| 1. |
- Ekberg, Kerstin, et al.
(författare)
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Lättare psykisk ohälsa
- 2015
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Ingår i: Återgång i arbete. Processer, bedömningar och åtgärder. - Lund : Studentlitteratur AB. ; , s. 111-127, s. 111-128
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Bokkapitel (populärvet., debatt m.m.)
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| 2. |
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| 3. |
- Johansson, Karl-Axel, et al.
(författare)
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The quality assurance process for the ARTSCAN head and neck study - a practical interactive approach for QA in 3DCRT and IMRT.
- 2008
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Ingår i: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 87:2, s. 290-9
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper describes the quality assurance (QA) work performed in the Swedish multicenter ARTSCAN (Accelerated RadioTherapy of Squamous cell CArcinomas in the head and Neck) trial to guarantee high quality in a multicenter study which involved modern radiotherapy such as 3DCRT or IMRT. MATERIALS AND METHODS: The study was closed in June 2006 with 750 randomised patients. Radiation therapy-related data for every patient were sent by each participating centre to the QA office where all trial data were reviewed, analysed and stored. In case of any deviation from the protocol, an interactive process was started between the QA office and the local responsible clinician and/or physicist to increase the compliance to the protocol for future randomised patients. Meetings and workshops were held on a regular basis for discussions on various trial-related issues and for the QA office to report on updated results. RESULTS AND DISCUSSION: This review covers the 734 patients out of a total of 750 who had entered the study. Deviations early in the study were corrected so that the overall compliance to the protocol was very high. There were only negligible variations in doses and dose distributions to target volumes for each specific site and stage. The quality of the treatments was high. Furthermore, an extensive database of treatment parameters was accumulated for future dose-volume vs. endpoint evaluations. CONCLUSIONS: This comprehensive QA programme increased the probability to draw firm conclusions from our study and may serve as a concept for QA work in future radiotherapy trials where comparatively small effects are searched for in a heterogeneous tumour population.
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| 4. |
- Ahlgren, Katrin, 1970-
(författare)
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Narrativa identiteter och levande metaforer i ett andraspråksperspektiv
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis consists of two separate yet connected studies which investigate how some adult second language speakers of Swedish with various backgrounds reflect on their experiences of language use. The studies are based on the same empirical data, which consists of questionnaires, diaries, essays and observations, but primarily of conversations conducted with a time interval of six years. This data is analysed from a theoretical framework based on Paul Ricœur’s ideas of interpretation, narrative analysis and identity creation, which recur as a leitmotif throughout the thesis.In the first study, data from three second language speakers are analysed by means of the concept of narrative identity, shedding light on the interplay between a static and a dynamic identity. The result is presented in the form of life narratives, which are commented on in relation to those strategies the participants express in relation to their second language use. The analysis shows a development over time moving from defiance to acceptance, from avoidance to flexibility and from planning to simplification. Adult language learning stands out as an arduous and time-consuming process with major consequences for the learner’s ego, a conclusion confirmed and clarified in the metaphor analysis of the second study in which language learning is related to hard work, a constant struggle and a long and strenuous journey. Here it also becomes evident that the participants equate language learning and language use to physical exertion and challenge as well as to individual achievement. This becomes particularly clear in the linked chains of metaphors in which language use is compared with skiing down the steepest slopes or appearing on stage.The participants in both studies are quoted by means of an ethnopoetic method which aims to bring out the creative aspects of their language use and to give second language speakers a voice – a voice which does not need to be corrected and gives the narratives a new dimension.
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| 5. |
- Baumann, Pia, et al.
(författare)
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Factors important for efficacy of stereotactic body radiotherapy of medically inoperable stage I lung cancer. A retrospective analysis of patients treated in the Nordic countries.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:7, s. 787-95
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Tidskriftsartikel (refereegranskat)abstract
- We reviewed results of SBRT treatment of 138 patients with medically inoperable stage I NSCLC treated during 1996-2003 at five different centres in Sweden and Denmark. Mean age was 74 years (range 56-90) with 69 men and 72 women. SBRT was delivered using a 3D conformal multifield technique and a stereotactic body frame. Doses delivered were 30-48 Gy (65% isodose at the periphery of planning target volume, PTV) in 2-4 fractions. Equivalent dose in 2 Gy fractions (EQD2) was in the range of 50-100 Gy. Mean gross tumour volume (GTV) was 39 cm3 (2-436), and planning target volume was 101 cm3 (11-719). Overall response rate (CR, PR) was 61% (84/138). SD was noted in 36% (50/138). During a median follow-up period of 33 months (1-107), 16 (12%) local failures occurred, ten of which also included distant metastases. Local failure was associated with tumour size, target definition and central or pleura proximity. Distant metastases occurred in 25% (35/138) of the patients. Ninety-one (65%) patients died during follow-up of which 55 patients (60%) died of other causes than lung cancer. Three- and 5-year overall survival was 52 and 26% respectively. Lung cancer specific 3- and 5-year overall survival was 66 and 40% respectively. Fifty nine percent (83/138) of the patients had no side effects. Fourteen patients experienced grade 3-4 toxicity according to radiation therapy oncology group (RTOG). EQD2 (> v.s.<55.6 Gy) showed a statistically significant benefit survival for the higher doses. SBRT for stage I NSCLC results in favourable local control not inferior to fractionated RT and with acceptable toxicity.
