| 1. |
- Collett-Solberg, Paulo F., et al.
(författare)
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Diagnosis, Genetics, and Therapy of Short Stature in Children : A Growth Hormone Research Society International Perspective
- 2019
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Ingår i: Hormone Research in Paediatrics. - : S. Karger. - 1663-2818 .- 1663-2826. ; 92:1, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- The Growth Hormone Research Society (GRS) convened a Workshop in March 2019 to evaluate the diagnosis and therapy of short stature in children. Forty-six international experts participated at the invitation of GRS including clinicians, basic scientists, and representatives from regulatory agencies and the pharmaceutical industry. Following plenary presentations addressing the current diagnosis and therapy of short stature in children, breakout groups discussed questions produced in advance by the planning committee and reconvened to share the group reports. A writing team assembled one document that was subsequently discussed and revised by participants. Participants from regulatory agencies and pharmaceutical companies were not part of the writing process. Short stature is the most common reason for referral to the pediatric endocrinologist. History, physical examination, and auxology remain the most important methods for understanding the reasons for the short stature. While some long-standing topics of controversy continue to generate debate, including in whom, and how, to perform and interpret growth hormone stimulation tests, new research areas are changing the clinical landscape, such as the genetics of short stature, selection of patients for genetic testing, and interpretation of genetic tests in the clinical setting. What dose of growth hormone to start, how to adjust the dose, and how to identify and manage a suboptimal response are still topics to debate. Additional areas that are expected to transform the growth field include the development of long-acting growth hormone preparations and other new therapeutics and diagnostics that may increase adult height or aid in the diagnosis of growth hormone deficiency.
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| 2. |
- Vanholder, Raymond, et al.
(författare)
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The role of EUTox in uremic toxin research.
- 2009
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Ingår i: Seminars in dialysis. - 0894-0959 .- 1525-139X. ; 22:4, s. 323-328
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Tidskriftsartikel (refereegranskat)abstract
- In this publication, we review the activities of the European Uremic Toxin Work Group (EUTox) in the field of uremic toxin research. Founded in 1999 under the umbrella of the European Society of Artificial Organs (ESAO), and active since 2000, this group focuses essentially on questions related to solute retention and removal during chronic kidney disease, and on the deleterious impact of those solutes on biological/biochemical systems. As of January 1, 2009, the group had met 28 times; it organized the third meeting, "Uremic Toxins in Cardiovascular Disease," which took place in October 2008 in Amiens, France. The current group is composed of 25 members belonging to 23 European research institutions. As of November 1, 2008, in total 69 papers had been published to which at least two different research groups belonging to EUTox have contributed in a collaborative effort. Of these, 40 papers were on original research and eight were specific EUTox reviews or position statements. A website (http://www.eutox.info) summarizes all relevant information concerning the work group. EUTox also developed an interactive uremic toxin database, where concentrations of known toxins are displayed, to be used by researchers in the field. In the future, EUTox intends to continue its focus on bench to bedside research with specific consideration of proteomics, metabonomics, secretomics, and genomics.
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| 3. |
- Abdo, A. A., et al.
(författare)
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A population of gamma-ray emitting globular clusters seen with the Fermi Large Area Telescope
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 524, s. A75-
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Tidskriftsartikel (refereegranskat)abstract
- Context. Globular clusters with their large populations of millisecond pulsars (MSPs) are believed to be potential emitters of high-energy gamma-ray emission. The observation of this emission provides a powerful tool to assess the millisecond pulsar population of a cluster, is essential for understanding the importance of binary systems for the evolution of globular clusters, and provides complementary insights into magnetospheric emission processes. Aims. Our goal is to constrain the millisecond pulsar populations in globular clusters from analysis of gamma-ray observations. Methods. We use 546 days of continuous sky-survey observations obtained with the Large Area Telescope aboard the Fermi Gamma-ray Space Telescope to study the gamma-ray emission towards 13 globular clusters. Results. Steady point-like high-energy gamma-ray emission has been significantly detected towards 8 globular clusters. Five of them (47 Tucanae, Omega Cen, NGC 6388, Terzan 5, and M 28) show hard spectral power indices (0.7 < Gamma < 1.4) and clear evidence for an exponential cut-off in the range 1.0-2.6 GeV, which is the characteristic signature of magnetospheric emission from MSPs. Three of them (M 62, NGC 6440 and NGC 6652) also show hard spectral indices (1.0 < Gamma < 1.7), however the presence of an exponential cut-off can not be unambiguously established. Three of them (Omega Cen, NGC 6388, NGC 6652) have no known radio or X-ray MSPs yet still exhibit MSP spectral properties. From the observed gamma-ray luminosities, we estimate the total number of MSPs that is expected to be present in these globular clusters. We show that our estimates of the MSP population correlate with the stellar encounter rate and we estimate 2600-4700 MSPs in Galactic globular clusters, commensurate with previous estimates. Conclusions. The observation of high-energy gamma-ray emission from globular clusters thus provides a reliable independent method to assess their millisecond pulsar populations.
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| 4. |
- Abdo, A. A., et al.
(författare)
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Fermi Large Area Telescope Search for Photon Lines from 30 to 200 GeV and Dark Matter Implications
- 2010
-
Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 104:9, s. 091302-
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Tidskriftsartikel (refereegranskat)abstract
- Dark matter (DM) particle annihilation or decay can produce monochromatic gamma rays readily distinguishable from astrophysical sources. gamma- ray line limits from 30 to 200 GeV obtained from 11 months of Fermi Large Area Space Telescope data from 20-300 GeV are presented using a selection based on requirements for a gamma-ray line analysis, and integrated over most of the sky. We obtain gamma-ray line flux upper limits in the range 0.6-4.5 x 10(-9) cm(-2) s(-1), and give corresponding DM annihilation cross-section and decay lifetime limits. Theoretical implications are briefly discussed.
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| 5. |
- Abdo, A. A., et al.
(författare)
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Multi-wavelength observations of the flaring gamma-ray blazar 3C 66A in 2008 October
- 2011
-
Ingår i: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 726:1, s. 43-
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Tidskriftsartikel (refereegranskat)abstract
- The BL Lacertae object 3C 66A was detected in a flaring state by the Fermi Large Area Telescope (LAT) and VERITAS in 2008 October. In addition to these gamma-ray observations, F-GAMMA, GASP-WEBT, PAIRITEL, MDM, ATOM, Swift, and Chandra provided radio to X-ray coverage. The available light curves show variability and, in particular, correlated flares are observed in the optical and Fermi-LAT gamma-ray band. The resulting spectral energy distribution can be well fitted using standard leptonic models with and without an external radiation field for inverse Compton scattering. It is found, however, that only the model with an external radiation field can accommodate the intra-night variability observed at optical wavelengths.
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| 6. |
- Acharya, B. S., et al.
