| 1. |
- Agardh, D., et al.
(författare)
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Antibodies against neo-epitope of microbial and human transglutaminase complexes as biomarkers of childhood celiac disease
- 2020
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Ingår i: Clinical and Experimental Immunology. - : Oxford University Press (OUP). - 0009-9104 .- 1365-2249. ; 199:3, s. 294-302
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Tidskriftsartikel (refereegranskat)abstract
- Tissue transglutaminase (tTG) and microbial transglutaminase (mTG) cross-link gliadins to form complexes that expose immunogenic neo-epitopes to produce tTG and mTG-neo-epitope antibodies. The aim of this study was to test the diagnostic performance of antibodies against non-complexed and complexed forms of transglutaminases, to correlate their activities to the intestinal damage and to explore age group dependency in celiac disease (CD). A total of 296 children with untreated CD and 215 non-celiac disease controls were checked by in-house enzyme-linked immunosorbent assays detecting immunoglobulin (Ig)A, IgG or combined detection of IgA and IgG (check) against tTG, AESKULISA® tTG New Generation (tTG-neo) and mTG-neo (RUO), IgA and IgG antibodies against deamidated gliadin peptide (DGP) and human IgA anti-endomysium antibodies (EMA) using AESKUSLIDES® EMA. Intestinal pathology was graded according the revised Marsh criteria, and age dependencies of the antibody activities were analysed. Using cut-offs estimated from receiver operating characteristic (ROC) curves, the highest area under curve (AUC) of the TG assays was 0·963 for tTG-neo check, followed by tTG check (0·962) when the diagnosis was based on enteric mucosal histology. tTG-neo check was the most effective to reflect the intestinal abnormalities in CD (r = 0·795, P < 0·0001). High levels of anti-mTG-neo IgG and anti-tTG-neo IgG appeared in the earlier age groups, as compared to anti-tTG IgG (P < 0·001). Considering antibody diagnostic performance based on AUC, enteric damage reflection and predictability at an early age, the anti-neo tTG check was the most effective diagnostic biomarker for pediatric CD. The mTG neo check might represent a new marker for CD screening, diagnosis and predictability.
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| 2. |
- Alam, M., et al.
(författare)
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An osteopontin-derived peptide inhibits human hair growth at least in part by decreasing fibroblast growth factor-7 production in outer root sheath keratinocytes
- 2020
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 182:6, s. 1404-1414
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Tidskriftsartikel (refereegranskat)abstract
- Background: Given that unwanted hair growth (hirsutism, hypertrichosis) can cause major psychological distress, new pharmacological treatment strategies with safe and effective hair growth inhibitors that do not destroy the hair follicle (HF) and its stem cells need to be developed. Objectives: To establish if osteopontin-derived fragments may modulate human hair growth given that human HFs express the multifunctional, immunomodulatory glycoprotein, osteopontin. Methods: Our hypothesis was tested ex vivo and in vivo by using a newly generated, toxicologically well-characterized, modified osteopontin-derived peptide (FOL-005), which binds to the HF. Results: In organ-cultured human HFs and scalp skin, and in human scalp skin xenotransplants onto SCID mice, FOL-005 treatment (60 nmol L−1 to 3 μmol L−1) significantly promoted premature catagen development without reducing the number of keratin 15-positive HF stem cells or showing signs of drug toxicity. Genome-wide DNA microarray, quantitative reverse-transcriptase polymerase chain reaction and immunohistochemistry revealed decreased expression of the hair growth promoter, fibroblast growth factor-7 (FGF7) by FOL-005, while cotreatment of HFs with recombinant FGF7 partially abrogated FOL-005-induced catagen promotion. Conclusions: With caveats in mind, our study identifies this osteopontin-derived peptide as an effective, novel inhibitory principle for human hair growth ex vivo and in vivo, which deserves systematic clinical testing in hirsutism and hypertrichosis. What's already known about this topic?. The treatment of unwanted hair growth (hypertrichosis, hirsutism) lacks pharmacological intervention, with only few and often unsatisfactory treatments available. Osteopontin is prominently expressed in human HFs and has been reported to be elevated during catagen in the murine hair cycle. What does this study add?. We tested the effects on hair growth of a novel, osteopontin-derived fragment (FOL-005) ex vivo and in vivo. In human hair follicles, high-dose FOL-005 significantly reduces hair growth both ex vivo and in vivo. What is the translational message?. High-dose FOL-005 may provide a new therapeutic opportunity as a treatment for unwanted hair growth.
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| 3. |
- Angelhoff, Charlotte, medicine doktor, 1974-, et al.
