| 1. |
- Ahmad, Bassam, et al.
(författare)
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Svenska som andraspråk på språkintroduktion
- 2019
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Ingår i: Didaktisk utvecklingsdialog. - Lund : Studentlitteratur AB. - 9789144125749 ; , s. 67-84
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
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| 4. |
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| 5. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.522.7) and 16.5 cm (13.319.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 6. |
- Bentham, James, et al.
(författare)
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A century of trends in adult human height
- 2016
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Ingår i: eLIFE. - : eLife Sciences Publications Ltd. - 2050-084X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
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| 7. |
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| 8. |
- Forslund, Kristoffer, et al.
(författare)
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Gearing up to handle the mosaic nature of life in the quest for orthologs
- 2018
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Ingår i: Bioinformatics. - : Oxford University Press (OUP). - 1367-4803 .- 1367-4811. ; 34:2, s. 323-329
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Tidskriftsartikel (refereegranskat)abstract
- The Quest for Orthologs (QfO) is an open collaboration framework for experts in comparative phylogenomics and related research areas who have an interest in highly accurate orthology predictions and their applications. We here report highlights and discussion points from the QfO meeting 2015 held in Barcelona. Achievements in recent years have established a basis to support developments for improved orthology prediction and to explore new approaches. Central to the QfO effort is proper benchmarking of methods and services, as well as design of standardized datasets and standardized formats to allow sharing and comparison of results. Simultaneously, analysis pipelines have been improved, evaluated and adapted to handle large datasets. All this would not have occurred without the long-term collaboration of Consortium members. Meeting regularly to review and coordinate complementary activities from a broad spectrum of innovative researchers clearly benefits the community. Highlights of the meeting include addressing sources of and legitimacy of disagreements between orthology calls, the context dependency of orthology definitions, special challenges encountered when analyzing very anciently rooted orthologies, orthology in the light of whole-genome duplications, and the concept of orthologous versus paralogous relationships at different levels, including domain-level orthology. Furthermore, particular needs for different applications (e.g. plant genomics, ancient gene families and others) and the infrastructure for making orthology inferences available (e.g. interfaces with model organism databases) were discussed, with several ongoing efforts that are expected to be reported on during the upcoming 2017 QfO meeting.
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| 9. |
- Forslund, Tomas
(författare)
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Antithrombotic treatment of atrial fibrillation before and after the introduction of non-vitamin K antagonist oral anticoagulants (NOAC) in the Stockholm health care region
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Atrial fibrillation (AF) is the most common cardiac arrhythmia and the major risk factor for thromboembolic stroke. Effective treatment with the oral anticoagulant (OAC) warfarin has been available for decades. However warfarin treatment is complicated, and demands dose adjustments and regular monitoring. Warfarin also increases the risk for bleeding, especially intracranial bleeding which is rare but often fatal. Undertreatment of AF with OACs has long been a global problem and it has been common to use low-dose aspirin (ASA) instead, despite evidence of poor efficacy. Several new directly acting oral anticoagulants (NOACs) have been introduced in routine care based on promising results from randomised trials – the first being dabigatran in 2011, followed by rivaroxaban in 2012 and apixaban in 2013. The introduction of these drugs has brought hope of facilitating OAC treatment, increasing the proportion of patients treated, and possibly also improving the effectiveness and/or safety of treatment. This thesis is based on four population based epidemiological studies describing the antithrombotic treatment of AF before and after the introduction of NOACs in the Stockholm health care region using the health registry of the Stockholm health care region, Vårdanalysdatabasen (VAL). Study I-II describe the entire AF population in the region, including demographics, risk stratification, treatment, and outcomes before the introduction of NOACs. Study III-IV compare treatment persistence, adherence, effectiveness, and safety of different antithrombotic treatments. The analyses show that undertreatment was common prior to the introduction of NOACs, but many of the patients without anticoagulant treatment were old, with complicating co-morbidities, high bleeding risk and a poor prognosis in addition to a high risk of ischemic stroke. With NOACs there was a dramatic increase in the number of AF patients in the registries and a substantially larger proportion of the patients received OAC treatment. NOACs now dominate new treatment initiations, while warfarin has decreased substantially. In routine care warfarin and apixaban was associated with better persistence than dabigatran or rivaroxaban. Adherence with OAC treatment was high (>90%), and slightly better with the once daily regimen of rivaroxaban than the twice daily regimens of apixaban and dabigatran. NOAC treatment had similar or better effectiveness and safety compared to warfarin treatment, with similar outcomes among the elderly (≥80 years) and patients with previous severe bleeds. NOACs were associated with fewer intracranial bleeds, but more gastrointestinal bleeds. The advantages with NOAC treatment were most pronounced with standard dosing in patients under the age of 80, and with reduced doses in patients aged 80 and above. In conclusion, this thesis shows improvements in the management of AF in the Stockholm health care region and confirms that NOACs are attractive antithrombotic treatments for AF patients in routine care. More research is needed to further optimize the use of NOACs.