(författare)
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Introducing the CTA concept
- 2013
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Ingår i: Astroparticle physics. - : Elsevier BV. - 0927-6505 .- 1873-2852. ; 43, s. 3-18
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The Cherenkov Telescope Array (CTA) is a new observatory for very high-energy (VHE) gamma rays. CTA has ambitions science goals, for which it is necessary to achieve full-sky coverage, to improve the sensitivity by about an order of magnitude, to span about four decades of energy, from a few tens of GeV to above 100 TeV with enhanced angular and energy resolutions over existing VHE gamma-ray observatories. An international collaboration has formed with more than 1000 members from 27 countries in Europe, Asia, Africa and North and South America. In 2010 the CTA Consortium completed a Design Study and started a three-year Preparatory Phase which leads to production readiness of CTA in 2014. In this paper we introduce the science goals and the concept of CTA, and provide an overview of the project. (C) 2013 Elsevier B.V. All rights reserved.
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| 7. |
- Ackermann, M., et al.
(författare)
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CONSTRAINTS ON THE COSMIC-RAY DENSITY GRADIENT BEYOND THE SOLAR CIRCLE FROM FERMI gamma-RAY OBSERVATIONS OF THE THIRD GALACTIC QUADRANT
- 2011
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 726:2, s. 81-
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Tidskriftsartikel (refereegranskat)abstract
- We report an analysis of the interstellar gamma-ray emission in the third Galactic quadrant measured by the Fermi Large Area Telescope. The window encompassing the Galactic plane from longitude 210 degrees to 250 degrees has kinematically well-defined segments of the Local and the Perseus arms, suitable to study the cosmic-ray (CR) densities across the outer Galaxy. We measure no large gradient with Galactocentric distance of the gamma-ray emissivities per interstellar H atom over the regions sampled in this study. The gradient depends, however, on the optical depth correction applied to derive the H I column densities. No significant variations are found in the interstellar spectra in the outer Galaxy, indicating similar shapes of the CR spectrum up to the Perseus arm for particles with GeV to tens of GeV energies. The emissivity as a function of Galactocentric radius does not show a large enhancement in the spiral arms with respect to the interarm region. The measured emissivity gradient is flatter than expectations based on a CR propagation model using the radial distribution of supernova remnants and uniform diffusion properties. In this context, observations require a larger halo size and/or a flatter CR source distribution than usually assumed. The molecular mass calibrating ratio, X(CO) = N(H(2))/W(CO), is found to be (2.08 +/- 0.11) x 10(20) cm(-2)(K km s(-1))(-1) in the Local arm clouds and is not significantly sensitive to the choice of Hi spin temperature. No significant variations are found for clouds in the interarm region.
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| 8. |
- Ackermann, M., et al.
(författare)
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DETECTION OF A SPECTRAL BREAK IN THE EXTRA HARD COMPONENT OF GRB 090926A
- 2011
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 729:2, s. 114-
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Tidskriftsartikel (refereegranskat)abstract
- We report on the observation of the bright, long gamma-ray burst, GRB 090926A, by the Gamma-ray Burst Monitor and Large Area Telescope (LAT) instruments on board the Fermi Gamma-ray Space Telescope. GRB 090926A shares several features with other bright LAT bursts. In particular, it clearly shows a short spike in the light curve that is present in all detectors that see the burst, and this in turn suggests that there is a common region of emission across the entire Fermi energy range. In addition, while a separate high-energy power-law component has already been observed in other gamma-ray bursts, here we report for the first time the detection with good significance of a high-energy spectral break (or cutoff) in this power-law component around 1.4 GeV in the time-integrated spectrum. If the spectral break is caused by opacity to electron-positron pair production within the source, then this observation allows us to compute the bulk Lorentz factor for the outflow, rather than a lower limit.
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| 9. |
- Ackermann, M., et al.
(författare)
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FERMI GAMMA-RAY SPACE TELESCOPE OBSERVATIONS OF GAMMA-RAY OUTBURSTS FROM 3C 454.3 IN 2009 DECEMBER AND 2010 APRIL
- 2010
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 721:2, s. 1383-1396
-
Tidskriftsartikel (refereegranskat)abstract
- The flat spectrum radio quasar 3C 454.3 underwent an extraordinary outburst in 2009 December when it became the brightest gamma-ray source in the sky for over 1 week. Its daily flux measured with the Fermi-Large Area Telescope at photon energiesE > 100 MeV reached F-100 = 22 +/- 1 x 10(6) photon cm(-2) s(-1), representing the highest daily flux of any blazar ever recorded in high-energy. -rays. It again became the brightest source in the sky in 2010 April, triggering a pointed-mode observation by Fermi. The correlated. -ray temporal and spectral properties during these exceptional events are presented and discussed. The main results show flux variability over time scales less than 3 hr and very mild spectral variability with an indication of gradual hardening preceding major flares. The light curves during periods of enhanced activity in 2008 July-August and 2010 December show strong resemblance, with a flux plateau of a few days preceding the major flare. No consistent loop pattern emerged in the. -ray spectral index versus the flux plane as would be expected in acceleration and cooling scenarios. The maximum energy of a photon from 3C 454.3 is approximate to 20 GeV and a minimum Doppler factor of approximate to 13 is derived. The gamma-ray spectrum of 3C 454.3 shows a significant spectral break between approximate to 2 and 3 GeV that is very weakly dependent on the flux state, even when the flux changes by an order of magnitude.
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| 10. |
- Ackermann, M., et al.
(författare)
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Fermi LAT observations of cosmic-ray electrons from 7 GeV to 1 TeV
- 2010
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Ingår i: PHYSICAL REVIEW D. - 1550-7998. ; 82:9, s. 092004-
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Tidskriftsartikel (refereegranskat)abstract
- We present the results of our analysis of cosmic-ray electrons using about 8 x 10(6) electron candidates detected in the first 12 months on-orbit by the Fermi Large Area Telescope. This work extends our previously published cosmic-ray electron spectrum down to 7 GeV, giving a spectral range of approximately 2.5 decades up to 1 TeV. We describe in detail the analysis and its validation using beam-test and on-orbit data. In addition, we describe the spectrum measured via a subset of events selected for the best energy resolution as a cross-check on the measurement using the full event sample. Our electron spectrum can be described with a power law proportional to E-3.08+/-0.05 with no prominent spectral features within systematic uncertainties. Within the limits of our uncertainties, we can accommodate a slight spectral hardening at around 100 GeV and a slight softening above 500 GeV.
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| 11. |
- Ackermann, M., et al.
