| 41. |
- Johansson, Maurits, et al.
(author)
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Apathy and anxiety are early markers of Alzheimer's disease
- 2020
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In: Neurobiology of Aging. - : Elsevier BV. - 0197-4580 .- 1558-1497. ; 85, s. 74-82
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Journal article (peer-reviewed)abstract
- In this study, we investigated associations between neuropsychiatric symptoms (i.e., apathy, anxiety, and depression) and cerebral atrophy, white matter lesions (WML), beta-amyloid (A beta) deposition, and cognitive decline in a nondemented sample. 104 cognitively unimpaired and 53 subjects with mild cognitive impairment were followed for up to 4 years within the Swedish BioFINDER study. Neuropsychiatric assessments included the Hospital Anxiety and Depression Scale and the Apathy Evaluation Scale. Magnetic resonance imaging and F-18-flutemetamol-positron emission tomography quantified brain atrophy, WML, and A beta deposition. Mini-Mental State Examination assessed longitudinal global cognition. Regression analyses were used to test for associations. Apathy and anxiety were shown related to A beta deposition and predicted cognitive decline. Anxiety also interacted with amyloid status to predict faster cognitive deterioration. Apathy was further related to frontotemporal and subcortical atrophy, as well as WML. To conclude, the associations between apathy and anxiety with A beta deposition and cognitive decline point to these symptoms as early clinical manifestations of Alzheimer's disease. (C) 2019 Elsevier Inc. All rights reserved.
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| 42. |
- Karling, Pontus, et al.
(author)
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Function and dysfunction of the colon and anorectum in adults: working team report of the Swedish Motility Group (SMoG).
- 2009
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In: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 44:6, s. 646-60
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Research review (peer-reviewed)abstract
- Symptoms of fecal incontinence and constipation are common in the general population. These can, however, be unreliably reported and are poorly discriminatory for underlying pathophysiology. Furthermore, both symptoms may coexist. In the elderly, fecal impaction always must be excluded. For patients with constipation, colon transit studies, anorectal manometry and defecography may help to identify patients with slow-transit constipation and/or pelvic floor dysfunction. The best documented medical treatments for constipation are the macrogols, lactulose and isphagula. Evolving drugs include lubiprostone, which enhances colonic secretion by activating chloride channels. Surgery is restricted for a highly selected group of patients with severe slow-transit constipation and for those with large rectoceles that demonstrably cause rectal evacuatory impairment. For patients with fecal incontinence that does not resolve on antidiarrheal treatment, functional and structural evaluation with anorectal manometry and endoanal ultrasound or magnetic resonance (MR) of the anal canal may help to guide management. Sacral nerve stimulation is a rapidly evolving alternative when other treatments such as biofeedback and direct sphincter repair have failed. Advances in understanding the pathophysiology as a guide to treatment of patients with constipation and fecal incontinence is a continuing important goal for translational research. The content of this article is a summary of presentations given by the authors at the Fourth Meeting of the Swedish Motility Group, held in Gothenburg in April 2007.
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| 43. |
- Karlsson, Beatrice, et al.
(author)
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Quasispecies dynamics and molecular evolution of human norovirus capsid P region during chronic infection
- 2009
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In: Journal of General Virology. - : Microbiology Society. - 0022-1317 .- 1465-2099. ; 90:2, s. 432-441
-
Journal article (peer-reviewed)abstract
- In this novel study, we have for the first time identified evolutionarily conserved capsid residues in an individual chronically infected with norovirus (GGII.3). From 2000 to 2003, a total of 147 P1-1 and P2 capsid sequences were sequenced and investigated for evolutionarily conserved and functionally important residues by the evolutionary trace (ET) algorithm. The ET algorithm revealed more absolutely conserved residues (ACR) in the P1-1 domain (47/53, 88 %) as compared with the P2 domain (86/133, 64 %). The capsid P1-1 and P2 domains evolved in time-dependent manner, with a distinct break point observed between autumn/winter of year 2000 (isolates P1, P3 and P5) and spring to autumn of year 2001 (isolates P11, P13 and P15), which presumably coincided with a change of clinical symptoms. Furthermore, the ET analysis revealed a similar receptor-binding pattern as reported for Norwalk and VA387 strains, with the CS-4 and CS-5 patch (Norwalk strain) including residues 329 and 377 and residues 306 and 310, respectively, all being ACR in all partitions. Most interesting was that residues 343, 344, 345, 374, 390 and 391 of the proposed receptor A and B trisaccharide binding site (VA387 strain) within the P2 domain remained ACR in all partitions, presumably because there was no selective advantage to alter the histo blood group antigens (HBGA) receptor binding specificity. In conclusion, this study provides novel insights to the evolutionary process of norovirus during chronic infection.
