| 1. |
- Ambrosi, Aurelie, et al.
(författare)
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Development of heart block in children of SSA/SSB-autoantibody-positive women is associated with maternal age and displays a season-of-birth pattern
- 2012
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Publishing Group. - 0003-4967 .- 1468-2060. ; 71:3, s. 334-340
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Tidskriftsartikel (refereegranskat)abstract
- Objective Congenital heart block may develop in the fetuses of Ro/SSA-positive and La/SSB-positive mothers. Recurrence rates of only 10-20% despite persisting maternal antibodies indicate that additional factors are critical for the establishment of heart block. The authors investigated the influence of other maternal and fetal factors on heart block development in a Swedish population-based cohort. less thanbrgreater than less thanbrgreater thanMethods The influence of fetal gender, maternal age, parity and time of birth on heart block development was analysed in 145 families, including Ro/La-positive (n=190) and Ro/La-negative (n=165) pregnancies. less thanbrgreater than less thanbrgreater thanResults There was a recurrence rate of 12.1% in Ro/La-positive women, and no recurrence in Ro/La-negative women. Fetal gender and parity did not influence the development of heart block in either group. Maternal age in Ro/La-positive pregnancies with a child affected by heart block was, however, significantly higher than in pregnancies resulting in babies without heart block (pandlt;0.05). Seasonal timing of pregnancy influenced the outcome. Gestational susceptibility weeks 18-24 occurring during January-March correlated with a higher proportion of children with heart block and lower vitamin D levels during the same period in a representative sample of Swedish women and a corresponding higher proportion of children with heart block born in the summer (pandlt;0.02). Maternal age or seasonal timing of pregnancy did not affect the outcome in Ro/La-negative pregnancies. less thanbrgreater than less thanbrgreater thanConclusion This study identifies maternal age and seasonal timing of pregnancy as novel risk factors for heart block development in children of Ro/La-positive women. These observations may be useful for counselling when pregnancy is considered.
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| 2. |
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| 3. |
- Salomonsson, S., et al.
(författare)
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A Population-based Investigation of the Autoantibody Profile in Mothers of Children with Atrioventricular Block
- 2011
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Ingår i: Scandinavian Journal of Immunology. - Oxford : Blackwell Publishing. - 0300-9475 .- 1365-3083. ; 74:5, s. 511-517
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to investigate the antigen specificity and occurrence of individual autoantibodies in mothers of children diagnosed with atrioventricular (AV) block in a nation-wide setting. Patients with AV block detected before 15 years of age were identified using national quality registries as well as a network of pediatric and adult cardiologists and rheumatologists at the six university hospitals in Sweden. Patients with gross heart malformations, surgically or infectiously induced blocks were excluded. Blood samples were obtained from the mothers and maternal autoantibody profile, including the occurrence of antibodies against Ro52, Ro60, La, SmB, SmD, RNP-70k, RNP-A, RNP-C, CENP-C, Scl-70, Jo-1, ribosomal RNP and histones was investigated in 193 mothers of children with AV block by immunoblotting and ELISA. Autoantibody reactivity was detected in 48% (93/193) of the mothers of children with AV block. In autoantibody-positive mothers, the vast majority, 95% (88/93), had antibodies against Ro52, while 63% (59/93) had autoantibodies to Ro60 and 58% (54/93) had autoantibodies to La. In addition, 13% (12/93) of the autoantibody-positive mothers had antibodies to other investigated antigens besides Ro52, Ro60 and La, and of these anti-histone antibodies were most commonly represented, detected in 8% (7/93) of the mothers. In conclusion, this Swedish population-based study confirms that maternal autoantibodies may associate with heart block in the child. Further, our data demonstrate a dominant role of Ro52 antibodies in association with AV block.
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| 4. |
- Brorsson, Anna, et al.