(författare)
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Fermi-LAT search for pulsar wind nebulae around gamma-ray pulsars
- 2011
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 726:1, s. 35-
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Tidskriftsartikel (refereegranskat)abstract
- The high sensitivity of the Fermi-LAT (Large Area Telescope) offers the first opportunity to study faint and extended GeV sources such as pulsar wind nebulae (PWNe). After one year of observation the LAT detected and identified three PWNe: the Crab Nebula, Vela-X, and the PWN inside MSH 15-52. In the meantime, the list of LAT detected pulsars increased steadily. These pulsars are characterized by high energy loss rates ((E) over dot) from similar to 3 x 10(33) erg s(-1) to 5 x 10(38) erg s(-1) and are therefore likely to power a PWN. This paper summarizes the search for PWNe in the off-pulse windows of 54 LAT-detected pulsars using 16 months of survey observations. Ten sources show significant emission, seven of these likely being of magnetospheric origin. The detection of significant emission in the off-pulse interval offers new constraints on the gamma-ray emitting regions in pulsar magnetospheres. The three other sources with significant emission are the Crab Nebula, Vela-X, and a new PWN candidate associated with the LAT pulsar PSR J1023-5746, coincident with the TeV source HESS J1023-575. We further explore the association between the HESS and the Fermi source by modeling its spectral energy distribution. Flux upper limits derived for the 44 remaining sources are used to provide new constraints on famous PWNe that have been detected at keV and/or TeV energies.
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| 12. |
- Ackermann, M., et al.
(författare)
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GeV GAMMA-RAY FLUX UPPER LIMITS FROM CLUSTERS OF GALAXIES
- 2010
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Ingår i: ASTROPHYS J LETT. - 2041-8205. ; 717:1, s. l71-L78
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Tidskriftsartikel (refereegranskat)abstract
- The detection of diffuse radio emission associated with clusters of galaxies indicates populations of relativistic leptons infusing the intracluster medium (ICM). Those electrons and positrons are either injected into and accelerated directly in the ICM, or produced as secondary pairs by cosmic-ray ions scattering on ambient protons. Radiation mechanisms involving the energetic leptons together with the decay of neutral pions produced by hadronic interactions have the potential to produce abundant GeV photons. Here, we report on the search for GeV emission from clusters of galaxies using data collected by the Large Area Telescope on the Fermi Gamma-ray Space Telescope from 2008 August to 2010 February. Thirty-three galaxy clusters have been selected according to their proximity and high mass, X-ray flux and temperature, and indications of non-thermal activity for this study. We report upper limits on the photon flux in the range 0.2-100 GeV toward a sample of observed clusters (typical values (1-5) x 10(-9) photon cm(-2) s(-1)) considering both point-like and spatially resolved models for the high-energy emission and discuss how these results constrain the characteristics of energetic leptons and hadrons, and magnetic fields in the ICM. The volume-averaged relativistic-hadron-to-thermal energy density ratio is found to be <5%-10% in several clusters.
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| 13. |
- Ackermann, M., et al.
(författare)
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Searches for cosmic-ray electron anisotropies with the Fermi Large Area Telescope
- 2010
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Ingår i: PHYS REV D. - 1550-7998. ; 82:9, s. 092003-
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Tidskriftsartikel (refereegranskat)abstract
- The Large Area Telescope on board the Fermi satellite (Fermi LAT) detected more than 1.6 x 10(6) cosmic-ray electrons/positrons with energies above 60 GeV during its first year of operation. The arrival directions of these events were searched for anisotropies of angular scale extending from similar to 10 degrees up to 90 degrees, and of minimum energy extending from 60 GeV up to 480 GeV. Two independent techniques were used to search for anisotropies, both resulting in null results. Upper limits on the degree of the anisotropy were set that depended on the analyzed energy range and on the anisotropy's angular scale. The upper limits for a dipole anisotropy ranged from similar to 0.5% to similar to 10%.
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| 14. |
- Ardo, A. A., et al.
(författare)
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FERMI LARGE AREA TELESCOPE OBSERVATIONS OF GAMMA-RAY PULSARS PSR J1057-5226, J1709-4429, AND J1952+3252
- 2010
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Ingår i: Astrophysical Journal. - 0004-637X .- 1538-4357. ; 720:1, s. 26-40
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Tidskriftsartikel (refereegranskat)abstract
- The Fermi Large Area Telescope (LAT) data have confirmed the pulsed emission from all six high-confidence gamma-ray pulsars previously known from the EGRET observations. We report results obtained from the analysis of 13 months of LAT data for three of these pulsars (PSR J1057-5226, PSR J1709-4429, and PSR 11952+3252) each of which had some unique feature among the EGRET pulsars. The excellent sensitivity of LAT allows more detailed analysis of the evolution of the pulse profile with energy and also of the variation of the spectral shape with phase. We measure the cutoff energy of the pulsed emission from these pulsars for the first time and provide a more complete picture of the emission mechanism. The results confirm some, but not all, of the features seen in the EGRET data.
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| 15. |
- Cohen, Joachim, et al.
(författare)
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Differences in place of death between lung cancer and COPD patients : a 14-country study using death certificate data
- 2017
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Ingår i: npj Primary Care Respiratory Medicine. - : Springer Science and Business Media LLC. - 2055-1010. ; 27
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Tidskriftsartikel (refereegranskat)abstract
- Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease.
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| 16. |
- Cohen, Joachim, et al.
(författare)
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Different trends in euthanasia acceptance across Europe. A study of 13 Western and 10 central and eastern European countries, 1981-2008
- 2013
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Ingår i: European Journal of Public Health. - 1101-1262 .- 1464-360X. ; 23:3, s. 378-380
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Tidskriftsartikel (refereegranskat)abstract
- We examined how acceptance of euthanasia among the general public has changed between 1981 and 2008 in western and central and eastern European (CEE) countries using data of the European Values Surveys. Data were collected in 1981, 1990, 1999 and 2008 for 13 western European countries and in 1990, 1999 and 2008 for 10 CEE countries. Euthanasia acceptance increased each decade up until 2008 in 11 of 13 western European countries; in CEE countries, it decreased or did not increase between 1999-2008 in 8 of 10 countries. A number of explanations for and implications of this apparent east-west polarization are suggested.
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| 17. |
- Cohen, Joachim, et al.
(författare)
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End-of-life decision-making in Belgium, Denmark, Sweden and Switzerland : does place of death make a difference?
- 2007
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 61:12, s. 1062-1068
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine differences in end-of-life decision-making in patients dying at home, in a hospital or in a care home. Design: A death certificate study: certifying physicians from representative samples of death certificates, taken between June 2001 and February 2002, were sent questionnaires on the end-of-life decision-making preceding the patient's death. Setting: Four European countries: Belgium (Flanders), Denmark, Sweden, and Switzerland (German-speaking part). Main outcome measures: The incidence of and communication in different end-of-life decisions: physician-assisted death, alleviation of pain/symptoms with a possible life-shortening effect, and non-treatment decisions. Results: Response rates ranged from 59% in Belgium to 69% in Switzerland. The total number of deaths studied was 12 492. Among all non-sudden deaths the incidence of several end-of-life decisions varied by place of death. Physician-assisted death occurred relatively more often at home (0.3-5.1%); non-treatment decisions generally occurred more often in hospitals (22.4-41.3%), although they were also frequently taken in care homes in Belgium (26.0%) and Switzerland (43.1%). Continuous deep sedation, in particular without the administration of food and fluids, was more likely to occur in hospitals. At home, end-of-life decisions were usually more often discussed with patients. The incidence of discussion with other caregivers was generally relatively low at home compared with in hospitals or care homes. Conclusion: The results suggest the possibility that end-of-life decision-making is related to the care setting where people die. The study results seem to call for the development of good end-of-life care options and end-of-life communication guidelines in all settings.
