| 1. |
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| 2. |
- Browaldh, Lars, et al.
(författare)
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Celiaki är en vanlig sjukdom som är lätt att missa
- 2014
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Ingår i: Läkartidningen. - : Swedish Medical Association. - 0023-7205 .- 1652-7518. ; 111:11, s. 484-488
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Tidskriftsartikel (refereegranskat)abstract
- Celiaki ansågs länge som en ovanlig barnsjukdom, men är en vanlig sjukdom som drabbar alla åldrar. Genomförda screeningar av normalbefolkningen visar att merparten inte fått diagnos eller behandling. Den kliniska bilden varierar: alltifrån diffusa besvär eller inga symtom alls till allvarliga gastrointestinala symtom med grav avmagring och tillväxtrubbning till följd av malabsorption. Klinisk misstanke om eller hereditet för celiaki bör föranleda analys av specifika serologiska markörer. Gastroskopi med tunntarmsbiopsi bör övervägas för att bekräfta eller utesluta diagnosen.
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| 3. |
- Dalmar, Abdirisak Ahmed, et al.
(författare)
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Rebuilding research capacity in fragile states : the case of a Somali-Swedish global health initiative
- 2017
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Ingår i: Global Health Action. - Abingdon : Informa UK Limited. - 1654-9716 .- 1654-9880. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.
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| 4. |
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| 5. |
- Ivarsson, Anneli, et al.
(författare)
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Prevalence of Childhood Celiac Disease and Changes in Infant Feeding
- 2013
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Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 131:3, s. E687-E694
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Between 1984 and 1996, Sweden experienced an "epidemic" of clinical celiac disease in children andlt;2 years of age, attributed partly to changes in infant feeding. Whether infant feeding affects disease occurrence and/or the clinical presentation remains unknown. We investigated and compared the total prevalence of celiac disease in 2 birth cohorts of 12-year-olds and related the findings to each cohorts ascertained infant feeding. less thanbrgreater than less thanbrgreater thanMETHODS: A 2-phase cross-sectional screening study was performed in which 13 279 children from 2 birth cohorts participated: children born during the epidemic (1993) and children born after the epidemic (1997). Previously diagnosed cases were reported and confirmed. Blood samples were analyzed for serological markers and children with positive values were referred for small intestinal biopsy. Infant feeding practices in the cohorts were ascertained via questionnaires. Prevalence comparisons were expressed as prevalence ratios. less thanbrgreater than less thanbrgreater thanRESULTS: The total prevalence of celiac disease was 29 in 1000 and 22 in 1000 for the 1993 and 1997 cohorts, respectively. Children born in 1997 had a significantly lower risk of having celiac disease compared with those born in 1993 (prevalence ratio: 0.75; 95% confidence interval: 0.60-0.93; P = .01). The cohorts differed in infant feeding (specifically, in the proportion of infants introduced to dietary gluten in small amounts during ongoing breastfeeding). less thanbrgreater than less thanbrgreater thanCONCLUSIONS: A significantly reduced prevalence of celiac disease in 12-year-olds indicates an option for disease prevention. Our findings suggest that the present infant feeding recommendation to gradually introduce gluten-containing foods from 4 months of age, preferably during ongoing breastfeeding, is favorable. Pediatrics 2013;131:e687-e694
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| 6. |
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| 7. |
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| 8. |
- Kjellström, Barbro, et al.
(författare)
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Societal costs associated to chronic thromboembolic pulmonary hypertension : A study utilizing linked national registries
- 2023
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Ingår i: Pulmonary Circulation. - : WILEY. - 2045-8932 .- 2045-8940. ; 13:2
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Tidskriftsartikel (refereegranskat)abstract
- Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but serious complication after a pulmonary embolism. Healthcare resource utilization (HCRU; hospitalization, outpatient visits, and drug utilization) as well as productivity loss (sick leave and disability pension) before and after the CTEPH diagnosis is sparsely studied. By linking several Swedish national databases, this study estimated the societal costs in a national CTEPH cohort (n = 369, diagnosed with CTEPH in 2008−2019) 5 years before and 5 years after diagnosis (index date) and compared to an age, sex, and geographically matched control group (n = 1845, 1:5 match). HCRU and productivity loss were estimated per patient per year. Patients were stratified as operated with pulmonary endarterectomy (PEA group) or not operated (non-PEA group). Direct and indirect societal costs were 2.1 times higher before, and 8.1 times higher after the index date for patients with CTEPH compared to the matched control groups. The higher costs were evident already several years preceding the index date. The main cost driver before the index date in both the PEA and the non-PEA groups was productivity loss. The productivity loss remained high for both groups in the 5-year period following the index date, but the main cost drivers were prescribed drugs and hospitalizations for patients that underwent PEA and prescribed drugs in the non-PEA group. In conclusion, CTEPH was associated with large societal costs related to healthcare consumption and productivity loss, both before and after diagnosis.
