| 1. |
- Kehoe, Laura, et al.
(författare)
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Make EU trade with Brazil sustainable
- 2019
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Ingår i: Science. - : American Association for the Advancement of Science (AAAS). - 0036-8075 .- 1095-9203. ; 364:6438, s. 341-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
- Escaned, Javier, et al.
(författare)
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Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes
- 2018
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Ingår i: JACC. - : Elsevier. - 1936-8798 .- 1876-7605. ; 11:15, s. 1437-1449
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to assess physiological significance. In deferred patients presenting with ACS, the event rate was significantly increased compared with SAP at 1 year. (C) 2018 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.
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| 4. |
- Furenbäck, Ingela, 1963-
(författare)
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Utveckling av samverkan : ett deltagarorienterat aktionsforskningsprojekt inom hälso- och sjukvård
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Syfte: Det övergripande vetenskapliga syftet med denna avhandling att nå en ökad förståelse om samverkansprocesser.Ansats och metoder: Studien har bedrivits genom deltagarorienterad aktionsforskning inom hälso- och sjukvården i Hässleholm. Aktörer på verksamhetsfältet har strävat efter att utveckla samverkan för att tillsammans kunna utveckla närsjukvård. Forskningen har genererat kunskap utifrån lokala omständigheter att tjäna som underlag för beslut om att genomföra praktiska förändringar i verksamheten. En kombination av olika metoder har använts för att generera empiriskt material, där den huvudsakliga metoden har varit deltagande observationer med dialog. Därutöver har intervjuer och granskning av dokument använts samt en forskningscirkel, som är en speciell metod inom deltagarorienterad aktionsforskning. Studien har haft en hermeneutisk ansats och tolkningar har gjorts med stöd av olika teoretiska perspektiv och modeller. Kurt Lewins fältteori har utgjort en övergripande teoretisk ram för studien.Resultat: En ökad förståelse om den studerade samverkansprocessen kunde nås genom att beskriva och tolka skeenden som antogs ha påverkat utvecklingen av samverkan. Processen beskrevs både utifrån vertikal och horisontell integrering inom och mellan organisationer. Beskrivningen innefattade komponenter som fanns både inom arbetsprocesser och sociala processer. Den studerade samverkansprocessen delades in i delprocesser där var och en del innehöll en viss typ av aktivitet som genomfördes för att stödja utvecklingen av samverkan. Två olika strategier för utvecklingen av samverkan identifierades och illustrerades genom olika modeller: den linjära hierarkiska modellen respektive den dynamiska modellen. Den sistnämnda utvecklades genom aktionsforskningen.Slutsatser:I ett första skede bedrev deltagarna på fältet samverkan med stöd av den linjära hierarkiska modellen. Denna modell utgör ett tankeschema där samverkan utvecklas i en linjär hierarkisk process. Politiker fattar beslut, chefer planerar och professionella genomför aktiviteterna. Modellen utgår ifrån ett konsensusteoretiskt perspektiv där konflikter betraktas som störande element. Det innebar i detta fall att aktörer inom olika domäner och organisationer undvek varandras olika föreställningsvärldar varpå samverkansprocessen stötte på hinder i utvecklingen. Aktionsforskningen intervenerade i processen genom arrangera kommunikationsarenor med deltagare från olika domäner och organisationer. Samverkan utvecklades på så sätt utifrån den dynamiska modellen. Denna modell innehåller antaganden om att samverkansprocesser är dynamiska och har sin utgångspunkt i ett konfliktteoretiskt perspektiv där konflikter betraktas som naturliga i processen.
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| 5. |
- Gustavsson, Carl Gunnar, et al.
(författare)
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Thrombotic occlusion of all left coronary branches in a young woman with severe ulcerative colitis
- 2011
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Ingår i: ISRN Cardiology. - : Hindawi Limited. - 2090-5580 .- 2090-5599.
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Tidskriftsartikel (refereegranskat)abstract
- Background. The thrombosis risk is increased in active ulcerative colitis. The limited number of reported complications have predominantly been cerebrovascular but other vessel territories may also be affected. Patient. During a severe attack of ulcerative colitis a 37-year-old woman suffered occlusion of all left coronary artery branches. Serial angiographies showed progressive recanalisation of the coronary arteries during anticoagulation, but no atherosclerotic stenosis. The cause of infarction was thus considered to be an extensive coronary thrombosis. However, a large battery of blood tests failed to identify any procoagulant abnormality. Conclusion. Evidence is now accumulating that the increased thrombosis risk also may involve the coronary arteries, even in young patients. To the best of our knowledge this is the third reported case ofmyocardial infarction despite angiographically normal coronary arteries in a patient with active ulcerative colitis. The extent of affected myocardiumwas in this case exceptionally large.
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| 6. |
- Gustavsson, Karl-Erik, et al.
(författare)
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Different types of organic pop-up fertilizers in carrot cultivation: Effects on the concentrations of polyacetylenes and sugars
- 2018
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Ingår i: Scientia Horticulturae. - : Elsevier BV. - 0304-4238 .- 1879-1018. ; 230, s. 126-133
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Tidskriftsartikel (refereegranskat)abstract
- The effects on the concentration of falcarinol-type of polyacetylenes and sugars at harvest and after storage of carrots after application of different types (powder, digestate, two micro-granular) of organic pop-up fertilizer, where the fertilizer was placed in small amounts together with the seeds, were studied. Both groups of investigated compounds reflect important sensory attributes of the carrots, while polyacetylenes are considered as potentially health-promoting compounds. Results showed that the type of pop-up organic fertilizer as well as the dose can affect the concentrations of polyacetylenes and sugars. The dose of nitrogen applied did not seem to alone affect the concentration of polyacetylenes in carrots, while low amounts of applied phosphorus could be related to higher amounts of falcarindiol. The liquid digestate resulted in the highest concentrations of poly acetylenes in two of the treatments, even though the applied doses of digestate contained among the lowest amounts of nutrients. Storage resulted in both increases and decreases of total polyacetylenes, falcarindiol and falcarinol, while falcarindiol-3-acetate generally increased during storage. The sugars showed less variation due to the type or dose of fertilizer applied, as compared with the polyacetylenes.
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| 7. |
- Götberg, Matthias, et al.
(författare)
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5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve
- 2022
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Ingår i: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 79:10, s. 965-974
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Instantaneous wave-free ratio (iFR) is a coronary physiology index used to assess the severity of coronary artery stenosis to guide revascularization. iFR has previously demonstrated noninferior short-term outcome compared to fractional flow reserve (FFR), but data on longer-term outcome have been lacking.OBJECTIVES: The purpose of this study was to investigate the prespecified 5-year follow-up of the primary composite outcome of all-cause mortality, myocardial infarction, and unplanned revascularization of the iFR-SWEDEHEART trial comparing iFR vs FFR in patients with chronic and acute coronary syndromes.METHODS: iFR-SWEDEHEART was a multicenter, controlled, open-label, registry-based randomized clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment. A total of 2,037 patients were randomized to undergo revascularization guided by iFR or FFR.RESULTS: No patients were lost to follow-up. At 5 years, the rate of the primary composite endpoint was 21.5% in the iFR group and 19.9% in the FFR group (HR: 1.09; 95% CI: 0.90-1.33). The rates of all-cause death (9.4% vs 7.9%; HR: 1.20; 95% CI: 0.89-1.62), nonfatal myocardial infarction (5.7% vs 5.8%; HR: 1.00; 95% CI: 0.70-1.44), and unplanned revascularization (11.6% vs 11.3%; HR: 1.02; 95% CI: 0.79-1.32) were also not different between the 2 groups. The outcomes were consistent across prespecified subgroups.CONCLUSIONS: In patients with chronic or acute coronary syndromes, an iFR-guided revascularization strategy was associated with no difference in the 5-year composite outcome of death, myocardial infarction, and unplanned revascularization compared with an FFR-guided revascularization strategy. (Evaluation of iFR vs FFR in Stable Angina or Acute Coronary Syndrome [iFR SWEDEHEART]; NCT02166736)
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| 8. |
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| 9. |
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| 10. |
- Muñoz, Nubia, et al.