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| 6. |
- Baumann, Pia, et al.
(författare)
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Outcome in a prospective phase II trial of medically inoperable stage I non-small-cell lung cancer patients treated with stereotactic body radiotherapy.
- 2009
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Ingår i: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. - 1527-7755 .- 0732-183X. ; 27:20, s. 3290-6
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The impact of stereotactic body radiotherapy (SBRT) on 3-year progression-free survival of medically inoperable patients with stage I non-small-cell lung cancer (NSCLC) was analyzed in a prospective phase II study. PATIENTS AND METHODS: Fifty-seven patients with T1NOMO (70%) and T2N0M0 (30%) were included between August 2003 and September 2005 at seven different centers in Sweden, Norway, and Denmark and observed up to 36 months. SBRT was delivered with 15 Gy times three at the 67% isodose of the planning target volume. RESULTS: Progression-free survival at 3 years was 52%. Overall- and cancer-specific survival at 1, 2, and 3 years was 86%, 65%, 60%, and 93%, 88%, 88%, respectively. There was no statistically significant difference in survival between patients with T1 or T2 tumors. At a median follow-up of 35 months (range, 4 to 47 months), 27 patients (47%) were deceased, seven as a result of lung cancer and 20 as a result of concurrent disease. Kaplan-Meier estimated local control at 3 years was 92%. Local relapse was observed in four patients (7%). Regional relapse was observed in three patients (5%). Nine patients (16%) developed distant metastases. The estimated risk of all failure (local, regional, or distant metastases) was increased in patients with T2 (41%) compared with those with T1 (18%) tumors (P = .027). CONCLUSION: With a 3-year local tumor control rate higher than 90% with limited toxicity, SBRT emerges as state-of-the-art treatment for medically inoperable stage I NSCLC and may even challenge surgery in operable instances.
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| 7. |
- Baumann, Pia, et al.
(författare)
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Stereotactic body radiotherapy for medically inoperable patients with stage I non-small cell lung cancer - a first report of toxicity related to COPD/CVD in a non-randomized prospective phase II study.
- 2008
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Ingår i: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - : Elsevier BV. - 0167-8140 .- 1879-0887. ; 88:3, s. 359-67
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: In a retrospective study using stereotactic body radiotherapy (SBRT) in medically inoperable patients with stage I NSCLC we previously reported a local control rate of 88% utilizing a median dose of 15Gyx3. This report records the toxicity encountered in a prospective phase II trial, and its relation to coexisting chronic obstructive pulmonary disease (COPD) and cardio vascular disease (CVD). MATERIAL AND METHODS: Sixty patients were entered in the study between August 2003 and September 2005. Fifty-seven patients (T1 65%, T2 35%) with a median age of 75 years (59-87 years) were evaluable. The baseline mean FEV1% was 64% and median Karnofsky index was 80. A total dose of 45Gy was delivered in three fractions at the 67% isodose of the PTV. Clinical, pulmonary and radiological evaluations were made at 6 weeks, 3, 6, 9, 12, 18, and 36 months post-SBRT. Toxicity was graded according to CTC v2.0 and performance status was graded according to the Karnofsky scale. RESULTS: At a median follow-up of 23 months, 2 patients had relapsed locally. No grade 4 or 5 toxicity was reported. Grade 3 toxicity was seen in 12 patients (21%). There was no significant decline of FEV1% during follow-up. Low grade pneumonitis developed to the same extent in the CVD 3/17 (18%) and COPD 7/40 (18%) groups. The incidence of fibrosis was 9/17 (53%) and pleural effusions was 8/17 (47%) in the CVD group compared with 13/40 (33%) and 5/40 (13%) in the COPD group. CONCLUSION: SBRT for stage I NSCLC patients who are medically inoperable because of COPD and CVD results in a favourable local control rate with a low incidence of grade 3 and no grade 4 or 5 toxicity.
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| 8. |
- Bengtsson Malmeblad, Lena, et al.
(författare)
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Avstämningsmötet. En utredningsmetod?