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| 9. |
- Myléus, Anna, 1978-, et al.
(författare)
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Celiac disease revealed in 3% of Swedish 12-year-olds born during an epidemic
- 2009
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - New York : Raven P. - 0277-2116 .- 1536-4801. ; 49:2, s. 170-176
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Tidskriftsartikel (refereegranskat)abstract
- Objetive: Sweden experienced a marked epidemic of celiac disease between 1984 and 1996 in children younger than 2 years of age, partly explained by changes in infant feeding. The objective of this study was to determine the prevalence of celiac disease in 12-year-olds born during the epidemic (1993), including both symptomatic and screening detected cases.Patients and methods: All sixth-grade children in participating schools were invited (n = 10,041). Symptomatic and, therefore, previously diagnosed celiac disease cases were ascertained through the National Swedish Childhood Celiac Disease Register and/or medical records. All serum samples were analyzed for antihuman tissue transglutaminase (tTG)-IgA (Celikey), and serum-IgA, and some for tTG-IgG and endomysial antibodies. A small intestinal biopsy was recommended for all children with suspected undiagnosed celiac disease.Results: Participation was accepted by 7567 families (75%). Previously diagnosed celiac disease was found in 67 children; 8.9/1000 (95% confidence interval [CI] 6.7-11). In another 192 children, a small intestinal biopsy was recommended and was performed in 180. Celiac disease was verified in 145 children, 20/1000 (95% CI 17-23). The total prevalence was 29/1000 (95% CI 25-33).Conclusions: The celiac disease prevalence of 29/1000 (3%)-with two thirds of cases undiagnosed before screening-is 3-fold higher than the usually suggested prevalence of 1%. When these 12-year-olds were infants, the prevailing feeding practice was to introduce gluten abruptly, often without ongoing breast-feeding, which might have contributed to this unexpectedly high prevalence.
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| 10. |
- Myléus, Anna, MD PhD, et al.
(författare)
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Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease
- 2019
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 108:6, s. 1140-1143
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Tidskriftsartikel (refereegranskat)abstract
- Aim: In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction.Methods: In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies.Results: All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia.Conclusion: The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.
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| 11. |
- Nordyke, Katrina, et al.
(författare)
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Health-related quality-of-life in children with coeliac disease, measured prior to receiving their diagnosis through screening
- 2011
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Ingår i: Journal of Medical Screening. - : SAGE Publications. - 1475-5793 .- 0969-1413. ; 18:4, s. 187-192
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare the health-related quality-of-life (HRQoL) of children with screening-detected coeliac disease (CD), before they learned of their diagnosis, with that of children without CD and in those previously diagnosed with CD. Methods In a cross-sectional CD screening study ('ETICS': Exploring the Iceberg of Coeliacs in Sweden), of 10,041 Swedish 12-year-olds invited, 7567 (75%) consented to participate, and 7208 (72%) children without previously diagnosed CD had serological markers analysed. Before the screening results were known, 7218 children (72%) and 6524 of their parents (65%) answered questionnaires. Questionnaires included the Swedish child-friendly pilot version of the EQ-5D instrument and proxy version of the EQ-5D instrument, which are generic tools used to describe HRQoL. Results We found no significant difference in HRQoL between the groups of children with screening-detected CD, without CD, and those previously diagnosed with CD. Conclusion The HRQoL reported by 12-year-olds with screening-detected CD, before they learned of their diagnosis, was not worse than that of the children without CD or those previously diagnosed with CD. Thus, mass screening for CD should not be justified on the basis that children with unrecognized CD have a poor HRQoL. However, because these children rated their HRQoL before diagnosis and treatment, they may not have recognized or perceived symptoms as severe enough to seek medical attention which demonstrates how difficult clinical/active case finding can be. Mass screening may still, therefore, be considered if the aim is early detection and prevention of future complications.
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| 12. |
- Norström, Fredrik, et al.