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| 18. |
- Cohen, Joachim, et al.
(författare)
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Public acceptance of euthanasia in Europe : a survey study in 47 countries
- 2014
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Ingår i: International Journal of Public Health. - 1661-8556 .- 1661-8564. ; 1:59, s. 143-156
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In recent years, the European euthanasia debate has become more intense, and the practice was legalized in the Netherlands, Belgium, and Luxembourg. We aimed to determine the current degree of public acceptance of euthanasia across Europe and investigate what factors explain differences. Methods: Data were derived from the 2008 wave of the European Values Survey (EVS), conducted in 47 European countries (N = 67,786, response rate = 69 %). Acceptance of euthanasia was rated on a 1-10 scale. Results: Relatively high acceptance was found in a small cluster of Western European countries, including the three countries that have legalized euthanasia and Denmark, France, Sweden and Spain. In a large part of Europe public acceptance was relatively low to moderate. Comparison with the results of the previous EVS wave (1999) suggests a tendency towards a polarization in Europe, with most of Western Europe becoming more permissive and most of Eastern Europe becoming less permissive. Conclusions: There is roughly a West-East division in euthanasia acceptance among the European public, making a pan- European policy approach to the issue difficult.
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| 19. |
- Cohen, Joachim, et al.
(författare)
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Using death certificate data to study place of death in 9 European countries : opportunities and weaknesses
- 2007
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 7, s. 283-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Systematic and reliable epidemiological information at population level, preferably cross-national, is needed for an adequate planning of (end-of-life) health care policies, e. g. concerning place of death, but is currently lacking. This study illustrates opportunities and weaknesses of death certificate data to provide such information on place of death and associated factors in nine European countries (seven entire countries and five regions). Methods: We investigated the possibility and modality of all partners in this international comparative study (BE, DK, IT, NL, NO, SE, UK) to negotiate a dataset containing all deaths of one year with their national/regional administration of mortality statistics, and analysed the availability of information about place of death as well as a number of clinical, socio-demographic, residential and healthcare system factors. Results: All countries negotiated a dataset, but rules, procedures, and cost price to get the data varied strongly between countries. In total, about 1.1 million deaths were included. For four of the nine countries not all desired categories for place of death were available. Most desired clinical and socio-demographic information was available, be it sometimes via linkages with other population databases. Healthcare system factors could be made available by linking existing healthcare statistics to the residence of the deceased. Conclusion: Death certificate data provide information on place of death and on possibly associated factors and confounders in all studied countries. Hence, death certificate data provide a unique opportunity for cross-national studying and monitoring of place of death. However, modifications of certain aspects of death certificate registration and rules of data-protection are perhaps required to make international monitoring of place of death more feasible and accurate.
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| 20. |
- de Jong, Roelof S., et al.
(författare)
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4MOST-4-metre Multi-Object Spectroscopic Telescope
- 2014
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Ingår i: Ground-based and Airborne Instrumentation for Astronomy V. - : SPIE. - 0277-786X .- 1996-756X. ; 9147
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Konferensbidrag (refereegranskat)abstract
- 4MOST is a wide-field, high-multiplex spectroscopic survey facility under development for the VISTA telescope of the European Southern Observatory (ESO). Its main science drivers are in the fields of galactic archeology, high-energy physics, galaxy evolution and cosmology. 4MOST will in particular provide the spectroscopic complements to the large area surveys coming from space missions like Gaia, eROSITA, Euclid, and PLATO and from ground-based facilities like VISTA, VST, DES, LSST and SKA. The 4MOST baseline concept features a 2.5 degree diameter field-of-view with similar to 2400 fibres in the focal surface that are configured by a fibre positioner based on the tilting spine principle. The fibres feed two types of spectrographs; similar to 1600 fibres go to two spectrographs with resolution R> 5000 (lambda similar to 390-930 nm) and similar to 800 fibres to a spectrograph with R> 18,000 (lambda similar to 392-437 nm & 515-572 nm & 605-675 nm). Both types of spectrographs are fixed-configuration, three-channel spectrographs. 4MOST will have an unique operations concept in which 5 year public surveys from both the consortium and the ESO community will be combined and observed in parallel during each exposure, resulting in more than 25 million spectra of targets spread over a large fraction of the southern sky. The 4MOST Facility Simulator (4FS) was developed to demonstrate the feasibility of this observing concept. 4MOST has been accepted for implementation by ESO with operations expected to start by the end of 2020. This paper provides a top-level overview of the 4MOST facility, while other papers in these proceedings provide more detailed descriptions of the instrument concept[1], the instrument requirements development[2], the systems engineering implementation[3], the instrument model[4], the fibre positioner concepts[5], the fibre feed[6], and the spectrographs[7].
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| 21. |
- Fokkens, Wytske J., et al.
(författare)
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EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists
- 2012
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Ingår i: Rhinology. - 0300-0729. ; 50:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also propose definitions for 'difficult to treat' rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between the upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists.
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| 22. |
- Harding, Richard, et al.
(författare)
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Place of death for people with HIV : a population-level comparison of eleven countries across three continents using death certificate data
- 2018
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Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: With over 1 million HIV-related deaths annually, quality end-of-life care remains a priority. Given strong public preference for home death, place of death is an important consideration for quality care. This 11 country study aimed to i) describe the number, proportion of all deaths, and demographics of HIV-related deaths; ii) identify place of death; iii) compare place of death to cancer patients iv), determine patient/health system factors associated with place of HIV-related death.METHODS: In this retrospective analysis of death certification, data were extracted for the full population (ICD-10 codes B20-B24) for 1-year period: deceased's demographic characteristics, place of death, healthcare supply.RESULTS: i) 19,739 deaths were attributed to HIV. The highest proportion (per 1000 deaths) was for Mexico (9.8‰), and the lowest Sweden (0.2‰). The majority of deaths were among men (75%), and those aged <50 (69.1%). ii) Hospital was most common place of death in all countries: from 56.6% in the Netherlands to 90.9% in South Korea. The least common places were hospice facility (3.3%-5.7%), nursing home (0%-17.6%) and home (5.9%-26.3%).iii) Age-standardised relative risks found those with HIV less likely to die at home and more likely to die in hospital compared with cancer patients, and in most countries more likely to die in a nursing home. iv) Multivariate analysis found that men were more likely to die at home in UK, Canada, USA and Mexico; a greater number of hospital beds reduced the likelihood of dying at home in Italy and Mexico; a higher number of GPs was associated with home death in Italy and Mexico.CONCLUSIONS: With increasing comorbidity among people ageing with HIV, it is essential that end-of-life preferences are established and met. Differences in place of death according to country and diagnosis demonstrate the importance of ensuring a "good death" for people with HIV, alongside efforts to optimise treatment.
