| 1. |
- Bejnö, Hampus, et al.
(författare)
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Adapting the Preschool Environment to the Needs of Children on the Autism Spectrum in Sweden : A quasi-experimental study
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 30:3, s. 278-297
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment.AIM This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff.MATERIAL AND METHODS In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period.RESULTS The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant.CONCLUSIONS AND SIGNIFICANCE In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI.
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| 2. |
- Bejnö, Hampus, 1984-
(författare)
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Early intervention and autism : Improving preschool program quality for children with autism spectrum disorder receiving Early Intensive Behavioral Intervention using the Autism Program Environment Rating Scale (APERS)
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The quality of the learning environment in preschool is of significant importance for children with autism spectrum disorder (ASD). However, very limited research has addressed how this environment can be improved. In regard to early intervention, most previous studies have primarily focused on child characteristics, and intervention content and quantity, rather than the broader learning environment in which interventions are delivered. Thus, the overall aim of this thesis was to study the quality of the learning environment for children with ASD. In particular, the focus was on children who receive Early Intensive Behavioral Intervention (EIBI) in community-based Swedish preschools, using the Autism Program Environment Rating Scale (APERS). Within this framework, three studies were conducted.In study 1, we translated, culturally adapted, and systematically assessed the content validity of APERS, a rating scale designed to assess the program quality for children with ASD in educational settings. In the process, the scale was modified to make the instrument as relevant as possible for the Swedish preschool context, and re-named APERS-P-SE. Nine experts rated the clarity and comprehensiveness of the individual items, as well as the relevance of the scale in its entirety. In study 2, we evaluated APERS-P-SE as the foundation for professional development for preschool staff working with children with ASD receiving EIBI, to promote preschool learning environment quality (primary outcome), and outcomes for autistic children, and preschool staff (secondary outcomes). Using a quasi-experimental design, preschool staff either implemented EIBI enriched by in-service training and on-site coaching based on APERS-P-SE assessments (k = 9), or EIBI only (k = 8) during 8 months. A total of 17 children and 35 preschool staff participated, across 17 preschools. In study 3, individual interviews and focus-group interviews were conducted with preschool staff, preschool principals, habilitation supervisors, and parents to children with ASD who had participated in study 2 and received the APERS-P-SE-based intervention. Through these interviews, the different groups of stakeholders provided their thoughts about what they found to be the most important aspects of preschool programs for autistic children who receive EIBI, and their opinions and experiences of participating in study 2. Study 1 demonstrated a high level of content validity for the Swedish version of the APERS. In study 2, the EIBI/APERS-P-SE preschools significantly improved their learning environment, compared to the preschools that received EIBI only. Outcomes for autistic children and preschool staff did not differ significantly between the groups, despite positive descriptive findings. In study 3, four themes were identified as being key aspects of preschool programs with high quality to promote optimal development of children with ASD: (1) staff’s competence, (2) children’s inclusion and participation, (3) collaboration, and (4) learning environment. Overall, the stakeholders described the APERS-P-SE-based model as helpful in improving children’s participation, preschool staff’s engagement with the child, and optimizing child outcomes.Taken together, the results indicate that APERS-P-SE is an instrument with a high level of content validity, and that it can be used in combination with in-service training and on-site coaching to improve preschool program quality for children with ASD.
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| 3. |
- Bejnö, Hampus, et al.
(författare)
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From Someone Who May Cause Trouble to Someone You Can Play With : Stakeholders' Perspectives on Preschool Program Quality for Autistic Children
- 2022
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Ingår i: Journal of autism and developmental disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 52:9, s. 3890-3908
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, young autistic children typically attend community-based preschool programs, which may not be adapted to their needs. In the current study, stakeholders to autistic children receiving Early Intensive Behavioral Intervention were interviewed following a quasi-randomized study (#NCT03634761) aimed at improving the preschool program quality using the Swedish version of the Autism Program Environment Rating Scale (APERS). Stakeholders provided their perceptions and experiences concerning key factors for high quality preschool programs as well as well as their experiences of the abovementioned APERS study. Applying thematic analysis, stakeholder groups differed in what they emphasized, but all highlighted staff’s competence, children’s inclusion and participation, collaboration, and the learning environment as key program areas that had been positively influenced by the APERS-based intervention.
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| 4. |
- Braide, Karin, et al.
