures on the additive and multiplicative scale.RESULTS: Smoking and IM were each found to be associated with an increased MS risk in all three countries, and there was a negative multiplicative interaction between the two exposures in each country separately as well as in the pooled analysis (p = 0.001). Among those who reported IM, there was no increased risk associated with smoking (odds ratio (OR): 0.95, 95% confidence interval (CI): 0.66-1.37). The direction of the estimated interactions on the additive scale was consistent with a negative interaction in all three countries (relative excess risk due to interaction (RERI): -0.98, 95% CI: -2.05-0.15, p = 0.09).CONCLUSION: Our findings indicate competing antagonism, where the two exposures compete to affect the outcome.
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| 8. |
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| 9. |
- Boström, Anita, 1957-, et al.
(författare)
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Förekomsten av våld i nära relationer bland äldre personer
- 2022
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Ingår i: Äldre personers utsatthet för våld i nära relationer. - : Studentlitteratur AB. - 9789144155142 ; , s. 31-64
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Frågor om våld i nära relationer är numera vanligt förekommande i media, politiska debatter, offentliga utredningar och lagändringar. Men trots detta uppmärksammas sällan äldre personers utsatthet för våld. Anledningarna kan vara flera, men tanken på att äldre kan utsättas för våld i en nära relation är för många avlägsen.Äldre personers utsatthet för våld i nära relationer vill synliggöra att olika typer av våld förekommer mot och bland äldre personer. Men det allra viktigaste är att ge kunskap om hur omgivningen kan uppmärksamma detta och förhindra våld, samt ge hjälp och stöd. Boken belyser det ansvar som olika myndigheter, såsom socialtjänst, hälso- och sjukvård samt tandvård, har. Ett kapitel beskriver rättsprocessen vid en anmälan och ett annat belyser vilka svårigheter en äldre person kan ha när det gäller att söka hjälp och att bryta upp från en relation. Flera kapitel innehåller konkreta råd för hur exempelvis personal kan ge hjälp och stöd.Äldre personers utsatthet för våld i nära relationer är i första hand skriven för högskoleutbildningar inom socialt arbete, vård, omsorg och medicin. Boken kan också vara till nytta för alla som vill öka sin kunskap om äldre personers utsatthet för våld i nära relationer.
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| 10. |
- Boström, Eva, et al.
(författare)
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Clinical challenges and ongoing role changes for primary health-care nurses
- 2012
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Ingår i: British Journal of Community Nursing. - : Mark Allen Group. - 1462-4753 .- 2052-2215. ; 17:2, s. 68-74
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the perceptions of primary health-care nurses (PHNs) about clinical demands and future challenges.METHOD: Qualitative content-analysis of open questions from a questionnaire. A total of 121 PHNs from health-care districts in northern Sweden filled in a questionnaire during a mandatory educational day.RESULTS: Key issues that were raised included: defending the specific professional role of the PHNs; strengthening their self-governance and authority; and ensuring adequate care in the future through education that focuses more on nursing practice than on academic work.CONCLUSION: To ensure that the role of the PHN continues to develop, it is necessary to enable them to articulate, discuss, and evaluate their profession and to learn, in concrete forms, how to implement science in clinical practice.
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| 11. |
- Boström, Eva, 1966-
(författare)
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Proximity and distance : challenges in person-centred care for diabetes specialist nurses in primary health care
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Type 2 diabetes demands self-management over time, to maintain health and reduce the risk for diabetes complications. However, despite efforts, many persons with type 2 diabetes are not reaching the treatment targets. In diabetes, person-centred care and group education are recommended. Diabetes specialist nurses (DSNs) working in primary healthcare have an important role in supporting patients with type 2 diabetes in their self-management to adapt to the demands of the disease in everyday life. Therefore, it is important to explore the DSNs’ professional role and their experiences of practising person-centred care. The overall aim of the thesis was to explore the professional role of DSNs in primary healthcare, and to describe their experiences of person-centred diabetes care.Methods The thesis includes three studies with qualitative, and one with a quantitative, approach. Data collection consisted of focus group interviews, individual interviews, observations, and questionnaires. Qualitative content analysis and statistics were used in the analysis. In studies I and II, 29 and 31 DSNs participated, respectively. In study III, 10 DSNs and 44 persons with type 2 diabetes participated. Lastly, in study IV, 10 DSNs participated.Results The results in the thesis showed that DSNs have a complex and multifaceted professional role that entails striving to be an expert, a fosterer, a leader, an executive, and a role model, which they found challenging. The DSNs perceived high job demands, such as decision-making and learning. The thesis also showed that the interaction between DSNs and persons with type 2 diabetes shifted from empowerment to authority struggles during group support sessions based on person-centred care. The experience of person-centred care was described as enriching, but DSNs also expressed ambivalence, related to an altered professional role.Conclusion There is a desire by DSNs to be close to persons with type 2 diabetes, although they have several challenges to fulfil, which makes it difficult to uphold a relation with proximity; thus, distance is also present. Even though person-centred care is recommended in healthcare, and despite DSNs’ efforts to practise PCC, the result of this thesis shows that it also implies an altered professional role for DSNs that has to be addressed.