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| 23. |
- Haynes, Roger, et al.
(författare)
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The 4MOST instrument concept overview
- 2014
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Ingår i: Ground-based and Airborne Instrumentation for Astronomy V. - : SPIE. - 0277-786X .- 1996-756X. ; 9147, s. 91476-91476
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Konferensbidrag (refereegranskat)abstract
- The 4MOST([1]) instrument is a concept for a wide-field, fibre-fed high multiplex spectroscopic instrument facility on the ESO VISTA telescope designed to perform a massive (initially >25x10(6) spectra in 5 years) combined all-sky public survey. The main science drivers are: Gaia follow up of chemo-dynamical structure of the Milky Way, stellar radial velocities, parameters and abundances, chemical tagging; eROSITA follow up of cosmology with x-ray clusters of galaxies, X-ray AGN/galaxy evolution to z similar to 5, Galactic X-ray sources and resolving the Galactic edge; Euclid/LSST/SKA and other survey follow up of Dark Energy, Galaxy evolution and transients. The surveys will be undertaken simultaneously requiring: highly advanced targeting and scheduling software, also comprehensive data reduction and analysis tools to produce high-level data products. The instrument will allow simultaneous observations of similar to 1600 targets at R similar to 5,000 from 390-900nm and similar to 800 targets at R>18,000 in three channels between similar to 395-675nm (channel bandwidth: 45nm blue, 57nm green and 69nm red) over a hexagonal field of view of similar to 4.1 degrees2. The initial 5-year 4MOST survey is currently expect to start in 2020. We provide and overview of the 4MOST systems: opto-mechanical, control, data management and operations concepts; and initial performance estimates.
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| 24. |
- Håkanson, Cecilia, et al.
(författare)
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Place of death of children with complex chronic conditions : cross-national study of 11 countries.
- 2017
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Ingår i: European Journal of Pediatrics. - : Springer Science and Business Media LLC. - 0340-6199 .- 1432-1076. ; 176:3, s. 327-335
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Tidskriftsartikel (refereegranskat)abstract
- Cross-national understanding of place of death is crucial for health service systems for their provision of efficient and equal access to paediatric palliative care. The objectives of this population-level study were to examine where children with complex chronic conditions (CCC) die and to investigate associations between places of death and sex, cause of death and country. The study used death certificate data of all deceased 1- to 17-year-old children (n = 40,624) who died in 2008, in 11 European and non-European countries. Multivariable logistic regression was performed to determine associations between place of death and other factors. Between 24.4 and 75.3% of all children 1-17 years in the countries died of CCC. Of these, between 6.7 and 42.4% died at home. In Belgium and the USA, all deaths caused by CCC other than malignancies were less likely to occur at home, whereas in Mexico and South Korea, deaths caused by neuromuscular diseases were more likely to occur at home than malignancies. In Mexico (OR = 0.91, 95% CI: 0.83-1.00) and Sweden (OR = 0.35, 95% CI: 0.15-0.83), girls had a significantly lower chance of dying at home than boys.CONCLUSION: This study shows large cross-national variations in place of death. These variations may relate to health system-related infrastructures and policies, and differences in cultural values related to place of death, although this needs further investigation. The patterns found in this study can inform the development of paediatric palliative care programs internationally. What is known: • There is a scarcity of population-level studies investigating where children with CCC die in different countries. • Cross-national understanding of place of death provides information to health care systems for providing efficient and equal access to paediatric palliative care. What is new : • There are large cross-national variations in the place of death of children with CCC, with few deathsoccuring at home in some countries whereas hospital deaths are generally most common. • In general, deaths caused by neuromuscular diseases and malignancies occur at home more often thanother CCC.
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| 25. |
- Håkanson, Cecilia, et al.
(författare)
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Where Do People Die in Sweden? A Population-based Study of the Distribution and Determinants of Place of Death
- 2015
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Ingår i: 14th World Congress of the European Association of Palliative Care.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Place of death, with home reported to be the most desirable place, is considered to be one important aspect of quality of care at the end of life. Sweden, until now, lacks population-based studies that not only examine place of death, but also what factors that may influence where people die. Objectives: The objectives were to examine place of death in Sweden and associations between place of death and diagnosis, personal characteristics, geographical and socioeconomic factors. Design and methods: This study, being part of the International Place of Death (IPoD) project, was based on all deaths in Sweden 2012 (n = 91874). Data was derived from death certificates and population-based registers. Distribution of place of death and other variables were analysed descriptively. Binary logistic regressions were performed to examine factors associated with dying in hospital, at home and in nursing homes. Results: Of all deaths in 2012, 42.1 % died in hospital, 17.8 % at home and 38.1 % in nursing homes. Being married and having higher education increased the likelihood of dying at home, whereas living in an urban area decreased the likelihood of dying at home. Being old, and dying from Dementia increased the likelihood of dying in nursing home. In fact, the majority of individuals >90 years (61.9 %), and with dementia (89.8 %) died in nursing home, while most (74.5 %) children 0–17 years died in hospital. Discussion and conclusions: In Sweden, people likely to be in need of palliative care continue to die in hospitals, and many old individuals die in nursing homes. While dying in hospital has been associated with risk of futile treatment, previous studies also report lack of palliative approaches in nursing homes. The geographical and socioeconomic differences in place of death call for further attention. As the Swedish national guidelines for palliative care were launched in 2012, these results provide important baseline information to evaluate its effects.
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| 26. |
- Johansson, Therese, et al.
(författare)
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Validation of a culturally adapted Swedish-language version of the Death Literacy Index
- 2023
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Ingår i: PLoS ONE. - 1932-6203. ; 18:11 November
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Tidskriftsartikel (refereegranskat)abstract
- The death literacy index (DLI) was developed in Australia to measure death literacy, a set of experience-based knowledge needed to understand and act on end-of-life (EOL) care options but has not yet been validated outside its original context. The aim of this study was to develop a culturally adapted Swedish-language version of the DLI, the DLI-S, and assess sources of evidence for its validity in a Swedish context. The study involved a multi-step process of translation and cultural adaptation and two validation phases: examining first content and response process validity through expert review (n = 10) and cognitive interviews (n = 10); and second, internal structure validity of DLI-S data collected from an online cross-sectional survey (n = 503). The psychometric evaluation involved analysis of descriptive statistics on item and scale-level, internal consistency and test-retest reliability, and confirmatory factor analysis. During translation and adaptation, changes were made to adjust items to the Swedish context. Additional adjustments were made following findings from the expert review and cognitive interviews. The content validity index exceeded recommended thresholds (S-CVIAve = 0.926). The psychometric evaluation provided support for DLI-S’ validity. The hypothesized six-factor model showed good fit (χ2 = 1107.631 p<0.001, CFI = 0.993, TLI = 0.993, RMSEA = 0.064, SRMR = 0.054). High internal consistency reliability was demonstrated for the overall scale (Cronbach’s α = 0.94) and each sub-scale (α 0.81–0.92). Test-retest reliability was acceptable, ICC ranging between 0.66–0.85. Through a comprehensive assessment of several sources of evidence, we show that the DLI-S demonstrates satisfactory validity and acceptability to measure death literacy in the Swedish context. There are, however, indications that the sub-scales measuring community capacity perform worse in comparison to other sca and may function differently in Sweden than in the original context. The DLI-S has potential to contribute to research on community-based EOL interventions.