(författare)
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Impact of Human Papillomavirus (HPV)-6/11/16/18 Vaccine on All HPV-Associated Genital Diseases in Young Women.
- 2010
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Ingår i: Journal of the National Cancer Institute. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 102, s. 325-339
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Tidskriftsartikel (refereegranskat)abstract
- Background The impact of the prophylactic vaccine against human papillomavirus (HPV) types 6, 11, 16, and 18 (HPV6/11/16/18) on all HPV-associated genital disease was investigated in a population that approximates sexually naive women in that they were "negative to 14 HPV types" and in a mixed population of HPV-exposed and -unexposed women (intention-to-treat group). Methods This analysis studied 17 622 women aged 15-26 years who were enrolled in one of two randomized, placebo-controlled, efficacy trials for the HPV6/11/16/18 vaccine (first patient on December 28, 2001, and studies completed July 31, 2007). Vaccine or placebo was given at day 1, month 2, and month 6. All women underwent cervicovaginal sampling and Papanicolaou (Pap) testing at day 1 and every 6-12 months thereafter. Outcomes were any cervical intraepithelial neoplasia; any external anogenital and vaginal lesions; Pap test abnormalities; and procedures such as colposcopy and definitive therapy. Absolute rates are expressed as women with endpoint per 100 person-years at risk. Results The average follow-up was 3.6 years (maximum of 4.9 years). In the population that was negative to 14 HPV types, vaccination was up to 100% effective in reducing the risk of HPV16/18-related high-grade cervical, vulvar, and vaginal lesions and of HPV6/11-related genital warts. In the intention-to-treat group, vaccination also statistically significantly reduced the risk of any high-grade cervical lesions (19.0% reduction; rate vaccine = 1.43, rate placebo = 1.76, difference = 0.33, 95% confidence interval [CI] = 0.13 to 0.54), vulvar and vaginal lesions (50.7% reduction; rate vaccine = 0.10, rate placebo = 0.20, difference = 0.10, 95% CI = 0.04 to 0.16), genital warts (62.0% reduction; rate vaccine = 0.44, rate placebo = 1.17, difference = 0.72, 95% CI = 0.58 to 0.87), Pap abnormalities (11.3% reduction; rate vaccine = 10.36, rate placebo = 11.68, difference = 1.32, 95% CI = 0.74 to 1.90), and cervical definitive therapy (23.0% reduction; rate vaccine = 1.97, rate placebo = 2.56, difference = 0.59, 95% CI = 0.35 to 0.83), irrespective of causal HPV type. Conclusions High-coverage HPV vaccination programs among adolescents and young women may result in a rapid reduction of genital warts, cervical cytological abnormalities, and diagnostic and therapeutic procedures. In the longer term, substantial reductions in the rates of cervical, vulvar, and vaginal cancers may follow.
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| 11. |
- Olsson, Ann-Margreth E., 1952-, et al.
(författare)
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Finsamprojekt förebyggande arbete : Kartläggning och behovsanalys av förebyggande arbete mot våld i nära relationer i Bromölla, Hässleholm, Kristianstad, Osby och Östra Göinge kommuner samt Region Skåne och Försäkringskassan
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kommunerna i Skåne Nordost var tidigt ute med planer mot våld 2005. Försäkringskassan har på central nivå starkt profilerat sig som en aktör som skall motverka mäns våld mot kvinnor, men det verkar inte ha fått genomslag, än så länge. Region Skåne har markerat sig i planarbete och utvecklande av metodverktyg, som Genushanden©, men fortfarande är praxis när det gället att Våga Fråga varierande. Samverkan mellan kommuner och Regionen i form av bl. a. Familjehus och föräldrautbildningsprogram, samtal och rådgivning lockar många deltagare. De är exempel på program för normpåverkan som i andra sammanhang visat sig fungera.Kommunerna samverkar, men har också gjort olika vägval. Hässleholm har satsat på sammanhållna processer inom kommunen, samverkan mellan tre förvaltningar och ett Familjefridscentrum som utvecklar och koordinerar arbetet mot våld i nära relationer. Övriga kommuner samverkar bland annat när det gäller spetskompetens genom Kriscentrum i Kristianstad. Alla kommuner satsar på förebyggande arbete genom bl.a. föräldrautbildningar. Samverkan med polis förefaller fungera bra när det gäller ungdom, men sämre när det handlar om kvinnor och/eller barn. Det framkom att det saknades stöd riktat till unga vuxna, där också personer som har eller kan vara aktuella för aktivitetsersättning återfinns. Det pågår och planeras fortsatt kompetensutveckling riktad till personal och genom KompetensCentrum. När det gäller Kristianstad kommun handlar det om 550 personer som skall gå utbildning.Viktiga områden att fokusera på framöver är: - Våga Fråga!, idag är stor variation. Frågeställaren behöver vara trygg i vad som kan göras och erbjudas vid upptäckt av våld eller hot om våld.- Mer information, utbildning och dialog inom och mellan verksamheter för att öka kompetens för överlämnande och tilltro till varandra som samverkanspartners.- Förebyggande insatser för unga vuxna.- Kopplingen arbetsliv – livet i övrigt. Ur arbetsgivarperspektiv går det att göra mycket när det gäller att upptäcka om anställd är utsatt för våld eller hot om våld såväl i arbetet som utanför arbetet.
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| 12. |
- Olsson, Ann-Margreth E., et al.
(författare)
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Finsamprojekt förebyggande arbete : Kartläggning och behovsanalys av förebyggande arbete mot våld i nära relationer i Bromölla, Hässleholm, Kristianstad, Osby och Östra Göinge kommuner samt Region Skåne och Försäkringskassan
- 2016
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Kommunerna i Skåne Nordost var tidigt ute med planer mot våld 2005. Försäkringskassan har på central nivå starkt profilerat sig som en aktör som skall motverka mäns våld mot kvinnor, men det verkar inte ha fått genomslag, än så länge. Region Skåne har markerat sig i planarbete och utvecklande av metodverktyg, som Genushanden©, men fortfarande är praxis när det gället att Våga Fråga varierande. Samverkan mellan kommuner och Regionen i form av bl. a. Familjehus och föräldrautbildningsprogram, samtal och rådgivning lockar många deltagare. De är exempel på program för normpåverkan som i andra sammanhang visat sig fungera. Kommunerna samverkar, men har också gjort olika vägval. Hässleholm har satsat på sammanhållna processer inom kommunen, samverkan mellan tre förvaltningar och ett Familjefridscentrum som utvecklar och koordinerar arbetet mot våld i nära relationer. Övriga kommuner samverkar bland annat när det gäller spetskompetens genom Kriscentrum i Kristianstad. Alla kommuner satsar på förebyggande arbete genom bl.a. föräldrautbildningar. Samverkan med polis förefaller fungera bra när det gäller ungdom, men sämre när det handlar om kvinnor och/eller barn. Det framkom att det saknades stöd riktat till unga vuxna, där också personer som har eller kan vara aktuella för aktivitetsersättning återfinns. Det pågår och planeras fortsatt kompetensutveckling riktad till personal och genom KompetensCentrum. När det gäller Kristianstad kommun handlar det om 550 personer som skall gå utbildning. Viktiga områden att fokusera på framöver är: - Våga Fråga!, idag är stor variation. Frågeställaren behöver vara trygg i vad som kan göras och erbjudas vid upptäckt av våld eller hot om våld. - Mer information, utbildning och dialog inom och mellan verksamheter för att öka kompetens för överlämnande och tilltro till varandra som samverkanspartners. - Förebyggande insatser för unga vuxna. - Kopplingen arbetsliv – livet i övrigt. Ur arbetsgivarperspektiv går det att göra mycket när det gäller att upptäcka om anställd är utsattför våld eller hot om våld såväl i arbetet som utanför arbetet.
