| 1. |
- Aidemark, Jan, 1967-, et al.
(författare)
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Co-designing self-care solutions with elderly : lessons learnt
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Ehealth solutions are in great need in the community of elderly in general, as patients or home carers, however a design approach that delivers this is illusive. In this research we present the experiences from a set of design processes targeting elderly’s needs of support or home care, based on a co-design approach. The purpose is to present guiding principles for how to work with elderly in a co-design process, to be used as basis for future set up of co-design processes.
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| 2. |
- Aidemark, Jan, 1967-, et al.
(författare)
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ICT challenges of Integrated care from a Co Design perspective using a Quadraple Helix
- 2020
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Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156. ; 20:S1
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Tidskriftsartikel (refereegranskat)abstract
- The Internet of Things (IoT) plays a vital role in today’s medicine (Islam et al, 2015). In 2020, 40% of IoT-related technologies will be assigned to the health domain, which makes up around a 117 $ billion in the global market (Bauer, Patel & Veira, 2016). Adding to this the demographic changes will further set a significant challenge in Europe (Steinführer & Haase, 2007). Innovative techniques for supporting health systems and independent life for the aging population is therefore essential, not at least in relation to fall prevention and technology for promoting a good life throughout the lifespan. Further, participation from patients is a goal for healthcare worldwide (Lundgren, Sunesson & Tunved, 2014). For example according to the Health and Medical care act in Sweden (1982:763) it is described that the goal for health care “is good health and care on equal terms for the entire population”. In line with this challenge of integrated care the patient itself will be the most important resource for promotion of health, why Co Design is needed as a method for innovation in healthcare sector. It is important for the users ‘experiences and insights to contribution in improvements but not at least because it has been shown that increased involvement with the user in care reduces the number of hospital visits (Simpsons, 2007).
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| 3. |
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| 4. |
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| 5. |
- Björk-Eriksson, Thomas, 1960, et al.
(författare)
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Mortality Among Pediatric Patients With Acute Lymphoblastic Leukemia in Sweden From 1988 to 2017
- 2022
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Ingår i: JAMA network open. - : American Medical Association (AMA). - 2574-3805. ; 5:11
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Tidskriftsartikel (refereegranskat)abstract
- Importance: Acute lymphoblastic leukemia (ALL) constitutes 20% to 30% of all pediatric cancers. The 5-year overall survival among pediatric patients with ALL in high-income countries such as Sweden is currently more than 90%, but long-term unselected nationwide mortality data and mortality data in relation to the general population are lacking. Objective: To compare mortality between pediatric patients with ALL and the general population during a 30-year period in Sweden and to assess the incidence of ALL in Sweden. Design, Setting, and Participants: This cohort study included pediatric patients (aged <18 years) with a morphologically verified ALL diagnosis in the Swedish Cancer Register and/or at least 2 ALL diagnoses in the Swedish National Patient Register between January 1, 1988, and December 31, 2017. Data were cross-linked to the Swedish Cause of Death Register. Data were analyzed from May 2019 to January 2022. Main Outcomes and Measures: The main outcomes were mortality among patients with ALL compared with that in the general population and mortality in different subgroups within the cohort. Standardized mortality ratios (SMRs) were calculated using the general Swedish population as a reference. Within-cohort survival analyses were performed. Results: A total of 2397 patients (1354 [56%] male; mean [SD] age at diagnosis, 6.1 [4.7] years) were included in the study. The mean (SD) incidence of pediatric ALL during the study period was 4.11 (0.60) cases per 100 000 persons per year (females, 3.68 [0.65] cases per 100 000 persons per year; males, 4.52 [0.81] cases per 100 000 persons per year; P<.001). The observed number of deaths among pediatric patients with ALL was 409 vs the 9.5 deaths expected in the general population, resulting in an overall SMR of 43.1 (95% CI, 39.0-47.5); females had a higher SMR than males (57.8 [95% CI, 49.5-67.2] vs 34.5 [95% CI, 32.0-41.4]; P<.001). Analysis within the cohort showed a continued decrease in survival throughout the 30-year follow-up. The association between calendar year of ALL diagnosis, corresponding with different ALL treatment protocols, and mortality showed the lowest survival for the 1988-1991 group and the highest for the 2008-2017 group (χ2=20.3; P<.001). Conclusions and Relevance: In this cohort study, a consistently high SMR was seen among pediatric patients with ALL. Within the ALL cohort, survival evolved to a similar extent as in the young general population of Sweden. Furthermore, survival among patients with ALL decreased throughout the whole follow-up period without any trend difference after the 5-year follow-up time point. The changes in ALL treatment protocols were associated with overall improved absolute survival over time.
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| 6. |
- Boström, Martina, et al.
