| 1. |
- Andréasson, Sven, et al.
(författare)
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Behandling av alkohol- och narkotikaproblem : En evidensbaserad kunskapssammanställning
- 2001
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Utvärderingens syfteMissbruk och beroende av alkohol är ett av de största folkhälsoproblemen. Narkotikamissbruk är mindre vanligt men har stora medicinska konsekvenser för de berörda. De sociala och juridiska aspekterna är betydande. En kritisk genomgång av litteraturen vad avser behandling av abstinens, protraherad abstinens, behandling i syfte att förhindra återfall, psykologiska och sociala behandlingar för att minska återfallsrisken, behandlingsprogram och institutionsvårdens roll, samt behandling av missbruk under graviditet. Dessutom en granskning av mini-intervention i primärvård och annan vård vars syfte är att minska konsumtionen hos högkonsumenter av alkohol. Nyligen gjorda meta-analyser inom området värderas och särskild vikt fästs vid interventioner som finns eller lätt kan introduceras i den svenska vårdorganisationen. Behandlingsprogram för patienter med samtidig annan psykisk störning värderas.Så kallat lågdosberoende av bensodiazepiner och andra lugnande medel eller sömnmedel behandlas inte. Inte heller belyses effekten av behandlingar vars primära mål är kroppsliga komplikationer av missbruket, och inte heller granskas metoder att minska tillgänglighet.TillvägagångssättStrukturerad översikt, kostnadsanalyser.Insamling av primärdataSystematisk sökning i relevanta databaser, litteraturlistor i påträffade studier samt i aktuella monografier. Ingen bakre tidsbegränsning och sökning i databaser till och med februari 1999.Utgångspunkt för urval av dataHuvudsakligen randomiserade, kontrollerade, dubbelblinda studier, samt metaanalyser som baseras på sådana studier. Vad gäller långtidsförlopp och ekonomiska analyser även kohortstudier och andra naturalistiska studier.Genomgång av publikationenSamtliga studier värderas med hjälp av en i gruppen utarbetad, och med övriga psykiatriprojekt gemensam, kvalitetsmall. Alla centrala studier läses av minst två i gruppen.Färdiga manuskript värderas av styrelse, expertgrupp samt externa granskare.
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| 2. |
- Benfatto, Mattias Nilsson, et al.
(författare)
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Screening for Dyslexia Using Eye Tracking during Reading
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- Dyslexia is a neurodevelopmental reading disability estimated to affect 5-10% of the population. While there is yet no full understanding of the cause of dyslexia, or agreement on its precise definition, it is certain that many individuals suffer persistent problems in learning to read for no apparent reason. Although it is generally agreed that early intervention is the best form of support for children with dyslexia, there is still a lack of efficient and objective means to help identify those at risk during the early years of school. Here we show that it is possible to identify 9-10 year old individuals at risk of persistent reading difficulties by using eye tracking during reading to probe the processes that underlie reading ability. In contrast to current screening methods, which rely on oral or written tests, eye tracking does not depend on the subject to produce some overt verbal response and thus provides a natural means to objectively assess the reading process as it unfolds in real-time. Our study is based on a sample of 97 high-risk subjects with early identified word decoding difficulties and a control group of 88 low-risk subjects. These subjects were selected from a larger population of 2165 school children attending second grade. Using predictive modeling and statistical resampling techniques, we develop classification models from eye tracking records less than one minute in duration and show that the models are able to differentiate high-risk subjects from low-risk subjects with high accuracy. Although dyslexia is fundamentally a language-based learning disability, our results suggest that eye movements in reading can be highly predictive of individual reading ability and that eye tracking can be an efficient means to identify children at risk of long-term reading difficulties.
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| 3. |
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| 4. |
- Flodin, Sara, 1974, et al.
(författare)
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Clinical measurements of normative subjective cyclotorsion and cyclofusion in a healthy adult population.
