| 1. |
- Ullmark, Peter, et al.
(författare)
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Design & visuell kommunikation : examensbok 2010
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Publiceras i samband med den första utexamineringen från kandidatprogrammet Design & Visuell Kommunikation på Malmö högskola. Boken innehåller artiklar om designforskning såväl som personliga presentationer av programmets studenter och deras examensarbeten eller portfolios. Boken definierar vad Design & Visuell Kommunikation står för i studenternas mening.
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| 2. |
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| 4. |
- Carlsson, Eva, 1959, et al.
(författare)
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Development and validation of the preparedness for Colorectal Cancer Surgery Questionnaire: PCSQ-pre 24
- 2016
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 25, s. 24-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The aims of the study were to develop and psychometrically evaluate a patient-reported outcome instrument for the measurement of preoperative preparedness in patients undergoing surgery for colorectal cancer. Methods This study was conducted in two stages: a) instrument development (item generation, construction of items and domains), empirical verification and b) instrument evaluation. A questionnaire with 28 items measuring preparedness for surgery was developed covering four domains and was tested for content validity with an expert panel and with patients. Psychometric testing of the questionnaire was conducted on 240 patients undergoing elective surgery for colorectal cancer. Results The scale content validity index of the preparedness items was 0.97. The final version consisted of 24 items measuring 4 subscales: Searching for and making use of information, Understanding and involvement in the care process, Making sense of the recovery process and Support and access to medical care. Confirmatory factor analysis revealed good model fit with standardized factor loadings ranging from 0.58 to 0.97. A well-fitting second-order factor model provided support for a total preparedness score with second-order factor loadings ranging from 0.75 to 0.93. The ordinal alpha values of the four latent factors ranged from 0.92 to 0.96, indicating good internal consistency. The polyserial correlations with the total score were 0.64 (p<0.01) for the overall preparedness question and 0.37 (p<0.01) for overall well-being. Conclusion The Swedish Preparedness for Colorectal Cancer Surgery Questionnaire for use in the preoperative phase demonstrated good psychometric properties based on a sound conceptualization of preparedness. © 2016 Elsevier Ltd
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| 7. |
- Carlsson, Frida, et al.
(författare)
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Prevalence of annoyance attributed to electrical equipment and smells in a Swedish population, and relationship with subjective health and daily functioning
- 2005
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Ingår i: Public Health. - : Elsevier BV. - 1476-5616 .- 0033-3506. ; 119:7, s. 568-577
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-reported annoyance from electrical equipment has been in evidence since the mid-1980s, and the first reports of illness from everyday chemicals arose in the 1960s. However, the extent of the problem has not yet been fully established.AIMS: The aim of this study was to estimate the prevalence of annoyance related to electrical and chemical factors in a Swedish general population, and to assess possible relationships with subjective health and daily functioning.METHODS: In total, 13,604 subjects, representative of the population of Scania, Sweden, answered a survey containing five questions regarding annoyance from five environmental factors: fluorescent tube lighting, visual display units, other electrical equipment, air that smells of chemicals, and other smells. The survey also obtained data on self-reported health (SRH-7), mental well-being [General Health Questionnaire (GHQ)-12], work situation and daily functioning.RESULTS: Almost one-third of the respondents reported annoyance from at least one environmental factor. Annoyance was more frequent among women, subjects of working age and immigrants. Subjects who reported environmental annoyance scored higher on GHQ-12 and lower on SRH-7, indicating impaired subjective physical and mental well-being. They were also more likely to report deteriorated daily functioning.CONCLUSIONS: Annoyance related to electrical and/or chemical factors was common in a Swedish population. Subjects reporting environmental annoyance rated their overall health significantly poorer than the general population. The association with subjective health and functional capacity increased with severity of annoyance, which suggests that there is some connection between environmental annoyance, well-being and functional capacity.
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| 8. |
- Carlsson, Frida, et al.
(författare)
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Representativity of a postal public health questionnaire survey in Sweden, with special reference to ethnic differences in participation
- 2006
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 34:2, s. 132-139
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Non-participation in health surveys is a common phenomenon. When differences between participants and non-participants are considerable, the external validity of the sample survey may decrease and false conclusions might be drawn about the health status of the population. For this reason, the authors aimed to investigate the representativity of a postal questionnaire survey performed in the county of Scania, Sweden, in 1999-2000. The survey, which was based on an 18- to 80-year-old population sample, had a 58% response rate (n = 13 604).METHODS: For some variables, the information obtained using the questionnaire was compared with information obtained from a population register that covers all the population in the county (for the 18- to 80-year-old group, n = 850 476). The population register includes, among other data, information on age, gender, educational level, country of birth, and healthcare expenditure.RESULTS: Men, individuals with a low level of education, and immigrants were under-represented in the survey. However, except for immigrants, the under-representation was not large. Among immigrants, particularly those born in former Yugoslavia, the Arabic-speaking countries, and Poland were very significantly under-represented in the study. By contrast, immigrants born in other Nordic countries had responded to almost the same extent as respondents born in Sweden. The survey sample had about the same healthcare utilization costs as did the general population.CONCLUSIONS: In summary, the "Health Survey for Scania, 2000" seems largely representative of the total Scanian population. A major concern, however, is the under-representation of the immigrant population.
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| 9. |
- Carlsson, Frida, et al.
(författare)
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Salivary cortisol and self-reported stress among persons with environmental annoyance
- 2006
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Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 32:2, s. 20-109
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Increased vulnerability to stress has been suggested as a possible mechanism behind medically unexplained conditions such as sensitivity to electricity and common smells. This study examined whether subjective environmental annoyance among the general population is associated with increased physiological reactivity or subjective stress scores.METHODS: Four groups were studied (N=141): an electrically annoyed (N=17), a smell-annoyed (N=29), and a generally annoyed group (N=39) and a reference group matched for age, gender, and socioeconomic status (N=56). Over 5 days, the participants collected saliva for cortisol determination at awakening, 30 minutes after awakening, 8 hours after awakening, and at 9 o'clock in the evening. On the evening preceding the fifth day, the participants ingested a 0.5-mg dexamethasone tablet so that possible differential suppression of the hypothalamic-pituitary-adrenal (HPA) axis could be assessed. Each day, the participants also rated their subjective stress and health complaints.RESULTS: No significant differences were found between the groups regarding cortisol secretion over 5 days. The dexamethasone suppression test showed inhibited cortisol secretion in all four groups. No associations were found between the cortisol concentrations and the self-reported stress scores or subjective health complaints.CONCLUSIONS: Although the environmentally annoyed groups showed no signs of increased HPA-axis activation, being annoyed by both electrical devices and smells seems to be related to increased psychological activation in terms of self-reported stress. Because the participants were otherwise healthy and recruited from the general population, the results imply that subtle psychological stress processes may be important in the early development of environmental annoyance.