(författare)
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A role for endothelial cells in radiation-induced inflammation
- 2018
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Ingår i: International Journal of Radiation Biology. - : Informa UK Limited. - 0955-3002 .- 1362-3095. ; 94:3, s. 259-271
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To unravel the role of the vasculature in radiation-induced brain tissue damage.Materials and methods: Postnatal day 14 mice received a single dose of 10Gy cranial irradiation and were sacrificed 6h, 24h or 7 days post-irradiation. Endothelial cells were isolated from the hippocampus and cerebellum using fluorescence-activated cell sorting, followed by cell cycle analysis and gene expression profiling.Results: Flow cytometric analysis revealed that irradiation increased the percentage of endothelial cells, relative to the whole cell population in both the hippocampus and the cerebellum. This change in cell distribution indicates that other cell types are more susceptible to irradiation-induced cell death, compared to endothelial cells. This was supported by data showing that genes involved in endothelial cell-specific apoptosis (e.g. Smpd1) were not induced at any time point investigated but that genes involved in cell-cycle arrest (e.g. Cdkn1a) were upregulated at all investigated time points, indicating endothelial cell repair. Inflammation-related genes, on the other hand, were strongly induced, such as Ccl2, Ccl11 and Il6.Conclusions: We conclude that endothelial cells are relatively resistant to ionizing radiation but that they play an active, hitherto unknown, role in the inflammatory response after irradiation. In the current study, this was shown in both the hippocampus, where neurogenesis and extensive cell death after irradiation occurs, and in the cerebellum, where neurogenesis no longer occurs at this developmental age.
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| 7. |
- Boström, Martina, et al.
(författare)
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Chronic disturbance in the thalamus following cranial irradiation to the developing mouse brain
- 2019
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Better survival rates among pediatric brain tumor patients have resulted in an increased awareness of late side effects that commonly appear following cancer treatment. Radiation-induced changes in hippocampus and white matter are well described, but do not explain the full range of neurological late effects in childhood cancer survivors. The aim of this study was to investigate thalamus following cranial irradiation (CIR) to the developing brain. At postnatal day 14, male mice pups received a single dose of 8Gy CIR. Cellular effects in thalamus were assessed using immunohistochemistry 4 months after CIR. Interestingly, the density of neurons decreased with 35% (p=0.0431) and the density of astrocytes increased with 44% (p=0.011). To investigate thalamic astrocytes, S100β+ cells were isolated by fluorescence-activated cell sorting and genetically profiled using next-generation sequencing. The phenotypical characterization indicated a disrupted function, such as downregulated microtubules' function, higher metabolic activity, immature phenotype and degraded ECM. The current study provides novel insight into that thalamus, just like hippocampus and white matter, is severely affected by CIR. This knowledge is of importance to understand the late effects seen in pediatric brain tumor survivors and can be used to give them the best suitable care.
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| 8. |
- Boström, Martina, et al.
(författare)
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How older people perceive and experience sense of security when moving into and living in a nursing home : [Hur äldre personer uppfattar och erfar trygghet i flytt till och boende i särskilt boende för äldre. En fallstudie]
- 2017
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Ingår i: European Journal of Social Work. - : Taylor & Francis. - 1369-1457 .- 1468-2664. ; 20:5, s. 697-710
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Tidskriftsartikel (refereegranskat)abstract
- Sense of security is important throughout the lifespan not at least in advanced age with increased risks of functional declines and decreased social capital. Despite this, knowledge concerning older person’s perceptions and experiences of sense of security when moving into nursing homes is scarce. This study is a longitudinal, descriptive, exploratory case study with in-depth interviews and observations of three older persons in the age of 87, 88, and 91 years in a mid-sized municipality in the south of Sweden, in order to highlight how sense of security is experienced when moving into and living in a nursing home. Data were analysed using qualitative content analysis, which resulted in one main theme and four categories. The main theme, ‘Adaptation and sense of security’, indicates older persons’ need to adapt to the new context of the nursing home, and how this relates to their sense of security. The categories – ‘Control’, ‘Struggling for understanding’, ‘Lack of influence’, and ‘Grasping’ – suggest that older persons’ sense of security is reduced when they must adjust to routines without sufficient management and understanding. When able to maintain control over daily routines, and felt as a part of the new context, they perceived a sense of security.
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| 9. |
- Boström, Martina, 1974-
(författare)
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Inte alltid trygg med trygghetslarm
- 2014
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Ingår i: Äldre i Centrum. - Äldre i Centrum. - 1401-5110. ; :3, s. 8-11
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 10. |
- Boström, Martina, et al.
(författare)
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Irradiation to the young mouse brain caused long-term, progressive depletion of neurogenesis but did not disrupt the neurovascular niche
- 2013
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Ingår i: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. - : SAGE Publications. - 1559-7016. ; 33:6, s. 935-943
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the effects of ionizing radiation on microvessel structure and complexity in the hippocampus. We also assessed neurogenesis and the neurovascular niche. Postnatal day 14 male C57BL/6 mice received a single dose of 8Gy to the whole brain and were killed 6 hours, 1 week, 7 weeks, or 1 year later. Irradiation decreased the total number of microvessels and branching points from 1 week onwards and decreased the total microvessel area 1 and 7 weeks after irradiation. After an initial increase in vascular parameter densities, concomitant with reduced growth of the hippocampus, the densities normalized with time, presumably adapting to the needs of the surrounding nonvascular tissue. Irradiation decreased the number of neural stem and progenitor cells in the hippocampus. The relative loss increased with time, resulting in almost completely ablated neurogenesis (DCX(+) cells) 1 year after irradiation (77% decreased 1 week, 86% decreased 7 weeks, and 98% decreased 1 year after irradiation compared with controls). After irradiation, the distance between undifferentiated stem cells and microvessels was unaffected, and very few dying endothelial cells were detected. Taken together, these results indicate that the vasculature adjusts to the surrounding neural and glial tissue after irradiation, not vice-versa.Journal of Cerebral Blood Flow & Metabolism advance online publication, 13 March 2013; doi:10.1038/jcbfm.2013.34.