- 2020
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Ingår i: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 98:2, s. 177-181
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate normative subjective cyclotorsion values and cyclofusion ranges in a healthy adult population.METHODS: A cross-sectional investigation was performed in 120 healthy, non-strabismic adults, 60 men and 60 women in the age range of 18-69 years. All subjects were assessed for cyclotorsion using the synoptophore and the single Maddox rod (SMR) methods. Cyclofusion was investigated with the synoptophore in 60 of the subjects.RESULTS: All age groups showed low values of subjective torsion, mainly excyclotorsion with mean values of -1 degree for both methods. Reference ranges of cyclotorsion were between -0.7 and -1.5 degrees for the SMR method and between -0.7 and -1.4 degrees using the synoptophore method. There were no significant differences between gender (p = 0.48), but the effect of age was significant for both methods (p = 0.026) demonstrating a slight increase in excyclotorsion with age. Cyclofusion showed a total mean amplitude of 16 degrees, the fusion range was +7 degrees of incyclotorsion to -9 degrees of excyclotorsion.CONCLUSIONS: Subjective reference ranges for cyclotorsion and cyclofusion reveal that low values of torsion are to be expected upon clinical investigation in non-strabismic adult individuals. Values outside of the reference range may be indicators of possible binocular abnormalities or physiological variations. The cyclotorsional measurements and prevalence in this adult population group can be regarded as normative data in clinical settings.
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| 5. |
- Flodin, Sara, 1974, et al.
(författare)
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Cyclofusion ranges in a healthy adult population
- 2018
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Ingår i: Poster ARVO annual meeting, Honolulu 2018.
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Konferensbidrag (refereegranskat)abstract
- Purpose: Cyclovergence is the simultaneous occurring cyclorotation of both eyes, which is performed in opposite directions to obtain or maintain binocular single vision (BSV), and ensures cyclofusion. To date, cyclovergence adaptation has only been estimated or observed objectively and subjective cyclofusion ranges are thus unknown. This study hypothesize that subjective cyclofusion can be measured in a healthy non-strabismic adult population using a standard clinical test, in order to establish clinical reference ranges. Methods: A cross-sectional investigation was performed on a random sample group of 60 healthy, non-strabismic adults (30 women, 30 men) in the age range of 18-69 years, median age 44 years. Ethnicity was 95% white. All subjects were assessed for cyclotorsion, before cyclofusion was investigated using the Clement Clark synoptophore model 2003 and fusion slides F9/10 (Figure 1a/b).The subject was instructed to create a composite image of one house with two trees outside. Once sensory fusion was proved, motor fusion was tested by the examiner. Break of fusion was recorded for incyclovergence and excyclovergence when the patient reported break of single image, tilting of image or suppression of one of the controls. The amplitude was the total amount of torsion fused between the in and excyclotorsion values recorded at breakpoints. Data analysis showed normal distribution, and the anova was used for statistical analysis. Results: Healthy non-strabismic adults in all age groups showed low values of cyclotorsion, mainly excyclotorsion. Mean values for the whole sample was -1 degrees (SD 2.13). Cyclovergence showed a total amplitude of 16 degrees (SD 3.96). Excyclo range was larger than the incyclo range, measuring -9 degrees (SD 2.59) and +7 degrees (SD 1.97) respectively. There was no age or gender related effect on cyclofusion range (p=0.59). Conclusions: To date, this is the first study providing true subjective scientific measures on a normal population for assessing cyclofusion in adults. A reference range for clinical guidance has been established. Values outside of the reference range are not necessarily pathologic or abnormal, but indicators of possible binocular abnormalities as well as physiological variations. The results suggest that cyclotorsion >9° interferes with vergences, dissociating binocular single vision. Patients, who complain of problems with double vision or maintaining binocularity without other obvious strabismic cause, should be assessed for cyclotorsion. If increased values of cyclotorsion are found, further investigations of fusion capacity with horizontal vergence control and cyclofusion amplitudes should be prompted.
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| 6. |
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| 7. |
- Flodin, Sara, 1974, et al.
