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1.	Conradsson, David Moulaee, et al. (författare) Employment status of people with multiple sclerosis in relation to 10-year changes in functioning and perceived impact of the disease 2020 Ingår i: Multiple Sclerosis and Related Disorders. - : ELSEVIER SCI LTD. - 2211-0348 .- 2211-0356. ; 46 Tidskriftsartikel (refereegranskat)abstract Background: Although it is well known that people with multiple sclerosis (PwMS) retire from work early, little is known about how long-term changes in functioning and perceived impact of multiple sclerosis (MS) interact with sustainability of employment.Objective: To explore changes in functioning and in perceived impact of MS over 10 years, in relation to employment status of PwMS.Methods: In order to measure functioning, data on activities (walking ability, fine hand use, personal activities in daily living); participation in activities of everyday life (domestic, outdoor and leisure activities); body functions (cognitive function, fatigue, depressive symptoms); and perceived impact of MS were collected in 116 PwMS at baseline and at a 10-year follow-up. Ten-year changes were explored with the participants divided into four subgroups based on employment status at the follow-up: 1) full-time work at the 10-year follow-up; 2) part-time work at the 10-year follow-up; 3) declined from working at baseline to not working at the 10-year follow-up; and 4) not working at baseline nor at the 10-year follow-up.Results: Patterns of change in functioning for PwMS who worked showed a more apparent deterioration over 10 years among those working part-time with regard to walking ability, fatigue and depressive symptoms. Members of the subgroups who declined from working at baseline to not working at the 10-year follow-up or who were working neither at baseline nor at the follow-up deteriorated the most in functioning. The subgroup whose employment status declined from baseline to follow-up showed a significant decrease in cognitive function and an increase in perceived physical impact of the disease. All subgroups experienced a deterioration in walking ability over the 10-year span, and in all subgroups a majority had limited fine hand use over the span of the study period.Conclusion: The deterioration in functioning was most apparent in those PwMS whose employment status declined from working at baseline to not working at the 10-year follow-up. Close monitoring of work situation and frequency of activities and participation in everyday activities, as well as recurrent training of functioning, are suggested for maintaining a high level of functioning and work status, or for supporting transition to an appropriate number of working hours.
2.	Fioretos, Thoas, et al. (författare) Implementing precision medicine in a regionally organized healthcare system in Sweden 2022 Ingår i: Nature Medicine. - : Springer Nature. - 1078-8956 .- 1546-170X. ; 28:10, s. 1980-1982 Tidskriftsartikel (refereegranskat)
3.	Kyhlbäck, Maria, et al. (författare) Postoperativ rehabilitering vid ländryggsdiskbråck 2011 Ingår i: Fysioterapi. - : Fysioterapeuterna,Swedish Association of Registered Physiotherapists. - 1653-5804. ; :1, s. 32-37 Tidskriftsartikel (refereegranskat)abstract Sedan några årtionden tillbaka är diskbråcksoperation en standardoperation som utförs på liknande sätt vid Sveriges ortopedkliniker. Det postoperativa omhändertagandet och rehabiliteringen av opererade patienter kan dock se olika ut, beroende på var operationen skett. Under 2008/09 har en grupp sjukgymnaster från olika delar av landet tagit fram nationella riktlinjer, baserat på vetenskaplig evidens och klinisk erfarenhet, vilket tidigare saknats för dessa patienter. Konklusionen är att sjukgymnastiken efter diskbråcksoperation bör vara inriktad på tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation, även om de positiva effekterna av den postoperativa träningen måste betraktas som kortsiktiga. En tidig återgång till aktiviteter som inkluderar ett aktivt förhållningssätt ger, förutom de kortsiktiga förbättringarna, troligen en positiv påverkan på patienternas inställning till smärta och aktivitet. Förhoppningen är att den aktuella, systematiskt sammanställda kunskapen ska bidra till diskussioner på enskilda arbetsplatser och att behandlingsrekommendationerna kan anpassas till lokala förhållanden.
4.	Kyhlbäck, Maria, et al. (författare) Postoperativ rehabilitering vid ländryggsdiskbråck 2011 Ingår i: Fysioterapi. - Stockholm. - 1653-5804. ; :1, s. 32-37 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Bakgrund och syfte:Under 2008 har en grupp sjukgymnaster tagit fram nationella behandlingsriktlinjer för patienter som genomgått diskbråcksoperation. Syftet var att dessa skulle baseras på vetenskaplig evidens och klinisk erfarenhet.Metoder:Litteratursökning gjordes i sju olika databaser, sökningen omfattade randomiserade, kontrollerade studier under tidsperioden 1990-2008. Inkluderade studier granskades utifrån ett modifierat kvalitetsindex enligt SBU (Statens Beredning för medicinsk Utvärdering). För bevisvärdering av studieresultat användes SBU:s gradering högt, medelhögt och lågt bevisvärde. Evidensgrad för olika sjukgymnastiska metoder som förekom i de inkluderade studierna kategoriserades i enlighet med SBU:s nivåer för vetenskaplig evidens; starkt vetenskapligt underlag, måttligt starkt vetenskapligt underlag, begränsat vetenskapligt underlag och otillräckligt vetenskapligt underlag. Resultat:Sexton artiklar som uppfyllde kriterierna för granskning inkluderades i granskningen.Baserat på dessa studier finns måttligt stark evidens för att aktiv träning som inkluderar ett mer aktivt förhållningssätt är mer effektiv på kort sikt än mer försiktig/passiv träning och förhållningssätt (< 6 månader efter operation). Det finns ett starkt vetenskapligt stöd för att den aktiva träningen inte påverkar smärta och funktion på lång sikt (ett år efter operation), liksom att tidig, aktiv träning inte ökar komplikationsrisken efter operation. Det vetenskapliga stödet är begränsat vad gäller de positiva effekterna av enbart råd om fysisk aktivitet, motsägande beträffande effekten av övervakad träning jämfört med hemträning och otillräckligt beträffande effekten av beteendemedicinskt inriktad träning.Konklusion:Sjukgymnastiken efter diskbråcksoperation bör ha ett aktivt förhållningssätt inkluderande tidig, aktiv träning för att förbättra patienternas ryggfunktion och höja aktivitetsgraden efter operation.
5.	Persson, Mia, et al. (författare) A new improved distributed e-healthcare system based on open standards for depression treatment 2012 Ingår i: ICICS '12 Proceedings of the 3rd International Conference on Information and Communication Systems. - New York, NY, USA : ACM Digital Library. - 9781450313278 ; , s. 1-6 Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract The use of open standards to promote responsible and available design in Internet-based healthcare systems is examined by using theoretical notations and recent research results from the literature. Moreover, empirical data will be gathered from a case study on an e-healthcare system for depression treatment. Our contribution is to initiate a discussion aiming at increasing the awareness on appropriate conceptual models for Internet-based depression treatment. Moreover, an up-to-date e-healthcare system, based on open standards and implemented with requirements of an Internet-based system treating patients suffering from depressions, is proposed.
6.	Rasmussen, Eva Rye, et al. (författare) Genome-wide association study of angioedema induced by angiotensin-converting enzyme inhibitor and angiotensin receptor blocker treatment. 2020 Ingår i: The Pharmacogenomics Journal. - : Springer Science and Business Media LLC. - 1470-269X .- 1473-1150. ; 20:6, s. 770-783 Tidskriftsartikel (refereegranskat)abstract Angioedema in the mouth or upper airways is a feared adverse reaction to angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) treatment, which is used for hypertension, heart failure and diabetes complications. This candidate gene and genome-wide association study aimed to identify genetic variants predisposing to angioedema induced by these drugs. The discovery cohort consisted of 173 cases and 4890 controls recruited in Sweden. In the candidate gene analysis, ETV6, BDKRB2, MME, and PRKCQ were nominally associated with angioedema (p < 0.05), but did not pass Bonferroni correction for multiple testing (p < 2.89 × 10-5). In the genome-wide analysis, intronic variants in the calcium-activated potassium channel subunit alpha-1 (KCNMA1) gene on chromosome 10 were significantly associated with angioedema (p < 5 × 10-8). Whilst the top KCNMA1 hit was not significant in the replication cohort (413 cases and 599 ACEi-exposed controls from the US and Northern Europe), a meta-analysis of the replication and discovery cohorts (in total 586 cases and 1944 ACEi-exposed controls) revealed that each variant allele increased the odds of experiencing angioedema 1.62 times (95% confidence interval 1.05-2.50, p = 0.030). Associated KCNMA1 variants are not known to be functional, but are in linkage disequilibrium with variants in transcription factor binding sites active in relevant tissues. In summary, our data suggest that common variation in KCNMA1 is associated with risk of angioedema induced by ACEi or ARB treatment. Future whole exome or genome sequencing studies will show whether rare variants in KCNMA1 or other genes contribute to the risk of ACEi- and ARB-induced angioedema.