(författare)
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Like Walking in a Fog : Parents' perceptions of sleep and consequences of sleep loss when staying overnight with their child in hospital
- 2020
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Ingår i: Journal of Sleep Research. - : WILEY. - 0962-1105 .- 1365-2869. ; 29:2
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Tidskriftsartikel (refereegranskat)abstract
- Disruption of parental sleep in hospital, with frequent awakenings and poor sleep quality, limits the parents resources to meet the childs needs and maintain parental wellbeing. The aim of the study was to explore and describe how parents perceive their sleep when staying overnight with their sick child in hospital. A further aim was to explore and describe parents perception of what circumstances influence their sleep in the hospital. Twenty-two parents who were accommodated with their sick child (0-17 years) in paediatric wards in Norway and Sweden participated. Interviews were conducted during the hospital stay to elicit their perspectives. Phenomenography was used to analyse data. Two descriptive categories were found: (a) "Perceptions of sleep", with two sub-categories: "Sleep in the paediatric ward" and "Consequences of sleep loss"; and (b) "Circumstances influencing sleep in the paediatric ward" with three sub-categories: "The importance of the family", "Information and routines at the paediatric ward", and "Accommodation facilities". Parents sleep and needs must be acknowledged in paediatric wards. An individual plan of care for the upcoming night could be a valuable tool for both the parents and nurses. The childs medical needs must be met with respect to the parents willingness to take part in the childs care during the night, and the need for rest and sleep for both parent and child.
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| 4. |
- Backman, Annica C., 1972-, et al.
(författare)
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Embodying person-centred being and doing : leading towards person-centred care in nursing homes as narrated by managers
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:1-2, s. 172-183
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To explore how managers describe leading towards person-centred care in Swedish nursing homes.BACKGROUND: Although a growing body of research knowledge exists highlighting the importance of leadership to promote person-centred care, studies focused on nursing home managers' own descriptions of leading their staff towards providing person-centred care is lacking.DESIGN: Descriptive interview study. COREQ guidelines have been applied.METHODS: The study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a nationwide survey of nursing homes in Sweden. Data collection was performed in April 2017, and the data were analysed using content analysis.RESULTS: Leading towards person-centred care involved a main category; embodying person-centred being and doing, with four related categories: operationalising person-centred objectives; promoting a person-centred atmosphere; maximising person-centred team potential; and optimising person-centred support structures.CONCLUSIONS: The findings revealed that leading towards person-centred care was described as having a personal understanding of the PCC concept and how to translate it into practice, and maximising the potential of and providing support to care staff, within a trustful and innovative work place. The findings also describe how managers co-ordinate several aspects of care simultaneously, such as facilitating, evaluating and refining the translation of person-centred philosophy into synchronised care actions.RELEVANCE TO CLINICAL PRACTICE: The findings can be used to inspire nursing home leaders' practices and may serve as a framework for implementing person-centred care within facilities. A reasonable implication of these findings is that if organisations are committed to person-centred care provision, care may need to be organised in a way that enables managers to be present on the units, to enact these strategies and lead person-centred care.
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| 5. |
- Bauducco, Serena, 1988-, et al.
(författare)
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Preventing sleep deficit in adolescents : Long-term effects of a quasi-experimental school-based intervention study
- 2020
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Ingår i: Journal of Sleep Research. - : Wiley-Blackwell. - 0962-1105 .- 1365-2869. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- Adolescents are at risk of sleep deficit, which has serious consequences for their daytime functioning. However, school-based interventions to improve sleep have shown limited success. This might be due to the content of the programmes (e.g., not targeting central factors such as daytime stress and technology use) or because changes have not been captured due to a lack of long-term follow-ups. Hence, the aim of this study was to evaluate the long-term effects of a school-based sleep education curriculum including time-management training. The study used a quasi-experimental design. Participants were 3,622 adolescents (mean age 13.7, 48% girls); 286 were in the intervention group and 3,336 were followed as a natural control group. Data were collected before the intervention and at a 1-year follow-up. We divided participants into three groups according to baseline sleep duration (calculated from self-reported bed- and wake times, minus sleep onset latency): insufficient (<7 hr), borderline (7-8 hr) and adequate (>8 hr). Adolescents in the intervention group were ~2 times less likely to report insufficient sleep at follow-up as compared to controls. Sleep knowledge improved significantly in the intervention group but there were no changes in emotional sleep hygiene (e.g., bedtime worry) and perceived stress. Surprisingly, technology use increased and behavioural sleep hygiene worsened in the intervention group. Although the mechanisms of change need further investigation, the results of this study point to potential long-term benefits of school-based sleep programmes.
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| 6. |
- Berg Skoog, Jessica, et al.
(författare)
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An intervention model with self-assessment and subsequent multi-professional review might be effective and feasible to improve drug safety in primary healthcare. A survey-based evaluation of SÄKLÄK2.