(författare)
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Is mass screening for coeliac disease a wise use of resources? A health economic evaluation
- 2021
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Ingår i: BMC Gastroenterology. - : Springer Science and Business Media LLC. - 1471-230X. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Living with undiagnosed symptomatic coeliac disease is connected with deteriorated health, and persons with coeliac disease often wait a long time for their diagnosis. A mass screening would lower the delay, but its cost-effectiveness is still unclear. Our aim was to determine the cost-effectiveness of a coeliac disease mass screening at 12 years of age, taking a life course perspective on future benefits and drawbacks. Methods: The cost-effectiveness was derived as cost per quality-adjusted life-year (QALY) using a Markov model. As a basis for our assumptions, we mainly used information from the Exploring the Iceberg of Celiacs in Sweden (ETICS) study, a school-based screening conducted in 2005/2006 and 2009/2010, where 13,279 12-year-old children participated and 240 were diagnosed with coeliac disease, and a study involving members of the Swedish Coeliac Association with 1031 adult participants. Results: The cost for coeliac disease screening was 40,105 Euro per gained QALY. Sensitivity analyses support screening based on high compliance to a gluten-free diet, rapid progression from symptom-free coeliac disease to coeliac disease with symptoms, long delay from celiac disease with symptoms to diagnosis, and a low QALY score for undiagnosed coeliac disease cases. Conclusions: A coeliac disease mass screening is cost-effective based on the commonly used threshold of 50,000 Euro per gained QALY. However, this is based on many assumptions, especially regarding the natural history of coeliac disease and the effects on long-term health for individuals with coeliac disease still eating gluten.
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| 13. |
- Norström, Fredrik, et al.
(författare)
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Parents' willingness to pay for coeliac disease screening of their child.
- 2011
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - Jpgn. - 1536-4801 .- 0277-2116. ; 52:4, s. 452-459
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: : The aim of this study is to determine Swedish parents' willingness to pay (WTP) for coeliac disease (CD) screening of their child. SUBJECTS AND METHODS: : CD screening was undertaken involving 10,041 12-year-old children, with 7567 (75%) agreeing to participate. Blood samples from the children were analysed for CD serological markers. Parents received a questionnaire including a scenario describing the health-related risks of having CD and screening and diagnostic procedures. Parents were also asked whether they were willing to pay for CD screening, should this not be offered free of charge, and, if so, what their maximum WTP would be. Their WTP was compared with the average cost per child for the screening and case ascertainment procedures. RESULTS: : The questionnaire was answered by 6524 parents, and of 6057 valid responses 63% stated that they were willing to pay something. The mean WTP was 79 EUR and the median 10 EUR. The average cost per child for the screening and case ascertainment procedures was 47 EUR, which 23% of the parents stated they were willing to pay. Parents' WTP increased with higher education and income, and with child symptoms that may indicate CD. CONCLUSIONS: : Swedish parents' WTP for school-based CD screening of their child was higher than the average cost per child; however, only a minority of the parents were willing to pay that amount.
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| 14. |
- Runheim, Hannes, et al.
(författare)
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Societal costs associated with pulmonary arterial hypertension : A study utilizing linked national registries
- 2023
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Ingår i: Pulmonary Circulation. - : Wiley. - 2045-8932 .- 2045-8940. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary arterial hypertension (PAH) is a progressive disease with no cure. Healthcare resource utilization (HCRU; hospitalization, outpatient visits, and drug utilization) before diagnosis and productivity loss (sick leave and disability pension) before and after PAH diagnosis are not well known. By linking several Swedish national databases, this study have estimated the societal costs in a national PAH cohort (n = 749, diagnosed with PAH in 2008−2019) 5 years before and 5 years after diagnosis and compared to an age, sex, and geographically matched control group (n = 3745, 1:5 match). HCRU and productivity loss were estimated per patient per year. The PAH group had significantly higher HCRU and productivity loss compared to the control group starting already 3 and 5 years before diagnosis, respectively. HCRU peaked the year after diagnosis in the PAH group with hospitalizations (mean ± standard deviation; 2.0 ± 0.1 vs. 0.2 ± 0.0), outpatient visits (5.3 ± 0.3 vs. 0.9 ± 0.1), and days on sick leave (130 ± 10 vs. 13 ± 1) significantly higher compared to controls. Total costs during the entire 10-year period were six times higher for the PAH group than the control group. In the 5 years before diagnosis the higher costs were driven by productivity loss (76%) and hospitalizations (15%), while the 5 years after diagnosis the main cost drivers were drugs (63%), hospitalizations (16%), and productivity loss (16%). In conclusion, PAH was associated with large societal costs due to high HCRU and productivity loss, starting several years before diagnosis. The economic and clinical burden of PAH suggests that strategies for earlier diagnosis and more effective treatments are warranted.
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| 15. |
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| 16. |
- Webb, Charlotta, et al.