7.	Söderström, Torbjörn, et al. (författare) 5alfa-reductase 2 polymorphisms as risk factors in prostate cancer 2002 Ingår i: Pharmacogenetics. - : Ovid Technologies (Wolters Kluwer Health). - 0960-314X .- 1473-561X. ; 12:4, s. 307-12 Tidskriftsartikel (refereegranskat)abstract Prostate cancer is a significant cause of death in Western countries and is under the strong influence of androgens. The steroid 5alpha-reductase 2 catalyzes the metabolism of testosterone into the more potent androgen dihydrotestosterone in the prostate gland. The enzyme is a target in pharmacological treatment of benign prostatic hyperplasia using specific inhibitors such as finasteride. Makridakis et al. have characterized the V89L and A49T polymorphisms in recombinant expression systems. The L allelic variant has a lower Vmax/Km ratio than the V variant. In the A49T polymorphism, the T variant has an increased Vmax/Km ratio. We performed a population-based case-control study of the impact of the SRD5A2 V89L and A49T polymorphisms on the risk of prostate cancer. We also studied the relation between the genotypes and age at diagnosis, tumor, node, metastasis stage, differentiation grade, prostate specific antigen and heredity. The study included 175 prostate cancer patients and 159 healthy controls that were matched for age. There was an association with SRD5A2 V89L LL genotype and metastases at the time of diagnosis, OR 5.67 (95% CI 1.44-22.30) when adjusted for age, differentiation grade, T-stage and prostate specific antigen. Heterozygous prostate cancer cases that carried the SRD5A2 A49T AT genotype were significantly younger than cases that carried the AA genotype, (mean age 66 years vs 71, P = 0.038). The SRD5A2 V89L and A49T polymorphisms were, however, not associated with altered prostate cancer risk. Further studies of the V89L polymorphism may lead to better understanding of the etiology of prostate cancer metastases.
8.	2017 swepub:Mat__t
9.	Albertsson, Per, 1964, et al. (författare) Astatine-211 based radionuclide therapy: Current clinical trial landscape 2023 Ingår i: Frontiers in Medicine. - : Frontiers Media SA. - 2296-858X. ; 9 Tidskriftsartikel (refereegranskat)abstract Astatine-211 (At-211) has physical properties that make it one of the top candidates for use as a radiation source for alpha particle-based radionuclide therapy, also referred to as targeted alpha therapy (TAT). Here, we summarize the main results of the completed clinical trials, further describe ongoing trials, and discuss future prospects.
10.	Axelsson, Anna, et al. (författare) Patient reported long-term side effects from treatment on urinary and sexual function in anal cancer survivors-3-and 6-year results from the Swedish national ANCA study 2024 Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318. Tidskriftsartikel (refereegranskat)abstract Aim: The standard treatment for anal cancer is chemoradiotherapy. Most patients survive anal cancer but remain living with long-term side effects related to the treatment received. The aim of this study was to assess the occurrence of long-term impairment of urinary and sexual function at 3 and 6 years after diagnosis and to investigate the additive effect from chemotherapy in combined chemoradiotherapy on urinary incontinence, compared to radiotherapy alone. Method: The ANal CAncer study (ANCA) is based on a national Swedish cohort of patients diagnosed with anal cancer between 2011 and 2013. All identified patients within the study were invited to respond to a study-specific questionnaire at 3 and 6 years. Descriptive analyses for the primary endpoint were performed. To investigate a possible additional effect from chemotherapy logistic regression was used. Results: A total of 388 patients were included in the study. At 3 years 264 patients were alive and invited to respond to an anal cancer specific questionnaire. The 3- and 6 year response rates were 195 (74%) and 155 patients (67%), respectively. The patient reported urinary function impairment at 3 years were urgency (63%), incomplete bladder emptying (47%), and incontinence (46%) and there was an absolute increase of the prevalence of urinary dysfunction in about 10% at 6 years. Three years after diagnosis, 77% reported that intercourse was not part of their sex life; this percentage increased at 6 years to 83%. We found no negative effect of chemotherapy in combined chemoradiotherapy versus radiotherapy alone on patient reported urinary incontinence. Conclusion: For anal cancer survivors, urinary function was impaired after 3 years and continued to deteriorate as measured at 6 years after diagnosis. Anal cancer and its treatment negatively affected sexual function for both men and women. This may explain why patients reported that sexual activity and frequency of intercourse was not of importance in their life.
11.	Axelsson, Anna, et al. (författare) Patient reported long-term side effects on bowel function and anal pain in anal cancer survivors-3-and 6-year results from the Swedish national ANCA study 2023 Ingår i: COLORECTAL DISEASE. - 1462-8910 .- 1463-1318. Tidskriftsartikel (refereegranskat)abstract AimThe primary therapeutic option for anal cancer treatment is chemoradiotherapy resulting in 80% survival. The aim of this study was to assess long-term bowel function impairment and anal pain at 3 and 6 years after anal cancer diagnosis, based on a hypothesis of an increase in impairment over time. A secondary aim was to investigate if chemoradiotherapy increased the risk for bowel impairment, compared to radiotherapy alone.MethodThe ANal CAncer study (ANCA) consists of a national Swedish cohort of patients diagnosed with anal cancer between 2011-2013. Patients within the study were invited to respond to a study-specific questionnaire at 3- and 6-years after diagnosis. Descriptive analyses for the primary endpoint and ordinal logistic regressions for secondary endpoint were performed.ResultsA total of 388 patients (84%) were included in the study. At 3 years of follow-up, 264 patients were alive. A total of 195 of these patients (74%) answered a study specific questionnaire, and at 6 years 154 patients (67%). Fifty-seven percent experienced bowel urgency at both 3 and 6 years. There was an increased risk for repeated bowel movement within 1 h (OR 2.44 [95% CI: 1.08-5.61, p = 0.03]) at 3 years in patients who had been treated by chemoradiation compared to radiotherapy alone.ConclusionsImpairment in bowel function and anal pain after anal cancer treatment should be expected and remains after 6 years. This suggests that long-term follow-up may be necessary in some form after customary follow-up. The addition of chemotherapy increases long-term side effects of bowel function.
12.	Axelsson, Anna, et al. (författare) Patient-reported QoL in anal cancer survivors 3 and 6 years after treatment-results from the Swedish national ANCA study 2022 Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 30:5, s. 4169-4178 Tidskriftsartikel (refereegranskat)abstract Purpose The impact of anal cancer treatment for the patients is best evaluated by the patients themselves. The purpose of this study was to investigate quality of life (QoL) in patients with anal cancer at 3 and 6 years after treatment. Methods A Swedish national cross-sectional prospective cohort study with patients diagnosed with anal cancer between 2011 and 2013. Patients were invited to respond to a QoL questionnaire at 3 and 6 years, with focus on bowel, urinary and sexual function, social and mental function, co-morbidity, lifestyle, daily activities, personal characteristics, and perceived QoL. It also contained questions on the severity of the symptoms regarding occurrence, frequency, and duration and the level of "bother" experienced related to functional symptoms. QoL and prevalence of bother with urinary, sexual, bowel dysfunction, and anal pain were described. The prevalence of impaired QoL was compared with a healthy reference population. The association between QoL and experiencing bother was quantified by regression models. Results From an original cohort of 464 patients with anal cancer, 264 (57%) were alive and contacted at 3 years and 230 (50%) at 6 years. One hundred ninety-five (74%) patients responded to the 3-year and 152 (66%) to the 6-year questionnaire. Sixty percent reported low QoL at both 3 and 6 years. Impaired QoL was more prevalent among patients with major bother due to bowel dysfunction (at 3 years RR 1.42, 95% CI (1.06-1.9) p-value 0.020, at 6 years RR 1.52, 95% CI (1.03-2.24) p-value 0.034) and urinary dysfunction (at 6 years RR 1.44, 95% CI (1.08-1.91) p-value 0.013). There was a tendency to a positive relationship between the number of bodily functions causing bother and risk for impaired QoL. Conclusion Patients treated for anal cancer reported bother regarding several bodily functions as well as poor QoL both at 3 and 6 years without much improvement. Bother was also associated with low QoL indicating that function-related bother should be addressed.
