1. |
- Berglund, Malin, 1970, et al.
(author)
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Hearing outcome after myringoplasty in Sweden: A nationwide registry-based cohort study
- 2020
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In: Clinical Otolaryngology. - : Wiley. - 1749-4478 .- 1749-4486 .- 1365-2273. ; 45:3, s. 357-363
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Journal article (peer-reviewed)abstract
- Objectives To present hearing results after successful primary myringoplasty surgeries registered in the Swedish Quality Registry for Myringoplasty and to evaluate the chance of hearing improvement and the risk of hearing loss. Design A retrospective nationwide cohort study based on prospectively collected registry data between 2002 and 2012. Settings Registry data from secondary and tertiary hospitals performing myringoplasty. Participants Patients with healed tympanic membrane after primary myringoplasty surgery performed from 2002 to 2012 in Sweden. Main outcome measures Postoperative hearing results, hearing gain and air-bone gap (ABG). Results In 2226 myringoplasties, air conduction audiograms were recorded, and the average preoperative pure tone average (PTA(4)) of the group was 28.5 dB, which improved postoperatively to 19.6 dB with an average of 8.8 dB improvement. Bone conduction was measured for 1476 procedures. Closure of the ABG to 10 dB or less was achieved in 51% of the ears and to less than 20 dB in 89% of the ears. Sixty-one percent of patients with preoperatively deteriorated hearing experienced improved hearing, but 3% of all patients experienced deteriorated hearing. After the surgery, 93% of the patients were satisfied. Conclusions Hearing results after successful myringoplasty surgery are often favourable, but although the tympanic membrane is healed, hearing improvement is not guaranteed, and hearing deterioration can also occur.
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2. |
- Berglund, Malin, 1970, et al.
(author)
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Tinnitus and taste disturbances reported after myringoplasty: Data from a national quality registry
- 2019
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In: Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 129:1, s. 209-215
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Journal article (peer-reviewed)abstract
- © 2018 The American Laryngological, Rhinological and Otological Society, Inc. Objectives/Hypothesis: Postoperative tinnitus and taste disturbances after myringoplasty are more common than previously reported. Study Design: This study was a retrospective analysis of prospectively collected data from the Swedish National Quality Registry for Myringoplasty. Methods: The analysis was performed on extracted data from all counties in Sweden collected from database A from 2002 to 2012 and database B from 2013 to 2016. Tinnitus and taste disturbance complications 1 year after myringoplasty were analyzed in relation to gender, age, procedure, and success rate. In database A, physicians reported tinnitus and taste disturbances. In database B, patients reported the complications. Results: A major difference was found when the complications were reported by physicians compared to when the complications were reported by patients. In database A, tinnitus was reported in 1.2% of the patients and taste disturbances in 0.5%. In database B, the frequencies were 12.3% and 11.2%, respectively. Tinnitus and taste disturbances were more frequent after conventional myringoplasty compared to those after fat grafting and were more frequent after primary compared to those after revision surgery when reported by physicians. Patients, however, reported the same frequency of tinnitus after fat graft myringoplasty compared to that after conventional myringoplasty (12.0% vs. 12.6%) and fewer taste disturbances after revision surgery. In follow-up assessments, complications persisted after surgery over a long time period. Conclusion: Tinnitus and taste disturbances are more common after myringoplasty when patients report their symptoms than when physicians report the symptoms. Level of Evidence: 2b. Laryngoscope, 2018.
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3. |
- Berglund, Malin, 1970, et al.