(författare)
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Accuracy in Celiac Disease Diagnostics by Controlling the Small-bowel Biopsy Process
- 2011
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Ingår i: JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION. - : Lippincott, Williams and Wilkins. - 0277-2116 .- 1536-4801. ; 52:5, s. 549-553
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: In a Swedish celiac disease screening study (Exploring the Iceberg of Celiacs in Sweden), we systematically reviewed the clinical diagnostic procedures with the aim to evaluate the diagnostic accuracy and to take advantage of lessons learned for improving diagnostic routines. Materials and Methods: A school-based celiac disease screening study involving 5 Swedish centers, with 10,041 invited 12-year-olds with 7567 consenting participation. All 192 children with elevated serological markers were recommended to undergo small-bowel biopsy, performed and evaluated according to local clinical routines. All of the mucosal specimens were reevaluated by 1 and, when needed, 2 expert pathologists to reach diagnostic consensus. Results: Small-bowel biopsies were performed in 184 children: 130 by endoscopy and 54 by suction capsule. Endoscopic biopsies were inconclusive in 0.6%, compared with 7.4% of biopsies by suction capsule. A patchy enteropathy was found in 9.1%. Reevaluation by the expert pathologist resulted in 6 additional cases with celiac disease and 1 cleared. Sixteen children with normal or inconclusive biopsies, 4 after endoscopy, and 12 after suction capsule were endoscopically rebiopsied, resulting in another 8 cases. The celiac disease prevalence of 30 of 1000 (95% confidence interval 26-34) was not statistically different from that previously reported. Conclusions: The present review revealed the importance of controlling each step of the diagnostic procedure. Several cases would have been missed by relying only on local routines. To improve the quality of childhood celiac disease diagnostics, we recommend multiple endoscopic biopsies from both proximal and distal duodenum and standardized evaluation by a pathologist with good knowledge of celiac disease.
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| 17. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Dose-dependent effect of growth hormone on final height in children with short stature without growth hormone deficiency
- 2008
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 93:11, s. 4342-4350
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: The effect of GH therapy in short non-GH-deficient children, especially those with idiopathic short stature (ISS), has not been clearly established owing to the lack of controlled trials continuing until final height (FH).OBJECTIVE: The aim of the study was to investigate the effect on growth to FH of two GH doses given to short children, mainly with ISS, compared with untreated controls.DESIGN AND SETTING: A randomized, controlled, long-term multicenter trial was conducted in Sweden.INTERVENTION: Two doses of GH (Genotropin) were administered, 33 or 67 microg/kg.d; control subjects were untreated.SUBJECTS: A total of 177 subjects with short stature were enrolled. Of these, 151 were included in the intent to treat (AllITT) population, and 108 in the per protocol (AllPP) population. Analysis of ISS subjects included 126 children in the ITT (ISSITT) population and 68 subjects in the PP (ISSPP) population.MAIN OUTCOME MEASURES: We measured FH sd score (SDS), difference in SDS to midparenteral height (diff MPHSDS), and gain in heightSDS.RESULTS: After 5.9+/-1.1 yr on GH therapy, the FHSDS in the AllPP population treated with GH vs. controls was -1.5+/-0.81 (33 microg/kg.d, -1.7+/-0.70; and 67 microg/kg.d, -1.4+/-0.86; P<0.032), vs. -2.4+/-0.85 (P<0.001); the diff MPHSDS was -0.2+/-1.0 vs. -1.0+/-0.74 (P<0.001); and the gain in heightSDS was 1.3+/-0.78 vs. 0.2+/-0.69 (P<0.001). GH therapy was safe and had no impact on time to onset of puberty. A dose-response relationship identified after 1 yr remained to FH for all growth outcome variables in all four populations.CONCLUSION: GH treatment significantly increased FH in ISS children in a dose-dependent manner, with a mean gain of 1.3 SDS (8 cm) and a broad range of response from no gain to 3 SDS compared to a mean gain of 0.2 SDS in the untreated controls.