(författare)
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Accessibility in public space as perceived by people with Alzheimer´s disease
- 2011
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Ingår i: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; :aug 11
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Tidskriftsartikel (refereegranskat)abstract
- Most people with dementia remain living at home as long as possible after being diagnosed, and hence their lives also include activities in the public space. The aim of this study was to illuminate experiences of accessibility in public space in people with Alzheimer’s disease. A qualitative grounded theory approach with repeated in-depth interviews was used. The core category, accessibility as a constantly changing experience, was characterized by changes in the relationship between informants and public space. Changes in the relationship took place in activities and use of place and related to familiarity and comfort, individual motives and interests, and planning and protecting. Other changes occurred in places and problematic situations related to everyday technologies, crowded places with high tempo and noise, and change of landmarks. These changes reduced feelings of accessibility and increased difficulties in carrying out activities in public space. These findings may be helpful when providing support, and supporting community living.
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| 5. |
- Brorsson, Anna, et al.
(författare)
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Managing critical incidents in grocery shopping by community-living people with Alzheimer's disease.
- 2013
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 4:20, s. 292-301
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Tidskriftsartikel (refereegranskat)abstract
- Aim: People with Alzheimer's disease (AD) remain in their ordinary housing and continue to use public space despite increasing disabilities. The aim of this study was to discover and describe problematic situations and critical incidents that took place when people with AD performed the ordinary outside-home activity of grocery shopping and how these were met by them. Methods: Individual interviews (n = 12) and participant observations (n = 8) with six informants were performed and analysed using a grounded theory approach. Results: The findings are presented in six categories and each category describes different critical incidents and actions used to meet these. The categories were: (a) Remembering to bring things when leaving home, (b) Finding the way to and from the grocery shop without getting lost, (c) Finding a way through traffic when not feeling safe, (d) Finding objects when organization is disrupted, (e) Choosing when a lot of objects and products are available, and (f) Finding a method to pay when payment opportunities are restricted. The core category, “A challenging and unstable process of meeting critical incidents in grocery shopping”, was characterised by reflections and creativity to achieve relative harmony in each critical incident. Conclusions: In conclusion, it is important that relatives and professionals take into account relevant actions to help people with AD coordinate with their environment.Read More: http://informahealthcare.com/doi/abs/10.3109/11038128.2012.752031
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| 6. |
- Idenfors, Annika, et al.
(författare)
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När det brister : En studie av dammsäkehet och säkerhetsarbete mot översvämningar längs Skellefte- och Umeälven
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport sammanfattar resultat från en studie om dammsäkerhet och säkerhetsarbete mot översvämningar längs två reglerade älvar i Västerbotten. Syftet med studien är att undersöka hur dammsäkerhetsarbetet, när det gäller dammbrott, säkerhetsarbete mot översvämningar och incidenter relaterade till nyttjandet av älvarna, är organiserat och fungerar längs Skellefte- och Umeälven. Övriga älvar i länet samt gruvdammar ingår inte i undersökningen. Det ansvar som Statens geotekniska institut (SGI), Sveriges meteorologiska och hydrologiska institut (SMHI), försvarsmakten, Boverket, Vägverket och polisen har för att förebygga och agera i samband med översvämningar behandlas inte heller i studien.Rapporten baseras på en litteraturöversikt rörande den senaste forskningen på området, dokumentstudier, intervjuer med säkerhetsansvariga vid Länsstyrelsen Västerbotten, Umeå, Vännäs, Lycksele och Skellefteå kommun, samt två vattenregleringsföretag.Studien tar sin utgångspunkt i begreppet mänsklig säkerhet och analyserar dammsäkerhet och säkerhetsarbete utifrån ett sociotekniskt perspektiv. Det innebär att varje teknisk konstruktion, varje tekniskt system, såsom vattenkraftverk och dammar, där olika tekniska instrument används för att kontrollera och reglera vattenflöden och producera elektricitet, också utgör sociala system. Det innebär att rapporten uppmärksammar deltagande och delaktighet som en central aspekt av säkerhetsarbetet.Utifrån resultaten drar studien följande slutsatser:Dammsäkerhetsarbetet och säkerhetsarbetet mot översvämningar längs Skellefte- och Umeälven uppvisar brister ifråga om resurser, kompetens och insyn.Dammsäkerhetsarbetet inkluderar inte allmänhetens säkerhet vid och på dammar (public safety around dams).Det finns oklarheter rörande vem som har ansvar för dammsäkerhet och för säkerhetsarbete mot översvämningar.Dammsäkerhetsarbetet i Västerbotten inkluderar endast i begränsad omfattning sociala aspekter, lokal kunskap tas inte tillvara, och allmänhet och rättighetsinnehavare ignoreras i stor utsträckning i säkerhetsarbetet.Det är generellt svårt att bedöma effekter av säkerhetsarbetet kring dammar och längs älvarna, men klart är att pågående säkerhetsarbete, i form av till exempel enskilda projekt och övningar, ökar kunskaperna om risker och ansvar, samt stärker samverkan mellan olika aktörer.Dammsäkerhet uppfattas främst handla om tekniska konstruktioner medan människa-maskin- natur och mellanmänskliga och organisatoriska säkerhetsaspekter hamnar i skymundan.