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| 44. |
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| 45. |
- Lindberg, Gunnar
(author)
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Valuation and pricing of traffic safety
- 2006
-
Doctoral thesis (other academic/artistic)abstract
- This thesis consists of six essays covering the topic of valuation and pricing of accidents. In the first essay a theory of the external marginal cost of accidents is presented. The external cost is dependent on the value of statistical life, the proportion internal cost and the so called risk elasticity, i.e. the relationship between traffic flow and accident risk. The two following essays present CV-studies on value of statistical life. Both CV-studies are based on the community approach built on the Swedish Vision Zero and ask respondents about their willingness-to-pay for absolute safety from fatal and severe accidents in one city.The first study focuses on the problem of scope and hypothetical bias and shows that ex post calibration based on respondents’ certainty in answering the WTP question reduces the willingness-to-pay with up to 30% for a public good. Based on these certain responses a lower bound VSL value is presented of SEK 53 million for a private good and 20 million for a public good. The second essay discusses the topic of nonselfish preferences and willingness-to-pay for children’s safety as well as for relatives and friends. The essay suggests that WTP for children safety is higher than private safety and that a WTP for the safety of relatives and friends is prevailing. Also this essay shows a big difference between the WTP for a private good and for a public good. The two following essays estimate the risk elasticity for railway level crossing accidents as well as for heavy goods vehicles in Sweden. Both essays find that the risk decreases with increased traffic i.e. negative risk elasticity. The last essay presents the result from a field experiment with speed related charges and bonuses. The experiment shows that internalisation of the external accident cost through speed related economic incentives strongly will affect drivers choice of speed. It is proposed that this can be achieved on a voluntary basis.
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| 46. |
- Lindberg, Jeanette, 1987, et al.
(author)
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Family Members’ Perspectives on Patient Participation in Spinal Cord Injury Rehabilitation
- 2014
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In: International Journal of Physical Medicine & Rehabilitation. - 2329-9096. ; 2:5, s. 1-7
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Journal article (peer-reviewed)abstract
- Purpose: To examine the importance and experiences of patient participation in spinal cord injury (SCI) rehabilitation from the perspective of family members, and compared with patients’ views. Method: Family members (N=83) and discharged patients with SCI (N=141) completed the Patient Participation in Rehabilitation Questionnaire (PPRQ), assessing the importance and experiences of the domains Respect and integrity; Planning and decision-making; Information and knowledge; Motivation and encouragement; and Involvement of family. Importance ratings were compared between all family members and patients, and experience ratings were compared between patient-family dyads (N=74). Results: Both family members and patients rated all participation domains as very or extremely important (m ≥4.0 of max 5). Family members rated all domains as slightly more important than did patients; however, patients rated Planning and decision-making more important that the family members (Δ=0.20; p<0.01). No significant differences were found between patients and family members regarding experience ratings and agreement was substantial (ICC=0.63-0.80). Conclusions: Current guidelines recommend involvement of family members in SCI care and rehabilitation. This study shows that family members, and patients alike, also considered their involvement as very important and that they were often given opportunities to be involved. Moreover, patients and family members shared perceptions of conditions necessary for facilitating and promoting participation. Although considerable congruence was found between family members’ and patients’ assessments, agreement was not perfect. As incongruence between patients and family members regarding the quality and delivery of care may disturb the rehabilitation process and its outcomes, it is important that differences in perspectives be identified and successfully resolved. The PPRQ may be useful in assessing patients’ and family members’ views of patient participation and in detecting disparities between them.
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| 47. |
- Lindberg, Jeanette, 1987, et al.
