| 1. |
- Wilhsson, Marie, et al.
(författare)
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Handling Demands of Success Among Girls and Boys in Primarly School : A Conceptual Model
- 2017
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Ingår i: Journal of School Nursing. - Thousand Oaks, CA : Sage Publications. - 1059-8405 .- 1546-8364. ; 33:4, s. 316-325
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Tidskriftsartikel (refereegranskat)abstract
- Stress among adolescents in Western societies is becoming an issue of increasing concern, and the global trend of adolescents’ health shows a gradual deterioration that is independent of national differences and increases with age. The aim of this study was to explore the main concern of adolescents and about how they cope with demands in everyday life. Participants were 14–16 years old, and data were collected from three sources. A constructivist grounded theory was used as a method for generating a model of the adolescents’ description of how they cope with demands in their everyday lives. The main concern described by participants in this study was to strive to be successful and to succeed in the present and throughout their lives. We conclude that differences between girls and boys, in terms of coping with demands in their everyday lives, are important to consider in the development of health promotion initiatives targeted at adolescents.
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| 2. |
- Andersson, Kristina E, et al.
(författare)
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Oats (Avena sativa) reduce atherogenesis in LDL-receptor-deficient mice.
- 2010
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; Jul 1, s. 93-99
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The cholesterol-lowering properties of oats, largely ascribed to its contents of soluble fibers, beta-glucans, are well established, whereas effects on atherogenesis are less well elucidated. Oats also contains components with reported antioxidant and anti-inflammatory effects that may affect atherogenesis. In this work we examined effects of oat bran on plasma cholesterol, markers of inflammation, eNOS expression and development of atherosclerosis in LDL-receptor-deficient (LDLr(-/-)) mice. METHODS AND RESULTS: Female LDLr(-/-) mice were fed Western diet+/-oat bran. Two concentrations of oat bran (40 and 27%) were compared regarding effects on plasma lipids. There was a dose-dependent reduction of plasma cholesterol by 42 and 20% with 40 and 27% oat bran, respectively. Both concentrations also lowered plasma triglycerides (by 45 and 33%) and relative levels of plasma LDL+VLDL. The reduction of plasma lipids was accompanied by increased faecal excretion of cholesterol and bile acids. Oat bran (40%) efficiently reduced atherosclerotic lesion area in the descending aorta (-77%) and aortic root (-33%). Plasma levels of fibrinogen and soluble vascular cell adhesion molecule-1 (VCAM-1) were significantly lower, and immunofluorescence of aortic sections revealed a 75% lower expression of VCAM-1 in oat-fed mice. The expression of eNOS protein in the aortic wall was increased in mice fed oat bran. CONCLUSIONS: Oat bran supplemented to a Western diet lowers plasma cholesterol, reduces levels of some inflammatory markers, increases eNOS expression and inhibits atherosclerotic lesion development in LDLr(-/-) mice. It remains to be investigated which components in oats contribute to these effects.
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| 3. |
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| 4. |
- Bergman, Sara, et al.
(författare)
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Synthesis and Labelling of a Piperazine-Based Library of 11C-Labeled Ligands for Imaging of the Vesicular Acetylcholine Transporter
- 2014
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Ingår i: Journal of labelled compounds & radiopharmaceuticals. - : Wiley. - 0362-4803 .- 1099-1344. ; 57:8, s. 525-532
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Tidskriftsartikel (refereegranskat)abstract
- The cholinergic system is involved in neurodegenerative diseases, and visualization of cholinergic innervations with positron emission tomography (PET) would be a useful tool in understanding these diseases. A ligand for the vesicular acetylcholine transporter (VAChT), acknowledged as a marker for cholinergic neurons, could serve as such a PET tracer. The aim was to find a VAChT PET tracer using a library concept to create a small but diverse library of labeled compounds. From the same precursor and commercially available aryl iodides 6a-f, six potential VAChT PET tracers, [C-11]-(+/-)5a-f, were C-11-labeled by a palladium (0)-mediated aminocarbonylation, utilizing a standard protocol. The labeled compounds [C-11]-(+/-)5a-f were obtained in radiochemical purities >95% with decay-corrected radiochemical yields and specific radioactivities between 4-25% and 124-597 GBq/mu mol, respectively. Autoradiography studies were then conducted to assess the compounds binding selectivity for VAChT. Labeled compounds [C-11]-(+/-)5d and [C-11]-(+/-)5e showed specific binding but not enough to permit further preclinical studies. To conclude, a general method for a facile synthesis and labeling of a small piperazine-based library of potential PET tracers for imaging of VAChT was shown, and in upcoming work, another scaffold will be explored using this approach.
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| 5. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Creating a communication space in the healthcare context : Children’s perspective of using the eHealth service, Sisom
- 2021
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Ingår i: Journal of Child Health Care. - London : Sage Publications. - 1367-4935 .- 1741-2889. ; 25:1, s. 31-43
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Tidskriftsartikel (refereegranskat)abstract
- According to the United Nation’s Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children’s perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6–13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children’s voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children’s needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice. © The Author(s) 2020.
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| 6. |
- Carlsson, Ing-Marie, 1961-, et al.
(författare)
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Patient participation, a prequisite for care : A grounded theory study of healthcare professionals’ perceptions of what participation means in a paediatric care context
- 2018
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Ingår i: Nursing Open. - Chichester : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 5:1, s. 45-52
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo explore healthcare professionals’ perceptions of what patient participation means in a paediatric care context.DesignA qualitative explorative design with grounded theory.MethodsFifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015–May 2016. Grounded theory was used as a method.ResultsThe study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category “participation a prerequisite for care” emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals’ different strategies used to enhance patient participation; “meeting each child where the child is,” “building a relationship with the child,” “showing respect for each individual child” and “making the most of the moment.” © 2017 The Authors. Nursing Open published by John Wiley & Sons Ltd
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| 7. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Exploring the role of optimism as a protective factor for adolescent quality of life
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL). Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups. This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.
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| 8. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Lost in Space - an exploration of help-seeking among young people with mental health problems : a constructivist grounded theory study
- 2020
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Ingår i: Archives of Public Health. - Brussels : Institut Scientifique de Sante Publique / Scientific Institut of Public Health. - 0778-7367 .- 2049-3258. ; 78
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health problems among young people is a worldwide public health concern. There has been an increase in mental health problems among young people in the Nordic countries in the last 25 years, particularly in Sweden. Despite this increase, international research has repeatedly shown that young people do not access or receive support when encountering mental health problems. The purpose of this study was to explore the process of help-seeking for professional support among young people with mental health problems. Methods: The study used qualitative constructivist Grounded Theory and open-ended interviews. Thirteen young people between 15 and 23, recruited from two local support clinics, were interviewed. Results: Lost in space emerged as the core category, capturing aspects of both the experience of self and mental health problems as well as the process of seeking and acquiring help from professional support systems. The study identified several prominent barriers for seeking and acquiring professional help for mental health problems. The young people expressed a lack of knowledge on mental health issues and support services and substantial efforts were made to try to cope with problems on one’s own. Lost in space involved Drifting - trying to make sense of own experiences and struggling to cope with problems, Navigating - searching for help through multiple attempts and contacts and Docking - finding support with something/somebody that feels right. Conclusions: The theoretical model sheds light on how young people with mental health problems were met with fragmented support services. Society needs to provide encompassing, youth-friendly and flexible support services, so that attempts at help-seeking are not missed. © The Author(s). 2020
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| 9. |
- Häggström Westberg, Katrin, 1968-, et al.