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Avstämningsmötet är en metod inom Försäkringskassan som syftar till att ge bättre beslutsunderlag för deras bedömningar av sjukskrivnas arbetsförmåga och rehabiliteringsbehov. Målet är att förkorta sjukskrivningstider och snabbare få människor tillbaka i arbete. I och med den kraftigt ökade sjukfrånvaron i slutet av 1990-talet uppmärksammades att Försäkringskassans tillämpning av sjukförsäkringens regelverk varierar mellan olika delar av landet och även mellan olika lokalkontor. Som en konsekvens påbörjades ett omfattande arbete med att professionalisera handläggningen genom att utveckla gemensamma metoder och arbetssätt. År 2005 gjordes en skärpning av lagstiftningen genom att starkare reglera de tidsgränser inom vilka ett avstämningsmöte skall hållas och man etablerade produktionsmål inom Försäkringskassan i termer av antal avstämningsmöten inom 90 dagar i sjukskrivningen. I denna studie har 11 handläggare inom Försäkringskassan intervjuats om sin syn på avstämningsmötet som utredningsmetod och på vilket sätt den påverkar den sjukskrivnes återgång i arbete. Studien fokuserar på det första avstämningsmötet i sjukskrivningen, sex av dessa genomfördes före 90-dagars gränsen och fem genomfördes senare i sjukskrivningsprocessen. Analyserna av intervjuerna resulterade i fem huvudområden som berör upplevelser av produktionskraven, förberedelser respektive genomförande av avstämningsmötet, läkarens roll vid avstämningsmötet samt mötets betydelse för återgång i arbete. Handläggarna upplever en konflikt mellan kravet på att hålla produktionsmålet på avstämningsmöte inom 90 dagar och sin professionella bedömning av när ett avstämningsmöte passar in i rehabiliteringsprocessen. Ur handläggarnas perspektiv har det skett en värderingsförskjutning från en helhetssyn på rehabiliteringsprocessen med individen i centrum, till mer kortsiktiga produktionsmål som fragmenterar processen. Produktionskraven leder också till att vissa sjukskrivningsärenden som bedöms vara lämpade för ett avstämningsmöte måste prioriteras bort då de passerat tidsgränsen, medan man genomför andra möten, där både handläggaren och läkaren anser att det kommer för tidigt i rehabiliteringsprocessen. Avstämningsmötena riskerar att bli formaliserade och rutindrivna aktiviteter, snarare än allsidiga bedömningar. Den formaliserade agendan vid avstämningsmötet tycks kunna leda till att deltagarna upplever en osäkerhet om mötets syfte, eller tolkar syftet annorlunda än handläggaren. Handläggaren uppfattar sig tappa kontrollen över mötet. Av tidsskäl gör man ofta avkall på att kalla läkaren till mötet, trots att mötet syftar till att diskutera arbetsförmåga och sjukskrivningens omfattning. Såväl strukturen, den reglering som styr avstämningsmötet, som handläggarnas egna erfarenheter av hur kontakter med läkare fungerar, bidrar till att handläggarna utvecklar olika strategier för att undvika att bli beroende av läkarnas fysiska deltagande i mötet. Det medicinska underlaget är centralt i bedömningen av individens arbetsförmåga, den ofta förekommande frånvaron av läkare, liksom den stora variationen i hur de fördjupade Sassam-utredningarna genomförs, skapar därför dilemman, som dock även kan innebära en handlingsfrihet för handläggaren i prioriteringar av ärenden. Rapporten visar sammanfattningsvis handläggares dilemman i sin roll att översätta politiska beslut och mål till vardagens praktik. Resultaten visar också deras möjligheter att prioritera och hantera dessa dilemman inom ramen för en ökad administrativ kontroll.
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| 9. |
- Boström, Per, 1982-
(författare)
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”Det här är ju dött tåg liksom…” : en studie av metaforer för ROMANTISK KÄRLEK i talad svenska
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study is to investigate the metaphorization of ROMANTIC LOVE in spoken Swedish. The study is based on 4 semi-structured focus group conversations with participants in two age groups; 24–33 and 50–54. A Swedish short film and questions related to the film were used as stimuli for the conversations. Research questions asked are 1) How is the concept of ROMANTIC LOVE metaphorized in the recorded group conversations? 2) How does the metaphorization vary between the conversations? and 3) What cultural model for ROMANTIC LOVE in the conversations can be reconstructed based on identified metaphorizations? The study is situated within Cognitive Linguistics and the framework of Conceptual Metaphor Theory and a Discourse Dynamics Approach to Metaphor. Consequently, metaphor is seen as a cognitive, linguistic, socio-cultural and discursive phenomenon, where metaphorization is a dynamic process that develops, adapts and flows within the conversations and between the participants. Accordingly, the identified metaphorizations are considered to be influenced by the speakers and their embodied experiences, their embodied cognition, the discourse event, and socio-cultural aspects of metaphorization. The focus of the present study, ROMANTIC LOVE, is considered as a dynamic concept based on philosophical, feminist, psychological and metaphorical research. Metaphors are identified through a discourse dynamic version of MIP and MIPVU.From the analyses, 6 systematic metaphors are proposed, where ROMANTIC LOVE is metaphorized as a PHYSICAL OBJECT (incl. as a POSSESSION and as a LIVING ORGANISM), as a CONTAINER (incl. CONSTRUCTION and BODY as a CONTAINER), as TRAVELLING together (with primary focus on TRAVELLING together rather than SOURCE or TARGET), as a UNITY (with focus on how a UNITY is ESTABLISHED, MAINTAINED and DISSOLVED, ideally by two COMPATIBLE partners), as a PHYSICAL and NATURAL FORCE and as a DISEASE (where LOVE can affect a person’s perception and sanity). In addition, ROMANTIC LOVE is, in a small number of expressions, metaphorized as a CRIME, as a PHYSICAL CONFLICT and as a GAME. The variation in metaphorization is small between the conversations. Some metaphorizations seem to be related to the age of the participants. ROMANTIC LOVE ismoreover something people usually have influence over and in some ways can control. In total, 780 metaphorical expressions and 9 source domains are identified. Departing from the interplay betweenmetaphorization and culture, a cultural model for ROMANTIC LOVE is reconstructed, where a multifaceted, embodied and experiential concept of ROMANTIC LOVE emerges.