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| 11. |
- Boström, Martina, et al.
(författare)
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Older persons have ambivalent feelings about the use of monitoring technologies
- 2013
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Ingår i: Information Technology and Disabilities. - 1073-5127. ; 25:2, s. 117-125
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As they age, older persons prefer to continue to live in their own homes. Sensors in the environment and/or bodily worn systems that monitor people might contribute to an increased sense of safety and security at home, but also raise concerns about the loss of privacy by surveillance. Little is known about how older persons, living at home independently and stating good health, perceive monitoring technology in terms of personal privacy.OBJECTIVE: to identify and describe how older persons, perceive monitoring technology in terms of personal privacy.METHOD: A qualitative study based on five focus group interviews was used. Concepts of "freedom" and "surveillance" were used as content areas in the data analysis.RESULTS: The results comprised three categories of ambivalence; "independence vs. security", "privacy vs. intrusion", and "in the best interest of me vs. in the best interest of others". These three categories merged into the overarching theme "maintaining a sense of self" which illustrates a desire to maintain control of one's life as long as possible.CONCLUSIONS: Older persons generally have positive feelings and attitudes toward technology and strive to maintaining a sense of self as long as possible, by having control. They stated high value to privacy, but valued being watched over if it ensured security. To feel good and bad about monitoring technologies, rather than good or does not necessarily lead to feelings of conflict.
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| 12. |
- Boström, Martina, 1974-, et al.
(författare)
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Personal emergency response system (PERS) alarms may induce insecurity feelings
- 2011
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Ingår i: Gerontechnology. - Eindhoven, Netherlands : International Society for gerontechnology. - 1569-1101 .- 1569-111X. ; 10:3, s. 140-145
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Tidskriftsartikel (refereegranskat)abstract
- (PERS) alarms have been used in Sweden since 1974 to enable older people to age safely at home. Despite this long use, we found no studies describing independent older users’ opinions of these devices.Aim Our aim was to describe how people living in Swedish independent senior housing perceive the alarms and to highlight their wishes for further developments and innovations.Methods We conducted five focus group interviews with residents of senior housing who used or had used a PERS alarm and analysed the data qualitatively for latent content.Results The data analysis revealed five themes in participants’ opinions and feelings about the PERS alarms: (i) safety, (ii) anxiety, (iii) satisfaction, (iv) being informed, and (v) older persons as active innovators.Conclusion The 40-year-old Swedish PERS used in senior housing seems to limit rather than liberate users in their daily lives and cause feelings of insecurity rather than security. Older Swedish people require a more personalized alarm with a built-in positioning system that would allow them a greater range of movement beyond their homes.
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| 13. |
- Boström, Martina, et al.
(författare)
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Senior alert : a tool for better care collaboration
- 2022
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Konferensbidrag (refereegranskat)abstract
- The increasing prevalence of negative events among older frail adults is a challenge for society which calls for pro-active and preventive actions. Senior Alert (SA) is a quality-registry focusing pro-actively on 5 risk areas common among older adults: malnutrition, pressure ulcers, falls, oral health and bladder dysfunction among people = 65 years. It is mandatory to assess risks in all risk areas. SA plays an unique roll among the more than 100 national quality registries in Sweden used for quality improvements, in aspect that it also stimulate staff to perform screening, action taking, and follow-up. However, the overall potential of the register to improve the care of older adults has so far not been recognized. Although the risks are registered to a high degree, the underlying causes are not identified to the same extent. If the need for intervention is not identified, the possibilities for an effective preventive care process and effective collaboration between different actors are missed. We want to study the factors that constitute support or obstacles to the preventive care process to contribute to an effective and robust preventive care process that promotes effective collaboration between different actors for best practice care of older frail adults. The project has an interdisciplinary approach and is based on a mixed method design meaning using both quantitative and qualitative methods
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| 14. |
- Boström, Martina, et al.
(författare)
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Senior alert – ett medel för bättre vård i samverkan (SeSam) : Hälsoriksdagen
- 2022
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Konferensbidrag (refereegranskat)abstract
- Vården och omsorgen av sköra äldre behöver stärkas. Senior alert är ett nationellt kommunalt kvalitetsregister som med evidensbaserade bedömningsinstrument värderar risker bland äldre inom riskområdena fall, trycksår, nutrition, munhälsa och blåsdysfunktion. Cirka 90 000 riskbedömningar görs per år. Registret är unikt då det har ett vårdpreventivt fokus och omfattar såväl riskbedömning som bakomliggande orsaker och åtgärder. Vi har tilldelats närmare 6 miljoner från Forte för att beforska stöd och hinder för den vårdpreventiva processen inom Senior alerts. Syfte: att studera samverkan inom och mellan huvudmän för äldreomsorg, hälso- och sjukvård och tandvård med avseende på vård prevention (VP) i Senior alert, och att identifiera faktorer som utgör stöd respektive hinder inom och mellan huvudmän för att fullfölja VP. Metod: Projektet består av 3 delstudier och bygger på en mixad metod. Delstudie 1 är en kvantitativ studie inom vård och omsorgsboende för att studera om det finns det skillnader mellan kommuner med god respektive bristande registrering i Senior alert med avseende på faktorer som invånarantal, socio-demografi, -ekonomi, organisation av äldreomsorgen, och politisk majoritet? Delstudie 2 är kvalitativ och ska studera uppfattningar om hinder och stöd för en god samverkan inom och mellan huvudmän för VP inom Senior altert. Detta görs genom enskilda intervjuer med personer i ledande ställning samt fokusgruppsintervjuer med tvärprofessionella arbetsgrupper, samt med äldre och deras närstående gällande deras syn på hur Senior alter bidrar till god vård. Delstudie 3 är en pilotstudie för att testa implementering av resultatet från den båda tidigare studierna. Tidsram 2022 - 2025 Elisabet Rothenberg, biträdande professor, fakulteten för hälsovetenskap, Högskolan Kristianstad
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| 15. |
- Boström, Martina, et al.
