| 1. |
- Conti, David, V, et al.
(författare)
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Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction
- 2021
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Ingår i: Nature Genetics. - : Springer Nature. - 1061-4036 .- 1546-1718. ; 53:1, s. 65-75
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Tidskriftsartikel (refereegranskat)abstract
- Prostate cancer is a highly heritable disease with large disparities in incidence rates across ancestry populations. We conducted a multiancestry meta-analysis of prostate cancer genome-wide association studies (107,247 cases and 127,006 controls) and identified 86 new genetic risk variants independently associated with prostate cancer risk, bringing the total to 269 known risk variants. The top genetic risk score (GRS) decile was associated with odds ratios that ranged from 5.06 (95% confidence interval (CI), 4.84-5.29) for men of European ancestry to 3.74 (95% CI, 3.36-4.17) for men of African ancestry. Men of African ancestry were estimated to have a mean GRS that was 2.18-times higher (95% CI, 2.14-2.22), and men of East Asian ancestry 0.73-times lower (95% CI, 0.71-0.76), than men of European ancestry. These findings support the role of germline variation contributing to population differences in prostate cancer risk, with the GRS offering an approach for personalized risk prediction. A meta-analysis of genome-wide association studies across different populations highlights new risk loci and provides a genetic risk score that can stratify prostate cancer risk across ancestries.
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| 2. |
- Vandenput, Liesbeth, et al.
(författare)
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A meta-analysis of previous falls and subsequent fracture risk in cohort studies
- 2024
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Ingår i: Osteoporosis International. - : Springer. - 0937-941X .- 1433-2965. ; 35:3, s. 469-494
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Tidskriftsartikel (refereegranskat)abstract
- SummaryThe relationship between self-reported falls and fracture risk was estimated in an international meta-analysis of individual-level data from 46 prospective cohorts. Previous falls were associated with an increased fracture risk in women and men and should be considered as an additional risk factor in the FRAX® algorithm.IntroductionPrevious falls are a well-documented risk factor for subsequent fracture but have not yet been incorporated into the FRAX algorithm. The aim of this study was to evaluate, in an international meta-analysis, the association between previous falls and subsequent fracture risk and its relation to sex, age, duration of follow-up, and bone mineral density (BMD).MethodsThe resource comprised 906,359 women and men (66.9% female) from 46 prospective cohorts. Previous falls were uniformly defined as any fall occurring during the previous year in 43 cohorts; the remaining three cohorts had a different question construct. The association between previous falls and fracture risk (any clinical fracture, osteoporotic fracture, major osteoporotic fracture, and hip fracture) was examined using an extension of the Poisson regression model in each cohort and each sex, followed by random-effects meta-analyses of the weighted beta coefficients.ResultsFalls in the past year were reported in 21.4% of individuals. During a follow-up of 9,102,207 person-years, 87,352 fractures occurred of which 19,509 were hip fractures. A previous fall was associated with a significantly increased risk of any clinical fracture both in women (hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.33–1.51) and men (HR 1.53, 95% CI 1.41–1.67). The HRs were of similar magnitude for osteoporotic, major osteoporotic fracture, and hip fracture. Sex significantly modified the association between previous fall and fracture risk, with predictive values being higher in men than in women (e.g., for major osteoporotic fracture, HR 1.53 (95% CI 1.27–1.84) in men vs. HR 1.32 (95% CI 1.20–1.45) in women, P for interaction = 0.013). The HRs associated with previous falls decreased with age in women and with duration of follow-up in men and women for most fracture outcomes. There was no evidence of an interaction between falls and BMD for fracture risk. Subsequent risk for a major osteoporotic fracture increased with each additional previous fall in women and men.ConclusionsA previous self-reported fall confers an increased risk of fracture that is largely independent of BMD. Previous falls should be considered as an additional risk factor in future iterations of FRAX to improve fracture risk prediction.
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| 3. |
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| 4. |
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| 5. |
- Fjellstrom, Sanna, et al.