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| 8. |
- Kovacevic, A., et al.
(författare)
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Fetal aortic valvuloplasty : investigating institutional bias in surgical decision-making
- 2014
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Ingår i: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 44:5, s. 538-544
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Fetal aortic valvuloplasty may prevent the progression of aortic stenosis to hypoplastic left heart syndrome and allow biventricular rather than univentricular postnatal treatment. This study aimed to investigate whether blinded simulation of a multidisciplinary team approach aids interpretation of multicenter data to uncover institutional bias in postnatal decision-making following fetal cardiac intervention for aortic stenosis. Methods The study included 109 cases of prenatally diagnosed aortic stenosis from 13 European countries, of which 32 had undergone fetal cardiac intervention. The multidisciplinary team, blinded to fetal cardiac intervention, institutional location and postnatal treatment, retrospectively assigned a surgical pathway (biventricular or univentricular) based on a review of recorded postnatal imaging and clinical characteristics. The team's decisions were the numerical consensus of silent voting, with case review when a decision was split. Funnel plots showing concordance between the multidisciplinary team and the local team's surgical choice (first pathway) and with outcome (final pathway) were created. Results In 105 cases the multidisciplinary team reached a consensus decision regarding the surgical pathway, with no decision in four cases because the available imaging records were inadequate. Blinded multidisciplinary team consensus for the first pathway matched the decision of the surgical center in 93/105 (89%) cases, with no difference in agreement between those that had undergone successful fetal cardiac intervention (n= 32) and no (n= 74) or unsuccessful (n= 3) valvuloplasty (no fetal cardiac intervention) (kappa = 0.73 (95% CI, 0.38-1.00) vs 0.74 (95% CI, 0.51-0.96)). However, funnel plots comparing multidisciplinary team individual decisions with those of the local teams displayed more discordance (meaning biventricular-univentricular conversion) for the final surgical pathway following fetal cardiac intervention than they did for cases without such intervention (36/74 vs 34/130; P = 0.002), and identified one outlying center. Conclusions The use of a blinded multidisciplinary team to simulate decision-making and presentation of data in funnel plots may assist in the interpretation of data submitted to multicenter studies and permit the identification of outliers for further investigation. In the case of aortic stenosis, a high level of agreement was observed between the multidisciplinary team and the surgical centers, but one outlying center was identified.
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| 9. |
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| 10. |
- Öhman, Annika, et al.
(författare)
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Occupational performance and awareness of disability in mild cognitive impairment or dementia.
- 2011
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 18:2, s. 133-142
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Tidskriftsartikel (refereegranskat)abstract
- Limited awareness of disabilities is common in mild cognitive impairment and dementia. In order to get a broader base in planning interventions, it is important to consider a person's awareness of his/her disability encountered in performance. The aim of this study was to examine the relationship between occupational performance and awareness of disability in older adults with mild cognitive impairment or dementia. Thirty-five older adults were evaluated with the AMPS (Assessment of Motor and Process Skills) and with the AAD (Assessment of Awareness of Disability). Many-faceted Rasch models generated individual measures of ADL performance and awareness of disability. Non-parametric correlation statistics were used to analyse the relationships. The findings showed that there was an overall positive relationship between occupational performance and awareness of disability. However, individual variations in the sample implied that limitations in performance were not equivalent to a limited awareness of disability. In conclusion, awareness of disability should be individually evaluated when planning interventions together with clients and their families.Read More: http://informahealthcare.com/doi/abs/10.3109/11038121003645993
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