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| 10. |
- Christensen, Torben, et al.
(författare)
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Factors controlling large scale variations in methane emissions from wetlands
- 2003
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Ingår i: Geophysical Research Letters. - 0094-8276 .- 1944-8007. ; 30:7
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Tidskriftsartikel (refereegranskat)abstract
- [1] Global wetlands are, at estimate ranging 115-237 Tg CH4/yr, the largest single atmospheric source of the greenhouse gas methane (CH4). We present a dataset on CH4 flux rates totaling 12 measurement years at sites from Greenland, Iceland, Scandinavia and Siberia. We find that temperature and microbial substrate availability (expressed as the organic acid concentration in peat water) combined explain almost 100% of the variations in mean annual CH4 emissions. The temperature sensitivity of the CH4 emissions shown suggests a feedback mechanism on climate change that could validate incorporation in further developments of global circulation models.
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| 11. |
- Djärv, Emma, et al.
(författare)
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Dummy run for a phase II study of stereotactic body radiotherapy of T1-T2 N0M0 medical inoperable non-small cell lung cancer.
- 2006
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 45:7, s. 973-7
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Tidskriftsartikel (refereegranskat)abstract
- In forthcoming multicentre studies on stereotactic body radiotherapy (SBRT) compliance with volume and dose prescriptions will be mandatory to avoid unnecessary heterogeneity bias. To evaluate compliance in a multicentre setting we used two cases from an ongoing phase II study of SBRT of T1-T2N0M0 inoperable NSCLC in a dummy run oriented on volumes and doses. Six Scandinavian centres participated. Each centre received CT-scans covering the whole lung volumes of two patients with instructions to follow the study protocol when outlining tumour and target volumes, prescribing doses and creating dose plans. Volumes and doses of the 12 dose plans were evaluated according to the study protocol. For the two patients the GTV volume range was 24 to 39 cm3 and 26 to 41 cm3, respectively. The PTV volume range was 90 to 116 cm3, and 112 to 155 cm3, respectively. For all plans the margin between CTV and PTV in all directions followed in detail the protocol. The prescribed dose was for all centres 45 Gy/3 fractions (isocentre dose about 66 Gy). The mean GTV doses ranged from 63 to 67 Gy and from 63 to 68 Gy, respectively. The minimum doses for GTV were between 50-64 Gy and between 55-65 Gy, respectively. The dose distribution was conformed to PTV for 10 of 12 plans and 2 of 12 plans from one centre had sub-optimal dose distribution. Most of the volume and dose parameters for the participating centres showed fully acceptable compliance with the study protocol.
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| 12. |
- Ekberg, Joakim, et al.
(författare)
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Web 2.0 Systems Supporting Childhood Chronic Disease Management: Design Guidelines Based on Information Behaviour and Social Learning Theories
- 2010
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Ingår i: JOURNAL OF MEDICAL SYSTEMS. - : Springer Science and Business Media LLC. - 0148-5598 .- 1573-689X. ; 34:2, s. 107-117
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Tidskriftsartikel (refereegranskat)abstract
- Self-directed learning denotes that the individual is in command of what should be learned and why it is important. In this study, guidelines for the design of Web 2.0 systems for supporting diabetic adolescents every day learning needs are examined in light of theories about information behaviour and social learning. A Web 2.0 system was developed to support a community of practice and social learning structures were created to support building of relations between members on several levels in the community. The features of the system included access to participation in the culture of diabetes management practice, entry to information about the community and about what needs to be learned to be a full practitioner or respected member in the community, and free sharing of information, narratives and experience-based knowledge. After integration with the key elements derived from theories of information behaviour, a preliminary design guideline document was formulated.
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| 13. |
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Ekberg, Lena, et al.
(författare)
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Evidentiality in language and cognition
- 2009
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Ingår i: Functions of language. - : John Benjamins. - 0929-998X .- 1569-9765. ; 16:1, s. 5-7
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Tidskriftsartikel (refereegranskat)
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| 19. |
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| 20. |
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| 21. |
- Ekberg, Lena
(författare)
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Flerspråkigheten och den nordiska språkgemenskapen
- 2015
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Ingår i: Språk i Norden. - 2246-1701. ; , s. 9-22
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- I artikeln diskuteras vilken roll flerspråkigheten har i nordisk språkpolitik, med utgångspunkt i Deklaration om nordisk språkpolitik. Vidare diskuteras ideologin bakom några av de centrala begreppen i den språkpolitiska diskursen, däribland den nordiska språkgemenskapen. Trots att flerspråkighet är en av fyra arbetsfrågor som pekas ut i deklarationen, är andraspråksperspektivet näst intill osynligt. Målet att alla nordbor i första hand ska kunna kommunicera med varandra på ett skandinaviskt språk ignorerar att runt en fjärdedel inte har ett skandinaviskt språk som modersmål. Slutsatsen är att en översyn av deklarationen är motiverad med hänsyn till de nya immigrationsmönster och språkkontaktsituationer som globaliseringen för med sig.