(författare)
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Web-based training intervention to increase physical activity level and improve health for adults with intellectual disability
- 2022
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Ingår i: Journal of Intellectual Disability Research. - : John Wiley & Sons. - 0964-2633 .- 1365-2788. ; 66:12, s. 967-977
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Tidskriftsartikel (refereegranskat)abstract
- Background: Individuals with intellectual disability (ID) are less physically active, have a higher body mass index (BMI) and are at greater risk for cardiovascular diseases (CVDs) than people without ID. The purpose of the study was to explore the effectiveness of a web-based training programme, consisting of 150 min of activity per week, on the health of people with ID.Method: Participants with ID living in supported accommodation (n = 28, 48% female, age = 36.4 ± 9.56 years) participated in a web-based training programme, consisting of a combination of exercises (endurance, strength balance and flexibility) of moderate intensity, 50 min, three times per week for 12 weeks. The body composition and waist circumference (WC) were measured, and questionnaires were used to assess enjoyment, quality of life (QoL) and physical activity (PA) level. Descriptive statistics and pairwise comparison pre and post intervention were carried out.Results: A total of 22 out of 28 participants completed the 12-week training intervention with 83% mean attendance of training sessions. The intensity of the PA level increased and a decrease in fat mass of 1.9 ± 2.4 kg, P < 0.001 and WC of 3 ± 5 cm, P = 0.009 were observed. Enjoyment of training sessions was 3.9 out of 5, and no differences in QoL were found.Conclusion: A web-based training programme is an effective tool for improving health parameters of people with ID and offers a new way for caregivers to enhance the PA for the target group.
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| 6. |
- Fjellström, Sanna, et al.
(författare)
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Difference in balance capacity for Special Olympics athletes and non-athletes with intellectual disabilities
- 2024
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Ingår i: European Journal of Adapted Physical Activity. - : European Federation of Adapted Physical Activities. - 1803-3857. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Fall incidents are a significant health problem for people with intellectual disabilities (ID) and physical activity improves balance capacity and can prevent the risk of falling. The Special Olympics Healthy Athletes® offers health screenings and education to athletes with ID. The aim of this cross-sectional study was to explore whether Special Olympics athletes have better balance capacity than non-athletes with ID. During the Special Olympics Sweden Invitational Games 2020, athletes and non-athletes participated in the Healthy Athletes programme. The results of athletes (n=47) and non-athletes (n=25) for balance tests (i.e. single leg stance, functional reach and timed sit-to stand test) and health markers (i.e. blood pressure and body mass index) were analysed. Athletes showed higher balance capacity, more physical activity at moderate intensity and a lower body mass index and diastolic blood pressure compared to non-athletes. However, the balance capacity of both athletes and non-athletes with ID were low, lower than for people without ID. From this study, Special Olympics athletes showed higher physical activity on moderate intensity and higher balance capacity which can decrease the risk of fall incidents compared to non-athletes.
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| 7. |
- Fjellström, Sanna, et al.
(författare)
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Increasing physical activity through an adapted web-based exercise program for people with intellectual disabilities : Support staff are crucial for feasibility
- 2024
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Ingår i: JARID. - : John Wiley & Sons. - 1360-2322 .- 1468-3148. ; 37:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPeople with intellectual disabilities are less physically active and suffer from ill-health more than the general population. Support staff play an important role in the person's life. This study aimed to explore the support staff's experiences regarding the feasibility of adapted web-based exercise for people with intellectual disabilities.MethodParticipants with intellectual disabilities living in community-based settings were recruited for a web-based exercise study. Eight semi-structured interviews were carried out with their support staff before and after the intervention period.ResultsThe main theme, ‘Support staff are crucial for feasibility’ encompasses the importance of communication, structure, and motivation in improving physical activity for people with intellectual disabilities.ConclusionThe experiences of support staff, indicate that a web-based exercise program is feasible for the target group, and one way to overcome challenges for PA, where the role of the staff is crucial.
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| 8. |
- Garrison, Julie A., 1993-, et al.