13.	Barimani, Mia, et al. (författare) Professional support and emergency visits during the first 2 weeks postpartum 2014 Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 28:1, s. 57-65 Tidskriftsartikel (refereegranskat)abstract Objectives: The aim of the study was to assess mothers' perceived satisfaction with professional support during the first 2 weeks after childbirth and the extent to which mothers seek emergency care during the same period. Design: A cross-sectional study was conducted of all mothers (n = 546) in Stockholm County, Sweden, who gave birth to a live baby during the same week in 2009. Ethical issues: The study was approved by the regional Research and Ethics Committee at the Karolinska Insititutet, Sweden. Methods: The mothers responded to a study-specific questionnaire on perceived satisfaction with professional support and the sense of coherence scale, which measures coping strategies. The mothers also provided information about their socio-demographic background, obstetric and infant data, and visits to hospital emergency departments. Descriptive and logistic regression analyses were performed. Results: Fifty-three percent of the mothers rated the support received as sufficient or more than sufficient, 29.7% as neither sufficient nor insufficient and 17.7% as insufficient or completely insufficient. The results indicate a lack of continuity in postpartum care. As many as 17% of the mothers in the study population visited hospital emergency departments during the first 2 weeks after childbirth, as a result of problems related to delivery, breastfeeding or infant health. A higher frequency of such emergency visits was associated with poor perception of professional support, low sense of coherence and delivery complications. Conclusions: Relative to otherwise comparable mothers, mothers who experience complications with delivery are less satisfied with professional support and turn more frequently to hospital emergency departments for support. © 2013 Nordic College of Caring Science. Published by Blackwell Publishing Ltd.
14.	Bergenmar, Mia, et al. (författare) Audio-recorded information to patients considering participation in cancer clinical trials - a randomized study 2014 Ingår i: Acta Oncologica. - 1651-226X. ; 53:9, s. 1197-1204 Tidskriftsartikel (refereegranskat)abstract Background. Patient information in cancer clinical trial is challenging. The value of audio-recording interventions for patients considering participating in clinical trials is unclear. The primary aim of this randomized study was to investigate effects of audio-recorded information on knowledge and understanding in patients considering participation in a clinical trial. Material and methods. Patients scheduled for information about a phases 2 or 3 trial by one of the 13 participating oncologists at the Department of Oncology during the study period (2008-2013) were eligible. The intervention consisted of an audio-recording on compact disc (CD) of the information at the medical consultation in which the patients were informed about a trial. Knowledge and understanding was measured by the questionnaire, Quality of Informed Consent. Results. A total of 130 patients were randomized, 70% of the calculated sample size (n = 186). Sixty-seven patients were randomized to the intervention. In total, 101 patients (78%) completed questionnaires. No statistical significant differences were found between the groups with respect to knowledge and understanding. The level of knowledge was relatively high, with the exceptions of the risks associated with, and the unproven nature of, the trial. Overall, patients who declined participation scored statistically significant lower on knowledge. Conclusion. The present study was underpowered and the results should therefore be interpreted with caution. Still, 130 patients were included with a response rate of 78%. A CD including the oral information about a clinical trial did not show any effects on knowledge or understanding. However, the levels of knowledge were high, possible due to the high levels of education in the study group. Information on risks associated with the trial is still an area for improvement.
15.	Berglund, Mia, et al. (författare) Suffering caused by care - Patients' experiences from hospital settings 2012 Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 7, s. Article number 18688- Tidskriftsartikel (refereegranskat)abstract Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.
16.	Berglund, Mia, 1964-, et al. (författare) The best of both worlds – entering the nursing profession with support of a transition programme 2022 Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 36:2, s. 446-455 Tidskriftsartikel (refereegranskat)abstract Background: Transition into clinical practice for newly graduated nurses is a difficult time, with high stress levels defined by a demanding period of personal and professional acclimatisation. Transitions are complicated and multi-dimensional, and to understand this process, it is crucial to identify the factors that facilitate or stand in the way of a healthy transition.Aim: The phenomenological study aimed to describe newly graduated nurses’ expectations of transitioning into the nursing profession at the start of a clinical nursing introduction programme, including education, supervision, and critical reflection with peers.Method: The study was based on seven group interviews with newly graduated nurses. The interviews utilised open-ended and follow-up questions and were carried out as a dialogue to enable reflection on the phenomenon of interest. This was explored and illuminated using the reflective lifeworld research approach, based on phenomenological epistemology.Findings: “Expectations of transition into the nursing profession viathe Clinical Nursing Introduction Programme” is signified by an oscillating movement between uncertainty, security, challenge, and growth on the threshold of a new identity. The phenomenon is constituted by the courage to grow, responsibility and fear, belonging and vulnerability, and support and challenge.Conclusion: Transitioning into the nursing profession viathe Clinical Nursing Introduction Programme means having the best of both worlds. Newly graduated nurses have the opportunity to receive education and structured support at the same time as they work independently in clinical practice.
17.	Carson, Dean B., 1970-, et al. (författare) Addressing the workforce crisis in (rural) social care : a scoping review 2024 Ingår i: International Journal of Health Planning and Management. - : John Wiley & Sons. - 0749-6753 .- 1099-1751. ; 39:3, s. 806-823 Forskningsöversikt (refereegranskat)abstract Background: This scoping review identifies strategies potentially addressing the ‘workforce crisis’ in rural social care. The increasing global demand for social care has been coupled with widely recognised challenges in recruiting and retaining sufficient staff to provide this care. While the social care workforce crisis is a global phenomenon, it is particularly acute in rural areas.Methods: The review identified 75 papers which (i) had been published since 2017, (ii) were peer reviewed, (iii) concerned social care, (iv) were relevant to rural settings, (v) referenced workforce shortages, and (vi) made recommendations for ways to address those shortages. Thematic synthesis was used to derive three analytical themes with a combined 17 sub-themes applying to recommended strategies and evidence supporting those strategies.Results: The most common strategies for addressing social care workforce shortages were to improve recruitment and retention (‘recruit and retain’) processes without materially changing the workforce composition or service models. Further strategies involved ‘revitalising’ the social care workforce through redeploying existing staff or identifying new sources of labour. A small number of strategies involved ‘re-thinking’ social care service models more fundamentally. Very few papers specifically considered how these strategies might apply to rural contexts, and evidence for the effectiveness of strategies was sparse.Conclusion: The review identifies a significant gap in the literature in relation to workforce innovation and placed-based studies in rural social care systems. It is unlikely that the social care workforce crisis can be addressed through continuing attempts to recruit and retain workers within existing service models.
18.	Christoffersson, Gustaf, et al. (författare) Clinical and Experimental Pancreatic Islet Transplantation to Striated Muscle : Establishment of a Vascular System Similar to that in Native Islets 2010 Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 59:10, s. 2569-2578 Tidskriftsartikel (refereegranskat)abstract Objective: Curing type 1 diabetes by transplanting pancreatic islets into the liver is associated with poor long-term outcome and graft failure at least partly due to inadequate graft revascularization. The aim of the current study was to evaluate striated muscle as a potential angiogenic site for islet transplantation. Research Design and Methods: The current study presents a new experimental model which is found applicable to clinical islet transplantation. Islets were implanted into striated muscle where after intra-islet vascular density and blood flow were visualized with intravital and confocal microscopy in mice, and by magnetic resonance imaging in three auto-transplanted pancreatectomized patients. Mice were rendered neutropenic by repeated injections of Gr-1 antibody and diabetes was induced by alloxan treatment. Results: Contrary to liver-engrafted islets, islets transplanted to mouse muscle were revascularized with vessel densities and blood flow entirely comparable to islets within intact pancreas. Initiation of islet revascularization at the muscular site was dependent on neutrophils, and the function of islets transplanted to muscle was proven by curing diabetic mice. The experimental data were confirmed in auto-transplanted patients where higher plasma volumes were measured in islets engrafted in forearm muscle compared to adjacent muscle tissue through high-resolution magnetic resonance imaging. Conclusions: This study presents a novel paradigm in islet transplantation whereby recruited neutrophils are crucial for the functionally restored intra-islet blood perfusion following transplantation to striated muscle under experimental and clinical situations.