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| 10. |
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| 12. |
- Carlsson-Lalloo, Ewa, 1976, et al.
(författare)
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Testing the feasibility of a translated and culturally adapted person-centred training programme in maternal and newborn healthcare in Democratic Republic of Congo: A process evaluation.
- 2024
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Ingår i: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives. - 1877-5764. ; 40
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Tidskriftsartikel (refereegranskat)abstract
- Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, "Mutual Meetings", has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC.The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application.The French PCC programme exceeded the participants' expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other.The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.
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| 13. |
- Djekic, Demir, 1989-, et al.
(författare)
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Effects of a Lacto-Ovo-Vegetarian Diet on the Plasma Lipidome and Its Association with Atherosclerotic Burden in Patients with Coronary Artery Disease-A Randomized, Open-Label, Cross-over Study
- 2020
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- A vegetarian diet has been associated with a lower risk of coronary artery disease (CAD). Plasma triacylglycerols, ceramides, and phosphatidylcholines may improve prediction of recurrent coronary events. We sought to investigate effects of a lacto-ovo-vegetarian diet (VD) on plasma lipidome in CAD patients and simultaneously assess associations of plasma lipids with the extent of coronary atherosclerotic burden. We analyzed 214 plasma lipids within glycerolipid, sphingolipid, and sterol lipid classes using lipidomics from a randomized controlled, crossover trial comprising 31 CAD patients on standard medical therapy. Subjects completed a four-week intervention with VD and isocaloric meat diet (MD), separated by a four-week washout period. The VD increased levels of 11 triacylglycerols and lowered 7 triacylglycerols, 21 glycerophospholipids, cholesteryl ester (18:0), and ceramide (d18:1/16:0) compared with MD. VD increased triacylglycerols with long-chain polyunsaturated fatty acyls while decreased triacylglycerols with saturated fatty acyls, phosphatidylcholines, and sphingomyelins than MD. The Sullivan extent score (SES) exhibited on coronary angiograms were inversely associated with triacylglycerols with long-chain unsaturated fatty acyls. Phosphatidylcholines that were lower with VD were positively associated with SES and the total number of stenotic lesions. The VD favorably changed levels of several lipotoxic lipids that have previously been associated with increased risk of coronary events in CAD patients.
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| 14. |
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| 15. |
- Djekic, Demir, 1989-, et al.
(författare)
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Effects of a Vegetarian Diet on Cardiometabolic Risk Factors, Gut Microbiota, and Plasma Metabolome in Subjects With Ischemic Heart Disease: A Randomized, Crossover Study
- 2020
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Ingår i: Journal of the American Heart Association. - : Wiley-Blackwell Publishing Inc.. - 2047-9980. ; 9:18, s. e016518-e016518
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Tidskriftsartikel (refereegranskat)abstract
- Background A vegetarian diet (VD) may reduce future cardiovascular risk in patients with ischemic heart disease. Methods and Results A randomized crossover study was conducted in subjects with ischemic heart disease, assigned to 4-week intervention periods of isocaloric VD and meat diet (MD) with individually designed diet plans, separated by a 4-week washout period. The primary outcome was difference in oxidized low-density lipoprotein cholesterol (LDL-C) between diets. Secondary outcomes were differences in cardiometabolic risk factors, quality of life, gut microbiota, fecal short-chain and branched-chain fatty acids, and plasma metabolome. Of 150 eligible patients, 31 (21%) agreed to participate, and 27 (87%) participants completed the study. Mean oxidized LDL-C (-2.73 U/L), total cholesterol (-5.03 mg/dL), LDL-C (-3.87 mg/dL), and body weight (-0.67 kg) were significantly lower with the VD than with the MD. Differences between VD and MD were observed in the relative abundance of several microbe genera within the families Ruminococcaceae, Lachnospiraceae, and Akkermansiaceae. Plasma metabolites, including l-carnitine, acylcarnitine metabolites, and phospholipids, differed in subjects consuming VD and MD. The effect on oxidized LDL-C in response to the VD was associated with a baseline gut microbiota composition dominated by several genera of Ruminococcaceae. Conclusions The VD in conjunction with optimal medical therapy reduced levels of oxidized LDL-C, improved cardiometabolic risk factors, and altered the relative abundance of gut microbes and plasma metabolites in patients with ischemic heart disease. Our results suggest that composition of the gut microbiota at baseline may be related to the reduction of oxidized LDL-C observed with the VD. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02942628.
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| 16. |
- Dohlmar, Frida, et al.
(författare)
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An audit of high dose-rate prostate brachytherapy treatment planning at six Swedish clinics
- 2021
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Ingår i: Journal of Contemporary Brachytherapy. - : TERMEDIA PUBLISHING HOUSE LTD. - 1689-832X .- 2081-2841. ; 13:1, s. 59-71
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: High dose-rate prostate brachytherapy has been implemented in Sweden in the late 1980s and early 1990s in six clinics using the same schedule: 20 Gy in two fractions combined with 50 Gy in 25 fractions with external beam radiation therapy. Thirty years have passed and during these years, various aspects of the treatment process have developed, such as ultrasound-guided imaging and treatment planning system. An audit was conducted, including a questionnaire and treatment planning, which aimed to gather knowledge about treatment planning methods in Swedish clinics. Material and methods: A questionnaire and a treatment planning case (non-anatomical images) were sent to six Swedish clinics, in which high-dose-rate prostate brachytherapy is performed. Treatment plans were compared using dosimetric indices and equivalent 2 Gy doses (EQD(2)). Treatment planning system report was used to compare dwell positions and dwell times. Results: For all the clinics, the planning aim for the target was 10.0 Gy, but the volume to receive the dose differed from 95% to 100%. Dose constraints for organs at risk varied with up to 2 Gy. The dose to 90% of target volume ranged from 10.0 Gy to 11.1 Gy, equivalent to 26.0 Gy EQD(2) and 31.3 Gy EQD(2), respectively. Dose non-homogeneity ratio differed from 0.18 to 0.32 for clinical target volume (CTV) in treatment plans and conformity index ranged from 0.52 to 0.59 for CTV. Conclusions: Dose constraints for the organs at risk are showing a larger variation than that reflected in compared treatments plans. In all treatment plans in our audit, at least 10 Gy was administered giving a total treatment of 102 Gy EQD(2), which is in the upper part of the prescription doses published in the GEC/ESTRO recommendations.
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| 17. |
- Dohlmar, Frida, et al.