(författare)
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Salvage radiation therapy in prostate cancer: relationship between rectal dose and long-term, self-reported rectal bleeding
- 2021
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Ingår i: Clinical & Translational Oncology. - : Springer Science and Business Media LLC. - 1699-048X .- 1699-3055. ; 23:2, s. 397-404
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To quantify the relationship between the rectal dose distribution and the prevalence of self-reported rectal bleeding among men treated with salvage radiotherapy (ST) delivered by three-dimensional conformal radiotherapy (3DCRT) for prostate cancer. To use this relationship to estimate the risk of rectal bleeding for a contemporary cohort of patients treated with volumetric modulated arc therapy (VMAT) ST. Methods and patients Rectal bleeding of any grade was reported by 56 (22%) of 255 men in a PROM-survey at a median follow-up of 6.7 years after 3DCRT ST. Treatment plan data were extracted and dose-response relationships for the rectal volumes receiving at least 35 Gy (V-35Gy) or 63 Gy (V-63Gy) were calculated with logistic regression. These relationships were used to estimate the risk of rectal bleeding for a cohort of 253 patients treated with VMAT ST. Results In the dose-response analysis of patients in the 3DCRT ST cohort, both rectal V(35Gy)and V(63Gy)were statistically significant parameters in univariable analysis (p = 0.005 and 0.003, respectively). For the dose-response models using either rectal V(35Gy)or V-63Gy, the average calculated risk of rectal bleeding was 14% among men treated with VMAT ST compared to a reported prevalence of 22% for men treated with 3DCRT ST. Conclusions We identified dose-response relationships between the rectal dose distribution and the risk of self-reported rectal bleeding of any grade in a long-term perspective for men treated with 3DCRT ST. Furthermore, VMAT ST may have the potential to decrease the prevalence of late rectal bleeding.
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| 5. |
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| 6. |
- Chen, Y. H., et al.
(författare)
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Genomic atlas of the plasma metabolome prioritizes metabolites implicated in human diseases
- 2023
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Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 55, s. 44-53
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Tidskriftsartikel (refereegranskat)abstract
- Metabolic processes can influence disease risk and provide therapeutic targets. By conducting genome-wide association studies of 1,091 blood metabolites and 309 metabolite ratios, we identified associations with 690 metabolites at 248 loci and associations with 143 metabolite ratios at 69 loci. Integrating metabolite-gene and gene expression information identified 94 effector genes for 109 metabolites and 48 metabolite ratios. Using Mendelian randomization (MR), we identified 22 metabolites and 20 metabolite ratios having estimated causal effect on 12 traits and diseases, including orotate for estimated bone mineral density, alpha-hydroxyisovalerate for body mass index and ergothioneine for inflammatory bowel disease and asthma. We further measured the orotate level in a separate cohort and demonstrated that, consistent with MR, orotate levels were positively associated with incident hip fractures. This study provides a valuable resource describing the genetic architecture of metabolites and delivers insights into their roles in common diseases, thereby offering opportunities for therapeutic targets.
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| 7. |
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| 8. |
- Eckersten, Sofia, 1989-
(författare)
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New perspectives on Strategic Choice of Measures in Swedish Transport Planning
- 2022
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Rapid changes in the global climate and declining biodiversity pronounces the need for adapting the transport system and transport infrastructure, which influence several sustainability issues and cause direct environmental impact through their use of land, as well as indirect impacts, for example, emissions of pollutants to air and water. The Swedish Transport Administration (STA) is responsible for and conducts a large part of the transport planning in Sweden and the STA endeavor to increase collaboration with other societal actors in transport planning. In 2013, the Strategic Choice of Measure (SCM) process was introduced by the STA to facilitate collaboration among multiple societal actors in the early stages of transport planning. In the SCM process many of the choices are made that will affect the development of the transport system as well as the future transport system's impact on the environment. Integrating environmental aspects at an early planning stage, such as in the SCM process, can help reduce and avoid the environmental impact of the transport system. Therefore, this licentiate thesis aims to explore the consideration of environmental aspects in the SCM process (Paper 1), and to analyze the SCM process from a systems perspective in order to illuminate the consequences of system boundaries on how environmental aspects are considered and what aspects are included or left out (Paper 2). In addition, proposals are being developed to strengthen practice (Papers 1 and 2).To achieve the aims of the thesis, interview studies, document studies and observational studies have been performed. Also, a case study of two SCM processes was conducted. This dissertation shows that there are several challenges associated with the consideration of environmental aspects in SCM processes. For example, the increased element of collaboration in the planning process implies that the coordination of the process will affect which environmental aspects are considered and in what way. Furthermore, land-use and transport planning are coordinated in the SCM process, which often leads to conflicting ideas about how an area should be developed. By finding solutions to transport and land-use related problems with synergetic effects, conflicts may be solved, and transport, land-use and environmental needs may be met simultaneously. To identify this type of measure and packages of measures in an SCM process, tools that enable the identification of links between transport, land-use and environmental aspects can be used as support.