(författare)
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Temporal and spatial changes in benthic invertebrate trophic networks along a taxonomic richness gradient
- 2022
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Ingår i: Ecology and Evolution. - : Wiley. - 2045-7758. ; 12:6
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Tidskriftsartikel (refereegranskat)abstract
- Species interactions underlie most ecosystem functions and are important for understanding ecosystem changes. Representing one type of species interaction, trophic networks were constructed from biodiversity monitoring data and known trophic links to assess how ecosystems have changed over time. The Baltic Sea is subject to many anthropogenic pressures, and low species diversity makes it an ideal candidate for determining how pressures change food webs. In this study, we used benthic monitoring data for 20 years (1980–1989 and 2010–2019) from the Swedish coast of the Baltic Sea and Skagerrak to investigate changes in benthic invertebrate trophic interactions. We constructed food webs and calculated fundamental food web metrics evaluating network horizontal and vertical diversity, as well as stability that were compared over space and time. Our results show that the west coast of Sweden (Skagerrak) suffered a reduction in benthic invertebrate biodiversity by 32% between the 1980s and 2010s, and that the number of links, generality of predators, and vulnerability of prey have been significantly reduced. The other basins (Bothnian Sea, Baltic Proper, and Bornholm Basin) do not show any significant changes in species richness or consistent significant trends in any food web metrics investigated, demonstrating resilience at a lower species diversity. The decreased complexity of the Skagerrak food webs indicates vulnerability to further perturbations and pressures should be limited as much as possible to ensure continued ecosystem functions.
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| 9. |
- Hardell, Lennart, et al.
(författare)
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Exposure to phenoxyacetic acids and glyphosate as risk factors for non-Hodgkin lymphoma– pooled analysis of three Swedish case-control studies including the sub-type hairy cell leukemia
- 2023
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Ingår i: Leukemia and Lymphoma. - : Informa UK Limited. - 1042-8194 .- 1029-2403. ; 64:5, s. 997-1004
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Tidskriftsartikel (refereegranskat)abstract
- The association between pesticide exposure and non-Hodgkin lymphoma (NHL) including hairy cell leukemia (HCL) was analyzed in a pooled study of three case-control studies. Results on exposure to pesticides were based on 1,425 cases and 2,157 controls participating in the studies. Exposures were assessed by self-administered questionnaires completed as needed by phone. In the pooled univariate analyses adjusted by age, gender and year of diagnosis, exposure to herbicides of the phenoxyacetic acid type yielded statistically significant increased risk with odds ratio (OR) = 1.9, 95% confidence interval CI) = 1.4–2.5. The herbicide glyphosate gave OR = 2.2, 95% CI = 1.3–3.8. Impregnating agents increased the risk. No clear dose-response effect was seen. OR was highest in the >10–20 years latency group for herbicides and impregnating agents. In the multivariate analysis including main pesticide groups, statistically significant increased risk was found for herbicides, OR = 1.6, 95% CI = 1.2–2.1 and impregnating agents with OR = 1.4, 95% CI = 1.1–1.8. This analysis confirmed an association between NHL including HCL and exposure to certain herbicides.
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| 10. |
- Hellgren, Rikard, 1988-, et al.
(författare)
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Measurement of ice pressure on a concrete dam with a prototype ice load panel
- 2020
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Ingår i: Cold Regions Science and Technology. - : Elsevier. - 0165-232X .- 1872-7441. ; 170
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Tidskriftsartikel (refereegranskat)abstract
- This paper presents the development and installation of a prototype ice load panel and measurements of ice load from February 2016 to February 2018 at the Rätan hydropower dam in Sweden. The design of the 1 × 3 m2 panel enables direct measurement of ice pressure on the concrete surface is based on previous experience from similar measurements with sea ice. Important features of the design are sufficient height and width to reduce scale effects and to cover the ice thickness and variations in water level. The Rätan dam was chosen based on several criteria so that the ice load is considered to be reasonably idealized against the dam structure.For the three winters 2016, 2016/2017, 2017/2018, the maximum ice load recorded was 161 kN/m, 164 kN/m and 61 kN/m respectively. There were significant daily fluctuations during the cold winter months, and the daily peak ice loads showed a visual correlation with the daily average temperature and with the daily pattern of operation of the power station with its corresponding water level variations.
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| 11. |
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| 12. |
- Klasson, Caritha, et al.