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| 13. |
- Olsson, Ann-Margreth E., 1952-, et al.
(författare)
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In search of the voice of children : social workers as allies and gate-keepers
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- To improve a collaborative work a new institute has emerged in some places in Sweden, the Children’s House (CH), inspired by the Children’s Advocacy Center (CAC) model. In a CH professionals; police, prosecutors, health care and social services collaborate. One of the guiding ideas for CH is that the child should have to go to only one place during the investigatory process. In an ongoing dialogical participatory action research (DPAR) study the intention is to explore the children’s participation and understanding of CH. The aim is to support and secure a collaborative process with respect for the views of the child where the participating child becomes involved and listened to not only as a victim in an interrogation but as an actor.In developing evidence-based social work and learning in social work it becomes important that researchers are given opportunity to follow proceedings and listen to different voices including young clients. In the ongoing research project the researchers are participating observing the proceedings in CH and interviewing social workers asking them to mediate contact with participating children and their parents for the researcher. The researchers want to listen to the child’s view about visiting CH, the understanding of the context and the processes before, during and after visiting CH including the process of the social investigation and meetings with social workers.Several initiatives have been taken to improve participation within the child protection system, among these to develop social workers and social investigation processes from the perspective of being the child’s advocate. Evidence has emerged indicating that the ideas of inviting children into partnership with their social worker, are risking to be superseded by the priority to the forensic interview in CH, conducted by the police. The social workers report and show difficulties in knowing how to orientate themselves in relation to the children. The researcher’s request asking the social workers to invite the participating children and their parents into research collaboration seems to, so far, made the social workers to gate-keepers protecting the children from initiative reminding them of old abusive stories as well as severe proceedings.
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| 14. |
- Olsson, Ann-Margreth E., et al.
(författare)
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In search of the voice of children : social workers as allies and gate-keepers
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- To improve a collaborative work a new institute has emerged in some places in Sweden, the Children’s House (CH), inspired by the Children’s Advocacy Center (CAC) model. In a CH professionals; police, prosecutors, health care and social services collaborate. One of the guiding ideas for CH is that the child should have to go to only one place during the investigatory process. In an ongoing dialogical participatory action research (DPAR) study the intention is to explore the children’s participation and understanding of CH. The aim is to support and secure a collaborative process with respect for the views of the child where the participating child becomes involved and listened to not only as a victim in an interrogation but as an actor. In developing evidence-based social work and learning in social work it becomes important that researchers are given opportunity to follow proceedings and listen to different voices including young clients. In the ongoing research project the researchers are participating observing the proceedings in CH and interviewing social workers asking them to mediate contact with participating children and their parents for the researcher. The researchers want to listen to the child’s view about visiting CH, the understanding of the context and the processes before, during and after visiting CH including the process of the social investigation and meetings with social workers. Several initiatives have been taken to improve participation within the child protection system, among these to develop social workers and social investigation processes from the perspective of being the child’s advocate. Evidence has emerged indicating that the ideas of inviting children into partnership with their social worker, are risking to be superseded by the priority to the forensic interview in CH, conducted by the police. The social workers report and show difficulties in knowing how to orientate themselves in relation to the children. The researcher’s request asking the social workers to invite the participating children and their parents into research collaboration seems to, so far, made the social workers to gate-keepers protecting the children from initiative reminding them of old abusive stories as well as severe proceedings.
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| 15. |
- Olsson, Ann-Margreth E., 1952-
(författare)
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Swedish families' responses to military deployment
- 2019
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Ingår i: The politics of military families. - : Routledge. - 036713442X - 9780367134426 ; , s. 253-266
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Bokkapitel (refereegranskat)abstract
- This study examines emergent responses in Swedish families when a family member working in the Swedish Armed Forces get deployed in an international military operation. A descriptive design encompassing eight years of dialogical participatory action research was used. During this period, 110 adults and 25 children participated in individual and/or group dialogical interviews. Qualitative content analysis was applied and emergent suggestions were subsequently validated in dialogues with participants. This eventually resulted in six ideal types of responses: Partnership; Supporting and mobilizing; Normalizing – ordinary life; Adjusting and negotiating; Emotional reacting; Suffering. The types, recognized by participating family members, including the soldiers, emerge as a matrix for the narrations of experiences and connected responses to the deployment. The Swedish families reject the notion that the general concept of military families captured ‘who we are’. We discuss the meaning of this in the context of organization (the Swedish Armed Forces) and society (family, government/politics).
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| 16. |
- Springett, Jane, 1952-, et al.
(författare)
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Närsjukvård : bakgrund, erfarenheter och pilotstudie
- 2005
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Närsjukvård är ett centralt begrepp i ett förändringsarbete som för genomförs i nordöstra Skåne för att utveckla hälso- och sjukvårdsväsendet. Det ingår därmed som en av de centrala delarna av Region Skånes vision om hälso- och sjukvård: Skånsk livskraft – vård och hälsa. Syftet med denna rapport är att ge en bakgrund till begreppet (Del A) och att presentera en del preliminära rön beträffande hur olika aktörer i nordöstra Skåne uppfattar begreppet (Del B). Del A ger en översikt kring ursprunget till begreppet Närsjukvård inom ramen för de förändringar i hälso- och sjukvården som sker i Sverige i stort. Den beskriver sedan vilka slags förändringar som har planerats på politisk nivå och som nu håller på att genomföras under detta paraplybegrepp, nationellt, regionalt och lokalt. För detta syfte används statliga dokument och publicerade utvärderingsstudier i stor utsträckning som källmaterial. Denna del ska därför inte ses som en heltäckande översikt. Del B inriktas på att belysa hur långt förverkligandet av idén om Närsjukvård har kommit inom regionen. Avsnittet är en kartläggning av olika aktörers förståelse av Närsjukvård i den nordöstra delen av Region Skåne. Forskningsfrågorna inriktades på hur folk pratade om Närsjukvård, det vill säga på hur de förstod och använde begreppet.
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| 17. |
- Springett, Jane, et al.