(författare)
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Optimism as a Candidate Health Asset : Exploring Its Links with Adolescent Quality of Life in Sweden
- 2019
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Ingår i: Child Development. - Hoboken : John Wiley & Sons. - 0009-3920 .- 1467-8624. ; 90:3, s. 970-984
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Tidskriftsartikel (refereegranskat)abstract
- This study aims to understand the role that optimism could play in the context of a health asset approach to promote adolescent health-related quality of life (HRQOL). Adolescents (n = 948), between 11 and 16 years old from a medium-sized rural town in Sweden, answered questionnaires measuring optimism, pessimism, and HRQOL. The findings indicate a significant decrease in optimism and a significant increase in pessimism between early and mid adolescence. The study has allowed us to present associational evidence of the links between optimism and HRQOL. This infers the potential of an optimistic orientation about the future to function as a health asset during adolescence and by implication may provide additional intervention tools in the planning of health promotion strategies.
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| 10. |
- Häggström Westerberg, Katrin, et al.
(författare)
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Exploring the role of optimism as a protective factor for adolescent quality of life
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL). Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups. This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.
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| 11. |
- Jahan, Mahabuba, et al.
(författare)
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The development of a GPR44 targeting radioligand [11C]AZ12204657 for in vivo assessment of beta cell mass.
- 2018
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Ingår i: EJNMMI Research. - : Springer Science and Business Media LLC. - 2191-219X. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The G-protein-coupled receptor 44 (GPR44) is a beta cell-restricted target that may serve as a marker for beta cell mass (BCM) given the development of a suitable PET ligand.METHODS: The binding characteristics of the selected candidate, AZ12204657, at human GPR44 were determined using in vitro ligand binding assays. AZ12204657 was radiolabeled using 11C- or 3H-labeled methyl iodide ([11C/3H]CH3I) in one step, and the conversion of [11C/3H]CH3I to the radiolabeled product [11C/3H]AZ12204657 was quantitative. The specificity of radioligand binding to GPR44 and the selectivity for beta cells were evaluated by in vitro binding studies on pancreatic sections from human and non-human primates as well as on homogenates from endocrine and exocrine pancreatic compartments.RESULTS: The radiochemical purity of the resulting radioligand [11C]AZ12204657 was > 98%, with high molar activity (MA), 1351 ± 575 GBq/μmol (n = 18). The radiochemical purity of [3H]AZ12204657 was > 99% with MA of 2 GBq/μmol. Pancreatic binding of [11C/3H]AZ12204657 was co-localized with insulin-positive islets of Langerhans in non-diabetic individuals and individuals with type 2 diabetes (T2D). The binding of [11C]AZ12204657 to GPR44 was > 10 times higher in islet homogenates compared to exocrine homogenates. In human islets of Langerhans GPR44 was co-expressed with insulin, but not glucagon as assessed by co-staining and confocal microscopy.CONCLUSION: We radiolabeled [11C]AZ12204657, a potential PET radioligand for the beta cell-restricted protein GPR44. In vitro evaluation demonstrated that [3H]AZ12204657 and [11C]AZ12204657 selectively target pancreatic beta cells. [11C]AZ12204657 has promising properties as a marker for human BCM.
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| 12. |
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| 13. |
- Kullenberg, Helena, et al.
(författare)
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Associations between the use of metformin and behavioral and psychological symptoms in patients with Alzheimer's disease, and type 2 diabetes mellitus : A register-based study
- 2023
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Ingår i: Current Alzheimer Research. - 1567-2050 .- 1875-5828. ; 20:2, s. 109-119
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Metformin, the first-line anti-diabetic drug treatment in patients with type 2 diabetes mellitus (T2DM), is suggested to be anti-inflammatory, antioxidative, and improve cognitive function, making it a promising contribution to treating Alzheimer´s disease (AD). However, the effect of metformin on behavioral and psychological symptoms of dementia (BPSD) in patients with AD has not been explored.OBJECTIVE: To investigate the associations between metformin and BPSD in patients with AD and T2DM and explore possible interaction with other antidiabetic drugs.METHODS: This cross-sectional study was based on data from the Swedish BPSD register. A total of 3745 patients with AD and antidiabetic drug treatment were included. Associations and interactions between antidiabetic drugs and BPSD were investigated by binary logistic regression.RESULTS: The use of metformin was associated with lower odds for symptoms of depression (OR 0.77, CI (95%) 0.61-0.96, p = 0.022) and anxiety (OR 0.74, CI (95%) 0.58-0.94, p = 0.015) after adjustment for age, gender, specific diagnosis, and drugs. We could not demonstrate this association with another antidiabetic drug. Interaction effects were limited to an increasing association in eating and appetite disorders using metformin and other antidiabetic drugs (i.e., drugs other than insulin, sulfonylurea, or dipeptidyl peptidase-4 inhibitors).CONCLUSION: The result of this study suggests that metformin could be beneficial for patients diagnosed with AD, other than for blood glucose control. Although, more knowledge is needed before assigning metformin a role in treating BPSD.
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| 14. |
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| 15. |
- Kullenberg, Helena, et al.
(författare)
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Correlation between insulin-degrading enzyme versus total tau and selected cytokines in patients with Alzheimer´s disease compared to non-demented controls.
- 2023
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Ingår i: Neuroendocrinology Letters. - 2354-4716. ; 44:4, s. 199-205
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: It has been increasingly recognized that the pathological progress of Alzheimer´s disease (AD) is connected to metabolic function and inflammation. Insulin-degrading enzyme (IDE) is essential for glucose metabolism and the degradation of amyloid-β. We aimed to explore the associations between IDE, total tau, and cytokines levels in plasma from subjects with AD and non-demented controls.METHODS AND MATERIAL: Plasma samples (18 patients diagnosed with AD and 6 non-demented controls) from the Netherlands Brain Bank were used to analyze IDE levels and total tau with an enzyme-linked immunosorbent assay. Cytokines were analyzed with Luminex custom plex assays for interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Results were analyzed using the Mann-Whitney U and Spearman´s rank correlation tests.RESULTS: Total tau in plasma was significantly increased in AD subjects compared to non-demented control subjects (p = 0.044). Total tau was positively correlated with IDE levels in plasma in all subjects (r = 0.494, p = 0.017). Significant correlations could be demonstrated between plasma levels of IDE and IL-6 (r = 0.546, p = 0.019), IL-8 (r = 0.664, p = 0.003), IL-10 (r = 0.833, p < 0.001), and TNF-α (r = 0.633, p = 0.005) in subjects with AD, but not in non-demented controls.CONCLUSION: Results from this study suggest that plasma IDE levels may be associated with inflammation and neurodegeneration and could potentially be a target for future diagnostic and treatment strategies.
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| 16. |
- Kullenberg, Helena, et al.
(författare)
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Correlations between insulin-degrading enzyme and metabolic markers in patients diagnosed with type 2 diabetes, Alzheimer's disease, and healthy controls : A comparative study
- 2024
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Ingår i: Endocrine. - 1355-008X .- 1559-0100. ; 84:2, s. 450-458
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study aimed to explore correlations between insulin-degrading enzyme (IDE) and markers of metabolic function in a group of patients diagnosed with type 2 diabetes mellitus (T2DM) or Alzheimer's disease (AD) and metabolically healthy volunteers.METHOD: We included 120 individuals (47 with T2DM, 9 with AD, and 64 healthy controls). Serum levels of IDE were measured with commercial kits for ELISA. Differences in IDE levels between groups were analyzed with non-parametric ANCOVA, and correlations were analyzed with Spearman's rank correlations. We also investigated the influence of age, sex, and the use of insulin on the correlation using a non-parametric version of partial correlation.RESULTS: Patients diagnosed with T2DM had higher IDE levels than patients diagnosed with AD and healthy controls after adjustment for age and sex. IDE was increasingly associated with body mass index (BMI), fasting blood glucose, C-peptide, hemoglobin A1c (HbA1c), insulin resistance, and triglycerides. In stratified analyses, we found a decreasing partial correlation between IDE and HbA1c in patients diagnosed with AD and a decreasing partial correlation between IDE and C-peptide in healthy controls. In patients diagnosed with T2DM, we found no partial correlations.CONCLUSION: These results indicate that IDE is essential in metabolic function and might reflect metabolic status, although it is not yet a biomarker that can be utilized in clinical practice. Further research on IDE in human blood may provide crucial insights into the full function of the enzyme.
