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| 2. |
- Heikkinen, Satu, et al.
(författare)
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Åtgärder för äldre bilförare : effekter på trafiksäkerhet och mobilitet
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten beskrivs och värderas trafiksäkerhetsåtgärder för äldre bilförare i Norge. Med hjälp av litteratursökningar (publikationer från år 2000 och senare) togs en översikt fram av åtgärder riktade mot såväl förare, fordon som väg- och trafikmiljö. En detaljerad beskrivning av tester som äldre själva kan använda för att bedöma sin egen förmåga och behov av eventuellt stöd presenteras också. I nästa steg värderades och diskuterades åtgärdernas effekter på trafiksäkerhet, mobilitet och säker mobilitet. Ävenåtgärdernas genomförbarhet i Norge beaktades.De åtgärder som utkristalliserades som trafiksäkerhetsfrämjande för äldre bilförare samtidigt som de intepåverkade mobiliteten på ett negativt sätt, var följande sju, utan inbördes rangordning:Det befintliga systemet i Norge med läkarintyg från och med 70 års ålder för personbilsförare börutvärderasDet befintliga systemet i Norge med begränsade körkort bör utvärderasUtbildning för äldre bilförare bör fortsätta och området utvecklas för att nå bättre effekterEgentester bör införas stegvis och denna användning bör evaluerasFramtagning och spridning av råd till äldre om att välja bil och utrustning bör stimulerasSeparat signalfas för vänstersvängande fordon bör om möjligt införas i signalregleradekorsningar, eventuellt kompletterad med ett separat körfältKomplexa korsningar utan signalreglering bör om möjligt byggas om till cirkulationsplatser
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| 3. |
- Henriksson, Per, 1965-, et al.
(författare)
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Challenging situations, self-reported driving habits and capacity among older drivers (70+) in Sweden : a questionnaire study
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the survey study in Sweden was to investigate health issues, driving habits and use of a car. The researchers were also interested in which traffic situations were judged as difficult or dangerous, avoidance strategies adopted for such situations, type of car used, equipment (ADAS systems) and its frequency of use. Respondents were asked to report any accidents in the previous two years, and to self-estimate their cognitive functioning and driving ability. Target population: Persons born in 1941 or earlier (aged 70 years or more in the year 2011), living in the county of Västra Götaland in Sweden, holder of a driving licence for category B, passenger car and still driving. This resulted in a target group comprising 1,362 active drivers. The overall picture of an older driver emerging from this study is one who enjoys car driving, uses the car often and is not particularly occupied by thoughts about stopping driving. Possible bias in this picture of older drivers may be due to the fact that those most interested in car driving were also those most interested in the study and thus in answering the questionnaire. There are several “truths” about older drivers reported in the literature that are questionable in the light of the present study. It is sometimes said that older people drive old cars, but this phenomenon is not supported by the questionnaire data in our study. The changes in driving behaviour often attributed to ageing drivers, e.g. driving more slowly, less frequently and over shorter distances, are applicable in the case of about one-third of the drivers in the present study. Analyses of this study confirm that health status is not the only reason someone stops driving; being less confident/apprehensive in the context of car driving may result in driving cessation. Findings indicate that preventive action, such as retraining sessions or developing driver assistance systems, will have to be taken into account if the risk associated with certain situations is to be reduced.
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- Malmström, Annika, et al.