(författare)
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Närsjukvård : bakgrund, erfarenheter och pilotstudie
- 2005
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Närsjukvård är ett centralt begrepp i ett förändringsarbete som för genomförs i nordöstra Skåne för att utveckla hälso- och sjukvårdsväsendet. Det ingår därmed som en av de centrala delarna av Region Skånes vision om hälso- och sjukvård: Skånsk livskraft – vård och hälsa. Syftet med denna rapport är att ge en bakgrund till begreppet (Del A) och att presentera en del preliminära rön beträffande hur olika aktörer i nordöstra Skåne uppfattar begreppet (Del B). Del A ger en översikt kring ursprunget till begreppet Närsjukvård inom ramen för de förändringar i hälso- och sjukvården som sker i Sverige i stort. Den beskriver sedan vilka slags förändringar som har planerats på politisk nivå och som nu håller på att genomföras under detta paraplybegrepp, nationellt, regionalt och lokalt. För detta syfte används statliga dokument och publicerade utvärderingsstudier i stor utsträckning som källmaterial. Denna del ska därför inte ses som en heltäckande översikt. Del B inriktas på att belysa hur långt förverkligandet av idén om Närsjukvård har kommit inom regionen. Avsnittet är en kartläggning av olika aktörers förståelse av Närsjukvård i den nordöstra delen av Region Skåne. Forskningsfrågorna inriktades på hur folk pratade om Närsjukvård, det vill säga på hur de förstod och använde begreppet.
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| 18. |
- Alfonsson, Sven, et al.
(författare)
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Is online treatment adherence affected by presentation and therapist support? : A randomized controlled trial
- 2016
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Ingår i: Computers in human behavior. - : Elsevier BV. - 0747-5632 .- 1873-7692. ; 60, s. 550-558
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Tidskriftsartikel (refereegranskat)abstract
- In both face to face and Internet based Cognitive Behavior Therapy, patients' adherence can be improved by different means such as by using motivational techniques or automatic reminders. The main aim of this study was to investigate whether enriched treatment material presentation and/or increased frequency and quality of support would increase participants' adherence to an online relaxation program. One hundred and sixty-two participants with mild to moderate symptoms of stress or worry were included in this study. Participants were randomized to either Normal or Enhanced intervention presentation and Normal or Enhanced support in a full factorial design. Main outcome variables were progress through the online intervention and adherence to prescribed exercises. Participants in the Enhanced support group progressed further through the program than participants in the Normal support group (Z = 2.11, p = .035, r = .17) but there were no significant differences found between the Normal and Enhanced presentation groups. Participants registered a mean of 60% of the prescribed exercises with no significant differences between groups. This study shows that adherence to online interventions can be increased by increased frequency and quality of therapeutic contact. Future studies may investigate how to increase adherence to prescribed homework assignments and whether parts of the therapeutic support may be substituted with automatic systems with retained effects.
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| 19. |
- Alfonsson, Sven, et al.
(författare)
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Motivation and Treatment Credibility Predicts Dropout, Treatment Adherence, and Clinical Outcomes in an Internet-Based Cognitive Behavioral Relaxation Program : A Randomized Controlled Trial.
- 2016
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 18:3
-
Tidskriftsartikel (refereegranskat)abstract
- Background: In previous research, variables such as age, education, treatment credibility, and therapeutic alliance have shown to affect patients' treatment adherence and outcome in Internet-based psychotherapy. A more detailed understanding of how such variables are associated with different measures of adherence and clinical outcomes may help in designing more effective online therapy.Objective: The aims of this study were to investigate demographical, psychological, and treatment-specific variables that could predict dropout, treatment adherence, and treatment outcomes in a study of online relaxation for mild to moderate stress symptoms.Methods: Participant dropout and attrition as well as data from self-report instruments completed before, during, and after the online relaxation program were analyzed. Multiple linear and logistical regression analyses were conducted to predict early dropout, overall attrition, online treatment progress, number of registered relaxation exercises, posttreatment symptom levels, and reliable improvement.Results: Dropout was significantly predicted by treatment credibility, whereas overall attrition was associated with reporting a focus on immediate consequences and experiencing a low level of intrinsic motivation for the treatment. Treatment progress was predicted by education level and treatment credibility, whereas number of registered relaxation exercises was associated with experiencing intrinsic motivation for the treatment. Posttreatment stress symptoms were positively predicted by feeling external pressure to participate in the treatment and negatively predicted by treatment credibility. Reporting reliable symptom improvement after treatment was predicted by treatment credibility and therapeutic bond.Conclusions: This study confirmed that treatment credibility and a good working alliance are factors associated with successful Internet-based psychotherapy. Further, the study showed that measuring adherence in different ways provides somewhat different results, which underscore the importance of carefully defining treatment adherence in psychotherapy research. Lastly, the results suggest that finding the treatment interesting and engaging may help patients carry through with the intervention and complete prescribed assignments, a result that may help guide the design of future interventions.
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| 20. |
- Alfonsson, Sven, et al.
(författare)
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Socio-demographic and clinical variables associated with psychological distress one and three years after a breast cancer diagnosis
- 2016
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 24:9, s. 4017-4023
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: A large group of women (20-30%) report psychological distress shortly after breast cancer diagnosis, and some experience continued or increased symptoms over time. The aim of this study was to investigate socio-demographic and clinical variables associated with sustained psychological distress in this patient group. METHODS: Women with breast cancer (n=833) completed self-report questionnaires regarding socio-demographic and clinical variables shortly after (T1) and 3years after diagnosis (T2) while data on illness severity were collected from a quality register. The Hospital Anxiety and Depression Scale was used as a measure of psychological distress at both time points. RESULTS: The number of participants who reported elevated levels of anxiety was 231 (28%) at T1 and 231 (28%) at T2 while elevated depressive symptoms was reported by 119 (14%) women at T1 and 92 (11%) at T2. Despite non-significant differences in mean scores over time, 91 (15%) participants reported increased anxiety symptoms and 47 (7%) reported increased depressive symptoms. Poor financial situation, lack of social support, previous psychiatric treatment, and high levels of fatigue were associated with both anxiety and depressive symptoms. Reporting high levels of fatigue was the variable most strongly associated with increased psychological distress over time. CONCLUSION: Most participants reported decreased psychological distress over time, but there were subgroups of women who experienced sustained or increased symptoms of anxiety or depression. Participants with poor financial status, previous psychological problems, or high levels of fatigue may be at increased risk of psychological distress. Such individuals may benefit most from psychosocial interventions.
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| 21. |
- Alfonsson, Sven, et al.
(författare)
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The effects of therapist support and treatment presentation on the clinical outcomes of an Internet based applied relaxation program
- 2015
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Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 2:3, s. 289-296
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Tidskriftsartikel (refereegranskat)abstract
- Symptoms of stress are common in the general population and associated with health risks and economic costs. Applied relaxation training has shown to be effective for reducing stress and worry both as a self-help treatment and as an internet-based intervention with therapist support. However, what factors may affect the outcome of internet based relaxation training is unclear. The aims of the present study were to investigate the effect of a brief internet based relaxation program for people with symptoms of stress or worry and to assess whether enhancing the quality of intervention presentation or therapist support had an impact on outcomes.Participants were randomized in a full factorial design to either Normal or Enhanced treatment Presentation and either Normal or Enhanced therapist Support in a four-week online program with applied relaxation. The main outcome measures were self-report instruments of stress and worry.A total of 162 participants were included in the study and 94 and 84 participants completed the post and follow-up measurements respectively. Participants in all conditions improved significantly on the main outcome measures, and the different levels of Presentation or therapist Support did not significantly affect treatment outcome. Registered number of completed exercises was a predictor of better treatment outcome, but this effect was independent of treatment condition. Enhancing internet based interventions by improving presentations and the quality of support may thus not be the best way to further improve the effect of internet based interventions. More specific knowledge of the mechanisms that affect outcomes in online psychotherapy is needed.
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| 22. |
- Ambrosi, Aurelie, et al.