- 2020
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Ingår i: Journal of Evaluation in Clinical Practice. - : Wiley. - 1365-2753 .- 1356-1294. ; 26:1, s. 125-133
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims, and objectivesDrug‐related morbidity is common, which results in suffering for the patients and a high cost to society. SÄKLÄK2 is a multi‐professional intervention model aiming at improving drug safety in primary health care. The objective of this study was to elucidate the perceptions of the participants' regarding the efficiency of the intervention and the feasibility to introduce this model widely.MethodSÄKLÄK2 is a multi‐professional intervention model in primary health care in Sweden that consisted of self‐assessment, peer‐review, written feedback, and agreements for change. Web‐based surveys were sent to both the management of participating primary health care centres (PHC) and to reviewers. The participating PHCs were fairly well‐staffed and had a high interest in improvement work. Descriptive analysis and content analysis was used.ResultsFor the PHC management, the following categories were formed: Comprehensive project, Time‐consuming, Multi‐professional character, Relevant action agreements, and Feasible to implement. For the reviewers, the following categories were formed: Multi‐professional character, Relevant action agreements, Feasible to implement, Useful self‐assessment questionnaire, and Valuable visit at the PHC. There was a high degree of consistency between the PHC management and the reviewers' answers, especially regarding the efficiency of the model to improve drug safety and the feasibility to implement it on a broad front.ConclusionSÄKLÄK2, a model with self‐assessment, peer review, written feedback, and the formation of action agreements was considered by both the participating heads of the PHC centres and the reviewers to be effective to improve drug safety in primary health care. Though time‐consuming, this multi‐professional model was considered to be feasible to implement on a broad front and might thereby be one way of working with quality improvement regarding drug safety.
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| 7. |
- Blonder, Benjamin, et al.
(författare)
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Remote sensing of ploidy level in quaking aspen (Populus tremuloides Michx.)
- 2020
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Ingår i: Journal of Ecology. - : Wiley. - 0022-0477 .- 1365-2745. ; 108:1, s. 175-188
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Tidskriftsartikel (refereegranskat)abstract
- Ploidy level in plants may influence ecological functioning, demography and response to climate change. However, measuring ploidy level typically requires intensive cell or molecular methods. We map ploidy level variation in quaking aspen, a dominant North American tree species that can be diploid or triploid and that grows in spatially extensive clones. We identify the predictors and spatial scale of ploidy level variation using a combination of genetic and ground-based and airborne remote sensing methods. We show that ground-based leaf spectra and airborne canopy spectra can both classify aspen by ploidy level with a precision-recall harmonic mean of 0.75-0.95 and Cohen's kappa of c. 0.6-0.9. Ground-based bark spectra cannot classify ploidy level better than chance. We also found that diploids are more common on higher elevation and steeper sites in a network of forest plots in Colorado, and that ploidy level distribution varies at subkilometer spatial scales. Synthesis. Our proof-of-concept study shows that remote sensing of ploidy level could become feasible in this tree species. Mapping ploidy level across landscapes could provide insights into the genetic basis of species' responses to climate change.
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| 8. |
- Bosma, A. L., et al.
(författare)
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TREatment of ATopic eczema (TREAT) Registry Taskforce : protocol for a European safety study of dupilumab and other systemic therapies in patients with atopic eczema
- 2020
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 182:6, s. 1423-1429
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Tidskriftsartikel (refereegranskat)abstract
- Background: A long-term prospective observational safety study is essential to characterize fully the safety profile of systemic immunomodulating therapies for patients with atopic eczema. The TREatment of ATopic eczema (TREAT) Registry Taskforce offers a large platform to conduct such research using national registries that collect the same data using a predefined core dataset. Objectives: To present a protocol for a safety study comparing dupilumab with other systemic immunomodulating therapies in children and adults with moderate-to-severe atopic eczema, to assess the long-term safety risk of these therapies in a routine clinical care setting. Methods: We describe a registry-embedded international observational prospective cohort study. Adult and paediatric patients who start treatment with dupilumab or another systemic immunomodulating agent for their atopic eczema will be included. The primary end point is the incidence of malignancies (excluding nonmelanoma skin cancer) compared between the treatment groups. Secondary end points include other serious adverse events and adverse events of special interest, such as eye disorders and eosinophilia. Conclusions: This protocol delineates a safety study for dupilumab in adult and paediatric patients with atopic eczema, using a standardized methodological approach across several national registries. The protocol could also be used for other novel systemic immunomodulating therapies, and could provide licensing and reimbursement authorities, pharmaceutical companies and clinicians with safety evidence from a routine clinical care setting. What's already known about this topic?. There is a need for long-term data on the safety of systemic immunomodulating therapies in patients with atopic eczema. Regulatory bodies, such as the European Medicines Agency, increasingly stipulate the collection of such data as part of the licensing agreement for new treatments, to assess the new agent's long-term safety profile against established therapies. Large numbers of patients with a long duration of follow-up are necessary in order to detect rare events like malignancies. What does this study add?. The TREAT Registry Taskforce offers a platform to conduct such research with a network of multiple national atopic eczema research registries. We present a protocol for an investigator-initiated multicentre safety study comparing dupilumab with other systemic immunomodulating therapies in adults and subsequently adolescents and children with moderate-to-severe atopic eczema. This protocol can be used as a framework for similar studies for other novel systemic immunomodulating therapies across both adult and paediatric populations.
