| 1. |
- Ericsson, Olle, et al.
(author)
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Clinical validation of a novel automated cell-free DNA screening assay for trisomies 21, 13, and 18 in maternal plasma.
- 2019
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In: Prenatal diagnosis. - : Wiley. - 1097-0223 .- 0197-3851. ; 39:11, s. 1011-1015
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Journal article (peer-reviewed)abstract
- To evaluate clinical performance of a new automated cell-free (cf)DNA assay in maternal plasma screening for trisomies 21, 18, and 13, and to determine fetal sex.Maternal plasma samples from 1200 singleton pregnancies were analyzed with a new non-sequencing cfDNA method, which is based on imaging and counting specific chromosome targets. Reference outcomes were determined by either cytogenetic testing, of amniotic fluid or chorionic villi, or clinical examination of neonates.The samples examined included 158 fetal aneuploidies. Sensitivity was 100% (112/112) for trisomy 21, 89% (32/36) for trisomy 18, and 100% (10/10) for trisomy 13. The respective specificities were 100%, 99.5%, and 99.9%. There were five first pass failures (0.4%), all in unaffected pregnancies. Sex classification was performed on 979 of the samples and 99.6% (975/979) provided a concordant result.The new automated cfDNA assay has high sensitivity and specificity for trisomies 21, 18, and 13 and accurate classification of fetal sex, while maintaining a low failure rate. The study demonstrated that cfDNA testing can be simplified and automated to reduce cost and thereby enabling wider population-based screening.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
- Rudman, Ann, et al.
(author)
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Sjuksköterskor i frontlinjen av COVID-19 pandemin : vilka blev konsekvenserna? Teknisk rapport om enkät och datainsamling
- 2022
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Reports (other academic/artistic)abstract
- Denna rapport summerar datainsamlingen som genomfördes av SCB (Statistiska centralbyrån) i projektet ”Sjuksköterskor i frontlinjen av COVID-19 pandemin: Vilka blev konsekvenserna?”. Projektet är finansierat av AFA försäkring (Diarienr 200311). I kapitel 1 beskrivs bakgrund till LUST (Longitudinell Undersökning om Sjuksköterskors Tillvaro) studien. I kapitel 2 beskrivs studien utifrån design, rekrytering och datainsamling. I kapitel 3 redovisas översikt över innehållet i enkäten som skickades ut studiedeltagarna. Projektet bedrivs på Högskolan Dalarna och inom ramen för Petter Gustavssons forskargrupp vid Karolinska Institutet.Sjuksköterskor har varit i frontlinjen av COVID-19-pandemin och de stressorer som de utsatts för i sitt arbete inom hälso- och sjukvården kan orsaka hälsoproblem. I föreliggande projekt har en nationell kartläggning av sjuksköterskors arbetssituation och hälsa under COVID-19 pandemin gjorts. Undersökningen är gjord utifrån de tre sjuksköterskekohorter som följts inom ramen för LUST-studien sedan 2002 (Gustavsson et al., 2013; Rudman, Hörberg, et al., 2020; Rudman et al., 2010). I LUST-studien har närmare 4500 sjuksköterskestudenter följts med uppföljande enkäter från deras utbildningstid 11 till 15 år efter examen. En uppföljande enkätundersökning genomfördes i september 2021 till januari 2022 vilket motsvarar 15 till 19 år efter examen. En speciellt anpassad enkät med relevans och aktualitet för arbetet under pandemin hade utvecklats gemensamt med forskare som har expertis gällande sjuksköterskor i olika verksamheter som belastats under COVID-19 pandemin. Enkäterna besvarades när pandemin pågått i ungefär ett år och nio månader.I samarbete med SCB har datainsamlingen genomförts som en postenkät med påminnelser och med möjlighet att besvara frågorna online. Svarsfrekvensen för enkätstudien blev 57% för hela undersökningen (för samtliga kohorter), vilket bedöms vara en hög svarsfrekvens med tanke på hur belastad sjuksköterskekåren har varit under COVID-19 pandemin.
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| 6. |
- Smedberg Bondesson, Anna, et al.
(author)
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”Vi snakker bare litt om porno” : Multimodal och platsorienterad analys av rumsligt gestaltade affekter i Sesam Sesam av Gro Dahle och Kaia Dahle Nyhus
- 2023
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In: Litteraturdidaktik och känslor. - : Stockholm University Press.