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| 17. |
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| 18. |
- Kullenberg, Helena, et al.
(författare)
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Increased levels of insulin-degrading enzyme in patients with type 2 diabetes mellitus
- 2022
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Ingår i: Endocrine. - : Springer Science and Business Media LLC. - 1355-008X .- 1559-0100. ; 77:3, s. 561-565
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Decreasing levels of serum insulin-degrading enzyme (IDE) have been associated with an increased risk for Alzheimer´s disease (AD) in patients with type 2 diabetes mellitus (T2DM). Research on serum IDE levels in patients with T2DM is sparse and the aim of this study was to explore serum levels of IDE in patients with T2DM.METHOD: Blood serum samples were obtained from a biobank. Samples from subjects with T2DM and without metabolic disease were divided into subgroups; lifestyle treatment (n = 10), oral antidiabetic treatment (n = 17), insulin treatment (n = 20) and metabolically healthy controls (n = 18). Serum levels of IDE were analysed using specific ELISA assays.RESULTS: Serum levels of IDE were elevated in subjects with T2DM compared to metabolically healthy individuals (p = 0.033). No significant differences were detected between treatment subgroups.CONCLUSION: The present study indicates that patients with T2DM have increased serum IDE levels, compared to metabolically healthy individuals. However, for IDE to be clinically useful as a biomarker, its full function and possible use needs to be further elucidated in larger studies showing reproducible outcomes.
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| 19. |
- Kullenberg, Helena
(författare)
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Insulin-degrading enzyme : A link between insulin resistance and Alzheimer's disease
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Prior research has demonstrated an elevated risk of Alzheimer's disease (AD) among individuals diagnosed with type 2 diabetes mellitus (T2DM). Insulin resistance is a potential common link between these conditions, and it is associated with AD due to the insulin-degrading enzyme (IDE), which also degrades amyloid-β (Aβ) in the brain. It has been suggested that high insulin levels may hinder IDE's effective degradation of Aβ, contributing to plaque formation. IDE is measurable in blood and is a promising biomarker for AD risk assessment and diagnosis. IDE has been demonstrated to decrease in blood from patients with cognitive impairment, but the overall knowledge about IDE in human blood is sparse. The aim of the thesis was to increase knowledge of the relationship between insulin resistance and AD, focusing on IDE as a biomarker for risk assessment and diagnosis of AD.Study participants: In study I, we included patients with type 2 diabetes (n=46) and compared them with patients without metabolic diseases (n=18). Serum samples were obtained from the Sophiahemmet biobank. In study II, we used post-mortem plasma samples from patients with Alzheimer's disease (n=18) and compared them with non-demented controls (n=6). These samples were obtained from the Netherlands Brain Bank. In study III, where we had three groups, we recruited patients with Alzheimer's disease (n=9) from a dementia care facility and healthy volunteers from Sophiahemmet University and Sophiahemmet Health Center (n=64). The serum samples from these individuals were then compared with serum samples from patients diagnosed with type 2 diabetes from Study I.In Study IV, we utilized data from the Swedish BPSD (Behavioral and Psychological Symptoms of Dementia) registry. This registry is used by healthcare units that work with patients with neurocognitive disorders and contains information about the patient's diagnosis, drug treatment, and behavioral and psychological symptoms. We selected a group of AD patients prescribed some form of antidiabetic drug treatment and analyzed whether the type of treatment impacted the registered behavioral and psychological symptoms.Methods: In study I-III, ELISA was used to analyze blood samples for levels of IDE and other metabolic markers. In study II, Luminex multiplex was used to measure inflammatory markers. These biomarkers and clinical data were analyzed statistically to investigate differences between groups and correlations between variables. In study IV, the association between BPSD and antidiabetic drug treatment was investigated using a bivariate logistic regression model, adjusted for age, sex, specific diagnosis, and drug treatment.Results: The results showed that patients with T2DM had higher serum IDE levels than patients without metabolic diseases, patients diagnosed with AD, and healthy volunteers. The results also indicated that higher IDE levels were associated with older age, higher weight, and elevated blood glucose. In the samples from the brain bank, we found that higher IDE levels were correlated to increased levels of inflammatory markers and total tau.In the analysis of registry data, we found that the prescription of metformin, one of the most common drugs for type 2 diabetes, was associated with lower odds for symptoms of depression and anxiety. This association was not observed for any other antidiabetic drug.Conclusion: The results suggest that IDE may be an essential factor in metabolic function but may also be associated with significant risk factors for neurocognitive disorders, such as inflammation. Although based on smaller studies, these findings contribute to the limited knowledge of IDE in human blood. Reduced IDE levels have been linked to an increased risk of AD. If patients diagnosed with T2DM have elevated IDE levels, a decrease in IDE levels possibly would indicate that the patient is at higher risk of or even in an early stage of AD. As interest in blood-based biomarkers grows, IDE emerges as a stable and reliable candidate in this thesis. Additionally, the research raises attractive possibilities for enhancing treatment strategies for AD patients experiencing affective symptoms. Metformin is believed to increase IDE levels and has previously been suggested to treat affective disorders and AD. Further investigation is needed to explore this promising avenue.
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| 20. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Children and young people’s participation in developing interventions in health and well-being : a scoping review
- 2018
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Ingår i: BMC Health Services Research. - London : BioMed Central. - 1472-6963. ; 18:507
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Forskningsöversikt (refereegranskat)abstract
- Background: Greater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people'shealth and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being. Methods: An interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier's Pathways to Participation Model. Results: The review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and youngpeople becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level. Conclusions: This scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted. © 2018 The Author(s).
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| 21. |
- Larsson, Ingrid, 1968-, et al.
(författare)
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Parents’ experiences of an e-health intervention implemented in pediatric healthcare : a qualitative study
- 2019
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Ingår i: BMC Health Services Research. - London, UK : BioMed Central. - 1472-6963. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: The growing field of participation in healthcare has the potential to provide a number of benefits for children, patients, healthcare professionals and also the healthcare systems. According to the Convention on the Rights of the Child (UNCRC), children have the right to participate in their own healthcare and make their voice heard. Children’s opportunities for understanding their conditions, sharing their views and participating in decisions regarding their care depend on healthcare professionals but also on parents’ ability to communicate and include children. E-health solutions can remove barriers to children’s communication with healthcare professionals. The aim of this study was to explore parents’ perspectives on the outcomes of an e-health solution, Sisom, used by children during healthcare appointments.Methods: The empirical data is based on interviews with 16 parents. In the present study constructivist, grounded theory was chosen as the method.Results: The theory of enhancing participation, by orientating communication about healthcare towards the voice of the child instead of the parents, summarizes the process of how the outcome of Sisom for children lead to enhanced participation, by making the child the main actor and an agent in his/her own healthcare. The facilitators for achieving participation in Sisom were four interrelated outcomes; engaging, voice-guarding, raising awareness and integrity preserving. In addition to generating increased participation, it emerged that the use of Sisom also initiated a process, which was evident in all four subcategories that facilitated the child in coping with the experience of having an illness.Conclusions: We conclude, that Sisom orientated communication about healthcare towards the voice of the child instead of the parents as well as including the child in the dialogue with the healthcare professional and thus increasing the child’s participation and human rights. © 2019 The Author(s)
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| 22. |
- Långström, Bengt, et al.