(författare)
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Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern
- 2012
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group. - 0003-4967 .- 1468-2060. ; 71:3, s. 334-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort. less thanbrgreater than less thanbrgreater thanMethods The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies. less thanbrgreater than less thanbrgreater thanResults There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (pandlt;0.05). Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18-24 occurring during January-March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (pandlt;0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies. less thanbrgreater than less thanbrgreater thanConclusion This study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered.
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| 23. |
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| 24. |
- Anrup, Roland, et al.
(författare)
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Centrala universitetsvärden hotas av bolagiseringsidén
- 2013
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Ingår i: Dagens nyheter. - 1101-2447.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Högskolestiftelser. Förslaget att driva svenska universitet i stiftelseform öppnar för bolagisering. Men det är ingen riktig utredning, utan en politisk pamflett utan eftertanke. Privatisering av universitet hotar både oberoendet, forskningskvaliteten och samhällsnyttan, skriver 36 forskare vid svenska högskolor och universitet.
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| 25. |
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| 26. |
- Bexell, Ulf
(författare)
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Surface Characterisation Using ToF-SIMS, AES and XPS of Silane Films and Organic Coatings Deposited on Metal Substrates
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This work focuses on the surface and interfacial characterisation of silane films of a non-organofunctional silane, 1,2-bis(triethoxysilyl)ethane (BTSE), and an organofunctional silane, γ-mercaptopropyltrimethoxysilane (γ-MPS), deposited on Al, Zn and Al-43.4Zn-1.6Si (AlZn) alloy coated steel. Furthermore, a tribological study of a vegetable oil coupled to an aluminium surface pre-treated with γ-MPS is presented and, finally, the tribological response of thin organic coatings exposed to a sliding contact as evaluated by surface analysis is discussed. The main analyses techniques used were time-of-flight secondary ion mass spectrometry (ToF-SIMS), Auger electron spectroscopy (AES) and x-ray photoelectron spectroscopy (XPS). The results presented in this thesis show that the combination of ToF-SIMS, AES and XPS analysis can be used in order to obtain useful and complementary information regarding the surface and interface characteristics of silane films and organic coatings deposited on metal substrates.The major result regarding the silane films is that the silane film composition/structure is not dependent of pH-value during deposition or type of metal substrate. The presence of Si-O-Me ion fragments in the ToF-SIMS spectra is a strong indication that a chemical interaction between the silane film and the metal substrate exists. Furthermore, it has been shown that it is possible to bond a vegetable oil to a thiol functionalised aluminium surface and to produce a coating thick enough to obtain desired friction and wear characteristics. Finally, the use of ToF-SIMS analysis makes it possible to distinguish between mechanical and tribochemical wear mechanisms.
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| 27. |
- Brown, Darron R., et al.
(författare)
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The Impact of Quadrivalent Human Papillomavirus (HPV; Types 6, 11, 16, and 18) L1 Virus-Like Particle Vaccine on Infection and Disease Due to Oncogenic Nonvaccine HPV Types in Generally HPV-Naive Women Aged 16-26 Years
- 2009
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Ingår i: Journal Of Infectious Diseases. - : Oxford University Press (OUP). - 0022-1899 .- 1537-6613. ; 199:7, s. 926-935
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Konferensbidrag (refereegranskat)abstract
- Background. Human papillomavirus (HPV)-6/11/16/18 vaccine reduces the risk of HPV-6/11/16/18-related cervical intraepithelial neoplasia (CIN) 1-3 or adenocarcinoma in situ (AIS). Here, its impact on CIN1-3/AIS associated with nonvaccine oncogenic HPV types was evaluated. Methods. We enrolled 17,622 women aged 16-26 years. All underwent cervicovaginal sampling and Pap testing at regular intervals for up to 4 years. HPV genotying was performed for biopsy samples, and histological diagnoses were determined by a pathology panel. Analyses were conducted among subjects who were negative for 14 HPV types on day 1. Prespecified analyses included infection of >= 6 months' duration and CIN1-3/AIS due to the 2 and 5 most common HPV types in cervical cancer after HPV types 16 and 18, as well as all tested nonvaccine types. Results. Vaccination reduced the incidence of HPV-31/45 infection by 40.3% (95% confidence interval [CI], 13.9% to 59.0%) and of CIN1-3/AIS by 43.6% (95% CI, 12.9% to 64.1%), respectively. The reduction in HPV-31/33/45/52/58 infection and CIN1-3/AIS was 25.0% (95% CI, 5.0% to 40.9%) and 29.2% (95% CI, 8.3% to 45.5%), respectively. Efficacy for CIN2-3/AIS associated with the 10 nonvaccine HPV types was 32.5% (95% CI, 6.0% to 51.9%). Reductions were most notable for HPV-31. Conclusions. HPV-6/11/16/18 vaccine reduced the risk of CIN2-3/AIS associated with nonvaccine types responsible for similar to 20% of cervical cancers. The clinical benefit of cross-protection is not expected to be fully additive to the efficacy already observed against HPV-6/11/16/18-related disease, because women may have >1 CIN lesion, each associated with a different HPV type.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Dillner, Joakim, et al.
(författare)
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Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial.
- 2010
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Ingår i: BMJ: British Medical Journal. - : BMJ. - 1756-1833 .- 0959-8138 .- 1468-5833. ; 341
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate the prophylactic efficacy of the human papillomavirus (HPV) quadrivalent vaccine in preventing low grade cervical, vulvar, and vaginal intraepithelial neoplasias and anogenital warts (condyloma acuminata). DESIGN: Data from two international, double blind, placebo controlled, randomised efficacy trials of quadrivalent HPV vaccine (protocol 013 (FUTURE I) and protocol 015 (FUTURE II)). The trials were to be 4 years in length, and the results reported are from final study data of 42 months' follow-up. SETTING: Primary care centres and university or hospital associated health centres in 24 countries and territories around the world. PARTICIPANTS: 17 622 women aged 16-26 years enrolled between December 2001 and May 2003. Major exclusion criteria were lifetime number of sexual partners (>4), history of abnormal cervical smear test results, and pregnancy. INTERVENTION: Three doses of quadrivalent HPV vaccine (for serotypes 6, 11, 16, and 18) or placebo at day 1, month 2, and month 6. MAIN OUTCOME MEASURES: Vaccine efficacy against cervical, vulvar, and vaginal intraepithelial neoplasia grade I and condyloma in a per protocol susceptible population that included subjects who received all three vaccine doses, tested negative for the relevant vaccine HPV types at day 1 and remained negative through month 7, and had no major protocol violations. Intention to treat, generally HPV naive, and unrestricted susceptible populations were also studied. RESULTS: In the per protocol susceptible population, vaccine efficacy against lesions related to the HPV types in the vaccine was 96% for cervical intraepithelial neoplasia grade I (95% confidence interval 91% to 98%), 100% for both vulvar and vaginal intraepithelial neoplasia grade I (95% CIs 74% to 100%, 64% to 100% respectively), and 99% for condyloma (96% to 100%). Vaccine efficacy against any lesion (regardless of HPV type) in the generally naive population was 30% (17% to 41%), 75% (22% to 94%), and 48% (10% to 71%) for cervical, vulvar, and vaginal intraepithelial neoplasia grade I, respectively, and 83% (74% to 89%) for condyloma. CONCLUSIONS: Quadrivalent HPV vaccine provided sustained protection against low grade lesions attributable to vaccine HPV types (6, 11, 16, and 18) and a substantial reduction in the burden of these diseases through 42 months of follow-up. TRIAL REGISTRATIONS: NCT00092521 and NCT00092534.