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| 18. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Growth hormone dose-dependent pubertal growth : a randomized trial in short children with low growth hormone secretion
- 2014
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Ingår i: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2818 .- 1663-2826. ; 82:3, s. 158-170
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Growth hormone (GH) treatment regimens do not account for the pubertal increase in endogenous GH secretion. This study assessed whether increasing the GH dose and/or frequency of administration improves pubertal height gain and adult height (AH) in children with low GH secretion during stimulation tests, i. e. idiopathic isolated GH deficiency.Methods: A multicenter, randomized, clinical trial (No. 88-177) followed 111 children (96 boys) at study start from onset of puberty to AH who had received GH(33) mu g/kg/day for >= 1 year. They were randomized to receive 67 mu g/kg/day (GH(67)) given as one (GH(67x1); n = 35) or two daily injections (GH(33x2); n = 36), or to remain on a single 33 mu g/kg/day dose (GH(33x1); n = 40). Growth was assessed as height SDS gain for prepubertal, pubertal and total periods, as well as AH SDS versus the population and the midparental height.Results: Pubertal height SDS gain was greater for patients receiving a high dose (GH(67), 0.73) than a low dose (GH(33x1), 0.41, p < 0.05). AH(SDS) was greater on GH(67) (GH(67x1), -0.84; GH(33x2), -0.83) than GH(33) (-1.25, p < 0.05), and height SDS gain was greater on GH(67) than GH(33) (2.04 and 1.56, respectively; p < 0.01). All groups reached their target height SDS.Conclusion: Pubertal height SDS gain and AH SDS were dose dependent, with greater growth being observed for the GH(67) than the GH(33) randomization group; however, there were no differences between the once-and twice-daily GH(67) regimens. (C) 2014 S. Karger AG, Basel.
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| 19. |
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Arbete: Passion och exploatering
- 2011
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Det har skett omfattande förändringar i samhället som påverkar både våra möjligheter på arbetsmarknaden och våra föreställningar om arbete. De självstyrande, kreativa och alltmer innovationsinritade delarna av arbetsmarkanden och de allt hårdare reglerade delarna av arbetsmarkanden kan beskrivas i termer av en ökad polarisering. Detta får också konsekvenser för hur förhållandet mellan exploatering, passion och arbete kan förstås. Föreliggande nummer av tidskriften Arbetsliv i omvandling försöker på olika sätt att belysa denna problematik. Inledningsvis diskuteras de två centrala begreppen, passion och exploatering, i syfte att visa hur dessa kan utgöra analytiska redskap när man närmar sig olika områden och problem knutna till arbete och arbetsliv. Med hjälp av ett antal exempel lyfts därefter olika aspekter fram som speglar de förändringar som präglar dagens arbetsmarknad. Bidragen försöker var och en på sitt att visa hur olika individer och yrkesgrupper hanterar sina liv i spänningsfältet mellan passion och exploatering
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| 20. |
- Asplund, Sara, 1976, et al.
(författare)
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Extended analysis of the effect of learning with feedback on the detectability of pulmonary nodules in chest tomosynthesis
- 2011
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Ingår i: Progress in Biomedical Optics and Imaging - Proceedings of SPIE. - : SPIE. - 1605-7422. ; 7966
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of section images of the chest, resulting in a reduction of disturbing anatomy at a moderate increase in radiation dose compared to chest radiography. In a previous study, we investigated the effects of learning with feedback on the detection of pulmonary nodules in chest tomosynthesis. Six observers with varying degrees of experience of chest tomosynthesis analyzed tomosynthesis cases for presence of pulmonary nodules. The cases were analyzed before and after learning with feedback. Multidetector computed tomography (MDCT) was used as reference. The differences in performance between the two readings were calculated using the jackknife alternative free-response receiver operating characteristics (JAFROC-2) as primary measure of detectability. Significant differences between the readings were found only for observers inexperienced in chest tomosynthesis. The purpose of the present study was to extend the statistical analysis of the results of the previous study, including JAFROC-1 analysis and FROC curves in the analysis. The results are consistent with the results of the previous study and, furthermore, JAFROC-1 gave lower p-values than JAFROC-2 for the observers who improved their performance after learning with feedback. © 2011 SPIE.
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| 21. |
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| 22. |
- Asplund, Sara, 1976, et al.
(författare)
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Learning aspects and potential pitfalls regarding detection of pulmonary nodules in chest tomosynthesis and proposed related quality criteria.
- 2011
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Ingår i: Acta radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 52:5, s. 503-512
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Tidskriftsartikel (refereegranskat)abstract
- Background In chest tomosynthesis, low-dose projections collected over a limited angular range are used for reconstruction of an arbitrary number of section images of the chest, resulting in a moderately increased radiation dose compared to chest radiography. Purpose To investigate the effects of learning with feedback on the detection of pulmonary nodules for observers with varying experience of chest tomosynthesis, to identify pitfalls regarding detection of pulmonary nodules, and present suggestions for how to avoid them, and to adapt the European quality criteria for chest radiography and computed tomography (CT) to chest tomosynthesis. Material and Methods Six observers analyzed tomosynthesis cases for presence of nodules in a jackknife alternative free-response receiver-operating characteristics (JAFROC) study. CT was used as reference. The same tomosynthesis cases were analyzed before and after learning with feedback, which included a collective learning session. The difference in performance between the two readings was calculated using the JAFROC figure of merit as principal measure of detectability. Results Significant improvement in performance after learning with feedback was found only for observers inexperienced in tomosynthesis. At the collective learning session, localization of pleural and subpleural nodules or structures was identified as the main difficulty in analyzing tomosynthesis images. Conclusion The results indicate that inexperienced observers can reach a high level of performance regarding nodule detection in tomosynthesis after learning with feedback and that the main problem with chest tomosynthesis is related to the limited depth resolution.