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| 10. |
- Forslund, Tomas, et al.
(författare)
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Improved Stroke Prevention in Atrial Fibrillation After the Introduction of Non-Vitamin K Antagonist Oral Anticoagulants
- 2018
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Ingår i: Stroke. - : Lippincott Williams & Wilkins. - 0039-2499 .- 1524-4628. ; 49:9, s. 2122-2128
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: The purpose of this study was to investigate the impact of improved antithrombotic treatment in atrial fibrillation after the introduction of non-vitamin K antagonist oral anticoagulants on the incidence of stroke and bleeding in a real-life total population, including both primary and secondary care.Methods: All resident and alive patients with a recorded diagnosis for atrial fibrillation during the preceding 5 years in the Stockholm County Healthcare database (Vårdanalysdatabasen) were followed for clinical outcomes during 2012 (n=41 008) and 2017 (n=49 510).Results: Pharmacy claims for oral anticoagulants increased from 51.6% to 73.8% (78.7% among those with CHA2DS2-VASc ≥2). Non-vitamin K antagonist oral anticoagulant claims increased from 0.4% to 34.4%. Ischemic stroke incidence rates decreased from 2.01 per 100 person-years in 2012 to 1.17 in 2017 (incidence rate ratio, 0.58; 95% CI, 0.52-0.65). The largest increases in oral anticoagulants use and decreases in ischemic strokes were seen in patients aged ≥80 years who had the highest risk of stroke and bleeding. The incidence rates for major bleeding (2.59) remained unchanged (incidence rate ratio, 1.00; 95% CI, 0.92-1.09) even in those with a high bleeding risk. Poisson regression showed that 10% of the absolute ischemic stroke reduction was associated with increased oral anticoagulants treatment, whereas 27% was related to a generally decreased risk for all stroke.Conclusions: Increased oral anticoagulants use contributed to a marked reduction of ischemic strokes without increasing bleeding rates between 2012 and 2017. The largest stroke reduction was seen in elderly patients with the highest risks for stroke and bleeding. These findings strongly support the adoption of current guideline recommendations for stroke prevention in atrial fibrillation in both primary and secondary care.
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| 11. |
- Forslund, Tomas, et al.
(författare)
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More with atrial fibrillation, anticoagulants since the coming of NOAK [Fler med förmaksflimmer får antikoagulantia sedan NOAK kom]
- 2015
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Ingår i: Läkartidningen. - : Läkartidningen AB. - 0023-7205 .- 1652-7518. ; 112
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Sedan introduktionen av NOAK (non-vitamin K antagonist oral anticoagulants) som trombosprofylax vid förmaksflimmer har det skett en markant ökning av antalet diagnostiserade patienter med förmaksflimmer i Stockholms läns landsting. Andelen som är behandlade med antikoagulantia har samtidigt ökat från 47 till 58 procent. Vid nyinsättning är NOAK lika vanliga som warfarin i nuläget. Förskrivningen av ASA sjunker kraftigt. NOAK-förskrivningen har varit avvaktande avseende de äldsta patienterna med hög risk för stroke, blödning och nedsatt njurfunktion.
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| 12. |
- Forslund, Tomas, et al.
(författare)
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Patterns of multimorbidity and pharmacotherapy : a total population cross-sectional study.
- 2020
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Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 38:2, s. 132-140
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment of multimorbid patients can be improved. Development of patient-centred care of high-quality requires context-bound understanding of the multimorbid population's patterns of demographics, co-morbidities and medication use.OBJECTIVE: The aim of this study was to identify patterns of multimorbidity in the total population of Region Stockholm, Sweden, by exploring demographics, claimed prescription drugs, risk of mortality and non-random association of conditions.METHODS: In this cross-sectional descriptive population-based cohort study, we extracted data from the Swedish VAL database (N = 2 323 667) including all consultations in primary and specialized outpatient care, all inpatient care and all prescriptions claimed during 2017. We report number of chronic conditions and claimed prescription drugs, physical and mental co-morbidity, and 1-year mortality. We stratified the analyses by sex. We examined non-random associations between diseases using cluster analysis.RESULTS: In total, 21.6% had multimorbidity (two or more chronic conditions) and 24.1% had polypharmacy (more than five claimed prescription drugs). Number of claimed drugs, co-occurrence of mental and physical conditions, and 1-year mortality increased as multimorbidity increased. We identified seven multimorbidity clusters with clinically distinct characteristics. The smallest cluster (7% of individuals) had prominent cardiovascular disease, the highest 1-year mortality rate, high levels of multimorbidity and polypharmacy, and was much older. The largest cluster (27% of individuals) was younger and heterogenous, with primarily mental health problems.CONCLUSIONS: Individuals with chronic conditions often show clinical complexity with both concordant and discordant conditions and polypharmacy. This study indicates that clinical guidelines addressing clustering of conditions may be one strategy for managing complexity.