(author)
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Validation of the Swedish Quality Register for Ear Surgery - SwedEar
- 2023
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In: BMC Medical Informatics and Decision Making. - : BioMed Central (BMC). - 1472-6947. ; 23:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: The Swedish Quality Register for Ear Surgery (SwedEar) is a national register monitoring surgical procedures and outcomes of ear surgery to facilitate quality improvement. The value of the register is dependent on the quality of its data. SwedEar has never been validated regarding data quality or missing entries. Therefor, the purpose of this study was to assess coverage, completeness and response rate in the register and validate the physicians' reported data accuracy.METHODS: In this validation study, the completeness, response rate and missing registrations were analysed. Data in SwedEar were compared with the yearly collected statistics of otosurgical procedures in The Swedish Otosurgical Society and the comparison of rates between groups was calculated with Fisher's exact test. Validation of registered data accuracy was performed on every 20th registered case during a five-year period. Data were reabstracted from medical records and compared with the original registration. Interrater agreement, reliability measures, Cohen's kappa, Gwet's AC1 and positive predictive value were calculated.RESULTS: SwedEar has a coverage of 100%. The completeness of registered cases was 84% and the response rate was 74%. The validation of data accuracy assessed 13 530 variables, including audiograms. Less than 3% of incorrect or missing variables were identified. For most of the pre- and postoperative variables the Kappa and Gwet´s AC1 results show an almost perfect agreement (> 0.80). For audiogram data the ICC shows an excellent reliability (> 0.9) for all but one value.CONCLUSION: This validation shows that SwedEar has excellent coverage, high completeness, and that the data in the register have almost perfect reliability. The data are suitable for both clinical and research purposes. Further efforts to improve completeness are warranted.
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4. |
- Hultgren, Olof H., 1970, et al.
(author)
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Serum interleukin-1 receptor antagonist is an early indicator of colitis onset in Galphai2-deficient mice.
- 2006
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In: World journal of gastroenterology : WJG. - 1007-9327. ; 12:4, s. 621-4
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Journal article (peer-reviewed)abstract
- AIM: To study the serum concentration of IL-1beta, IL-1 receptor antagonist (IL-1Ra) and IL-18 in Galphai2-deficient mice at the age of 6 (healthy), 12 (pre-colitic) and 24 wk (colitic) and in healthy control mice. METHODS: At the time of killing, serum samples were collected and IL-1beta, IL-1Ra and IL-18 levels were measured using enzyme-linked immunosorbent assays. RESULTS: Serum concentration of IL-1Ra was significantly increased in pre-colitic (median: 524 ng/L; P=0.02) and colitic (450 ng/L; P=0.01), but not in healthy (196 ng/L) Galphai2-deficient mice as compared with controls (217 ng/L). Serum concentrations of IL-1beta did not differ between Galphai2-deficient mice and their controls, irrespective of age, IL-18 was significantly increased in colitic, but not in pre-colitic mice compared with controls (510 ng/L vs 190 ng/L; P=0.05). CONCLUSION: The increased serum concentrations of IL-18 and IL-1Ra in established diseases are suggested as markers of ongoing colitis. Interestingly, the significantly increased serum concentration of IL-1Ra in pre-colitic mice is found to be an early marker of disease progression.
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5. |
- Lönnerblad, Malin, 1970-
(author)
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Academic Performance in Swedish Ninth Grade Students Treated for Brain Tumours
- 2021
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to investigate how children in Sweden treated for brain tumours performed in their ninth year at school compared with matched controls. The studies investigated grades and results from national tests in the theoretical subjects of Swedish, English, and mathematics; grades in the practical and aesthetic subjects of art, crafts, music, home and consumer studies, physical education and health; and the frequency of delayed graduation and qualification for school years 10-12 (corresponding to upper-secondary school or high school).The results from this thesis demonstrate significant differences in performance between the group of children treated for brain tumours (cases) and their controls, both in the theoretical subjects and in the practical and aesthetic subjects. However, there were larger differences between cases and controls in the theoretical subjects than in the practical and aesthetic subjects. The largest differences were found in the subject of English, and there were also significant differences between cases and controls with regard to delayed graduation and qualification for school years 10-12. Graduation for children treated for brain tumours was delayed more often than for controls, and qualification for school years 10-12 was significantly higher among controls than for children treated for brain tumours. The results also showed different effects based on sex. For example, the gap between the girls treated for brain tumours and their controls was, in most cases, greater than for the boys and their controls. Whether the child had been treated for a high- or low-grade tumour did not have any significant impact on the results in any of the studies. Children treated at ages 0-5 and 6-9 years old were at particular risk of lower average grades in theoretical subjects or not qualifying for school years 10-12, although the latter result was significant only for the girls. Age at diagnosis was another significant factor for national test performance. There was also a positive correlation between the parents’ education levels and qualification for school years 10-12 for children treated for brain tumours.The implication of the results are that the academic performance of all children treated for brain tumours, regardless of sex, age at diagnosis, tumour grade, or parents’ education should be closely monitored when starting or returning to school after brain tumour treatment. It is also important to have a long-term perspective, as school difficulties do not disappear, but rather may increase over the years. Children treated before starting school should be monitored extra closely as well as children treated at ages 6-9, as a considerable number of basic skills are taught during these first school years. Moreover, it is of particular importance that girls and boys are equally monitored. Yet, the range of difficulties for children treated for brain tumours is wide and extremely heterogeneous. Thus, the type of support or intervention should be adapted to each child’s individual needs.