(författare)
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Validation of automated post-adjustments of HDR prostate brachytherapy treatment plans by quantitative measures and oncologist observer study
- 2023
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Ingår i: Brachytherapy. - : Elsevier BV. - 1538-4721 .- 1873-1449. ; 22:3, s. 407-415
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim was to evaluate a postprocessing optimization algorithm's ability to improve the spatial properties of a clinical treatment plan while preserving the target coverage and the dose to the organs at risk. The goal was to obtain a more homogenous treatment plan, minimizing the need for manual adjustments after inverse treatment planning. MATERIALS AND METHODS: The study included 25 previously treated prostate cancer pa-tients. The treatment plans were evaluated on dose-volume histogram parameters established clin-ical and quantitative measures of the high dose volumes. The volumes of the four largest hot spots were compared and complemented with a human observer study with visual grading by eight oncologists. Statistical analysis was done using ordinal logistic regression. Weighted kappa and Fleiss' kappa were used to evaluate intra-and interobserver reliability. RESULTS: The quantitative analysis showed that there was no change in planning target volume (PTV) coverage and dose to the rectum. There were significant improvements for the adjusted treatment plan in: V150% and V200% for PTV, dose to urethra, conformal index, and dose nonhomogeneity ratio. The three largest hot spots for the adjusted treatment plan were significantly smaller compared to the clinical treatment plan. The observers preferred the adjusted treatment plan in 132 cases and the clinical in 83 cases. The observers preferred the adjusted treatment plan on homogeneity and organs at risk but preferred the clinical plan on PTV coverage. CONCLUSIONS: Quantitative analysis showed that the postadjustment optimization tool could improve the spatial properties of the treatment plans while maintaining the target coverage.
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| 18. |
- Friberg, Febe, 1950, et al.
(författare)
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Exploration of dynamics in a complex person-centred intervention process based on health professionals' perspectives
- 2018
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The assessment and evaluation of practical and sustainable development of health care has become a major focus of investigation in health services research. A key challenge for researchers as well as decision-makers in health care is to understand mechanisms influencing how complex interventions work and become embedded in practice, which is significant for both evaluation and later implementation. In this study, we explored nurses' and surgeons' perspectives on performing and participating in a complex multi-centre person-centred intervention process that aimed to support patients diagnosed with colorectal cancer to feel prepared for surgery, discharge and recovery. Method: Data consisted of retrospective interviews with 20 professionals after the intervention, supplemented with prospective conversational data and field notes from workshops and follow-up meetings (n = 51). The data were analysed to construct patterns in line with interpretive description. Results: Although the participants highly valued components of the intervention, the results reveal influencing mechanisms underlying the functioning of the intervention, including multiple objectives, unclear mandates and competing professional logics. The results also reveal variations in processing the intervention focused on differences in using and talking about intervention components. Conclusions: The study indicates there are significant areas of ambiguity in understanding how theory-based complex clinical interventions work and in how interventions are socially constructed and co-created by professionals' experiences, assumptions about own professional practice, contextual conditions and the researchers' intentions. This process evaluation reveals insights into reasons for success or failure and contextual aspects associated with variations in outcomes. Thus, there is a need for further interpretive inquiry, and not only descriptive studies, of the multifaceted characters of complex clinical interventions and how the intervention components are actually shaped in constantly shifting contexts.
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| 19. |
- Gottvall, Maria, 1980-, et al.
(författare)
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Post‐migration psychosocial experiences and challenges amongst LGBTQ + forced migrants : A meta‐synthesis of qualitative reports
- 2023
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 79:1, s. 358-371
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Synthesize qualitative research to illuminate the post-migration psychosocial experiences amongst LGBTQ+ forced migrants.Design: Meta-synthesis of qualitative reports.Data sources: Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English-language reports containing empirical qualitative findings about post-migration experiences and published 10 years prior to the searches, based on migrants as the primary source.Review Methods: Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse-midwife researchers and experienced clinical professionals, reports were analysed with a two-stage qualitative meta-synthesis including an inductive qualitative content analysis.Results: The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta-synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships.Conclusion: After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research.Impact: Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength-building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons.Patient or Public Contribution: No patient or public contribution.
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| 20. |
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| 21. |
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| 22. |
- Henningsson, Frida, et al.
(författare)
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IgE-Mediated Enhancement of CD4(+) T Cell Responses in Mice Requires Antigen Presentation by CD11c(+) Cells and Not by B Cells
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:7, s. e21760-
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Tidskriftsartikel (refereegranskat)abstract
- IgE antibodies, administered to mice together with their specific antigen, enhance antibody and CD4(+) T cell responses to this antigen. The effect is dependent on the low affinity receptor for IgE, CD23, and the receptor must be expressed on B cells. In vitro, IgE-antigen complexes are endocytosed via CD23 on B cells, which subsequently present the antigen to CD4(+) T cells. This mechanism has been suggested to explain also IgE-mediated enhancement of immune responses in vivo. We recently found that CD23(+) B cells capture IgE-antigen complexes in peripheral blood and rapidly transport them to B cell follicles in the spleen. This provides an alternative explanation for the requirement for CD23(+) B cells. The aim of the present study was to determine whether B-cell mediated antigen presentation of IgE-antigen complexes explains the enhancing effect of IgE on immune responses in vivo. The ability of spleen cells, taken from mice 1-4 h after immunization with IgE-antigen, to present antigen to specific CD4(+) T cells was analyzed. Antigen presentation was intact when spleens were depleted of CD19(+) cells (i.e., primarily B cells) but was severely impaired after depletion of CD11c(+) cells (i.e., primarily dendritic cells). In agreement with this, the ability of IgE to enhance proliferation of CD4(+) T cells was abolished in CD11c-DTR mice conditionally depleted of CD11c(+) cells. Finally, the lack of IgE-mediated enhancemen of CD4(+) T cell responses in CD23(-/-) mice could be rescued by transfer of MHC-II-compatible as well as by MHC-II-incompatible CD23(+) B cells. These findings argue against the idea that IgE-mediated enhancement of specific CD4(+) T cell responses in vivo is caused by increased antigen presentation by B cells. A model where CD23(+) B cells act as antigen transporting cells, delivering antigen to CD11c(+) cells for presentation to T cells is consistent with available experimental data.
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| 23. |
- Hjalte, Frida, et al.
(författare)
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Real-world outcome analysis of continuously and intermittently treated patients with moderate to severe psoriasis after switching to a biologic agent
- 2015
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Ingår i: Dermatology. - : S. Karger. - 1018-8665 .- 1421-9832. ; 230:4, s. 347-353
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical studies of continuous versus intermittent biologic therapy for moderate to severe psoriasis demonstrate improved efficacy with continuous treatment. Objective: To analyse Swedish real-world data of continuously and intermittently treated biologic-naive patients after switching to a biologic agent. Methods: This is an observational study based on PsoReg, the Swedish registry for systemic psoriasis treatment. Outcome effects in biologic-naive patients who switched to a biologic agent (n = 351) were analysed in groups of continuous, intermittent and terminated treatment. Results: Intermittently treated patients (n = 50) reported higher Psoriasis Area and Severity Index and Dermatology Life Quality Index values after switching than patients with continuous (n = 260) or terminated treatment (n = 41). Study Limitations:The reason for intermittent treatment was not recorded. The intermittently treated patients may be a heterogeneous group and a limitation is that it cannot be determined whether less than continuous use was offered to handle negative aspects. Conclusion: Patients with continuous biologic treatment tend to achieve better outcomes compared to intermittently treated patients.