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| 9. |
- Bruze, M., et al.
(författare)
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Validation of a questionnaire algorithm based on repeated open application testing with the constituents of fragrance mix I
- 2020
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Ingår i: British Journal of Dermatology. - : Oxford University Press (OUP). - 0007-0963 .- 1365-2133. ; 182:4, s. 955-964
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Tidskriftsartikel (refereegranskat)abstract
- Background: In a European study on contact allergy in the general population, it was hypothesized that the combination of contact allergy to a fragrance together with a history indicating dermatitis at exposure, and thereafter subsequent avoidance of scented products, implied a diagnosis of allergic contact dermatitis. Objectives: The primary aim of this study was to validate this hypothesis and algorithm. The secondary aim was to investigate whether there was any association between the outcome of the repeated open application test (ROAT) and the patch test reactivity. Methods: In total, 109 patients with and without contact allergy to fragrance mix (FM) I were recruited. Volunteers from six European dermatology clinics participated in the study including a patch test and a ROAT. Results: Positive ROAT reactions were noted in 26 of the 44 volunteers with contact allergy to FM I. None of the volunteers reacted to the vehicle (P < 0·001). More individuals with a positive algorithm had positive ROATs than those with a negative algorithm. However, the difference was not statistically significant. The lower the patch test concentration eliciting a positive test reaction, the more likely a positive ROAT and the more likely that the positive ROAT appeared early during the investigative period. Conclusions: The algorithm used in this study was not substantiated in this ROAT set-up. The stronger the patch test reactivity the more likely was a positive ROAT and the more likely it was that the positive ROAT appeared early during the application period. What's already known about this topic?. To the best of our knowledge, a scientifically designed and conducted repeated open application test (ROAT) has never been performed before to validate a diagnosis of allergic contact dermatitis partly based on a questionnaire. What does this study add?. This is the largest controlled, randomized and blinded ROAT performed to date. Higher patch test reactivity to fragrance mix I indicated a greater likelihood of a positive ROAT. What are the clinical implications of this work?. Further refinement of the questions is required in order to diagnose allergic contact dermatitis from fragrances based on a questionnaire.
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| 10. |
- Carlsson, Marianne
(författare)
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Self-reported competence in female and male nursing students in the light of theories of hegemonic masculinity and femininity
- 2020
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 76:1, s. 191-198
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In most parts of the world, nursing historically has been considered an occupation for women. Gender stereotypes are associated with the nursing profession.AIM: The aim was to describe and compare the self-reported competence in female and male nursing students. The students were also compared according to their different background college educations. The theoretical framework of hegemonic masculinity and femininity was used.DESIGN: A cross-sectional design with a questionnaire was used at two points in time, 2012 and 2017.METHODS: Nursing students completed a questionnaire on graduation from a three-year university nursing program from 12 universities/university colleges in Sweden. In total, 1,810 students were participating, 1577 female and 227 male students. The Nurse Professional Competence scale was used for data collection.RESULTS: There were statistical significant differences in the self-reported competence between female and male students (t-tests and ANOVAs). These differences are in agreement with the patterns of hegemonic masculinity and femininity. Female students estimated their competence in giving value-based nursing care as higher than male did. Male students estimated their competence in development and leadership higher than female did.CONCLUSION: The pattern of hegemonic masculinity and femininity could be identified. This indicates a difference in power between female and male students.IMPACT: The study addresses the self-reported competence of female and male nursing students. The results indicated that male students possibly looked on themselves as superior to the female students. In order to change the image of nursing as a woman's work, the self-images should be discussed in nursing education as well as in college education. Women interested in development, research and leadership and men interested in nursing care and administration must feel that nursing is a suitable profession for them. The stereotypical image of nursing as a women's work is a barrier to nurses' professional development.
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| 11. |
- Christensson, E., et al.
