| 1. |
- Lundgren, Markus, et al.
(författare)
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Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity
- 2017
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
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| 2. |
- Allassonnière-Tang, Marc, et al.
(författare)
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Expansion by migration and diffusion by contact is a source to the global diversity of linguistic nominal categorization systems
- 2021
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Ingår i: Humanities & Social Sciences Communications. - : Springer Science and Business Media LLC. - 2662-9992. ; 8, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Languages of diverse structures and different families tend to share common patterns if they are spoken in geographic proximity. This convergence is often explained by horizontal diffusibility, which is typically ascribed to language contact. In such a scenario, speakers of two or more languages interact and influence each other’s languages, and in this interaction, more grammaticalized features tend to be more resistant to diffusion compared to features of more lexical content. An alternative explanation is vertical heritability: languages in proximity often share genealogical descent. Here, we suggest that the geographic distribution of features globally can be explained by two major pathways, which are generally not distinguished within quantitative typological models: feature diffusion and language expansion. The first pathway corresponds to the contact scenario described above, while the second occurs when speakers of genetically related languages migrate. We take the worldwide distribution of nominal classification systems (grammatical gender, noun class, and classifier) as a case study to show that more grammaticalized systems, such as gender, and less grammaticalized systems, such as classifiers, are almost equally widespread, but the former spread more by language expansion historically, whereas the latter spread more by feature diffusion. Our results indicate that quantitative models measuring the areal diffusibility and stability of linguistic features are likely to be affected by language expansion that occurs by historical coincidence. We anticipate that our findings will support studies of language diversity in a more sophisticated way, with relevance to other parts of language, such as phonology.
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| 3. |
- Andersson, Axel G, et al.
(författare)
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High Exposure to Perfluoroalkyl Substances and Antibody Responses to SARS-CoV-2 mRNA Vaccine-an Observational Study in Adults from Ronneby, Sweden.
- 2023
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Ingår i: Environmental health perspectives. - 1552-9924. ; 131:8
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Tidskriftsartikel (refereegranskat)abstract
- Per- and polyfluoroalkyl substances (PFAS) are widely used, environmentally ubiquitous, and stable chemicals that have been associated with lower vaccine-induced antibody responses in children; however, data on adults are limited. The drinking water from one of the two waterworks in Ronneby, Sweden, was heavily contaminated for decades with PFAS from firefighting foams, primarily perfluorohexane sulfonic acid and perfluorooctanesulfonic acid (PFOS). Vaccination against SARS-CoV-2 offered a unique opportunity to investigate antibody responses to primary vaccination in adults who had been exposed to PFAS.Our objective was to evaluate associations between PFAS, across a wide range of exposure levels, and antibody responses in adults 5 wk and 6 months after a two-dose vaccination regime against SARS-CoV-2.Adults age 20-60 y from Ronneby (n=309, median PFOS serum level 47ng/mL, fifth to 95th percentile 4-213ng/mL) and a group with background exposure (n=47, median PFOS serum level 4ng/mL) received two doses of the Spikevax (Moderna) mRNA vaccine. The levels of seven PFAS were measured in serum before vaccination. Serum immunoglobulin G antibodies against the SARS-CoV-2 spike antigen (S-Abs) were measured before vaccination and at 5 wk (n=350) and 6 months (n=329) after the second vaccine dose. Linear regression analyses were fitted against current, historical, and prenatal exposure to PFAS, adjusting for sex, age, and smoking, excluding individuals with previous SARS-CoV-2-infection.PFAS exposure, regardless of how it was estimated, was not negatively associated with antibody levels 5 wk [current PFOS: -0.5% S-Abs/PFOS interquartile range (IQR); 95% confidence interval (CI): -8, 7] or 6 months (current PFOS: 3% S-Abs/PFOS IQR; 95% CI: -6, 12) after COVID-19 vaccination.Following a strict study protocol, rigorous study design, and few dropouts, we found no indication that PFAS exposure negatively affected antibody responses to COVID-19 mRNA vaccination for up to 6 months after vaccination. https://doi.org/10.1289/EHP11847.
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| 4. |
- Begley, Cecily, 1954, et al.
(författare)
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Evaluation of an intervention to increase vaginal birth after caesarean section through enhanced women-centred care: The OptiBIRTH randomised trial (ISRCTN10612254)
- 2017
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Ingår i: 31th ICM Triennial Congress.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Vaginal birth after a previous caesarean (VBAC) is a safe alternative to repeat caesarean section (CS), is the preferred option of most women and may reduce overall CS rates.1 However, VBAC rates vary; e.g., rates in Germany, Ireland and Italy are considerably lower (29-36%) than those in the Netherlands, Sweden and Finland (45-55%). Purpose/Objective: To evaluate the effectiveness of an intervention to maximise VBAC rates. The OptiBIRTH Project was funded by a European Union Grant: FP7-HEALTH-2012-INNOVATION-1-HEALTH.2012.3.2-1. Agreement No:305208 Method: A cluster randomised trial was used. A sample size of 12 maternity units was required, each recruiting 120 consenting women, to detect an absolute 15% difference in successful VBACs (increase from 25% in control to 40% in intervention groups), using an ICC of 0.05, with power of >80% and an alpha of 0.05. To allow for loss to follow-up, 15 trial units were randomised across three countries with low VBAC rates (Germany, Ireland and Italy) and the trial commenced April 2014. An evidence-based intervention was introduced in all intervention sites. Control sites had usual care. Interim analysis by an independent Data Monitoring Committee at mid-point permitted continuation. Data were analysed using intention to treat. Key Findings: Recruitment closed October 2015, with the last babies born in December 2015, and data analysis will be completed in April 2016. The primary outcome, comparison of annual VBAC rates for each hospital before and after introduction of the intervention will be presented, and selected secondary outcomes for the recruited women including: mode of birth, perineal trauma, breastfeeding, uterine rupture, wound breakdown, perinatal mortality, Apgar scores, and admission to neonatal intensive care unit. Discussion: If the OptiBIRTH intervention increases VBAC rates safely, its introduction across Europe could prevent 160,000 unnecessary CSs every year, saving maternity services >€150 million annually and contributing to the normalisation of birth for thousands of women. References: 1 Cunningham et al (2010). National Institute of Health Consensus Development Conference Statement: Vaginal birth after caesarean. Obstet & Gynecol 115(6): 1279-1295. 2 EURO-PERISTAT 2008: CD006066.EURO-PERISTAT Project (2008). European Perinatal Health Report. (www.europeristat.com).