(författare)
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Sexualitet och åldrande.
- 2011
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Ingår i: Äldre och åldrande.. - Stockholm : Gothia Förlag AB. - 9789172057548 ; , s. 221-240
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Bokkapitel (populärvet., debatt m.m.)
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| 16. |
- Boström, Martina, et al.
(författare)
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Stärka tryggheten i flytt till särskilt boende
- 2016
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Ingår i: 10 förbättringar från DIALOGEN. - Jönköping : Jönköpings kommun, socialtjänsten. ; , s. 133-150
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- De flesta kan kanske känna igen sig i en situation då flytt till särskilt boende blir aktuellt, oavsett om det gäller en nära anhörigs flytt eller sin egen. Våra skäl och orsaker till flytten kan variera men behovet av vård och omsorg är ofta detsamma. I en tid av livet då skörheten gör sig påmind och behovet av hjälp och stöd ökar, kan flytten bli ett känslosamt möte mellan det förflutna och en oviss framtid. Att arbeta för att få den äldre personen att känna trygghet under hela flyttprocessen och även under den första tiden på det särskilda boendet blir därför viktigt. Socialtjänsten och Hälsohögskolan har sedan 2013 genomfört ett samverkansprojekt i syfte att fördjupa kunskapen om äldres upplevelse av trygghet i flyttprocessen, för att på så vis förbättra och stärka den.
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| 17. |
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| 18. |
- Boström, Martina
(författare)
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Teknik och åldrande.
- 2011
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Ingår i: Äldre och åldrande.. - Stockholm : Gothia Förlag AB. - 9789172057548 ; , s. 330-347
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Bokkapitel (populärvet., debatt m.m.)
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| 19. |
- Boström, Martina, et al.
(författare)
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The hippocampal neurovascular niche during normal development and after irradiation to the juvenile mouse brain.
- 2014
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Ingår i: International journal of radiation biology. - : Informa UK Limited. - 1362-3095 .- 0955-3002. ; 90:9, s. 778-89
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Tidskriftsartikel (refereegranskat)abstract
- To investigate the effects of cranial irradiation on the neurovascular niche in the young brain. Disruption of this niche has previously been observed in the adult rat brain after irradiation.We subjected postnatal day 14 (P14) mice to a single dose of 8 Gy whole brain irradiation and measured the distance between microvessels and either neural progenitor cells (doublecortin-positive, DCX(+)) or proliferating cells (Ki-67(+)) in the dorsal hippocampal subgranular zone (SGZ) 6 hours, 1 week and 7 weeks post-irradiation. In addition, pericyte coverage of microvessels in the SGZ was measured.DCX(+) and Ki-67(+) cells were located closer to microvessels in the adult brain compared to young, still growing brains, constituting new information on normal development. We found an increased distance between microvessels and DCX(+) cells 6 h post-irradiation and between microvessels and Ki-67(+) cells 1 week post-irradiation. Furthermore, pericyte coverage was transiently decreased by 17% 6 h post-irradiation.The hippocampal neurovascular niche in the young, growing brain is transiently disrupted by irradiation. It remains to be elucidated what role these transient changes play in the apparently permanent ablation of hippocampal neurogenesis previously demonstrated in the same model.
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| 20. |
- Boström, Martina
(författare)
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Trygghet - på vems villkor? Uppfattningar om och erfarenheter av trygghet hos äldre personer med behov av omsorg
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med avhandlingen var att bidra till ökad förståelse av hur äldre personer med skiftande omsorgsbehov uppfattade och erfor trygghet, i ordinärt och särskilt boende.Avhandlingens två första studier baserades på material från fokusgruppintervjuer med totalt 45 äldre personer boende i seniorboende. Intervjuerna analyserades med kvalitativ innehållsanalys (I, II). Den tredje studien bestod av en sekundäranalys av en brukarenkät till 350 äldre personer i ordinärt boende med hemtjänst och 145 äldre personer i särskilt boende. Materialet bearbetades med deskriptiv och analytisk statistik (III). I den fjärde studien följdes tre äldre personer, genom djupintervjuer och observationer under 12-16 veckor, vid flytt till särskilt boende och den första tiden på särskilt boende. Även detta material analyserades med kvalitativ innehållsanalys (IV).Avhandlingens resultat visar bland annat att de trygghetslarm som de äldre hade erfarenhet av uppfattades som begränsande då larmets korta räckvidd gav orsak till minskad frihet, otrygghet, oro och rädsla (I). Övervakningsteknik, där den äldres person och position övervakas i större omfattning, ansågs inte som något problem att använda när omsorgsinsatserna ökade, så länge detta medförde ökad trygghet (II). Upplevd hälsa, relationstrygghet samt kunskap och kontroll var faktorer som var positivt relaterade till hur äldre personer med äldreomsorg uppfattade och erfor trygghet i vardagen, både i ordinärt och i särskilt boende (III). Flytt till särskilt boende som innebar att stegvis överlämna sitt livoch sin kontroll till omsorgspersonalen, ledde till en känsla av ökad säkerhet för de äldre personerna men inte nödvändigtvis till känsla av trygghet (IV).Resultatet tolkades i förhållande till Antonovskys salutogena teori där de tre koncepten meningsfullhet, hanterbarhet och begriplighet, tillsammans utgör grunden för känsla av sammanhang (KASAM).Sammanfattningsvis uppfattade och erfor äldre personer trygghet som så meningsfull att de kunde tänka sig att ge avkall på en del av sin frihet, integritet, självständighet och självbevarande för att uppnå den. De äldre personerna beskrev att resurser som personal och trygghetslarm stärkte tryggheten, men att hanterbarheten av dessa resurser kan stärkas ytterligare, i både ordinärt boende och särskilt boende. Resultaten visaratt äldre personers begriplighet av vardagen relaterar positivt till uppfattningar och erfarenheter av trygghet. Äldre personer saknar dock begriplighet avseende exempelvis trygghetslarm och nya rutiner, vilket får negativ inverkan på deras trygghet. Äldre personer bör ges större utrymme att själva beskriva trygghet utifrån sina unika villkor. För att stärka trygghet på äldre personers villkor, oavsett deras omsorgsbehov, bör således hanterbarheten, men framförallt begripligheten, stärkas.