(författare)
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Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial
- 2012
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Ingår i: The Lancet Oncology. - : Elsevier. - 1470-2045 .- 1474-5488. ; 13:9, s. 916-926
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Tidskriftsartikel (refereegranskat)abstract
- Background Most patients with glioblastoma are older than 60 years, but treatment guidelines are based on trials in patients aged only up to 70 years. We did a randomised trial to assess the optimum palliative treatment in patients aged 60 years and older with glioblastoma. less thanbrgreater than less thanbrgreater thanMethods Patients with newly diagnosed glioblastoma were recruited from Austria, Denmark, France, Norway, Sweden, Switzerland, and Turkey. They were assigned by a computer-generated randomisation schedule, stratified by centre, to receive temozolomide (200 mg/m(2) on days 1-5 of every 28 days for up to six cycles), hypofractionated radiotherapy (34.0 Gy administered in 3.4 Gy fractions over 2 weeks), or standard radiotherapy (60.0 Gy administered in 2.0 Gy fractions over 6 weeks). Patients and study staff were aware of treatment assignment. The primary endpoint was overall survival. Analyses were done by intention to treat. This trial is registered, number ISRCTN81470623. less thanbrgreater than less thanbrgreater thanFindings 342 patients were enrolled, of whom 291 were randomised across three treatment groups (temozolomide n=93, hypofractionated radiotherapy n=98, standard radiotherapy n=100) and 51 of whom were randomised across only two groups (temozolomide n=26, hypofractionated radiotherapy n=25). In the three-group randomisation, in comparison with standard radiotherapy, median overall survival was significantly longer with temozolomide (8.3 months [95% CI 7.1-9.5; n=93] vs 6.0 months [95% CI 5.1-6.8; n=100], hazard ratio [HR] 0.70; 95% CI 0.52-0.93, p=0.01), but not with hypofractionated radiotherapy (7.5 months [6.5-8.6; n=98], HR 0.85 [0.64-1.12], p=0.24). For all patients who received temozolomide or hypofractionated radiotherapy (n=242) overall survival was similar (8.4 months [7.3-9.4; n=119] vs 7.4 months [6.4-8.4; n=123]; HR 0.82, 95% CI 0.63-1.06; p=0.12). For age older than 70 years, survival was better with temozolomide and with hypofractionated radiotherapy than with standard radiotherapy (HR for temozolomide vs standard radiotherapy 0.35 [0.21-0.56], pandlt;0.0001; HR for hypofractionated vs standard radiotherapy 0.59 [95% CI 0.37-0.93], p=0.02). Patients treated with temozolomide who had tumour MGMT promoter methylation had significantly longer survival than those without MGMT promoter methylation (9.7 months [95% CI 8.0-11.4] vs 6.8 months [5.9-7.7]; HR 0.56 [95% CI 0.34-0.93], p=0.02), but no difference was noted between those with methylated and unmethylated MGMT promoter treated with radiotherapy (HR 0.97 [95% CI 0.69-1.38]; p=0.81). As expected, the most common grade 3-4 adverse events in the temozolomide group were neutropenia (n=12) and thrombocytopenia (n=18). Grade 3-5 infections in all randomisation groups were reported in 18 patients. Two patients had fatal infections (one in the temozolomide group and one in the standard radiotherapy group) and one in the temozolomide group with grade 2 thrombocytopenia died from complications after surgery for a gastrointestinal bleed. less thanbrgreater than less thanbrgreater thanInterpretation Standard radiotherapy was associated with poor outcomes, especially in patients older than 70 years. Both temozolomide and hypofractionated radiotherapy should be considered as standard treatment options in elderly patients with glioblastoma. MGMT promoter methylation status might be a useful predictive marker for benefit from temozolomide.
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| 5. |
- Suzuki, Nobuyuki, 1971, et al.
(författare)
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Physical exercise affects cell proliferation in lumbar intervertebral disc regions in rats
- 2012
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Ingår i: Spine. - 0362-2436. ; 37:17, s. 1440-1447
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. Descriptive experimental study.Objective. The aim of this study was to investigate the effect of exercise on cell proliferation in different areas of the IVD and recruitment of cells possibly active in regeneration of normal rat lumbar IVDs.Summary of Background Data. Little is known about the effects of physical exercise on lumbar intervertebral disc (IVD) tissue. Recently, stem cell niches in the perichondrium area of the IVD were identified and cells in these niches have been suggested to be involved in the normal regeneration of the IVD.Methods. Thirty Sprague-Dawley rats were exposed to 5-bromo-2-deoxyuridine (BrdU) diluted in the drinking water during 14 days. Fifteen rats ran on a treadmill daily for 50 min/day, 5 days/week (exercise group) and 15 non-exercised rats served as controls. Immunohistochemical analyses (anti-BrdU antibody) were performed at 9, 14, 28, 56 and 105 days after the start of the exercise protocol. BrdU positive cells were counted in the stem cell niche area (SN), peripheral region of epiphyseal cartilage area (pEC), the annulus fibrous outer and inner area (AFo and AFi). Data were analyzed by two-way ANOVA (significance level; p<0.05).Results. The BrdU positive cell numbers in the SN and AFo region were increased in discs from the exercising group on days 14 (p<0.01) and 105 (p<0.05) and at day 14 (p<0.01) in the pEC region as compared to controls.Conclusions. Physical exercise was shown to have positive effects on cell proliferation in intervertebral discs with involvement of various disc regions, indicating a differential response by disc tissue to exercise depending on anatomical location and tissue characteristics.