(author)
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Patient participation in care and rehabilitation from the perspective of patients with spinal cord injury
- 2013
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In: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 834-7
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Journal article (peer-reviewed)abstract
- Study design:Qualitative method, semi-structured interviews.Objectives:The aim of the study was to explore the meaning of patient participation in care and rehabilitation from the perspective of patients with spinal cord injury (SCI).Setting:Post discharge community setting.Methods:Semi-structured interviews were performed with 10 persons with SCI representing different ages, gender and levels of injury. All interviews were conducted individually and lasted 40-120 min. The interviews were verbally transcribed and the data were analyzed by means of content analysis.Results:All informants stressed the importance of patient participation as a necessary prerequisite for successful care and rehabilitation, but emphasized that participation must be tailored to each patient's own preferences, capacities and needs. They also underscored that the staff should be sensitive and responsive to the fact that desired levels and kinds of participation may vary from patient to patient, as well as for the same patient during the course of the rehabilitation. Five themes reflecting central aspects of participation emerged: respect and integrity, planning and decision-making, information and knowledge, motivation and encouragement, and involvement of family.Conclusions:Patient participation is a critical component of successful SCI rehabilitation and must be facilitated, promoted and tailored to each patient by the staff. Based on the finding from this study a questionnaire has been developed for assessing patient experiences of five domains of participation in rehabilitation to serve as a tool to help in evaluating provided care and in identifying patients' preferences for participation
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| 48. |
- Lindberg, Jeanette, 1987, et al.
(author)
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Patient Participation in Rehabilitation Questionnaire (PPRQ)-development and psychometric evaluation
- 2013
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In: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 838-42
-
Journal article (peer-reviewed)abstract
- Study design:A cross-sectional postal questionnaire study.Objectives:The aim of the study was to evaluate selected psychometric properties of a draft version of the Patient Participation in Rehabilitation Questionnaire (PPRQ) measuring patients' experiences of participation in care and rehabilitation.Setting:Sweden.Methods:On the basis of previous qualitative analyses of patient interview data, a 32-item questionnaire covering five domains of participation was developed and sent to 268 persons with spinal cord injury, aged 18-80 years and injured 1-12 years previously. In total, 141 (51%) evaluable questionnaires were returned. Multi-trait analysis was used to assess scaling assumptions by testing item convergent and discriminant validity and internal consistency reliability (Cronbach's α) associated with the hypothesized item-scale structure of the questionnaire.Result:Nine items failed to meet scaling assumptions and were omitted. Scaling assumptions were thereafter substantiated for the scales: 'respect and integrity' (6 items); 'planning and decision-making' (4 items); 'information and knowledge' (4 items); 'motivation and encouragement' (5 items); and 'involvement of family' (4 items). Item-scale correlations ranged from 0.67 to 0.85 and most items correlated higher or significantly higher with their hypothesized scale than with other scales. Cronbach's α was 0.89 for all scales.Conclusion:The PPRQ appears to adequately assess central aspects of participation in care and rehabilitation from the perspective of patients with spinal cord injury. Further studies using larger samples will be undertaken to confirm the scale structure as well as the sensitivity and responsiveness of the questionnaire.
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| 49. |
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| 50. |
- Lindberg, Nils-Olof, et al.
(author)
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Use of software to facilitate pharmaceutical formulation : experiences from a tablet formulation
- 2004
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In: Journal of Chemometrics. - Chichester : John Wiley & Sons, Ltd. - 0886-9383 .- 1099-128X. ; 18:3-4, s. 133-138
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Journal article (peer-reviewed)abstract
- This paper exemplifies the benefits of using experimental design together with software to facilitate the formulation of a tablet for specific purposes, from screening to robustness testing. By applying a multivariate design for the screening experiments, many excipients were evaluated in comparatively few experiments. The formulation work was generally based on designed experiments. Most of the experiments were fractional or full factorial designs, generated and evaluated in Modde with the centre point replicated. The robustness of the formulation was evaluated with experimental designs on two different occasions. Tested flavours were found to have limited influence on the important responses, which was key information in order to proceed with that particular composition. The formulation was also robust towards normal batch-to-batch variation of the excipients and the active pharmaceutical ingredient. A process step was investigated and, by applying experimental design and keeping in mind previous findings, important information could be gained from the study. The different studies yielded good and very useful models. Established relationships between design factors and responses provided information that was vital for the project. In cases of poor models, essential information regarding robustness was obtained.
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