19.	Dalmo, Erika, et al. (författare) Growth-Inhibitory Activity of Bone Morphogenetic Protein 4 in Human Glioblastoma Cell Lines Is Heterogeneous and Dependent on Reduced SOX2 Expression 2020 Ingår i: Molecular Cancer Research. - 1541-7786 .- 1557-3125. ; 18:7, s. 981-991 Tidskriftsartikel (refereegranskat)abstract Glioblastoma multiforme continues to have a dismal prognosis. Even though detailed information on the genetic aberrations in cell signaling and cell-cycle checkpoint control is available, no effective targeted treatment has been developed. Despite the advanced molecular defects, glioblastoma cells may have remnants of normal growth-inhibitory pathways, such as the bone morphogenetic protein (BMP) signaling pathway. We have evaluated the growth-inhibitory effect of BMP4 across a broad spectrum of patient samples, using a panel of 40 human glioblastoma initiating cell (GIC) cultures. A wide range of responsiveness was observed. BMP4 sensitivity was positively correlated with a proneural mRNA expression profile, high SOX2 activity, and BMP4-dependent upregulation of genes associated with inhibition of the MAPK pathway, as demonstrated by gene set enrichment analysis. BMP4 response in sensitive cells was mediated by the canonical BMP receptor pathway involving SMAD1/5/9 phosphorylation and SMAD4 expression. SOX2 was consistently downregulated in BMP4-treated cells. Forced expression of SOX2 attenuated the BMP4 sensitivity including a reduced upregulation of MAPK-inhibitory genes, implying a functional relationship between SOX2 downregulation and sensitivity. The results show an extensive heterogeneity in BMP4 responsiveness among GICs and identify a BMP4-sensitive subgroup, in which SOX2 is a mediator of the response.
20.	Denby, Bruce, et al. (författare) ESTIMATING DOMESTIC WOOD BURNING EMISSIONS OF PARTICULATE MATTER IN TWO NORDIC CITIES BY COMBINING AMBIENT AIR OBSERVATIONS WITH RECEPTOR AND DISPERSION MODELS 2010 Ingår i: Chemical Industry and Chemical Engineering Quarterly. - 1451-9372. ; 16:3, s. 237-241 Tidskriftsartikel (refereegranskat)abstract The major emission source of primary PM2 (5) in many Nordic countries is wood burning for domestic heating Though direct measurements of wood burning emissions are possible under controlled conditions, emission inventories for urban scale domestic heating are difficult to calculate and remain uncertain As an alternative method for estimating these emissions, this paper makes use of ambient air measurements chemical analysis of filter samples receptor models, dispersion models, and simple inverse modelling methods to infer the emission strengths A comparison of dispersion models with receptor models indicates that the dispersion models tend to overestimate the contribution from wood burning The inverse modelling results are found to agree with those from the receptor modelling Though both the receptor and inverse modelling point to an overestimation of the wood burning emissions of PM2 (5), it is not possible to assign this solely to errors in the emissions inventory as a dispersion model error can be significant It is recommended to improve plume rise and urban canopy meteorological descriptions in the dispersion models before these models are of sufficient quality to allow quantitative assessments of emission inventories
21.	Engström, Åsa, et al. (författare) Nursing Care of ICU Patients Lightly Sedated with Dexmedetomidine 2016 Ingår i: Journal of Clinical Intensive Care and Medicine. - : Heighten Science Publications Corporation. - 2639-6653. ; 1, s. 5-13 Tidskriftsartikel (refereegranskat)abstract Background: Intensive care patients are often in need of sedation to endure being intubated. Lightsedation is increasingly common since it has been proved to offer benefi ts such as faster recovery to patients.Aim: The aim of this study was to describe critical care nurses’ experiences of nursing patients lightlysedated with dexmedetomidine.Research Methodology: Qualitative personal interviews were conducted during 2015 with 10 critical carenurses in Sweden. Interview transcripts were analysed using inductive qualitative thematic analysis.Results: Light sedation of the patient facilitated communication and interaction with him or her, and therelationship between the patient and his or her family members. Dexmedetomidine was described as a fairlynew drug, and the critical care nurses stated that they needed more knowledge about it and about sedationscales in order to learn more about the drug’s mechanism of action and its potential side effects on patients.Conclusion: It is important to critical care nurses to learn more about dexmedetomidine and about sedationscales to assess levels of sedation, as light sedation has been shown to benefi t the patient as opposed to deepsedation that can increase recovery time.
22.	Eriksson, Mats, Professor, 1959-, et al. (författare) Oetiskt att vägra vård till vaccinmotståndare 2021 Ingår i: Dagens Nyheter. - : AB Dagens nyheter. - 1101-2447. Tidskriftsartikel (populärvet., debatt m.m.)
23.	Eyre, Sintra, et al. (författare) Bioimpedance analysis in patients with chronic kidney disease 2023 Ingår i: Journal of Renal Care. - : John Wiley & Sons. - 1755-6678 .- 1755-6686. ; 49:3, s. 147-157 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
24.	Faucillion, Marie-Line, 1989-, et al. (författare) Genome-wide RNA stability analysis in Drosophila melanogaster reveals two distinct gene expression regulation mechanisms Annan publikation (övrigt vetenskapligt/konstnärligt)
25.	Faucillion, Marie-Line, 1989-, et al. (författare) Modulation of RNA stability regulates gene expression in two opposite ways : through buffering of RNA levels upon global perturbations and by supporting adapted differential expression 2022 Ingår i: Nucleic Acids Research. - : Oxford University Press. - 0305-1048 .- 1362-4962. ; 50:8, s. 4372-4388 Tidskriftsartikel (refereegranskat)abstract The steady state levels of RNAs, often referred to as expression levels, result from a well-balanced combination of RNA transcription and decay. Alterations in RNA levels will therefore result from tight regulation of transcription rates, decay rates or both. Here, we explore the role of RNA stability in achieving balanced gene expression and present genome-wide RNA stabilities in Drosophila melanogaster male and female cells as well as male cells depleted of proteins essential for dosage compensation. We identify two distinct RNA-stability mediated responses involved in regulation of gene expression. The first of these responds to acute and global changes in transcription and thus counteracts potentially harmful gene mis-expression by shifting the RNA stability in the direction opposite to the transcriptional change. The second response enhances inter-individual differential gene expression by adjusting the RNA stability in the same direction as a transcriptional change. Both mechanisms are global, act on housekeeping as well as non-housekeeping genes and were observed in both flies and mammals. Additionally, we show that, in contrast to mammals, modulation of RNA stability does not detectably contribute to dosage compensation of the sex-chromosomes in D. melanogaster.
26.	Frank, Jens, et al. (författare) Rekommendationer för informationsmöten i problemsituationer med rovdjur 2018 Ingår i: Vilt och tamt fakta: ett faktablad från Viltskadecenter och SLU. Annan publikation (populärvet., debatt m.m.)
27.	Franks, P. W., et al. (författare) Technological readiness and implementation of genomic-driven precision medicine for complex diseases 2021 Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 290:3, s. 602-620 Forskningsöversikt (refereegranskat)abstract The fields of human genetics and genomics have generated considerable knowledge about the mechanistic basis of many diseases. Genomic approaches to diagnosis, prognostication, prevention and treatment - genomic-driven precision medicine (GDPM) - may help optimize medical practice. Here, we provide a comprehensive review of GDPM of complex diseases across major medical specialties. We focus on technological readiness: how rapidly a test can be implemented into health care. Although these areas of medicine are diverse, key similarities exist across almost all areas. Many medical areas have, within their standards of care, at least one GDPM test for a genetic variant of strong effect that aids the identification/diagnosis of a more homogeneous subset within a larger disease group or identifies a subset with different therapeutic requirements. However, for almost all complex diseases, the majority of patients do not carry established single-gene mutations with large effects. Thus, research is underway that seeks to determine the polygenic basis of many complex diseases. Nevertheless, most complex diseases are caused by the interplay of genetic, behavioural and environmental risk factors, which will likely necessitate models for prediction and diagnosis that incorporate genetic and non-genetic data.