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| 22. |
- Ekberg, Lena, 1954-
(författare)
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Flerspråkigheten och språkpolitiken : svenskan, engelskan och alla andra språk
- 2013
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Ingår i: Profession, politik och passion. - Göteborg : Om institutionen Arbetsmiljö Beredningsgrupper Bibliotek Doktorand Institutionsråd Internt Ledningsgruppen Likabehandling Miljö och hållbar utveckling Styrdokument Institutionen för svenska språket, Göteborgs universitet. - 9789163733765 ; , s. 121-139
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 23. |
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| 24. |
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| 27. |
- Ekberg, Lena, et al.
(författare)
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Identity construction and dialect acquisition among immigrants in rural areas–the case of Swedish-language Finland
- 2024
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Ingår i: Journal of Multilingual and Multicultural Development. - : Informa UK Limited. - 0143-4632 .- 1747-7557.
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Tidskriftsartikel (refereegranskat)abstract
- The study focuses on how transnational migration affects the socio-political peripheries of communities. Specifically, we focus on identity construction and on how identities are worked out among second-generation immigrants from Bosnia, whose parents came to the Swedish-language countryside in Finland as refugees in the early 1990s. We analyse the Bosnians’ small stories and their use of linguistic traits from the different varieties in the rural community where they have settled. The framework is narrative analysis coupled with Bhabha’s notion of identity as a third space and how this is manifested in the way the immigrants position themselves in their small stories and how realizations of their third positionings are related to their attitudes and use of the local dialect. The third position is realised as clusters of experiences and attitudes, suggesting different prototypical identity-constructional positions, three of them being the immigrant (i) as a mediator between the traditional local population and immigrants, expressing solidarity to both groups; (ii) as a generic immigrant, belonging neither to the local population nor to his/her ‘own’ ethnic group but affiliating with immigrants in general; and (iii) as an identification of oneself as a permanentemigrant aligning oneself with other adolescents in the diaspora.
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| 28. |
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| 29. |
- Ekberg, Lena, et al.
(författare)
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Joint attention and cooperation in the Swedish of adolescents in multilingual settings: the use of sån 'such' and såhär 'like'.
- 2011
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Ingår i: Ethnic Styles of Speaking in European Metropolitan Areas. - 978 90 272 8253 8 ; , s. 217-237
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Bokkapitel (refereegranskat)abstract
- This article describes the use of the Swedish sån 'such' and såhär 'like', respectively, as a means to establish joint attention and cooperation among adolescents in multilingual settings. In the south of Sweden, in the city of Malmö, sån 'such' is used, primarily, as a determiner, and also a focus marker. In contrast, adolescents in Stockholm (approximately 600 kilometres north of Malmö) make frequent use of såhär 'like' as a focus marker. However, there is no corresponding development into a determiner. The two expressions have overlapping meaning and function. They both serve to direct the hearer's attention to a linguistic expression. Simultaneously, sån and såhär may function as an appeal to the hearer to co-construct a referent that is being introduced by the following expression.
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| 30. |
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| 31. |
- Ekberg, Lena, et al.
(författare)
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Meningen med semantiken
- 2003
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Ingår i: Grammatik i fokus : festskrift till Christer Platzack den 18 november 2003 = Grammar in focus : festschrift for Christer Platzack 18 November 2003. Vol. 1. - 9163145707
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
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| 32. |
- Ekberg, Lena
(författare)
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Objektiv språkriktighet finns inte
- 2005
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Ingår i: Språkvård. Tidskrift utgiven av Svenska språknämnden. - 0038-8440. ; 41:4, s. 38-44
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 33. |
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| 36. |
- Ekberg, Lars, et al.
(författare)
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What margins should be added to the clinical target volume in radiotherapy treatment planning for lung cancer?
- 1988
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Ingår i: Radiotherapy and Oncology. - 1879-0887. ; 48:1, s. 71-77
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The planning target volume in radiotherapy treatment planning takes into account both movements of the clinical target volume (CTV) and set-up deviations. MATERIALS AND METHODS: A group of patients who received radiotherapy for lung cancer were studied. In order to measure the CTV movements due to respiration and other internal organ motions, fluoroscopy was performed for 20 patients. To study the accuracy and reproducibility of patient and beam set-up, 553 electronic portal images from 20 patients were evaluated. Discrepancies between planned and actual field positions were measured and the systematic and random errors were identified. The combined effect of these geometrical variations was evaluated. RESULTS: The average CTV movement with quiet respiration was about 2.4 mm in the medio-lateral and dorso-ventral directions. Movement in the cranio-caudal direction was on average 3.9 mm with a range of 0-12 mm. The systematic set-up errors were on average 2.0 mm in the transversal plane and 3.0 mm in the cranio-caudal direction. The random errors can be described by their standard deviations of 3.2 and 2.6 mm. In this study, the combined effect of the two parameters (CTV movement and set-up deviations) varied between 7.5 and 10.3 mm in different anatomical directions. CONCLUSIONS: In our daily clinical routine, we use a margin of 11 mm in the transversal plane and 15 mm cranially and caudally, also taking into account other unquantified variations and uncertainties.