(författare)
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In vitro imaging techniques in neurodegenerative diseases
- 2007
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Ingår i: Molecular Imaging and Biology. - : Springer Science and Business Media LLC. - 1536-1632 .- 1860-2002. ; 9:4, s. 161-175
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Tidskriftsartikel (refereegranskat)abstract
- Neurodegeneration induces various changes in the brain, changes that may be investigated using neuroimaging techniques. The in vivo techniques are useful for the visualization of major changes, and the progressing abnormalities may also be followed longitudinally. However, to study and quantify minor abnormalities, neuroimaging of postmortem brain tissue is used. These in vitro methods are complementary to the in vivo techniques and contribute to the knowledge of pathophysiology and etiology of the neurodegenerative diseases. In vitro radioligand autoradiography has given great insight in the involvement of different neuronal receptor systems in these diseases. Data on the dopamine and cholinergic systems in neurodegeneration are discussed in this review. Also, the amyloid plaques are studied using in vitro radioligand autoradiography. Using one of the newer methods, imaging matrix-assisted laser desorption ionization mass spectrometry, the distribution of a large number of peptides and proteins may be detected in vitro on brain cryosections. In this overview, we describe in vitro imaging techniques in the neurodegenerative diseases as a complement to in vivo positron emission tomography and single photon emission computed tomography imaging.
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| 23. |
- Magnusson, Kristina, et al.
(författare)
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Specific Uptake of an Amyloid-beta Protofibril-Binding Antibody-Tracer in A beta PP Transgenic Mouse Brain
- 2013
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 37:1, s. 29-40
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Tidskriftsartikel (refereegranskat)abstract
- Evidence suggests that amyloid-beta (A beta) protofibrils/oligomers are pathogenic agents in Alzheimer's disease (AD). Unfortunately, techniques enabling quantitative estimates of these species in patients or patient samples are still rather limited. Here we describe the in vitro and ex vivo characteristics of a new antibody-based radioactive ligand, [I-125]mAb158, which binds to A beta protofibrils with high affinity. [I-125]mAb158 was specifically taken up in brain of transgenic mice expressing amyloid-beta protein precursor (A beta PP) as shown ex vivo. This was in contrast to [I-125]mAb-Ly128 which does not bind to A beta. The uptake of intraperitoneally-administered [I-125]mAb158 into the brain was age- and time-dependent, and saturable in A beta PP transgenic mice with modest A beta deposition. Brain uptake was also found in young A beta PP transgenic mice that were devoid of A beta deposits, suggesting that [I-125]mAb158 targets soluble A beta protofibrils. The radioligand was diffusely located in the parenchyma, sometimes around senile plaques and only occasionally colocalized with cerebral amyloid angiopathy. A refined iodine-124-labeled version of mAb158 with much improved blood-brain barrier passage and a shorter plasma half-life might be useful for PET imaging of A beta protofibrils.
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| 24. |
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| 25. |
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| 26. |
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| 27. |
- Nordström, Axel, et al.
(författare)
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Distinct eicosanoid patterns in severe recalcitrant nasal polyposis
- 2023
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Ingår i: International Forum of Allergy & Rhinology. - 2042-6984. ; 13:11, s. 2043-2054
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although altered eicosanoid levels are related to disease severity in chronic rhinosinusitis with nasal polyps (CRSwNP), identifying patients prone to recurrent NPs is still difficult. We investigated levels of nasally secreted eicosanoids before and after NP surgery in patients with or without NP recurrence and explored potential endotypes based on pre-surgical eicosanoid levels.METHODS: Levels of leukotriene (LT) E4 , LTB4 , prostaglandin (PG) D2 , PGE2 and 15(S) hydroxyeicosatetraenoic acid (15(S)-HETE) were measured in nasal secretions with specific immunoassays at pre-surgery (n = 38) and six- and 12-months post-surgery (n = 35) where NP recurrence was identified endoscopically. Pre- and post-surgical levels were compared between patients with and without NP recurrence. Eicosanoid patterns among patients were explored with cluster analysis and evaluated with clinical parameters.RESULTS: Patients with recurrent NPs had pronounced pre-surgical levels of nasal 15(S)-HETE, PGD2 and LTE4 . From pre-surgery to 12-months after, NP recurrence was associated with significant decrease of 15(S)-HETE and PGD2 relative to non-recurrence whereas levels of LTE4 decreased at six-months but increased again at 12-months. Clustering revealed three potential endotypes. Cluster 1 and 3 featured high and low eicosanoid levels, respectively. Cluster 2 had higher levels of LTE4 and PGD2 , lower levels of PGE2 and LTB4 , and more cases of recurrent NPs and previous NP surgeries.CONCLUSION: Elevated nasal LTE4 , 12-month post-surgery, in NP recurrent subjects suggests that postoperative LTE4 measurements may indicate rapid NP regrowth. A distinct nasal eicosanoid profile may be used for the identification of the most severe recalcitrant patients in need of targeted immunomodulatory therapies. This article is protected by copyright. All rights reserved.
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| 28. |
- Nordström, Axel
(författare)
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Exploring eicosanoids as biomarkers in severe chronic rhinosinusitis with nasal polyps
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic rhinosinusitis (CRS) is one of the most common inflammatory chronic conditions, leading to a persistent nasal congestion, nasal discharge, and a loss of smell. Despite sinus surgery and frequent use of oral corticosteroids, a large proportion of individuals with CRS are difficult to treat and have recurrent inflammation. They are usually referred to as individuals with recalcitrant disease and having recurrent nasal polyps (NPs; CRSwNP). The disease poses a significant impact on the patients' health-related quality of life (HrQoL), mainly because of a complete loss of smell. Pharmacological treatment with biological therapies has recently been developed, targeting mediators of the type 2 inflammatory response. However, not everyone benefits from the biological therapy, and it has proven difficult to identify and characterise patients that are responsive to these new medications. Eicosanoids, being arachidonic acid derived bioactive lipid mediators, has been shown to be implicated in CRSwNP. Although there is a clear link between an imbalanced biosynthesis of pro- and anti-inflammatory eicosanoids and type 2 inflammation, to date research has not focused on them as biomarkers in CRSwNP.The overall aim of this thesis was to explore the potential role of eicosanoids as biomarkers and characterise changes over time in HrQoL as well as the degree of smell loss in patients with severe recalcitrant CRSwNP. The project involved immunoassay analysis of levels of various inflammatory mediators, including a selection of eicosanoids, in nasal tissue, nasal secretions and urine from patients with CRSwNP as well as gene expression analyses regarding biosynthetic enzymes and receptors for eicosanoids in nasal tissues. HrQoL was assessed with SNOT-22 and RAND-36, along with point-of-care tests as eosinophil blood count, fractional exhaled nitric oxide (FeNO) and smell tests with Burghart Sniffin’ Sticks.Levels of eicosanoids in nasal secretions were found to associate with the disease severity, defined as the extent of NP growth (paper I). One of the eicosanoids, leukotriene E4 (LTE4), were correlated to the degree of smell loss (paper I). An increase in LTE4 between six and 12 months after surgery was demonstrated in patients with recurrent NPs (paper II). Recurrent NPs were identified endoscopically 12 months after surgery and a distinct eicosanoid profile involving LTE4, prostaglandin D2 and 15(S) hydroxyeicosatetraenoic acid was found to be more common in those with recurrence (paper II). A similar eicosanoid profile, based on measurements from nasal tissue samples instead, was also associated with NP recurrence (paper III).Levels of eicosanoids in nasal tissue and nasal secretions were correlated suggesting that analysis of biomarkers in nasal secretions reflects release from the nasal tissue (paper III). Patients with recurrent NPs had elevated blood eosinophil counts before their surgery, and their sense of smell was significantly impaired both before and after (paper IV). This finding suggests that loss of smell may be the first symptom during recurrence. Although measures of HrQoL could not distinguish patients with recurrent NPs, there was a strong correlation to the degree of smell loss suggesting that loss of smell has a significant impact on the HrQoL (paper IV).In summary, the results from this thesis contribute to an extended knowledge regarding characteristics relevant for identifying severe recalcitrant CRSwNP. Characteristics of interest included a distinct eicosanoid profile, severe loss of smell and eosinophil involvement, all of which may be possible prognostic markers for severe recalcitrant CRSwNP with rapid NP growth. It may be concluded that such biomarkers can guide the choice of treatment for these severely ill patients – repeated surgery or pharmacological treatment with the newly developed biological therapies.