28.	Fretts, Amanda M., et al. (författare) Consumption of meat is associated with higher fasting glucose and insulin concentrations regardless of glucose and insulin genetic risk scores : a meta-analysis of 50,345 Caucasians 2015 Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 102:5, s. 1266-1278 Tidskriftsartikel (refereegranskat)abstract Background: Recent studies suggest that meat intake is associated with diabetes-related phenotypes. However, whether the associations of meat intake and glucose and insulin homeostasis are modified by genes related to glucose and insulin is unknown. Objective: We investigated the associations of meat intake and the interaction of meat with genotype on fasting glucose and insulin concentrations in Caucasians free of diabetes mellitus. Design: Fourteen studies that are part of the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium participated in the analysis. Data were provided for up to 50,345 participants. Using linear regression within studies and a fixed-effects meta-analysis across studies, we examined l) the associations of processed meat and unprocessed red meat intake with fasting glucose and insulin concentrations; and 2) the interactions of processed meat and unprocessed red meat with genetic risk score related to fasting glucose or insulin resistance on fasting glucose and insulin concentrations. Results: Processed meat was associated with higher fasting glucose, and unprocessed red meat was associated with both higher fasting glucose and fasting insulin concentrations after adjustment for potential confounders [not including body mass index (BMI)]. For every additional 50-g serving of processed meat per day, fasting glucose was 0.021 mmol/L (95% CI: 0.011, 0.030 mmol/L) higher. Every additional 100-g serving of unprocessed red meat per day was associated with a 0.037-mmol/L (95% CI: 0.023, 0.051-mmol/L) higher fasting glucose concentration and a 0.049-1n-pmon (95% CI: 0.035, 0.063-1n-pmol/L) higher fasting insulin concentration. After additional adjustment for BMI, observed associations were attenuated and no longer statistically significant. The association of processed meat and fasting insulin did not reach statistical significance after correction for multiple comparisons. Observed associations were not modified by genetic loci known to influence fasting glucose or insulin resistance. Conclusion: The association of higher fasting glucose and insulin concentrations with meat consumption was not modified by an index of glucose- and insulin-related single-nucleotide polymorphisms.
29.	Gerlee, Philip, 1980, et al. (författare) Inferring rates of metastatic dissemination using stochastic network models 2019 Ingår i: Plos Computational Biology. - : Public Library of Science (PLoS). - 1553-7358 .- 1553-734X. ; 15:4 Tidskriftsartikel (refereegranskat)abstract The formation of metastases is driven by the ability of cancer cells to disseminate from the site of the primary tumour to target organs. The process of dissemination is constrained by anatomical features such as the flow of blood and lymph in the circulatory system. We exploit this fact in a stochastic network model of metastasis formation, in which only anatomically feasible routes of dissemination are considered. By fitting this model to two different clinical datasets (tongue & ovarian cancer) we show that incidence data can be modelled using a small number of biologically meaningful parameters. The fitted models reveal site specific relative rates of dissemination and also allow for patient-specific predictions of metastatic involvement based on primary tumour location and stage. Applied to other data sets this type of model could yield insight about seed-soil effects, and could also be used in a clinical setting to provide personalised predictions about the extent of metastatic spread. Author summary For most cancer patients the occurrence of metastases equals incurable disease. Despite this fact our quantitative knowledge about the process of metastatic dissemination is limited. In this manuscript we improve on a previously published mathematical model by incorporating known biological facts about metastatic spread and also consider the temporal dimension of dissemination. The model is fit to two different cancer types with very different patterns of spread, which highlights the versatility of our framework. Properly parametrised this type of model can be used for making personalised predictions about metastatic burden.
30.	Gustafsson, Anna, et al. (författare) Fiskreproduktion i naturtyperna estuarier (1130) och laguner (1150) i Bottenviken och Bottenhavet : Pilotdrift och utvärdering 2014 2014 Rapport (övrigt vetenskapligt/konstnärligt)abstract Föreliggande rapport presenterar en pilotdrift av uppföljning av fiskreproduktion i habitatdirektivets naturtyper laguner 1150 och estuarier 1130 enligt Havs- och vattenmyndighetens föreslagna undersökningstyp Yngelprovfiske med små undervattensdetonationer. Syftet var att undersöka hur provfiske enligt den framtagna manualen fungerar i stor skala och hur väl metoden möter kraven för biogeografisk uppföljning. Undersökningen omfattade 42 områden av naturtyp laguner (naturtypskod1150) och estuarier (naturtypskod 1130) i havsbassängerna Bottenhavet och Bottenviken. Hälften av områdena ingår i naturvårdsnätverket Natura 2000 och hälften saknar motsvarande skydd. Resultaten visar stor variation mellan områden och provtagningsstationer samt att mycket litet av variansen i fiskyngelsamhället kan härledas till bassäng, naturtyp och naturskydd. Tidigare studier har visat att öppenhet mot havet och vattnets utbytestid är starka strukturerande faktorer för både fiskyngel och bottenvegetation. För att förklara variationen mellan områden är det därför önskvärt att hänsyn tas till åtminstone dessa faktorer vid inventeringar och analyser. Resultaten ger stöd åt biogeografisk uppföljning på marin atlantisk och baltisk nivå så till vida att de två undersökta östersjöbassängerna sinsemellan uppvisade mycket små skillnader. En jämförelse med Egentliga Östersjön samt med marin atlantisk region bör genomföras för att vidare undersöka detta. Att skillnaderna var små mellan naturtyperna laguner och estuarier indikerar att denna indelning har låg biologisk relevans. Merparten av de områden som valts ut som estuarier i föreliggande studie uppfyller dock inte Naturvårdsverkets kriterier för naturtypen då årsmedelvattenföringen till områdena är alltför låg. Dessa områden måste därför anses vara tveksamma representanter för naturtyp estuarier. Precisionsberäkningar visar att flera variabler (antalet arter, antalet typiska arter, Shannons diversitetsindex och andelen rovfisk) var möjliga att med uppdragets omfattning provta på acceptabel nivå. Precisionen för abundans av enskilda arter av fiskyngel var dock dålig vilket försvårar uppföljning av bevarandestatus med nuvarande målindikator för rekrytering. I rapporten diskuteras för- och nackdelar med undersökningstypen. Förslag lämnas för att förtydliga och förbättra manualen, sett inte bara till själva provfisket utan också vad gäller förberedelser och efterarbete. Projektet är ett samarbete mellan Havs- och vattenmyndigheten och ArtDatabanken samt länsstyrelserna i Uppsala, Gävleborgs, Västernorrlands, Västerbottens och Norrbottens län. Provfiske och resultatredovisning utfördes av Naturvatten AB i samarbete med JP Aquakonsult KB, Hydrophyta Ekologikonsult, Hansen EcoResearch samt Aquanalys med Länsstyrelsen i Gävleborg som beställare.
31.	Hallberg, Pär, et al. (författare) Comparison of Clinical Factors Between Patients With Angiotensin-Converting Enzyme Inhibitor-Induced Angioedema and Cough 2017 Ingår i: The Annals of Pharmacotherapy. - Thousand Oaks, USA : Sage Publications. - 1060-0280 .- 1542-6270. ; 51:4, s. 293-300 Tidskriftsartikel (refereegranskat)abstract Background: Angioedema is a rare and serious adverse drug reaction (ADR) to angiotensin-converting enzyme (ACE) inhibitor treatment. Dry cough is a common side effect of ACE inhibitors and has been identified as a possible risk factor for angioedema.Objective: We compared characteristics between patients with ACE inhibitor-induced angioedema and cough with the aim of identifying risk factors that differ between these adverse events.Methods: Data on patients with angioedema or cough induced by ACE inhibitors were collected from the Swedish database of spontaneously reported ADRs or from collaborating clinicians. Wilcoxon rank sum test, Fisher's exact test, and odds ratios (ORs) with 95% CIs were used to test for between-group differences. The significance threshold was set to P <0.00128 to correct for multiple comparisons.Results: Clinical characteristics were compared between 168 patients with angioedema and 121 with cough only. Smoking and concomitant selective calcium channel blocker treatment were more frequent among patients with angioedema than cough: OR = 4.3, 95% CI = 2.1-8.9, P = 2.2 × 10(-5), and OR = 3.7, 95% CI = 2.0-7.0, P = 1.7 × 10(-5) Angioedema cases were seen more often in male patients (OR = 2.2, 95% CI = 1.4-3.6, P = 1.3 × 10(-4)) and had longer time to onset and higher doses than those with cough (P = 3.2 × 10(-10) and P = 2.6 × 10(-4)). A multiple model containing the variables smoking, concurrent calcium channel blocker treatment, male sex, and time to onset accounted for 26% of the variance between the groups.Conclusion: Smoking, comedication with selective calcium channel blockers, male sex, and longer treatment time were associated with ACE inhibitor-induced angioedema rather than cough.