(författare)
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Sex Differences in the Effect of Vitamin D on Fatigue in Palliative Cancer Care : A Post Hoc Analysis of the Randomized, Controlled Trial 'Palliative-D'
- 2022
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 14:3
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Tidskriftsartikel (refereegranskat)abstract
- In the randomized, placebo-controlled, double-blind trial 'Palliative-D', vitamin D treatment of 4000 IE/day for 12 weeks reduced opioid use and fatigue in vitamin-D-deficient cancer patients. In screening data from this trial, lower levels of vitamin D were associated with more fatigue in men but not in women. The aim of the present study was to investigate possible sex differences in the effect of vitamin D in patients with advanced cancer, with a specific focus on fatigue. A post hoc analysis of sex differences in patients completing the Palliative-D study (n = 150) was performed. Fatigue assessed with the Edmonton Symptom Assessment Scale (ESAS) was reduced in vitamin-D-treated men; -1.50 ESAS points (95%CI -2.57 to -0.43; p = 0.007) but not in women; -0.75 (95%CI -1.85 to 0.36; p = 0.18). Fatigue measured with EORTC QLQ-C15-PAL had a borderline significant effect in men (-0.33 (95%CI -0.67 to 0.03; p = 0.05)) but not in women (p = 0.55). The effect on fatigue measured with ESAS in men remained the same after adjustment for opioid doses (p = 0.01). In conclusion, the positive effect of the correction of vitamin D deficiency on fatigue may be more pronounced in men than in women. However, studies focused on analyzing sex differences in this context must be performed before firm conclusions can be drawn.
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| 13. |
- Klasson, Caritha, et al.
(författare)
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Vitamin D and Fatigue in Palliative Cancer : A Cross-Sectional Study of Sex Difference in Baseline Data from the Palliative D Cohort
- 2021
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Ingår i: Journal of Palliative Medicine. - : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 24:3, s. 433-437
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fatigue is one of the most distressing symptoms in patients with advanced cancer. Previous studies have shown an association between low vitamin D levels and fatigue. Objectives: The aim of this study was to investigate the association between vitamin D levels and self-assessed fatigue in cancer patients admitted to palliative care, with focus on possible sex differences. Design: This is a cross-sectional study. Subjects: Baseline data from 530 screened patients, 265 women and 265 men, from the randomized placebo-controlled trial "Palliative-D" were analyzed. Measurements: Vitamin D status was measured as 25-hydroxyvitamin D (25-OHD) and fatigue was assessed with EORTC-QLQ-PAL15 and with Edmonton Symptom Assessment System (ESAS). Results: In men, there was a significant correlation between 25-OHD and fatigue measured with the "Tiredness question" (Q11) in EORTC-QLQ-PAL15 (p < 0.05), where higher 25-OHD levels were associated with less fatigue. No correlation between 25-OHD and fatigue was seen for women. Fatigue measured with ESAS did not show any significant association with 25-OHD levels neither in men nor in women. Conclusion: Low vitamin D levels were associated with more fatigue in men but not in women. The study underscores the importance of subgroup analysis of men and women when evaluating the effect of vitamin D in clinical trials since the effect may differ between the sexes. The ongoing "Palliative-D study" will reveal whether vitamin D supplementation may counteract fatigue in both men and women.ClinicalTrial.gov: NCT03038516.
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| 14. |
- Korpinen, Samuli, et al.
(författare)
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Food web assessments in the Baltic Sea : Models bridging the gap between indicators and policy needs
- 2022
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 51:7, s. 1687-1697
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Tidskriftsartikel (refereegranskat)abstract
- Ecosystem-based management requires understanding of food webs. Consequently, assessment of food web status is mandatory according to the European Union’s Marine Strategy Framework Directive (MSFD) for EU Member States. However, how to best monitor and assess food webs in practise has proven a challenging question. Here, we review and assess the current status of food web indicators and food web models, and discuss whether the models can help addressing current shortcomings of indicator-based food web assessments, using the Baltic Sea as an example region. We show that although the MSFD food web assessment was designed to use food web indicators alone, they are currently poorly fit for the purpose, because they lack interconnectivity of trophic guilds. We then argue that the multiple food web models published for this region have a high potential to provide additional coherence to the definition of good environmental status, the evaluation of uncertainties, and estimates for unsampled indicator values, but we also identify current limitations that stand in the way of more formal implementation of this approach. We close with a discussion of which current models have the best capacity for this purpose in the Baltic Sea, and of the way forward towards the combination of measurable indicators and modelling approaches in food web assessments.