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6. |
- Lönnerblad, Malin, 1970-, et al.
(author)
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Occupational outcomes after high-grade or low-grade brain tumors in childhood: A Swedish, nationwide, registry-based study
- 2023
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In: Cancer Medicine. - : Wiley. - 2045-7634. ; 12:6, s. 7459-7469
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Journal article (peer-reviewed)abstract
- BackgroundSurvivors of pediatric brain tumors are at high risk of late complications that may affect their daily life in both short- and long-term perspectives. MethodsIn this nationwide registry-based study we explored the occupational outcomes, including employment, sickness or activity compensation and parental leave, in 452 individuals in Sweden, born 1988-1996, and diagnosed with a brain tumor before their 15th birthday. Their results were compared with 2188 matched controls. ResultsThere were significant differences between cases and controls for all assessed variables. The cases had benefitted from sickness or activity compensation 11 times more often than controls (CI 7.90-15.83; p < 0.001) between 2005 and 2016. Controls were almost three times more likely to have an employment (OR 0.36; CI 0.28-0.47; p < 0.001) and nearly twice as likely to have been on parental leave (OR 0.56; CI 0.39-0.80; p = 0.002). Although cases treated for high-grade tumors typically fared worse than those treated for low-grade tumors, significant differences for all assessed variables were also observed for cases treated for a low-grade tumor compared with controls. ConclusionsOur findings emphasize the need for follow-up programs for all brain tumor diagnoses, not only those known to be at most risk. This is evident, for example, from the high number of cases who received sickness or activity compensation.
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7. |
- Lönnerblad, Malin, 1970-, et al.
(author)
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Post-Compulsory Education in Teenagers and Young Adults Treated for Brain Tumors in Childhood: A Swedish Nationwide Registry-Based Study
- 2023
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In: Cancers. - : MDPI AG. - 2072-6694. ; 15:1
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Journal article (peer-reviewed)abstract
- Simple Summary Individuals treated for brain tumors in childhood are at high risk of cognitive and other late complications. The aim of this nationwide registry study was to explore further education following the nine years of compulsory school in Sweden in teenagers and young adults treated for childhood brain tumors. Individuals treated for embryonal tumors, low grade astrocytomas, optic pathway gliomas, craniopharyngiomas, and neuronal and mixed neuronal-glial tumors, were analyzed separately. All individuals treated for brain tumors were compared to about five times as many matched controls without cancer diagnoses or treatments. Our results demonstrate significant differences between cases and controls regarding attendance in high school, folk high school, and university. Individuals treated for embryonal tumors or optic pathway gliomas attended post-compulsory education less frequently than other analyzed diagnoses. There was a positive correlation between parental education levels and attendance in high school and university for both cases and controls. The risk of late complications after a brain tumor in childhood is high. Both the tumor itself and the treatments give rise to sequelae that affect daily life activities. In this registry study, we explored post-compulsory education, i.e., further education following the nine compulsory years in school, in 452 cases born 1988-1996 and diagnosed with a brain tumor before their fifteenth birthday. They were compared with 2188 individual controls who were not treated for cancer. Significantly fewer teenagers and young adults treated for brain tumors in childhood attended high school or university compared with controls, especially individuals treated for embryonal tumors or optic pathway gliomas. A significantly larger proportion of subjects treated for embryonal tumors and craniopharyngiomas attended folk high schools, a type of post-compulsory school with a more accessible learning environment. For both cases and controls, we observed a positive correlation between parental education levels and attendance in high school and university. In our previous studies we have shown that children treated for brain tumors, as a group, tend to perform worse during their last year of compulsory school compared with their peers, and the current study confirms that these differences remain over time.
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8. |
- Mobjörk, Malin, et al.