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| 7. |
- Vestergren, Peter, 1974-
(författare)
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On the subjective–objective distinction for measures of memory and cognition : Theoretical and methodological issues in questionnaire development and validation
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to develop a questionnaire for cognitive functioning, which could possibly be used as a screening instrument for early signs of dementia in the future. The introduction discusses the often made distinction between subjective and objective measures. A background to the four articles is provided, focussing on findings of weak relationships between self-report- and laboratory measures of memory/cognition. Studies I and II provided results and conclusions that guided instrument development and validation in Studies III and IV. All studies were based on data from participants in the Betula Prospective Cohort Study. Study I investigated predictors of scores on an established self-report instrument for memory failures (PRMQ). Candidate predictors were memory performance on laboratory tests, age, depressive symptoms, and personality traits. There was no relation to age, and test performance did not predict self-reported memory, but depressive symptoms and personality did. Given the finding of a lack of a relation to age, and a bulk of research articles claiming that memory complaints are common in the elderly or increase with age, Study II used a global rating of problems with memory, and reports of perceived causes. In contrast to Study I, problems ratings were related to age, such that increasing age meant higher severity of problems. Furthermore, perceived causes of memory problems differed across age. The elderly reported aging while the young reported stress and multitasking as primary causes. With these results as a background, the purpose of Study III was to develop a new instrument (the Cognitive Dysfunction Questionnaire - CDQ) with the explicit aim that scores should be related to laboratory test performance. A global construct of cognitive functioning with an emphasis on memory systems was adopted, and an item pool was generated. Based on exploratory principal components analysis and correlations with criterion measures (laboratory test performance), twenty items in six domains were selected. Preliminary psychometric evidence showed that the CDQ was reliable, and related to age and objective measures, but not to depressive symptoms. In Study IV, twenty additional items were constructed, and the CDQ was responded to by participants in independent samples. Confirmatory factor analysis was used to test the factor structure derived from Study III, and refinement was undertaken by collapse of two domains and exclusion of items. The final factor structure was cross-validated. Competing models and measurement invariance across age and sex was tested. Psychometric properties were investigated for the final 20-item version.
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| 8. |
- Wichardt, Emma, et al.
(författare)
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Rhabdomyolysis/myoglobinemia and NSAID during 48-hours ultra-endurance exercise (adventure racing)
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer Science and Business Media LLC. - 1439-6319 .- 1439-6327. ; 111:7, s. 1541-1544
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine if rhabdomyolysis with myoglobinemia exists during a 48+ hour adventure race and if there is a correlation with NSAID use, race time and perceived pain or exertion. Method: Blood samples for analyses of myoglobin (Mb) were collected, and perception of exertion and pain registered on the Borg-RPE and CR scales, from 20 subjects (3 female, 17 male) Pre, Mid and Post race. Subjects were asked about NSAID use at each sampling and within 12 hours pre race. Result: A significant rise in Mb was observed throughout the race, with the NSAID group (n=6) having significantly lower Mb-Post than the no-NSAID group (n=14). High Mb-Pre and Post correlated to shorter race time and high Mb-Pre to lower Pain-Post. Race time also correlated to NSAID use, with the NSAID group having significantly longer race time than the no-NSAID group. Conclusion: Rhabdomyolysis with myoglobinemia, which might be reduced with NSAID use, exists during a 48+ hour adventure race. Indications that high Mb-levels correlate with shorter race time and less pain, and the reasons for the NSAID groups longer race time, need further investigation.
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