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| 26. |
- Iversen, Kia Nøhr, et al.
(författare)
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A hypocaloric diet rich in high fiber rye foods causes greater reduction in body weight and body fat than a diet rich in refined wheat : A parallel randomized controlled trial in adults with overweight and obesity (the RyeWeight study)
- 2021
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983 .- 2405-4577. ; 45, s. 155-169
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: A high intake of whole grain foods is inversely associated with body mass index (BMI) and body fat in observational studies, but mixed results have been found in interventional studies. Among whole grains, rye is the richest source of dietary fiber and meals containing high-fiber rye foods have shown increased satiety up to 8 h, compared to meals containing refined wheat products. The aim of the study was to determine the effect of consuming high fiber rye products, compared to refined wheat products, on body weight and body fat loss in the context of an energy restricted diet.Methods: After a 2-week run-in period, 242 males and females with overweight or obesity (BMI 27-35 kg/m2), aged 30-70 years, were randomized (1:1) to consume high fiber rye products or refined wheat products for 12 weeks, while adhering to a hypocaloric diet. At week 0, week 6 and week 12 body weight and body composition (dual energy x-ray absorptiometry) was measured and fasting blood samples were collected. Subjective appetite was evaluated for 14 h at week 0, 6 and 12.Results: After 12 weeks the participants in the rye group had lost 1.08 kg body weight and 0.54% body fat more than the wheat group (95% confidence interval (CI): 0.36; 1.80, p < 0.01 and 0.05; 1.03, p = 0.03, respectively). C-reactive protein was 28% lower in the rye vs wheat group after 12 weeks of intervention (CI: 7; 53, p < 0.01). There were no consistent group differences on subjective appetite or on other cardiometabolic risk markers.Conclusion: Consumption of high fiber rye products as part of a hypocaloric diet for 12 weeks caused a greater weight loss and body fat loss, as well as reduction in C-reactive protein, compared to refined wheat. The difference in weight loss could not be linked to differences in appetite response
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| 27. |
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| 28. |
- Jönsen, Andreas, et al.
(författare)
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Direct and indirect costs for systemic lupus erythematosus in Sweden. A nationwide health economic study based on five defined cohorts
- 2016
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Ingår i: Seminars in Arthritis & Rheumatism. - : Elsevier BV. - 0049-0172 .- 1532-866X. ; 45:6, s. 684-690
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Forskningsöversikt (refereegranskat)abstract
- Objectives: The main objectives of this study were to calculate total costs of illness and cost -driving disease features among patients with systemic lupus erythematosus (SLE) in Sweden. Methods: Five cohorts of well-defined SLE patients, located in different parts of the country were merged. Incident and prevalent cases from 2003 through 2010 were included. The American College of Rheumatology (ACR) classification criteria was used. From the local cohorts, data on demographics, disease activity (SLEDAI 2K), and organ damage (SDI) were collected. Costs for inpatient care, specialist outpatient care and drugs were retrieved from national registries at the National Board of Health and Welfare. Indirect costs were calculated based on sickness leave and disability pensions from the Swedish Social Insurance Agency. Results: In total, 1029 SLE patients, 88% females, were included, and approximately 75% were below 65 years at the end of follow-up, and thus in working age. The mean number of annual specialist physician visits varied from six to seven; mean annual inpatient days were 3.1-3.6, and mean annual sick leave was 123-148 days, all per patient. The total annual cost was 208,555 SEK ($33,369 = 22,941(sic)), of which direct cost was 63,672kr ($10,188 = 7004(sic)) and the indirect cost was 144,883 SEK ($23,181 = 15,937(sic)), all per patient. The costs for patients with short disease duration were higher. Higher disease activity as measured by a SLEDAI 2K score > 3 was associated with approximately 50% increase in both indirect and direct costs. Damage in the neuropsychiatric and musculoskeletal domains were also linked to higher direct and indirect costs, while organ damage in the renal and ocular systems increased direct costs. Conclusion: Based on this study and an estimate of slightly more than 6000 SLE patients in Sweden, the total annual cost for SLE in the country is estimated at $188 million (= 129.5 million (sic)). Both direct (30%) and indirect costs (70%) are substantial. Medication accounts for less than 10% of the total cost. The tax paid national systems for health care and social security in Sweden ensure equal access to health care, sick leave reimbursements, and disability pensions nationwide. Our extrapolated annual costs for SLE in Sweden are therefore the best supported estimations thus far, and they clearly underline the importance of improved management, especially to reduce the indirect costs. (C) 2016 Elsevier Inc. All rights reserved.
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| 29. |
- Malmberg, Birgitta, et al.