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| 15. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Med en salutogen blick för att främja oral hälsa
- 2022
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Ingår i: Aktuel Nordisk Odontologi. - : Universitetsforlaget. - 1902-3545 .- 2058-7538. ; 47:1, s. 33-47
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Tidskriftsartikel (refereegranskat)abstract
- Tandvården är främst präglad av ett patogent synsätt med fokus på riskfaktorer och behandling. Om vi istället sätter på oss salutogena glasögon kan vi med detta synsätt se individens livssituation och dennes resurser för att främja hälsosamma vanor. Tandvårdspersonal kan stödja individen genom personcentrerade samtal och på så sätt skapa delaktighet och motivation och uppmuntra individen till att använda sin kapacitet och resurser i syfte att påverka sin orala hälsa. Tandvården är också en viktig hälsofrämjande arena som bör samverka med andra arenor utanför kliniken och integrera den orala hälsan med allmänhälsan. Att arbeta med hälsoresurser och främjande bestämningsfaktorer enligt en salutogen grundsyn för ett hälsofrämjande arbete i praktiken är en framgångsfaktor för en jämställd och god hälsa för alla.
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| 16. |
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| 17. |
- Nordström, Axel, et al.
(författare)
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Distinct eicosanoid patterns in severe recalcitrant nasal polyposis
- 2023
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Ingår i: International Forum of Allergy & Rhinology. - 2042-6984. ; 13:11, s. 2043-2054
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although altered eicosanoid levels are related to disease severity in chronic rhinosinusitis with nasal polyps (CRSwNP), identifying patients prone to recurrent NPs is still difficult. We investigated levels of nasally secreted eicosanoids before and after NP surgery in patients with or without NP recurrence and explored potential endotypes based on pre-surgical eicosanoid levels.METHODS: Levels of leukotriene (LT) E4 , LTB4 , prostaglandin (PG) D2 , PGE2 and 15(S) hydroxyeicosatetraenoic acid (15(S)-HETE) were measured in nasal secretions with specific immunoassays at pre-surgery (n = 38) and six- and 12-months post-surgery (n = 35) where NP recurrence was identified endoscopically. Pre- and post-surgical levels were compared between patients with and without NP recurrence. Eicosanoid patterns among patients were explored with cluster analysis and evaluated with clinical parameters.RESULTS: Patients with recurrent NPs had pronounced pre-surgical levels of nasal 15(S)-HETE, PGD2 and LTE4 . From pre-surgery to 12-months after, NP recurrence was associated with significant decrease of 15(S)-HETE and PGD2 relative to non-recurrence whereas levels of LTE4 decreased at six-months but increased again at 12-months. Clustering revealed three potential endotypes. Cluster 1 and 3 featured high and low eicosanoid levels, respectively. Cluster 2 had higher levels of LTE4 and PGD2 , lower levels of PGE2 and LTB4 , and more cases of recurrent NPs and previous NP surgeries.CONCLUSION: Elevated nasal LTE4 , 12-month post-surgery, in NP recurrent subjects suggests that postoperative LTE4 measurements may indicate rapid NP regrowth. A distinct nasal eicosanoid profile may be used for the identification of the most severe recalcitrant patients in need of targeted immunomodulatory therapies. This article is protected by copyright. All rights reserved.
