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- Veronese, N., et al.
(författare)
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Inverse relationship between body mass index and mortality in older nursing home residents : a meta-analysis of 19,538 elderly subjects
- 2015
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Ingår i: Obesity Reviews. - : Wiley. - 1467-7881 .- 1467-789X. ; 16:11, s. 1001-1015
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Forskningsöversikt (refereegranskat)abstract
- Body mass index (BMI) and mortality in old adults from the general population have been related in a U-shaped or J-shaped curve. However, limited information is available for elderly nursing home populations, particularly about specific cause of death. A systematic PubMed/EMBASE/CINAHL/SCOPUS search until 31 May 2014 without language restrictions was conducted. As no published study reported mortality in standard BMI groups (<18.5, 18.5-24.9, 25-29.9, 30kg/m(2)), the most adjusted hazard ratios (HRs) according to a pre-defined list of covariates were obtained from authors and pooled by random-effect model across each BMI category. Out of 342 hits, 20 studies including 19,538 older nursing home residents with 5,223 deaths during a median of 2 years of follow-up were meta-analysed. Compared with normal weight, all-cause mortality HRs were 1.41 (95% CI=1.26-1.58) for underweight, 0.85 (95% CI=0.73-0.99) for overweight and 0.74 (95% CI=0.57-0.96) for obesity. Underweight was a risk factor for higher mortality caused by infections (HR=1.65 [95% CI=1.13-2.40]). RR results corroborated primary HR results, with additionally lower infection-related mortality in overweight and obese than in normal-weight individuals. Like in the general population, underweight is a risk factor for mortality in old nursing home residents. However, uniquely, not only overweight but also obesity is protective, which has relevant nutritional goal implications in this population/setting.
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- Gustafsson, B. M., et al.
(författare)
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Parents experiences of investigations and interventions by Child Healthcare, Child and Adolescent Psychiatry and Child and Youth Habilitation
- 2024
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Ingår i: Children's health care. - : Routledge; Taylor & Francis. - 0273-9615 .- 1532-6888. ; 53:1, s. 1-22
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Tidskriftsartikel (refereegranskat)abstract
- This study examines parents experiences of support, investigation and treatment from child healthcare/psychiatry and habilitation in children with ESSENCE symptoms (neurodevelopmental symptoms). Data were collected through focus interviews, with 13 parents. A conventional qualitative analysis revealed four main categories: confidence, information, competence and collaboration, affecting parents. While waiting for an investigation parents experience anxiety, frustration, lack of information and confidence and doubts about their parenting ability, which also affects the child. The categories were interpreted using Bronfenbrenners bioecological model to illustrate the effects on the familys interaction with the context. Parents demand a greater insight and participation in the ongoing process and improved collaboration between the various professionals
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| 6. |
- Gustafsson, Berit, et al.
(författare)
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The assessment of preschool children with ESSENCE symptoms: concordance between parents, preschool teachers and child psychologists
- 2024
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Ingår i: BMC Pediatrics. - : BMC. - 1471-2431. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIt is important to detect children with Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) in order to implement early intervention and support for the child and family. Standardized instruments for assessment in different contexts of behaviour problems, engagement and psychosocial health obtain an objective picture of the preschool child's mental health.AimTo explore and compare parents', preschool teachers' and child health care psychologists' assessment of behaviour, everyday function, engagement, social interaction and psychosocial health in children with ESSENCE symptoms.MethodParents of 152 children (114 boys and 38 girls, 4.5 +/- 1 years) with ESSENCE symptoms, 155 preschool teachers and 8 child psychologists participated. Parents and preschool teachers assessed externalizing and internalizing behavioural problems using the Strengths and Difficulties Questionnaire (SDQ), including the SDQ supplement for assessing the impact of behavioral problems on daily function. Preschool teachers also assessed engagement and social interaction using the Children's Engagement Questionnaire (CEQ), and the child psychologists assessed psychosocial health with the Child Psychosocial Health Assessment (LillaLAPS) and template in conversations with parents of children with neurodevelopmental problems.ResultsParents', preschool teachers' and child psychologists' assessment of the child's ESSENCE symptoms overall agreed. Both parents and preschool teachers see a strength in the child's social abilities. Differences in mean values show that parents assess more conduct, emotional symptoms and problems in daily life and more social skills, compared to the preschool teachers rating more peer problems.ConclusionIt is important to consider different contexts to identify the child's need for support in everyday life. Expanded use of validated screening instruments in clinical practice would promote detection of children not already identified as exhibiting neurodevelopmental problems.
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| 7. |
- Jaraj, D., et al.
(författare)
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Long-Term Prognostication for 20 114 Women With Small and Node-Negative Breast Cancer (T1abN0)
- 2021
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Ingår i: Jnci Cancer Spectrum. - : Oxford University Press (OUP). - 2515-5091. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although small, node-negative breast cancer (ie, T1abN0) constitutes 20% of all newly diagnosed breast cancers, data on prognosis and prognostic factors are limited. Methods: We conducted a population-based cohort study including 20 114 Swedish women treated for T1abN0 breast cancer from 1977 onward. Patient and tumor data were collected from Swedish breast cancer registries. Cohort subjects were followed through linkage to the Cause of Death Register. We calculated the cumulative incidence of breast cancer-specific and overall death and used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During a median follow-up of 9.1 years (range = 0-38), 915 women died of breast cancer and 5416 of any cause. The 10-, 20-, and 30-year cumulative incidences of breast cancer death were 3.4% (95% CI = 3.1% to 3.7%), 7.6% (95% CI = 7.1% to 8.2%), and 10.5% (95% CI = 9.6% to 11.4%), respectively. The multivariable hazard ratios and 95% confidence intervals of breast cancer death were 0.92 (95% CI = 0.88 to 0.97) for each additional calendar year of diagnosis, 4.38 (95% CI = 2.79 to 6.87) for grade 3 vs grade 1 tumors, 0.43 (95% CI = 0.31 to 0.62) for progesterone receptor-positive vs progesterone receptor-negative disease, and 2.01 (95% CI = 0.99 to 4.07) for HER2-positive vs HER2-negative disease. Women with grade 3 vs grade 1 tumors had a 56% increased risk of death from any cause (HR = 1.56, 95% CI = 1.30 to 1.88). Conclusions: The risk of breast cancer death in T1abN0 disease continues to increase steadily beyond 10 years after diagnosis, has improved over time, and varies substantially by tumor characteristics.
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