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| 5. |
- Carling, Gerd, et al.
(författare)
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The evolution of lexical semantics dynamics, directionality, and drift
- 2023
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Ingår i: Frontiers in Communication. - 2297-900X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The directionality of semantic change is problematic in traditional comparative models of language reconstruction. Compared to, e.g., phonological and morphological change, the directions of meaning change over time are potentially endless and difficult to reconstruct. The current paper attempts to reconstruct the mechanisms of lexical meaning change by a quantitative model. We use a data set of 104 core concepts in 160 Eurasian languages from several families, which are coded for colexification as well as cognacy, including semantic change of lexemes in etymologies. In addition, the various meanings are coded for semantic relation to the core concept, including relations such as metaphor, metonymy, generalization, specialization, holonymy, and meronymy. Further, concepts are coded into classes and semantic properties, including factors such as animacy, count/mass, concrete/abstract, or cultural connotations, such as taboo/non-taboo.Methodology: We use a phylogenetic comparative model to reconstruct the probability of presence at hidden nodes of different colexifying meanings inside etymological trees. We find that these reconstructions come close to meaning reconstructions based on the comparative method. By means of the phylogenetic reconstructions, we measure the evolutionary dynamics of meaning loss of co-lexifying meanings as well as concepts.Results and discussion: These change rates are highly varying, from almost complete stability to complete unstability. Change rates vary between different semantic classes, where for instance wild animals have low change rates and domestic animals and implements have high change rates. We find a negative correlation between taboo animals and change rate, i.e., taboo animals have lower change rates than non-taboo words. Further, we find a negative correlation between animacy and change rate, indicating that animate nouns have lower change rate than inanimate nouns. A further result is a negative correlation between change rate and degree of borrowing (borrowability) of concepts, indicating that lexemes that are more likely to be borrowed are less likely to change semantically. Among semantic relations, we find that metonomy is more frequent than any other change, including metaphor, and that a change from general to more specific is in all cases more frequent than the other way round.
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| 6. |
- Clarke, Mike, et al.
(författare)
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OptiBIRTH: a cluster randomised trial of acomplex intervention to increase vaginalbirth after caesarean section
- 2020
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393.
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite evidence supporting the safety of vaginal birth after caesarean section (VBAC), rates are lowin many countries.Methods: OptiBIRTH investigated the effects of a woman-centred intervention designed to increase VBAC ratesthrough an unblinded cluster randomised trial in 15 maternity units with VBAC rates < 35% in Germany, Ireland andItaly. Sites were matched in pairs or triplets based on annual birth numbers and VBAC rate, and randomised, 1:1 or 2:1, intervention versus control, following trial registration. The intervention involved evidence-based education ofclinicians and women with one previous caesarean section (CS), appointment of opinion leaders, audit/peer review,and joint discussions by women and clinicians. Control sites provided usual care. Primary outcome was annualhospital-level VBAC rates before the trial (2012) versus final year of the trial (2016). Between April 2014 and October2015, 2002 women were recruited (intervention 1195, control 807), with mode-of-birth data available for 1940women.Results: The OptiBIRTH intervention was feasible and safe across hospital settings in three countries. There was nostatistically significant difference in the change in the proportion of women having a VBAC between interventionsites (25.6% in 2012 to 25.1% in 2016) and control sites (18.3 to 22.3%) (odds ratio adjusted for differences betweenintervention and control groups (2012) and for homogeneity in VBAC rates at sites in the countries: 0.87, 95% CI:0.67, 1.14, p = 0.32 based on 5674 women (2012) and 5284 (2016) with outcome data. Among recruited womenwith birth data, 4/1147 perinatal deaths > 24 weeks gestation occurred in the intervention group (0.34%) and 4/782in the control group (0.51%), and two uterine ruptures (one per group), a rate of 1:1000.Conclusions: Changing clinical practice takes time. As elective repeat CS is the most common reason for CS inmultiparous women, interventions that are feasible and safe and that have been shown to lead to decreasingrepeat CS, should be promoted. Continued research to refine the best way of promoting VBAC is essential. Thismay best be done using an implementation science approach that can modify evidence-based interventions inresponse to changing clinical circumstances.Trial registration: The OptiBIRTH trial was registered on 3/4/2013. Trial registration number ISRCTN10612254.