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| 12. |
- Boström, Eva, et al.
(författare)
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Registered nurses' experiences of communication with patients when practising person-centred care over the phone: a qualitative interview study
- 2020
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Ingår i: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. Results The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. Conclusions PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.
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| 13. |
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| 14. |
- Boström, Inger, et al.
(författare)
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An ecological study of industry in a high-risk region of multiple sclerosis
- 2011
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Ingår i: Journal of the Neurological Sciences. - : Elsevier. - 0022-510X .- 1878-5883. ; 311:1-2, s. 50-57
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Tidskriftsartikel (refereegranskat)abstract
- The county of Varmland, Sweden, has shown a high frequency of multiple sclerosis in several investigations. It has been presented in three studies: a period prevalence study in 1925-1934, a mortality study during 1952-1992 and a prevalence investigation in 2002. The aim of this study was to investigate the pattern of industry in this high-risk area for multiple sclerosis. The three investigations were correlated with industry in 1913 and in the 1950s, all analyzed by the Kruskall-Wallis test. Select industries from wood-pulp, paper and iron/mechanical sectors were tested also in whole Sweden. The Spearman rank correlation was used for these data and forestry data in Varmland. In Varmland, industrial data from 1913 revealed that large sawmills were associated with the period prevalence in 1925-1934 and there was a possible correlation with the prevalence for 2002. Wood-pulp factories showed a possible association with the prevalence 1925-1934 and the mortality 1952-1992. Some industries in the 1950s were correlated with the prevalence 2002. Wood and paper industries in Sweden 1913 showed an association with the MS mortality 1952-1992. In summary, data on MS prevalence in Varmland and mortality both in Varmland and all Sweden from the past 100 years suggest an association with wood-related industries in 1913 and in the 1950s, whereas no consistent association was found for other industries.
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| 15. |
- Boström, Inger, et al.
(författare)
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Does the changing sex ratio of multiple sclerosis give opportunities for intervention?
- 2015
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Ingår i: Acta Neurologica Scandinavica. - : Wiley. - 0001-6314 .- 1600-0404 .- 0065-1427 .- 1600-5449. ; 132, s. 42-45
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Forskningsöversikt (refereegranskat)abstract
- In several international studies, an increasing women-to-men (w/m) ratio in patients with multiple sclerosis (MS) has been reported. Such sex ratios have been analysed by year of onset or by year of birth. In a Swedish study, data from the Swedish MS register (SMSreg) were used to analyse the w/m ratio in Sweden. The sex ratio was analysed both by year of birth (8834 patients) and by year of onset (9098 patients). No increased w/m ratio was seen in this study. The age-specific sex ratio did not demonstrate any significant changes. However, a new investigation of the sex ratio in Sweden, based on data from all available data sources (19,510 patients), showed a significantly increased w/m ratio of MS in Sweden from 1.70 to 2.67. Environmental factors such as cigarette smoking, hormonal factors and nutrition are of interest in this context, but the cause of the increasing w/m ratio in MS is yet not possible to explain.
