| 1. |
- Wester, Tomas, et al.
(författare)
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Attention deficit hyperactivity and autism spectrum disorders in patients with anorectal malformations
- 2021
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 110:11, s. 3131-3136
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Tidskriftsartikel (refereegranskat)abstract
- AimTo assess the risk of neurodevelopmental disorders in patients with anorectal malformations compared to controls.MethodsThis was a population-based cohort study including all patients born in Sweden 1997–2012 with anorectal malformation in the Swedish National Patient Register and five matched controls per patient. Anorectal malformation was the exposure. All individuals were evaluated for the outcomes, attention deficit hyperactivity disorder or autism spectrum disorder in the National Patient Register. Data on drugs for attention deficit hyperactivity disorder were retrieved from the Swedish Prescribed Drug Register and used as proxy for attention deficit hyperactivity disorder. Conditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Analyses were adjusted for confounders.ResultsFive hundred and fifteen patients with anorectal malformations and 2560 controls were included. Patients with anorectal malformation had a higher risk of attention deficit hyperactivity disorder (OR 3.01 (95% CI, 1.83–4.95)) and autism spectrum disorders (OR 3.07 (95% CI, 1.62–5.79)) compared to the controls. Significantly more patients with anorectal malformation had been prescribed medication for attention deficit hyperactivity disorder compared to controls (OR 2.26 (95% CI 1.33–3.85)).ConclusionPatients with anorectal malformations have a higher risk of attention deficit hyperactivity disorder and autism spectrum disorders than controls.
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| 2. |
- Dahlberg, Maria, et al.
(författare)
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The Evidenced Effects of Early Childhood Interventions to Promote Mental Health and Parenting in the Nordic Countries : A Systematic Review
- 2023
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Ingår i: International Journal of Mental Health Promotion. - : Tech Science Press. - 1462-3730 .- 2049-8543. ; 25:4, s. 505-537
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Tidskriftsartikel (refereegranskat)abstract
- The first years of life and the family context are key to the promotion and protection of children’s health and well-being, emphasizing the need for interventions aimed to support families with young children. This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries. Six electronic databases were systematically searched, and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria. The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention. Outcomes of interest encompassed mental health, related risk and protective factors among the parents and/or the children, or child-parent interaction. The results from studies applying statistical methods show significant improvements in parents’ self-efficacy, self-esteem, and parental satisfaction, while few improvements in parents’ social support or parental relationship were identified. Improvements in social support and parental relationships were however reported in qualitative studies. Most quantitative studies reporting on parents’ mental health problems and stress found a significant decrease, and qualitative studies highlighted experienced positive effects on mental health and well-being. The majority of studies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development. No significant changes were however found for existing behaviora lproblems. The majority of studies examining parenting strategies and/or parent-child interaction found significant positive changes after the interventions. In sum, although findings are heterogeneous, early childhood interventions show various positive effects on the parenting and mental health of both children and their parents. The fact that different types of initiatives have been developed and implemented can be seen as an advantage, considering the varying needs and expectations of different families.
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| 3. |
- Eklund, Anna-Lena, et al.
(författare)
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Assessing and promoting responsive interaction between parents and children – A qualitative study of the experiences of child health care nurses in Sweden
- 2022
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Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 63
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: One of the main tasks of a child health care nurse is to assess and promote a responsive interaction and secure connection between children and their parents for the future. This study aims to develop an understanding of Swedish child health care nurses´ experiences of assessing and promoting responsive interaction between parents and children. Design and method: A qualitative interview study using an inductive approach was implemented. Eleven nurses were interviewed (range: 30–58 min) during the period March to August 2016, and the transcripts were analysed using qualitative content analysis according to Graneheim and Lundman. Results: Three categories emerged: Interpreting signals in parent and child behaviour, Reinforcing the parents in their role and Feeling inadequate as professional. Interpreting signals in parent and child behaviour was described fundamental when promoting responsive interaction. Further reinforcing the parents in their role was described central. The child health care nurses also described how they often felt inadequate in promoting responsive interaction. Conclusions: Assessing and promoting responsive interaction is an important but challenging task which requires extensive knowledge and good communication skills. The child health care nurses express their insufficiency in that regard. Practice implications: A targeted education and sufficient time for each visit at the child health care center should be allocated to facilitate the important work on parenting and child interaction and to enhance nurses' feelings of managing their work. © 2021 The Authors
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| 4. |
- Eklund Karlsson, Leena, 1956-, et al.
