| 1. |
- Eilertsen, M.E, et al.
(författare)
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The Voices of Cancer-Bereaved Siblings : A Nation-Wide Long-Term Follow-up
- 2018
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Ingår i: Pediatric blood & cancer. - : Wiley. - 1545-5009. ; , s. 555-556
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Konferensbidrag (refereegranskat)abstract
- Background/Objectives: Siblings face many challenges and the aim of this paper is to explore bereaved siblings’ memories and experiences of their brother's or sister's illness and death.Design/Methods: In this nationwide Swedish study 174 of 240 (73 %) bereaved siblings participated and 70 % responded to two open‐ended questions on siblings’ positive and negative memories and experiences of illness and death. The data were analyzed using systematic text condensation.Results: The bereaved siblings’ responses were categorized into four different themes: endurance vs. vulnerability; family cohesion vs. family conflicts; growth vs. stagnation; professional support vs. lack of professional support. Endurance was expressed as the influence that the ill siblings’ willpower, good mood and stamina had on the healthy siblings, whereas vulnerability was expressed as the feeling of emptiness and loneliness. Family cohesion was expressed as the bonds being strengthened between family members, whereas family conflicts often led siblings to feel invisible and unacknowledged. In the third theme, most siblings expressed feeling that they grew as individuals in the process of their brother's or sister's illness and death, whereas others experienced stagnation because of the physical and mental distress they bore throughout this time, often feeling forgotten. In the last theme, most siblings perceived support by physicians and staff at the hospital as being warm, kind and honest, while some siblings had negative experiences.Conclusions: Our study shows that bereaved siblings can have positive memories and experiences, even though the death of a sibling is a distressing situation. The significance of the positive buffering effect on the bereaved siblings’ own endurance, personal growth, family cohesion and social support should be noted. The knowledge acquired by listening to the voices of bereaved siblings can be valuable in showing healthcare professionals the importance of supporting siblings of children with cancer throughout the cancer trajectory and afterwards into bereavement.
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| 2. |
- Jepsen, M. S., et al.
(författare)
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A fully general and adaptive inverse analysis method for cementitious materials
- 2016
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Ingår i: Materials and Structures/Materiaux et Constructions. - : Springer Science and Business Media LLC. - 1359-5997. ; 49:10, s. 4335-4348
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Tidskriftsartikel (refereegranskat)abstract
- The paper presents an adaptive method for inverse determination of the tensile relationship, direct tensile strength and Young's modulus of cementitious materials. The method facilitates an inverse analysis with a multi-linear function. Usually, simple bi- or tri-linear functions are applied when modeling the fracture mechanisms in cementitious materials, but the vast development of pseudo-strain hardening, fiber reinforced cementitious materials require inverse methods, capable of treating multi-linear functions. The proposed method is fully general in the sense that it relies on least square fitting between test data obtained from various kinds of test setup, three-point bending or wedge splitting test, and simulated data obtained by either FEA or analytical models. In the current paper adaptive inverse analysis is conducted on test data obtained from three-point bending of notched specimens and simulated data from a nonlinear hinge model. The paper shows that the results obtained by means of the proposed method is independent on the initial shape of the function and the initial guess of the tensile strength. The method provides very accurate fits, and the increased number of variables describing the relationship constitutes the basis for obtaining detailed information of crack propagation in any cementitious material.
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| 3. |
- Jepsen, M. S., et al.