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| 7. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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A person-centred, theory-based, behavioural intervention programme for improved oral hygiene in adolescents: A randomized clinical field study
- 2022
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 49:4, s. 237-387
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To test the effectiveness of a person-centred and theory-based educational intervention to increase adolescents′ adherence to adequate oral hygiene behaviour, that is, self-performed periodontal infection control. Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study in which treatment was performed by dental hygienists (DHs) within the Public Dental Service, Västra Götaland, Sweden. Adolescents with poor oral hygiene conditions were invited to participate. The test intervention was based on cognitive behavioural theory and principles, and the DHs used a collaborative communicative approach, inspired by motivational interviewing. The control intervention consisted of conventional information/instruction. Clinical assessments and oral hygiene behaviours were evaluated at 6months. Results: Three-hundred and twelve adolescents were enrolled, of whom 274 followed the treatment to 6-month follow-up. There were significant improvements in gingival bleeding and plaque scores for both treatment groups at 6months, with significantly greater improvements in the test group. Adolescents in the test group brushed their teeth and used interdental cleaning aids more frequently compared to participants in the control group at 6months. Conclusion: A person-centred and theory-based oral health education programme ismore effective than conventional oral health education in improving adolescents' oral hygiene behaviour and periodontal infection control. ClinicalTrials.gov (NCT02906098). © 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.
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| 8. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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Adolescents' experiences of a theory-based behavioural intervention for improved oral hygiene: A qualitative interview study
- 2022
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Ingår i: International journal of dental hygiene. - : Wiley. - 1601-5029 .- 1601-5037. ; 20:4, s. 609-619
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Adequate oral hygiene, that is self-performed infection control, is crucial to prevent periodontal disease. Epidemiological studies reveal poor oral hygiene conditions among Swedish adolescents and indicate a need for more effective prevention programs. The aim of the current study was to analyse adolescents' experiences of a person-centred, theory-based, oral health education program for improved oral hygiene. Methods Data were obtained by interviewing 19 adolescents treated by dental hygienists in accord with the person-centred education program in a preceding clinical field study ( NCT02906098). Study participants were selected to reflect a variation of male and female adolescents, treated at clinics in areas with various socio-demographic profiles within Region Vastra Gotaland, Sweden. Interviews were audio-taped, transcribed verbatim and analysed with qualitative content analysis. Results A main theme was identified: 'Adolescents on a guided and challenging journey towards beneficial oral hygiene behavior'. The results elucidate the importance of a person-centred approach in therapy. The adolescents described insight on a personal level about the importance of improved oral hygiene as fundamental for behavioural change. Planning and monitoring of the behaviour, with guidance and support by the dental hygienist, was considered to facilitate change and encouraged further behavioural efforts. However, the adolescents expressed a need of reminders and support to keep up oral hygiene routines over time. Conclusions The study brings knowledge on factors of importance in educational interventions to increase beneficial health behaviours among adolescents and emphasize areas for further improvements of such interventions.
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| 9. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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Adolescents' self-reported experiences following a person-centred, theory-based educational intervention versus conventional education for improved oral hygiene: Analysis of secondary outcomes of a randomized field study
- 2023
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Ingår i: JOURNAL OF CLINICAL PERIODONTOLOGY. - 0303-6979. ; 51:1, s. 63-73
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse adolescents' self-reported experiences and behavioural outcomes of a person-centred, theory-based intervention in comparison with conventional information/instruction for improved oral hygiene.Materials and Methods: Data were derived from a prospective, multi-centred, two-arm, quasi-randomized field study focusing on the effectiveness of educational interventions for improved oral hygiene. Dental hygienists working within the Public Dental Service, Vastra Gotaland, Sweden, provided treatments, and adolescents with poor oral hygiene conditions were eligible for participation. The person-centred test intervention was based on social cognitive constructs, and motivational interviewing was used as an approach in communication. The control intervention included conventional information/instructions. Clinical examinations were performed, and questionnaires were distributed at baseline and at 6 months. Three-hundred and twelve patients were enrolled, and data from 276 patients, following treatment per protocol, were analysed.Results: The test group was more satisfied with the education about gingivitis (very good: 61% vs. 37%) and communication during therapy (very good: 69% vs. 50%) and reported to a larger extent that they were much more careful regarding their oral hygiene after the treatment (30% vs. 15%) and had higher confidence about keeping up healthy gingival conditions, in comparison with the control group (all p < .01).Conclusions: The person-centred, theory-based intervention was superior in terms of adolescents' experiences of education and communication during therapy and self-reported oral hygiene behavioural outcomes at 6 months, in comparison with conventional information/instruction.
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| 10. |
- Dimenäs, Sandra L., 1989, et al.