32.	Hallberg, Pär, et al. (författare) Genetic variants associated with angiotensin-converting enzyme inhibitor-induced cough : a genome-wide association study in a Swedish population 2017 Ingår i: Pharmacogenomics (London). - : FUTURE MEDICINE LTD. - 1462-2416 .- 1744-8042. ; 18:3, s. 201-213 Tidskriftsartikel (refereegranskat)abstract Aim: We conducted a genome-wide association study on angiotensin-converting enzyme inhibitor-induced cough and used our dataset to replicate candidate genes iden-tified in previous studies. Patients & methods: A total of 124 patients and 1345 treated controls were genotyped using Illumina arrays. The genome-wide significance level was set to p < 5 x 10(-8). Results: We identified nearly genome-wide significant associations in CLASP1, PDE11A, KCNMB2, TGFA, SLC38A6 and MMP16. The strongest association was with rs62151109 in CLASP1 (odds ratio: 3.97; p = 9.44 x 10(-8)). All top hits except two were located in intronic or noncoding DNA regions. None of the candidate genes were significantly associated in our study. Conclusion: Angiotensin-converting enzyme inhibitor-induced cough is potentially associated with genes that are independent of bradykinin pathways.
33.	Hallqvist, Andreas, 1973, et al. (författare) Intraperitoneal Alpha-emitting Radio Immunotherapy with Astatine-211 in Relapsed Ovarian Cancer; Long-term Follow-up with Individual Absorbed Dose Estimations. 2019 Ingår i: Journal of Medical Imaging and Radiation Sciences. - 1939-8654. Konferensbidrag (övrigt vetenskapligt/konstnärligt)
34.	Hallqvist, Andreas, 1973, et al. (författare) Intraperitoneal alpha-Emitting Radioimmunotherapy with At-211 in Relapsed Ovarian Cancer: Long-Term Follow-up with Individual Absorbed Dose Estimations 2019 Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 2159-662X. ; 60:8, s. 1073-1079 Tidskriftsartikel (refereegranskat)abstract Eliminating microscopic residual disease with alpha-particle radiation is theoretically appealing. After extensive preclinical work with alpha-particle-emitting At-211, we performed a phase I trial with intraperitoneal alpha-particle therapy in epithelial ovarian cancer using At-211 conjugated to MX35, the antigen-binding fragments-F(ab')(2)-of a mouse monoclonal antibody. We now present clinical outcome data and toxicity in a long-term follow-up with individual absorbed dose estimations. Methods: Twelve patients with relapsed epithelial ovarian cancer, achieving a second complete or nearly complete response with chemotherapy, received intraperitoneal treatment with escalating (20-215 MBq/L) activity concentrations of At-211-MX35 F(ab')(2). Results: The activity concentration was escalated to 215 MBq/L without any dose-limiting toxicities. Most toxicities were low-grade and likely related to the treatment procedure, not clearly linked to the alpha-particle irradiation, with no observed hematologic toxicity. One grade 3 fatigue and 1 grade 4 intestinal perforation during catheter implantation were observed. Four patients had a survival of more than 6 y, one of whom did not relapse. At progression, chemotherapy was given without signs of reduced tolerability. Overall median survival was 35 mo, with a 1-, 2-, 5-, and 10-y survival of 100%, 83%, 50%, and 25%, respectively. Calculations of the absorbed doses showed that a lower specific activity is associated with a lower single-cell dose, whereas a high specific activity may result in a lower central dose in microtumors. Individual differences in absorbed dose to possible microtumors were due to variations in administered activity and the specific activity. Conclusion: No apparent signs of radiation-induced toxicity or decreased tolerance to relapse therapy were observed. The dosimetric calculations show that further optimization is advisable to increase the efficacy and reduce possible long-term toxicity.
35.	Hedner, E., et al. (författare) Brominated cyclodipeptides from the marine sponge Geodia barretti as selective 5-HT ligands 2006 Ingår i: Journal of Natural Products. - : American Chemical Society (ACS). - 0163-3864 .- 1520-6025. ; 69:10, s. 1421-1424 Tidskriftsartikel (refereegranskat)abstract The brominated cyclodipeptides barettin(cyclo[(6-bromo-8-entryptophan) arginine]) and 8,9-dihydrobarettin ( cyclo[(6-bromotryptophan) arginine]) isolated from the marine sponge Geodia barretti have previously been shown to inhibit settlement of barnacle larvae in a dose-dependent manner in concentrations ranging from 0.5 to 25 mu M. To further establish the molecular target and mode of action of these compounds, we investigated their affinity to human serotonin receptors. The tryptophan residue in the barettins resembles that of endogenous serotonin [5-hydroxytryptamine]. A selection of human serotonin receptors, including representatives from all subfamilies (1-7), were transfected into HEK-293 cells. Barettin selectively interacted with the serotonin receptors 5-HT2A, 5-HT2C, and 5-HT4 at concentrations close to that of endogenous serotonin, with the corresponding K-i values being 1.93, 0.34, and 1.91 mu M, respectively. 8,9-Dihydrobarettin interacted exclusively with the 5-HT2C receptor with a K-i value of 4.63 mu M; it failed to show affinity to 5-HT2A and 5-HT4, indicating that the double bond between the tryptophan and arginine residue plays an important role in the interaction with the receptor proteins.
36.	Hedström, Johanna, et al. (författare) Quality of care in dysphagia patients: adaptation and validation of the Swedish SWAL-CARE questionnaire 2020 Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 18:1 Tidskriftsartikel (refereegranskat)abstract Background The aim of this study was to adapt the instrument and evaluate the psychometric properties of the Swedish version of the Swallowing Quality of Care questionnaire (S-SWAL-CARE) in patients with oropharyngeal dysphagia. Methods Translation and adaptation of the original SWAL-CARE into Swedish was performed according to established international guidelines. Field testing was performed using 100 patients with oropharyngeal dysphagia due to multiple reasons such as head and neck cancer and neurologic/neuromuscular disease, who had undergone swallowing evaluation within 6 months prior to the study. The patients answered the S-SWAL-CARE, the Quality from the Patient's Perspective (QPP) and the Swallowing Quality of Life (SWAL-QOL). Test-retest was performed in 20% of the participants. The reliability and validity of the S-SWAL-CARE were assessed by Pearson correlation coefficient and Cronbach's alpha as well as convergent and discriminative validity, respectively. Results The field testing of the S-SWAL-CARE resulted in sufficient reliability, with Cronbach's alpha values exceeding 0.90 for all domains. All items correlated strongly to their own domain, with weaker correlations to the other domains, indicating proper scale structure. Results also indicate sufficient convergent and discriminant validity when tested for association to the QPP domains and the SWAL-QOL Total score. The test-retest reliability of the S-SWAL-CARE demonstrated sufficient intraclass correlation coefficient (ICC) for the General advice domain (0.73) and Clinical advice domain (0.82). The ICC for the Patient satisfaction domain was lower (0.44). Conclusion The S-SWAL-CARE can be considered a reliable and valid tool to assess the dysphagia-related quality of care in a mixed Swedish dysphagia patient population.