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| 21. |
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| 22. |
- Boström, Martina, 1974-
(författare)
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What do old persons think about the first generation of security systems?
- 2010
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Ingår i: Gerontechnology. ; , s. 266-
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Konferensbidrag (refereegranskat)abstract
- Background: Older people don’t always know what new technology can do, so it may be difficult to outline needs, constraints and specifications. The marketing functions, the demand for technology and the supply of technology therefore needs to be strengthened. Though many older persons rely on various assistive technologies in their daily life and therefore represent a large group of consumers with the experience of existing technology, their influence over the technology they have access to as well as their involvement in design processes and product development is also very small. Aim: This study has two objectives; the first is to describe older people's experiences about using their existing security systems. The second is to highlight and make the older peoples thoughts and wishes available in further development and innovations of the second generation of context-aware distributed assistive systems, like wireless sensor network (WSN). Method: Five focus group interviews including 7-10 persons were conducted. Totally, 45 community living men and females (75-85 years of age) without home help and who had not been diagnosed with dementia participated. Data were analyzed by content analysis and selected into six themes. Result: The preliminary results show that the old persons feel dissatisfied as well as unsafe with their present security alarms. They feel limited when security alarms are only fit in their own apartment, and therefore they feel insecure and restricted in their freedom. They are experiencing a need to compensate the lack of safety with other products or persons. They also report that they have received poor information, which affect their sense of security. The elderly seem to have specific needs with their alarm systems that might be useful in further development of context-aware distributed assistive systems as well as ethical issues also has arisen in the discussion about enlarged alarm systems.
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| 23. |
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| 24. |
- Bull, Cecilia, 1977, et al.
(författare)
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A novel mouse model of radiation-induced cancer survivorship diseases of the gut
- 2017
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Ingår i: American journal of physiology. Gastrointestinal and liver physiology. - : American Physiological Society. - 1522-1547 .- 0193-1857. ; 313:5, s. G456-G466
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Tidskriftsartikel (refereegranskat)abstract
- A deeper understanding of the radiation-induced pathophysiological processes that develop in the gut is imperative to prevent, alleviate, or eliminate cancer survivorship diseases after radiotherapy to the pelvic area. Most rodent models of high-dose gastrointestinal radiation injury are limited by high mortality. We therefore established a model that allows for the delivering of radiation in fractions at high doses while maintaining long-term survival. Adult male C57/BL6 mice were exposed to small-field irradiation, restricted to 1.5 cm of the colorectum using a linear accelerator. Each mouse received 6 or 8 Gy, two times daily in 12-h intervals in two, three, or four fractions. Acute cell death was examined at 4.5 h postirradiation and histological changes at 6 wk postirradiation. Another group was given four fractions of 8 Gy and followed over time for development of visible symptoms. Irradiation caused immediate cell death, mainly limited to the colorectum. At 6 wk postirradiation, several crypts displayed signs of radiation-induced degeneration. The degenerating crypts were seen alongside crypts that appeared perfectly healthy. Crypt survival was reduced after the fourth fraction regardless of dose, whereas the number of macrophages increased. Angiogenesis was induced, likely as a compensatory mechanism for hypoxia. Four months postirradiation, mice began to show radiation-induced symptoms, and histological examination revealed an extensive crypt loss and fibrosis. Our model is uniquely suitable for studying the long-term trajectory and underlying mechanisms of radiation-induced gastrointestinal injury. NEW & NOTEWORTHY A novel mouse model for studying the long-term trajectory of radiation-induced gut injury. The method allows for the use of high doses and multiple fractions, with minor impact on animal health for at least 3 mo. Crypt loss and a slow progression of fibrosis is observed. Crypt degeneration is a process restricted to isolated crypts. Crypt degeneration is presented as a convenient proxy endpoint for long-term radiation-induced gut injury.
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| 25. |
- Eriksson, Yohanna, 1982, et al.