(författare)
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Changing from disease-centred to person-centred – Swedish dental hygienists' views on a theory-based behavioural intervention for improved oral hygiene among adolescents
- 2024
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Ingår i: International Journal of Dental Hygiene. - 1601-5029 .- 1601-5037.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore dental hygienists' (DHs') views on (i) a person-centred, theory-based, behavioural intervention for improving oral hygiene among adolescents and (ii) professional and organizational factors to consider in the implementation of such an intervention in daily dental practice. Methods: Semi-structured interviews were conducted with 13 DHs who had applied the person-centred, theory-based, behavioural intervention directed at adolescents with poor oral hygiene in a field study within the Public Dental Service, Region Västra Götaland, Sweden. The interviews were audio-taped, transcribed verbatim and analysed using qualitative content analysis. Results: The main theme ‘From individual experts to partners – DHs changing direction from a disease-centred towards a person-centred approach’ illustrated a changed professional approach among DHs, from exerting their roles as experts to encouraging partnership in treatment by supporting the adolescents in taking health behavioural decisions and responsibility for their oral health. The DHs considered the changed approach as challenging, but also more enjoyable, compared to conventional information/instruction. Adequate knowledge and skills, personal interest and willingness for a change as well as support from colleagues and clinic management were identified as prerequisites for implementing the person-centred, theory-based, behavioural intervention in daily practice, while the expenditure of time needed in relation to economic demands in care were seen as barriers. Conclusions: The findings elucidate that DHs considered the application of a person-centred, theory-based, behavioural intervention to be challenging but also enjoyable. For such an intervention to be implemented in daily practice, prerequisites and barriers need to be considered on both personal/professional and organizational levels.
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| 11. |
- Edström, Dag, et al.
(författare)
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Integrin α10β1-selected mesenchymal stem cells reduced hypercoagulopathy in a porcine model of acute respiratory distress syndrome
- 2023
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Ingår i: Respiratory Research. - 1465-9921. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Mesenchymal stem cells (MSCs) have been studied for their potential benefits in treating acute respiratory distress syndrome (ARDS) and have reported mild effects when trialed within human clinical trials. MSCs have been investigated in preclinical models with efficacy when administered at the time of lung injury. Human integrin α10β1-selected adipose tissue-derived MSCs (integrin α10β1-MSCs) have shown immunomodulatory and regenerative effects in various disease models. We hypothesized that integrin α10β1 selected-MSCs can be used to treat a sepsis-induced ARDS in a porcine model when administering cells after established injury rather than simultaneously. This was hypothesized to reflect a clinical picture of treatment with MSCs in human ARDS. 12 pigs were randomized to the treated or placebo-controlled group prior to the induction of mild to moderate ARDS via lipopolysaccharide administration. The treated group received 5 × 10 6 cells/kg integrin α10β1-selected MSCs and both groups were followed for 12 h. ARDS was confirmed with blood gases and retrospectively with histological changes. After intervention, the treated group showed decreased need for inotropic support, fewer signs of histopathological lung injury including less alveolar wall thickening and reduction of the hypercoagulative disease state. The MSC treatment was not associated with adverse events over the monitoring period. This provides new opportunities to investigate integrin α10β1-selected MSCs as a treatment for a disease which does not yet have any definitive therapeutic options.
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| 12. |
- Ferrari, Desiree, et al.
(författare)
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Concentration of carprofen in the milk of lactating bitches after cesarean section and during inflammatory conditions
- 2022
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Ingår i: Theriogenology. - : Elsevier. - 0093-691X .- 1879-3231. ; 181, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- Pain treatment of lactating bitches is a clinically relevant, but complicated issue. Published scientific studies regarding the excretion of drugs in canine milk are scarce. When considering the risk of side effects in their offspring, lactating bitches have traditionally received very restricted analgesic and anti-inflammatory therapy. Our aim was to quantify the concentrations of carprofen in milk from lactating bitches and relate those to potential risks for the puppies. A second aim was to evaluate the impact mastitis may have on the concentration of carprofen in milk. A population of 100 bitches was enrolled in the study, among which 88 were bitches treated with carprofen after cesarean section (Group CS), eight were bitches with painful inflammatory conditions (Group I) and four were bitches with mastitis (Group M). The patients enrolled in the study received carprofen 4 mg/kg sc at day 1 followed by 2 mg/kg po every 12 h for the following 2-5 days. Owners were instructed to collect milk once a day for five days. The concentration of carprofen in the milk was quantified with ultra-performance liquid chromatography-tandem mass spectrometry. The data obtained were statistically analyzed as repeated-measures data with a mixed-model approach. Data were used to calculate the theoretical maximum total daily intake of carprofen by the puppies in order to perform a computerized simulation of the plasma concentration of carprofen in the puppies. Follow-up telephone interviews to check the status of the enrolled bitches and their litters occurred at one week and three-six months after treatment with car-profen. The major finding of the study was that the concentration of carprofen in the milk was <700 ng/ mL from bitches undergoing CS or suffering painful conditions other than mastitis. In comparison, administration of 2 mg/kg of carprofen sc or po to adult dogs, results in mean maximal plasma con-centrations of 19480 +/- 5420 ng/mL (mean +/- SD). Moreover, data suggests that inflammation of the mammary gland results in a higher concentration of carprofen in milk (up to 1300 ng/mL). In the computerized simulation, the plasma concentrations of carprofen in puppies in group CS and in group I are one tenth of the concentration in adult dogs receiving carprofen at standard doses. Considering the low excretion into milk, carprofen provides an analgesic alternative to lactating bitches without mastitis.(c) 2022 Published by Elsevier Inc.
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| 13. |
- Hummel, Sandra, et al.
(författare)
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Early-childhood body mass index and its association with the COVID-19 pandemic, containment measures and islet autoimmunity in children with increased risk for type 1 diabetes
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Ingår i: Diabetologia. - 0012-186X.