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| 27. |
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| 28. |
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| 29. |
- Morin, Lucas, et al.
(författare)
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Estimating the need for palliative care at the population level : A cross-national study in 12 countries
- 2017
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 31:6, s. 526-536
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Tidskriftsartikel (refereegranskat)abstract
- Background: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed.Aim: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries.Design: This is a cross-sectional study using death certificate data.Setting/participants: All adults (18years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand (N=4,908,114). Underlying causes of death were used to apply three estimation methods developed by Rosenwax et al., the French National Observatory on End-of-Life Care, and Murtagh et al., respectively.Results: The proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 38% to 74%. We found important cross-country variation: the population potentially in need of palliative care was lower in Mexico (24%-58%) than in the United States (41%-76%) and varied from 31%-83% in Hungary to 42%-79% in Spain. Irrespective of the estimation methods, female sex and higher age were independently associated with the likelihood of being in need of palliative care near the end of life. Home and nursing home were the two places of deaths with the highest prevalence of palliative care needs.Conclusion: These estimations of the size of the population potentially in need of palliative care provide robust indications of the challenge countries are facing if they want to seriously address palliative care needs at the population level.
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| 30. |
- Nakamura, Rumi, et al.
(författare)
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Multiscale Currents Observed by MMS in the Flow Braking Region
- 2018
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Ingår i: Journal of Geophysical Research - Space Physics. - : AMER GEOPHYSICAL UNION. - 2169-9380 .- 2169-9402. ; 123:2, s. 1260-1278
-
Tidskriftsartikel (refereegranskat)abstract
- We present characteristics of current layers in the off-equatorial near-Earth plasma sheet boundary observed with high time-resolution measurements from the Magnetospheric Multiscale mission during an intense substorm associated with multiple dipolarizations. The four Magnetospheric Multiscale spacecraft, separated by distances of about 50 km, were located in the southern hemisphere in the dusk portion of a substorm current wedge. They observed fast flow disturbances (up to about 500 km/s), most intense in the dawn-dusk direction. Field-aligned currents were observed initially within the expanding plasma sheet, where the flow and field disturbances showed the distinct pattern expected in the braking region of localized flows. Subsequently, intense thin field-aligned current layers were detected at the inner boundary of equatorward moving flux tubes together with Earthward streaming hot ions. Intense Hall current layers were found adjacent to the field-aligned currents. In particular, we found a Hall current structure in the vicinity of the Earthward streaming ion jet that consisted of mixed ion components, that is, hot unmagnetized ions, cold ExB drifting ions, and magnetized electrons. Our observations show that both the near-Earth plasma jet diversion and the thin Hall current layers formed around the reconnection jet boundary are the sites where diversion of the perpendicular currents take place that contribute to the observed field-aligned current pattern as predicted by simulations of reconnection jets. Hence, multiscale structure of flow braking is preserved in the field-aligned currents in the off-equatorial plasma sheet and is also translated to ionosphere to become a part of the substorm field-aligned current system.
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| 31. |
- Nakamura, Rumi, et al.
(författare)
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Near-Earth plasma sheet boundary dynamics during substorm dipolarization
- 2017
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Ingår i: Earth Planets and Space. - : Springer Berlin/Heidelberg. - 1343-8832 .- 1880-5981. ; 69
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Tidskriftsartikel (refereegranskat)abstract
- We report on the large-scale evolution of dipolarization in the near-Earth plasma sheet during an intense (AL similar to -1000 nT) substorm on August 10, 2016, when multiple spacecraft at radial distances between 4 and 15 RE were present in the night-side magnetosphere. This global dipolarization consisted of multiple short-timescale (a couple of minutes) Bz disturbances detected by spacecraft distributed over 9 MLT, consistent with the large-scale substorm current wedge observed by ground-based magnetometers. The four spacecraft of the Magnetospheric Multiscale were located in the southern hemisphere plasma sheet and observed fast flow disturbances associated with this dipolarization. The high-time-resolution measurements from MMS enable us to detect the rapid motion of the field structures and flow disturbances separately. A distinct pattern of the flow and field disturbance near the plasma boundaries was found. We suggest that a vortex motion created around the localized flows resulted in another fieldaligned current system at the off-equatorial side of the BBF-associated R1/R2 systems, as was predicted by the MHD simulation of a localized reconnection jet. The observations by GOES and Geotail, which were located in the opposite hemisphere and local time, support this view. We demonstrate that the processes of both Earthward flow braking and of accumulated magnetic flux evolving tailward also control the dynamics in the boundary region of the near-Earth plasma sheet.
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| 32. |
- Nidever, David L., et al.
(författare)
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The Lazy Giants : APOGEE Abundances Reveal Low Star Formation Efficiencies in the Magellanic Clouds
- 2020
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Ingår i: Astrophysical Journal. - : Institute of Physics (IOP). - 0004-637X .- 1538-4357. ; 895:2
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Tidskriftsartikel (refereegranskat)abstract
- We report the first APOGEE metallicities and alpha-element abundances measured for 3600 red giant stars spanning a large radial range of both the Large (LMC) and Small Magellanic Clouds, the largest Milky Way (MW) dwarf galaxies. Our sample is an order of magnitude larger than that of previous studies and extends to much larger radial distances. These are the first results presented that make use of the newly installed southern APOGEE instrument on the du Pont telescope at Las Campanas Observatory. Our unbiased sample of the LMC spans a large range in metallicity, from [Fe/H] = -0.2 to very metal-poor stars with [Fe/H] -2.5, the most metal-poor Magellanic Cloud (MC) stars detected to date. The LMC [alpha/Fe]-[Fe/H] distribution is very flat over a large metallicity range but rises by similar to 0.1 dex at -1.0 < [Fe/H] less than or similar to -0.5. We interpret this as a sign of the known recent increase in MC star formation activity and are able to reproduce the pattern with a chemical evolution model that includes a recent "starburst." At the metal-poor end, we capture the increase of [alpha/Fe] with decreasing [Fe/H] and constrain the "alpha-knee" to [Fe/H] less than or similar to -2.2 in both MCs, implying a low star formation efficiency of similar to 0.01 Gyr(-1). The MC knees are more metal-poor than those of less massive MW dwarf galaxies such as Fornax, Sculptor, or Sagittarius. One possible interpretation is that the MCs formed in a lower-density environment than the MW, a hypothesis that is consistent with the paradigm that the MCs fell into the MW's gravitational potential only recently.
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| 33. |
- Oka, Mitsuo, et al.
