| 1. |
- Fritz, Michael, et al.
(author)
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Prostaglandin-dependent modulation of dopaminergic neurotransmission elicits inflammation-induced aversion in mice
- 2016
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In: Journal of Clinical Investigation. - : AMER SOC CLINICAL INVESTIGATION INC. - 0021-9738 .- 1558-8238. ; 126:2, s. 695-705
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Journal article (peer-reviewed)abstract
- Systemic inflammation causes malaise and general feelings of discomfort. This fundamental aspect of the sickness response reduces the quality of life for people suffering from chronic inflammatory diseases and is a nuisance during mild infections like common colds or the flu. To investigate how inflammation is perceived as unpleasant and causes negative affect, we used a behavioral test in which mice avoid an environment that they have learned to associate with inflammation-induced discomfort. Using a combination of cell-type-specific gene deletions, pharmacology, and chemogenetics, we found that systemic inflammation triggered aversion through MyD88-dependent activation of the brain endothelium followed by COX1-mediated cerebral prostaglandin E-2 (PGE(2)) synthesis. Further, we showed that inflammation-induced PGE(2) targeted EP1 receptors on striatal dopamine D1 receptor-expressing neurons and that this signaling sequence induced aversion through GABA-mediated inhibition of dopaminergic cells. Finally, we demonstrated that inflammation-induced aversion was not an indirect consequence of fever or anorexia but that it constituted an independent inflammatory symptom triggered by a unique molecular mechanism. Collectively, these findings demonstrate that PGE(2)-mediated modulation of the dopaminergic motivational circuitry is a key mechanism underlying the negative affect induced by inflammation.
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| 3. |
- Condelius, Anna, et al.
(author)
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Exploring the Implementation of Individual Care Plans in Relation to Characteristics of Staff
- 2016
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In: Open Journal of Nursing. - Irvine, CA : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 6:8, s. 582-590
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Journal article (peer-reviewed)abstract
- The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distributed to all staff working in the care for older people, (N = 908, n = 245) in four municipalities in Sweden. The number of care plans established during a one-year period was collected through a contact person in each municipality. In total 47 individual care plans were es-tablished during the study year. Significantly more staff in the municipality that had the most number of established individual care plans agreed that there had been sufficient education (p = 0.017), sufficient time (p = 0.002) and routines established regarding individual care plans (p = 0.014) and had a significantly better job satisfaction (p = 0.001), compared to staff in the other municipalities. Implementation leaders may need to take the working conditions and the percep-tion of available resources among staff into consideration in the on-going process of implementing individual care plans.
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| 4. |
- Cotgreave, Ian, et al.
(author)
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Pyriproxifen and microcephaly: an investigation of potential ties to the ongoing "Zika epidemic"
- 2016
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Reports (other academic/artistic)abstract
- As part of the Swetox mission to react to emerging concerns in chemical health and environmental safety, a preliminary litterature investigation was undertaken to gather all readily available scientific information on PPF with respect to safety assessment, in order to better understand potential links between chemical exposure and the devopment of microcephaly in affected areas. Therefore the contents of the report do not constitute an attempt at either questioning the use of existing regulatory data in the manner prescribed by international regulatory proceedures, or as a new risk assessment, based on the scientific information and concepts discussed. Here we report our findings, with particular emphasis on exisiting regulatory information, potential for lack of translation of results from regulatory animal testing to humans, lack of human exposure data and suggestions on plausible mode(s) of action of PPF in human neurodevelopmental adversities such as microcephaly.
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| 6. |
- Jeong, Choongwon, et al.