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| 23. |
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| 25. |
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| 26. |
- Bergman, Ann, 1963-, et al.
(författare)
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Att lämna yrket eller stanna kvar, organisationskultur och sexuella trakasserier, delat ledarskap samt arbetets estetik
- 2019
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 25:2, s. 4-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Tre av detta nummers artiklar berör organisation på ett eller annat sätt.Det handlar om varför poliser väljer att frivilligt säga upp sig och lämnayrket; sexuella trakasserier och hur sådana hanteras i mansdomineradeorganisationer samt erfarenheter av delat ledarskap i skolväsendet. Den sistaartikeln utgörs av en essä om hur arbete har framställts i bildkonst, musik ochlitteratur. Detta nummer av Arbetsmarknad & Arbetsliv avslutas med att JanCh Karlsson recenserar boken Job Quality in an Era of Flexibility. Experiences ina European Context.
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| 27. |
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| 28. |
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| 29. |
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| 30. |
- Bergman, Ann, 1963-, et al.
(författare)
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Profession, anställningsformer, frivilligarbete och religion
- 2018
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 24:1-2, s. 4-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Artiklarna i detta nummer av Arbetsmarknad & Arbetsliv behandlar olika områden. Den första handlar om hur gymnasielärare upplever att de förberetts för sitt yrke under lärarutbildningen. Den andra rör hemtjänstens förhållningssätt till äldre personer med alkoholproblem. Den tredje artikeln handlar om anställda i handeln, en bransch som kännetecknas av olika typer av anställningsformer. Nästa artikel belyser samverkan mellan räddningstjänsten och frivilliga insatser vid branden i Västmanland för några år sedan. Därefter följer en artikel om begränsningen av kvinnors rätt att manifestera sin religion i arbetslivet. Numret avslutas med tre recensioner. Eskil Wadensjö recenserar Tora Nords doktorsavhandling Arbete som rättighet eller skyldighet. Föreställningar om arbetsmarknadsfrånvaro i välfärdsstaten; Peter Håkansson recenserar Jack Lainpeltos doktorsavhandling Ämnade för restaurangarbete? - Om politisk styrning och lågutbildade ungdomars väg fram till arbetsmarknadens tröskel; Erik Sjödin recenserar Rasmus Hästbackas licentiatavhandling Europeiska företagsråd i svenska koncerner: En rättsvetenskaplig studie av EWC-regleringens betydelse för arbetstagarinflytande och styrning.
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| 33. |
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| 34. |
- Blom, Mathias C., et al.
(författare)
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Primary triage nurses do not divert patients away from the emergency department at times of high in-hospital bed occupancy - a retrospective cohort study
- 2016
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Ingår i: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Emergency department (ED) overcrowding is frequently described in terms of input- throughput and output. In order to reduce ED input, a concept called primary triage has been introduced in several Swedish EDs. In short, primary triage means that a nurse separately evaluates patients who present in the Emergency Department (ED) and either refers them to primary care or discharges them home, if their complaints are perceived as being of low acuity. The aim of the present study is to elucidate whether high levels of in-hospital bed occupancy are associated with decreased permeability in primary triage. The appropriateness of discharges from primary triage is assessed by 72-h revisits to the ED. Methods: The study is a retrospective cohort study on administrative data from the ED at a 420-bed hospital in southern Sweden from 2011-2012. In addition to crude comparisons of proportions experiencing each outcome across strata of in-hospital bed occupancy, multivariate models are constructed in order to adjust for age, sex and other factors. Results: A total of 37,129 visits to primary triage were included in the study. 53.4 % of these were admitted to the ED. Among the cases referred to another level of care, 8.8 % made an unplanned revisit to the ED within 72 h. The permeability of primary triage was not decreased at higher levels of in-hospital bed occupancy. Rather, the permeability was slightly higher at occupancy of 100-105 % compared to <95 % (OR 1.09 95 % CI 1.02-1.16). No significant association between in-hospital bed occupancy and the probability of 72-h revisits was observed. Conclusions: The absence of a decreased permeability of primary triage at times of high in-hospital bed occupancy is reassuring, as the opposite would have implied that patients might be denied entry not only to the hospital, but also to the ED, when in-hospital beds are scarce.