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| 18. |
- Nordström, Axel
(författare)
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Exploring eicosanoids as biomarkers in severe chronic rhinosinusitis with nasal polyps
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic rhinosinusitis (CRS) is one of the most common inflammatory chronic conditions, leading to a persistent nasal congestion, nasal discharge, and a loss of smell. Despite sinus surgery and frequent use of oral corticosteroids, a large proportion of individuals with CRS are difficult to treat and have recurrent inflammation. They are usually referred to as individuals with recalcitrant disease and having recurrent nasal polyps (NPs; CRSwNP). The disease poses a significant impact on the patients' health-related quality of life (HrQoL), mainly because of a complete loss of smell. Pharmacological treatment with biological therapies has recently been developed, targeting mediators of the type 2 inflammatory response. However, not everyone benefits from the biological therapy, and it has proven difficult to identify and characterise patients that are responsive to these new medications. Eicosanoids, being arachidonic acid derived bioactive lipid mediators, has been shown to be implicated in CRSwNP. Although there is a clear link between an imbalanced biosynthesis of pro- and anti-inflammatory eicosanoids and type 2 inflammation, to date research has not focused on them as biomarkers in CRSwNP.The overall aim of this thesis was to explore the potential role of eicosanoids as biomarkers and characterise changes over time in HrQoL as well as the degree of smell loss in patients with severe recalcitrant CRSwNP. The project involved immunoassay analysis of levels of various inflammatory mediators, including a selection of eicosanoids, in nasal tissue, nasal secretions and urine from patients with CRSwNP as well as gene expression analyses regarding biosynthetic enzymes and receptors for eicosanoids in nasal tissues. HrQoL was assessed with SNOT-22 and RAND-36, along with point-of-care tests as eosinophil blood count, fractional exhaled nitric oxide (FeNO) and smell tests with Burghart Sniffin’ Sticks.Levels of eicosanoids in nasal secretions were found to associate with the disease severity, defined as the extent of NP growth (paper I). One of the eicosanoids, leukotriene E4 (LTE4), were correlated to the degree of smell loss (paper I). An increase in LTE4 between six and 12 months after surgery was demonstrated in patients with recurrent NPs (paper II). Recurrent NPs were identified endoscopically 12 months after surgery and a distinct eicosanoid profile involving LTE4, prostaglandin D2 and 15(S) hydroxyeicosatetraenoic acid was found to be more common in those with recurrence (paper II). A similar eicosanoid profile, based on measurements from nasal tissue samples instead, was also associated with NP recurrence (paper III).Levels of eicosanoids in nasal tissue and nasal secretions were correlated suggesting that analysis of biomarkers in nasal secretions reflects release from the nasal tissue (paper III). Patients with recurrent NPs had elevated blood eosinophil counts before their surgery, and their sense of smell was significantly impaired both before and after (paper IV). This finding suggests that loss of smell may be the first symptom during recurrence. Although measures of HrQoL could not distinguish patients with recurrent NPs, there was a strong correlation to the degree of smell loss suggesting that loss of smell has a significant impact on the HrQoL (paper IV).In summary, the results from this thesis contribute to an extended knowledge regarding characteristics relevant for identifying severe recalcitrant CRSwNP. Characteristics of interest included a distinct eicosanoid profile, severe loss of smell and eosinophil involvement, all of which may be possible prognostic markers for severe recalcitrant CRSwNP with rapid NP growth. It may be concluded that such biomarkers can guide the choice of treatment for these severely ill patients – repeated surgery or pharmacological treatment with the newly developed biological therapies.
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| 19. |
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| 20. |
- Nordström, Axel, et al.
(författare)
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Hot saline irrigation in comparison to nasal packing after sinus surgery
- 2021
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Ingår i: Laryngoscope Investigative Otolaryngology (LIO). - : Wiley. - 2378-8038. ; 6:6, s. 1267-1274
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Previous studies have shown that hot saline solution (HSS) nasal irrigation is effective against nasal bleeding and is used to treat nasal hemorrhage. In a pilot study, we evaluated hot saline nasal irrigation in comparison to a routinely used nasal packing in terms of self-reported complications and mucosal healing after functional endoscopic sinus surgery.Methods: Patients undergoing surgery for bilateral chronic rhinosinusitis received polyvinyl acetate (PVA) nasal packing in the left nostril, and the right nostril was rinsed with 47°C sterile saline immediately after surgery. Patients' experiences of pain, bleeding, and other types of uncomfortable experiences were measured using a visual analog scale for each nostril before, during, and immediately after nasal packing removal. Two weeks post-surgery, the assessments were repeated including an endoscopic evaluation of the mucosa by the surgeon.Results: Twenty-seven patients completed the study. Prior to removal of the packing, the patients experienced significantly more pain and other uncomfortable experiences in the nostril treated with nasal packing, as compared to the nostril solely rinsed with hot saline. After removal, patients reported significantly more uncomfortable experiences from the packing treated nostril. Two weeks post-surgery, no difference in mucosal healing was observed between the two nostrils.Conclusions: The results from this study indicate that irrigation with HSS could be an alternative postoperative treatment to conventional PVA nasal packing. Hot saline irrigation may contribute to patients experiencing improved control of postoperative bleeding, pain, and less suffering of other causes as well as health-economic benefits, without affecting the mucosal healing up to 2 weeks post-surgery.Level of Evidence: 1b.