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| 29. |
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| 30. |
- Nordström, Axel, et al.
(författare)
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Hot saline irrigation in comparison to nasal packing after sinus surgery
- 2021
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Ingår i: Laryngoscope Investigative Otolaryngology (LIO). - : Wiley. - 2378-8038. ; 6:6, s. 1267-1274
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Previous studies have shown that hot saline solution (HSS) nasal irrigation is effective against nasal bleeding and is used to treat nasal hemorrhage. In a pilot study, we evaluated hot saline nasal irrigation in comparison to a routinely used nasal packing in terms of self-reported complications and mucosal healing after functional endoscopic sinus surgery.Methods: Patients undergoing surgery for bilateral chronic rhinosinusitis received polyvinyl acetate (PVA) nasal packing in the left nostril, and the right nostril was rinsed with 47°C sterile saline immediately after surgery. Patients' experiences of pain, bleeding, and other types of uncomfortable experiences were measured using a visual analog scale for each nostril before, during, and immediately after nasal packing removal. Two weeks post-surgery, the assessments were repeated including an endoscopic evaluation of the mucosa by the surgeon.Results: Twenty-seven patients completed the study. Prior to removal of the packing, the patients experienced significantly more pain and other uncomfortable experiences in the nostril treated with nasal packing, as compared to the nostril solely rinsed with hot saline. After removal, patients reported significantly more uncomfortable experiences from the packing treated nostril. Two weeks post-surgery, no difference in mucosal healing was observed between the two nostrils.Conclusions: The results from this study indicate that irrigation with HSS could be an alternative postoperative treatment to conventional PVA nasal packing. Hot saline irrigation may contribute to patients experiencing improved control of postoperative bleeding, pain, and less suffering of other causes as well as health-economic benefits, without affecting the mucosal healing up to 2 weeks post-surgery.Level of Evidence: 1b.
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| 31. |
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| 32. |
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| 33. |
- Nordström, Axel, et al.
(författare)
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Levels of eicosanoids in nasal secretions associated with nasal polyp severity in chronic rhinosinusitis
- 2022
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Ingår i: Prostaglandins, Leukotrienes and Essential Fatty Acids. - : Elsevier BV. - 0952-3278 .- 1532-2823. ; 184
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Tidskriftsartikel (refereegranskat)abstract
- Severe nasal polyposis and mucosal inflammation, in patients with chronic rhinosinusitis (CRS) may include a dysregulated eicosanoid profile, but a clinical role for eicosanoids in CRS with nasal polyps (NP; CRSwNP) remains to be elucidated. This study focused on assessing levels and clinical implications of inflammatory mediators in nasal secretions and urine from patients with different NP severity or Aspirin Exacerbated Respiratory Disease (AERD). Levels of leukotrienes E4 and B4, prostaglandins D2 and E2 as well as 15(S)-hydroxyeicosatetraenoic acid were measured with enzyme immunoassays and cytokines with magnetic bead immunoassays. Patients with CRSwNP were subdivided based on NP score; CRSwNP-low (NP score ≤ 4, n = 11) or CRSwNP-high (NP score ≥ 5, n = 32) and compared to CRS without polyps (CRSsNP, n = 12), CRSwNP-AERD (n = 11) and individuals without CRS (n = 25). Smell test score, fractional exhaled nitric oxide (FeNO), blood eosinophils and Sinonasal outcome test-22 were assessed as clinical markers. Leukotriene E4, prostaglandin D2 and 15(S)-hydroxyeicosatetraenoic acid in nasal secretions correlated with NP score. Nasal leukotriene E4 also correlated with FeNO and smell test score, with highest levels found in CRSwNP-AERD. Levels of prostaglandin D2 in nasal secretion as well as urinary levels of the prostaglandin D2 metabolite 11β-prostaglandin F2α differed between CRSNP-high and CRSwNP-low. Urinary 11β-prostaglandin F2α was associated with asthma comorbidity whereas a similar association with prostaglandin D2 in nasal secretions was not observed. In conclusion, subdividing patients based on NP severity in combination with analysis of eicosanoids in non-invasively collected nasal secretions, may have clinical implications when assessing CRS disease severity.
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| 34. |
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| 35. |
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| 36. |
- Sjöberg, Carina, 1964-
(författare)
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Barncentrerat förhållningssätt i perioperativ vård
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Barns möjligheter att involveras i den perioperativa vårdkontexten kan förbättras med ett barncentrerat förhållningssätt. För att uppnå detta behöver hänsyn både tas till att barn är beroende av sin familj och att de som enskilda individer ska involveras och vara medaktörer i sin vård. Barns involvering i den perioperativa vården har många fördelar. Det bidrar till minskad oro och rädsla och att barnet kan stärka sin kompetens och bli behandlad med respekt. Barn upplever dock att det är svårt för dem att vara delaktiga och att ha kontroll i den främmande och skrämmande perioperativa sjukhusmiljön. Barns möjligheter att vara delaktiga i den perioperativa vården är därför beroende av föräldrar och hälso-och sjukvårdspersonal liksom rutiner och fördelning av resurser i vården. Det är därför viktigt att de vuxna som ska stödja barnen har förståelse för att barn är unika och uppfattar saker ur sitt eget perspektiv baserat på sina erfarenheter.Syfte: Det övergripande syftet med avhandlingen var att öka förståelsen för vad ett barncentrerat förhållningssätt innebär inom perioperativ vård - utifrån barn, föräldrars och ett organisatoriskt perspektiv. Metod: I delarbete I användes en deskriptiv kvalitativ design med intervjuer av 10 barn (8 till 11år). Delarbete II hade en explorativ kvalitativ design med intervjuer av 20 föräldrar. Delarbete I och II analyserades med kvalitativ innehållsanalys för att beskriva barn och föräldrars erfarenheter av delaktighet i pediatrisk perioperativ vård. I delarbete III användes en explorativ kvalitativ design med intervjuer av hälso-och sjukvårdpersonal. Analysen genomfördes med grundad teori för att utforska processen av ett organisatoriskt förbättringsarbete för barn som genomgick sedering för intratekal cytostatikabehandling. I delarbete IV användes en deduktiv kvantitativ design med registerdata och analys med deskriptiv statistik för att beskriva tidsintervall och använd Propofol-dos vid sedering för intratekal cytostatikabehandling i tre olika miljöer. Resultat: Delarbete I visar att barns upplevelse av delaktighet påverkats av hur de informerats inför och under det perioperativa vårdförloppet. Vidare har relationen till hälso-och sjukvårdspersonalen haft betydelse för barns möjligheter att involveras i beslutsfattande. Dessutom har sjukhusmiljön, väntetid och möjligheter att förströ sig haft inflytande på barns upplevelse av delaktighet. I delarbete II beskriver huvudkategorin att föräldrars delaktighet i pediatrisk perioperativa vård vid dagkirurgi betydde ”Having strength to participate despite an increased vulnerability ”. Tillsammans med underkategorierna; få information om vad som ska hända, att bli sedd som en resurs och att få tillgång till miljön. I delarbete III beskriver “The theory of a shielding place” hur hälso-och sjukvårdspersonalen med ett barncentrerat förhållningssätt utförde proceduren sedering för intratekal cytostatikabehandling på barnavdelningen. Resultatet i delarbete IV kontrollerar och kvantifierar objektivt delar av resultatet från delarbete III. Genom att visa att när proceduren utförs på barnavdelningen minskas väntetid och tidsåtgång för proceduren som helhet. Konklusion: För barn och föräldrar som genomgår dagkirurgi har information, samspelet med hälso-och sjukvårdspersonalen och miljön haft betydelse för upplevelsen av delaktighet. Ur ett organisatoriskt perspektiv påverkas ett barncentrerat förhållningssätt av de rutiner som har betydelse för hur barn och föräldrar förbereds. Resurser och rutiner påverkar också om sjukhusmiljöer är anpassade för barn, väntetid och tidsåtgång, liksom relationer mellan barn och hälso-och sjukvårdspersonal.