(författare)
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Adaptive inverse analysis (AIA) applied and verified on various fiber reinforced concrete composites
- 2018
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Ingår i: Materials and Structures/Materiaux et Constructions. - : Springer Science and Business Media LLC. - 1359-5997. ; 51:3
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Tidskriftsartikel (refereegranskat)abstract
- During the past decades several inverse approaches have been developed to identify the stress-crack opening (σ−w) by means of indirect test methods, such as the notched three point bending-, wedge splitting-, and round panel testing. The aim is to establish reliable constitutive models for the tensile behavior of fiber reinforced concrete materials, suitable for structural design. Within this context, the adaptive inverse analysis (AIA) was recently developed to facilitate a fully general and automatized inverse analysis scheme, which is applicable in conjunction with analytical or finite element simulation of the experimental response. This paper presents a new formulation of the adaptive refinement criterion of the AIA method. The paper demonstrates that the refinement criterion of the nonlinear least square curve fitting process, is significantly improved by coupling the model error to the crack mouth opening and the crack opening displacement relationship. This enables an adaptive refinement of the σ−w model in the line segment with maximum model error, which entails significant improvement of the numerical efficiency of the AIA method without any loss of robustness. The improved method is applied on various fiber reinforced concrete composites and the results are benchmarked with the inverse analysis method suggested by the Japanese Concrete Institute (Method of test for fracture energy of concrete by use of notched beam, Japanese Concrete Institute Standard, Tokyo, 2003) and recently adopted in ISO 19044 (Test methods for fibre-reinforced cementitious composites—load-displacement curve using notched specimen, 2015). The benchmarking demonstrates that the AIA method, in contradiction to the JCI/ISO method, facilitates direct determination of the tensile strength and operational multi-linear σ−w models.
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| 4. |
- Lövgren, Anna, et al.
(författare)
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Temporomandibular pain and jaw dysfunction at different ages covering the lifespan - A population based study
- 2016
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Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 20:4, s. 532-540
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTemporomandibular pain and jaw dysfunction can have a negative effect on daily life, but these conditions are not well recognized in the health care systems. The general aim was to examine the cross-sectional prevalence of frequent temporomandibular pain and jaw dysfunction in men and women across the lifespan.MethodsThe analysis was based on data from 137,718 individuals (mean age 35years, SD 22.7) who answered three questions (3Q/TMD) included in the digital health declaration in the Public Dental Health care in the county of Vasterbotten, Sweden; Q1: Do you have pain in your temple, face, jaw or jaw joint once a week or more?'; Q2: Does it hurt once a week or more when you open your mouth or chew?'; and Q3: Does your jaw lock or become stuck once a week or more?'ResultsThe prevalence of frequent temporomandibular pain (Q1) was 5.2% among women and 1.8% among men (p<0.0001). The prevalence of frequent pain on jaw movement (Q2) was 2.5% among women and 0.9% among men (p<0.0001). The prevalence of frequent locking of the jaw (Q3) was 2.7% among women and 1.2% among men (p<0.0001).ConclusionsThe study shows that the cross-sectional prevalence of temporomandibular pain and jaw dysfunction varies during the lifespan. For men and women, respectively, symptoms increase during adolescence, peak in middle age and then gradually diminish. The prevalence of these symptoms is significantly higher among women except from the first and last decades of a 100-year lifespan.
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| 5. |
- Lövgren, Anna, et al.
(författare)
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Validity of three screening questions (3Q/TMD) in relation to the DC/TMD
- 2016
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Ingår i: Journal of Oral Rehabilitation. - : John Wiley & Sons. - 1365-2842 .- 0305-182X. ; 43:10, s. 729-736
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Tidskriftsartikel (refereegranskat)abstract
- Temporomandibular disorders (TMD) are common but seem to be largely undetected within general dental care. To improve dentists' awareness of these symptoms, three screening questions (3Q/TMD) have been introduced. Our aim was to validate 3Q/TMD in relation to the diagnostic criteria for TMD (DC/TMD), while taking into account the severity level of the symptoms. The study population consisted of 7831 individuals 20-69 years old, who had their routine dental check-up at the Public Dental Health Service in Västerbotten, Sweden. All patients answered a health declaration, including the 3Q/TMD regarding frequent temporomandibular pain, pain on movement and catching/locking of the jaw. All 3Q-positives (at least one affirmative) were invited for examination in randomised order. For each 3Q-positive, a matched 3Q-negative was invited. In total, 152 3Q-positives and 148 3Q-negatives participated. At examination, participants answered 3Q/TMD a second time, before they were examined and diagnosed according to DC/TMD. To determine symptom's severity, the Graded Chronic Pain Scale and Jaw Functional Limitation Scale-20 (JFLS-20) were used. In total, 74% of 3Q-positives and 16% of 3Q-negatives met the criteria for DC/TMD pain or dysfunction (disc displacements with reduction and degenerative joint disorder were excluded). Fifty-five per cent of 3Q-positives had a TMD diagnosis and CPI score ≥3 or a JFLS-20 score ≥5, compared to 4% of 3Q-negatives. The results show that the 3Q/TMD is an applicable, cost-effective and valid tool for screening a general adult population to recognise patients in need of further TMD examination and management.