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Book chapter (pop. science, debate, etc.)abstract
- Kännetecknade för Gro Dahles bilderböcker är att de inte värjer sig för att gestalta komplexa och kontroversiella teman. Agnes-Margrethe Bjorvand menar i sin analys av boken Sinna mann (2003) att Dahle bidragit till att förnya bilderboksgenren:”[w]hat is new, however, is that such a concrete presentation of physical abuse and violence inside the home finds its way into picturebooks intended to be read to and by relatively small children” (2010, s. 217). Därutöver finns det inte sällan i bilderböckerna en problematiserande ansats som erbjuder flera tolkningsvägar. Ett exempel är Snill (2002) av Dahle (text) och Svein Nyhus (bild) där problemställningen kretsar kring flickan Lussis frigörelse från att inledningsvis vara en snäll, tyst och osynlig tyst flicka till att bli en individ med egen vilja. Eva Maagerø och Guri Lorentzen Østbye (2017) resonerar kring hur Snill i första hand gestaltar Lussis frigörelse men att den avslutande bilden också signalerar andra barns, till exempel pojkars, behov av frigörelse, vilket även är en slutsats som Alfredsson (2021) drar. I föreliggande studie är det Sesam Sesam (2017) av Gro Dahle (text) och Kaia Dahle Nyhus (bild) som är i fokus. Berättelsen handlar kortfattat om hur pojken Al blir påkommen av sin mor när han tittar på pornografi på nätet, moderns reaktion och samtalet mellan Al och hans storebror Kas om vad porr egentligen är. Precis som i Snill och Sinna mann gestaltas ett brett känsloregister ur barnets perspektiv. Ämnet är känslomässigt komplicerat och berättelsen visar hur olika typer av affekter i Silvan S. Tomkins definition som exempelvis nyfikenhet, avsmak och skam, kan ta sig uttryck. I denna artikel är syftet att visa hur Dahles text och Kaia Dahle Nyhus illustrationer samspelar och skapar ett expressivt formspråk genom att framhäva, tona ned eller problematisera olika affekter (Nathanson 1992; Tomkins 1995). Vidare kommer vi att diskutera vilka litteraturdidaktiska möjligheter vår analys rymmer. Detta resonemang är samtidigt en vidareutveckling av ett redan påbörjat projekt med syftet att undersöka möjligheterna med att fläta samman litteraturvetenskapliga och språkvetenskapliga analysmetoder i undervisningen vid svensklärarutbildningen (Dahl & Smedberg Bondesson 2021). Den visuella analysen rymmer tre delar: ideationell, textuell och interpersonell betydelse. Ideationell betydelse avser här det Kress & van Leeuwen benämner narrativa processer och de frågor vi ställer är: Vad händer i bilden och hur gestaltas det? Textuell analys innebär en kartläggning av hur de avbildade är relaterade till varandra i fråga om avstånd och storlek och de betydelser som samspelen mellan de avbildade ger uttryck för. Vi tar fasta på aspekterna avgränsning och sambandsskapande, samt avstånd, visuellt rim och kontrast (Kress & van Leeuwen, s. 201ff). Den interpersonella analysen handlar om de sociala relationer människor etablerar visuellt. Här fokuserar vi på hur bruk av färg realiserar interpersonell betydelse som glädje, sorg, ilska eller rädsla med hjälp av aspekterna färgmättnad, modulation och differentiering (Kress & van Leeuwen, s. 232ff). Vidare kommer vi i analysen och tolkningen med mer litteraturvetenskapliga anspråk att använda tre topi-begrepp, nämligen Bakhtins kronotopi, främst tröskelkronotopin, Foucaults heterotopi, samt lingvistikens diatopi-begrepp, omformulerat och omdefinierat för att tjäna litteraturvetenskapliga syften. Atle Krogstads artikel ”The family house chronotope in three picturebooks by Gro Dahle and Svein Nyhus: idyll, fantasy, and threshold experiences” (2016) konstaterar att familjehuset är den primära scenen för händelserna i Dahles och Nyhus bilderboksuniversum. Vi instämmer med Krogstad i detta liksom i påståendet att Dahles och Nyhus bilderboksberättelser kan betraktas som just tröskelstudier som utforskar, förtydligar och tänjer ut det tillfälle och den tidpunkt då barnet förändras och blir synligt i den vuxna världen. Bakhtins tröskelkronotopi gestaltar existentiellt avgörande förändringar, medan Foucaults heterotopi erbjuder en motplats som ställer övriga världen på ända (Bachtin 1991, s. 157; Foucault 2008, s. 252 f.). Smedberg Bondessons diatopi häver klaustrofobin och innebär en öppning mellan den inre och den yttre världen, en genomsläpplighet och vidgning mot universums oändlighet, i fantasin såväl som i verkligheten (Smedberg Bondesson 2014, s. 50; 2017, s. 208; 217 f; 2018, s. 75). Analysen visar hur visuella val som rör narrativa processer, samband och avstånd samt interpersonella aspekter av färg såsom färgmättnad, differentiering och kontrast förstärker och förtydligar såväl materiella (yttre) som mentala (inre) dimensioner av den skrivna berättelsen. Starka affekter som avsmak, nyfikenhet och skam men också den nödvändiga tryggheten, känslan av att dela världen med någon, det ömsesidiga förtroendet som förutsättning för att klara av att reglera affekterna, kan urskiljas i berättelsens dramaturgi. En slutsats är att Kress & van Leeuwens modell möjliggör en detaljerad multimodal analys av olika affekter i en bilderbok som Sesam Sesam – och vidare ger detta en fingervisning om att man med fördel torde kunna kombinera en litteraturvetenskaplig/litteraturdidaktisk analys med en språkvetenskaplig/sociosemiotisk. Denna kombination är intressant ur många perspektiv, inte minst ett didaktiskt och svenskämnesperspektiv med tanke på hur språk- och litteraturdelen många gånger behandlas som skilda entiteter i klassrummet. Vidare står det i läroplanen att elever ska arbeta med ”texter som kombinerar ord, bild och ljud, och deras språkliga och dramaturgiska komponenter. Hur uttrycken kan samspela med varandra, till exempel i tv-serier, teaterföreställningar och webbtexter.” Här kan man tillägga bilderböcker. Den nordiska bilderboken utmärker sig nämligen på så vis att den inte uteslutande riktar sig till småbarn. Författare som till exempel Gro Dahle eller danskarna Oskar K och Dorte Karrebæk har visat hur gränsen mellan barn- och ungdomslitteratur samt vuxenlitteratur kan tänjas och problematiseras. Referenser Alfredsson, J. (2021). Den poetiska zonen. Poesins performativa potential i bilderböcker for barn. Samlaren. Tidskrift för forskning om svensk och annan nordisk litteratur årgång 142. Bachtin, M. (1991). Det dialogiska ordet. Översättning Johan Öberg. Gråbo: Anthropos. Bjorvand, A-M. (2010). Do Sons Inherit the Sins of Their Fathers? An Analysis of the Picturebook Angry Man. In T. Colomer, B. Kümmerling-Meibauer & C. Silva-Diaz (eds.), New Directions in Picturebook Research. New York & London: Routledge. Dahle, G & Dahle Nyhus, K. (2017). Sesam Sesam. Oslo: Cappelen Damm. Dahl, C. & Smedberg Bondesson, A. (2021). Skönlitteraturens språk – Det dubbla perspektivets möjligheter vid textanalys. Educare nr 2. Foucault. M. (2008). Diskursernas kamp. Översättning Jonas (J) Magnusson. Thomas Götselius & Ulf Olsson (eds). Stockholm/Stehag: Symposion. Kress, G. & van Leeuwen, T. (2006). Reading Images. The Grammar of Visual Design. New York & London: Routledge. Krogstad, A. (2016). The family house chronotope in three picturebooks by Gro Dahle and Svein Nyhus: idyll, fantasy, and threshold experiences. Barnelitterært Forskningstidsskrift. Nordic Journal of ChildLits Aesthetics, 7:1, 26040, DOI: 10.3402/blft.v7.26040. Maagerø, E. & Lorentzen Østbye, G. (2017). What a Girl! Fighting Gentleness in the Picture Book World. An Analysis of the Norwegian Picture Book What a Girl! by Gro Dahle and Svein Nyhus. Children’s Literature in Education nr 48. Nathanson, D. L. (1992). Shame and pride. Affect, sex and the birth of the self. New York & London: Norton. Smedberg Bondesson, A. (2014). Ditt språk i min mun. Grannspråkets glädje och gagn. Göteborg & Stockholm: Makadam. Smedberg Bondesson, A. (2017). Through the land of lagom in literature. Passing small towns in middle Sweden. Steven P. Sondrup & Mark B. Sandberg (eds.), Nordic Literature. A Comparative History. Volume I: Thomas A. Dubois & Dan Ringgaard (eds), Spatial Nodes. Amsterdam & Philadelphia: John Benjamins. Smedberg Bondesson, A. (2018). Gösta Berling på La Scala. Selma Lagerlöf och Italien. Göteborg & Stockholm: Makadam. Tomkins, S. S. (1995). Exploring affect. The selected writings of Silvan. S. Tomkins. Virginia E. Demos (eds). Cambridge: Cambridge University Press.