(författare)
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Surgical outcome of graded Harada-Ito procedure in the treatment of torsional diplopia : a retrospective case study with long-term results
- 2022
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Ingår i: Strabismus. - : Taylor & Francis. - 0927-3972 .- 1744-5132. ; 30:1, s. 8-17
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Tidskriftsartikel (refereegranskat)abstract
- To review and evaluate the surgical outcomes of the Fells-modified Harada-Ito procedure using a dosage scale approach with long-term follow up in patients with torsional diplopia. The records of patients who underwent the modified Harada-Ito procedure by the same surgeon during 2012–2019 were retrospectively reviewed regarding pre- and post-operative data and individual dose-scale used for the surgery. The modified Harada-Ito procedure involved advancing the anterior half of the superior oblique tendon toward the inferior edge of the lateral rectus muscle by a distance determined using a five-graded scale. A total of 27 patients (mean age 57.6 years, range, 22–81 years; 10 female) were included. Evaluating surgical outcome showed a significant difference in pre- to post-operative cyclodeviation (p = <0.001). Pre-operative mean extorsion was −10.4° and mean torsional correction achieved was 7.7°. The dose-effect relationship showed a wide spread effect, yet yielded a high success rate. All but two patients were symptom free from their torsional diplopia at the last post-operative evaluation, on average 24 months after surgery. Post-operative results and the dose-effect of the modified Harada-Ito corresponded with the aimed-for correction of torsional diplopia.. Fusion evaluation and individually based pre-operative assessments proved essential in determining individual doses for successful surgical outcomes.
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| 8. |
- Holmström, Gerd, et al.
(författare)
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Prevalence and Development of Strabismus in 10-Year-Old Premature Children : A population-based study
- 2006
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Ingår i: Journal of pediatric ophthalmology and strabismus. - : SLACK, Inc.. - 0191-3913 .- 1938-2405. ; 43:6, s. 346-352
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the prevalence and development of strabismus, at 10 years, in children born prematurely. Methods: This population-based study included 216 premature and 217 full-term children from the same geographic area. Results: Strabismus was noted in 16.2% (35 of 216) premature and in 3.2% (7 of 217) full-term children. The most important risk factors for strabismus at 10 years were anisometropia at 6 months, spherical equivalent refractive errors (ie, > +3 D or < -3 D) at 2.5 years, and various neurologic conditions. Conclusion: At 10 years, children born prematurely have a greater risk of strabismus than children born at term.
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| 9. |
- Jakobsson, Joel, et al.
(författare)
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CACNA1C polymorphism and altered phosphorylation of tau in bipolar disorder.
- 2016
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Ingår i: The British journal of psychiatry : the journal of mental science. - : Royal College of Psychiatrists. - 1472-1465. ; 208:2, s. 195-196
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Tidskriftsartikel (refereegranskat)abstract
- Several genome-wide association studies and case-control studies have associated the single nucleotide polymorphism (SNP) rs1006737, situated in CACNA1C encoding the alpha 1C subunit of the L-type voltage-gated calcium channel, with bipolar disorder and other psychiatric disorders. However, the causal pathway linking genetic variants in CACNA1C with increased risk for developing brain disorders remains unclear. Here, we explored the association between the rs1006737 SNP and cerebrospinal fluid (CSF) markers. We found a significant association between the risk allele in rs1006737 and a decreased CSF hyperphosphorylated tau/total tau ratio in patients with bipolar disorder, thus linking variation in the CACNA1C gene to a neurochemical marker of neuroaxonal plasticity in those with this disorder.
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| 10. |
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| 11. |
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| 12. |
- Larsson, Eva, et al.
(författare)
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Accommodation and convergence in 10-year-old prematurely born and full-term children : a population-based study
- 2012
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Ingår i: Strabismus. - : Informa UK Limited. - 0927-3972 .- 1744-5132. ; 20:3, s. 127-132
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the accommodative amplitude and convergence in 10-year-old prematurely born children previously screened for retinopathy of prematurity (ROP) and to compare with full-term controls of the same age.Methods: Two-hundred and thirteen prematurely born and 217 children born at term were included. Accommodative amplitude and near-point convergence were assessed, together with best-corrected visual acuity (VA). A questionnaire was answered regarding possible problems at school.Results: Binocular accommodation (P = 0.03) and convergence (P = 0.003) were significantly poorer in prematurely born children. Accommodation was correlated to neurological findings in the preterm group, but not to the degree of prematurity or stage of ROP. Regarding convergence there were no correlations to neurology, stage of ROP, or degree of prematurity. For neither accommodation nor convergence were any correlations with distance and near VA found. Preterm children had a higher prevalence of school problems, and there was an association with poor accommodation.Conclusions: Prematurely born children had poorer accommodation and convergence than full-term children, but no association with near VA was found. The reduction of accommodative amplitude and convergence was small and was probably of little clinical significance. However, it may have additional effects on other ophthalmological problems and school problems in the preterm group.
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| 13. |
- Larsson, Eva, 1961-, et al.