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| 13. |
- Forslund, Tomas, et al.
(författare)
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Risk scoring and thromboprophylactic treatment of patients with atrial fibrillation with and without access to primary healthcare data : experience from the Stockholm health care system
- 2013
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Ingår i: International Journal of Cardiology. - Amsterdam, Netherlands : Elsevier. - 0167-5273 .- 1874-1754. ; 34, s. 746-746
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Earlier validation studies of risk scoring by CHA2DS2VASc for assessments of appropriateness of warfarin treatment in patients with atrial fibrillation have been performed solely with diagnoses recorded in hospital based care, even though many patients to a large extent are managed in primary care.METHODS: Cross-sectional registry study of all 43 353 patients with a diagnosis of non-valvular atrial fibrillation recorded in inpatient care, specialist ambulatory care or primary care in the Stockholm County during 2006-2010.RESULTS: The mean CHA2DS2VASc score was 3.82 (4.67 for women and 3.14 for men). 64% of the entire cohort of patients with atrial fibrillation had the diagnosis in primary care (12% only there). The mean CHA2DS2VASc score of patients with a diagnosis only in inpatient care or specialist ambulatory care increased from 3.63 to 3.83 when comorbidities registered in primary care were added. In 2010 warfarin prescriptions were claimed by 47.2%, and ASA by 41.6% of the entire cohort. 34% of patients with CHA2DS2VASc=1 and 20% with CHA2DS2VASc=0 had warfarin treatment. ASA was more frequently used instead of warfarin among women and elderly patients.CONCLUSIONS: Registry CHA2DS2VASc scores were underestimated without co-morbidity data from primary care. Many individuals with scores 0 and 1 were treated with warfarin, despite poor documentation of clinical benefit. In contrast, warfarin appears to be underused and ASA overused among high risk atrial fibrillation patients. Lack of diagnoses from primary care underestimated CHA2DS2VASc scores and may thereby have overestimated treatment benefits in low-risk patients in earlier studies.
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| 14. |
- Forslund, Tomas, et al.
(författare)
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Risks for stroke and bleeding with warfarin or aspirin treatment in patients with atrial fibrillation at different CHA(2)DS(2)VASc scores : experience from the Stockholm region
- 2014
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Ingår i: European Journal of Clinical Pharmacology. - Berlin, germany : Springer. - 0031-6970 .- 1432-1041. ; 70:12, s. 1477-1485
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study evaluated the benefits of and possible contraindications to warfarin treatment in patients with atrial fibrillation (AF) prior to the introduction of new oral anticoagulants using health registry data from inpatient care, specialist ambulatory care, and primary care.METHODS: This is a cohort study including all patients in the region of Stockholm, Sweden (2.1 million inhabitants) with a diagnosis of non-valvular AF (n = 41 810) recorded during 2005-2009. The risks of suffering ischemic stroke, bleeding, or death with warfarin, aspirin, or no antithrombotic treatment during 2010 were related to CHA2DS2VASc scores, age, and complicating co-morbidities.RESULTS: One-year risks for ischemic stroke were 1.0-1.2 % with aspirin, 0-0.3 % with warfarin, and 0.1-0.2 % without treatment at CHA2DS2VASc scores 0-1. Among the aspirin-treated patients with CHA2DS2VASc scores ≥2, half had possible contraindications and high risks for ischemic stroke (5.2 %), bleeding (5.0 %), and death (19.3 %). The other half of the patients with no identified contraindications had a high risk for ischemic stroke (4.0 %) but a low bleeding risk (1.8 %) and a moderate mortality rate (8.4 %).CONCLUSIONS: The present observations confirm earlier findings of undertreatment with warfarin and half of the high-risk patients treated with aspirin were obvious candidates for anticoagulant treatment. However, the other half of the patients had complicating co-morbidities, high bleeding risk, and poor prognosis. This and possible overtreatment of low-risk patients should be taken into account when considering more aggressive use of anticoagulant treatment.