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| 37. |
- Sjöberg, Carina, 1964-, et al.
(författare)
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Creating a shielding place for children with leukaemia during sedation for intrathecal chemotherapy : A grounded theory study
- 2020
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Ingår i: European Journal of Oncology Nursing. - Oxford : Elsevier. - 1462-3889 .- 1532-2122. ; 44
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Childhood cancer invades the child's daily life and has a strong influence on their living conditions and lifestyle. The treatment is an unpleasant experience and the children often perceive the treatment as worse than the actual disease. The aim of the present study was thus to explore the process of how healthcare professionals improved care for children undergoing sedation for intrathecal chemotherapy.Method: A constructivist grounded theory approach was applied and qualitative interviews with paediatricians (n = 2), anaesthetists (n = 2), paediatric nurses (n = 3) and nurse anaesthetists (n = 5).Results: The theory of creating a shielding place emerged and conceptualized the pattern of behavior of healthcare professionals throughout the procedure of sedation for intrathecal chemotherapy for pediatric leukaemia. The theory explains the core category ‘shielding’ and the process of how healthcare professionals developed strategies to resolve their main concern: a striving to reduce discomfort and suffering induced by the procedure and the treatment. These strategies, used throughout the procedure, were; de-dramatizing, de-exposing and minimizing trespassing.Conclusions: The theory of creating a shielding place offers a greater understanding of how healthcare professionals included the child's perspective in their work and thereby enabled a more sensitive and supportive care that had an impact on both quality of care and patient safety. The results from the study contributes with theoretical knowledge that can be used for developing evidence-based care guidelines for the procedure of sedating a child with leukaemia for intrathecal chemotherapy. © 2019 Published by Elsevier Ltd.
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| 38. |
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| 39. |
- Sjöberg, Carina, 1964-, et al.
(författare)
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Participation in pediatric perioperative care : "what it means for parents"
- 2017
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Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 4246-4254
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore what it means for parents to participate in their children's paediatric perioperative care.Background: Allowing parents to participate in paediatric perioperative care can make a major difference for children in terms of their well-being, a decreased need for painkillers, fewer sleeping disorders and a more positive experience for both parties. The nurse anaesthetist should have a holistic view and develop a shared vision for the child, the parents and for themselves to perform successful paediatric perioperative care.Design: Descriptive qualitative study.Methods: The study was conducted in 2014. Data were collected in 20 narrative interviews with 15 mothers and five fathers who had experience of participating in their child's paediatric perioperative day surgery. The analysis was carried out with qualitative content analysis to describe the variations, differences and similarities in the experiences.Results: The analysis revealed a main category that describes that parental participation in the context of paediatric perioperative care in day surgery meant 'having strength to participate despite an increased vulnerability'. Three generic categories with additional subcategories explained what was essential for the parents to be able to preserve this strength and participate in their child's care despite their increased vulnerability. The generic categories were named, 'gaining information about what will happen', 'being seen as a resource' and 'gaining access to the environment'.Conclusion: Efforts should be made to improve parents' roles and opportunities to participate in paediatric perioperative care.Relevance to clinical practice: Nurse anaesthetists have a crucial role in enabling parents' participation and need knowledge to develop strategies and nursing interventions that meet parents' needs. © 2017 John Wiley & Sons Ltd.
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| 40. |
- Sjöberg, Carina, 1964-, et al.
(författare)
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The Importance of Place During Sedation for Intrathecal Chemotherapy in Pediatric Oncology Care
- 2019
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Ingår i: Pediatric Blood & Cancer. - Hoboken : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 66:S4, s. S446-S446
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background/Objectives: Children who are treated for childhood cancer are exposed to hospitalization, interaction with unfamiliar people in strange environments, and unpleasant, and sometimes, procedures. Having to wait for procedures is one of the worst situations, experienced by child patients. It is therefore important that hospitals provide environments that are non-stressful and safe for children in conjunction with procedures. Especially important, is the possibility for children who are hospitalized to sustain everyday activities, such as play, irrespective of their age and severity of illness.Objective: To assess differences in expenditure of time and dose of anesthetic drugs during sedation for intrathecal chemotherapy in two different environments- the children's ward, where the child was hospitalized, and the operation theatre.Design/Methods: The study is based on retrospective data from repeated treatment sessions recorded in operation planning programs and journals during 2011-2018 (n=164). Children of the ages 1-12 years (n=22) with varying number of treatments were included in the study. Data was analyzed with the Kruskal-Wallis test and post-hoc analyses included the Mann-Whitney Test with Bonferroni correction.Results: The time from the start of the procedure until the start of sedation was significantly lower at the children's ward, which was also the case if including the waiting time before the start of the procedure. No significant differences could be found regarding the dose of anesthetic drugs used.Conclusions: Sedation for intrathecal chemotherapy at the children's ward provides care to a higher extent in accordance with the needs of the child, by reducing the time for the procedure and thus the interference with the child’s everyday life at the hospital. © 2019 Wiley Periodicals, Inc.
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| 41. |
- Sjöberg, Carina, 1964-, et al.
(författare)
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The Importance of the Setting during Sedation for Intrathecal Chemotherapy in Pediatric Oncology Care : A Case Study
- 2020
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Ingår i: Healthcare. - Basel : MDPI. - 2227-9032. ; 8:3
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Tidskriftsartikel (refereegranskat)abstract
- Abstract: Increasing survival rates for childhood cancer have brought attention to the high level of burden of cancer and its treatment. Improving supportive care for children throughout their cancer trajectory is thus important and could reduce the difficulties related to treatment, including time-consuming treatments and the waiting time associated with treatment procedures. The aim of this study is to describe time intervals and the Propofol dose used during sedation for intrathecal chemotherapy in three different settings. The study is based on retrospective data from repeated treatment sessions recorded in operation planning programs and hospital records in the period 2011–2018 (n = 164). Children, 1–12 years old (n = 22), undergoing a varying number of treatments, were included in the study. The most crucial finding in this study is that the time from the child’s first meeting with the nurse anesthetist to the induction of sedation is significantly reduced if the procedure is performed in the children’s ward. The study highlights the importance of the setting for sedation for intrathecal chemotherapy when implementing a child-centered approach in pediatric oncology care
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| 42. |
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| 43. |
- Stepanov, Vladimir, et al.