(author)
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Facilitating Doctoral Education in Cross-disciplinary Milieus : Experiences from PhD-candidates
- 2019
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Reports (other academic/artistic)abstract
- Cross-disciplinarity shapes much research today and many PhD candidates areengaged in this research. The doctoral education is a formative phase in a scientist’sintellectual development. Despite a large body of research about cross-disciplinarity,less attention has focused on how cross-disciplinarity shapes doctoral education.This report explores the organisation of doctoral education in four cross-disciplinaryresearch milieus and the experiences of 14 PhD candidates enrolled in these milieus.One key finding is that PhD candidates are more comfortable when their educationhas involved meta-communication about conceptual approaches and experiencesof conducting cross-disciplinary research. This calls for research milieus’ providingdoctoral education in cross-disciplinary settings to take a deliberative approach.This will both benefit the PhD candidates and the research milieus, and is centralin the socialisation process of the next cadre of researchers and for the future ofcross-disciplinary research.
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9. |
- Mobjörk, Malin, et al.
(author)
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Sustainable development and cross-disciplinary research education: Challenges and opportunities for learning
- 2020
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In: Högre Utbildning. - : Cappelen Damm Akademisk. - 2000-7558. ; 10:1, s. 76-89
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Journal article (peer-reviewed)abstract
- It is widely accepted that cross-disciplinarity influences education in issues of sustainability and sustainable development. However, despite a large body of research on cross-disciplinarity, less attention has been given to how it shapes research education. Research education is a formative phase in a researcher’s intellectual development and this article considers the whole research education process, including both its formal and informal aspects. It explores this arena and builds on the experiences of PhD candidates engaged in research education characterised by cross-disciplinarity in the realm of sustainable development. Drawing on pedagogical research on socialisation, this article examines how research education is organised in four research milieus and the experiences of PhD candidates pursuing their education in these learning contexts. The aim is to provide insights into how these research milieus can facilitate future cross-disciplinary research education on sustainable development. The analysis finds that in research milieus that provide courses and seminars about cross-disciplinarity, PhD candidates are more confident in situating their own research. The engagement of senior staff and supervisors in these activities is also key to develop a conceptual apparatus and building the capacity to interact with different disciplines and practitioners. Furthermore, the findings show the importance of communicating about cross-disciplinarity throughout the research education process, starting when PhD candidates are recruited and supervisors are appointed.
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10. |
- Olaison, Sara, 1976-, et al.
(author)
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Hearing Outcomes After Ossiculoplasty With Bone or Titanium Prostheses : A Nationwide Register-Based Study
- 2024
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In: Clinical Otolaryngology. - : John Wiley & Sons. - 1749-4478 .- 1365-2273 .- 1749-4486. ; 49:5, s. 660-669
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Journal article (peer-reviewed)abstract
- OBJECTIVES: This study compares hearing outcomes of two prosthesis materials, bone and titanium, used in ossiculoplasty.DESIGN: This retrospective nationwide registry-based study uses data systematically collected by the Swedish Quality Registry for Ear Surgery (SwedEar). SETTING: The data were obtained from clinics in Sweden that perform ossiculoplasty.PARTICIPANTS: Patients who underwent ossiculoplasty using either bone or titanium prostheses were registered in SwedEar between 2013 and 2019.MAIN OUTCOME MEASURES: Hearing outcome expressed as air-bone gap (ABG) gain.RESULTS: The study found no differences between bone and titanium for ABG or air conduction (AC) for either partial ossicular replacement prostheses (PORP) or total ossicular replacement prostheses (TORP). In a comparison between PORP and TORP for ABG and AC outcomes, regardless of the material used, PORP showed a small advantage, with an additional improvement of 3.3 dB (95% CI [confidence interval], 0.1-4.4) in ABG and 2.2 dB (95% CI, 1.7-4.8) in AC. In secondary surgery using TORP, titanium produced slightly better results for high-frequency pure tone average. The success rate, a postoperative ABG ≤20 dB, was achieved in 62% of the operations for the whole group.CONCLUSION: Both bone and titanium used to reconstruct the ossicular chain produce similar hearing outcomes for both PORP and TORP procedures. However, titanium may be a preferable option for secondary surgeries involving TORP. The success rate, a postoperative ABG ≤20 dB, is consistent with other studies, but there is room for improvement in patient selection criteria and surgical techniques.
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