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| 21. |
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| 22. |
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| 23. |
- Nordström, Axel, et al.
(författare)
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Levels of eicosanoids in nasal secretions associated with nasal polyp severity in chronic rhinosinusitis
- 2022
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Ingår i: Prostaglandins, Leukotrienes and Essential Fatty Acids. - : Elsevier BV. - 0952-3278 .- 1532-2823. ; 184
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Tidskriftsartikel (refereegranskat)abstract
- Severe nasal polyposis and mucosal inflammation, in patients with chronic rhinosinusitis (CRS) may include a dysregulated eicosanoid profile, but a clinical role for eicosanoids in CRS with nasal polyps (NP; CRSwNP) remains to be elucidated. This study focused on assessing levels and clinical implications of inflammatory mediators in nasal secretions and urine from patients with different NP severity or Aspirin Exacerbated Respiratory Disease (AERD). Levels of leukotrienes E4 and B4, prostaglandins D2 and E2 as well as 15(S)-hydroxyeicosatetraenoic acid were measured with enzyme immunoassays and cytokines with magnetic bead immunoassays. Patients with CRSwNP were subdivided based on NP score; CRSwNP-low (NP score ≤ 4, n = 11) or CRSwNP-high (NP score ≥ 5, n = 32) and compared to CRS without polyps (CRSsNP, n = 12), CRSwNP-AERD (n = 11) and individuals without CRS (n = 25). Smell test score, fractional exhaled nitric oxide (FeNO), blood eosinophils and Sinonasal outcome test-22 were assessed as clinical markers. Leukotriene E4, prostaglandin D2 and 15(S)-hydroxyeicosatetraenoic acid in nasal secretions correlated with NP score. Nasal leukotriene E4 also correlated with FeNO and smell test score, with highest levels found in CRSwNP-AERD. Levels of prostaglandin D2 in nasal secretion as well as urinary levels of the prostaglandin D2 metabolite 11β-prostaglandin F2α differed between CRSNP-high and CRSwNP-low. Urinary 11β-prostaglandin F2α was associated with asthma comorbidity whereas a similar association with prostaglandin D2 in nasal secretions was not observed. In conclusion, subdividing patients based on NP severity in combination with analysis of eicosanoids in non-invasively collected nasal secretions, may have clinical implications when assessing CRS disease severity.
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| 24. |
- Nordström, Marie, et al.
(författare)
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Common resilience factors among healthy individuals exposed to chronic adversity : a systematic review
- 2023
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:3, s. 176-185
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Forskningsöversikt (refereegranskat)abstract
- Objective: To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.Materials and methods: The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).Results: A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.Conclusions: Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.
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| 25. |
- Nordström, Marie, et al.
(författare)
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Karies : världens vanligaste icke smittsamma sjukdom
- 2024
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 121
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Tidskriftsartikel (refereegranskat)abstract
- More than 2.8 billion individuals worldwide suffer from untreated caries. Over ninety-five percent of all 50-year-olds in Sweden have caries experience. Caries is the most common cause of dental restorations and tooth loss. Tooth loss is associated with cardiovascular diseases, dementia, and death. Periapical tooth infections caused by caries can spread and cause severe infection, however rarely with lethal outcome. Sugars are a common risk factor for caries and other noncommunicable diseases such as cardiovascular diseases, diabetes, and obesity. Caries is a consequence of sugar-provoked acid production and dysbiosis in the tooth biofilm (dental plaque). There are several conditions which may increase the risk for dental caries, such as different medical conditions and medications which may cause dry mouth. Treatment costs for caries are high.
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| 26. |
- Nordström, Marie, et al.
(författare)
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Some young adults can maintain good oral health despite socioeconomic challenges
- 2024
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Ingår i: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722. ; 132:3
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Tidskriftsartikel (refereegranskat)abstract
- The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.
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| 27. |
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| 28. |
- Nowak, Marie, et al.
