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- Corazzini, Kirsten N., et al.
(författare)
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Toward Common Data Elements for International Research in Long-term Care Homes : Advancing Person-Centered Care
- 2019
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Ingår i: Journal of the American Medical Directors Association. - : Elsevier. - 1525-8610 .- 1538-9375. ; 20:5, s. 598-603
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Tidskriftsartikel (refereegranskat)abstract
- To support person-centered, residential long-term care internationally, a consortium of researchers in medicine, nursing, behavioral, and social sciences from 21 geographically and economically diverse countries have launched the WE-THRIVE consortium to develop a common data infrastructure. WE-THRIVE aims to identify measurement domains that are internationally relevant, including in low-, middle-, and high-income countries, prioritize concepts to operationalize domains, and specify a set of data elements to measure concepts that can be used across studies for data sharing and comparisons. This article reports findings from consortium meetings at the 2016 meeting of the Gerontological Society of America and the 2017 meeting of the International Association of Gerontology and Geriatrics, to identify domains and prioritize concepts, following best practices to identify common data elements (CDEs) that were developed through the US National Institutes of Health/National Institute of Nursing Research's CDEs initiative. Four domains were identified, including organizational context, workforce and staffing, person-centered care, and care outcomes. Using a nominal group process, WE-THRIVE prioritized 21 concepts across the 4 domains. Several concepts showed similarity to existing measurement structures, whereas others differed. Conceptual similarity (convergence; eg, concepts in the care outcomes domain of functional level and harm-free care) provides further support of the critical foundational work in LTC measurement endorsed and implemented by regulatory bodies. Different concepts (divergence; eg, concepts in the person-centered care domain of knowing the person and what matters most to the person) highlights current gaps in measurement efforts and is consistent with WE-THRIVE's focus on supporting resilience and thriving for residents, family, and staff. In alignment with the World Health Organization's call for comparative measurement work for health systems change, WE-THRIVE's work to date highlights the benefits of engaging with diverse LTC researchers, including those in low-, middle-, and high-income countries, to develop a measurement infrastructure that integrates the aspirations of person-centered LTC.
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- Joffe, Roberts, et al.
(författare)
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Analysis of single fiber fragmentation data
- 1995
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Ingår i: Deformation and fracture of composites : 3rd International conference. - London : Institute of metals. ; , s. 126-131
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Konferensbidrag (refereegranskat)
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3. |
- Margulis, Walter
(författare)
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Glowing fabrics communicate
- 2018
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Ingår i: Nature. - : NATURE PUBLISHING GROUP. - 0028-0836 .- 1476-4687. ; 560:7717, s. 170-171
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Yacamán Méndez, Diego
(författare)
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Risk factor patterns in type 2 diabetes and cardiovascular disease : exploring methods for precision medicine in public health
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Non-communicable diseases, including type 2 diabetes and cardiovascular disease, are leading contributors to the global burden of disease and an important public health challenge. At an individual level, there is important variability in the risk of these conditions. However, public health interventions often adopt a generalized one-size-fits-all approach. The overall aim of this thesis was to explore the utility of a precision medicine approach to public health and epidemiology, by applying different analytical methods to classify individuals into similar sub-populations based on their individual level characteristics. In study I, I investigated the patterns of weight changes from childhood to early adulthood and how they relate to the occurrence of type 2 diabetes later in life. The results indicate that exposure to overweight/obesity during early adulthood explains a large proportion of the cases of type 2 diabetes, highlighting the importance of public health interventions during this period. In study II, I used different methods for mediation analysis to study the importance of different mechanisms linking low socioeconomic status and type 2 diabetes. The findings show that around 50% of the association between socioeconomic status and type 2 diabetes could be reduced if unhealthy behaviors and metabolic exposures were removed. Interestingly, the results were similar across the different mediation methods. Finally, in studies III and IV, I used data-driven methods to identify sub-groups of healthy adults based on simple clinical characteristics and laboratory values. The findings show that this method was equally effective, or even better, than those commonly used in clinical practice, and could improve the way we define who is at high risk of type 2 diabetes or cardiovascular disease. In conclusion, these studies provide evidence that precision medicine can be a useful approach to guide development and implementation of public health interventions.
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- Bylander, Lars, et al.
(författare)
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SCALE : A Scaleable Wire Boom System
- 2002
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Ingår i: Smaller Satellites. - Dordrecht : Springer Netherlands. - 9789048159062 - 9789401730082 ; , s. 355-356
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The SCALE wire boom is a compact wire boom unit designed mainly for scientific spin-stabilized satellites. The boom unit provides storage and deployment of a wire boom (length 5–50 m) and a probe (diameter up to about 100 mm). The wire is both a boom and a supplier of the electrical connections between the probe at the end of the wire and the experiment unit in the spacecraft body. The SCALE wire boom is unique because its volume and weight are scaleable with respect to the required boom length and probe diameter.
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- Shukur, Hasanain
(författare)
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Comorbidity and mortality in Prader-Willi syndrome
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Prader-Willi syndrome (PWS) is a multisymptomatic, rare, genetic, disorder, due to lack of the expression of paternal genes in the q11-q13 region of chromosome 15. The main characteristics of PWS are muscular hypotonia, hyperphagia, obesity, behavioral problems, cognitive disabilities, and endocrine deficiencies. Comorbidities, are frequent, including sleep apnea. Mortality rate is high, and life expectancy short. The aim of this thesis was to further describe comorbidity, use of medication and mortality in PWS, and to evaluate long-term cortisol exposure and the effects of GH treatment on respiratory parameters. Methods: Data of comorbidity, mortality and use of drugs were retrieved from Swedish National registers and categorized into groups and subgroups (study 1). Long-term cortisol exposure was assessed in hair in adults with PWS and age and sex matched controls, and related to responses to questionnaires on health and medication (study 2). The effect of GH treatment on polysomnographic measurements were evaluated in 12 months randomized, placebocontrolled GH trial, followed by a two-year open phase GH treatment period (study 3). Results: In 411 patients, 37658 comorbidity diagnoses were registered, and in 365 patients, 83629 different drug prescriptions. Many codes were unspecific, but mental and behavioral problems and corresponding prescriptions were the most common; followed by diabetes, and antidiabetic treatments. The most common cause of death (n=144, mean age 24,7 years, (SD 17,4) range 0 months to 67 years, 61% males), were unspecific (34%) cardiovascular (23%), and endocrine (diabetes and obesity complications) (13,9%) (study 1). Hair cortisol in patients with PWS (n=29) was higher (12.8±25.4 pg/mg) than in controls (n=105) (3.8±7.3 pg/mg), and increased with BMI and reported stress (study 2). In the GH treatment trial apnea-hypopnea index (AHI) was 1.4 (0.0-13.9). No differences in sleep or respiratory parameters were seen between GH and placebo treated patients. The sleep efficiency improved throughout the study, independent of BMI. AHI inconsistently increased within normal range (study 3). Conclusion: The pattern of comorbidity, mortality and prescribed drugs confirmed the multisymptomatic character of the syndrome. The high frequency of unspecific codes for comorbidity and mortality could indicate undetected hypocortisolism, but the long-term cortisol exposure suggested an adequate cortisol response to chronic stress. No clinically significantly negative impact of GH treatment on respiration was seen. The increased morbidity and mortality were mainly related to diseases secondary to obesity, which underscore the need for continued and intensified efforts to prevent obesity in this vulnerable group.
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