(författare)
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Are universal measures sufficient in reducing child poverty in the Nordic countries? : An analysis of policies and political commitments
- 2022
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Ingår i: Scandinavian Journal of Public Health. - London : Sage Publications. - 1403-4948 .- 1651-1905. ; 50:7, s. 892-902
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Tidskriftsartikel (refereegranskat)abstract
- Background: The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have long traditions of social welfare policies that have eradicated poverty as part of their goals. The purpose of this study was to increase our understanding of why child poverty is still significant in the Nordic countries despite existing strategies. Methods: A qualitative analysis of Nordic government documents and reports between 2007 and 2019 was carried out to track changes in public health priorities and political measures and to determine the similarities and differences between the five countries. Results: In all countries, most of the measures were universal, such as benefits during pregnancy, paid parental leave before and after the child was born, paid parental leave related to children’s sickness, child allowances, day care, free health care for children and support for disabled children. National policies aimed to reduce social inequalities and child poverty exist in all five countries, but unaffordable housing, unequal disposable family income distribution and unequal income distribution at local municipality levels seem to be obstacles to reaching national policy goals. Conclusions: Despite comprehensive universal measures to eradicate child poverty, inequalities are significant and increasing in some of the Nordic countries. This might be due to a lack of proportional universalism, where universal measures are in place in all Nordic countries, but with a lack of scale and intensity proportional to the children and families at risk. The significance of eliminating social inequalities needs to be emphasised at the local level.
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| 5. |
- Gunnarsdottir, Frida Björk, et al.
(författare)
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Serum immuno-oncology markers carry independent prognostic information in patients with newly diagnosed metastatic breast cancer, from a prospective observational study
- 2023
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Ingår i: Breast Cancer Research. - : Springer Science and Business Media LLC. - 1465-5411 .- 1465-542X. ; 25
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Tidskriftsartikel (refereegranskat)abstract
- Background Metastatic breast cancer (MBC) is a challenging disease, and despite new therapies, prognosis is still poor for a majority of patients. There is a clinical need for improved prognostication where immuno-oncology markers can provide important information. The aim of this study was to evaluate serum immuno-oncology markers in MBC patients and their respective relevance for prediction of survival.Patients and methods We investigated a broad panel of 92 immuno-oncology proteins in serum from 136 MBC patients included in a prospective observational study (NCT01322893) with long-term follow-up. Serum samples were collected before start of systemic therapy and analyzed using multiplex proximity extension assay (Olink Target 96 Immuno-Oncology panel). Multiple machine learning techniques were used to identify serum markers with highest importance for prediction of overall and progression-free survival (OS and PFS), and associations to survival were further evaluated using Cox regression analyses. False discovery rate was then used to adjust for multiple comparisons.Results Using random forest and random survival forest analyses, we identified the top nine and ten variables of highest predictive importance for OS and PFS, respectively. Cox regression analyses revealed significant associations (P < 0.005) of higher serum levels of IL-8, IL-10 and CAIX with worse OS in multivariable analyses, adjusted for established clinical prognostic factors including circulating tumor cells (CTCs). Similarly, high serum levels of IL-8, IL-10, ADA and CASP8 significantly associated with worse PFS. Interestingly, high serum levels of FasL significantly associated with improved OS and PFS. In addition, CSF-1, IL-6, MUC16, TFNSFR4 and CD244 showed suggestive evidence (P < 0.05) for an association to survival in multivariable analyses. After correction for multiple comparisons, IL-8 still showed strong evidence for correlation to survival.Conclusion To conclude, we found six serum immuno-oncology markers that were significantly associated with OS and/or PFS in MBC patients, independently of other established prognostic factors including CTCs. Furthermore, an additional five serum immuno-oncology markers provided suggestive evidence for an independent association to survival. These findings highlight the relevance of immuno-oncology serum markers in MBC patients and support their usefulness for improved prognostication.
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| 6. |
- Gunnarsdottir, Maria J., et al.