(författare)
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Jourtjänstgöring: påverkan på katabola processer och återhämtning
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Anestesiläkare rapporterades i en svensk studie ha en högre mortalitet än genomsnittet av läkare. Detta fynd har dock ej kunnat reproduceras i motsvarande studier i de övriga nordiska länderna. Likväl har det spekulerats i om den angivna överrisken bland svenska anestesiläkare kan relateras till gruppens jourarbete med höga krav, nattarbete och stress. Kunskapen om hälsoeffekter av läkares jourarbete är generellt sett bristfällig. Mot denna bakgrund kontaktade Anestesikliniken i Lund den Yrkes- och miljömedicinska kliniken för genomförande av en stressfysiologisk undersökning av anestesiläkarna. Syftet var att undersöka om läkarnas upplevelse av den psykosociala arbetsmiljön och deras fysiologiska och psykologiska reaktioner i samband med jourarbete nådde nivåer som kan anses indikera risk för ohälsa. Ett primärt mål var att studera möjligheterna till återhämtning efter jour. En viktig fråga var också om anestesiläkarnas reaktioner vid jour skiljde sig från reaktioner hos läkare med annan specialitet. Deltagarna arbetade vid Lunds Universitetssjukhus som anestesiläkare (N=19) eller som läkare på öron-näsa-hals eller barnklinik (N=20). Samtliga hade nattjour (primärjour). Dessutom har anestesiläkare med nattjour från Göteborg (N=45), vilka under samma tidsperiod blev undersökta med samma psykosociala frågeformulär som läkarna i Lund, använts som en extern kontrollgrupp. Jämförelser har även gjorts mot populationsbaserade kontroller från Region Skåne. I början av undersökningsperioden besvarade samtliga deltagare ett omfattande frågeformulär. Deltagarna i Lund genomgick sedan en fysiologisk monitorering under en schemacykel på 2-3 veckor. Under denna period mättes reglering av autonom balans via hjärtfrekvensvariabilitet (HRV) med personburen ekg-logger samt påverkan på hypothalamus-hypofys-binjurebark-axeln (HPA-axeln) via salivkortisol. Provtagning och mätning genomfördes både på vanlig arbetsdag, jourdygn, dag efter jour och i vissa fall på ledig dag. Dessa mätningar ufördes i en motbalanserad design då tillvänjning till mätningen skulle kunna ge en förändrad respons. Med fasteblodprov (insulin, glukos, TSH, T4, testosteron, SHBG, IGF-1, HbA1c, TG, HDL, LDL) följdes individernas övriga metabola reaktioner före och efter nattjour. Subjektiv hälsa och trivsel i arbetet upplevdes av majoriteten i läkargrupperna som god, trots att en tredjedel av de undersökta uppgav en pressad arbetssituation med höga krav och låg kontroll. Det fanns inga skillnader mellan grupperna avseende dessa variabler. Även i frågor angående sömn, trötthet och balans mellan ansträngning och belöning låg läkargrupperna väsentligen på samma nivåer som personer från tidigare undersökningar på arbetsplatser i regionen. Blodprovsmarkörer för insulinkänslighet och blodfettsbalans låg stabilt över jourcykeln för samtliga undersökta grupper. TSH-värdet var i genomsnitt 26 % lägre ett dygn efter jour i hela läkargruppen jämfört med en vanlig arbetsdag (p<0,001). Det fanns ingen skillnad mellan grupperna. Det förelåg ingen förändrad kortisolrespons vid jour jämfört med en vanlig arbetsdag. Ej heller någon statistiskt säkerställd gruppskillnad i kortisolnivåer kunde påvisas. 4 När det gäller hjärtfrekvensvariabiliteten var dock situationen en annan: I HRV-analyser kväll och natt visade hela läkargruppen 15-30 % minskad högfrekvent variabilitet i relation till total variabilitet (HFnu, p<0,001) vid jour. Detta indikerar ett minskat inslag av parasympatikus, vilket kan innebära en högre stressnivå. Anestesiläkarnas jour-reaktion skiljde sig inte från de övriga läkarnas. Dock avvek anestesiläkarna i ett par avseenden generellt och oberoende av jour: Vi fann en 30 % lägre nivå (p=0,03) av RMSSD (HRV-variabel som speglar parasympatikusinslaget under 24 timmar) hos anestesiläkarna. Detta tyder på att deras autonoma balans var präglad av en lägre parasympatikus-tonus. Dessutom hade anestesiläkarna i genomsnitt 40-50 % lägre total hjärtfrekvensvariabilitet (total power, TP) vid analyser i entimmes analysfönster kväll och natt (kl 21-22 samt 03-04) jämfört med barn- och önh-läkarna (p=0,001), vilket också antyder skillnader mellan grupperna i autonom reglering. Den exakta fysiologiska betydelsen av detta kan dock diskuteras. Att de påvisade skillnaderna mellan läkargrupperna skulle bero på de psykiska och fysiska kraven i anestesiläkarnas arbete är tänkbart, men kan inte avgöras i denna undersökning. Det bör framhållas att fysisk aktivitet och sömn inverkar på den autonoma balansen, vilket kan innebära problem vid tolkningen av HRV-data i fältundersökningar. Här kan även finnas en för anestesiläkargruppen gemensam faktor utanför arbetet som förklaring till skillnaderna mellan grupperna. Då helt specifika HRV-mått för aktivering av sympatikus saknas baseras tolkningen av förändringar i autonom balans på förändringar i parasympatikus inverkan (RMSSD, HFnu). Slutligen kan det konstateras att de metabola förändringarna i samband med jourtjänstgöring var ytterst begränsade och bedömes ej innebära några negativa hälsoeffekter. Förändringarna i hjärtfrekvensvariabilitet kan indikera en förhöjd stressaktivering, särskilt hos anestesiläkarna. Tolkningen av bakomliggande mekanismer är dock ej entydig och behöver närmare utvärderas. En selektion av läkare med relativt lång erfarenhet i yrket kan ha bidragit till de begränsade fynden vad gäller subjektiv hälsa och trivsel samt markörer för stressaktivering.
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| 30. |
- Mehmeti-Ajradini, Meliha, et al.
(författare)
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Human G-MDSCs are neutrophils at distinct maturation stages promoting tumor growth in breast cancer
- 2020
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Ingår i: Life Science Alliance. - 2575-1077. ; 3:11
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Tidskriftsartikel (refereegranskat)abstract
- Myeloid-derived suppressor cells (MDSCs) are known to contribute to immune evasion in cancer. However, the function of the human granulocytic (G)-MDSC subset during tumor progression is largely unknown, and there are no established markers for their identification in human tumor specimens. Using gene expression profiling, mass cytometry, and tumor microarrays, we here demonstrate that human G-MDSCs occur as neutrophils at distinct maturation stages, with a disease-specific profile. G-MDSCs derived from patients with metastatic breast cancer and malignant melanoma display a unique immature neutrophil profile, that is more similar to healthy donor neutrophils than to G-MDSCs from sepsis patients. Finally, we show that primary G-MDSCs from metastatic breast cancer patients cotransplanted with breast cancer cells, promote tumor growth, and affect vessel formation, leading to myeloid immune cell exclusion. Our findings reveal a role for human G-MDSC in tumor progression and have clinical implications also for targeted immunotherapy.
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| 31. |
- Mehmeti-Ajradini, Meliha, et al.
(författare)
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Human G-MDSCs are neutrophils at distinct maturation stages promoting tumor growth in breast cancer
- 2020
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Ingår i: Life Science Alliance. - : LIFE SCIENCE ALLIANCE LLC. - 2575-1077. ; 3:11
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Tidskriftsartikel (refereegranskat)abstract
- Myeloid-derived suppressor cells (MDSCs) are known to contribute to immune evasion in cancer. However, the function of the human granulocytic (G)-MDSC subset during tumor progression is largely unknown, and there are no established markers for their identification in human tumor specimens. Using gene expression profiling, mass cytometry, and tumor microarrays, we here demonstrate that human G-MDSCs occur as neutrophils at distinct maturation stages, with a disease-specific profile. G-MDSCs derived from patients with metastatic breast cancer and malignant melanoma display a unique immature neutrophil profile, that is more similar to healthy donor neutrophils than to G-MDSCs from sepsis patients. Finally, we show that primary G-MDSCs from metastatic breast cancer patients co-transplanted with breast cancer cells, promote tumor growth, and affect vessel formation, leading to myeloid immune cell exclusion. Our findings reveal a role for human G-MDSC in tumor progression and have clinical implications also for targeted immunotherapy.
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| 32. |
- Morén, Björn, 1987-, et al.