(författare)
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Hypoxic ventilatory response after rocuronium-induced partial neuromuscular blockade in men with obstructive sleep apnoea
- 2020
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Ingår i: Anaesthesia. - : Blackwell Publishing. - 0003-2409 .- 1365-2044. ; 75:3, s. 338-347
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Tidskriftsartikel (refereegranskat)abstract
- Obstructive sleep apnoea and residual neuromuscular blockade are, independently, known to be risk factors for respiratory complications after major surgery. Residual effects of neuromuscular blocking agents are known to reduce the hypoxic ventilatory response in healthy volunteers. Patients with obstructive sleep apnoea have impaired control of breathing, but it is not known to what extent neuromuscular blocking agents interfere with the regulation of breathing in such patients. In a physiological study in 10 unsedated men with untreated obstructive sleep apnoea, we wished to examine if partial neuromuscular blockade had an effect on hypoxic ventilatory response (isocapnic hypoxia to oxygen saturation of 80%) and hypercapnic ventilatory response (normoxic inspired carbon dioxide 5%). The hypoxic ventilatory response was reduced by 32% (p = 0.016) during residual neuromuscular block (rocuronium to train-of-four ratio 0.7), but the hypercapnic ventilatory response was unaffected. We conclude that neuromuscular blockade specifically depresses peripheral chemosensitivity, and not respiratory muscle function since the hypercapnic ventilatory response was unaffected.
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| 12. |
- Corneliusson, Laura, et al.
(författare)
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Well‐being and Thriving in Sheltered Housing versus Ageing in Place : Results from the U‐Age Sheltered Housing Study
- 2020
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 73:3, s. 856-866
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore to what extent type of residence (sheltered housing or ageing in place) contributes to thriving and well-being in older adults, when controlling for age, sex, living alone, being a widow and adjusting for functional status, self-rated health, and depressive mood.Design: A matched cohort study.Methods A self-report survey was sent out to a total population of residents in all sheltered housings in Sweden and a matched control group ageing in place (N = 3,805). The data collection took place between October 2016-January 2017.Results: The interaction analyses related to thriving showed that with increasing level of depressive mood and decreasing levels of self-rated health and functional status, those residing in sheltered housing generally reported higher levels of thriving, as compared with those ageing in place. Well-being was not found to be significantly associated with type of accommodation.Conclusion: There may be features in sheltered housing that are associated with resident thriving especially among individuals with impairments of function, health or mood, although further studies are required to identify these specific features.Impact: This study informs staff and policymakers about thriving and well-being in sheltered housing accommodations. These findings may be used to further the development of sheltered housing accommodations.
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| 13. |
- De Neve, Jan-Walter, et al.
(författare)
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Are out-of-school adolescents at higher risk of adverse health outcomes? Evidence from 9 diverse settings in sub-Saharan Africa
- 2020
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Ingår i: Tropical Medicine & International Health. - : Wiley. - 1365-3156 .- 1360-2276. ; 25:1, s. 70-80
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We analysed mutually comparable surveys on adolescent attitudes and behaviours from nine sites in seven sub‐Saharan African countries, to determine the relationship between school enrolment and adolescent health outcomes.Methods: Data from the Africa Research, Implementation Science, and Education Network cross‐sectional adolescent health surveys were used to examine the associations of current school enrolment, self‐reported general health and four major adolescent health domains: (i) sexual and reproductive health; (ii) nutrition and non‐communicable diseases; (iii) mental health, violence and injury; and (iv) healthcare utilisation. We used multivariable Poisson regression models to calculate relative risk ratios with 95% confidence intervals (CI), controlling for demographic and socio‐economic characteristics. We assessed heterogeneity by gender and study site.Results: Across 7829 adolescents aged 10–19, 70.5% were in school at the time of interview. In‐school adolescents were 14.3% more likely (95% CI: 6–22) to report that their life is going well; 51.2% less likely (95% CI: 45–67) to report ever having had sexual intercourse; 32.6% more likely (95% CI: 9–61) to report unmet need for health care; and 30.1% less likely (95% CI: 15–43) to report having visited a traditional healer. School enrolment was not significantly associated with malnutrition, low mood, violence or injury. Substantial heterogeneity was identified between genders for sexual and reproductive health, and in‐school adolescents were particularly less likely to report adverse health outcomes in settings with high average school enrolment.Conclusions: School enrolment is strongly associated with sexual and reproductive health and healthcare utilisation outcomes across nine sites in sub‐Saharan Africa. Keeping adolescents in school may improve key health outcomes, something that can be explored through future longitudinal, mixed‐methods, and (quasi‐)experimental studies.
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| 14. |
- Dingemanse, Niels J., et al.
(författare)
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Individual variation in age-dependent reproduction: Fast explorers live fast but senesce young?