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| 37. |
- Eriksson, Lars I, et al.
(författare)
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Functional assessment of the pharynx at rest and during swallowing in partially paralyzed humans: simultaneous videomanometry and mechanomyography of awake human volunteers
- 1997
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Ingår i: Anesthesiology. - : Ovid Technologies (Wolters Kluwer Health). - 1528-1175 .- 0003-3022. ; 87:5, s. 1035-1043
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Functional characteristics of the pharynx and upper esophagus, including aspiration episodes, were investigated in 14 awake volunteers during various levels of partial neuromuscular block. Pharyngeal function was evaluated using videoradiography and computerized pharyngeal manometry during contrast bolus swallowing. METHODS: Measurements of pharyngeal constrictor muscle function (contraction amplitude, duration, and slope), upper esophageal sphincter muscle resting tone, muscle coordination, bolus transit time, and aspiration under fluoroscopic control (laryngeal or tracheal penetration) were made before (control measurements) and during a vecuronium-induced partial neuromuscular paralysis, at fixed intervals of mechanical adductor pollicis muscle train-of-four (TOF) fade; that is, at TOF ratios of 0.60, 0.70, 0.80, and after recovery to a TOF ratio > 0.90. RESULTS: Six volunteers aspirated (laryngeal penetration) at a TOF ratio < 0.90. None of them aspirated at a TOF ratio > 0.90 or during control recording. Pharyngeal constrictor muscle function was not affected at any level of paralysis. The upper esophageal sphincter resting tone was significantly reduced at TOF ratios of 0.60, 0.70, and 0.80 (P < 0.05). This was associated with reduced muscle coordination and shortened bolus transit time at a TOF ratio of 0.60. CONCLUSIONS: Vecuronium-induced partial paralysis cause pharyngeal dysfunction and increased risk for aspiration at mechanical adductor pollicis TOF ratios < 0.90. Pharyngeal function is not normalized until an adductor pollicis TOF ratio of > 0.90 is reached. The upper esophageal sphincter muscle is more sensitive to vecuronium than is the pharyngeal constrictor muscle.
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| 38. |
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Evidentiality
- 2009
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Samlingsverk (redaktörskap) (populärvet., debatt m.m.)
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| 39. |
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| 40. |
- Jacobsson, Jenny, et al.
(författare)
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Developing web-based health guidance for coaches and parents in child athletics (track and field)
- 2020
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : WILEY. - 0905-7188 .- 1600-0838. ; 30:7, s. 1248-1255
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to develop athletics health guidance (AHG) aimed at supporting coaches and parents involved in organized child athletics by providing practical advice and tools for the management of the most common health problems experienced in athletics by the 12- to 15-year olds. The study used participatory action research (PAR) and an established health service guideline development procedure modified to fit AHG development in child athletics. A sequential process consisting of four steps with associated subgoals was employed. The collected data were structured according to the AHG development steps and analyzed using qualitative methods. The most common health concern identified was injuries related to growth and overuse. No randomized controlled studies investigating injury prevention programs or any existing concepts/guidelines in child athletics were found that could be used in the development of the AHG. A requirements document was instead defined in a nominal group process and used for the AHG development. The areas included in the final AHG were as follows: training youth athletes, growth and puberty, recovery, injury prevention, injuries and illnesses, mental illness, safe sport, and anti-doping. The evidence regarding health issues in child athletics is limited, indicating that actions to support good health in the sport are currently based essentially on best practice. The long-term aim of the AHG and associated website is to systematically create and introduce conditions that can bridge the "know-do gap" and provide coaches and parents with easy-to-access and up-to-date knowledge in the field of child athlete health in athletics.
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| 41. |
- Jerkeman, Mats, et al.
(författare)
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Nationwide Assessment of Patient Trajectories in Mantle Cell Lymphoma : The Swedish MCLcomplete Project
- 2023
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Ingår i: HemaSphere. - : Ovid Technologies (Wolters Kluwer Health). - 2572-9241. ; 7:8
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Tidskriftsartikel (refereegranskat)abstract
- Mantle cell lymphoma (MCL) is a B-cell malignancy currently considered incurable. Although some patients obtain prolonged remission after first-line chemoimmunotherapy, many will need several treatment lines. Here, we present a nationwide assessment of treatment strategies, time to progression and survival in MCL. All patients diagnosed with MCL 2006-2018 were identified in the Swedish Lymphoma Register. Information on all lines of therapy was extracted from the medical records. Overall and progression-free survival (OS and PFS) were assessed through August 2021. In total, 1367 patients were included (median age, 71 years) and median follow-up was 6.8 years. Two hundred and one (15%) were managed initially with watch-and-wait, but 1235 (90%) eventually received treatment. The most frequently used first-line regimens were rituximab-bendamustine (BR) (n = 368; 30%) and Nordic MCL2 (n = 342; 28%). During follow-up, 630 patients (46%) experienced relapse/progression and 546 (40%) received second-line treatment. The most frequently used second-line regimen was BR (n = 185; 34%) but otherwise a wide variety of second-line treatments were used. Further, 382 and 228 patients experienced a second or third relapse/progression, respectively. Median PFS after first (PFS-1), second (PFS-2), third (PFS-3), and fourth (PFS-4) treatment lines was 29.4, 8.9, 4.3, and 2.7 months. Patients with early progression, defined as a PFS-1 <24 months, had an inferior median OS of 13 versus 37 months in patients with later relapse. For patients treated with frontline BR, however, time to relapse had no impact on later outcome. By use of nationwide population-based data, we provide important benchmarks for future studies of all treatment lines in MCL.