(författare)
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The anti-asthmatic drug, montelukast, modifies the neurogenic potential in the young healthy and irradiated brain
- 2018
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Ingår i: Cell Death & Disease. - : Springer Science and Business Media LLC. - 2041-4889. ; 9:7
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Tidskriftsartikel (refereegranskat)abstract
- Brain tumors are the most common form of solid tumors in children. Due to the increasing number of survivors, it is of importance to prevent long-term treatment-induced side effects. Montelukast, a leukotriene receptor antagonist, may have the desired neuroprotective properties. The aim of the study was to determine whether montelukast could reduce adverse effects of cranial irradiation (CIR) to the young brain. Daily injections of montelukast or vehicle was given to young mice for 4 or 14 days in combination with CIR or under normal conditions. Montelukast treatment for 4 days protected against cell death with 90% more cell death in the vehicle group compared to the montelukast group 24 h after CIR. It also resulted in less microglia activation 6 h after CIR, where montelukast lowered the levels of CD68 compared to the vehicle groups. Interestingly, the animals that received montelukast for 14 days had 50% less proliferating cells in the hippocampus irrespective of receiving CIR or not. Further, the total number of neurons in the granule cell layer was altered during the sub-acute phase. The number of neurons was decreased by montelukast treatment in control animals (15%), but the opposite was seen after CIR, where montelukast treatment increased the number of neurons (15%). The results show beneficial effects by montelukast treatment after CIR in some investigated parameters during both the acute phase and with longer drug treatment. However, it also resulted in lower proliferation in the hippocampus under normal conditions, indicating that the effects of montelukast can be either beneficial or unfavorable, depending on the circumstances.
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| 26. |
- Erkenstam, Nina Hellström, 1976, et al.
(författare)
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Temporal Characterization of Microglia/Macrophage Phenotypes in a Mouse Model of Neonatal Hypoxic-Ischemic Brain Injury.
- 2016
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Ingår i: Frontiers in cellular neuroscience. - : Frontiers Media SA. - 1662-5102. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Immune cells display a high degree of phenotypic plasticity, which may facilitate their participation in both the progression and resolution of injury-induced inflammation. The purpose of this study was to investigate the temporal expression of genes associated with classical and alternative polarization phenotypes described for macrophages and to identify related cell populations in the brain following neonatal hypoxia-ischemia (HI). HI was induced in 9-day old mice and brain tissue was collected up to 7 days post-insult to investigate expression of genes associated with macrophage activation. Using cell-markers, CD86 (classic activation) and CD206 (alternative activation), we assessed temporal changes of CD11b(+) cell populations in the brain and studied the protein expression of the immunomodulatory factor galectin-3 in these cells. HI induced a rapid regulation (6 h) of genes associated with both classical and alternative polarization phenotypes in the injured hemisphere. FACS analysis showed a marked increase in the number of CD11b(+)CD86(+) cells at 24 h after HI (+3667%), which was coupled with a relative suppression of CD11b(+)CD206(+) cells and cells that did not express neither CD86 nor CD206. The CD11b(+)CD206(+) population was mixed with some cells also expressing CD86. Confocal microscopy confirmed that a subset of cells expressed both CD86 and CD206, particularly in injured gray and white matter. Protein concentration of galectin-3 was markedly increased mainly in the cell population lacking CD86 or CD206 in the injured hemisphere. These cells were predominantly resident microglia as very few galectin-3 positive cells co-localized with infiltrating myeloid cells in Lys-EGFP-ki mice after HI. In summary, HI was characterized by an early mixed gene response, but with a large expansion of mainly the CD86 positive population during the first day. However, the injured hemisphere also contained a subset of cells expressing both CD86 and CD206 and a large population that expressed neither activation marker CD86 nor CD206. Interestingly, these cells expressed the highest levels of galectin-3 and were found to be predominantly resident microglia. Galectin-3 is a protein involved in chemotaxis and macrophage polarization suggesting a novel role in cell infiltration and immunomodulation for this cell population after neonatal injury.
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| 27. |
- Johansson, Ann, 1955-, et al.
(författare)
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A participatory evaluation of the health promotion programme “more healthy years of life” programme among senior citizens in Sweden
- 2018
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Ingår i: Cogent Medicine. - : Cogent OA. - 2331-205X. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older adults have, in general, been sparsely involved in development and evaluation of programmes intended to promote their health.Aim: To describe older adults’ reflections on and involvement in the development and evaluation of a health promotion programme.Material and Method: Ten older persons participated in a health promotion programme (HPP) focusing on activity during four sessions. After each HPP session, focus group discussions were held, analysed through qualitative content analysis.Results: The main theme; “Being involved adds value and new experiences to life“, were built from sub-themes; “From sceptical individual to engaged group member”, “From beholder to active co-creator”, and “From individual knowledge recipient to collective knowledge sharer”.Conclusions: Having a leader with a gerontological competence was mentioned as important, as well as to integrate existential topics into the HPP. Social inclusion together with the possibility to influence the HPP had a positive effect on the participants and provided a sense of belonging.Significance: Several contributions to the development of the HPP were given, that would not have been captured without the reflections and involvement of the participants. However, more and larger studies are needed to develop strategies that enable older adult’s involvement in the development of HHP.