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| 6. |
- Lövgren, M. L., et al.
(författare)
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Prevalence of impacted maxillary canines-an epidemiological study in a region with systematically implemented interceptive treatment
- 2019
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Ingår i: European Journal of Orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 41:5, s. 454-459
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In dentistry, epidemiological studies are important for establishing high-quality care for the individual patient as well as for socio-economic reasons. OBJECTIVE: The aim of this epidemiological study was to evaluate the prevalence of impacted maxillary canines in a geographical region in which interceptive treatment is implemented systematically. Furthermore, the aim was to study the age and gender of the patients, and the location and surgical technique used for the impacted maxillary canine. METHOD: The study was based on 54 716 adolescents in the Region Västra Götaland, Sweden who were born in the period 1996-98. All patients in the three cohorts who had impacted maxillary canines treated with surgical exposure or surgical removal were identified in the dental record system used in the region. RESULTS: The prevalence of impacted maxillary canines when interceptive treatment was systematically implemented was 1.1% (N = 601). Overall, the cohorts of patients with impacted canines comprised 65% girls and 35% boys. Most of the canines were palatally impacted and the most common surgical technique was closed exposure. CONCLUSION: The prevalence of impacted maxillary canines in a geographical area in which interceptive treatment is systematically implemented is lower than that reported previously. The distributions of impacted canines with respect to gender and location are in accordance with those reported previously in similar studies. © The Author(s) 2019. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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| 7. |
- Lövgren, Malin, et al.
(författare)
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Sweden and Finland need to improve the support provided for the siblings of children with cancer.
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 108:2, s. 369-370
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Tidskriftsartikel (refereegranskat)abstract
- Evidence favours sibling support as a standard of care in paediatric oncology (1). Guidelines published in 1999 by the International Society of Paediatric Oncology (2) recommended involving siblings in the ill child's care and supporting siblings during and after the illness. Studies have shown that this is something that siblings want and need (3) and lack of support has increased the risk of long-term psychological distress (4). Sibling support varies between countries. This article is protected by copyright. All rights reserved.
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| 8. |
- Melin-Johansson, Christina, 1956-, et al.
(författare)
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End of life conversations from a life cycle perspective
- 2019
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Konferensbidrag (refereegranskat)abstract
- Palliative care is provided over a long period of time in parallel with curative interventions but sooner or later a breakpoint occurs when curative treatment no longer has an effect. A new state enters and the patients need a palliative breakpoint conversation (PBC). This requires a medical assessment and should be documented in the patients record. PBC are often conducted as a response to patient´s unexpected deterioration or not at all. According to the Swedish Register of Palliative Care (SRPC) about 27 000 patients in hospitals (year 2014-2017) did not receive PBC and 50 % of all patients (N=500 000) PBC were not documented.Aim: To explore the proportion of patients in all clinical units in Sweden that did not receive PBC documented in the medical records.Methods: All clinical units N=6000 in the SRPC that collects data from hospitals, hospices, nursing homes and home care, with an end-of-life questionnaire about palliative care content focusing on the last week of life will be included. We will explore what units documented PBC (answered yes in the questionnaire) or not documented PBC (answered no in the questionnaire). Data analysis is under progress with statistical analysis, and preliminary results will be presented at the conference.Outcomes: Patients that do not receive PBC may suffer in a greater extent, in comparison with those who get PBC, from pain and other symptoms and have less frequent access to drugs for pain, anxiety and nausea. They die with parenteral nutritional treatment and with pressure ulcers. Patients don't die where they prefer and they die alone. Their relatives don't receive information and are not offered bereavement support.Discussion: Insufficient documentation about PBC may bring about unnecessary unclarity on how to care for the patient, this uncertainty can be perceived as confusing for both patient and family. A PBC late in the disease can also impair the patients ability to participate in decision-making.