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| 9. |
- Frysz, Monika, et al.
(författare)
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The influence of adult hip shape genetic variants on adolescent hip shape : Findings from a population-based DXA study
- 2021
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Ingår i: Bone. - : Elsevier. - 8756-3282 .- 1873-2763. ; 143
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Hip shape is a well-recognized risk factor for hip osteoarthritis (OA) and hip fracture. We aimed to investigate whether the genetic variants known to be associated with adult hip shape were also associated with adolescent hip shape.Methods: Hip DXA scans, obtained in offspring from the Avon Longitudinal Study of Parents and Children (ALSPAC) at two time points (mean ages 13.8 and 17.8 years), were used to quantify hip morphology using a 53-point Statistical Shape Model (SSM). Principal component analysis was used to generate hip shape modes (HSMs). Genetic variants which had previously shown genome-wide significant association with specific HSMs in adults were tested for association with the same HSMs in adolescents (at each timepoint separately) using SNPTEST v2.Results: Complete genotypic and phenotypic data were available for 3550 and 3175 individuals at 14 and 18 years, respectively. The strongest evidence for association with adolescent hip shape was for a variant located near SOX9 (rs2158915) with consistent effects across both time points for HSM1 (age 14: beta -0.05, p = 9.9 x 10(-8); age 18: -0.05, p = 3.3 x 10(-6)) and HSM5 (age 14: beta -0.07, p = 1.6 x 10(-4); age 18: -0.1, p = 2.7 x 10(-6)). There was also strong evidence of association between rs10743612 (near PTHLH) and HSM1 (age 14: 0.05, p = 1.1 x 10(-5); age 18: 0.04, p = 0.003) and between rs6537291 (near HHIP) and HSM2 (age 14: -0.06, p = 0.001; age 18: -0.07, p = 0.001) across both time points. The genes with the strongest associations with hip shape in adolescents, (SOX9, PTHLH and HHIP) are known to be involved in endochondral bone formation. HSM1 indicates narrower aspect ratio of the upper femur, whereas both HSM2 and HSM5 reflect variation in the femoral head size and femoral neck width, features previously found to be related to the risk of OA in later life. The SOX9 locus has previously been found to associate with increased risk of hip fracture.Conclusion: In conclusion, variants implicated in endochondral bone formation appear to consistently influence hip shape between adolescence and adulthood, including those aspects related to risk of hip OA and/or fracture in later life.
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| 10. |
- Grahnemo, Louise, et al.
(författare)
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Low Circulating Valine Associate With High Risk of Hip Fractures
- 2023
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Ingår i: Journal of Clinical Endocrinology & Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 108:11
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Tidskriftsartikel (refereegranskat)abstract
- Context Hip fractures constitute a major health concern. An adequate supply of amino acids is crucial to ensure optimal acquisition and remodeling of bone. Circulating amino acid levels have been proposed as markers of bone mineral density, but data on their ability to predict incident fractures are scarce. Objectives To investigate the associations between circulating amino acids and incident fractures. Methods We used UK Biobank (n = 111 257; 901 hip fracture cases) as a discovery cohort and the Umea Fracture and Osteoporosis (UFO) hip fracture study (hip fracture cases n = 2225; controls n = 2225) for replication. Associations with bone microstructure parameters were tested in a subsample of Osteoporotic Fractures in Men Sweden (n = 449). Results Circulating valine was robustly associated with hip fractures in the UK Biobank (HR per SD increase 0.79, 95% CI 0.73-0.84), and this finding was replicated in the UFO study (combined meta-analysis including 3126 incident hip fracture cases, odds ratio per SD increase 0.84, 95% CI 0.80-0.88). Detailed bone microstructure analyses showed that high circulating valine was associated with high cortical bone area and trabecular thickness. Conclusion Low circulating valine is a robust predictor of incident hip fractures. We propose that circulating valine may add information for hip fracture prediction. Future studies are warranted to determine whether low valine is causally associated with hip fractures.
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