(författare)
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Technical note: evaluation of a spatial optimization model for prostate high dose‐rate brachytherapy in a clinical treatment planning system
- 2023
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Ingår i: Medical physics (Lancaster). - : WILEY. - 0094-2405 .- 2473-4209. ; 50:2, s. 688-693
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSpatial properties of a dose distribution, such as volumes of contiguous hot spots, are of clinical importance in treatment planning for high dose-rate brachytherapy (HDR BT). We have in an earlier study developed an optimization model that reduces the prevalence of contiguous hot spots by modifying a tentative treatment plan. PurposeThe aim of this study is to incorporate the correction of hot spots in a standard inverse planning workflow and to validate the integrated model in a clinical treatment planning system. The spatial function is included in the objective function for the inverse planning, as opposed to in the previous study where it was applied as a separate post-processing step. Our aim is to demonstrate that fine-adjustments of dose distributions, which are often performed manually in todays clinical practice, can be automated. MethodsA spatial optimization function was introduced in the treatment planning system RayStation (RaySearch Laboratories AB, Stockholm, Sweden) via a research interface. A series of 10 consecutive prostate patients treated with HDR BT was retrospectively replanned with and without the spatial function. ResultsOptimization with the spatial function decreased the volume of the largest contiguous hot spot by on average 31%, compared to if the function was not included. The volume receiving at least 200% of the prescription dose decreased by on average 11%. Target coverage, measured as the fractions of the clinical target volume (CTV) and the planning target volume (PTV) receiving at least the prescription dose, was virtually unchanged (less than a percent change for both metrics). Organs-at-risk received comparable or slightly decreased doses if the spatial function was included in the optimization model. ConclusionsOptimization of spatial properties such as the volume of contiguous hot spots can be integrated in a standard inverse planning workflow for brachytherapy, and need not be conducted as a separate post-processing step.
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| 33. |
- Roumeliotis, Filip, 1980-, et al.
(författare)
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The constitution of the alcoholic self, communicative processes and administrative practices : On the varied uses of four terms denoting problematic drinking
- 2021
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Ingår i: Nordic Studies on Alcohol and Drugs. - : SAGE Publications. - 1455-0725 .- 1458-6126. ; 38:1, s. 3-21
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aims of this article were to examine the various meanings ascribed by three stakeholder groups – social workers, journalists and individuals with previous experience of problematic drinking – to four widely used terms in the alcohol field – alcoholism, alcohol dependence, alcohol misuse and risky drinking – and to examine how variations in the definitions of these terms correspond to specific pragmatic needs arising within different practices. Design: We conducted focus-group interviews with 15 individuals from the above-mentioned stakeholder groups. We identified three practices which shaped the meanings ascribed to the four terms denoting problematic drinking. Results: The results showed that the meanings ascribed to the four terms were both fixed and fluid. For the individuals with previous experience of problematic drinking, the four terms had fixed meanings, and their definition of the term “alcoholism” as denoting a disease, for example, was vital to the practice through which they sought to come to an understanding of themselves (“practice of self”). The social workers and the journalists on the other hand saw the four terms as being context dependent – as fluid and imprecise. This allowed them to establish trustful communicative relationships with informants and clients (“practice of trustful communication”), and to control the communicative process and successfully navigate between different administrative systems (“practice of administration”). Conclusions: Since the meanings ascribed to the examined terms denoting problematic drinking are shaped within varying practices, confusion regarding the actual meaning of a given term could be avoided by referring to the practical context in which it is used.
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| 34. |
- Rutemark, Christian, et al.
(författare)
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B cells lacking complement receptors 1 and 2 are equally efficient producers of IgG in vivo as wildtype B cells
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The complement system, including the complement receptors 1 and 2 (CR1/2), is crucial for the development of antibody responses against a wide range of antigens. Cr2-/- mice are deficient in both CR1 and CR2 and respond poorly upon immunization with antigen alone and with IgM-containing immune complexes. In mice, CR1/2 are expressed exclusively on B cells and follicular dendritic cells (FDC) but it is not clear which of the two cell-types that need to express the receptors for a normal antibody response. Here, bone marrow chimeras were used to distinguish between B cells and FDC. The animals were immunized with SRBC alone or with IgM anti-SRBC and SRBC. For an antibody response to SRBC alone, CR1/2 expression on FDC was crucial. When CR1/2+ FDC were present, B cells from Cr2-/- mice produced equal amounts of antibodies against SRBC as did B cells from WT. However, the response to IgM-SRBC complexes was more efficient in the presence of CR1/2+ B cells although CR1/2+ FDC still played a dominant role. In conclusion, antibody responses to antigen alone required CR1/2+ FDC, whereas CR1/2 expression on B cells was irrelevant. In contrast, in antibody responses to IgM-IC, presence of CR1/2+ B cells led to a higher and more rapid onset of the antibody response.
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| 35. |
- Sawatzky, Richard, et al.
(författare)
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Predictors of preparedness for recovery following colorectal cancer surgery: a latent class trajectory analysis.
- 2023
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Ingår i: Acta Oncologica. - 0284-186X .- 1651-226X. ; 62:12, s. 1625-1634
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Tidskriftsartikel (refereegranskat)abstract
- With an interest in providing knowledge for person-centred care, our overall goal is to contribute a greater understanding of diversity among patients in terms of their preparedness before and up to six months after colorectal cancer surgery. Our aim was to describe and provide a tentative explanation for differences in preparedness trajectory profiles.The study was explorative and used prospective longitudinal data from a previously published intervention study evaluating person-centred information and communication. The project was conducted at three hospitals in Sweden. Patient-reported outcomes measures, including the Longitudinal Preparedness for Colorectal Cancer Surgery Questionnaire, were collected before surgery, at discharge, and four to six weeks, three months, and six months after surgery. Clinical data were retrospectively obtained from patients' medical records. We used latent class growth models (LCGMs) to identify latent classes that distinguish subgroups of patients who represent different preparedness trajectory profiles. To determine the most plausible number of latent classes, we considered statistical information about model fit and clinical practice relevance. We used multivariable regression models to identify variables that explain the latent classes.The sample (N=488) comprised people with a mean age of 68years (SD = 11) of which 44% were women. Regarding diagnoses, 60% had colon cancer and 40% rectal cancer. The LCGMs identified six latent classes with different preparedness for surgery and recovery trajectories. The latent classes were predominantly explained by differences in age, sex, physical classification based on comorbidities, treatment hospital, global health status, distress, and sense of coherence (comprehensibility and meaningfulness).Contrary to the received view that emphasizes standardized care practices, our results point to the need for adding person-centred and tailored approaches that consider individual differences in how patients are prepared before and during the recovery period related to colorectal cancer surgery.
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| 36. |
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| 37. |
- Smith, Frida, et al.