(författare)
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Development of [C-11]/[H-3-1]THK-5351-A potential novel carbon-11 tau imaging PET radioligand
- 2017
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Ingår i: Nuclear Medicine and Biology. - : Elsevier BV. - 0969-8051 .- 1872-9614. ; 46, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Due to the rise in the number of patients with dementia the imperative for finding new diagnostic and treatment options becomes ever more pressing. While significant progress has been made in PET imaging of A beta aggregates both in vitro and in vivo, options for imaging tau protein aggregates selectively are still limited. Based on the work previously published by researchers from the Tohoku University, Japan, that resulted in the development of [F-18]THK-5351, we have undertaken an effort to develop a carbon-11 version of the identical structure - [C-11]THK-5351. In parallel, THK-5351 was also labeled with tritium ([H-3]THK-5351) for use in in vitro autoradiography (ARG). Methods: The carbon -11 labeling was performed starting with di-protected enantiomeric pure precursor-tertbutyl 5-(6-( (2S)-3-fluoro-2-(tetrahydro-2H-Pyran-2-yloxy)proPoxy)quinolin-2-yl)pyridin-2-yl carbamate, which was reacted with [C-11]MeI, using DMF as the solvent and NaH as base, followed by deprotection with trifluoroacetic acid/water mixture, resulting in enantiomerically pure carbon-11 radioligand,[C-11]THK-5351 (S)-1-fluoro-3-(2-(6-([C-11]methylamino)pyridin-3-yl)quinolin-6-yloxy)propan-2-ol. Tritium labeling and purification of [H-3]THK-5351 were undertaken using similar approach, resulting in [H-3]THK-5351 with RCP >99.8% and specific radioactivity of 13 GB q/mu mol. Results: [C-11]THK-5351 was produced in good yield (1900 +/- 355 MBq), specific radioactivity (SRA) (361 +/- 119 GBq/mu rnol at EOS + 20 min) and radiochemical purity (RCP) (>99.8%), with enantiomeric purity of 98.7%. [H-3]TM-5351 was evaluated for ARG of tau binding in post-mortem human brain tissue using cortical sections from one AD patient and one control subject. [H-3]THK-5351 binding density was higher in the AD patient compared to the control subject, the binding was displaced by unlabeled THK-5351 confirming specific [H-3] THK-5351 binding. (C) 2016 Elsevier Inc. All rights reserved.
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| 44. |
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| 45. |
- Svedberg, Marie M., et al.
(författare)
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[C-11]PIB-amyloid binding and levels of A beta 40 and A beta 42 in postmortem brain tissue from Alzheimer patients
- 2009
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Ingår i: Neurochemistry International. - : Elsevier BV. - 0197-0186 .- 1872-9754. ; 54:5-6, s. 347-357
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Tidskriftsartikel (refereegranskat)abstract
- beta-Amyloid (A beta) deposits are one of the major histopathological hallmarks of Alzheimer's disease (AD). The amyloid-imaging positron emission tomography (PET) tracer [C-11]PIB (N-methyl[C-11]2-(4'-methylaminophenyl)-6-hydroxy-benzothiazole) is used in the assessment of A beta deposits in the human brain. [C-11]PIB-amyloid interaction and insoluble A beta 40 and A beta 42 peptide levels in the brain were quantified in postmortem tissue from nine AD patients and nine age-matched control subjects in the temporal, frontal and parietal cortices and the cerebellum. Autoradiographical studies showed significantly higher densities of specific [C-11]PIB-amyloid binding in gray matter in the temporal and parietal cortex (62 fmol/mg tissue) in AD patients as compared to control subjects, whereas the density was somewhat lower in the frontal cortex (56 fmol/mg tissue). No specific binding could be detected in the AD cerebellum or in the tissues from the control subjects (<= 5 fmol/mg tissue). Insoluble A beta 40 and total A beta levels (i.e. sum of A beta 40 and A beta 42) were significantly higher in patients than in controls in all measured cortical regions as determined using ELISA, which was confirmed using immunohistochemistry. The present findings show a more regional selective distribution of [C-11]PIB amyloid binding than previously reported. Moreover, it is suggested that some of the [C-11]PIB binding and insoluble A beta seen in control subjects may be amyloid in the blood vessels. (C) 2009 Elsevier Ltd. All rights reserved.
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| 46. |
- Svedberg, Marie M., et al.
(författare)
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Preclinical studies of potential amyloid binding PET/SPECT ligands in Alzheimer's disease
- 2012
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Ingår i: Nuclear Medicine and Biology. - : Elsevier BV. - 0969-8051 .- 1872-9614. ; 39:4, s. 484-501
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Tidskriftsartikel (refereegranskat)abstract
- Visualizing the neuropathological hallmarks amyloid plaques and neurofibrillary tangles of Alzheimer's disease in vivo using positron emission tomography (PET) or single photon emission computed tomography will be of great value in diagnosing the individual patient and will also help in our understanding of the disease. The successful introduction of [C-11]PIB as a PET tracer for the amyloid plaques less than 10 years ago started an intensive research, and numerous new compounds for use in molecular imaging of the amyloid plaques have been developed. The candidates are based on dyes like thioflavin T, Congo red and chrysamine G, but also on other types such as benzoxazoles, curcumin and stilbenes. In the present review, we present methods of the radiochemistry and preclinical evaluation as well as the main properties of some of these compounds.
