| 1. |
- Krischer, Jeffrey P, et al.
(författare)
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Predicting Islet Cell Autoimmunity and Type 1 Diabetes : An 8-Year TEDDY Study Progress Report
- 2019
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Ingår i: Diabetes Care. - : American Diabetes Association. - 1935-5548 .- 0149-5992. ; 42:6, s. 1051-1060
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Assessment of the predictive power of The Environmental Determinants of Diabetes in the Young (TEDDY)-identified risk factors for islet autoimmunity (IA), the type of autoantibody appearing first, and type 1 diabetes (T1D).RESEARCH DESIGN AND METHODS: A total of 7,777 children were followed from birth to a median of 9.1 years of age for the development of islet autoantibodies and progression to T1D. Time-dependent sensitivity, specificity, and receiver operating characteristic (ROC) curves were calculated to provide estimates of their individual and collective ability to predict IA and T1D.RESULTS: HLA genotype (DR3/4 vs. others) was the best predictor for IA (Youden's index J = 0.117) and single nucleotide polymorphism rs2476601, in PTPN22, was the best predictor for insulin autoantibodies (IAA) appearing first (IAA-first) (J = 0.123). For GAD autoantibodies (GADA)-first, weight at 1 year was the best predictor (J = 0.114). In a multivariate model, the area under the ROC curve (AUC) was 0.678 (95% CI 0.655, 0.701), 0.707 (95% CI 0.676, 0.739), and 0.686 (95% CI 0.651, 0.722) for IA, IAA-first, and GADA-first, respectively, at 6 years. The AUC of the prediction model for T1D at 3 years after the appearance of multiple autoantibodies reached 0.706 (95% CI 0.649, 0.762).CONCLUSIONS: Prediction modeling statistics are valuable tools, when applied in a time-until-event setting, to evaluate the ability of risk factors to discriminate between those who will and those who will not get disease. Although significantly associated with IA and T1D, the TEDDY risk factors individually contribute little to prediction. However, in combination, these factors increased IA and T1D prediction substantially.
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| 2. |
- Johnson, Randi K., et al.
(författare)
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Metabolite-related dietary patterns and the development of islet autoimmunity
- 2019
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- The role of diet in type 1 diabetes development is poorly understood. Metabolites, which reflect dietary response, may help elucidate this role. We explored metabolomics and lipidomics differences between 352 cases of islet autoimmunity (IA) and controls in the TEDDY (The Environmental Determinants of Diabetes in the Young) study. We created dietary patterns reflecting pre-IA metabolite differences between groups and examined their association with IA. Secondary outcomes included IA cases positive for multiple autoantibodies (mAb+). The association of 853 plasma metabolites with outcomes was tested at seroconversion to IA, just prior to seroconversion, and during infancy. Key compounds in enriched metabolite sets were used to create dietary patterns reflecting metabolite composition, which were then tested for association with outcomes in the nested case-control subset and the full TEDDY cohort. Unsaturated phosphatidylcholines, sphingomyelins, phosphatidylethanolamines, glucosylceramides, and phospholipid ethers in infancy were inversely associated with mAb+ risk, while dicarboxylic acids were associated with an increased risk. An infancy dietary pattern representing higher levels of unsaturated phosphatidylcholines and phospholipid ethers, and lower sphingomyelins was protective for mAb+ in the nested case-control study only. Characterization of this high-risk infant metabolomics profile may help shape the future of early diagnosis or prevention efforts. © 2019, The Author(s).
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| 3. |
- Lundgren, Markus, et al.
(författare)
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Analgesic antipyretic use among young children in the TEDDY study : No association with islet autoimmunity
- 2017
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of analgesic antipyretics (ANAP) in children have long been a matter of controversy. Data on their practical use on an individual level has, however, been scarce. There are indications of possible effects on glucose homeostasis and immune function related to the use of ANAP. The aim of this study was to analyze patterns of analgesic antipyretic use across the clinical centers of The Environmental Determinants of Diabetes in the Young (TEDDY) prospective cohort study and test if ANAP use was a risk factor for islet autoimmunity. Methods: Data were collected for 8542 children in the first 2.5 years of life. Incidence was analyzed using logistic regression with country and first child status as independent variables. Holm's procedure was used to adjust for multiplicity of intercountry comparisons. Time to autoantibody seroconversion was analyzed using a Cox proportional hazards model with cumulative analgesic use as primary time dependent covariate of interest. For each categorization, a generalized estimating equation (GEE) approach was used. Results: Higher prevalence of ANAP use was found in the U.S. (95.7%) and Sweden (94.8%) compared to Finland (78.1%) and Germany (80.2%). First-born children were more commonly given acetaminophen (OR 1.26; 95% CI 1.07, 1.49; p = 0.007) but less commonly Non-Steroidal Anti-inflammatory Drugs (NSAID) (OR 0.86; 95% CI 0.78, 0.95; p = 0.002). Acetaminophen and NSAID use in the absence of fever and infection was more prevalent in the U.S. (40.4%; 26.3% of doses) compared to Sweden, Finland and Germany (p < 0.001). Acetaminophen or NSAID use before age 2.5 years did not predict development of islet autoimmunity by age 6 years (HR 1.02, 95% CI 0.99-1.09; p = 0.27). In a sub-analysis, acetaminophen use in children with fever weakly predicted development of islet autoimmunity by age 3 years (HR 1.05; 95% CI 1.01-1.09; p = 0.024). Conclusions: ANAP use in young children is not a risk factor for seroconversion by age 6 years. Use of ANAP is widespread in young children, and significantly higher in the U.S. compared to other study sites, where use is common also in absence of fever and infection.