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| 16. |
- Boström, Inger, 1946-
(författare)
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Epidemiological Studies of Multiple Sclerosis in Sweden with focus on the County of Värmland
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to study the frequency of MS in the suggested high-risk area of Värmland county by investigating the current prevalence and analyzing the development over time; secondly to investigate some aetiological factors – the pattern of industry, both in relation to MS in Värmland and in the whole country, and also to examine the possible relation between the distribution of MS and ALS, as it has previously shown a positive correlation in two studies; finally to analyze the women-to-men ratio of MS in Sweden because of international reports of an increasing ratio.Clinical data was collected from hospitals and other health care units in the county of Värmland, to calculate the prevalence ratio. The prevalence was 170.07 per 100,000 population on the prevalence day, 31 December 2002. The incidence rates analysed during ten years was 6.46 per 100,000 personyears (1991-1995) and 6.39 (1996-2000).The ecological study used data from the beginning of the 20th century on industries in Värmland and in all Sweden, which were correlated with the two MS prevalence studies (1925-1934 and 2002), and the mortality study on the time period 1952-1990. There was a statistical significant association between large sawmills and the prevalence 1925-1934 (p = 0.022). For all Sweden, wood-pulp factories and papermills correlated significantly with MS mortality 1952-1990 (p = <0.05).Collected data from Causes of death Register and from the Total Population Register were used when analysing mortality from ALS and MS. The previously shown correlation between ALS and MS mortality distribution in the Swedish counties was not confirmed in this study. However, the mean MS mortality rate was still highest in the county in Värmland. The mean MS mortality rates for whole Sweden was increased from 1.65 per 100,000 person-years (1952-1992) to 2.04 (1990-2010).For analysing sex ratio in MS, data from the Swedish Multiple Sclerosis Register and data from Total Population Register of the Swedish Statistics Office were used. These data was analysed by birth day cohort and by year of onset. The sex ratios in Sweden showed a stable women-to-men ratio.These investigations give indication that Värmland is a high-risk region of multiple sclerosis, and particularly the municipality of Säffle.We conclude that Värmland is a suitable area for continued epidemiological studies with both an environment and genetic focus.
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| 17. |
- Boström, Inger, et al.
(författare)
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High prevalence of multiple sclerosis in the Swedish county of Värmland
- 2009
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 15:11, s. 1253-1262
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Tidskriftsartikel (refereegranskat)abstract
- Previous epidemiological studies have indicated that the county of Värmland in western Sweden may be a high-risk zone for multiple sclerosis (MS). The objective of this study was to determine the prevalence in the area. Hospital and general practice medical files were scrutinized. The diagnostic criteria of Poser were used, with 31 December 2002 as prevalence day. The prevalence was 170.07 per 100,000 inhabitants. The average annual incidence was 6.39 to 6.46 per 100,000 (1991—1995, 1996—2000). Multiple sclerosis was 2.3 times more common among women than men. There was a variation in prevalence among the 16 municipalities, however it was not statistically significant. The rates seemed highest in the southwestern part of the county, roughly similar in location to findings some 70 years earlier. When the prevalence ratios by geographical units for the county in 1933 were applied to the current prevalence, the distribution from these estimated cases differed from homogeneity with very high significance (p < 0.00001 ). In conclusion, this study supports previous reports indicating that Värmland continues to be a high-risk zone for MS and shares in the diffusion of the disease at the county level which we had presented for the country as a whole.
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| 18. |
- Boström, Inger, et al.
(författare)
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Mortality Statistics Studies of Multiple Sclerosis and Amyotrophic Lateral Sclerosis in Sweden
- 2012
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Ingår i: Neuroepidemiology. - : S. Karger. - 0251-5350 .- 1423-0208. ; 38:4, s. 245-249
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) are chronic neurologic diseases where distinct explanations of the pathogenesis are lacking. Two large Swedish register studies have rather unexpectedly detected a correlation between MS and ALS.The aim of this study was to investigate if an association between ALS and MS could be demonstrated as has been shown earlier.Material and methods: Data on mortality from ALS and MS, 1990-2010 were collected from the Swedish national statistics office. In all there were 5,696 deaths due to ALS and 3,941 deaths due to MS. Age- and sex-adjusted mortality rates were calculated.Results: There was no correlation between the mortality rates of ALS and MS in the 21 counties of Sweden for the period 1990 to 2010 (Spearman’s rho = - 0.052; p = 0.822; n = 21).The national mean mortality rate for ALS throughout the period of 1990 to 2010 was 2.98 per 100 000 person-years (95% CI 2.87 – 3.08). For MS the national mean mortality rate was 2.04 per 100 000 person-years (95% CI 1.95 – 2.12). Both ALS and MS mortality showed significant variation between the counties. Conclusion: This study did not confirm the previously shown association between MS and ALS in Sweden.
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| 19. |
- Boström, Inger, et al.