- 2020
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Ingår i: Journal of Animal Ecology. - : WILEY. - 0021-8790 .- 1365-2656. ; 89:2, s. 601-613
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Tidskriftsartikel (refereegranskat)abstract
- Adaptive integration of life history and behaviour is expected to result in variation in the pace-of-life. Previous work focused on whether risky phenotypes live fast but die young, but reported conflicting support. We posit that individuals exhibiting risky phenotypes may alternatively invest heavily in early-life reproduction but consequently suffer greater reproductive senescence. We used a 7-year longitudinal dataset with amp;gt;1,200 breeding records of amp;gt;800 female great tits assayed annually for exploratory behaviour to test whether within-individual age dependency of reproduction varied with exploratory behaviour. We controlled for biasing effects of selective (dis)appearance and within-individual behavioural plasticity. Slower and faster explorers produced moderate-sized clutches when young; faster explorers subsequently showed an increase in clutch size that diminished with age (with moderate support for declines when old), whereas slower explorers produced moderate-sized clutches throughout their lives. There was some evidence that the same pattern characterized annual fledgling success, if so, unpredictable environmental effects diluted personality-related differences in this downstream reproductive trait. Support for age-related selective appearance was apparent, but only when failing to appreciate within-individual plasticity in reproduction and behaviour. Our study identifies within-individual age-dependent reproduction, and reproductive senescence, as key components of life-history strategies that vary between individuals differing in risky behaviour. Future research should thus incorporate age-dependent reproduction in pace-of-life studies.
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| 15. |
- Epstein, Majken, et al.
(författare)
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Sleep and fatigue in newly graduated nurses-Experiences and strategies for handling shiftwork
- 2020
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:1-2, s. 184-194
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed to understand what support should be provided. Background: For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management and, at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk. Design and Methods: Semi-structured interviews were conducted with nurses (N = 11) from four different Swedish hospitals, and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board in Stockholm. The COREQ checklist was followed. Results: Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and nonexecutive cognitive function. Conclusion: The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance to improve well-being among nurses and increase patient safety. Relevance to clinical practice: This study highlights the importance of addressing sleep and fatigue issues in nursing education and work introduction programmes to increase patient safety and improve well-being among nurses.
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| 16. |
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| 17. |
- Forsman, Henrietta, et al.
(författare)
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Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students
- 2020
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Ingår i: Journal of Advanced Nursing. - Hoboken, NJ : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 76:1, s. 199-208
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo identify clusters based on graduating nursing students’ self‐reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students’ perceptions of overall quality of the nursing programme and students’ general self‐efficacy.DesignA cross‐sectional study combining survey data and results from a national examination.MethodsData were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self‐Efficacy scale and results from the National Clinical Final Examination. A Two‐Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.ResultsThree clusters were identified illustrating students’ different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self‐assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.ConclusionThe study illustrates how nursing students’ self‐assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self‐evaluation is a key learning outcome and is, in the long run, essential to patient safety.ImpactThe study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self‐efficacy lower than other students. The findings illuminate the need for student‐centered strategies in nursing education, including elements of self‐assessment in relation to examination to make the students more aware of their clinical competence.
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| 18. |
- Fröbert, Ole, 1964-, et al.
(författare)
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The brown bear as a translational model for sedentary lifestyle related diseases
- 2020
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Ingår i: Journal of Internal Medicine. - : Wiley-Blackwell Publishing Inc.. - 0954-6820 .- 1365-2796. ; 287:3, s. 263-270
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Forskningsöversikt (refereegranskat)abstract
- Sedentary lifestyle accelerates biological aging, is a major risk factor for developing metabolic syndrome and is associated with cardiovascular disease, diabetes mellitus, kidney failure, sarcopenia and osteoporosis. In contrast to the linear path to worsening health in humans with metabolic syndrome, brown bears have developed a circular metabolic plasticity enabling these animals to tolerate obesity and a "sedentary lifestyle" during hibernation and exit the den metabolically healthy in spring. Bears are close to humans physiology-wise, much closer than rodents, the preferred experimental animals in medical research, and may better serve as translational model to develop treatments for lifestyle-related diseases. In this review aspects of brown bear hibernation survival strategies are outlined and conceivable experimental strategies to learn from bears are described.
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| 19. |
- Gilljam, Britt-Mari, 1957-, et al.
(författare)
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Child participation in health care (ChiPaC)—Development and psychometric evaluation of a self‐report instrument for children's participation in health care
- 2020
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Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 29:1-2, s. 107-118
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To develop and evaluate the psychometric properties of a self‐report instrument measuring 6‐ to 12‐year‐old children's own experiences of participation in health care.Background: Validated measures to evaluate children's participation in health care can play a critical role in strategic work towards supporting children's participation at an individual level and in working towards quality improvements at an organisational level. There are, however, no available instruments to achieve this.Methods: An instrument development design was used, together with the TRIPOD checklist. Item construction was based on research about children's perspectives on participation in health care and Shier's model for participation. The face and content validity was evaluated by 14 healthy children, 9 paediatric nurses and 8 children with different diseases. The construct validity, internal consistency and stability reliability were evaluated based on data from 138 children visiting a paediatric clinic.Results: The testing of the face and content validity resulted in an instrument with child‐friendly language, additional instructions and visual attractive presentation. The principle component analysis resulted in the four‐factor solution: “To be included,” “To trust professionals,” “To take control,” and “To understand information.” Internal consistency and intraclass correlation coefficients were acceptable.Conclusion: We conclude that the child participation in health care (ChiPaC) instrument has adequate reliability and validity when used to evaluate children's participation in health care. The involvement of children in the development of ChiPaC resulted in a brief, colourful and user‐friendly instrument for use in paediatric health care.Relevance to clinical practice: This new questionnaire, ChiPaC, is adapted for children between 6–12 years measuring participation in health care from a child perspective. ChiPaC can be used in the practical work of supporting individual children's participation in health care as well as in the strategical work towards quality improvements on an organisational level.What does this paper contribute to the wider global clinical community?The instrument provides a contribution for the practical implementation of the Convention on the Rights of the Child in health care.The high degree of involvement of children in the development of the instrument resulted in a brief, colourful and user‐friendly instrument that can be used in paediatric health care.The instrument can play a critical role in the practical work of supporting individual children's participation in health care as well as in the strategical work of quality improvement on an organisational level.