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| 4. |
- Bagger, Anette, 1974-
(författare)
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Prövningen av en skola för alla : nationella provet i matematik i det tredje skolåret
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis presents the contribution to research that my doctoral education led to. My starting point was a large scale qualitative research project (here after called the VR-project) which reviewed the implementation of national tests in the third grade on the subject of mathematics. The VR-project investigated how the test affected the pupils with a special focus on pupils in need of special support. An urge to look further into issues concerning the support, the pupil in need and the test was revealed in he initial VR-project. These issues therefore constitutes the problem area of this thesis. The VR-project studied a total of 22 classrooms in two different municipalities' during 2010- 2012. The methodology used for this project was inspired by ethnography and discourse analysis. The raw data consisted of test instructions, video observations of the actual test subjects, interviews from teachers and pupils about the test, the support that was given throughout the testing as well as the observations and interviews of the pupils requiring special assistance. Activated discourses and positions of the participants were demarcated. The results revealed that a traditional testing discourse, a caring discourse and a competitive discourse are activated during the tests. The testing discourse is stable and traditional. Much of what was shown and said in classrooms, routines and rules regarding the test were repeated in all the schools and in all the classrooms. The discourse on support is affected by ambiguity, which is revealed especially when issues of pupils’ equity is put against the tests equality. This is connected to the teachers restricted agency to give support due to the teacher position as a test taker. The positions in need that are available to students are not the same in pupils, teachers and steering documents. The situation is especially troublesome for pupils that do not manage Swedish good enough to take the test and for pupils in need of special support. Some of the conclusions from this thesis is that the national test format: Disciplines not only the pupil, but also the teacher, the classroom and the school at large. Results indicate that the test:Activates a focus on achievementLeads attention away from learning Activates issues of accountability Influences pupils and teachers with stakes involvedBesides evaluating knowledge, the test disciplines not only the pupil, but also the teacher, the classroom and the school at large. Discussing the national test as an arena for equity might be a way towards attaining equality in education for all pupils.
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| 5. |
- Duarte-Salles, Talita, et al.
(författare)
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Dietary fat, fat subtypes and hepatocellular carcinoma in a large European cohort
- 2015
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Ingår i: International Journal of Cancer. - : Wiley-Blackwell. - 0020-7136 .- 1097-0215. ; 137:11, s. 2715-2728
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Tidskriftsartikel (refereegranskat)abstract
- The role of amount and type of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) is poorly understood, despite suggestive biological plausibility. The associations of total fat, fat subtypes and fat sources with HCC incidence were investigated in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, which includes 191 incident HCC cases diagnosed between 1992 and 2010. Diet was assessed by country-specific, validated dietary questionnaires. A single 24-hr diet recall from a cohort subsample was used for measurement error calibration. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated from Cox proportional hazard models. Hepatitis B and C viruses (HBV/HCV) status and biomarkers of liver function were assessed separately in a nested case-control subset with available blood samples (HCC = 122). In multivariable calibrated models, there was a statistically significant inverse association between total fat intake and risk of HCC (per 10 g/day, HR = 0.80, 95% CI: 0.65-0.99), which was mainly driven by monounsaturated fats (per 5 g/day, HR = 0.71, 95% CI: 0.55-0.92) rather than polyunsaturated fats (per 5 g/day, HR = 0.92, 95% CI: 0.68-1.25). There was no association between saturated fats (HR = 1.08, 95% CI: 0.88-1.34) and HCC risk. The ratio of polyunsaturated/monounsaturated fats to saturated fats was not significantly associated with HCC risk (per 0.2 point, HR = 0.86, 95% CI: 0.73-1.01). Restriction of analyses to HBV/HCV free participants or adjustment for liver function did not substantially alter the findings. In this large prospective European cohort, higher consumption of monounsaturated fats is associated with lower HCC risk.
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| 6. |
- Haghighi, Mona, et al.
(författare)
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A Comparison of Rule-based Analysis with Regression Methods in Understanding the Risk Factors for Study Withdrawal in a Pediatric Study
- 2016
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Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Regression models are extensively used in many epidemiological studies to understand the linkage between specific outcomes of interest and their risk factors. However, regression models in general examine the average effects of the risk factors and ignore subgroups with different risk profiles. As a result, interventions are often geared towards the average member of the population, without consideration of the special health needs of different subgroups within the population. This paper demonstrates the value of using rule-based analysis methods that can identify subgroups with heterogeneous risk profiles in a population without imposing assumptions on the subgroups or method. The rules define the risk pattern of subsets of individuals by not only considering the interactions between the risk factors but also their ranges. We compared the rule-based analysis results with the results from a logistic regression model in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Both methods detected a similar suite of risk factors, but the rule-based analysis was superior at detecting multiple interactions between the risk factors that characterize the subgroups. A further investigation of the particular characteristics of each subgroup may detect the special health needs of the subgroup and lead to tailored interventions.