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| 42. |
- Jönsson, Anders, 1970-, et al.
(författare)
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Bedömning i NO : grundskolans tidiga år
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Undervisning i biologi, fysik och kemi ska ge eleverna förutsättningar att bland annat ta ställning i frågor med naturvetenskapligt innehåll, genomföra undersökningar och använda begrepp för att beskriva och förklara olika fenomen och sammanhang. Men hur vet man i vilken utsträckning eleverna har utvecklat dessa förmågor? Och hur kan man stödja elevernas fortsatta utveckling?I den här boken diskuteras vilka aspekter som ska bedömas i förhållande till de förmågor som beskrivs i kursplanerna för NO-ämnena samt hur bedömningen kan genomföras för att hjälpa eleverna att utveckla dessa förmågor. Huvudfokus ligger på strategier för formativ bedömning – hur man kommunicerar förväntningar till eleverna, ger konstruktiv återkoppling och låter eleverna arbeta med själv- och kamratbedömning – men boken tar även upp skriftliga omdömen, betyg, likvärdighet, nationella prov och sambedömning. Boken riktar sig i första hand till lärare, och blivande lärare, som undervisar i NO-ämnena i grundskolans årskurs 1–6. En stor del av innehållet är dock relevant även för andra årskurser och andra ämnen. Författarna har varit ansvariga för utvecklingen av Skolverkets diagnosmaterial i NO för årskurs 1–6 (DiNO) samt medverkar i konstruktionen av de nationella proven i biologi, fysik och kemi för årskurs 6.
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| 43. |
- Jönsson, Anders, et al.
(författare)
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Bedömning i NO : grundskolans tidiga år
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Undervisning i biologi, fysik och kemi ska ge eleverna förutsättningar att bland annat ta ställning i frågor med naturvetenskapligt innehåll, genomföra undersökningar och använda begrepp för att beskriva och förklara olika fenomen och sammanhang. Men hur vet man i vilken utsträckning eleverna har utvecklat dessa förmågor? Och hur kan man stödja elevernas fortsatta utveckling? I den här boken diskuteras vilka aspekter som ska bedömas i förhållande till de förmågor som beskrivs i kursplanerna för NO-ämnena samt hur bedömningen kan genomföras för att hjälpa eleverna att utveckla dessa förmågor. Huvudfokus ligger på strategier för formativ bedömning – hur man kommunicerar förväntningar till eleverna, ger konstruktiv återkoppling och låter eleverna arbeta med själv- och kamratbedömning – men boken tar även upp skriftliga omdömen, betyg, likvärdighet, nationella prov och sambedömning. Boken riktar sig i första hand till lärare, och blivande lärare, som undervisar i NO-ämnena i grundskolans årskurs 1–6. En stor del av innehållet är dock relevant även för andra årskurser och andra ämnen. Författarna har varit ansvariga för utvecklingen av Skolverkets diagnosmaterial i NO för årskurs 1–6 (DiNO) samt medverkar i konstruktionen av de nationella proven i biologi, fysik och kemi för årskurs 6.
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| 44. |
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| 45. |
- Larsson, Lena C, et al.
(författare)
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Induction of operational tolerance to discordant dopaminergic porcine xenografts.
- 2003
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Ingår i: Transplantation. - 1534-6080 .- 0041-1337. ; 75:9, s. 1448-1454
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Porcine embryonic neural tissue transplanted intracerebrally could potentially relieve the symptoms of Parkinson's disease if the immune response toward the graft could be overcome. However, conventional immunosuppressive treatments have proven inefficient in preventing rejection. An alternative is blocking the costimulatory signals for lymphocyte activation. Treatment with cytotoxic T-lymphocyte antigen 4 immunoglobulin (CTLA4Ig) and anti-CD40L has been successful in preventing rejection of xenografts in some experimental studies, but not all. Lymphocyte function antigen (LFA)-1 is an important costimulatory molecule for CD8+ T cells, and we hypothesize that blockade with anti-LFA-1 may enhance the efficacy of CTLA4Ig and anti-CD40L therapy. METHODS: C57BL/6 mice received intracerebral transplants of ventral mesencephalic tissue from embryonic porcine donors. CTLA4Ig, anti-CD40L, and anti-LFA-1 were administered every other day on days 0 to 8, and the transplants were studied after 4 to 6 weeks. Grafts were histologically analyzed for size, survival of dopaminergic nerve cells, and immune responses. Recipients were challenged with cultured glia cells of donor origin or an allogeneic skin graft to evaluate tolerance induction. RESULTS: Mice treated with all three substances had large grafts containing high amounts of dopamine cells but a low degree of immune response. Grafts in recipients challenged with glial cells showed an increased immunologic activity but were not rejected. Triple-treated mice showed a normal rejection process of the allogeneic skin grafts. CONCLUSION: After a short course of costimulation blocking therapy, discordant neural xenografts demonstrate long-term survival, withstand immunologic challenge, yet maintain host-versus-graft reactivity. Anti-LFA-1 complements CTLA4Ig and anti-CD40L in the induction of operational tolerance to these xenografts.