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| 47. |
- Svedberg, Marie M
(författare)
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Regulatory mechanisms and plasticity of nicotinic receptors in transgenic mice overexpressing human beta-amyloid (APPswe) and acetylcholinesterase : implications for Alzheimer’s disease
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Alzheimer’s disease (AD) is the most frequent type of dementia and is characterized neuropathologically by deposition of plaques containing beta-amyloid (Abeta) and by neurofibrillary tangles, of which the main component is hyperphosphorylated tau. The degenerative progression seen in AD is accompanied by disturbances in several neurotransmitter systems, especially the cholinergic neurotransmitter system. Three different transgenic mouse models have been used in this thesis: APPswe transgenic mice harbouring the 670/671 APP Swedish mutation (APPswe), transgenic mice that overexpress human acetylcholinesterase in the brain (hAChE-Tg) and double transgenic mice generated by crossing the two mouse strains (hAChE-Tg//APPswe). The overall aim of these studies was to investigate how pathological processes and disruption of a balanced cholinergic neurotransmission, as created in these transgenic mouse models, influence the plasticity and regulation of the neuronal nicotinic acetylcholine receptors (nAChRs). Immunostaining of Abeta in the brain of APPswe showed Abeta deposition from 9 months of age. Similar investigation in the brain of hAChE-Tg//APPswe showed deposition of Abeta142 at 7 months of age and deposition consisting of Abeta1-40 and Abeta1-42 at 10 months of age. The nAChR subtypes, measured by receptor binding techniques, and levels of mRNA encoding nicotinic receptor subunits were quantified. A persistent increase of the alpha4 nAChR subtype initiated at transcription level and evident at post-transcription level, was found in the cortex and striatum of hAChE-Tg mice, from early postnatal to adult age, compared to control mice. The increase in the alpha4 nAChR in the hAChE-Tg mice most likely reflects a compensatory action from the excess of AChE that causes lack of neurotransmitter in the synaptic cleft and thereby increases the alpha4 nAChR subtypes both at mRNA and binding site level. No major differences in the alpha4 nAChR subtypes were observed in the APPswe or hAChETg//APPswe transgenic mice in comparison to non-transgenic mice. The alpha7 nAChR subtypes were significantly increased in most brain regions in the APPswe mice at 4 months and the increase was still detectable at 17-19 months of age compared to control mice. Similarly, an increase in alpha7 nAChRs, initiated at mRNA level at 3 and 7 months and evident at binding site level at 7 months of age, was found in the cortex of hAChETg//APPswe transgenic mice compared to controls. The increase in the alpha7 nAChR subtypes seen in these transgenic mice probably reflect a compensatory mechanisms in response to Abeta burden. The increase in alpha7 nAChRs might also reflect the noncholinergic distribution of the alpha7 nAChRs. No major changes in alpha7 nAChR binding sites were detected in the hAChE-Tg mice. This thesis also investigated changes in nAChR and muscarinic acetylcholine receptor (mAChR) subtypes in the brain of hAChE-Tg and control mice following treatment with the AChE inhibitor (AChEl) galantamine. In addition to its effect of inhibiting AChE, galantamine is proposed to act as an allosteric ligand, at the nicotinic receptor. No significant change in nAChR binding was observed in the galantamine treated hAChE-Tg compared to saline treated hAChE-Tg mice. The results showed that the alpha4 and the alpha7 nAChR subtypes were upregulated following treatment with galantamine in the hippocampus (alpha4), cortex (alpha7) and thalamus (alpha7) in the control mice. The M1 and M2 mAChRs were found to be nonselectively decreased in the brain following galantamine treatment in both the hAChETg and control mice. The lack of further increase in the nAChR binding sites in the hAChE-Tg mice following galantamine treatment may be a due to the already extensively elevated number of nicotinic receptors in these mice.
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| 48. |
- Svedberg, Petra, 1973-, et al.
(författare)
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Barriers and Enablers Affecting Successful Implementation of the Electronic Health Service Sisom : Multicenter Study of Child Participation in Pediatric Care
- 2019
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Ingår i: Journal of Medical Internet Research. - Toronto : JMIR Publications, Inc.. - 1438-8871. ; 21:11, s. 1-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Children's participation in health care is one of the most important components in the management of their disease. Electronic health (eHealth) services that are adapted to the needs of children have the potential for restructuring how children and professionals work together. Therefore, a digital interactive assessment and communication tool, Sisom, was developed to give children aged between 6 and 12 years a voice in their own health care. However, the implementation of eHealth services such as Sisom in daily practice in pediatric health care is rarely investigated. OBJECTIVE: The aim of this study was to explore the process of implementing Sisom for children in pediatric care in Sweden. More specifically, the study aimed to (1) evaluate whether the implementation strategy was conducted as planned, (2) understand the barriers and facilitators of the implementation strategy in pediatric care settings, (3) gain insight into how professionals work with the specific intervention, and (4) gain insight into the usefulness and effects of the intervention from the professionals' perspectives. METHODS: A process evaluation design was used to study the implementation of Sisom at 4 pediatric care centers in Sweden. An extensive amount of qualitative and quantitative data was collected before, during, and after the intervention through self-report checklists, memos, and interviews with professionals. In total, 46 children, aged between 6 and 13 years, participated. The children used Sisom on two occasions during 6 months. When they used Sisom, a printed report formed the basis for a forthcoming dialogue between professionals, children, and their parents. RESULTS: To our knowledge, this is the first implementation study of an eHealth communication tool aimed at strengthening children's participation in pediatric health care. Key factors for successful implementation were alignment of the solution with the values and goals of the organization, health care professionals' beliefs in the usefulness and usability of the solution, and health care professionals' willingness to change their professional roles guided by the solution. CONCLUSIONS: The results from the study show that it is possible to restructure health care delivery toward a child-centered approach, if there is a willingness and preparedness in the organization to implement an eHealth solution with the aim of restructuring the way of working with children's participation. ©Petra Svedberg, Susann Arvidsson, Ingrid Larsson, Ing-Marie Carlsson, Jens M Nygren.
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| 49. |
- Svedberg, Petra, 1973-, et al.
(författare)
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Barriers And Enablers for Successful Implementation of the eHealth Service Sisom for Improved Child Participation in Paediatric Care - A Multi-Centre Study
- 2019
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Ingår i: Pediatric Blood & Cancer. - Hoboken, NJ : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 66:S4, s. S122-S122
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objectives:Participation in healthcare is one of the most important components in management of children’s disease. eHealth services that are adapted to the needs of children have the potential to reorganize how children and professionals work together. The digital interactive communication tool Sisom, was developed to give children in pediatric oncology care “a voice". However, the implementation of eHealth services, such as Sisom, in daily practice is rarely being investigated. The objective of this study was to explore the process and effects of implementing Sisom at four pediatric care centers in Sweden.Design/Methods:A process and effect evaluation design was used to investigate the implementation of Sisom in a clinical context at four pediatric care centers in Sweden. In total, 46 children, age 6- 13 years, participated and most of them had a cancer diagnosis. The children used Sisom at two occasions during 6 months. Following the use of Sisom, a printed report formed the basis for a forthcoming dialogue between professionals, children and their parents.Results:Key factors for successful implementation of Sisom was; i) alignment of the solution with values and goals of the organization, ii) professional’s beliefs in the usefulness and usability of the solution, and iii) professional’s willingness to apply changes in their professional roles promoted by the solution. Sisom directed healthcarecommunication from the parents’ voices toward the child’s voice and made children’s needs and preferences explicitly visible in decision-making.Sisom was experienced, by the children, as a user-friendly tool through which they could find ways to express themselves and share information with their parents and healthcare professionals.Conclusions:The results show how healthcare deliverycan be reorganized towards a child-centered approach, and the importance of implementing an eHealth service to support restructuring ofways of working with children’s participation to succeed with this.
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| 50. |
- Veldman, Emma R, et al.
(författare)
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Serotonin 1B receptor density mapping of the human brainstem using positron emission tomography and autoradiography
- 2022
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Ingår i: Journal of Cerebral Blood Flow and Metabolism. - 0271-678X .- 1559-7016. ; 42:4, s. 630-641
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Tidskriftsartikel (refereegranskat)abstract
- The serotonin 1B (5-HT1B) receptor has lately received considerable interest in relation to psychiatric and neurological diseases, partly due to findings based on quantification using Positron Emission Tomography (PET). Although the brainstem is an important structure in this regard, PET radioligand binding quantification in brainstem areas often shows poor reliability. This study aims to improve PET quantification of 5-HT1B receptor binding in the brainstem.Volumes of interest (VOIs) were selected based on a 3D [3H]AZ10419369 Autoradiography brainstem model, which visualized 5-HT1B receptor distribution in high resolution. Two previously developed VOI delineation methods were tested and compared to a conventional manual method. For a method based on template data, a [11C]AZ10419369 PET template was created by averaging parametric binding potential (BPND) images of 52 healthy subjects. VOIs were generated based on a predefined volume and BPND thresholding and subsequently applied to test-retest [11C]AZ10419369 parametric BPND images of 8 healthy subjects. For a method based on individual subject data, VOIs were generated directly on each individual parametric image.Both methods showed improved reliability compared to a conventional manual VOI. The VOIs created with [11C]AZ10419369 template data can be automatically applied to future PET studies measuring 5-HT1B receptor binding in the brainstem.
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