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| 15. |
- Hjemdahl, Paul, et al.
(författare)
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Förbättrad strokeprevention vid förmaksflimmer med NOAK [Improved stroke prevention in atrial fibrillation: The stockholm experience of the introduction of NOACs]
- 2018
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Ingår i: Läkartidningen. - : Läkartidningen AB. - 0023-7205 .- 1652-7518. ; 115:46
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The introduction of NOACs has put a focus on stroke prevention in atrial fibrillation (AF). The number of patients in Stockholm diagnosed with non-valvular AF increased from 41 008 in 2011 to 51 266 in 2017 and their treatment has been markedly improved. Between 2011 and 2017 total oral anticoagulant treatment increased from 51.6% (warfarin) to 77.3% (31% warfarin, 46.3% NOACs) and aspirin decreased from 31.6% to 7.2%. Treatment was especially improved among patients with CHA2DS2-VASc scores ≥2 and elderly high risk patients. We found an excellent persistence with OAC treatment (88% at 1 year and 83% at 2 years). A comparative effectiveness study showed that NOACs were at least as effective and safe as warfarin even among patients ≥80 years or with previous serious bleeds. After a gradual introduction of NOACs with many educational activities apixaban is now the first-line choice for stroke prevention in AF in Stockholm. Swedish guideline goals are fulfilled and outcomes are improved.
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| 16. |
- Komen, Joris J., et al.
(författare)
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Association of Preceding Antithrombotic Therapy in Atrial Fibrillation Patients With Ischemic Stroke, Intracranial Hemorrhage, or Gastrointestinal Bleed and Mortality
- 2021
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Ingår i: European Heart Journal - Cardiovascular Pharmacotherapy. - Oxford : Oxford University Press. - 2055-6837 .- 2055-6845. ; 7:1, s. 3-10
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To analyze 90-day mortality in AF patients after a stroke or a severe bleed and assess associations with the type of antithrombotic treatment at the event.METHODS AND RESULTS: From the Stockholm Healthcare database, we selected 6 017 patients with a known history of AF who were diagnosed with ischemic stroke, 3 006 with intracranial hemorrhage, and 4 291 with a severe gastrointestinal bleed (GIB). The 90-day mortality rates were 25.1% after ischemic stroke, 31.6% after intracranial hemorrhage, and 16.2% after severe GIB. We used Cox regression and propensity score matched analyses to test the association between antithrombotic treatment at the event and 90-day mortality. After intracranial hemorrhage, there was a significantly higher mortality rate in warfarin compared to NOAC treated patients (adjusted hazard ratio (aHR): 1.36 CI: 1.04 - 1.78). After an ischemic stroke and a severe GIB, patients receiving antiplatelets or no antithrombotic treatment had significantly higher mortality rates compared to patients on NOACs, but there was no difference comparing warfarin to NOACs (aHR 0.84 CI: 0.63 - 1.12 after ischemic stroke, aHR 0.91 CI: 0.66 - 1.25 after severe GIB). Propensity score matched analysis yielded similar results.CONCLUSION: Mortality rates were high in AF patients suffering from an ischemic stroke, an intracranial hemorrhage, or a severe GIB. NOAC treatment was associated with a lower 90 day mortality after intracranial hemorrhage than warfarin.
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| 17. |
- Komen, Joris J., et al.