(författare)
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Boosting Sustainable Food Choice with Carbon Labels in Tourism Destination Restaurants - A Field Experiment
- 2023
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Konferensbidrag (refereegranskat)abstract
- Proposal and OriginalityFood consumption in tourism is a key contributor to the tourism industry’s carbon footprint. Yet, empirically tested interventions aimed at nudging tourists towards more sustainable food choices are lacking. By conducting a field experiment in a restaurant at a major Swedish winter destination, we study how food service providers in tourism can boost the sustainable food choices of consumers via carbon labels. Our findings contribute to knowledge on the drivers of sustainable tourist behaviour. This has practical implications for providers aiming to trigger sustainable behaviour.Methodology We ran two workshops with restaurant staff to design an intervention (CO2e labels) aimed at triggering sustainable food choices of consumers. A field experiment tested the intervention over 6 weeks using an A-B-A experimental design. In the analysis, 9 menu items and 1449 data cases were used.Results and ImplicationsTheoretical implications concern the advancement of knowledge on the behavioural factors that drive sustainable food choices of tourists and the challenges and opportunities tourism providers face in facilitating more sustainable food choices. Practical implications concern new knowledge on the design of effective interventions and how these can reduce providers’ carbon footprint with sustained or increased profitability. Methodologically, we contribute with new understandings of field experiments designed in collaboration with restaurant managers and staff.Research Limitations The study was conducted in only one restaurant. Other factors that might influence consumers’ food choices (price, taste, personal disposition etc) were not measured.
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| 29. |
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| 30. |
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Ramverkspraktikern #VPF5
- 2021
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Konstnärligt arbete (film/video)abstract
- Videon handlar om skillnaden mellan att vara en reflekterande praktiker och en ramverkspraktiker. Ramverket pm3 och portföljstyrning används som exempel i berättelsen. Ramverkspraktikern har svårt att ta sig bortom orden i ett standardiserat ramverk. Det som går förlorat är de organisatoriska anpassningar som är nödvändiga för att ett ramverk ska ge de nyttor som är avsedda. Motsatsen till ramverkspraktikern är den reflekterande praktikern som tar sig till en konceptuell nivå och genom ständig reflektion utvecklas genom hela yrkeslivet. Videon är också en illustration av den ramverksoptimism som präglar offentliga organisationer. Videon är baserad på ett möte som utspelade sig strax före utbrottet av pandemin. Det är den enskilda händelse som kom att bli det avgörande startskottet för Tankesmedjan Praktikforskarna.
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| 31. |
- Vikberg, Sanna, et al.
(författare)
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Adapted internet-based training program improves exercise accessibility for people with intellectual disabilities
- 2021
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Konferensbidrag (refereegranskat)abstract
- Introduction and objective Individuals with intellectual disability (ID) are less physically active than people without ID, and rarely or never reach the recommended daily dose of physical activity level. People with ID have a higher BMI than their peers and therefore a higher risk of obesity causing cardiovascular diseases. The overall objective was to determine the effectiveness on health and user experience of a 12-week, internet-based training program, customized for people with ID. Methods Participants with ID living in communal settings (n=27, 48% female, age = 36.4±9.56 years) were recruited for a training study including 50 minutes training 3 times a week in 12 weeks. Staff working with these participants (n=7, 57% female) were recruited for interviews. Questionnaires were used to evaluate enjoyment, quality of life and physical activity level, along with interviews. Body composition was measured as well as waist circumference. Results This study showed that 85% of the participants completed the web-based training. The level of physical activity (PA) increased during this period and positive changes in health outcomes were observed, for example a significant decrease in fat mass by a mean of 1.9kg ±2.4. The study also high-lighted barriers and facilitators for people with ID to use web-based training, along with perspectives and experiences on health and exercise among the staff within the supported housings. Conclusion A web-based training program is a new way to increase level of PA for people with ID. This study showed that web-based training program is an effective tool to improve health parameters, reduces hinders such as transport. Moreover, it is an easy way for staff to enhance PA in their work. This study present how web-based training was appreciated by many but not all participants ID which would probably be the same for people in general. The study was performed during the Covid-19 pandemic, which might have influenced the interest of the study in a positive manner. Individuals with ID can be difficult to reach in health care. Barriers such as transport, less knowledge in health literacy and difficulties in seeking care are examples why. A web based exercise program is one of many parameters that can help to improve health and an effective way for health care to reach this target group in a cost effective manner.
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