(författare)
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Sex ratio of multiple sclerosis in Sweden
- 2013
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 13:1, s. 46-52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Sex ratio of multiple sclerosis has been reported from several areas. The disease is more common in women. In Europe the women-to-men ratio varies from 1.1 to 3.4. Recently a study in Canada has reported a significant increased female-to-male ratio in multiple sclerosis.Our objective was to analyse the development of sex ratio in multiple sclerosis in the Swedish population.Data from the Swedish MS Register and data from the Swedish National Statistics Office were used to estimate sex ratio by year of birth and year of onset.In analyse of sex ratio by year of birth there were 8,834 patients (6,271 women and 2,563 men) born during 1931 to 1985. The mean value of women-to-men ratio was 2.62. No clear trend was noted for the women-to-men ratio by year of birth (Spearman’s rho = 0.345, p=0.298, n=11). Patients analysed by year of onset was 9,098 (6,452 women and 2,646 men) during the study time period 1946 until 2005. The mean women-to-men ratio was 2.57. There was no significant change of the women-to-men ratio (Spearman’s rho = -0.007, p = 0.983, n = 12).Conclusion: In the Swedish patients there was no evidence for an increased womento-men ratio in multiple sclerosis.
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| 20. |
- Boström, Ullalena, et al.
(författare)
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Seasonal variation in sprouting capacity from intact rhizome systems of three perennial weeds.
- 2013
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Ingår i: Weed research (Print). - : Wiley. - 0043-1737 .- 1365-3180. ; 53:5, s. 387-398
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Tidskriftsartikel (refereegranskat)abstract
- The three rhizomatous perennials Elytrigia repens, Equisetum arvense and Tussilago farfara are all problematic in Scandinavian agriculture, due to their low susceptibility to soil cultivation. While repeated soil tillage is a fundamental part of the integrated control of these species, it is highly energy consuming and inefficient during periods when little sprout regrowth occurs. Substituting cultivation with mowing will reduce the environmental impact and labour costs, but its efficiency will still depend on the capacity of plants to sprout. Therefore, we studied the seasonal pattern in emergence and rhizome biomass allocation from July to April in six populations for each of the species. Plants were grown outdoors in pots buried in soil and exhumed at regular intervals in a two-year experiment. In all three species, biomass allocation to rhizomes continued until late in the autumn. Emergence was severely impaired in E.arvense and T.farfara in September-October, while in E.repens, there was no such reduction in the number of emerged shoots. However, in the latter species, the shoot/rhizome ratio decreased and remained low until the plants had been exposed to a period of low temperatures. The increase in shoot/rhizome ratio for E.repens coincided with the resumed capacity to emerge for E.arvense and T.farfara. These results imply that there is no need to repeat a defoliation of E.arvense and T.farfara, if carried out in September-October. However, removal of the aerial plant parts early in the autumn is important to interrupt the upload of storage compounds to the rhizome systems of all species.
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| 21. |
- Bränn, Emma, et al.
(författare)
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Inflammatory markers in late pregnancy in association with postpartum depression-A nested case-control study.
- 2017
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 79, s. 146-159
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies indicate that the immune system adaptation during pregnancy could play a significant role in the pathophysiology of perinatal depression. The aim of this study was to investigate if inflammation markers in a late pregnancy plasma sample can predict the presence of depressive symptoms at eight weeks postpartum. Blood samples from 291 pregnant women (median and IQR for days to delivery, 13 and 7-23days respectively) comprising 63 individuals with postpartum depressive symptoms, as assessed by the Edinburgh postnatal depression scale (EPDS≥12) and/or the Mini International Neuropsychiatric Interview (M.I.N.I.) and 228 controls were analyzed with an inflammation protein panel using multiplex proximity extension assay technology, comprising of 92 inflammation-associated markers. A summary inflammation variable was also calculated. Logistic regression, LASSO and Elastic net analyses were implemented. Forty markers were lower in late pregnancy among women with depressive symptoms postpartum. The difference remained statistically significant for STAM-BP (or otherwise AMSH), AXIN-1, ADA, ST1A1 and IL-10, after Bonferroni correction. The summary inflammation variable was ranked as the second best variable, following personal history of depression, in predicting depressive symptoms postpartum. The protein-level findings for STAM-BP and ST1A1 were validated in relation to methylation status of loci in the respective genes in a different population, using openly available data. This explorative approach revealed differences in late pregnancy levels of inflammation markers between women presenting with depressive symptoms postpartum and controls, previously not described in the literature. Despite the fact that the results do not support the use of a single inflammation marker in late pregnancy for assessing risk of postpartum depression, the use of STAM-BP or the novel notion of a summary inflammation variable developed in this work might be used in combination with other biological markers in the future.