37.	Hendrickson, Sara J., et al. (författare) Plasma Carotenoid- and Retinol-Weighted Multi-SNP Scores and Risk of Breast Cancer in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium 2013 Ingår i: Cancer Epidemiology, Biomarkers and Prevention. - Philadelphia, PA, USA : American Association for Cancer Research. - 1055-9965 .- 1538-7755. ; 22:5, s. 927-936 Tidskriftsartikel (refereegranskat)abstract Background: Dietary and circulating carotenoids have been inversely associated with breast cancer risk, but observed associations may be due to confounding. Single-nucleotide polymorphisms (SNPs) in beta-carotene 15,15'-monooxygenase 1 (BCMO1), a gene encoding the enzyme involved in the first step of synthesizing vitamin A from dietary carotenoids, have been associated with circulating carotenoid concentrations and may serve as unconfounded surrogates for those biomarkers. We determined associations between variants in BCMO1 and breast cancer risk in a large cohort consortium. Methods: We used unconditional logistic regression to test four SNPs in BCMO1 for associations with breast cancer risk in 9,226 cases and 10,420 controls from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium (BPC3). We also tested weighted multi-SNP scores composed of the two SNPs with strong, confirmed associations with circulating carotenoid concentrations. Results: Neither the individual SNPs nor the weighted multi-SNP scores were associated with breast cancer risk [OR (95% confidence interval) comparing extreme quintiles of weighted multi-SNP scores = 1.04 (0.94-1.16) for beta-carotene, 1.08 (0.98-1.20) for alpha-carotene, 1.04 (0.94-1.16) for beta-cryptoxanthin, 0.95 (0.87-1.05) for lutein/zeaxanthin, and 0.92 (0.83-1.02) for retinol]. Furthermore, no associations were observed when stratifying by estrogen receptor status, but power was limited. Conclusions: Our results do not support an association between SNPs associated with circulating carotenoid concentrations and breast cancer risk. Impact: Future studies will need additional genetic surrogates and/or sample sizes at least three times larger to contribute evidence of a causal link between carotenoids and breast cancer. (C) 2013 AACR.
38.	Hookway, Samantha, 1982, et al. (författare) The Problem with Problems: Reframing and Cognitive Bias in Healthcare Innovation 2018 Ingår i: R&D Management Conference - R&Designing Innovation: Transformational Challenges for Organisations and Society. Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract Design Thinking (DT), a term that has become well-branded in the world of innovation, is typically defined broadly as a methodology for problem-solving stemming from the way designers think and do. However, from cognitive science or social psychology perspective, DT can be more specifically viewed as a process for overcoming cognitive bias in thinking and decision-making (Liedtka 2014). The purpose of this study is to better understand how cognitive bias influences the way in which decision-makers frame their problems and the impact of DT methods to substantially reframe the problem leading to better innovative solutions. Specifically, the relationship between cognitive bias and reframing was investigated through a comparative, cross-sectional analysis of nine healthcare innovation projects in the Västra Götaland Region of Sweden and two in-depth case studies. Thus, we ask in this paper, (1) is the problem really what people think it is, and if not, why? and (2) which methods are most useful in exposing misunderstandings and reframing the problem? The cognitive difference between the original framing and the reframed problem is further analyzed and interpreted, resulting in a new theoretical concept of reframing distance and reframing space.
39.	Hookway, Samantha, 1982, et al. (författare) The Problem with Problems: Reframing and Cognitive Bias in Healthcare Innovation 2019 Ingår i: The Design Journal. - : Informa UK Limited. - 1460-6925 .- 1756-3062. ; 22:Issue sup1: Running with Scissors: 13th International Conference of the European Academy of Design, Dundee, 10-12th April, 2019, edited by Louise Valentine and Leon Cruickshank, s. 553-574 Tidskriftsartikel (refereegranskat)abstract Design Thinking (DT), well-branded in the world of innovation, is typically defined as a methodology for problem-solving stemming from the way designers think and do. However, from a cognitive science or social psychology perspective, DT can be viewed as a process for overcoming cognitive bias in decision-making (Liedtka 2015). The purpose of this study is to better understand how cognitive biases influence the way decision-makers frame problems and the impact of DT methods to reframe the problem. Specifically, this relationship was investigated through a comparative analysis of nine healthcare innovation projects and two in-depth case studies. Thus, asking (1) is the problem really what people think it is, and if not, why? and (2) which methods are most useful in exposing misunderstandings and reframing the problem? The cognitive difference between the original and the reframed problem is further propositioned; resulting in the theoretical concepts of reframing distance and reframing space.
40.	Introduction – Knowledge qualities within the field of sloyd : Techne series A: 10/2007. Research in Sloyd Education and Crafts Science. (eds.) Johansson, M. & Porko-Hudd, M. 2007 Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract The theme for this Techne A-series report is Knowledge, Qualities and Sloyd. Research results show that individual and collective values and traditions often have a remarkable influence on one´s vision on sloyd. The lack of research re-sults or insufficient insights into existing research add to the fact that many knowledge qualities within the field of sloyd remain hidden. It is therefore a challenge to make visible how versatile the learning situations can be when making sloyd objects. Knowledge and experiences in sloyd practices develop by giving and taking in interaction with other persons, with materials, tools and artefacts. The five articles in this report are written by some of the researchers that took part in the first international research conference on sloyd Tradition in transition – teaching Sloyd, Arts and Crafts in Contemporary Society, 2006, that was arranged by Umeå University, Sweden and Åbo Akademi University, Finland. In the articles the researchers reflect on the view and complexity of Knowledge, Qualities and Sloyd.
41.	Jansson, E, et al. (författare) On the formation of fibrous capsule and fluid space around machined and porous blood plasma clot coated titanium. 2001 Ingår i: Journal of materials science. Materials in medicine. - 0957-4530. ; 12:10-12, s. 1019-24 Tidskriftsartikel (refereegranskat)abstract Machined and machined submicron porous titanium, with and without a thin blood plasma coating (100 nm), were implanted for 7 or 28 days in subcutaneous pockets on the back of the rat. After explantation the specimens were analyzed by light microscopy with respect to thickness of the fibrous capsule, the fluid space width between implants and fibrous capsule, and formation of blood vessels. The results at 7 days indicate a thinnest fluid space for the plasma clot coated porous titanium surface, and the spaces vanished at the light microscopic level after 28 days outside all the analyzed surfaces. The thickness of the fibrous capsule increased outside the different surfaces at 7-28 days, and in this respect no significant differences were observed between the different surfaces at any time. Analysis of neovascularization showed that the number of vessels and proportion of vessels in the fibrous capsule increased with time at all surfaces, except machined Ti where the number instead decreased from 7 to 28 days. The average distance between the blood vessels and the fluid space increased with time for all types of surfaces. The results in the present study indicate that the healing process around titanium can be modulated by porosity and thin pre-prepared plasma coatings.
42.	Johansson, Anita, et al. (författare) Clinical nursing introduction program for new graduate nurses in Sweden : Study protocol for a prospective longitudinal cohort study 2021 Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:2 Tidskriftsartikel (refereegranskat)abstract Introduction High levels of nursing turnover represent a problem for healthcare organisations and patient safety. Experiences during the first years in the nursing profession have a significant impact on nurses' future decisions concerning their careers. Nurses at the start of their professional career need to practise their hands-on skills as well as their theoretical knowledge. In addition, new graduate nurses need regular support and opportunities to reflect on experiences in their new profession. The aim of the present study is to describe the Clinical Nursing Introduction Program (CNIP) and present a study design in which the programme is used to support new graduate nurses' transition into the nursing profession. Method and analysis The present study examines the CNIP at a general hospital in southwest Sweden, which lasts for 14 months. The programme has a unique profile based on a person-centred approach and consists of five components: employment and organisation, a compulsory introduction week, two placements in different clinical settings, education days and process-oriented nursing supervision. The present study presents a protocol for a prospective longitudinal cohort study, using qualitative and quantitative methods in the collection and analysis of data. Measurements will include data collection between 2019 and 2023 when the nurses start the CNIP (baseline) and then after 1 and 2 years. Ethics and dissemination This study has been approved by the Regional Ethical Review Board in Gothenburg (Dnr 1056-18). Study findings will be presented at national and international conferences and published in peer-reviewed journals. Trial registration number 273573 (https://www.researchweb.org/is/vgr).
