| 61. |
- Bornehag, Carl-Gustaf, 1957-, et al.
(författare)
-
The SELMA study : a birth cohort study in Sweden following more than 2000 mother-child pairs
- 2012
-
Ingår i: Paediatric and Perinatal Epidemiology. - Hoboken, USA : Wiley-Blackwell. - 0269-5022 .- 1365-3016. ; 26:5, s. 456-467
-
Tidskriftsartikel (refereegranskat)abstract
- Background: This paper describes the background, aim and study design for the Swedish SELMA study that aimed to investigate the importance of early life exposure during pregnancy and infancy to environmental factors with a major focus on endocrine disrupting chemicals for multiple chronic diseases/disorders in offspring.Methods: The cohort was established by recruiting women in the 10th week of pregnancy. Blood and urine from the pregnant women and the child and air and dust from home environment from pregnancy and infancy period have been collected. Questionnaires were used to collect information on life styles, socio-economic status, living conditions, diet and medical history.Results: Of the 8394 reported pregnant women, 6658 were invited to participate in the study. Among the invited women, 2582 (39%) agreed to participate. Of the 4076 (61%) non-participants, 2091 women were invited to a non-respondent questionnaire in order to examine possible selection bias. We found a self-selection bias in the established cohort when compared with the non-participant group, e.g. participating families did smoke less (14% vs. 19%), had more frequent asthma and allergy symptoms in the family (58% vs. 38%), as well as higher education among the mothers (51% vs. 36%) and more often lived in single-family houses (67% vs. 60%).Conclusions: These findings indicate that the participating families do not fully represent the study population and thus, the exposure in this population. However, there is no obvious reason that this selection bias will have an impact on identification of environmental risk factors.
|
|
| 62. |
- Munthe, Christian, 1962
(författare)
-
A New Ethical Landscape of Prenatal Testing: Individualizing Choice to Serve Autonomy and Promote Public Health: A Radical Proposal
- 2015
-
Ingår i: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 29:1, s. 36-45
-
Tidskriftsartikel (refereegranskat)abstract
- A new landscape of prenatal testing (PNT) is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development supports a radical individualization of how PNT screening is organized. This reformation is, at the same time, difficult to reconcile with responsible spending of resources in a publicly funded healthcare context. Thus, while the ethical imperative of individualization holds and applies to PNT, the new landscape of PNT provides reasons to start rolling back the type of mass-screening programmes currently established in many countries. Instead, more limited offers are suggested, based on considerations of severity of conditions and optimized to simultaneously serve reproductive autonomy and public health within an acceptable frame of priorities. The new landscape of PNT furthermore underscores the ethical importance of supporting and including people with disabilities. For the very same reason, no ban on what may be analysed using PNT in the new landscape should be applied, although private offers must, of course, conform to strict requirements of respecting reproductive autonomy and what that means in terms of counselling.
|
|
| 63. |
- Groglopo, Adrián, 1967
(författare)
-
Hälsa, vård och strukturell diskriminering
- 2006
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Antologin behandlar den strukturella diskrimineringens inverkan på hälsotillstånd samt tillgång till en adekvat hälsa- och sjukvård för personer med utländsk bakgrund. Antologins olika bidrag ger viktiga insikter om hur den strukturella diskrimineringen tar sig uttryck och om dess konsekvenser.
|
|
| 64. |
|
|
| 65. |
- Nilsson, Lisbeth, et al.
(författare)
-
Driving to Learn in a Powered Wheelchair: The Process of Learning Joystick Use in People With Profound Cognitive Disabilities
- 2011
-
Ingår i: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 65:6, s. 652-660
-
Tidskriftsartikel (refereegranskat)abstract
- The Driving to Learn project explored ways to help people with profound cognitive disabilities practice operating a joystick-operated powered wheelchair. The project used a grounded theory approach with constant comparative analysis and was carried out over 12 yr. The participants were 45 children and adults with profound cognitive disabilities. Reference groups included 17 typically developing infants and 64 participants with lesser degrees of cognitive disability. The data sources included video recordings, field notes, open interviews, and a rich mixture of literature. The findings that emerged yielded strategies for facilitating achievements, an 8-phase learning process, an assessment tool, and a grounded theory of deplateauing explaining the properties necessary for participants to exceed expected limitations and plateaus. Eight participants with profound cognitive disabilities reached goal-directed driving or higher. Participants were empowered by attaining increased control over tool use, improving their autonomy and quality of life.
|
|
| 66. |
- Wikberg, Carl, et al.