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Tidskriftsartikel (refereegranskat)abstract
- Aims/hypothesis: The aim of this study was to determine whether BMI in early childhood was affected by the COVID-19 pandemic and containment measures, and whether it was associated with the risk for islet autoimmunity. Methods: Between February 2018 and May 2023, data on BMI and islet autoimmunity were collected from 1050 children enrolled in the Primary Oral Insulin Trial, aged from 4.0 months to 5.5 years of age. The start of the COVID-19 pandemic was defined as 18 March 2020, and a stringency index was used to assess the stringency of containment measures. Islet autoimmunity was defined as either the development of persistent confirmed multiple islet autoantibodies, or the development of one or more islet autoantibodies and type 1 diabetes. Multivariate linear mixed-effect, linear and logistic regression methods were applied to assess the effect of the COVID-19 pandemic and the stringency index on early-childhood BMI measurements (BMI as a time-varying variable, BMI at 9 months of age and overweight risk at 9 months of age), and Cox proportional hazard models were used to assess the effect of BMI measurements on islet autoimmunity risk. Results: The COVID-19 pandemic was associated with increased time-varying BMI (β = 0.39; 95% CI 0.30, 0.47) and overweight risk at 9 months (β = 0.44; 95% CI 0.03, 0.84). During the COVID-19 pandemic, a higher stringency index was positively associated with time-varying BMI (β = 0.02; 95% CI 0.00, 0.04 per 10 units increase), BMI at 9 months (β = 0.13; 95% CI 0.01, 0.25) and overweight risk at 9 months (β = 0.23; 95% CI 0.03, 0.43). A higher age-corrected BMI and overweight risk at 9 months were associated with increased risk for developing islet autoimmunity up to 5.5 years of age (HR 1.16; 95% CI 1.01, 1.32 and HR 1.68, 95% CI 1.00, 2.82, respectively). Conclusions/interpretation: Early-childhood BMI increased during the COVID-19 pandemic, and was influenced by the level of restrictions during the pandemic. Controlling for the COVID-19 pandemic, elevated BMI during early childhood was associated with increased risk for childhood islet autoimmunity in children with genetic susceptibility to type 1 diabetes. Graphical Abstract: [Figure not available: see fulltext.]
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| 14. |
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| 15. |
- Landegren, Nils, et al.
(författare)
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Transglutaminase 4 as a prostate autoantigen in male subfertility
- 2015
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Ingår i: Science Translational Medicine. - : American Association for the Advancement of Science. - 1946-6234 .- 1946-6242. ; 7:292
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Tidskriftsartikel (refereegranskat)abstract
- Autoimmune polyendocrine syndrome type 1 (APS1), a monogenic disorder caused by AIRE gene mutations, features multiple autoimmune disease components. Infertility is common in both males and females with APS1. Although female infertility can be explained by autoimmune ovarian failure, the mechanisms underlying male infertility have remained poorly understood. We performed a proteome-wide autoantibody screen in APS1 patient sera to assess the autoimmune response against the male reproductive organs. By screening human protein arrays with male and female patient sera and by selecting for gender-imbalanced autoantibody signals, we identified transglutaminase 4 (TGM4) as a male-specific autoantigen. Notably, TGM4 is a prostatic secretory molecule with critical role in male reproduction. TGM4 autoantibodies were detected in most of the adult male APS1 patients but were absent in all the young males. Consecutive serum samples further revealed that TGM4 autoantibodies first presented during pubertal age and subsequent to prostate maturation. We assessed the animal model for APS1, the Aire-deficient mouse, and found spontaneous development of TGM4 autoantibodies specifically in males. Aire-deficient mice failed to present TGM4 in the thymus, consistent with a defect in central tolerance for TGM4. In the mouse, we further link TGM4 immunity with a destructive prostatitis and compromised secretion of TGM4. Collectively, our findings in APS1 patients and Aire-deficient mice reveal prostate autoimmunity as a major manifestation of APS1 with potential role in male subfertility.
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| 16. |
- Lundgren, Ingela, 1957, et al.
(författare)
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Clinicians' views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section) : a study from countries with low VBAC rates.
- 2016
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Caesarean section (CS) rates are increasing worldwide and the most common reason is repeat CS following previous CS. For most women a vaginal birth after a previous CS (VBAC) is a safe option. However, the rate of VBAC differs in an international perspective. Obtaining deeper knowledge of clinicians' views on VBAC can help in understanding the factors of importance for increasing VBAC rates. Focus group interviews with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of "OptiBIRTH", an ongoing research project. The study reported here aims to explore the views of clinicians from countries with low VBAC rates on factors of importance for improving VBAC rates.METHODS: Focus group interviews were held in Ireland, Italy and Germany. In total 71 clinicians participated in nine focus group interviews. Five central questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language and then translated into English. All data were then analysed together and final categories were validated in each country.RESULTS: The findings are presented in four main categories with several sub-categories: 1) "prameters for VBAC", including the importance of the obstetric history, present obstetric factors, a positive attitude among those who are centrally involved, early follow-up after CS and antenatal classes; 2) "organisational support and resources for women undergoing a VBAC", meaning a successful VBAC requires clinical expertise and resources during labour; 3) "fear as a key inhibitor of successful VBAC", including understanding women's fear of childbirth, clinicians' fear of VBAC and the ways that clinicians' fear can be transferred to women; and 4) "shared decision making - rapport, knowledge and confidence", meaning ensuring consistent, realistic and unbiased information and developing trust within the clinician-woman relationship.CONCLUSIONS: The findings indicate that increasing the VBAC rate depends on organisational factors, the care offered during pregnancy and childbirth, the decision-making process and the strategies employed to reduce fear in all involved.