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| 33. |
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| 34. |
- Eckerström, Carl, et al.
(författare)
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Small baseline volume of left hippocampus is associated with subsequent conversion of MCI into dementia. The Göteborg MCI study.
- 2008
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Ingår i: Journal of the Neurological Sciences. - : Elsevier BV. - 0022-510X .- 1878-5883. ; 272:1-2, s. 48-59
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Tidskriftsartikel (refereegranskat)abstract
- Background: Earlier studies have reported that hippocampal atrophy can to some extent predict which patients with mild cognitive impairment (MCI) will subsequently convert to dementia, and that converters have an enhanced rate of hippocampal volume loss. Objective: To further validate the hypothesis that hippocampal atrophy predicts conversion from MCI to dementia, to relate baseline hippocampal volume to different forms of dementia, and to investigate the role of hippocampal side differences and rate of volume loss over time. Patients: The subjects (N = 68) include patients with MCI at baseline and progression to dementia at the two-year follow-up (N = 21), stable MCI patients (N = 21), and controls (N = 26). Among the progressing patients, 13 were diagnosed as having AD. Methods: The Göteborg MCI study is a clinically based longitudinal study with biannual clinical assessments. Hippocampal volumetry was performed manually on the MRI investigations at baseline and at the two-year follow-up. Results: Hippocampal volumetry could predict conversion to dementia in both the AD and the non-AD subgroup of converters. Left hippocampal volume in particular discriminated between converting and stable MCI. Cut off points for individual discrimination were shown to be potentially useful. The converting MCI group had a significantly higher rate of hippocampal volume loss as compared to the stable MCI group. Conclusions: In MCI patients, hippocampal volumetry at baseline gives prognostic information about possible development of AD and non-AD dementia. Contrary to earlier studies, we found that left hippocampal volume has the best predictive power. Reliable predictions appear to be possible in many individual cases.
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| 35. |
- Eriksson, Sven-Erik, 1949-, et al.
(författare)
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Survival and recurrent strokes in patients with different subtypes of stroke : A fourteen-year follow-up study
- 2001
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1015-9770 .- 1421-9786. ; 12:3, s. 171-180
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Tidskriftsartikel (refereegranskat)abstract
- In this study, 339 patients (154 men, 185 women) with a median age of 74 years (range 23-97) admitted to the Stroke Unit, Department of Neurology in 1986, have been followed up for 14 years. The diagnoses were intra-cerebral hemorrhage (ICH, 30, 8.8%), cardioembolic cerebral infarction (CE, 71, 20.9%), lacunar infarction (LI, 47, 13.9%) and atherosclerotic cerebral infarction (ACI, 191, 56.3%). The cumulative probabilities of recurrent stroke rates at 1-, 5- and 10-year follow-ups were 13.5% (95% confidence interval, CI, 9.6-17.4), 38.7% (95% CI 32.6-44.8) and 53.9% (95% CI 46.7-61.1). According to Cox proportional hazard regression analysis, age, severity of stroke, previous stroke and systolic blood pressure are each of importance in predicting recurrent stroke. During the observation period, 290 patients (85.5%) died. The mortality rate of 24.5% during the first year was 4.5 times higher compared to the normal population of the same age and gender. Patients with LI had lower mortality rates compared to ICH by the log rank test (p =0.0275), to CE (p =0.000) and to ACI (p =0.049). Thirty-nine percent of all vascular deaths after the first year were caused by recurrent strokes. Fatal index/recurrent stroke occurred statistically more frequently in the CE group versus the non-CE one (p =0.005). Cox proportional hazard regression analysis indicated that age, severity of stroke, previous stroke, heart failure and fasting blood glucose exceeding 6 mmol/l or history of diabetes were each predictors of mortality. In conclusion, this study has shown the worse outcomes for all subtypes of stroke compared to the normal population and also clearly pointed out independent predictors of recurrent stroke or death at the time of diagnosis. Copyright
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| 36. |
- Evans Axelsson, Susan, et al.
(författare)
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Targeting free prostate-specific antigen for in vivo imaging of prostate cancer using a monoclonal antibody specific for unique epitopes accessible on free prostate-specific antigen alone
- 2012
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Ingår i: Cancer Biotherapy and Radiopharmaceuticals. - : Mary Ann Liebert Inc. - 1084-9785 .- 1557-8852. ; 27:4, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the feasibility of targeting the free, unbound forms of prostate-specific antigen (fPSA) for in vivo imaging of prostate adenocarcinomas (PCa), as PSA is produced and secreted at abundance during every clinical stage and grade of PCa, including castration-resistant disease. We injected 125I-labeled monoclonal antibody PSA30 (specific for an epitope uniquely accessible on fPSA alone) intravenously in male nude mice carrying subcutaneous xenografts of LNCaP tumors (n=36). Mice were sacrificed over a time course from 4 hours to 13 days after injecting 125I-labeled PSA30. Tissue uptake of 125I-PSA30 at 48 and 168 hours after intravenous injection was compared with two clinically used positron emission tomography radiopharmaceuticals, 18F-fluoro-deoxy-glucose (18F-FDG) or 18F-choline, in cryosections using Digital AutoRadiography (DAR) and also compared with immunohistochemical staining of PSA and histopathology. On DAR, the areas with high 125I-PSA30 uptake corresponded mainly to morphologically intact and PSA-producing LNCaP cells, but did not associate with the areas of high uptake of either 18F-FDG or 18F-choline. Biodistribution of 125I-PSA30 measured in dissected organs ex vivo during 4 to 312 hours after intravenous injection demonstrated maximum selective tumor uptake 24–48 hours after antibody injection. Our data showed selective uptake in vivo of a monoclonal antibody highly specific for fPSA in LNCaP cells. Hence, in vivo imaging of fPSA may be feasible with putative usefulness in disseminated PCa.
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| 37. |
- Genot, Emmanuel, et al.
(författare)
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The Dissemination of Scientific Fake News : On the Ranking of Retracted Articles in Google
- 2021
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Ingår i: The Epistemology of Fake News. - : Oxford University PressOxford. - 9780198863977 ; , s. 228-242
-
Bokkapitel (refereegranskat)abstract
- Fake news can originate from an ordinary person carelessly posting what turns out to be false information orfrom the intentional actions of fake news factory workers,but broadly speaking it can also originate from scientific fraud. In the latter case, the article can be retracted upon discovery of the fraud. A case study shows, however, that such fake sciencecan be visible in Google even after the article was retracted, in fact more visible thanthe retraction notice. We hypothesize that the reason for this lies in the popularity-based logic governing Google, in particular its foundational PageRank algorithm,in conjunction with a psychological law which we refer to as the “law of retraction”: a retraction notice is typically taken to be less interestingand therefore less popular with internet users than the original content retracted. We conduct anempiricalstudy drawing on records of articles retracted due to fraud (fabrication of data) in the Retraction Watch public database. The study tests the extent to which such retracted scientific articles are still highly ranked in Google –and more so than information about the retraction. We find, among other things, thatboth Google Search and Google Scholar more often than not rankeda link to the original article higher than a link indicating that the article has been retracted.Surprisingly, Google Scholar did not perform better in this regard than Google Search.We also foundcases in which Google didnot track the retraction of anarticle on the first result page at all.We conclude thatboth Google Search and Google Scholar runthe risk of disseminating fake science through theirranking algorithms.
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| 38. |
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| 39. |
- Hagsund, Tora, et al.