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| 28. |
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| 29. |
- Johansson, Ann, 1955-
(författare)
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Occupational adaptation in diverse contexts with focus on persons in vulnerable life situations
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction. This present thesis focuses on occupational adaptation in the empirical context of vulnerable populations relative to ageing (Study II, III), disability (Study I, II) and poverty (Study IV) and in a theoretical context (V).Aim. The overall aim was to explore and describe occupational adaptation in diverse contexts with a focus on persons in vulnerable life situations.Methods. The thesis was conducted with a mixed design embracing quantitative and qualitative methods and a literature review. The data collection methods comprised questionnaires (Study I, II, III), individual interviews (Study II, IV), group interviews (Study III) and data base searches (Study V). Altogether 115 persons participated in the studies and 50 articles were included in the literature review. Qualitative content analysis was used to analyse the interviews (Study I, II, III, IV) and the literature review (Study V). Parametric and non-parametric statistics were applied when analysing the quantitative data (Study II, III).Results: Women in St Petersburg, Russia, who have had a minor stroke reported more dependence in everyday occupations than the stroke symptoms indicated and they overemphasized their disability and dysfunction. When the environmental press did not meet their competence, it caused negative adaptive behaviour (Study I). In home rehabilitation for older persons with disabilities, interventions based on the occupational adaptation model was compared with interventions based on well-tried professional experience. The results indicated that the use of the occupational adaptation model increased experienced health and the participants acquired adaptive strategies to manage every day occupations. (Study II). An occupation based health-promoting programme for older community dwelling persons was compared with a control group. The intervention group showed statistically significant improvement in general health variables as vitality and mental health, but there were no statistically significant differences between the groups. A qualitative evaluation, in the intervention group, showed that participation in meaningful, challenging occupations in different environments stimulated the occupational adaptation process (Study III). Occupational adaptation among vulnerable EU citizens begging in Sweden was explored by interviews. The results showed that the participants experienced several occupational challenges when begging abroad. The results show a variety of adaptive responses, but whether they are experienced as positive or negative is a matter of perspective and can only be determined by the participants themselves (Study IV). Finally, the results from a literature review (Study V) showed that research on occupational adaptation was mainly based on Schkade and Schultz’s and Kielhofner’s theoretical approaches. Occupational adaptation was also used without further explanation or theoretical argument (Study V).Conclusion: The surrounding context was shown to play an important role for the participants’ occupational adaptation. There were no general occupational challenges or adaptive responses to the various vulnerable life situations, but some common features in the participant groups’ adaptive responses were found. For example, if the environment put too great demand on the person and social support was lacking, there was a risk of negative adaptation. Moreover, persons with low functional capacity were vulnerable to environmental demands and dependent on a supportive environment for their adaptive response. However, persons living in supportive environments developed adaptive responses by themselves. Further, personal factors needed to be strengthened to meet the demands of the environment. Upholding occupational roles was a driving force in finding ways to adapt and perform occupations. Considering the theoretical context, the occupational adaptation theoretical approaches need to be further developed in relation to negative adaptation and to support use within community-based and health-promotive areas.
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| 30. |
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| 31. |
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| 32. |
- Johansson, Ann, 1955-, et al.
(författare)
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Occupational challenges and adaptations of vulnerable EU citizens from Romania begging in Sweden
- 2019
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Ingår i: Journal of Occupational Science. - : Taylor & Francis. - 1442-7591 .- 2158-1576. ; 26:2, s. 200-210
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: People from European Union (EU) countries such as Latvia, Romania and Bulgaria who beg on the streets have become a common part of the townscape in Sweden. While demanding situations in their home countries drive them abroad to earn their living, those who turn to begging still face challenges in their everyday lives. Additional knowledge is needed, from their perspective, about the occupational challenges of begging, as well as how they adapt to those challenges.Aim: To describe the occupational challenges and related adaptations of vulnerable EU citizens begging in Sweden.Methods: We used a descriptive qualitative design. Individual interviews with 20 Romanian participants were conducted and analysed using qualitative content analysis with a deductive and inductive approach.Results: Six categories of occupational adaptation responses were identified: Keeping the family tier intact despite distance; Dealing with shame and stress; Managing body and mind when begging despite the monotony; Living as cheaply as possible; Trying to get a night's sleep without drawing attention to oneself; and Seeking alternatives for earning their living.Conclusion: Everyday life, when begging abroad, is filled with occupational challenges requiring occupational adaptations, for better or for worse, to sustain basic human needs. To further understand the needs of this vulnerable and marginalised group in society, human rights discourses that go beyond the individual level are needed.
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| 33. |
- Johansson, Ann, 1955-, et al.
(författare)
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The use of occupational adaptation in research articles : a scoping review
- 2018
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Ingår i: Occupational Therapy in Health Care. - : Taylor & Francis. - 0738-0577 .- 1541-3098. ; 32:4, s. 422-439
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Forskningsöversikt (refereegranskat)abstract
- The aim of this scoping review was to identify and describe how occupational adaptation has been used in different research studies published from 1992 to 2015 and to identify possible gaps in study design. Four categories of studies were identified: those focused on understanding how occupational adaptation occurs in different life situations and different health conditions, those focused on the use of occupational adaptation as a guide or model in organizing the occupational therapy process, and those using occupational adaptation as a part of instrument development. Several gaps in research are evident including updating the theory development on occupational adaptation, types of maladaptation, studies conducted in less affluent countries, quantitative studies with robust designs, inclusion of men and younger persons as subjects, vulnerable groups, health promotion, and community settings.
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| 34. |
- Kalm, Marie, 1981, et al.