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| 17. |
- Lundgren, Ingela, 1957, et al.
(författare)
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How can the VBAC rates be improved – according to midwives and obstetricians in six European countries.
- 2017
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Ingår i: 31th ICM Trienníal Congress 18-22 June 2017.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The most common reason for caesarean section (CS) is repeat CS following previous CS. Vaginal birth after CS (VBAC) rates vary widely in different healthcare settings and countries. Interview studies with clinicians and women in three countries with high VBAC rates (Finland, Sweden and the Netherlands) and three countries with low VBAC rates (Ireland, Italy and Germany) are part of ‘OptiBIRTH’, a research project funded by EU aiming to increase VBAC rates across Europe through enhanced woman-centred maternity care. Purpose/Objective: To investigate the views of clinicians on factors of importance for improving VBAC rates. Method: Individual interviews and focus group interviews with clinicians in six countries with high and low VBAC rates were conducted during 2012–2013. 115 clinicians participated: 61 midwives and 54 physicians. Five questions about VBAC were used and interviews were analysed using content analysis. The analysis was performed in each country in the native language, translated into English, analysed together, and finally categories were validated in each country. Key Findings: According to midwives and obstetricians from countries with high VBAC rates, the important factors for improving the VBAC rate are a common approach, obstetricians’ final decision on the mode of birth, support during birth, and the strengthening of women’s trust in VBAC. Therefore the structure of the maternity care system in the country, cooperation between midwives and obstetricians, and the care offered during pregnancy and birth should be focused. Findings from the low VBAC countries will be presented at the conference and shows similarities in some aspects but also major differences. Discussion: Similarities and differences between factors of importance for improving the VBAC rate are related to both the care structure, and the views and attitudes of midwives and physicians, which has implications for the care of women post CS.
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| 18. |
- Morano, Sandra, et al.
(författare)
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Emotions in labour: Italian obstetricians’ experiences of presence during childbirth
- 2018
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Ingår i: Journal of Reproductive and Infant Psychology. - : Informa UK Limited. - 0264-6838 .- 1469-672X. ; 36:1, s. 30-41
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The present study represents a qualitative research aimed to explore the obstetricians’ psychological experiences of birth. Background: During labour the role of obstetricians assumes a fundamental importance in hospitalised childbirth. However, literature analysis has shown that the psychological side of birth has been investigated only considering the woman’s and midwife’s points of view. The obstetricians’ psychological experiences have not been considered enough and only a few studies at a quantitative level have been performed. Methods: Seven focus groups for a total of 72 obstetricians were conducted in hospital contexts in Italy. The qualitative methodology of grounded theory was adopted. Findings: The results were divided into three different core themes: obstetricians’ approaches to delivery, critical aspects about relationships in the delivery room, and obstetricians’ feelings and emotions in the delivery room. Each theme was subdivided into different subthemes. Conclusion: The results highlight different ways obstetricians approach their profession, the complex and multifaceted relationship with the woman and the extraordinary variety of feelings and emotions, which enrich, but also may complicate, life in the delivery room. Further studies could provide more details to help researchers to develop new and more effective strategies to support obstetricians’ training and work.
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| 19. |
- Nilsson, Christina, 1959, et al.
(författare)
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Vaginal Birth After Caesarean: Views of women from countries with low VBAC rates
- 2017
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 30:6, s. 481-490
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Tidskriftsartikel (refereegranskat)abstract
- Problem and background: Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women´s views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low. Aim: To investigate women’s views on important factors to improve the rate of vaginal birth after caesarean in countries where vaginal birth rates after caesarean rates are low. Methods: A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country. Findings: Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean section, thet they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean section. Discussion and conclusion: Women’s decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychological, social, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after caesarean as a mode of birth.
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| 20. |
- Olsson, Mats J., et al.
(författare)
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Odor Memory Performance and Memory Awareness : A Comparison to Word Memory Across Orienting Tasks and Retention Intervals
- 2009
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Ingår i: Chemosensory Perception. - : Springer Science and Business Media LLC. - 1936-5802 .- 1936-5810. ; 2:3, s. 161-171
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Tidskriftsartikel (refereegranskat)abstract
- Odor memory has been argued to exhibit unique characteristics in relation to memory for other types of stimuli such as visually presented words. Two experiments investigated episodic recognition performance as well as memory awareness for odors and words across manipulations of orienting task and retention interval. Orienting task mattered little to odor recognition. However, in contradiction with several previous studies, substantial forgetting of odors was found. After controlling for effects of odor identifiability, it was found that memory for identified odors exhibited greater similarities to memory for words than to memory for unidentified odors.
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| 21. |
- Sinclair, Marlene, et al.
(författare)
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A systematic literature review of computer-based behavioural change interventions to inform the design of an online VBAC intervention for the OptiBIRTH European randomized trial.