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| 22. |
- Edvinsson, Åsa, 1982-, et al.
(författare)
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Lower inflammatory markers in women with antenatal depression brings the M1/M2 balance into focus from a new direction
- 2017
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 80, s. 15-25
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antenatal depression and use of serotonin reuptake inhibitors (SSRI) in pregnancy have both been associated with an increased risk of poor pregnancy outcomes, such as preterm birth and impaired fetal growth. While the underlying biological pathways for these complications are poorly understood, it has been hypothesized that inflammation may be a common physiological pathway. The aim of the present study was to assess peripheral inflammatory markers in healthy women, women with antenatal depression, and in women using SSRI during pregnancy.Methods: 160 healthy pregnant controls, 59 women with antenatal depression and 39 women on treatment with SSRIs were included. The relative levels of 92 inflammatory proteins were analyzed by proximity extension assay technology.Results: Overall, 23 of the inflammatory markers were significantly lower in women with antenatal depression and in women on treatment with SSRIs in comparison with the healthy controls. No difference in any of the inflammatory markers was observed between women with antenatal depression and those who were using SSRI. Top three inflammatory markers that were down-regulated in women with antenatal depression were TNF-related apoptosis-inducing ligand (TRAIL), p = 0.000001, macrophage colony-stimulating factor 1 (CSF-1), p = 0.000004, and fractalkine (CX3CL1), p =0.000005. Corresponding inflammatory markers in SSRI users were CSF-1, p = 0.000011, vascular endothelial growth factor A (VEGF-A), p =0.000016, and IL-15 receptor subunit alpha (IL-15RA), p = 0.000027. The inflammatory markers were negatively correlated with cortisone serum concentrations in controls, but not in the cases. Differential DNA methylation of was found for seven of these inflammatory markers in an independent epigenetics cohort.Conclusion: Women with antenatal depression or on SSRI treatment have lower levels of a number of peripheral inflammatory markers than healthy pregnant controls. Hypothetically, this could be due to dysregulated switch to the pro-M2 milieu that characterizes normal third trimester pregnancy. However, longitudinal blood sampling is needed to elucidate whether the presumably dysregulated M2 shift is driving the development of antenatal depression or is a result of the depression.
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| 23. |
- Gauffin, Helena, et al.
(författare)
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Characterization of the Increase in Narcolepsy following the 2009 H1N1 Pandemic in Sweden
- 2024
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Ingår i: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 13:3
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: In the context of the H1N1 pandemic and the Pandemrix vaccination campaign, an increased number of narcolepsy cases were noted in several countries. In Sweden, this phenomenon was attributed to the effect of the Pandemrix vaccination in the first place. Studies from China indicated that narcolepsy could occur as a consequence of the H1N1 infection itself. We performed an analysis of the increase, with a specific interest in age and sex distribution. We also aimed to validate the origin of the excess cases, post hoc. (2) Methods: Data for narcolepsy patients (ICD code G 47.4, both type 1 and type 2) distributed by sex and age at 5-year intervals, annually between 2005 and 2017, were retrieved from the National Patient Register. Information on the total population was collected from the Swedish Population Register. (3) Results: The number of narcolepsy cases increased markedly from 2009 to 2014 compared to the period before 2009. A particular increase in 2011 among children and teenagers was observed. The sex ratio did not change significantly during the study period. (4) Conclusions: Our results support an association between the increased prevalence of narcolepsy cases and Pandemrix vaccination, but the effect of the virus itself cannot be ruled out as a contributing factor.
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| 24. |
- Gauffin, Helena, et al.