(författare)
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Serum concentrations of the axonal injury marker neurofilament light protein are not influenced by blood-brain barrier permeability
- 2017
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Ingår i: Brain Research. - : Elsevier BV. - 0006-8993. ; 1668, s. 12-19
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Tidskriftsartikel (refereegranskat)abstract
- A blood biomarker to monitor individual susceptibility to neuronal injury from cranial radiotherapy could potentially help to individualize radiation treatment and thereby reduce the incidence and severity of late effects. An important feature of such a blood biomarker is that its concentration is not confounded by varying degrees of release from the brain into the blood across the blood-brain barrier (BBB). In this study, we investigated serum neurofilament light protein (NFL) concentrations in 21-day old mice following a single dose of cranial irradiation (8 Gy). Cranial irradiation resulted in acute cell injury measured as a 12.9-fold increase in caspase activity 6 h after irradiation; activation of inflammation measured by levels of CCL2 and increased BBB permeability measured by C-14-sucrose concentration ratios in brain and cerebrospinal fluid (CSF). Serum levels of NFL peaked at 6 h after both anesthesia and cranial irradiation, but no timely correlation of serum NFL concentration with BBB permeability was found. Further, three groups of patients with different degrees of BBB impairment (measured as the CSF/serum albumin ratio) were investigated. There was no correlation between serum NFL concentration and CSF/serum albumin ratio (r = 0.139, p = 0.3513), however a strong correlation was found for NFL concentration in serum and NFL concentration in CSF (r = 0.6303, p < 0.0001). In conclusion, serum NFL appears to be a reliable blood biomarker for neuronal injury, and its concentration is not confounded by BBB permeability. (C) 2017 Elsevier B.V. All rights reserved.
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| 35. |
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| 36. |
- Prosén, Martina, et al.
(författare)
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Fridsriket som börjat
- 2010
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Ingår i: I ljuset av återkomsten : En bok om tro och liv - En bok om tro och liv. - 9789173870856
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Bokkapitel (populärvet., debatt m.m.)
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| 37. |
- Prosén, Martina, et al.
(författare)
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Guds rike och mänskliga relationer
- 2010
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Ingår i: I ljuset av återkomsten : En bok om tro och liv - En bok om tro och liv. - 9789173870856
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Bokkapitel (populärvet., debatt m.m.)
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| 38. |
- Roughton, Karolina, 1977, et al.
(författare)
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Irradiation to the young mouse brain impaired white matter growth more in females than in males
- 2013
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Ingår i: Cell Death & Disease. - : Springer Science and Business Media LLC. - 2041-4889. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Modern therapy cures 80% of all children with brains tumors, but may also cause long-lasting side effects, so called late effects. Radiotherapy is particularly prone to cause severe late effects, such as intellectual impairment. The extent and nature of the resulting cognitive deficits may be influenced by age, treatment and gender, where girls suffer more severe late effects than boys. The reason for this difference between boys and girls is unknown, but very few experimental studies have addressed this issue. Our aim was to investigate the effects of ionizing radiation on the corpus callosum (CC) in both male and female mice. We found that a single dose of 8 Gray (Gy) to the brains of postnatal day 14 mice induced apoptosis in the CC and reduced the number of proliferating cells by one third, as judged by the number of phospho-histone H3 positive cells 6 h after irradiation (IR). BrdU incorporation was reduced (62% and 42% lower in females and males, respectively) and the number of oligodendrocytes (Olig2(+) cells) was lower (43% and 21% fewer in females and males, respectively) 4 months after IR, so the lack of developing and differentiated cells was more pronounced in females. The number of microglia was unchanged in females but increased in males at this late time point. The density of microvessel profiles was unchanged by IR. This single, moderate dose of 8 Gy impaired the brain growth to some extent (8.1% and 0.4% lower brain/body weight ratio in females and males, respectively) but the CC growth was even more impaired (31% and 19% smaller in females and males, respectively) 4 months after IR compared with non-irradiated mice. In conclusion, this is the first study to our knowledge demonstrating that IR to the young rodent brain affects white matter development more in females than in males.
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| 39. |
- Zhou, K., et al.
(författare)
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Radiation induces progenitor cell death, microglia activation, and blood-brain barrier damage in the juvenile rat cerebellum
- 2017
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Posterior fossa tumors are the most common childhood intracranial tumors, and radiotherapy is one of the most effective treatments. However, irradiation induces long-term adverse effects that can have significant negative impacts on the patient's quality of life. The purpose of this study was to characterize irradiation-induced cellular and molecular changes in the cerebellum. We found that irradiation-induced cell death occurred mainly in the external germinal layer (EGL) of the juvenile rat cerebellum. The number of proliferating cells in the EGL decreased, and 82.9% of them died within 24 h after irradiation. Furthermore, irradiation induced oxidative stress, microglia accumulation, and inflammation in the cerebellum. Interestingly, blood-brain barrier damage and blood flow reduction was considerably more pronounced in the cerebellum compared to other brain regions. The cerebellar volume decreased by 39% and the migration of proliferating cells to the internal granule layer decreased by 87.5% at 16 weeks after irradiation. In the light of recent studies demonstrating that the cerebellum is important not only for motor functions, but also for cognition, and since treatment of posterior fossa tumors in children typically results in debilitating cognitive deficits, this differential susceptibility of the cerebellum to irradiation should be taken into consideration for future protective strategies.
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