- 2017
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Ingår i: Evidence Based Midwifery. - 1479-4489. ; 15:1, s. 5-13
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this research was o systematically review computer-based, behavior change (BC) interventions during pregnancy and their design components in order to determine their best application within the context of the OptiBIRTH intervention. Design: A systematic literature review was undertaken using the Cochrane collaboration guidelines for systematic reviews of health promotion and public health interventions. Literature searches were conducted in; Ovid MEDLINE, PubMed, Cochrane Library, Embase, PsycINFO, from database inception to June 2015. Cochrane Risk of Bias criteria was applied to assess the methodological quality of the papers and a taxonomy of BC techniques was used to appraise the interventions. PICO. Participants included healthy pregnant women who were ≥18 years old. The types of intervention used were computer-based interventions designed to facilitate a BC approach in a sample of pregnant women. The comparison was routine antenatal care. The primary outcome included improved health behavior(s), as an indicator of the intention behind the intervention design. Results. A total of 343 papers were identified through database-searching and hand- searching methods; 80 duplicates were removed. From the remaining 263, 244 did not explicitly address the subject under review. Therefore, 19 full text articles were assessed for eligibility; 16 did not meet eligibility criteria and were excluded at this stage. This resulted in a total of three studies being selected for inclusion in this review (Jackson et al, 2011; Tzilos et al, 2011; Tsoh et al, 2010). The computer-based interventions were designed to bring about BC in relation to alcohol consumption, smoking or diet and exercise during pregnancy. Interventions delivered varied between two types; purely computer-delivered (Tzilos et al. 2011) or a combination of both computer plus face-to-face input (Jackson et al, 2011; Tsoh et al. 2010). Techniques used included motivational interviewing, problem solving cognitive dissonance and goal setting. Types of measurement outcomes varied but were all self-reported behavioral outcomes. Statistically significant improvements in behavioral outcomes were seen in the interventions by Jackson et al (2011) and Tsoh et al (2011), but not in the intervention by Tzilos et al (2011). The GRADE analysis identified that all studies combined lacked blinding and relied on self-reported data increasing risk of bias. Conclusion. This systematic review reports on the best available evidence and theory to design an online component of a complex intervention for use in an RCT to enhance women´s shared decision-making experience about vaginal births after caesarean (VBAC). The review reports the differences between the observed BC approach and that of a decision-making being focused on a more healthy option. As a result, techniques designed to create dissonance are considered appropriate. Shared decision-making, however, is conceptually different, in that the goal is to facilitate a woman in discovering the best direction of travel for her as person. Therefore, the authors argue that it is crucial for healthcare professionals designing complex healthcare interventions (either BC techniques or shared decision-making) to ensure that a person´s self-determination is respected through having access to relevant and understandable information and healthcare professionals who understand a woman´s motivation. However, it is not possible to draw firm conclusions from three studies and there is a requirement for further research.
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| 22. |
- Sinclair, Marlene, et al.
(författare)
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Assisting women in autonomous decision making about vaginal birth after C section (VBAC): Designing motivational Apps in OptiBIRTH cluster randomised trial (ISRCTN10612254
- 2017
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Ingår i: 31th ICM Triennial Congress 18-22 June 2017.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Optibirth is a funded FP7 research programme using a cluster randomised trial in Ireland, Germany and Italy, with 15 clusters of 94 women per cluster. The aim of OptiBIRTH is to evaluate the effectiveness of a complex intervention aimed at increased VBAC rates through enhanced women-centred care1 .The intervention consisted of motivationally enhanced, evidence-based, educational information for women and clinicians for use in face to face and online modes. Purpose/Objective: This paper reports the design process associated with creating three interrelated mobile apps, as part of a complex intervention, to enable women with a previous caesarean section to decide autonomously between a repeat caesarean section and a vaginal birth. The emphasis has been on using technology creatively and effectively maximizing optimality bearing in mind the needs of the new “Z” generation. Method: Focus groups were undertaken across six European countries to illicit women’s need for information about caesarean section and VBAC. Motivational theory underpinned the development of subsequent e-learning materials to enhance woman-led-decision-making. Ethical approval was obtained from Trinity College University, Dublin. Following analysis of focus group data, consultation with experts and exploration of technological solutions, three electronic applications were designed. Following three iterations, the Apps were reviewed for content, motivational design and functionality by Irish, German and Italian midwifery experts and translated into German and Italian. Key Findings: The following interrelated Apps were designed to provide women and health professionals with rapid access to women’s perceptions of their previous birth experience and their current decision-making-in-progress: “My birth story” uses a wordle to communicate past birth experience “My birth thoughts” enables women to communicate their current decision making “My Birth plan” generates a personalised birth plan Discussion: Discussion will focus on challenges facing midwives including, embedding the Apps into a motivationally-designed portal, staff support and training, timeline, cultural differences and translation issues
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| 23. |
- Tegner, Cecilia, et al.