(författare)
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Oral anticoagulants in patients with atrial fibrillation at low stroke risk : a multicentre observational study
- 2022
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Ingår i: European Heart Journal. - : OXFORD UNIV PRESS. - 0195-668X .- 1522-9645. ; 43:37, s. 3528-3538
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Tidskriftsartikel (refereegranskat)abstract
- Aims There is currently no consensus on whether atrial fibrillation (AF) patients at low risk for stroke (one non-sex-related CHA(2)DS(2)-VASc point) should be treated with an oral anticoagulant. Methods and results We conducted a multi-country cohort study in Sweden, Denmark, Norway, and Scotland. In total, 59 076 patients diagnosed with AF at low stroke risk were included. We assessed the rates of stroke or major bleeding during treatment with a non-vitamin K antagonist oral anticoagulant (NOAC), a vitamin K antagonist (VKA), or no treatment, using inverse probability of treatment weighted (IPTW) Cox regression. In untreated patients, the rate for ischaemic stroke was 0.70 per 100 person-years and the rate for a bleed was also 0.70 per 100 person-years. Comparing NOAC with no treatment, the stroke rate was lower [hazard ratio (HR) 0.72; 95% confidence interval (CI) 0.56-0.94], and the rate for intracranial haemorrhage (ICH) was not increased (HR 0.84; 95% CI 0.54-1.30). Comparing VKA with no treatment, the rate for stroke tended to be lower (HR 0.81; 95% CI 0.59-1.09), and the rate for ICH tended to be higher during VKA treatment (HR 1.37; 95% CI 0.88-2.14). Comparing NOAC with VKA treatment, the rate for stroke was similar (HR 0.92; 95% CI 0.70-1.22), but the rate for ICH was lower during NOAC treatment (HR 0.63; 95% CI 0.42-0.94). Conclusion These observational data suggest that NOAC treatment may be associated with a positive net clinical benefit compared with no treatment or VKA treatment in patients at low stroke risk, a question that can be tested through a randomized controlled trial. Key question What is the association between anticoagulant treatment and stroke and bleeding rate, in patients with one non-sex-related risk factor for stroke? Key findings Non-vitamin K antagonist oral anticoagulant (NOAC) treatment was associated with a lower stroke rate compared with no treatment. Non-vitamin K antagonist oral anticoagulant treatment was associated with a lower rate of intracranial haemorrhage compared with vitamin K antagonist (VKA) treatment. Take-home message These observational data suggest that NOAC treatment may be associated with a positive net clinical benefit compared with no treatment or VKA treatment in patients at low stroke risk, a hypothesis that can be tested through a randomized controlled trial.
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| 18. |
- Komen, Joris J, et al.
(författare)
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Persistence and adherence to non-vitamin K antagonist oral anticoagulant treatment in patients with atrial fibrillation across five Western European countries
- 2021
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 23:11, s. 1722-1730
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo assess persistence and adherence to non-vitamin K antagonist oral anticoagulant (NOAC) treatment in patients with atrial fibrillation (AF) in five Western European healthcare settings.Methods and resultsWe conducted a multi-country observational cohort study, including 559 445 AF patients initiating NOAC therapy from Stockholm (Sweden), Denmark, Scotland, Norway, and Germany between 2011 and 2018. Patients were followed from their first prescription until they switched to a vitamin K antagonist, emigrated, died, or the end of follow-up. We measured persistence and adherence over time and defined adequate adherence as medication possession rate ≥90% among persistent patients only.ResultsOverall, persistence declined to 82% after 1 year and to 63% after 5 years. When including restarters of NOAC treatment, 85% of the patients were treated with NOACs after 5 years. The proportion of patients with adequate adherence remained above 80% throughout follow-up. Persistence and adherence were similar between countries and was higher in patients starting treatment in later years. Both first year persistence and adherence were lower with dabigatran (persistence: 77%, adherence: 65%) compared with apixaban (86% and 75%) and rivaroxaban (83% and 75%) and were statistically lower after adjusting for patient characteristics. Adherence and persistence with dabigatran remained lower throughout follow-up.ConclusionPersistence and adherence were high among NOAC users in five Western European healthcare settings and increased in later years. Dabigatran use was associated with slightly lower persistence and adherence compared with apixaban and rivaroxaban.
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| 19. |
- Loikas, Desirée, et al.
(författare)
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Sex and Gender Differences in Thromboprophylactic Treatment of Patients With Atrial Fibrillation After the Introduction of Non-Vitamin K Oral Anticoagulants
- 2017
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Ingår i: American Journal of Cardiology. - : Elsevier. - 0002-9149 .- 1879-1913. ; 120:8, s. 1302-1308
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Tidskriftsartikel (refereegranskat)abstract
- To examine sex differences in thromboprophylaxis in patients with atrial fibrillation before and after the introduction of non-vitamin K oral anticoagulants, we performed a cross-sectional registry study based on anonymized individual-level patient data of all individuals with a diagnosis of nonvalvular atrial fibrillation (International Classification of Diseases, Tenth Revision code I48) in the region of Stockholm, Sweden (2.2 million inhabitants), in 2011 and 2015, respectively. Thromboprophylaxis improved considerably during the period. During 2007 to 2011, 23,198 men and 18,504 women had an atrial fibrillation diagnosis. In 2011, more men than women (53% men vs 48% women) received oral anticoagulants (almost exclusively warfarin) and more women received aspirin only (35% women vs 30% men), whereas there was no sex difference for no thromboprophylaxis (17%). During 2011 to 2015, 27,237 men and 20,461 women had a diagnosis of atrial fibrillation. Compared with the earlier time period, a higher proportion used oral anticoagulants (71% women vs 70% men), but fewer women ≥80 years received anticoagulants (67% women vs 72% men), more women received aspirin (15% women vs 13% men), and fewer women had no thromboprophylaxis (15% women vs 17% men). Patients with co-morbidities potentially complicating oral anticoagulant use used more oral anticoagulant in 2015 compared with 2011. The sex differences observed in 2011 with fewer women using oral anticoagulants had disappeared in 2015 except in women 80 years and older and in patients with complicated co-morbidity.