(författare)
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Narcolepsy treatment in Sweden: An observational study
- 2022
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 145:2, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To describe the pharmacological treatments (2005-2017) and the healthcare utilization (1997-2016) for patients with narcolepsy in Sweden in order to create a framework for future organizational and economic analyses. Material & Methods Patients of all ages with a diagnosis of narcolepsy registered in the National Patient Registry in specialist care in Sweden were included and information on treatments for narcolepsy was retrieved from The Swedish Prescribed Drug Register. Results We collected 2508 patients with narcolepsy, 43,3% men and 56,7% women and 47,9% were prescribed modafenil, 33,8% metylphenidate and 26,2% amphetamine. In total, 3817 treatments were initiated. Patients treated with amphetamine had a higher mean age. More women than men used modafinil, methylphenidate, amphetamine and antidepressants. The narcolepsy population had more outpatient than inpatient healthcare. Patients treated with sodium oxybate had more outpatient visits than other narcolepsy patients, before and during treatment (p = .00). Conclusions This study gives valuable information on pharmaceutical treatments and healthcare utilization for patients with narcolepsy and can be used to estimate the healthcare cost in the future. Patients with sodium oxybate treatment had more outpatient visits than other patients before and during treatment which may be due to the need to monitor potentially severe side-effects or may indicate that patients with sodium oxybate treatment have a severe disease. The number of included patients was less than expected; however, this may depend on patients escaping our collection of data, which does not contain information from primary care.
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| 25. |
- Hollmén, Jaakko, et al.
(författare)
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Exploring epistaxis as an adverse effect of anti-thrombotic drugs and outdoor temperature
- 2018
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Ingår i: Proceedings of the 11th PErvasive Technologies Related to Assistive Environments Conference (PETRA). - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450363907 ; , s. 1-4
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Konferensbidrag (refereegranskat)abstract
- Electronic health records contain a wealth of epidemiological information about diseases at the population level. Using a database of medical diagnoses and drug prescriptions in electronic health records, we investigate the correlation between outdoor temperature and the incidence of epistaxis over time for two groups of patients. One group consists of patients that had been diagnosed with epistaxis and also been prescribed at least one of the three anti-thrombotic agents: Warfarin, Apixaban, or Rivaroxaban. The other group consists of patients that had been diagnosed with epistaxis and not been prescribed any of the three anti-thrombotic drugs. We find a strong negative correlation between the incidence of epistaxis and outdoor temperature for the group that had not been prescribed any of the three anti-thrombotic drugs, while there is a weaker correlation between incidence of epistaxis and outdoor temperature for the other group. It is, however, clear that both groups are affected in a similar way, such that the incidence of epistaxis increases with colder temperatures.
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| 26. |
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| 27. |
- Landtblom, Anne-Marie, et al.
(författare)
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Multiple sclerosis and COVID-19 : The Swedish experience
- 2021
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Ingår i: Acta Neurologica Scandinavica. - : John Wiley & Sons. - 0001-6314 .- 1600-0404. ; 144:3, s. 229-235
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Forskningsöversikt (refereegranskat)abstract
- The COVID-19 pandemic has brought challenges for healthcare management of patients with multiple sclerosis (MS). Concerns regarding vulnerability to infections and disease-modifying therapies (DMTs) and their complications have been raised. Recent published guidelines on the use of DMTs in relation to COVID-19 in MS patients have been diverse between countries with lack of evidence-based facts. In Sweden, there exists a particular interest in anti-CD20 therapy as a possible risk factor for severe COVID-19 due to the large number of rituximab-treated patients off-label in the country. Rapid responses from the Swedish MS Association (SMSS) and the Swedish MS registry (SMSreg) have resulted in national guidelines on DMT use for MS patients and implementation of a COVID-19 module in the SMSreg. Recently updated guidelines also included recommendations on COVID-19 vaccination with regard to the different DMTs. Social distancing policies forced implementation of telemedicine consultation to replace in-person consultations as part of regular MS health care. Patient-reported outcome measures (PROMs) in SMSreg have been useful in this respect. This paper reports our experiences on the progress of national MS health care during the COVID-19 pandemic, in addition to offering an overview of the present scientific context.
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| 28. |
- Landtblom, Anne-Marie, et al.
(författare)
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Organic solvent exposure as a risk factor for multiple sclerosis : An updated review
- 2019
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Ingår i: Revue neurologique (Paris). - Issy les Moulineaux Cedex, France : Elsevier BV. - 0035-3787 .- 2213-0004. ; 175:10, s. 625-630
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Forskningsöversikt (refereegranskat)abstract
- Organic solvents exposure has for a long time been suspected as a risk factor for developing multiple sclerosis. The evidence, containing case reports, case-control studies and cohort studies has been contradictory. An early meta-analysis, however, pointed to a doubled risk for MS. Recent major case-control studies confirm this, but also have elucidated the risk pattern, being dependent on another risk factor, i.e. smoking.
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| 29. |
- Liew, Josefine, et al.