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| 9. |
- Narbe, Ulrik, et al.
(författare)
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The estrogen receptor coactivator AIB1 is a new putative prognostic biomarker in ER-positive/HER2-negative invasive lobular carcinoma of the breast
- 2019
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Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 175:2, s. 305-316
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: According to the 2017 St Gallen surrogate definitions of the intrinsic subtypes, Ki67, progesterone receptor (PR) and Nottingham histological grade (NHG) are used for prognostic classification of estrogen receptor (ER) positive/HER2-negative breast cancer into luminal A- or luminal B-like. The aim of the present study was to investigate if additional biomarkers, related to endocrine signaling pathways, e.g., amplified in breast cancer 1 (AIB1), androgen receptor (AR), and G protein-coupled estrogen receptor (GPER), can provide complementary prognostic information in a subset of ER-positive/HER-negative invasive lobular carcinoma (ILC). Methods: Biomarkers from 224 patients were analyzed immunohistochemically on tissue microarray. The primary endpoint was breast cancer mortality (BCM), analyzed with 10- and 25-year follow-up (FU). In addition, the prognostic value of gene expression data for these biomarkers was analyzed in three publicly available ILC datasets. Results: AIB1 (high vs. low) was associated to BCM in multivariable analysis (adjusted for age, tumor size, nodal status, NHG, Ki67, luminal-like classification, and adjuvant systemic therapy) with 10-year FU (HR 6.8, 95% CI 2.3–20, P = 0.001) and 25-year FU (HR 3.0, 95% CI 1.1–7.8, P = 0.03). The evidence of a prognostic effect of AIB1 could be confirmed by linking gene expression data to outcome in independent publicly available ILC datasets. AR and GPER were neither associated to BCM with 10-year nor with 25-year FU (P > 0.33). Furthermore, Ki67 and NHG were prognostic for BCM at both 10-year and 25-year FU, whereas PR was not. Conclusions: AIB1 is a new putative prognostic biomarker in ER-positive/HER2-negative ILC.
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| 10. |
- Wang, C., et al.
(författare)
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Injecting different types of biomass products to the blast furnace and their impacts on the CO2 emission reduction
- 2015
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Ingår i: AISTech - Iron and Steel Technology Conference Proceedings. - : Association for Iron and Steel Technology, AISTECH. - 9781935117476 ; , s. 1525-1535
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Konferensbidrag (refereegranskat)abstract
- Recent years more research has been focusing on utilizing biomass in the blast furnaces (BFs). One driving force is linked to the climate change mitigation, i.e. to reduce CO2 emission from fossil reducing agents or fuels, by using biomass. The amounts of biomass that could be utilized in BF is limited by different parameters, such as metallurgical properties of reducing agents, fuel properties such as volatile content, fixed carbon and oxygen content, ash chemistry (S, Na2O, K2O, etc.). In this paper, different types of biomass products in the form of solid, liquid and gas are investigated as injectants to the blast furnace. The modelling work has been done for a BF from a Nordic country. The possible amounts of injected biomass products are presented. With the replacement ratios of pulverized coal (PC), the potential CO2emission reduction when injecting different biomass products is quantified. In addition, the strategy of using biomass at the studied iron-making plant is discussed. AISTech 2015 Proceedings
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