(författare)
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Ophthalmological findings in 10-year-old full-term children : a population-based study
- 2015
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 93:2, s. 192-198
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo determine different ophthalmological parameters in 10-year-old, healthy, full-term children in Stockholm County, Sweden.MethodsTwo hundred and seventeen children were included in the study. Best-corrected distance and near visual acuities (VA) were measured using logMAR charts. Cycloplegic retinoscopy was performed, and spherical equivalent and astigmatism were determined. Examination of ocular movement and cover test for distance and near were performed. Stereopsis was assessed with the TNO test, and contrast sensitivity with the Vistech test. The Royal Air Force rule was used for assessing accommodation, and near point of convergence was measured with the Lang fixation stick. Ophthalmoscopy was performed through dilated pupils.ResultsEighty-two per cent of the children had a distance VA of −0.1 logMAR (1.3 Snellen acuity) or better. None of the children were visually impaired [VA >0.6 logMAR (<0.3 Snellen acuity)]. Ninety-three per cent had a near VA of −0.1 logMAR (1.25 Snellen acuity) or better. Mean spherical equivalent was 0.6 D. Eight (3.6%) children had hypermetropia (≥+2 D), and 17 (7.8%) were myopic (≤−0.5 D). Nine (4.1%) children had an astigmatism ≥1 D, and two (0.9%) had anisometropia of ≥1 D. Manifest strabismus was found in seven (3.2%) children, five of whom had exotropia. Heterophoria for distance and/or near was found in 80.2% of the children. In children without manifest strabismus, stereopsis >60 seconds of arc was found in five (2.4%). Three (1.4%) of 215 children had contrast sensitivity below normal limits. Binocular median near point of accommodation was 14 D, and median near point of convergence 6 cm.ConclusionKnowledge of various visual functions in normally developing children is crucial to be able to draw conclusions from ophthalmological examinations in children with eye diseases. This population-based study describes different ophthalmological parameters in full-term ten-year-old children. The material can be used as a control when examining children of similar ages with various ophthalmological conditions, such as groups of children with specific neurological or retinal diseases, and syndromes.
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| 14. |
- Olsson, Monica, et al.
(författare)
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Ocular Motor Score (OMS): a clinical tool to evaluating ocular motor functions in children. Intrarater and inter-rater agreement
- 2015
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Ingår i: Acta Ophthalmologica. - : WILEY-BLACKWELL. - 1755-375X .- 1755-3768. ; 93:5, s. 444-449
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Tidskriftsartikel (refereegranskat)abstract
- PurposeOcular motor score (OMS) is a new clinical test protocol for evaluating ocular motor functions in children and young adults. OMS is a set of 15 important and relevant non-invasive ocular motor function parameters derived from clinical practice. The aim of the study was to evaluate OMS according to intrarater and inter-rater agreement. MethodsForty children aged 4-10years, 23 girls median age 6.5 (range 4.3-9.3) and 17 boys median age 5.8 (range 4.1-9.8) were included. The ocular motor functions were assessed and scored according to the OMS protocol. The examinations were videotaped. To obtain the intrarater agreement, the first author examined and scored the children twice, first in the clinic and 2weeks later by watching the videotape. To obtain the inter-rater agreement, three other raters independently scored the ocular motor function of the children by watching the videotapes. ResultsThe overall observed intrarater agreement was 88%, and the observed inter-rater agreement between the three raters was 80%. For none of the subtests was there an observed intrarater agreement lower than 65%. Three of the subtests had an observed inter-rater agreement of 65% or below. ConclusionOverall there was high observed intra- and inter-rater agreement for the OMS test protocol. Subtests such as saccades and smooth pursuit were more difficult for raters to score similarly according the clinical OMS test protocol.