(författare)
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Influence of temperature and photoperiod on sprouting capacity of Cirsium arvense and Sonchus arvensis root buds
- 2012
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Ingår i: Weed research (Print). - : Wiley. - 0043-1737 .- 1365-3180. ; 52:5, s. 449-457
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Tidskriftsartikel (refereegranskat)abstract
- Influence of temperature and photoperiod on sprouting capacity of Cirsium arvense and Sonchus arvensis root buds. Weed Research.52, 449-457. Summary Timing of treatment is a key to successful and sustainable weed management. For perennial weeds, highly energy-demanding, repeated stubble cultivation or tillage is a common strategy in organic agriculture. The fragmentation of underground material stimulates root buds to grow and, if repeated, significantly reduces the energy and nutrient resources of the roots. However, the effect might differ depending on variation in sprouting over the season and among species. Here, we studied the impact of different photoperiods and temperatures on sprouting capacity of root buds of Cirsium arvense and Sonchus arvensis in a climate chamber experiment. Two populations of each species, collected in northern and southern Sweden, were used. Plants were exposed to long (18 h), short (12 h) or decreasing (from 18 to 8 h) photoperiods in combinations with high (18/12 degrees C for 16/8 h), low (12/6 degrees C), decreasing (from 21 to 5 degrees C in 4 weeks) or constant high (16 degrees C) temperatures. Sprouting capacity was evaluated based on the proportion of sprouting buds from short root fragments. Neither temperature nor photoperiod affected root bud sprouting in C. arvense, while in S. arvensis, photoperiod seemed to regulate sprouting capacity. The proportion of sprouted buds decreased in short photoperiods, especially if combined with high temperature. In northern conditions, this suggests that weeding strategies based on fragmentation of the root system of S. arvensis will have low efficiency if the autumns are warm.
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| 30. |
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| 31. |
- Liew, Josefine, et al.
(författare)
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Regeneration capacity from buds on roots and rhizomes in five herbaceous perennials as affected by time of fragmentation
- 2013
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Ingår i: Plant Ecology. - : Springer Science and Business Media LLC. - 1385-0237 .- 1573-5052. ; 214:10, s. 1199-1209
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Tidskriftsartikel (refereegranskat)abstract
- Variation in seasonal sprouting pattern from roots and rhizomes of perennial herbaceous plants influence the success of plant proliferation ability, invasiveness and escape from weed control measures. The latter often rely on methods, which repeatedly fragment the underground system, thereby trigger adventitious and axillary buds to sprout, and consequently reduce the amount of stored energy. If carried out at times when no re-growth occurs, treatments will have little effect on weed populations, but cost much in terms of labour and energy. The purpose of this experiment was to determine the seasonal variation in bud sprouting capacity after fragmentation. Five troublesome perennial weed species, collected in northern and southern Sweden, were grown outdoors in Uppsala, Sweden (N 59°49′, E 17°39′), from May 2009 to January 2010. Cut root and rhizome fragments, taken at two weeks intervals from July to January, were used to evaluate bud sprouting capacity, which was statistically analyzed using generalized additive models. In Elytrigia repens from southern Sweden and Sonchus arvensis sprouting capacity was significantly impaired during a period from September to November. In Equisetum arvense and Tussilago farfara sprouting was low between July and November where after it increased. In contrast, Cirsium arvense and E. repens from northern Sweden sprouted readily throughout the period. Except for E. repens, a model by populations was significantly better than one based on latitudinal origin. The result suggests a species-specific timing of treatments in weed management, avoiding the non-effective autumn period for E. arvense, S. arvensis and T. farfara, and in some cases in E. repens.
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| 32. |
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| 33. |
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| 34. |
- Melin-Johansson, Christina, 1956-, et al.
(författare)
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Reflections of older people living in nursing homes
- 2014
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Ingår i: International Journal of Older People Nursing. - : RCN Publishing Ltd.. - 1748-3735 .- 1748-3743. ; 26:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore experiences of ageing in older people living in nursing homes, based on the gerotranscendence theory.MethodInterviews were held with 14 people aged between 80 and 96 years. The results were analysed using content analysis.FindingsThe findings were divided into three categories: the self, the cosmic dimension, and social and personal relationships. These three categories were underpinned by eight subcategories. Most participants described improved knowledge about themselves, decreased concern about body and appearance, acceptance and appreciation of life, and less regard for social norms. A fewer participants described a greater affinity with past generations, or thought that the borders between past and present had become blurred.ConclusionThis study provides a better understanding of how people experience old age. It also indicates how healthcare professionals could apply the gerotranscendence theory of ageing as a conversation model to enable care to be adjusted according to older people's wishes.