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| 35. |
- Blom, Mathias, et al.
(författare)
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The probability of readmission within 30 days of hospital discharge is positively associated with inpatient bed occupancy at discharge - a retrospective cohort study.
- 2015
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Ingår i: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Previous work has suggested that given a hospital's need to admit more patients from the emergency department (ED), high inpatient bed occupancy may encourage premature hospital discharges that favor the hospital's need for beds over patients' medical interests. We argue that the effects of such action would be measurable as a greater proportion of unplanned hospital readmissions among patients discharged when the hospital was full than when not. In response, the present study tested this hypothesis by investigating the association between inpatient bed occupancy at the time of hospital discharge and the 30-day readmission rate.
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| 36. |
- Bosmans, Kim, et al.
(författare)
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Experiences of insecurity among non-standard workers across different welfare states : A qualitative cross-country study
- 2023
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 327
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Tidskriftsartikel (refereegranskat)abstract
- In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the prevalence of NSE and the level of employment insecurity it creates, but the extent to which a country’s policy context mitigates the health influences of NSE is unclear. This study describes how workers experience insecurities created by NSE, and how this influences their health and well-being, in countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden, and the United States. Interviews with 250 workers in NSE were analysed using a multiple-case study approach. Workers in all countries experienced multiple insecurities (e.g., income and employment insecurity) and relational tension with employers/clients, with negative health and well-being influences, in ways that were shaped by social inequalities (e.g., related to family support or immigration status). Welfare state differences were reflected in the level of workers’ exclusion from social protections, the time scale of their insecurity (threatening daily survival or longer-term life planning), and their ability to derive a sense of control from NSE. Workers in Belgium, Sweden, and Spain, countries with more generous welfare states, navigated these insecurities with greater success and with less influence on health and well-being. Findings contribute to our understanding of the health and well-being influences of NSE across different welfare regimes and suggest the need in all six countries for stronger state responses to NSE. Increased investment in universal and more equal rights and benefits in NSE could reduce the widening gap between standard and NSE.
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| 37. |
- Brockstedt, Sara, et al.
(författare)
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Vertical field MR imaging of upper thorax and spine in small children. Evaluation of a new surface coil
- 1993
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Ingår i: Acta Radiologica. - 1600-0455. ; 34:6, s. 549-553
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Tidskriftsartikel (refereegranskat)abstract
- To improve image quality in a vertical field MR imaging unit, operating at low field strength (0.3 T), we have designed a half-elliptical coil for use in the upper thoracic region of small children. Our intention was also to shorten the examination time, which until now has been long, because several scans with different coils have been necessary to cover the thoracic region. The experimental coil is designed so that a child's shoulders fit into the central region. The coil consists of 2 serially connected cable-loops, mounted on a foam rubber vest. The coil performance was tested in a phantom and improvements relative to standard coils were demonstrated in in vivo studies. The results indicate that by using the half-elliptical coil, the signal-to-noise (S/N) ratio can be improved by a factor of 2 to 3 in the thoracic region of a child.
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| 38. |
- Cederkrantz, Elin, et al.
(författare)
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Evaluation of Effects on the Peritoneum After Intraperitoneal α-Radioimmunotherapy with (211)At.
- 2012
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Ingår i: Cancer biotherapy & radiopharmaceuticals. - : Mary Ann Liebert Inc. - 1557-8852 .- 1084-9785. ; 27:6, s. 353-364
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The introduction of the short-lived α-emitter (211)At to intraperitoneal radioimmunotherapy has raised the issue of the tolerance dose of the peritoneum. The short range of the α-particles (70μm) and the short half-life (7.21h) of the nuclide yield a dose distribution in which the peritoneum is highly irradiated compared with other normal tissues. To address this issue, mice were injected with (211)At-trastuzumab to irradiate the peritoneum to absorbed doses ranging between 0 and 50 Gy and followed for up to 34 weeks. The peritoneum-to-plasma clearance of a small tracer, (51)Cr-ethylenediamine tetraacetic acid, was measured for evaluation of the small solute transport capacity of the peritoneal membrane. The macroscopic status of the peritoneum and the mesenteric windows was documented when the mice were sacrificed. Biopsies of the peritoneum were taken for morphology and immunohistochemical staining against plasminogen activator inhibitor-1 and calprotectin. Peritoneum-to-plasma clearance measurements indicated a dose-dependent decrease in peritoneal transport capacity in irradiated mice. However, macroscopic and microscopic evaluations of the peritoneal membrane showed no difference between irradiated mice versus controls. The results imply that the peritoneal membrane tolerates absorbed doses as high as 30-50 Gy from α-particle irradiation with limited response.