(författare)
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Developing a toolkit for written information materials for patients with colorectal cancer undergoing elective surgery
- 2011
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Ingår i: Svenska Läkaresällskapets Riksstämman.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- This study examines language complexity, readability and suitability, of written health information materials given to patients undergoing colorectal cancer (CRC) surgery. The overall aim is to investigate whether the implementation of adapted, person-centred information and communication for patients with CRC undergoing elective surgery, can enhance the patients’ self-care beliefs and well-being during recovery in the phase following diagnosis and initial treatment. Several explorative, qualitative studies are planned and will function both as a basis for the proposed interventions and provide explanations for the actual processes leading to the desired outcomes. Patients’ knowledge enablement will be reached by several interrelated intervention strategies and specific activities. One of these strategies deals with means to facilitate patients’ information seeking patterns and the goal is to provide patients with written information materials according to preferences for complex and detailed or legible texts. Thus, the interventions planed aim to enhance a movement from receiving information and instructions to participating in knowing. Written and printed patient information material from 28 Swedish clinics for patients diagnosed with CRC undergoing elective surgery were selected for analysis by means of standard metrics and more elaborate language technology techniques. Various text parameters such as lexical variation, frequency bands and the use of terminology were examined. The material was also analysed using a Suitability Assessment Instrument in order to examine content, literacy demand, graphic illustrations, layout and typography, learning stimulation and finally cultural appropriateness. In addition, five focusgroups were conducted where patients were asked to give their experiences of using written information. Results from the language technology analysis showed a variety in materials, where it could be divided in to easy, medium and difficult to read and comprehend. Patients in focusgroups told they would like written materials to be levelled in order to gain information stepwise, but also stressed the importance of information given both orally and in writing, and that they must correspond. Using the SAM-instrument was a good complement for deeper understanding, and taking all three analyses in account, we aim to design a balanced toolkit for how to best design written information materials where a person tailored approach can be offered.
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| 38. |
- Smith, Frida, et al.
(författare)
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Hur kan vi förbättra skriftligt informations- och utbildningsmaterial för patienter som opereras elektivt för kolorektal cancer?
- 2012
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Ingår i: Nationella konferensen i Cancervård, 24-25 maj 2012, Stockholm.
-
Konferensbidrag (refereegranskat)abstract
- Kolorektal cancer (KRC) är den tredje största cancerdiagnosen i Sverige med drygt 5500 drabbade årligen. Primär behandling är kirurgi kompletterad av pre- och postoperativ onkologisk behandling. Standardiserade koncept för accelererat vårdförlopp med kortare vårdtider lägger mycket fokus på fysisk rehabilitering, men mindre på den psykiska påfrestning det innebär att bli opererad för en cancerdiagnos. Patienter förväntas ta stort ansvar för sin rehabilitering, både på sjukhuset och hemma. För att vara förberedd behövs både skriftlig och muntlig information. Syftet med studien var att kartlägga och karaktärisera det skriftliga informations- och utbildningsmaterial (IOU) som används till patienter som opereras elektivt för KRC. Vidare var syftet att beskriva patienters uppfattning om struktur och innehåll på IOU. IOU från 28 kliniker som opererar patienter med KRC samlades in (totalt 220 st). För att kunna ge ett mått på texternas svårighetsgrad gjordes språkteknologisk analys på samtliga IOU, där bl.a. ordlängd, meningsbyggnad och jämförelse med annan typ av litteratur mättes På 117 st gjordes en suitabilityanalys med instrumentet SAM+CAM där domän som innehåll, läsbarhet, bilder, layout samt stimulans och motivation för lärande bedömdes. Fem fokusgrupper med patienter genomfördes där patienterna uppmanades att berätta om vad de tycker utmärker ett bra respektive dåligt IOU, vad de saknar i innehåll och när och på vilket sätt de vill ha materialet utlämnat. Resultatet av språkteknologiska- och suitabilityanalysen visar att de flesta IOU bedömdes som ”adequate”, men spridningen var stor. Patienterna hade önskemål om mer nivåuppdelat/nivåriktat material, där man själv kan välja hur mycket information man vill ha vid ett visst tillfälle. Flera ämnen saknades, eller var för otydligt beskrivna för att patienterna skulle känna sig trygga vid hemgång. Resultatet av de tre analysmetoderna bör kunna användas för att utveckla en ”verktygslåda” för att i framtiden kunna utforma bättre riktat IOU för patientgruppen.
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| 39. |
- Smith, Frida, et al.
(författare)
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Ny studie visar hur information till patienter med kolorektal cancer kan förbättras
- 2012
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Ingår i: Cancervården. - 1401-6583. ; :5, s. 18-21
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Skriftligt informationsmaterial är ofta skrivet på för hög nivå och ställer höga krav på den tänkta läsaren (patienten). Förutom läsbarhet finns det fler faktorer att utvärdera för att se om materialet är lämpligt. Innehåll, struktur, layout och typsnitt, illustrationer och lärande och motivation är sådant som bör tas hänsyn till. Ett lämpligare, bättre anpassat material kan hjälpa personer med sjukdom att ställa bättre frågor när de har samtal med vårdpersonal och det kan göra personen mindre osäker och orolig för det okända som väntar. En ny studie som ingår i forskningsprojektet PINCORE (personcentred information and communication in colorectal cancer care) syftar till att förbättra information och kommunikation vid kolorektal cancer.
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| 40. |
- Smith, Frida, 1973, et al.
(författare)
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Readability, suitability and comprehensibility in patient education materials for Swedish patients with colorectal cancer undergoing elective surgery: a mixed method design
- 2014
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 94:2, s. 202-209
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To characterize education materials provided to patients undergoing colorectal cancer surgery to gain a better understanding of how to design readable, suitable, comprehensible materials. Method: Mixed method design. Deductive quantitative analysis using a validated suitability and comprehensibility assessment instrument (SAM. +. CAM) was applied to patient education materials from 27 Swedish hospitals, supplemented by language technology analysis and deductive and inductive analysis of data from focus groups involving 15 former patients. Results: Of 125 patient education materials used during the colorectal cancer surgery process, 13.6% were rated 'not suitable', 76.8% 'adequate' and 9.6% 'superior'. Professionally developed stoma care brochures were rated 'superior' and 44% of discharge brochures were 'not suitable'. Language technology analysis showed that up to 29% of materials were difficult to comprehend. Focus group analysis revealed additional areas that needed to be included in patient education materials: general and personal care, personal implications, internet, significant others, accessibility to healthcare, usability, trustworthiness and patient support groups. Conclusion: Most of the patient education materials were rated 'adequate' but did not meet the information needs of patients entirely. Discharge brochures particularly require improvement. Practice implications: Using patients' knowledge and integrating manual and automated methods could result in more appropriate patient education materials.
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| 41. |
- Teixeira, Pedro F., et al.
(författare)
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Assisting the implementation of screening for type 1 diabetes by using artificial intelligence on publicly available data
- 2024
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Ingår i: DIABETOLOGIA. - : SPRINGER. - 0012-186X .- 1432-0428.