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| 20. |
- Nord, Maria, et al.
(författare)
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The effectiveness of area protection to capture coastal bird richness and occurrence in the Swedish archipelago
- 2019
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Ingår i: Global Ecology and Conservation. - : Elsevier BV. - 2351-9894. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Protected areas are a key component in biodiversity conservation strategies, but evaluations of how effective they are in capturing species diversity is lacking for many ecosystems. We compared different protection types (animal sanctuaries, nature reserves and unprotected areas) using data on species richness and occurrence of coastal breeding bird species in a large archipelago in the Baltic Sea. Data were from extensive inventories based on a grid with 1 x 1 km resolution covering 4646 km(2) on the East coast of Sweden. We focused on specialist species breeding exclusively in coastal habitats since these species are of specific conservation concern, but considered generalists, which also breeds in inland wetlands, as well. Animal sanctuaries had significantly higher species richness of specialist species than unprotected areas and nature reserves. Nature reserves had even lower richness of specialist species than unprotected areas. Further, a rarity-weighted diversity index showed that animal sanctuaries were better in capturing hotspots of bird diversity compared to nature reserves and unprotected areas. Hotspots, both protected and unprotected, were scattered throughout the entire archipelago. The rarity-weighted richness is therefore useful to identify gaps in the protected area network. Overall, we conclude that the establishment of animal sanctuaries has been a successful conservation measure for protecting specialist species in several aspects. Ongoing human exploitation of the Baltic archipelagos prompt further consideration of protecting still unprotected but species rich shorelines for the benefit of many coastal breeding birds.
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| 21. |
- Paquet, Matthieu, et al.
(författare)
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Integrated population models poorly estimate the demographic contribution of immigration
- 2021
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Ingår i: Methods in Ecology and Evolution. - 2041-210X. ; 12, s. 1899-1910
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Tidskriftsartikel (refereegranskat)abstract
- Estimating the contribution of demographic parameters to changes in population growth is essential for understanding why populations fluctuate. Integrated population models (IPMs) offer a possibility to estimate the contributions of additional demographic parameters, for which no data have been explicitly collected-typically immigration. Such parameters are often subsequently highlighted as important drivers of population growth. Yet, accuracy in estimating their temporal variation, and consequently their contribution to changes in population growth rate, has not been investigated. To quantify the magnitude and cause of potential biases when estimating the contribution of immigration using IPMs, we simulated data (using northern wheatear Oenanthe oenanthe population estimates) from controlled scenarios to examine potential biases and how they depend on IPM parameterization, formulation of priors, the level of temporal variation in immigration and sample size. We also used empirical data on populations with known rates of immigration: Soay sheep Ovis aries and Mauritius kestrel Falco punctatus with zero immigration and grey wolf Canis lupus in Scandinavia with near-zero immigration. IPMs strongly overestimated the contribution of immigration to changes in population growth in scenarios when immigration was simulated with zero temporal variation (proportion of variance attributed to immigration = 63% for the more constrained formulation and real sample size) and in the wild populations, where the true number of immigrants was zero or near-zero (kestrel 19.1%-98.2%, sheep 4.2%-36.1% and wolf 84.0%-99.2%). Although the estimation of the contribution of immigration in the simulation study became more accurate with increasing temporal variation and sample size, it was often not possible to distinguish between an accurate estimation from data with high temporal variation versus an overestimation from data with low temporal variation. Unrealistically, large sample sizes may be required to estimate the contribution of immigration well. To minimize the risk of overestimating the contribution of immigration (or any additional parameter) in IPMs, we recommend to: (a) look for evidence of variation in immigration before investigating its contribution to population growth, (b) simulate and model data for comparison to the real data and (c) use explicit data on immigration when possible.
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| 22. |
- Paquet, Matthieu, et al.