(author)
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Long-term genetic stability and a high-altitude East Asian origin for the peoples of the high valleys of the Himalayan arc
- 2016
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In: Proceedings of the National Academy of Sciences of the United States of America. - : NATL ACAD SCIENCES. - 0027-8424 .- 1091-6490. ; 113:27, s. 7485-7490
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Journal article (peer-reviewed)abstract
- The high-altitude transverse valleys [>3,000 m above sea level (masl)] of the Himalayan arc from Arunachal Pradesh to Ladahk were among the last habitable places permanently colonized by prehistoric humans due to the challenges of resource scarcity, cold stress, and hypoxia. The modern populations of these valleys, who share cultural and linguistic affinities with peoples found today on the Tibetan plateau, are commonly assumed to be the descendants of the earliest inhabitants of the Himalayan arc. However, this assumption has been challenged by archaeological and osteological evidence suggesting that these valleys may have been originally populated from areas other than the Tibetan plateau, including those at low elevation. To investigate the peopling and early population history of this dynamic high-altitude contact zone, we sequenced the genomes (0.04x-7.25x, mean 2.16x) and mitochondrial genomes (20.8x-1,311.0x, mean 482.1x) of eight individuals dating to three periods with distinct material culture in the Annapurna Conservation Area (ACA) of Nepal, spanning 3,150-1,250 y before present (yBP). We demonstrate that the region is characterized by long-term stability of the population genetic make-up despite marked changes in material culture. The ancient genomes, uniparental haplotypes, and high-altitude adaptive alleles suggest a high-altitude East Asian origin for prehistoric Himalayan populations.
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| 8. |
- Klockmo, Carolina, 1976-, et al.
(author)
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En väg in : Arbetsmarknadstorget, en plattform för samverkan
- 2016
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Reports (other academic/artistic)abstract
- Arbetsmarknadstorget i Sundsvall är ett samverkansprojekt där ingående parter är Arbetsförmedlingen, Försäkringskassan, Socialtjänsten, Förvaltningen för arbetsmarknad, vuxenutbildning och integration (Favi) och Landstinget Västernorrland. Vid Arbetsmarknadstorget arbetar olika personalkategorier från de ingående aktörerna under samma tak gemensamt med stöd och insatser. Inom arbetsmarknadsområdet benämns arbetsmodellen som ”one-stop-shop” eller ”En gemensam in-gång”. FoU Västernorrland har följeforskat projektet under en treårsperiod med fokus på analys av framgångsfaktorer och utvecklingsmöjligheter rörande samverkan mellan de ingående aktörerna. Följeforskningen bygger på deltagande observation vid olika möten, intervjuer med deltagare, anställd personal, representanter från referensgrupp chefer, och styrgrupp samt Arbetsmarknadstorgets egen statistik.Resultaten visar att projektets effekt- och projektmål har uppnåtts. Resultatet visade att personalen vid Arbetsmarknadstorget har närmat sig varandra och har hittat ett gemensamt arbetssätt, etik och värdegrund. Detta återspeglas tydligt i deltagarnas berättelser där tron på individen, helhetssyn, flexibilitet och meningsfullhet lyfts fram som de viktigaste framgångsfaktorerna. När det gäller samverkan på organisationsnivån, står Arbetsmarknadstorget inför utmaningar. En utmaning handlar om att gemensamt hitta lösningar för att täcka upp de grå zonerna som identifieras. En sådan fråga uppstod under projekttiden, som också organisationerna med gemensamma krafter funnit en lösning på. Ledningskonstellationen har förändrats under projekttiden vilket innebär att det är viktigt att hitta gemensamma mål och visioner så att samtliga aktörer ”drar åt samma håll”. En diskussion gällande målgruppen för Arbetsmarknadstorget är särskilt viktig eftersom resultaten pekar på att vissa grupper inte nås. Ett viktigt led i det framtida arbetet är att aktörerna enas om en målgruppsdefinition och synliggör vilka motiv varje aktör har med sitt deltagande i samverkan. Det handlar om att få syn på var och hur varje myndighet kan mötas. Ett led i att skapa goda förutsättningar för samverkan är att samtliga aktörer bemannar Arbetsmarknadstorget enligt avtal samt att det finns en kontinuitet i bemanningen. Resultaten visar att den kollegiala nivån (teamet) och teamets gemensamma värdegrund och arbetssätt är avgörande för ett lyckat utfall för deltagarna. En viktig faktor är också att enbart Arbetsmarknadstorgets ärenden behandlas på Arbetsmarknadstorget för att skapa kongruens och därmed stärka verksamhetens legitimitet. Sammantaget finns flera framgångsfaktorer att peka på och Arbetsmarknadstorget har goda förutsättningar att möta framtida utmaningar.