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Tidskriftsartikel (refereegranskat)abstract
- The type 1 diabetes community is coalescing around the benefits and advantages of early screening for disease risk. To be accepted by healthcare providers, regulatory authorities and payers, screening programmes need to show that the testing variables allow accurate risk prediction and that individualised risk-informed monitoring plans are established, as well as operational feasibility, cost-effectiveness and acceptance at population level. Artificial intelligence (AI) has the potential to contribute to solving these issues, starting with the identification and stratification of at-risk individuals. ASSET (AI for Sustainable Prevention of Autoimmunity in the Society; www.asset.healthcare) is a public/private consortium that was established to contribute to research around screening for type 1 diabetes and particularly to how AI can drive the implementation of a precision medicine approach to disease prevention. ASSET will additionally focus on issues pertaining to operational implementation of screening. The authors of this article, researchers and clinicians active in the field of type 1 diabetes, met in an open forum to independently debate key issues around screening for type 1 diabetes and to advise ASSET. The potential use of AI in the analysis of longitudinal data from observational cohort studies to inform the design of improved, more individualised screening programmes was also discussed. A key issue was whether AI would allow the research community and industry to capitalise on large publicly available data repositories to design screening programmes that allow the early detection of individuals at high risk and enable clinical evaluation of preventive therapies. Overall, AI has the potential to revolutionise type 1 diabetes screening, in particular to help identify individuals who are at increased risk of disease and aid in the design of appropriate follow-up plans. We hope that this initiative will stimulate further research on this very timely topic.
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| 42. |
- Thorsén, Frida, et al.
(författare)
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Digital nerve injuries: Epidemiology, results, costs, and impact on daily life.
- 2012
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - 2000-656X. ; 46:3-4, s. 184-190
-
Tidskriftsartikel (refereegranskat)abstract
- Epidemiology, results of treatment, impact on activity of daily living (ADL), and costs for treatment of digital nerve injuries have not been considered consistently. Case notes of patients of 0-99 years of age living in Malmö municipality, Sweden, who presented with a digital nerve injury and were referred to the Department of Hand Surgery in 1995-2005 were analysed retrospectively. The incidence was 6.2/100 000 inhabitants and year. Most commonly men (75%; median age 29 years) were injured. Isolated nerve injuries and concomitant tendon injuries were equally common. The direct costs (hospital stay, operation, outpatient visits, visits to a nurse and/or a hand therapist) for a concomitant tendon injury was almost double compared with an isolated digital nerve injury (6136 EUR [range, 744-29 689 EUR] vs 2653 EUR [range, 468-6949 EUR]). More than 50% of the patients who worked were injured at work and 79% lost time from work (median 59 days [range 3-337]). Permanent nerve dysfunction for the individual patient with ADL problems and subjective complaints of fumbleness, cold sensitivity, and pain occur in the patients despite surgery. It is concluded that digital nerve injuries, often considered as a minor injury and that affect young people at productive age, cause costs, and disability. Focus should be directed against prevention of the injury and to improve nerve regeneration from different aspects.
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| 43. |
- Wärdig, Rikard, et al.
(författare)
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Saving lives by asking questions : nurses experiences of suicide risk assessment in telephone counselling in primary health care
- 2022
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore nurses experiences of suicide risk assessment in telephone counselling (TC) in primary health care (PHC). Background: Globally, priority is given to developing suicide prevention work in PHC. However, suicide risk assessments in TC are not included in these interventions even though these are a common duty of nurses in PHC. More expertise in the field can contribute to knowledge important for developing nurses tasks within PHC. Methods: A qualitative interview study was conducted with 15 nurses. Data were analysed using conventional content analysis. Findings: As suicide risk assessment in TC is a common duty for nurses in PHC, they need to be listened to and given the right conditions to perform this work. The nurses lack training in how to carry out suicide risk assessments and are forced to learn through experience. Intuition guides them in their work. A prerequisite for making correct assessments over the telephone is that the nurses are given time as well as the right competence. The PHC organisation needs to create these conditions. Furthermore, interventions to support suicide prevention need to include strategies to help nurses perform suicide assessment in TC.
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| 44. |
- Åberg, Maria A I, 1972, et al.
(författare)
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Selective introduction of antisense oligonucleotides into single adult CNS progenitor cells using electroporation demonstrates the requirement of STAT3 activation for CNTF-induced gliogenesis
- 2001
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Ingår i: Mol Cell Neurosci. - : Elsevier BV. ; 17:3, s. 426-43
-
Tidskriftsartikel (refereegranskat)abstract
- We have developed a novel method in which antisense DNA is selectively electroporated into individual adult neural progenitor cells. By electroporation of antisense oligonucleotides against signal transducer and activator of transcription 3 (STAT3) we demonstrate that ciliary neurotrophic factor (CNTF) is an instructive signal for astroglial type 2 cell fate specifically mediated via activation of STAT3. Activation of the mitogen-activated protein kinase (MAPK) signaling pathway induced only a transient increase in glial fibrillary acidic protein (GFAP) expression, and inhibition of this signaling pathway did not block the induction by CNTF of glial differentiation in progenitor cells. In addition we show that microelectroporation is a new powerful method for introducing antisense agents into single cells in complex cellular networks.
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| 45. |
- Öhlén, Joakim, 1958, et al.
(författare)
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Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention - A quasi-experimental longitudinal design.
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:12
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Tidskriftsartikel (refereegranskat)abstract
- To meet patients' information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing surgery can improve the patients' preparedness for surgery, discharge and recovery during six months following diagnosis and initial treatment. The intervention components involving a novel written interactive patient education material and person-centred communication was based on critical analysis of conventional information and communication for these patients. During 2014-2016, 488 consecutive patients undergoing elective surgery for colorectal cancer were enrolled in a quasi-experimental longitudinal study. In three hospitals, first a conventional care group (n = 250) was recruited, then the intervention was introduced, and finally the intervention group was recruited (n = 238). Patients' trajectories of preparedness for surgery and recovery (Preparedness for Colorectal Cancer Surgery Questionnaire-PCSQ) health related quality of life (EORTC QLQ-C30) and distress (NCCS Distress Thermometer) were evaluated based on self-reported data at five time points, from pre-surgery to 6 months. Length of hospital stay and patients' behavior in seeking health care pre- and post-surgery were extracted from patient records. Longitudinal structural equation models were used to test the hypothesized effects over time. Statistically significant positive effects were detected for two of the four PCSQ domains (patients searching for and making use of information, and making sense of the recovery) and for the role functioning domain of the EORTC QLQ-C30. Patients in the intervention group were also more likely to contact their assigned cancer "contact nurse" (a.k.a. nurse navigator) instead of contacting a nurse on duty at the ward or visiting the emergency department. In conclusion, the overall hypothesis was not confirmed. Further research is recommended on written and oral support tools to facilitate person-centred communication.
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