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| 15. |
- Rydberg, Agneta
(författare)
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Clinical assessment of visual function with particular emphasis on testing methods for young children
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Research during the last decades has emphasised the importance of visual stimulation during the first months of life. It is consequently of great importance to identify children with subnormal vision as early as possible in order to start treatment and habilitation. A prerequisite is that reliable testing methods are available and can reveal visual defects as early as possible. The aim of the study was to evaluate different methods for testing visual acuity in young children. The possibility of using the Preferential Looking (PL)-method as a screening test for the detection of amblyopia was assessed in 28 adult patients with strabismic amblyopia. PL regularly overestimated the visual acuity. The method is not sensitive enough for the detection of amblyopia and approximately 30% of the cases would have been missed. Contrast sensitivity could be a suitable method for the detection of amblyopia. Seven different contrast sensitivity tests were assessed in 20 adult patients with strabismic amblyopia to determine various parameters of the contrast sensitivity function. Depending on the parameters applied, all the tests investigated could be used in the detection of amblyopia. Various acuity tests, have been assessed in 151 children 0-6 years of age with assumed normal vision, ocular disease usually connected with visual impairment, and strabismus. The children were divided into three age groups: 0-1 1/2 years, 1 1/2-3 years and 9 month, and 3 years and 9 months -6 years. The acuity tasks were divided into three subtypes according to the kind of stimulus used; detection acuity, resolution acuity, and recognition acuity. Children under the age of 1 1/2 years were tested with the Stycar Rolling Balls, PL (the acuity card procedure) and the detection of raisins, puffed rice and black and white sugar strands on a white and black background. It was found impossible to reliably detect subnormal vision in this age group with the tests presently available, representing detection and resolution acuities. Children aged 1 1/2 - 6 years were examined with several tests. Detection acuity with the Stycar Rolling Balls highly overestimated visual acuity, and only gave a very rough estimate of the visual function. Resolution acuity, PL, regularly led to an overestimation of the acuity values in all the three groups, especially the strabismic children. Good correlation was found between the different recognition tests in line. Slightly better values were obtained with single optotypes, a sign of crowding. Different acuity values were obtained depending on whether detection, resolution, or recognition acuity was tested. Reliable visual acuity values can only be obtained when visual acuity can be assessed with a recognition test using lines of letters or symbols. However, the detection and resolution acuities give valuable information about the child’s total visual behaviour. Contrast sensitivity function was assessed, in children 3 years and 9 months - 6 years, with the LH contrast test, and the ability to detect raisins, puffed rice, and sugar strands. It was found that a separation between the subjects with subnormal vision due to ocular disease and strabismic amblyopia in comparison with the subjects with normal vision could be made with the LH - contrast test, but not with the other tests.
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| 16. |
- Sellström, Åke, et al.
(författare)
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Final Report of CBRNEmap : A better preparedness and response for European citizens facing CBRNE Threats
- 2011
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Rapport (populärvet., debatt m.m.)abstract
- CBRNEmap was a pre-study to the upcoming CBRNE technology demonstrator. Accordingly, considerable efforts were used to describe the feasibility and to sort out a number of basic requirements of the contemplated demonstrator object. This report deals with two areas deemed important when constructing a civilian CBRNE system of systems, its limitations and some suggested specifications: A useful CBRNE system of systems will improve and connect important societal functions vital before, during and after a CBRNE accident and/or attack. CBRNEmap identifies three clusters of activities as the most important when making our society resilient to CBRNE. These are, the cluster of activities making up the response function, the cluster of activities defining the function to protect identified targets and the cluster of societal investments enabling Europe to become more resilient. As examples and as a source of inspiration the three societal functions described above (response, protect and enabling) were used to discuss the CBRNE technology demonstrator. The demonstrator objects were populated by technologies and thereafter discussed with respect to choice of scenarios, choice of parameters to be used for its validation and with respect to its market value. Based on its conclusions, its working process and its interaction with external partners CBRNEmap recommends that:The use of Integrated Project Teams will be given priority when evaluating the upcoming demonstrator objects.The European Commission does everything possible to ensure that the results of previous “EU project” get integrated into the upcoming demonstrator object.Appropriate limitations and projections are made to the CBRNE system of systems perspective, in order to produce a CBRNE demonstrator serving the societal functions responsible or operational active.Considerable efforts are given to validating the improvements and/or added value of the demonstrator object.The cluster of societal investment we refer to as the enabler is further investigated in a future SSA.
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| 17. |
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| 18. |
- Sundelin Wahlsten, Viveka, et al.
(författare)
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Uppspårning och behandling av gravida missbrukare
- 2006
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Rapport (populärvet., debatt m.m.)abstract
- Reserach evidence of eeficay of sce reening and treatment of substance abuce (including alcohol) as well as risk drinking of alcohol, in pregnacy. Effetct of treatment on the mothers and the phoetuses.
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