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| 35. |
- Teljas, Cecilia, et al.
(författare)
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Validating the diagnosis of multiple sclerosis using Swedish administrative data in Värmland County
- 2021
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Ingår i: Acta Neurologica Scandinavica. - : John Wiley & Sons. - 0001-6314 .- 1600-0404. ; 144:6, s. 680-686
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Multiple sclerosis (MS) is a chronic neurodegenerative disease of the central nervous system. Identifying MS at the population level is important for disease surveillance and allocation of resources. The Swedish National Patient Registry (NPR) has been used to study the epidemiology of MS, but the accuracy of this resource is not known. We aimed to validate a definition of MS using the Swedish NPR in Varmland County using a longitudinal cohort design.Materials and Methods: Data were extracted from the NPR, the Total Population Register, the Swedish MS Register, and medical records for the years 2001-2013. Fifteen algorithms of hospitalizations and clinic visits for MS were developed and compared with findings in medical records, which acted as the "gold standard" definition. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were estimated.Results: Of 805 eligible persons identified in the NPR, 763 had MS (94.8%) according to medical records. Of these, 544 (71.3%) were also registered in the SMSreg. The case definition that had a well-balanced sensitivity and specificity required three or more clinic or hospital visits for MS (sensitivity of 85.3% (95% CI: 82.6-87.8) and specificity of 81.0% (95%CI: 65.9-91.4).Conclusions: Multiple case definitions with high sensitivity and moderate specificity were found, suggesting that the NPR can be used to accurately identify persons with MS.
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| 36. |
- Wesnes, Kristin, et al.
(författare)
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Physical Activity Is Associated With A Decreased Multiple Sclerosis Risk : The EnvIMS study
- 2018
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications. - 1352-4585 .- 1477-0970. ; 24:2, s. 150-157
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Tidskriftsartikel (refereegranskat)abstract
- Background: The lifestyle factors smoking and obesity have been associated with the risk of multiple sclerosis (MS). Physical activity (PA) may also be of importance.Objective: To examine the association between PA and MS risk in Italy, Norway, and Sweden and to evaluate the possible influence by established risk factors.Methods: In this case–control study, 1904 cases and 3694 controls were asked to report their average weekly amounts of light and vigorous PA during adolescence on a scale ranging from none to more than 3 hours activity. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and adjusted for potential confounders.Results: Vigorous PA was inversely associated with MS risk in the pooled analysis (p-trend < 0.001) with an age- and sex-adjusted OR of 0.74 (95% CI: 0.63–0.87) when comparing the highest and lowest levels. Adjusting for outdoor activity, infectious mononucleosis, body size, and smoking yielded similar results. The association was present in all countries and was not affected by exclusion of patients with early disease onset. Light PA was not associated with the risk of MS.Conclusion: Our findings suggest that vigorous PA can modify the risk of developing MS independent of established risk factors.
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| 37. |
- Westerlind, Helga, et al.
(författare)
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New data identify an increasing sex ratio of multiple sclerosis in Sweden
- 2014
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Ingår i: Multiple Sclerosis Journal. - : SAGE Publications (UK and US). - 1352-4585 .- 1477-0970. ; 20:12, s. 1578-1583
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing women-to-men ratio in later birth cohorts of patients with multiple sclerosis (MS) has been observed in several populations and has been hypothesised to be due to one or several environmental factors of importance for disease aetiology. However, in a study based on data from the Swedish MS registry (SMSreg) this ratio was recently reported to be rather stable during the 20th century. Objective: The purpose of this study was to reinvestigate the women-to-men ratio in Sweden based on data from all available data sources, including deceased patients. Method: We combined data from the SMSreg with data from national patient registers. Results: In total we obtained information on 19,510 MS patients born 1931-1985, 13,321 women and 6189 men. The women-to-men ratio increased from 1.70 for patients born in the 1930s to 2.67 for patients born in the 1980s. When comparing the coverage of SMSreg to the full data set, a significantly higher proportion of women born 1931-1935 compared to men born in the same period were found in SMSreg, resulting in a sampling bias hiding the increasing sex ratio in the full material. Conclusion: The women-to-men ratio in MS has increased in Sweden during the 20th century similarly to observations in other western countries.
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