(författare)
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Quantifying the links between land use and population growth rate in a declining farmland bird
- 2019
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Ingår i: Ecology and Evolution. - : Wiley. - 2045-7758. ; 9, s. 868-879
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Tidskriftsartikel (refereegranskat)abstract
- Land use is likely to be a key driver of population dynamics of species inhabiting anthropogenic landscapes, such as farmlands. Understanding the relationships between land use and variation in population growth rates is therefore critical for the management of many farmland species. Using 24 years of data of a declining farmland bird in an integrated population model, we examined how spatiotemporal variation in land use (defined as habitats with Short and Tall ground vegetation during the breeding season) and habitat-specific demographic parameters relates to variation in population growth taking into account individual movements between habitats. We also evaluated contributions to population growth using transient life table response experiments which gives information on contribution of past variation of parameters and real-time elasticities which suggests future scenarios to change growth rates. LTRE analyses revealed a clear contribution of Short habitats to the annual variation in population growth rate that was mostly due to fledgling recruitment, whereas there was no evidence for a contribution of Tall habitats. Only 18% of the variation in population growth was explained by the modeled local demography, the remaining variation being explained by apparent immigration (i.e., the residual variation). We discuss potential biological and methodological reasons for high contributions of apparent immigration in open populations. In line with LTRE analysis, real-time elasticity analysis revealed that demographic parameters linked to Short habitats had a stronger potential to influence population growth rate than those of Tall habitats. Most particularly, an increase of the proportion of Short sites occupied by Old breeders could have a distinct positive impact on population growth. High-quality Short habitats such as grazed pastures have been declining in southern Sweden. Converting low-quality to high-quality habitats could therefore change the present negative population trend of this, and other species with similar habitat requirements.
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| 23. |
- Paquet, Matthieu, et al.
(författare)
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Why we should care about movements: Using spatially explicit integrated population models to assess habitat source-sink dynamics
- 2020
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Ingår i: Journal of Animal Ecology. - : Wiley. - 0021-8790 .- 1365-2656. ; 89, s. 2922-2933
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Tidskriftsartikel (refereegranskat)abstract
- Assessing the source-sink status of populations and habitats is of major importance for understanding population dynamics and for the management of natural populations. Sources produce a net surplus of individuals (per capita contribution to the metapopulation > 1) and will be the main contributors for self-sustaining populations, whereas sinks produce a deficit (contribution < 1). However, making these types of assessments is generally hindered by the problem of separating mortality from permanent emigration, especially when survival probabilities as well as moved distances are habitat-specific. To address this long-standing issue, we propose a spatial multi-event integrated population model (IPM) that incorporates habitat-specific dispersal distances of individuals. Using information about local movements, this IPM adjusts survival estimates for emigration outside the study area. Analysing 24 years of data on a farmland passerine (the northern wheatearOenanthe oenanthe), we assessed habitat-specific contributions, and hence the source-sink status and temporal variation of two key breeding habitats, while accounting for habitat- and sex-specific local dispersal distances of juveniles and adults. We then examined the sensitivity of the source-sink analysis by comparing results with and without accounting for these local movements. Estimates of first-year survival, and consequently habitat-specific contributions, were higher when local movement data were included. The consequences from including movement data were sex specific, with contribution shifting from sink to likely source in one habitat for males, and previously noted habitat differences for females disappearing. Assessing the source-sink status of habitats is extremely challenging. We show that our spatial IPM accounting for local movements can reduce biases in estimates of the contribution by different habitats, and thus reduce the overestimation of the occurrence of sink habitats. This approach allows combining all available data on demographic rates and movements, which will allow better assessment of source-sink dynamics and better informed conservation interventions.
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| 24. |
- Pärt, Tomas, et al.
(författare)
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Unclear relationships between mean survival rate and its environmental variance in vertebrates
- 2024
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Ingår i: Ecology and Evolution. - : Wiley. - 2045-7758. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- Current environmental changes may increase temporal variability of life history traits of species thus affecting their long-term population growth rate and extinction risk. If there is a general relationship between environmental variances (EVs) and mean annual survival rates of species, that relationship could be used as a guideline for analyses of population growth and extinction risk for populations, where data on EVs are missing. For this purpose, we present a comprehensive compilation of 252 EV estimates from 89 species belonging to five vertebrate taxa (birds, mammals, reptiles, amphibians and fish) covering mean annual survival rates from 0.01 to 0.98. Since variances of survival rates are constrained by their means, particularly for low and high mean survival rates, we assessed whether any observed relationship persisted after applying two types of commonly used variance stabilizing transformations: relativized EVs (observed/mathematical maximum) and logit-scaled EVs. With raw EVs at the arithmetic scale, mean–variance relationships of annual survival rates were hump-shaped with small EVs at low and high mean survival rates and higher (and widely variable) EVs at intermediate mean survival rates. When mean annual survival rates were related to relativized EVs the hump-shaped pattern was less distinct than for raw EVs. When transforming EVs to logit scale the relationship between mean annual survival rates and EVs largely disappeared. The within-species juvenile-adult slopes were mainly positive at low (<0.5) and negative at high (>0.5) mean survival rates for raw and relativized variances while these patterns disappeared when EVs were logit transformed. Uncertainties in how to interpret the results of relativized and logit-scaled EVs, and the observed high variation in EV's for similar mean annual survival rates illustrates that extrapolations of observed EVs and tests of life history drivers of survival–EV relationships need to also acknowledge the large variation in these parameters.