(författare)
-
Is the Thoughts and Health programme feasible in the context of Swedish schools? : A quasi-experimental controlled trial study protocol
- 2021
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:1
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction Clinical depression is a substantial problem among adolescents, increasing significantly at about age 15 years. It causes impairment in social, academic and familial relationships, as well as ongoing cognitive and emotional difficulties for the individual. A study in Iceland demonstrated that a cognitive-behavioural, developmentally based intervention programme, 'Thoughts and Health', prevented initial episodes of depression and/or dysthymia (DYS) (major depressive disorder/DYS) in adolescents for up to 12 months following completion of the programme. We would like to test the feasibility of implementing the Icelandic method in a Swedish context and to evaluate the long-term effects of such a programme. Methods and analysis A quasi-experimental controlled design, combined with qualitative and quantitative methods, will be used to address the research questions. In this study, 617 children aged similar to 14 years will be screened for depression, and those "at risk" for development of clinical depression will be offered a 12 week course, 'Thoughts and Health'. This course aims to prevent first depression in adolescents. A comparable group of children will function as controls. Depending on the type of variable, baseline comparisons between the two groups of relevant initial measures will be evaluated with t-tests or chi(2) analyses. The effects of the programme on the development of clinical levels of depression will be evaluated using the follow-up data of 6, 12 and 18 months. Index parental depression at baseline will be tested as a moderator in the evaluation of the effects of the prevention programme. Ethics and dissemination This study is approved by the Swedish Ethical Review Board (reference number 2019-03347) in Gothenburg. We plan to disseminate the knowledge gained from this study by publishing our results in peer-reviewed scientific journals and other scholarly outlets.
|
|
| 67. |
- Groglopo, Adrián, 1967, et al.
(författare)
-
Coloniality and decolonisation in the Nordic region: An introduction
- 2023
-
Ingår i: Groglopo, Adrián & Julia Suárez-Krabbe (2023).Coloniality and Decolonisation in the Nordic Region. Routledge: New York.. - New York : Routledge - Taylor & Francis Group. - 9781032274867 ; , s. 1-21
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter aims to further fruitful conversations about the meaning and implications of coloniality, decoloniality and decolonization in the Nordic region. Such a collective endeavour cannot bypass the perspectives and historical experience of people in the Nordic region who are produced as non-belonging, absent, criminal and/or barbaric in general, including ‘non-Western’ migrants and refugees, Afro-Nordics and Muslim communities, as well as the Romani and the indigenous communities of the region such as the Sami and Inuit. However, much of the decolonial scholarship in the Nordic region approaches coloniality through a poststructuralist and postcolonial lens and reproduces the coloniality of knowledge by ignoring and depoliticizing the radical political concepts and projects emanating the abovementioned peoples in the Nordic region and the colonized regions of the world, resulting in undertheoretization. On this basis, the chapter argues for the need of reclaiming the political, which involves theorizing the materiality of colonial politics in contemporary Nordic societies, including its imperial investments and political economy.
|
|
| 68. |
- Brundin, Peik M. A., 1975-
(författare)
-
Sex differences in immune response and sex hormone receptor expression in healthy individuals and during viral infection
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is sex-bias in morbidity and mortality from infectious diseases. Infections kill more men than women and several studies have pointed out differences in the immune system as a reason. The sex hormones estrogen, progesterone and testosterone all shape the effect of the immune response on multiple levels. Women at fertile age have been suggested to have higher proinflammatory responses from inflammatory stimuli compared to men and post-menopausal women, which has been ascribed to their higher estrogen levels. This could possibly lead to a more active pathogen response but may also result in a detrimental immunopathology to infections or development of autoimmune reaction.The overall aim of this thesis is to study the contribution of sex hormones and sex hormone receptors (SHR) to sex differences in immune response. We focus on peripheral blood mononuclear cells (PBMCs) to study such relationships in healthy individuals, as well as in individuals with asymptomatic Torque Teno Virus infection, and individuals with acute Puumala virus infection.In Paper I, we investigated expression of SHR and immune response genes in PBMC from healthy premenopausal (pre-MP) women during the menstrual cycle. The expression levels were estimated using a qPCR Array (Taqman low-density array, TLDA). SHR expression did not change significantly during the menstrual cycle, but several key immune regulatory genes were significantly more expressed during the ovulatory and mid luteal phase. Further, we separated PBMC into cell subsets (CD4+ T-cells, CD8+ T-cells, CD56+ NK-cells, CD14+ monocytes and CD19+ B-cells) and analyzed the expression through qPCR of estrogen receptors (ERs), ERα, ERβ1 (wildtype) and the isoform ERβ2. For the first time and unexpectedly, we demonstrate that the isoform ERβ2 was more abundant than wildtype ERβ1. The data from this paper provides new knowledge on the contribution of the menstrual cycle on immune response.In Paper II, we explored the use of Torque Teno Virus as a secondary functional immune marker in men and women. Expression of viral TTV DNA in PBMCs was estimated using a qPCR kit from Argene (R-gene) and analyzed in relation to serum sex hormone levels. The results showed that 50% of the men, 25% the post-MP women, and 18% of the pre-MP women were TTV+. Interestingly, all pre-MP women that were TTV+ had hormonal aberrances and were either anovulatory and/or hypothyroid. TTV+ pre-MP women also had significantly lower progesterone levels than TTV- pre-MP women. This paper indicates that the prevalence of TTV in PBMC differs between men, pre-MP and post-MP women. Furthermore, hormonal aberrances (at least in pre-MP women) will lead to increased prevalence of TTV.In Paper III we investigated the expression of ERα, ERβ1 and ERβ2 in PBMC from patients with Nephropathia epidemica, the viral zoonotic disease caused by Puumala virus, a Hanta virus known to affect more men than women. Expression of ERs in PBMCs and clinical laboratory results during the acute and convalescent phases were analyzed using a principal component analysis (PCA). The results show differences in ER expression and support previous findings that men and women have a different clinical pictureIn conclusion, the results in this thesis reveal distinct patterns of immune response related to sex hormone levels, SHR expression and the phases of the menstrual cycle supporting that there a link between sex hormone levels and immune responses. Further, we show that the ER isoform ERβ2 is more abundant in PBMCs than what was previously described. The data in this thesis adds to the knowledge to the sex differences in immune response and exemplifies the importance of taking these differences into account in the clinic.