(författare)
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β-blockers after myocardial infarction and 1-year clinical outcome - A retrospective study
- 2020
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261. ; 20:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Long term β-blocker therapy after myocardial infarction (MI) reduces mortality and recurrent MI but evidence for this treatment predates contemporary acute coronary care. β-blocker treatment is a key quality of care indicator in the Swedish national quality register for acute coronary care, Riks-HIA. Between 2011 and 2015 a declining number of MI-patients discharged with a β-blocker from the coronary care unit (CCU) at Helsingborg and other hospitals was reported. This retrospective observational study aimed to investigate the causes for discharge without a β-blocker and relate it to outcome, compared to patients discharged with a β-blocker. Methods: MI-patients registered in Riks-HIA discharged without β-blocker during 2011-2015 (no-β-group) and a control group (β-group) comprised of patients discharged with β-blocker treatment between January 1 to December 31, 2013, were matched by RIKS-HIA criteria for β-blocker use. Clinical characteristics, date of death, readmission for MI, other cardiovascular events were collected from Riks-HIA and medical records. Results: The no-β-group included 141 patients, where 65.2% had a justified reason for non-β-blocker use. The β-group included 206 patients. There was no difference in cardiovascular risk factor profile. There were a trend towards a higher number of readmissions for MI in the no-β-group was (n = 8 (5.7%) vs n = 2 (1.0%), p = 0.02), but not mortality (6 (4.3%) vs 2 (1.0%), p = 0.07) and combined readmission for angina pectoris, heart failure, arrhythmias or stroke/TIA (n = 23 (16.3%) vs n = 25 (12.1%), p = 0.27). Conclusion: A majority of the patients in the no-β-group had a justified absence of a β-blocker. β-blocker treatment post-MI showed a trend towards fewer readmissions for MI. But important quality information is lacking to make a firm conclusion of the effect on outcome.
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| 40. |
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| 41. |
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| 42. |
- Hoogendoorn, Billy W., et al.
(författare)
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Cellulose nanofibers (CNFs) in the recycling of nickel and cadmium battery metals using electrodeposition
- 2023
-
Ingår i: Nanoscale Advances. - : Royal Society of Chemistry (RSC). - 2516-0230. ; 5:19, s. 5263-5275
-
Tidskriftsartikel (refereegranskat)abstract
- Cellulose nanofibers (CNFs) were employed in the aqueous electrodeposition of nickel and cadmium for battery metal recycling. The electrowinning of mixed Ni-Cd metal ion recycling solutions demonstrated that cadmium with a purity of over 99% could be selectively extracted while leaving the nickel in the solution. Two types of CNFs were evaluated: negatively charged CNFs (a-CNF) obtained through acid hydrolysis (−75 μeq. g−1) and positively charged CNFs (q-CNF) functionalized with quaternary ammonium groups (+85 μeq. g−1). The inclusion of CNFs in the Ni-Cd electrolytes induced growth of cm-sized dendrites in conditions where dendrites were otherwise not observed, or increased the degree of dendritic growth when it was already present to a lesser extent. The augmented dendritic growth correlated with an increase in deposition yields of up to 30%. Additionally, it facilitated the formation of easily detachable dendritic structures, enabling more efficient processing on a large scale and enhancing the recovery of the toxic cadmium metal. Regardless of the charged nature of the CNFs, both negatively and positively charged CNFs led to a significant formation of protruding cadmium dendrites. When deposited separately, dendritic growth and increased deposition yields remained consistent for the cadmium metal. However, dendrites were not observed during the deposition of nickel; instead, uniformly deposited layers were formed, albeit at lower yields (20%), when positively charged CNFs were present. This paper explores the potential of utilizing cellulose and its derivatives as the world's largest biomass resource to enhance battery metal recycling processes.
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| 43. |
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| 44. |
- Kjaer, Susanne K., et al.
(författare)
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A Pooled Analysis of Continued Prophylactic Efficacy of Quadrivalent Human Papillomavirus (Types 6/11/16/18) Vaccine against High-grade Cervical and External Genital Lesions
- 2009
-
Ingår i: Cancer Prevention Research. - 1940-6207. ; 2:10, s. 868-878
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Tidskriftsartikel (refereegranskat)abstract
- Quadrivalent human papillomavirus (HPV) vaccine has been shown to provide protection from HPV 6/11/16/18-related cervical, vaginal, and vulvar disease through 3 years. We provide an update on the efficacy of the quadrivalent HPV vaccine against high-grade cervical, vaginal, and vulvar lesions based on end-of-study data from three clinical trials. Additionally, we stratify vaccine efficacy by several baseline characteristics, including age, smoking status, and Papanicolaou (Pap) test results. A total of 18,174 females ages 16 to 26 years were randomized and allocated into one of three clinical trials (protocols 007, 013, and 015). Vaccine or placebo was given at baseline, month 2, and month 6. Pap testing was conducted at regular intervals. Cervical and anogenital swabs were collected for HPV DNA testing. Examination for the presence of vulvar and vaginal lesions was also done. Endpoints included high-grade cervical, vulvar, or vaginal lesions (CIN 2/3, VIN 2/3, or VaIN 2/3). Mean follow-up time was 42 months post dose 1. Vaccine efficacy against HPV 6/11/16/18-related high-grade cervical lesions in the per-protocol and intention-to-treat populations was 98.2% [95% confidence interval (95% CI), 93.3-99.8] and 51.5% (95% CI, 40.6-60.6), respectively. Vaccine efficacy against HPV 6/11/16/18-related high-grade vulvar and vaginal lesions in the per-protocol and intention-to-treat populations was 100.0% (95% CI, 82.6-100.0) and 79.0% (95% CI, 56.4-91.0), respectively. Efficacy in the intention-to-treat population tended to be lower in older women, women with more partners, and women with abnormal Pap test results. The efficacy of quadrivalent HPV vaccine against high-grade cervical and external anogenital neoplasia remains high through 42 months post vaccination.
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| 45. |
- Levin, Rikard, 1965-
(författare)
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Uncertainty in risk assessment : contents and modes of communication
- 2005
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Assessments of chemical health risks are performed by scientific experts. Their intended use is as bases for decisions. This thesis tries to answer the questions of how uncertainty is, and should be, communicated in such risk assessments. The thesis consists of two articles and an introductory essay. Article I focuses on the linguistic aspect of the communication of uncertainty in risk assessments. The aim of the article is to elucidate how risk assessors actually indicate uncertainty in risk assessment reports. Because of the prevalent uncertainty in risk assessment, deriving from several sources, uncertainty is communicated in verbal, rather than numerical terms. A typology of uncertainty indicators – phrases used to express uncertainty – is proposed and applied to the reviewed reports. It is found that the use of such phrases is not transparent, and the article concludes by a number of recommendations for improving the practice. Article II mainly deals with the content of the communication. The overall question treated is what a characterization of uncertainty should include if a decision made on the basis of the risk assessment information is to be as well-founded as possible. A set of conditions is put forward to be fulfilled by a characterization of uncertainty if it is to be adequate from a decision-making point of view. The greater part of the introductory essay is devoted to the concept of uncertainty which, at the conceptual level, does not appear to have been much discussed by philosophers
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| 46. |
- Madru, Renata, et al.
(författare)
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99mTc-Labeled Superparamagnetic Iron Oxide Nanoparticles for Multimodality SPECT/MRI of Sentinel Lymph Nodes.