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| 39. |
- Danielsson, Henrik, et al.
(författare)
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A Systematic Review of Longitudinal Trajectories of Mental Health Problems in Children with Neurodevelopmental Disabilities
- 2024
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Ingår i: Journal of Developmental and Physical Disabilities. - : Springer. - 1056-263X .- 1573-3580. ; 36, s. 203-242
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Forskningsöversikt (refereegranskat)abstract
- To review the longitudinal trajectories - and the factors influencing their development - of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.
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| 40. |
- Elmarghani, Ahmed, 1975-, et al.
(författare)
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Contribution of pharmaceuticals, fecal bacteria and endotoxin to the inflammatory responses to inland waters
- 2014
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 488-489, s. 228-235
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Tidskriftsartikel (refereegranskat)abstract
- The increasing contamination of freshwater with pharmaceuticals, surfactants, pesticides and other organic compounds are of major concern. As these contaminants are detected at trace levels in the environment it is important to determine if they elicit biological responses at the observed levels. In addition to chemical pollutants, there is also a concern for increasing levels of bacteria and other microorganisms in freshwater systems. In an earlier study, we observed the activation of inflammatory systems downstream of a wastewater treatment plant (WWTP) in southern Sweden. We also observed that the water contained unidentified components that were pro-inflammatory and potentiated the immune response in human urinary bladder epithelial cells. In order to determine if these effects were unique for the studied site or represent a common response in Swedish water, we have now performed a study on three WWTPs and their recipient waters in central Sweden. Analysis of immune responses in urinary bladder epithelial cells, monocyte-like cells and blood mononuclear cells confirm that these waters activate the immune system as well as induce pro-inflammatory responses. The results indicate that the cytokine profiles correlate to the endotoxin load of the waters rather than to the levels of pharmaceuticals or culturable bacteria load, suggesting that measurements of endotoxin levels and immune responses would be a valuable addition to the analysis of inland waters.
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| 41. |
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| 42. |
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| 43. |
- Gillberg, Gunnar, 1958, et al.
(författare)
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Arbetsförmedlingen, socialtjänsten och skolan
- 2021
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 27:4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 44. |
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| 45. |
- Gillberg, Gunnar, 1958, et al.
(författare)
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Arbetstrivsel och arbetsmiljö
- 2023
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Ingår i: Arbetsmarknad & Arbetsliv. - 1400-9692. ; 29:2
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 46. |
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| 47. |
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| 48. |
- Gillberg, Gunnar, et al.
(författare)
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Digitalisering, lärande och utbildning.
- 2018
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 24:3-4, s. 4-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- De två första artiklarna i detta nummer handlar om digitalisering och dess påverkan på arbetet och arbetssituationen i olika avseenden. Dessa följs av en artikel som behandlar lärande i arbetsorganisationer. Den fjärde artikeln belyser hur nyutexaminerade lärare i Sverige och Finland ser på den utbildning de har genomgått. Därefter följer en debattartikel – ”Snabbt förändrade arbetsmiljöer kräver forskning som bidrar till bred kunskap och metodik” – i vilken styrelsen för FALF fokuserat implikationer av dagens varierade arbetsmiljöer för verkningsfullt arbetsmiljöarbete. De argumenterar för mer arbetsplatsnära, intersektionella och mångvetenskapliga ansatser i arbetslivsforskningen – och att alltför förenklade beskrivningar i övergripande medeltal kan, liksom effektivitetshetsen i dagens samhälle, fördumma både arbetsmiljöarbetet och forskningen. Arbetsmiljö är ett mycket viktigt tema, och vi på redaktionen vill uppmärksamma det kommande numret som har just tema arbetsmiljö. Detta nummer avslutas med tre recensioner. Roland Kadefors recenserar Susan P Chens doctorsavhandling Knowledge management in the time of organisational change: Implications of a post-merger early retirement downsizing strategy in an aging knowledge based economy. A socio-technical system approach to a Norwegian case study; Jonas Axelsson recenserar boken Social struktur och mänskligt handlande: en introduktion till kritisk realistisk samhällsanalys (Gillberg, Persson, Seldén & Wennerström); Robin Färdig recenserar boken Beslut (Brunsson & Brunsson).
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| 49. |
- Gillberg, Gunnar, 1958, et al.
(författare)
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Digitalisering, lärande och utbildning
- 2018
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Ingår i: Arbetsmarknad & Arbetsliv. - 1400-9692 .- 2002-343X. ; 24:3-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 50. |
- Gillberg, Gunnar, et al.
(författare)
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Introduktion
- 2023
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 29:2, s. 4-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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