|
|
| 69. |
- Toschke, Audré M., et al.
(författare)
-
Paternal smoking is associated with a decreased prevalence of type 1 diabetes mellitus among offspring in two national British birth cohort studies (NCDS and BCS70)
- 2007
-
Ingår i: Journal of Perinatal Medicine. - Berlin : Walter de Gruyter. - 0300-5577 .- 1619-3997. ; 35:1, s. 43-7
-
Tidskriftsartikel (refereegranskat)abstract
- AB Aims: An association between paternal age and type 1 diabetes (IDDM) among their offspring was recently reported as well as transgenerational responses in humans. This paper aims to assess the association of markers for prenatal exposures with IDDM. Methods: We analysed data from two birth cohorts in Great Britain on 5214 cohort members from the National Child Development Study (NCDS) and 6068 members of the 1970 British Birth Cohort Study (BCS70) with full information on IDDM and explanatory variables using multivariate logistic regression. Results: IDDM prevalence was 0.7% (95% CI 0.5-1.0%; n = 38) in the NCDS and 0.4% (95% CI 0.3-0.6%; n = 27) in the BCS70 cohort. Paternal age was not associated with IDDM possibly due to lack of sample power. Unex-pectedly, a lowered prevalence of IDDM was observed among offspring of smoking fathers in both cohorts, with a combined odds ratio of 0.44 (95% CI 0.25-0.75). This association could not be explained by maternal smoking prior to, during or after pregnancy, number of siblings, parental social class, maternal and paternal age, or cohort. Maternal smoking in pregnancy did not alter the IDDM prevalence among offspring. Conclusions: This unexpected finding may be explained by germ-line mutations or other mechanisms associated with paternal smoking. This phenomenon should be investigated and these results should not be used as a justification for smoking. Paternal exposures may be important in determining IDDM risk.
|
|
| 70. |
- Grynne, A., et al.
(författare)
-
Women's experience of the health information process involving a digital information tool before commencing radiation therapy for breast cancer : a deductive interview study
- 2023
-
Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Individuals undergoing radiation therapy for breast cancer frequently request information before, throughout and after the treatment as a means to reduce distress. Nevertheless, the provision of information to meet individuals needs from their level of health literacy is often overlooked. Thus, individuals information needs are often unmet, leading to reports of discontent. Internet and digital information technology has significantly augmented the available information and changed the way in which persons accesses and comprehends information. As health information is no longer explicitly obtained from healthcare professionals, it is essential to examine the sequences of the health information process in general, and in relation to health literacy. This paper reports on qualitative interviews, targeting women diagnosed with breast cancer who were given access to a health information technology tool, Digi-Do, before commencing radiation therapy, during, and after treatment. METHODS: A qualitative research design, inspired by the integrated health literacy model, was chosen to enable critical reflection by the participating women. Semi-structured interviews were conducted with 15 women with access to a digital information tool, named Digi-Do, in addition to receiving standard information (oral and written) before commencing radiation therapy, during, and after treatment. A deductive thematic analysis process was conducted. RESULTS: The results demonstrate how knowledge, competence, and motivation influence women's experience of the health information process. Three main themes were found: Meeting interactive and personal needs by engaging with health information; Critical recognition of sources of information; and Capability to communicate comprehended health information. The findings reflect the women's experience of the four competencies: to access, understand, appraise, and apply, essential elements of the health information process. CONCLUSIONS: We can conclude that there is a need for tailored digital information tools, such as the Digi-Do, to enable iterative access and use of reliable health information before, during and after the radiation therapy process. The Digi-Do can be seen as a valuable complement to the interpersonal communication with health care professionals, facilitating a better understanding, and enabling iterative access and use of reliable health information before, during and after the radiotherapy treatment. This enhances a sense of preparedness before treatment starts.
|
|