- 2012
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Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 2159-662X. ; 53:3, s. 459-463
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to develop multimodality SPECT/MRI contrast agents for sentinel lymph node (SLN) mapping in vivo. METHODS: Nanoparticles with a solid iron oxide core and a polyethylene glycol coating were labeled with (99m)Tc. The labeling efficiency was determined with instant thin-layer chromatography and magnetic separation. The stability of the radiolabeled superparamagnetic iron oxide nanoparticles (SPIONs) was verified in both sterile water and human serum at room temperature 6 and 24 h after labeling. Five Wistar rats were injected subcutaneously in the right hind paw with (99m)Tc-SPIONs (25-50 MBq, ∼0.2 mg of Fe) and sacrificed 4 h after injection. Two animals were imaged with SPECT/MRI. All 5 rats were dissected; the lymph nodes, liver, kidneys, spleen, and hind paw containing the injection site were removed and weighed; and activity in the samples was measured. The microdistribution within the lymph nodes was studied with digital autoradiography. RESULTS: The efficiency of labeling of the SPIONs was 99% 6 h after labeling in both water and human serum. The labeling yield was 98% in water and 97% in human serum 24 h after labeling. The SLN could be identified in vivo with SPECT/MRI. The accumulation of (99m)Tc-SPIONs (as the percentage injected dose/g [%ID/g]) in the SLN was 100 %ID/g, whereas in the liver and spleen it was less than 2 %ID/g. Digital autoradiography images revealed a nonhomogeneous distribution of (99m)Tc-SPIONs within the lymph nodes; nanoparticles were found in the cortical, subcapsular, and medullary sinuses. CONCLUSION: This study revealed the feasibility of labeling SPIONs with (99m)Tc. The accumulation of (99m)Tc-SPIONs in lymph nodes after subcutaneous injection in animals, verified by SPECT/MRI, is encouraging for applications in breast cancer and malignant melanoma.
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| 47. |
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| 48. |
- Mattsson, Susanne, et al.
(författare)
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Internet-based stepped care with interactive support and cognitive behavioral therapy for reduction of anxiety and depressive symptoms in cancer : a clinical trial protocol
- 2013
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 13, s. 414-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Approximately 20-30% of patients with cancer experience a clinically relevant level of emotional distress in response to disease and treatment. This in itself is alarming but it is even more problematic because it is often difficult for physicians and nurses to identify cancer patients who experience clinically relevant levels of anxiety and depression symptoms. This can result in persistent distress and can cause human suffering as well as costs for individuals and to the community. Methods: Applying a multi-disciplinary and design-oriented approach aimed at attaining new evidence-based knowledge in basic and applied psychosocial oncology, this protocol will evaluate an intervention to be implemented in clinical practice to reduce cancer patient anxiety and depression. A prospective randomized design will be used. The overarching goal of the intervention is to promote psychosocial health among patients suffering from cancer by means of self-help programmes delivered via an Internet platform. Another goal is to reduce costs for individuals and society, caused by emotional distress in response to cancer. Following screening to detect levels of patient distress, patients will be randomized to standard care or a stepped care intervention. For patients randomized to the intervention, step 1 will consist of self-help material, a chat forum where participants will be able to communicate with each other, and a Frequently Asked Questions (FAQ) section where they can ask questions and get answers from an expert. Patients in the intervention group who still report symptoms of anxiety or depression after access to step 1 will be offered step 2, which will consist of cognitive behavioral therapy (CBT) administered by a personal therapist. The primary end point of the study is patients' levels of anxiety and depression, evaluated longitudinally during and after the intervention. Discussion: There is a lack of controlled studies of the psychological and behavioral processes involved in this type of intervention for anxiety and depressive disorders. Since anxiety and depressive symptoms are relatively common in patients with cancer and the availability of adequate support efforts is limited, there is a need to develop evidence-based stepped care for patients with cancer, to be delivered via the Internet.
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| 49. |
- Mattsson, Susanne, et al.
(författare)
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Measuring Use of Health-Related Support on the Internet : Development of the Health Online Support Questionnaire (HOSQ)
- 2015
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 17:11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social support plays an important role for the perceived health in people with health problems and chronic diseases.Provision of different kinds of support during the disease trajectory is crucial for many people. Online support is ubiquitous andrepresents a promising modality for people with chronic diseases. There are no existing instruments that measure various aspectsof online support.Objective: The objective of this study was to create a generic questionnaire regarding health-related support online that can beapplied to people with various health problems and illnesses. Additionally, we wanted to test the questionnaire in a cancerpopulation to assess its adequacy in the context of severe disease.Methods: Initial items for the Health Online Support Questionnaire (HOSQ) were inspired by sociologist James House regardingsocial support. An exploratory factor analysis was conducted in healthy persons or with minor health problems (n=243) on 31initial items. The scale was reduced to 18 items and the internal consistency and reliability of the scale was examined along withcontent validity. Further validation was conducted by a confirmatory analysis on the 18-item scale in a cancer population (n=215).In addition, data on demographics, health problems experienced, and Internet use were collected.Results: The exploratory factor analysis on the final 18-item scale resulted in 2 factors. After scrutinizing the content, thesefactors were labeled “reading” and “interacting” and they demonstrated good internal consistency (Cronbach alphas .88 and .77,respectively). The factors were confirmed in the cancer population. The response pattern revealed expected differences bothbetween the interaction and reading scales and according to age, gender, education, and health problems thereby supporting thevalidity of the HOSQ.Conclusions: The HOSQ may be a reliable and valid instrument for measuring the use of online support for people with healthproblems, but the results ought to be replicated in more studies to confirm the results for different diagnoses. If the results of thisstudy are corroborated by future studies, the HOSQ may be used as a basis for the development of different forms of support onthe Internet.
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| 50. |
- Meisgen, Sabrina, et al.
(författare)
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The HLA locus contains novel foetal susceptibility alleles for congenital heart block with significant paternal influence
- 2014
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 275:6, s. 640-651
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The main aim of this study was to identify foetal susceptibility genes on chromosome six for Ro/SSA autoantibody-mediated congenital heart block.SUBJECTS AND DESIGN: Single nucleotide polymorphism (SNP) genotyping of individuals in the Swedish Congenital Heart Block (CHB) study population was performed. Low-resolution HLA-A, -Cw and -DRB1 allele typing was carried out in 86 families comprising 339 individuals (86 Ro/SSA autoantibody-positive mothers, 71 fathers, 87 CHB index cases, and 95 unaffected siblings).RESULTS: A case-control comparison between index cases and population-based out-of-study controls (n=1710) revealed association of CHB with 15 SNPs in the 6p21.3 MHC locus at a chromosome-wide significance of p<2.59×10(-6) (OR 2.21-3.12). In a family-based analysis of association of SNP markers as well as distinct MHC class I and II alleles with CHB, HLA-DRB1*04 and HLA-Cw*05 variants were significantly more frequently transmitted to affected individuals (p<0.03 and p<0.05, respectively), while HLA-DRB1*13 and HLA-Cw*06 variants were significantly less often transmitted to affected children (p<0.04 and p<0.03). We further observed marked association of increased paternal (but not maternal) HLA-DRB1*04 transmission to affected offspring (p<0.02).CONCLUSIONS: HLA-DRB1*04 and HLA-Cw*05 were identified as novel foetal HLA allele variants that confer susceptibility to CHB in response to Ro/SSA autoantibody exposure, while DRB1*13 and Cw*06 emerged as protective alleles. Additionally, we demonstrated a paternal contribution to foetal susceptibility to CHB for the first time.
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