43.	Johansson, Anna-Mia, 1978- (författare) Chromosome-wide gene regulatory mechanisms in Drosophila melanogaster 2010 Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract In Drosophila there are two different chromosome-wide targeting systems, the dosage compensation system that equalizes the transcriptional output from X-linked genes between males and females, and the regulation of the 4th chromosome mediated by the POF protein. The best studied of these two mechanisms is the dosage compensation system. To attain dosage compensation in Drosophila at least five different proteins, encoded by the male-specific lethal genes msl1, msl2, msl3, mle and mof, are required. These proteins together with two non-coding RNAs (roX1 and roX2) form a dosage compensation complex (MSL complex), which binds exclusively to the X chromosome in Drosophila males and up-regulates the transcription approximately two times. In this thesis I show that roX1 and roX2 are most likely the only non-coding RNAs within the MSL complex. As expected, the roX transcripts were enriched within the MSL complex. Interestingly, one additional transcript was identified within the MSL complex. This transcript did not associate with the X chromosome and is therefore not believed to be involved in up-regulation of the X-linked genes. This transcript encodes for the rate limiting component in the MSL complex, the MSL2 protein. A model is proposed in which free, partial or complete, MSL complex feed-back regulates the amount of msl2 transcript, and thereby limits the MSL complex production. The second chromosome-wide regulatory system in flies acts on an autosome, the heterochromatic 4th chromosome. This regulation is a balancing mechanism between at least two different proteins, the chromosome 4 specific protein painting of fourth (POF) and heterochromatin protein 1 (HP1). POF binds to nascent RNAs transcribed from the 4th chromosome and HP1 target the same set of genes at the chromatin level. POF stimulates the transcribed genes, while HP1 represses them; together they create the most optimal condition for these genes. This type of balancing mechanism may be a more general way to fine-tune transcription at a chromosome-wide level and raises the question about autosomal gene regulation as a general mechanism.
44.	Johansson, Anna-Mia, 1978-, et al. (författare) Genome-wide mapping of Painting of fourth on Drosophila melanogaster salivary gland polytene chromosomes 2014 Ingår i: Genomics Data. - : Elsevier BV. - 2213-5960. ; 2, s. 63-65 Tidskriftsartikel (refereegranskat)abstract The protein Painting of fourth (POF) in Drosophila melanogaster specifically targets and stimulates expression output from the heterochromatic 4th chromosome, thereby representing an autosome specific protein [1,2]. Despite the high specificity for chromosome 4 genes, POF is occasionally observed binding to the cytological region 2L:31 in males and females [3] and two loci on the X-chromosome, PoX1 and PoX2 only in females [4]. Here we provide a detailed description of the experimental design and analysis of the tiling array data presented by Lundberg and colleagues in G3: Genes, Genomes, Genetics 2013 [4], where the female specific POF binding to PoX1 and PoX2 loci on the X chromosome was reported. We show the genome-wide high resolution binding profile of the POF protein where these different POF binding sites are detected. The complete data set is available at http://www.ncbi.nlm.nih.gov/geo/ (accession: GSE45402).
45.	Johansson, Anna-Mia, et al. (författare) msl2 mRNA is bound by free nuclear MSL complex in Drosophila melanogaster 2011 Ingår i: Nucleic Acids Research. - : Oxford University Press. - 0305-1048 .- 1362-4962. ; 39:15, s. 6428-6439 Tidskriftsartikel (refereegranskat)abstract In Drosophila, the global increase in transcription from the male X chromosome to compensate for its monosomy is mediated by the male-specific lethal (MSL) complex consisting of five proteins and two non-coding RNAs, roX1 and roX2. After an initial sequence-dependent recognition by the MSL complex of 150-300 high affinity sites, the spread to the majority of the X-linked genes depends on local MSL-complex concentration and active transcription. We have explored whether any additional RNA species are associated with the MSL complex. No additional roX RNA species were found, but a strong association was found between a spliced and poly-adenylated msl2 RNA and the MSL complex. Based on our results, we propose a model in which a non-chromatin-associated partial or complete MSL-complex titrates newly transcribed msl2 mRNA and thus regulates the amount of available MSL complex by feedback. This represents a novel mechanism in chromatin structure regulation.
46.	Johansson, Anna-Mia, et al. (författare) Painting of fourth and chromosome-wide regulation of the 4th chromosome in Drosophila melanogaster. 2007 Ingår i: EMBO J. - 0261-4189. ; 26:9, s. 2307-2316 Tidskriftsartikel (refereegranskat)abstract Drosophila melanogaster exhibits two expression-regulating systems that target whole, specific chromosomes: the dosage compensation system whereby the male-specific lethal complex doubles transcription of genes on the male X-chromosome and the chromosome 4-specific protein Painting of fourth, POF. POF is the first example of an autosome-specific protein and its presence raises the question of the universality of chromosome-specific regulation. Here we show that POF and heterochromatin protein 1 (HP1) are involved in the global regulation of the 4th chromosome. Contrary to previous conclusions, Pof is not essential for survival of diplo-4th karyotype flies. However, Pof is essential for survival of haplo-4th individuals and expression of chromosome 4 genes in diplo-4th individuals is decreased in the absence of Pof. Mapping of POF using chromatin immunoprecipitation suggested that it binds within genes. Furthermore, we show that POF binding is dependent on heterochromatin and that POF and HP1 bind interdependently to the 4th chromosome. We propose a balancing mechanism involving POF and HP1 that provides a feedback system for fine-tuning expression status of genes on the 4th chromosome.
47.	Johansson, Anna-Mia, et al. (författare) POF and HP1 bind expressed exons, suggesting a balancing mechanism for gene regulation 2007 Ingår i: PLoS Genet. - : Public Library of Science (PLoS). - 1553-7404. ; 3:11, s. e209- Tidskriftsartikel (refereegranskat)abstract Two specific chromosome-targeting and gene regulatory systems are present in Drosophila melanogaster. The male X chromosome is targeted by the male-specific lethal complex believed to mediate the 2-fold up-regulation of the X-linked genes, and the highly heterochromatic fourth chromosome is specifically targeted by the Painting of Fourth (POF) protein, which, together with heterochromatin protein 1 (HP1), modulates the expression level of genes on the fourth chromosome. Here we use chromatin immunoprecipitation and tiling microarray analysis to map POF and HP1 on the fourth chromosome in S2 cells and salivary glands at high resolution. The enrichment profiles were complemented by transcript profiles to examine the link between binding and transcripts. The results show that POF specifically binds to genes, with a strong preference for exons, and the HP1 binding profile is a mirror image of POF, although HP1 displays an additional "peak" in the promoter regions of bound genes. HP1 binding within genes is much higher than the basal HP1 enrichment on Chromosome 4. Our results suggest a balancing mechanism for the regulation of the fourth chromosome where POF and HP1 competitively bind at increasing levels with increased transcriptional activity. In addition, our results contradict transposable elements as a major nucleation site for HP1 on the fourth chromosome.
48.	Johansson, Anna-Mia, 1978-, et al. (författare) POF Regulates the Expression of Genes on the Fourth Chromosome in Drosophila melanogaster by Binding to Nascent RNA 2012 Ingår i: Molecular and Cellular Biology. - : American Society for Microbiology. - 0270-7306 .- 1098-5549. ; 32:11, s. 2121-2134 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract In Drosophila, two chromosome-wide compensatory systems have been characterized: the dosage compensation system that acts on the male X chromosome and the chromosome-specific regulation of genes located on the heterochromatic fourth chromosome. Dosage compensation in Drosophila is accomplished by hypertranscription of the single male X chromosome mediated by the male-specific lethal (MSL) complex. The mechanism of this compensation is suggested to involve enhanced transcriptional elongation mediated by the MSL complex, while the mechanism of compensation mediated by the painting of fourth (POF) protein on the fourth chromosome has remained elusive. Here, we show that POF binds to nascent RNA, and this binding is associated with increased transcription output from chromosome 4. We also show that genes located in heterochromatic regions spend less time in transition from the site of transcription to the nuclear envelope. These results provide useful insights into the means by which genes in heterochromatic regions can overcome the repressive influence of their hostile environment.
49.	Johansson, Karin, et al. (författare) Manoeuvring between anxiety and control : Patients' experience of learning to live with diabetes : A lifeworld phenomenological study 2015 Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 10 Tidskriftsartikel (refereegranskat)abstract Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.
50.	Johansson, Karin, et al. (författare) Patients' experiences of support for learning to live with diabetes to promote health and well-being : A lifeworld phenomenological study 2016 Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 11:1 Tidskriftsartikel (refereegranskat)abstract Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.

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