(författare)
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Particle Acceleration by Magnetic Reconnection in Geospace
- 2023
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Ingår i: Space Science Reviews. - : Springer. - 0038-6308 .- 1572-9672. ; 219
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Forskningsöversikt (refereegranskat)abstract
- Particles are accelerated to very high, non-thermal energies during explosive energy-release phenomena in space, solar, and astrophysical plasma environments. While it has been established that magnetic reconnection plays an important role in the dynamics of Earth's magnetosphere, it remains unclear how magnetic reconnection can further explain particle acceleration to non-thermal energies. Here we review recent progress in our understanding of particle acceleration by magnetic reconnection in Earth's magnetosphere. With improved resolutions, recent spacecraft missions have enabled detailed studies of particle acceleration at various structures such as the diffusion region, separatrix, jets, magnetic islands (flux ropes), and dipolarization front. With the guiding-center approximation of particle motion, many studies have discussed the relative importance of the parallel electric field as well as the Fermi and betatron effects. However, in order to fully understand the particle acceleration mechanism and further compare with particle acceleration in solar and astrophysical plasma environments, there is a need for further investigation of, for example, energy partition and the precise role of turbulence.
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| 34. |
- O'Sullivan, Anna, et al.
(författare)
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Place of care and death preferences among recently bereaved family members: a cross-sectional survey.
- 2024
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Ingår i: BMJ Supportive & Palliative Care. - 2045-4368.
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Tidskriftsartikel (refereegranskat)abstract
- The aim was: (1) to investigate preferred place for end-of-life care and death for bereaved family members who had recently lost a person with advanced illness and (2) to investigate associations between bereaved family members' preferences and individual characteristics, health-related quality of life, as well as associations with their perception of the quality of care that the ill person had received, the ill person's preferred place of death and involvement in decision-making about care.A cross-sectional survey with bereaved family members, employing descriptive statistics and multinominal logistic regression analyses.Of the 485 participants, 70.7% were women, 36.1% were ≥70 years old, 34.5% were partners and 51.8% were children of the deceased. Of the bereaved family members, 52% preferred home for place of end-of-life care and 43% for place of death. A higher likelihood of preferring inpatient palliative care was associated with being female and having higher education, whereas a lower likelihood of preferring a nursing home for the place of care and death was associated with higher secondary or higher education. Partners were more likely to prefer hospital for place of care and nursing home for place of death.Home was the most preferred place for end-of-life care and death. Bereaved people's experiences of end-of-life care may impact their preferences, especially if they had a close relationship, such as a partner who had a higher preference for nursing home and hospital care. Conversations about preferences for the place of care and death considering previous experience are encouraged.
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| 35. |
- Pivodic, Lara, et al.
(författare)
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Place of death in the population dying from diseases indicative of palliative care need : a cross-national population-level study in 14 countries
- 2016
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 70:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- Background Studying where people die across countries can serve as an evidence base for health policy on end-of-life care. This study describes the place of death of people who died from diseases indicative of palliative care need in 14 countries, the association of place of death with cause of death, sociodemographic and healthcare availability characteristics in each country and the extent to which these characteristics explain country differences in the place of death. Methods Death certificate data for all deaths in 2008 (age >= 1 year) in Belgium, Canada, the Czech Republic, England, France, Hungary, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain (Andalusia), the USA and Wales caused by cancer, heart/renal/liver failure, chronic obstructive pulmonary disease, diseases of the nervous system or HIV/AIDS were linked with national or regional healthcare statistics (N=2 220 997). Results 13% (Canada) to 53% (Mexico) of people died at home and 25% (the Netherlands) to 85% (South Korea) died in hospital. The strength and direction of associations between home death and cause of death, sociodemographic and healthcare availability factors differed between countries. Differences between countries in home versus hospital death were only partly explained by differences in these factors. Conclusions The large differences between countries in and beyond Europe in the place of death of people in potential need of palliative care are not entirely attributable to sociodemographic characteristics, cause of death or availability of healthcare resources, which suggests that countries' palliative and end-of-life care policies may influence where people die.
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| 36. |
- Reyniers, Thijs, et al.
(författare)
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International Variation in Place of Death of Older People Who Died From Dementia in 14 European and non-European Countries
- 2015
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier BV. - 1525-8610 .- 1538-9375. ; 16:2, s. 165-171
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The objective of this study was to examine variation in place of death of older people dying from dementia in countries across 4 continents. Design: Study of death certificate data. Methods: We included deaths of older (65 + years) people whose underlying cause of death was a dementia-related disease (ICD-10: F01, F02, F03, G30) in Belgium, the Netherlands, England, Wales, France, Italy, Spain, Czech Republic, Hungary, New Zealand, United States, Canada, Mexico and South Korea. We examined associations between place of death and sociodemographic factors, social support, and residential and health care system factors. Results: Overall, 4.8% of all deaths were from a dementia-related disease, ranging from 0.4% in Mexico to 6.9% in Canada. Of those deaths, the proportion occurring in hospital varied from 1.6% in the Netherlands to 73.6% in South Korea. When controlling for potential confounders, hospital death was more likely for men, those younger than 80, and those married or living in a region with a higher availability of long-term care beds, although this could not be concluded for each country. Hospital death was least likely in the Netherlands compared with other countries. Conclusions: Place of death of older people who died from a dementia-related disease differs substantially between countries, which might point to organizational differences in end-of-life care provision.
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| 37. |
- Robinson-Cohen, Cassianne, et al.
(författare)
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Genetic Variants Associated with Circulating Fibroblast Growth Factor 23
- 2018
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Ingår i: Journal of the American Society of Nephrology. - : AMER SOC NEPHROLOGY. - 1046-6673 .- 1533-3450. ; 29:10, s. 2583-2592
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fibroblast growth factor 23 (FGF23), a bone-derived hormone that regulates phosphorus and vitamin D metabolism, contributes to the pathogenesis of mineral and bone disorders in CKD and is an emerging cardiovascular risk factor. Central elements of FGF23 regulation remain incompletely understood; genetic variation may help explain interindividual differences.Methods: We performed a meta-analysis of genome-wide association studies of circulating FGF23 concentrations among 16,624 participants of European ancestry from seven cohort studies, excluding participants with eGFR<30 ml/min per 1.73 m(2) to focus on FGF23 under normal conditions. We evaluated the association of single-nucleotide polymorphisms (SNPs) with natural log-transformed FGF23 concentration, adjusted for age, sex, study site, and principal components of ancestry. A second model additionally adjusted for BMI and eGFR.Results: We discovered 154 SNPs from five independent regions associated with FGF23 concentration. The SNP with the strongest association, rs17216707 (P=3.0x10(-24)), lies upstream of CYP24A1, which encodes the primary catabolic enzyme for 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D. Each additional copy of the T allele at this locus is associated with 5% higher FGF23 concentration. Another locus strongly associated with variations in FGF23 concentration is rs11741640, within RGS14 and upstream of SLC34A1 (a gene involved in renal phosphate transport). Additional adjustment for BMI and eGFR did not materially alter the magnitude of these associations. Another top locus (within ABO, the ABO blood group transferase gene) was no longer statistically significant at the genome-wide level.Conclusions: Common genetic variants located near genes involved in vitamin D metabolism and renal phosphate transport are associated with differences in circulating FGF23 concentrations.