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| 46. |
- Larsson, Lena Cecilia, et al.
(författare)
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Simultaneous inhibition of B7 and LFA-1 signaling prevents rejection of discordant neural xenografts in mice lacking CD40L.
- 2002
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Ingår i: Xenotransplantation. - : Wiley. - 0908-665X. ; 9:1, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- Transplantation of embryonic human neural tissue can restore dopamine neurotransmission and improve neurological function in patients with Parkinson's disease. Logistical and ethical factors limit the availability of human embryonic allogeneic tissue. Embryonic xenogeneic neural tissue from porcine donors is an alternative form of donor tissue, but effective immunomodulatory techniques are warranted for neural xenotransplantation to become clinically feasible. We transplanted embryonic porcine ventral mesencephalic tissue into the brains of adult untreated C57BL/6 mice, untreated CD40L-/-mice and CD40L-/-mice that received injections of anti-LFA-1, CTLA41g or both compounds. Double-treated CD40L-/-mice had large grafts with high numbers of dopaminergic neurons 4 wk after transplantation. The grafts were completely devoid of lymphocytes, macrophages and activated microglia. Untreated C57BL/6 mice had rejected their grafts. Untreated CD40L-/-mice and CD40L-/-mice treated with monotherapy of anti-LFA-1 or CTLA41g had smaller grafts and more microglial and lymphocytic infiltration than double-treated CD40L-/-mice. We conclude that immunomodulation with concomitant inhibition of LFA-1 and B7 signaling in the perioperative period in CD40L-/-mice prevented the rejection of discordant neural xenografts. The treatment most likely reduced antigen presenting capacity and interfered with the costimulatory signaling needed for T cell activation to occur.
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| 47. |
- Lönnberg, Lena, et al.
(författare)
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Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care.
- 2020
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Ingår i: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; 125:3, s. 250-256
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite well-known preventive effects for future cardiovascular disease (CVD) risk through lifestyle changes, scientific evaluations of lifestyle programmes in primary care are scarce. Moreover, structured lifestyle counselling is still not integrated in everyday clinical practice. We aimed to evaluate change in cardiovascular risk factors and Framingham 10-year risk score of developing CVD in men and women at high cardiovascular risk after participation in a structured lifestyle programme over 1 year. A single-group study was carried out with a 1-year follow-up including before and after measurements.Methods: The lifestyle programme comprised five appointments to a district nurse over 1 year, focussing on lifestyle habits based on motivational interviewing. Fasting blood samples and anthropometric measurements were obtained at baseline and 1-year follow-up. The 10-year risk of CVD was calculated according to Framingham general CVD risk score.Results: A total of 404 patients were included in the study. There was a positive change over 1 year in the total study population for all risk factors evaluated. This included improvements in weight, waist circumference, blood pressure, blood lipids, and fasting glucose. The 10-year risk of developing CVD decreased for the total population from 24.8% to 21.4% at 1 year, equivalent to a 14% decrease.Conclusions: A structured lifestyle programme in primary care contributes to significant improvements of cardiovascular risk factors and the reduction of 10-year risk for CVD for both men and women at high cardiovascular risk.
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| 48. |
- Moro, Elena, et al.
(författare)
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Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease
- 2010
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185. ; 25:5, s. 578-586
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Tidskriftsartikel (refereegranskat)abstract
- We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-live STN patients and 16 GPi patienis were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN. P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with of regardless of the sequence of stimulation. In open assessment. both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN. P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society
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| 49. |
- Mäkitie, Antti A., et al.
(författare)
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Transoral Robotic Surgery in the Nordic Countries : Current Status and Perspectives
- 2018
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Ingår i: Frontiers in Oncology. - : Frontiers Media S.A.. - 2234-943X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: The five Nordic countries with a population of 27 M people form a rather homogenous region in terms of health care. The management of head and neck cancer is centralized to the 21 university hospitals in these countries. Our aim was to gain an overview of the volume and role of transoral robotic surgery (TORS) and to evaluate the need to centralize it in this area as the field is rapidly developing.Materials and Methods: A structured questionnaire was sent to all 10 Departments of Otorhinolaryngology-Head and Neck Surgery in the Nordic countries having an active programme for TORS in December 2017.Results: The total cumulative number of performed robotic surgeries at these 10 Nordic centers was 528 and varied between 5 and 240 per center. The median annual number of robotic surgeries was 38 (range, 5-60). The observed number of annually operated cases remained fairly low (<25) at most of the centers.Conclusions: The present results showing a limited volume of performed surgeries call for considerations to further centralize TORS in the Nordic countries.
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| 50. |
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