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| 20. |
- Hinchcliffe, James, 1992, et al.
(författare)
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Comparative survival and growth performance of European lobster Homarus gammarus post-larva reared on novel feeds
- 2020
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Ingår i: Aquaculture Research. - : Hindawi Limited. - 1355-557X .- 1365-2109. ; 51:1, s. 102-113
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Tidskriftsartikel (refereegranskat)abstract
- One approach to ongrow juvenile European lobster, Homarus gammarus, is to utilize land based rearing systems, incorporating automated feeding, individual culture and provision of stable pelleted feeds, preferably using sustainable ingredients. We initiated three feeding experiments to investigate the general suitability of ingredients produced from seafood by-products as novel feeds for H. gammarus, in terms of promoting survival, development and growth of post-larval lobsters from post-larvae (PL) stage IV to the first juvenile stage (stage V). The first experiment was designed to screen an array of candidate, locally produced, novel protein sources on growth performance parameters. This initial experiment revealed that PL reared on a raw (i.e. wet, unprocessed shrimp) feed used as a reference showed superior performance to those reared on experimental feeds containing fishmeal, herring protein isolate or mussel meal; however, a novel type of shrimp meal, produced by flocculation from waste water, promoted the best PL performance of any experimental feed. A second experiment was designed to test the effect of drying method and to optimize the form of a wet shrimp reference feed used by lobster hatcheries. This showed that the performance of PL reared on experimental freeze-dried shrimp feed was not significantly different to those reared on the wet, unprocessed shrimp used as a reference feed. However, lobsters offered experimental oven-dried shrimp feed (with or without an immune supplement) resulted in significantly lower survival or growth performance. A third and final experiment was designed in an attempt to improve a candidate herring-based protein source, by supplementing with nutrients found in shrimp. However, the results showed that PL reared on the wet reference shrimp feed still showed superior growth and survival than those reared on a herring feed alone, or supplemented with additives found in shrimp meal (either glucosamine, astaxanthin or both supplements combined). The high survival and growth, low incidence of moulting problems and high availability of waste shrimp material, suggest that non-heat-treated shrimp products are a promising feed ingredient for post-larval European lobsters.
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| 21. |
- Holl, Marieke, et al.
(författare)
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Subgroups of tenants at risk of eviction due to rent arrears in five Dutch cities : A latent class approach
- 2020
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 28:1, s. 148-159
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Tidskriftsartikel (refereegranskat)abstract
- This study identifies subgroups of tenants in a sample of 495 tenants at risk of eviction, due to rent arrears, by 16 housing associations in five Dutch municipalities, and examines the attuning of services to the needs of the tenants in these subgroups. Latent class analysis with eight known risk factors for eviction identified five sub‐groups of tenants, which can be characterised as young immigrants, native Dutch tenants with little support, highly educated native Dutch tenants with much support, depressed tenants with little support and highly educated mentally stable older single tenants. The young immigrants reported the highest number of unmet care needs; the highly educated native Dutch tenants with much support, on the other hand, mentioned the least unmet care needs. This study demonstrates the diversity of a population of tenants at risk of eviction. Together with the differences in care needs, this indicates the necessity to develop targeted and personalised interventions to prevent evictions.
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| 22. |
- Hukkinen, Maria, et al.