(författare)
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Status of risk-based approach and national framework for safe drinking water in small water supplies of the Nordic water sector
- 2020
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Ingår i: International Journal of Hygiene and Environmental Health. - : Elsevier BV. - 1438-4639. ; 230
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Tidskriftsartikel (refereegranskat)abstract
- Reliable safe water supply is a pillar of society and a key to public health. The Nordic countries have an abundance of clean fresh water as a source for drinking water supplies. They have followed developments in safeguarding water, both the recommendations of the World Health Organization framework for safe drinking water and European legislation. Worldwide, including the Nordic countries, small water supplies are less compliant with water safety regulation. The forthcoming EU directive on drinking water require risk-based approaches and improved transparency on water quality. This research looks at the Nordic frameworks for safe water supply, with emphasis on risk-based approaches and smaller systems. We analyzed the legal frameworks for safe water, the structure of the water sector across the Nordic countries and explored how prepared these countries are to meet these requirements. Our findings show that, while legal requirements are mostly in place, delivery of information to the public needs to be improved. Most Nordic countries are in the process of implementing risk-based management in large and medium size water supplies, whereas small supplies are lagging. We conclude that a key to success is increased training and support for small supplies. We suggest wider adoption of the Nordic model of cooperation with benchmarking of safe water for all to transfer knowledge between the countries. This work provides insights into challenges and opportunities for the Nordic countries and provides insights relevant to countries worldwide in their effort towards realization of SDG Target 6.1.
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| 7. |
- Gunnarsdottir, Thora Jenny, et al.
(författare)
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Customising clinical studies for the new nursing generation
- 2021
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Ingår i: Nordic journal of nursing research. - : SAGE. - 2057-1585 .- 2057-1593. ; 42:1, s. 3-6
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Tidskriftsartikel (refereegranskat)abstract
- Nursing education in the Nordic countries follows the European Union directive requirements, and clinical studies for nursing students in the Nordic countries have many similarities. Now a new generation of students with different needs and characteristics is entering the nursing profession. The faculty, teachers and nurses will face challenges in meeting this new generation’s needs. The primary aim of this discussion paper is to explore and compare the current clinical studies in the five Nordic countries. The secondary aim is to find means to address the future challenges with a focus on the new generation. The idea of Objective Structured Clinical Reflection creates the possibility to discuss a new form of evaluation that may enhance the clinical competencies of the new generation entering clinical studies during their nursing education.
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| 8. |
- Henriksen, Jette, et al.
(författare)
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European Union directives and clinical practice in nursing education in the Nordic countries
- 2020
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Ingår i: Nordic journal of nursing research. - : Sage. - 2057-1585 .- 2057-1593. ; 40:1, s. 3-5
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Tidskriftsartikel (refereegranskat)abstract
- Nursing education in countries belonging to the European Union (EU) must follow EU directive requirements. The aim of this opinion paper is to explore and discuss the challenges presented by EU requirements to clinical practice in nursing education. These requirements prescribe that clinical practice must be carried out in a variety of different and specialized areas that provide care in hospital units. This may offer students only a limited range of experience; thus, they may not be fully prepared to care for patients with common diseases, and only have a restricted knowledge about the ongoing development of caring for patients at home. EU directives require that half of a nursing education course be allocated to clinical practice. This is challenging, since the number of hours is laid down without considering such aspects as the need for pedagogical qualifications for preceptors, which in turn may affect the quality of the clinical practice.
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| 9. |
- Hulme, Heather, et al.
(författare)
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Simultaneous mass spectrometry imaging of multiple neuropeptides in the brain and alterations induced by experimental parkinsonism and L-DOPA therapy
- 2020
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Ingår i: Neurobiology of Disease. - : ACADEMIC PRESS INC ELSEVIER SCIENCE. - 0969-9961 .- 1095-953X. ; 137
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Tidskriftsartikel (refereegranskat)abstract
- Neuropeptides are important signalling molecules in the brain and alterations in their expression levels have been linked to neurological disorders such as Parkinson's disease. It is challenging to map neuropeptide changes across and within brain regions because of their low in vivo concentrations and complex post-translational processing. Consequently, the role of neuropeptides in Parkinson's disease is not well understood. Thus, we have developed and evaluated a method to image multiple neuropeptides simultaneously in both rat and primate brain tissue sections by matrix-assisted laser desorption/ionisation mass spectrometry imaging at high lateral resolution. Using a unilateral 6-hydroxydopamine rat model of Parkinson's disease, we imaged changes in enkephalins, dynorphins, tachykinins and neurotensin associated with the dopaminergic denervation and L-DOPA treatment in multiple brain regions. L-DOPA administration significantly affected neuropeptides in the globus pallidus, while neuropeptides in the caudate-putamen were mostly affected by dopamine depletion. Using high lateral resolution imaging, we observed an increase of neurotensin in the dorsal sub-region of the globus pallidus after dopamine depletion. This study highlights the capacity of mass spectrometry imaging to elucidate the dynamics of neuropeptide signalling during Parkinson's disease and its treatment.