(författare)
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Alpha-chloralose poisoning in cats : clinical findings in 25 confirmed and 78 suspected cases
- 2022
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Ingår i: Journal of feline medicine and surgery. - : SAGE Publications. - 1098-612X .- 1532-2750. ; 24:10, s. E324-E329
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to describe the clinical picture in cats with alpha-chloralose (AC) intoxication and to confirm AC in serum from suspected cases of AC poisoning. Methods Suspected cases of AC poisoning were identified in patient records from a small animal university hospital from January 2014 to February 2020. Clinical signs of intoxication described in respective records were compiled, the cats were graded into four intoxication severity scores and hospitalisation time and mortality were recorded. Surplus serum from select cases in late 2019 and early 2020 was analysed to detect AC with a quantitative ultra-high performance liquid chromatography tandem mass spectrometry analysis, and the AC concentration was compared with the respective cat's intoxication severity score. Results Serum from 25 cats was available for analysis and AC poisoning was confirmed in all. Additionally, 78 cats with a clinical suspicion of AC intoxication were identified in the patient records, most of which presented from September to April. The most common signs of intoxication were ataxia, tremors, cranial nerve deficits and hyperaesthesia. The prevalence of clinical signs and intoxication severity differed from what has previously been reported, with our population presenting with less severe signs and no deaths due to intoxication. The majority had a hospitalisation time <48 h, irrespective of intoxication severity score. Conclusions and relevance This study describes the clinical signs and prognosis in feline AC intoxication. There were no mortalities in confirmed cases, indicating that AC-poisoned cats have an excellent prognosis when treated in a timely manner. Recognition of AC intoxication as a differential diagnosis for acute onset of the described neurological signs in areas where AC exposure is possible may influence clinical decision-making and help avoid excessive diagnostic procedures. A severe clinical picture upon presentation could be misinterpreted as a grave prognosis and awareness about AC poisoning may avoid unnecessary euthanasia.
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| 24. |
- Windahl, Ulrika, et al.
(författare)
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Alpha-chloralose poisoning in cats in three Nordic countries-the importance of secondary poisoning
- 2022
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Ingår i: BMC Veterinary Research. - : Springer Nature. - 1746-6148. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Alpha-chloralose (AC) is a compound known to be toxic to various animal species and humans. In 2018 and 2019 an increase in suspected cases of AC poisoning in cats related to the use of AC as a rodenticide was reported to national veterinary and chemical authorities in Finland, Norway and Sweden by veterinarians working in clinical practices in respective country. The aims of this study were to prospectively investigate AC poisoning in cats, including possible secondary poisoning by consuming poisoned mice, and to study metabolism and excretion of AC in cats through analysis of feline urine. Methods Data on signalment, history and clinical findings were prospectively collected in Finland, Norway and Sweden from July 2020 until March of 2021 using a questionnaire which the attending veterinarian completed and submitted together with a serum sample collected from suspected feline cases of AC-poisoning. The diagnosis was confirmed by quantification of AC in serum samples. Content of AC was studied in four feline urine samples, including screening for AC metabolites by UHPLC-HRMS/MS. Bait intake and amount of AC consumed by mice was observed in wild mice during an extermination of a rodent infestation. Results In total, 59 of 70 collected questionnaires and accompanying serum samples were included, with 127 to 70 100 ng/mL AC detected in the serum. Several tentative AC-metabolites were detected in the analysed feline urine samples, including dechlorinated and oxidated AC, several sulfate conjugates, and one glucuronic acid conjugate of AC. The calculated amount of AC ingested by each mouse was 33 to 106 mg with a mean of 61 mg. Conclusions Clinical recognition of symptoms of AC poisoning in otherwise healthy cats roaming free outdoors and known to be rodent hunters strongly correlated with confirmation of the diagnosis through toxicological analyses of serum samples. The collected feline exposure data regarding AC show together with the calculation of the intake of bait and subsequent AC concentrations in mice that secondary poisoning from ingestion of mice is possible. The results of the screening for AC metabolites in feline urine confirm that cats excrete AC both unchanged and metabolized through dechlorination, oxidation, glucuronidation and sulfatation pathways.
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| 25. |
- Windahl, Ulrika, et al.
(författare)
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Development and Validation of a Quantitative UHPLC-MS-MS Method for the Determination of Alpha-Chloralose in Feline Blood and Application on Blood Samples Collected from Cats with Symptoms of Alpha-Chloralose Poisoning
- 2022
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Ingår i: Journal of Analytical Toxicology. - : Oxford University Press. - 0146-4760 .- 1945-2403. ; 46:6, s. 651-657
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Tidskriftsartikel (refereegranskat)abstract
- Alpha-chloralose (AC) is used as a rodenticide as well as an anesthetic agent in laboratory animals. It was previously also used as an avicide. Detection of AC in blood samples or in body tissues collected postmortem is key for the diagnosis of clinical cases and a requirement for surveillance of secondary toxicosis, including potential cases in wild animals. Reports on poisoning of humans and non-laboratory animals confirmed by the detection of AC or its metabolites are available, however poisoning of domestic animals are rarely available. Furthermore, reports on clinical cases in domestic animals rarely report quantifications of AC in blood or body tissues. The present study describes the validation of a quantitative Ultrahigh Performance Liquid Chromatography tandem Mass Spectrometry (UHPLC-MS-MS) method that can be used in cases of suspected AC poisoning in cats. The validation study showed the method to be fit for purpose. In serum, the limit of quantification was 100 ng/mL and the limit of detection was 30 ng/mL. The new analytical method was applied on blood samples collected from 20 individual cats with a preliminary clinical diagnosis of acute AC poisoning. AC was confirmed in all 20 feline blood samples, and the concentration range of AC was 538-17,500 ng/mL. The quantitative method developed in this study was found to be a fast and selective method for confirmation of AC poisoning using blood samples from cats.
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