(författare)
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Management strategies and treatment results of pediatric choledochal malformations in the Nordic countries
- 2020
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Ingår i: HPB. - : Elsevier BV. - 1365-182X. ; 22:1, s. 161-168
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Tidskriftsartikel (refereegranskat)abstract
- Background: Incidence and long-term outcomes of choledochal malformations (CMs) in children remain unclear. Methods: Clinical characteristics, operative details, complications, and follow-up data were collected from eight pediatric surgical centers in Sweden, Norway, Denmark, and Finland, which also answered a questionnaire addressing management practices. Results: During 2000–2017, 126 pediatric CMs were diagnosed, corresponding an incidence of 1:37,400. Diagnostic, treatment, and follow-up practices varied markedly. Of patients with complete clinical data (n = 119), 85% and 11% had type I and IV CMs and were managed by open hepaticojejunostomy at median age of 2.5 (interquartile range 0.46–5.8) years. Associated malformations were more common in fusiform and type IV (23%) than cystic CMs (8%, p = 0.043). Pancreaticobiliary maljunction was more frequently confirmed in patients presenting with pancreatitis (26% vs. 7%, p = 0.005) and with fusiform CMs (56% vs. 25%, p = 0.001). Cholangitis/pancreatitis episodes, occurring in 12% during postoperative follow-up of 4.0 (2.0–7.9) years, associated with longer surveillance (OR 1.32, 95% CI 1.13–1.54, p < 0.001). However, only two thirds of centers continued follow-up until adulthood. No malignancies were reported. Conclusions: CM incidence was higher than traditionally reported among Western populations. Although open hepaticojejunostomy carries good short-term outcomes, long-term morbidity is noteworthy. Standardized evidence-based management strategies and long-term follow-up are encouraged.
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| 23. |
- Jönsson, D., et al.
(författare)
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Periodontal disease is associated with carotid plaque area: the Malmö Offspring Dental Study (MODS).
- 2020
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 287:3, s. 301-309
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Tidskriftsartikel (refereegranskat)abstract
- Background: Periodontal disease is associated with cardiovascular disease (CVD) but it is unknown if periodontal disease severity is associated with asymptomatic carotid plaque. The aim of the current population-based, observational study was to investigate if signs of periodontal disease are associated with the occurrence of carotid plaque and total plaque area (TPA). Methods: The Malmö Offspring Study (MOS) is a population-based study. MOS participants underwent a thorough cardiovascular phenotyping, including carotid ultrasonography. The Malmö Offspring Dental Study (MODS) invited participants of MOS for dental examination, including periodontal charting. Multivariable regression models were used to analyse the presence of carotid plaque and TPA in relation to periodontal parameters. Results: In all, 831 MODS participants were recruited, out of which 495 belonged to the children generation with mean age of 53 years, 63% had carotid plaque and 38% had moderate or severe periodontal disease. In models adjusted for CVD risk factors, the OR for having carotid plaque in subjects with vs without periodontal disease was 1.75 (95% CI: 1.11–2.78). In a linear model with TPA as dependent and number of periodontal pockets ≥ 4 mm as independent variable, the adjusted beta-coefficient was 0.34 mm2 (95% CI 0.16–0.52). Conclusion: Individuals within the highest quartile of periodontal pockets are expected to have 9 mm2 larger TPA compared to those without pockets. Our results suggest that intervention studies addressing periodontal disease could be useful for prevention of CVD.
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| 24. |
- Lin, Chung-Ying, et al.
(författare)
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A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer
- 2020
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia – Athens Insomnia Scale and Insomnia Severity Index – among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61–0.87; test–retest reliability = 0.72–0.82; infit mean square = 0.81–1.17; outfit MnSq = 0.79–1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61–0.81; test–retest reliability = 0.72–0.82; infit mean square = 0.72–1.14; outfit mean square = 0.76–1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer.
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| 25. |
- Mageroy, Melissa H., et al.
(författare)
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Priming of inducible defenses protects Norway spruce against tree‐killing bark beetles
- 2020
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Ingår i: Plant, Cell and Environment. - : John Wiley & Sons. - 0140-7791 .- 1365-3040. ; 43:2, s. 420-430
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Tidskriftsartikel (refereegranskat)abstract
- Plants can form an immunological memory known as defense priming, whereby exposure to a priming stimulus enables quicker or stronger response to subsequent attack by pests and pathogens. Such priming of inducible defenses provides increased protection and reduces allocation costs of defense. Defense priming has been widely studied for short–lived model plants such as Arabidopsis, but little is known about this phenomenon in long‐lived plants like spruce. We compared the effects of pre‐treatment with sub‐lethal fungal inoculations or application of the phytohormone methyl jasmonate (MeJA) on the resistance of 48‐year‐old Norway spruce (Picea abies) trees to mass attack by a tree‐killing bark beetle beginning 35 days later. Bark beetles heavily infested and killed untreated trees, but largely avoided fungus‐inoculated trees and MeJA‐treated trees. Quantification of defensive terpenes at the time of bark beetle attack showed fungal inoculation induced 91‐fold higher terpene concentrations compared to untreated trees, while application of MeJA did not significantly increase terpenes. These results indicate that resistance in fungus‐inoculated trees is a result of direct induction of defenses while resistance in MeJA‐treated trees is due to defense priming. This work extends our knowledge of defense priming from model plants to an ecologically important tree species.
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