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| 38. |
- Sallnow, Libby, et al.
(författare)
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Research in public health and end-of-life care : building on the past and developing the new
- 2016
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Ingår i: Progress in Palliative Care. - : Taylor & Francis. - 0969-9260 .- 1743-291X. ; 24:1, s. 25-30
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Public health approaches offer the opportunity to move beyond clinical and health services approaches to end-of-life (EoL) care, to focus on whole populations, individuals and communities rather than patients and carers. They also allow concepts such as capacity, resilience, and wellbeing to come to the fore. Methods: This paper, drawing on the experience of a diverse group of academics and practitioners from three countries in Europe, considers the research challenges related to examining new public health approaches to EoL care and how learning from more traditional or classic public health research can influence a future research agenda. Additional opportunities provided by the new public health approach to broaden learning and participation in research are considered. Results: By bringing together strong traditional methods such as analysis of longitudinal population-level data with participatory approaches that draw on communities' experience and aspirations for care, the authors suggest that new and improved opportunities exist to evaluate the impact of participatory approaches. Discussion: In conclusion, the paper urges researchers from classic and new public health to work in partnership to generate and respond to the emerging research agenda around new public health initiatives. There is much to be learned from both.
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| 39. |
- Scholz, Joachim, et al.
(författare)
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The IASP classification of chronic pain for ICD-11 : chronic neuropathic pain.
- 2019
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 160:1, s. 53-59
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Tidskriftsartikel (refereegranskat)abstract
- The upcoming 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD) of the World Health Organization (WHO) offers a unique opportunity to improve the representation of painful disorders. For this purpose, the International Association for the Study of Pain (IASP) has convened an interdisciplinary task force of pain specialists. Here, we present the case for a reclassification of nervous system lesions or diseases associated with persistent or recurrent pain for ≥3 months. The new classification lists the most common conditions of peripheral neuropathic pain: trigeminal neuralgia, peripheral nerve injury, painful polyneuropathy, postherpetic neuralgia, and painful radiculopathy. Conditions of central neuropathic pain include pain caused by spinal cord or brain injury, poststroke pain, and pain associated with multiple sclerosis. Diseases not explicitly mentioned in the classification are captured in residual categories of ICD-11. Conditions of chronic neuropathic pain are either insufficiently defined or missing in the current version of the ICD, despite their prevalence and clinical importance. We provide the short definitions of diagnostic entities for which we submitted more detailed content models to the WHO. Definitions and content models were established in collaboration with the Classification Committee of the IASP's Neuropathic Pain Special Interest Group (NeuPSIG). Up to 10% of the general population experience neuropathic pain. The majority of these patients do not receive satisfactory relief with existing treatments. A precise classification of chronic neuropathic pain in ICD-11 is necessary to document this public health need and the therapeutic challenges related to chronic neuropathic pain.
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| 40. |
- Treede, Rolf-Detlef, et al.
(författare)
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A classification of chronic pain for ICD-11.
- 2015
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 156:6, s. 1003-1007
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Tidskriftsartikel (refereegranskat)
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| 41. |
- Treede, Rolf-Detlef, et al.
(författare)
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Chronic pain as a symptom or a disease : the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11).
- 2019
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Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 160:1, s. 19-27
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain is a major source of suffering. It interferes with daily functioning and often is accompanied by distress. Yet, in the International Classification of Diseases, chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain such as adequate financing of access to multimodal pain management. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and low-resource environments. Chronic pain is defined as pain that persists or recurs for more than 3 months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. In conditions such as fibromyalgia or nonspecific low-back pain, chronic pain may be conceived as a disease in its own right; in our proposal, we call this subgroup "chronic primary pain." In 6 other subgroups, pain is secondary to an underlying disease: chronic cancer-related pain, chronic neuropathic pain, chronic secondary visceral pain, chronic posttraumatic and postsurgical pain, chronic secondary headache and orofacial pain, and chronic secondary musculoskeletal pain. These conditions are summarized as "chronic secondary pain" where pain may at least initially be conceived as a symptom. Implementation of these codes in the upcoming 11th edition of International Classification of Diseases will lead to improved classification and diagnostic coding, thereby advancing the recognition of chronic pain as a health condition in its own right.
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| 42. |
- Vanholder, Raymond, et al.
(författare)
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A bench to bedside view of uremic toxins.
- 2008
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Ingår i: Journal of the American Society of Nephrology : JASN. - 1533-3450. ; 19:5, s. 863-70
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Tidskriftsartikel (refereegranskat)abstract
- Reviewing the current picture of uremic toxicity reveals its complexity. Focusing on cardiovascular damage as a model of uremic effects resulting in substantial morbidity and mortality, most molecules with potential to affect the function of a variety of cell types within the vascular system are difficult to remove by dialysis. Examples are the larger middle molecular weight molecules and protein-bound molecules. Recent clinical studies suggest that enhancing the removal of these compounds is beneficial for survival. Future therapeutic options are discussed, including improved removal of toxins and the search for pharmacologic strategies blocking responsible pathophysiologic pathways.
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| 43. |
- Öhlén, Joakim, 1958, et al.
(författare)
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Determinants in the place of death for people with different cancer types: a national population-based study.
- 2017
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Ingår i: Acta oncologica. - 0284-186X .- 1651-226X. ; 56:3, s. 455-461
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Tidskriftsartikel (refereegranskat)abstract
- Place of death has for the past decade increasingly come to be regarded as a robust indicator of how palliative care is organized and provided, and is also recognized as an important factor for well being at the end of life. Variations in place of cancer deaths have previously been reported in the context of country-specific healthcare organization, but without differentiating between cancer types and national regional variations. Our aim was to examine, at a population level, where people with cancer diseases die in Sweden, and to investigate associations of place of death and cancer type with individual, socioeconomic and geographical characteristics of the deceased.This population level study is based on death certificate data (sex; age; underlying cause of death and place of death) and population register data (educational attainment, marital status, living arrangements, area of residence, degree of urbanization, and healthcare region) of all 2012 cancer deaths in Sweden, with a registered place of death (hospital, nursing home, home, other places). Data were explored descriptively. To investigate associations between place of death and cancer types, and individual, socioeconomic and environmental characteristics, a series of multivariable logistic regression analyses were performed.The most frequent type of cancer death occurring at home was upper gastrointestinal cancer (25.6%) and the least frequent was hematological cancer (15.2%). Regional variations in cancer deaths occurring at home ranged from 17.1% to 28.4%. Factors associated with place of death by cancer type were age, educational attainment, marital status, healthcare regions and degree of urbanization.Large healthcare regional variations in place of death among different cancer types were found. The socioeconomic inequality previously demonstrated for screening, diagnostic and treatment processes, rehabilitation and survival thus also seems to be reflected in the place of death.
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