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| 25. |
- Wilhelmsson, Margareta, et al.
(författare)
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How to think about interprofessional competence: A metacognitive model
- 2012
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Ingår i: Journal of Interprofessional Care. - : Informa Healthcare. - 1356-1820 .- 1469-9567. ; 26:2, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Different professions meet and work together in teams every day in health and social care. To identify and deliver the best quality of care for the patient, teamwork should be both professionally and interprofessionally competent. How can enhanced education prepare teamworkers to be both professionally and interprofessionally competent? To achieve interprofessional skills and design effective interprofessional curricula, there is a need for metacognitive frameworks focusing on the relationship between theories and the problem-solving process as well as the structure and content of professional competence. The aim of this article is to discuss the need for shared metacognitive structures/models as a tool for securing successful interprofessional learning and developing personal, professional and interprofessional competence to improve the quality of care. A metacognitive model for interprofessional education and practice is presented in this article. This model has been developed as a tool for analyzing professional competence on three levels: individual, team and organization. The model comprises seven basic components of professional competence and the way they are related and interact. Examples of how this metacognitive model can be used in the early, middle and late stages in interprofessional education are given.
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| 26. |
- Zhou, Bin, et al.
(författare)
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Worldwide trends in diabetes since 1980: A pooled analysis of 751 population-based studies with 4.4 million participants
- 2016
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Ingår i: The Lancet. - : Elsevier B.V.. - 0140-6736 .- 1474-547X. ; 387:10027, s. 1513-1530
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the global targets for non-communicable diseases is to halt, by 2025, the rise in the age standardised adult prevalence of diabetes at its 2010 levels. We aimed to estimate worldwide trends in diabetes, how likely it is for countries to achieve the global target, and how changes in prevalence, together with population growth and ageing, are aff ecting the number of adults with diabetes.Methods: We pooled data from population-based studies that had collected data on diabetes through measurement of its biomarkers. We used a Bayesian hierarchical model to estimate trends in diabetes prevalence-defined as fasting plasma glucose of 7.0 mmol/L or higher, or history of diagnosis with diabetes, or use of insulin or oral hypoglycaemic drugs-in 200 countries and territories in 21 regions, by sex and from 1980 to 2014. We also calculated the posterior probability of meeting the global diabetes target if post-2000 trends continue.Findings: We used data from 751 studies including 4372000 adults from 146 of the 200 countries we make estimates for. Global age-standardised diabetes prevalence increased from 4.3% (95% credible interval 2.4-17.0) in 1980 to 9.0% (7.2-11.1) in 2014 in men, and from 5.0% (2.9-7.9) to 7.9% (6.4-9.7) in women. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014 (28.5% due to the rise in prevalence, 39.7% due to population growth and ageing, and 31.8% due to interaction of these two factors). Age-standardised adult diabetes prevalence in 2014 was lowest in northwestern Europe, and highest in Polynesia and Micronesia, at nearly 25%, followed by Melanesia and the Middle East and north Africa. Between 1980 and 2014 there was little change in age-standardised diabetes prevalence in adult women in continental western Europe, although crude prevalence rose because of ageing of the population. By contrast, age-standardised adult prevalence rose by 15 percentage points in men and women in Polynesia and Micronesia. In 2014, American Samoa had the highest national prevalence of diabetes (>30% in both sexes), with age-standardised adult prevalence also higher than 25% in some other islands in Polynesia and Micronesia. If post-2000 trends continue, the probability of meeting the global target of halting the rise in the prevalence of diabetes by 2025 at the 2010 level worldwide is lower than 1% for men and is 1% for women. Only nine countries for men and 29 countries for women, mostly in western Europe, have a 50% or higher probability of meeting the global target.Interpretation: Since 1980, age-standardised diabetes prevalence in adults has increased, or at best remained unchanged, in every country. Together with population growth and ageing, this rise has led to a near quadrupling of the number of adults with diabetes worldwide. The burden of diabetes, both in terms of prevalence and number of adults aff ected, has increased faster in low-income and middle-income countries than in high-income countries.
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