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| 10. |
- Mehmeti-Ajradini, Meliha, et al.
(författare)
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Human G-MDSCs are neutrophils at distinct maturation stages promoting tumor growth in breast cancer
- 2020
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Ingår i: Life Science Alliance. - 2575-1077. ; 3:11
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Tidskriftsartikel (refereegranskat)abstract
- Myeloid-derived suppressor cells (MDSCs) are known to contribute to immune evasion in cancer. However, the function of the human granulocytic (G)-MDSC subset during tumor progression is largely unknown, and there are no established markers for their identification in human tumor specimens. Using gene expression profiling, mass cytometry, and tumor microarrays, we here demonstrate that human G-MDSCs occur as neutrophils at distinct maturation stages, with a disease-specific profile. G-MDSCs derived from patients with metastatic breast cancer and malignant melanoma display a unique immature neutrophil profile, that is more similar to healthy donor neutrophils than to G-MDSCs from sepsis patients. Finally, we show that primary G-MDSCs from metastatic breast cancer patients cotransplanted with breast cancer cells, promote tumor growth, and affect vessel formation, leading to myeloid immune cell exclusion. Our findings reveal a role for human G-MDSC in tumor progression and have clinical implications also for targeted immunotherapy.
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| 11. |
- Mehmeti-Ajradini, Meliha, et al.
(författare)
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Human G-MDSCs are neutrophils at distinct maturation stages promoting tumor growth in breast cancer
- 2020
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Ingår i: Life Science Alliance. - : LIFE SCIENCE ALLIANCE LLC. - 2575-1077. ; 3:11
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Tidskriftsartikel (refereegranskat)abstract
- Myeloid-derived suppressor cells (MDSCs) are known to contribute to immune evasion in cancer. However, the function of the human granulocytic (G)-MDSC subset during tumor progression is largely unknown, and there are no established markers for their identification in human tumor specimens. Using gene expression profiling, mass cytometry, and tumor microarrays, we here demonstrate that human G-MDSCs occur as neutrophils at distinct maturation stages, with a disease-specific profile. G-MDSCs derived from patients with metastatic breast cancer and malignant melanoma display a unique immature neutrophil profile, that is more similar to healthy donor neutrophils than to G-MDSCs from sepsis patients. Finally, we show that primary G-MDSCs from metastatic breast cancer patients co-transplanted with breast cancer cells, promote tumor growth, and affect vessel formation, leading to myeloid immune cell exclusion. Our findings reveal a role for human G-MDSC in tumor progression and have clinical implications also for targeted immunotherapy.
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| 12. |
- Smith, Frida, 1973, et al.
(författare)
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Exploring the meaning, role and experiences of a patient-led social innovation for people affected by cancer: a new collaborative care model complementing traditional cancer rehabilitation in Sweden
- 2021
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Ingår i: BMJ open quality. - : BMJ. - 2399-6641. ; 10:4
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Tidskriftsartikel (refereegranskat)abstract
- Objective Kraftens Hus is the first support centre in Sweden designed by and for people affected by cancer, including patients, family, friends, staff members and local community representatives (collectively 'stakeholders'). The purpose of this study was to explore the meaning, role and experiences of Kraftens Hus stakeholders using a patient and public involved methodology. Methods To understand and map the experiences of visitors to Kraftens Hus, we applied concept mapping (CM), a mixed methods approach where data are collected and analysed in four structured steps designed to capture the diverse perspectives of multiple stakeholders. Qualitative interviews with relevant stakeholders supplemented the CM findings. Results The final concept map contained six clusters of ideas. Within the clusters, there was a recurring theme that cancer-affected people value accessible and long-term psychosocial support (PSS). The intended emotional, social and practical needs identified in a previous design process seem to have been addressed and appreciated by Kraftens Hus visitors. Conclusion Kraftens Hus is an example of a new patient-led social innovation based on a life-event perspective and integration of resources from different sectors in society. By focusing on life, not the disease, the care continuum expands, and long-term PSS is provided alongside cancer treatment. The evaluation confirms that PSS should focus on health and well-being in the broadest sense.
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| 13. |
- Thorell, Kaisa, 1983, et al.
(författare)
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The Helicobacter pylori Genome Project: insights into H. pylori population structure from analysis of a worldwide collection of complete genomes
- 2023
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Ingår i: Nature Communications. - 2041-1723. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics.
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