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| 7. |
- Huusko, Linda, et al.
(författare)
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First-Time Fathers´ Experience of Support from Midwives in Maternity Clinics : An Interview Study
- 2018
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437.
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Tidskriftsartikel (refereegranskat)abstract
- Background.Research shows that first-time fathers want to take part in preparation for birth and parenthood but they describe being excluded by health professionals. Aim. The aim of this study was to illustrate first-time fathers' experiences of support from midwives in maternity clinics as a step in the validation of "The Father Perceived-Professional-Support" (The FaPPS) scale.Methods.A qualitative content analysis with an inductive and deductive approach was used; seven first-time fathers were strategically selected and interviewed. In the inductive part the following open question was asked: "How did you perceive the support from the antenatal midwife/midwives?" In the deductive part, the fathers were asked to respond to the FaPPS scale, in order to receive their thoughts and understanding of the scale, inspired by the "Think-aloud" method. Findings. The inductive results showed two main categories: Experience of not knowing what support they needed and Experience of being excluded. The fathers found support from other fathers in parental education classes, but they lack time to discuss. Overall it seems as if the fathers answered both from their own perspective and from the mothers' perspective. This was not evident in the deductive results. The FaPPs scale should therefore include professionals' ability to strengthen social support from other first-time fathers and professionals' ability to offer support to the mother.Conclusion and Clinical Implications.The fathers experienced exclusion both by themselves and also by midwives. Midwives should offer both parents the opportunity to pose questions. It is important for expectant fathers that time for discussion is planned in parental education classes. The FaPPS scale is useful but needs further development. Parts of our result are in line with earlier research, for decades; therefore it is necessary to focus more on support for fathers.
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| 8. |
- Nyroos, Mikaela, 1973-, et al.
(författare)
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Cultural and Gender Differences in Experiences and Expression of Test Anxiety Among Chinese, Finnish, and Swedish Grade 3 Pupils
- 2015
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Ingår i: International Journal of School & Educational Psychology. - : Routledge. - 2168-3603 .- 2168-3611. ; 3:1, s. 37-48
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Tidskriftsartikel (refereegranskat)abstract
- While test anxiety has been studied extensively, little consideration has been given to the cultural impacts of children's experiences and expressions of test anxiety. The aim of this work was to examine whether variance in test anxiety scores can be predicted based on gender and cultural setting. Three hundred and ninety-eight pupils in Grade 3 in China, Finland, and Sweden, each of which has different testing realities, completed the Children's Test Anxiety Scale (CTAS). Exploratory structural equation modeling (ESEM) results indicated that the Chinese sample scored more highly on the autonomic reactions component, whereas the Nordic sample scored higher on the off-task behaviors component. Significant interaction effects between gender and culture were also observed: The Nordic girls exhibited higher levels of autonomic reactions, but the opposite was seen in the Chinese sample, with boys reporting higher levels of the cognitive component. The conceptualization of test anxiety encompassing the off-task behaviors component does not appear to be universal for children. It is also suggested that gender differences vary as a function of culture.
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| 9. |
- Silfver, Eva, 1958-, et al.
(författare)
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An 'appropriate' test taker : the everyday classroom during the national testing period in school year three in Sweden
- 2016
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Ingår i: Ethnography and Education. - : Routledge. - 1745-7823 .- 1745-7831. ; 11:3, s. 237-252
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Tidskriftsartikel (refereegranskat)abstract
- This article draws on data from a bigger project where we explore what is taking place in the daily life of classrooms during the national testing period in mathematics for nine- to ten-year-old children in Sweden. Data was produced by observations, video-recordings, and interviews with children. The article shows on a micro level how assessment trends, on a macro level, affect children. It further focuses how children through different repertoires of time position themselves as 'appropriate' test takers.
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| 10. |
- Sjöberg, Gunnar, 1958-, et al.
(författare)
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Disciplined by tests
- 2015
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Ingår i: Nordisk matematikkdidaktikk, NOMAD. - Göteborg : Nationellt centrum för matematikutbildning (NCM). - 1104-2176. ; 20:1, s. 55-75
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Tidskriftsartikel (refereegranskat)abstract
- This article reports on a Swedish research project on the reintroduction of national tests in mathematics for nine- to ten-year-old pupils. Data were collected over a period of three years (2010-2012) by video recording test situations in different classrooms and by conducting video-stimulated recall interviews with children. The aim is to explore and analyse the testing situation and how it creates different positions for children. We conclude that discourses of testing, caring and competition, sometimes strengthening and sometimes shadowing each other and thereby, produce knowledge in children about success and failure in mathematics, positioning children as ‘winners’ or ‘losers’. The tests are interpreted as a technology – a form of disciplinary power that functions at the level of the body (Foucault, 1980).
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