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| 9. |
- Oudin, Anna, et al.
(author)
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Poor housing conditions in association with child health in a disadvantaged immigrant population : a cross-sectional study in Rosengård, Malmö, Sweden
- 2016
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In: BMJ Open. - : BMJ. - 2044-6055. ; 6:1
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To describe the home environment in terms of housing conditions and their association with child health in a disadvantaged immigrant population.DESIGN: A cross-sectional observational study.SETTING: Enrolment took place during 2010-2011 in Rosengård, Malmö, Sweden.PARTICIPANTS: Children aged 0-13 years in 2 study neighbourhoods were recruited from local health records and from schools. 359 children participated, with a participation rate of 40%. Data on health, lifestyle and apartment characteristics from questionnaire-led interviews with the mothers of the children were obtained together with data from home inspections carried out by trained health communicators.OUTCOME MEASURES: Logistic regression analysis was used to estimate ORs for various health outcomes, adjusted for demographic information and lifestyle factors.RESULTS: The housing conditions were very poor, especially in one of the study neighbourhoods where 67% of the apartments had been sanitised of cockroaches, 27% were infested with cockroaches and 40% had a visible mould. The association between housing conditions and health was mostly inconclusive, but there were statistically significant associations between current asthma and dampness (OR=4.1, 95% CI 1.7 to 9.9), between asthma medication and dampness (OR=2.8, 95% CI 1.2 to 6.4), and between mould and headache (OR=4.2, 95% CI 1.2 to 14.8). The presence of cockroaches was associated with emergency care visits, with colds, with headache and with difficulty falling asleep, and worse general health was associated with mould and presence of cockroaches.CONCLUSIONS: The associations between dampness and asthma, and the association between mould and headache, are in line with current knowledge. The presence of cockroaches seemed to be associated with various outcomes, including those related to mental well-being, which is less described in the literature. The results of the present study are hypothesis generating and provide strong incentives for future studies in this study population.
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| 10. |
- Salzer, Jonatan, et al.
(author)
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Rituximab in multiple sclerosis : a retrospective observational study on safety and efficacy
- 2016
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In: Neurology. - 0028-3878 .- 1526-632X. ; 87:20, s. 2074-2081
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Journal article (peer-reviewed)abstract
- Objective: To investigate the safety and efficacy of rituximab in multiple sclerosis (MS). Methods: In this retrospective uncontrolled observational multicenter study, off-label rituximab-treated patients with MS were identified through the Swedish MS register. Outcome data were collected from the MS register and medical charts. Adverse events (AEs) grades 2-5 according to the Common Terminology Criteria for Adverse Events were recorded. Results: A total of 822 rituximab-treated patients with MS were identified: 557 relapsing-remitting MS (RRMS), 198 secondary progressive MS (SPMS), and 67 primary progressive MS (PPMS). At baseline, 26.2% had contrast-enhancing lesions (CELs). Patients were treated with 500 or 1,000 mg rituximab IV every 6-12 months, during a mean 21.8 (SD 14.3) months. During treatment, the annualized relapse rates were 0.044 (RRMS), 0.038 (SPMS), and 0.015 (PPMS), and 4.6% of patients displayed CELs. Median Expanded Disability Status Scale remained unchanged in RRMS (p = 0.42) and increased by 0.5 and 1.0 in SPMS and PPMS, respectively (p = 0.10 and 0.25). Infusion-related AEs occurred during 7.8% of infusions and most were mild. A total of 89 AEs grades >= 2 (of which 76 infections) were recorded in 72 patients. No case of progressive multifocal leukoencephalopathy was detected. Conclusions: This is the largest cohort of patients with MS treated with rituximab reported so far. The safety, clinical, and MRI findings in this heterogeneous real-world cohort treated with different doses of rituximab were similar to those reported in previous randomized controlled trials on B-cell depletion therapy in MS. Classification of evidence: This study provides Class IV evidence that for patients with MS, rituximab is safe and effective.
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