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| 7. |
- Bokenberger, Kathleen, et al.
(author)
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Association between sleep characteristics and incident dementia accounting for baseline cognitive status : A prospective population-based study
- 2017
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In: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 72:1, s. 134-139
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Journal article (peer-reviewed)abstract
- Background: While research has shown that sleep disorders are prevalent among people with dementia, the temporal relationship is unclear. We investigated whether atypical sleep characteristics were associated with incident dementia while accounting for baseline cognitive functioning.Methods: Screening Across the Lifespan Twin Study (SALT) participants were 11,247 individuals from the Swedish Twin Registry who were at least 65 years at baseline (1998-2002). Sleep and baseline cognitive functioning were assessed via the SALT telephone screening interview. Data on dementia diagnoses came from national health registers. Cox regression was performed to estimate hazard ratios (HR) for dementia.Results: After 17 years of follow-up, 1,850 dementia cases were identified. Short (≤ 6 hours) and extended (> 9 hours) time-in-bed (TIB) compared to the middle reference group (HR=1.40, 95% CI=1.06-1.85, HR=1.11, 95% CI=1.00-1.24, respectively) and rising at 8:00AM or later compared to earlier rising (HR=1.12, 95% CI=1.01-1.24) were associated with higher dementia incidence. Bedtime, sleep quality, restorative sleep, and heavy snoring were not significant predictors. Findings stratified by baseline cognitive status indicated that the association between short TIB and dementia remained in those cognitively intact at the start.Conclusions: Short and extended TIB as well as delayed rising among older adults predicted increased dementia incidence in the following 17 years. The pattern of findings suggests that extended TIB and late rising represent prodromal features whereas short TIB appeared to be a risk factor for dementia.
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| 8. |
- Ericsson, Malin, et al.
(author)
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Life-course socioeconomic differences and social mobility in preventable and non-preventable mortality : a study of Swedish twins
- 2019
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In: International Journal of Epidemiology. - : Oxford University Press. - 0300-5771 .- 1464-3685. ; 48:5, s. 1701-1709
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Journal article (peer-reviewed)abstract
- BackgroundDespite advances in life expectancy, low socioeconomic status is associated with a shorter lifespan. This study was conducted to investigate socioeconomic differences in mortality by comparing preventable with non-preventable causes of death in 39 506 participants from the Swedish Twin Registry born before 1935.MethodsChildhood social class, own education, own social class and social mobility were used as separate indicators of socioeconomic status. These data were linked to the Swedish Cause of Death Register. Cause of death was categorized as preventable or non-preventable mortality according to indicators presented in the Avoidable Mortality in the European Union (AMIEHS) atlas. Using Cox proportional hazard models, we tested the association between the socioeconomic measures and all-cause mortality, preventable mortality and non-preventable mortality. Additional co-twin control analyses indicated whether the associations reflected genetic confounding.ResultsThe social gradient for mortality was most prominent for the adult socioeconomic measures. There was a social gradient in both preventable mortality and non-preventable mortality, but with an indication of a moderately stronger effect in preventable causes of death. In analyses of social mobility, those who experienced life-time low socioeconomic status (SES) or downward social mobility had an increased mortality risk compared with those with life-time high SES and upward social mobility. Adjustments for genetic confounding did not change the observed associations for education, social class or social mobility and mortality. In the co-twin control analyses of reared-apart twins, the association between childhood social class and mortality weakened, indicating possible genetic influences on this association.ConclusionsOur results indicate that there is an association between low adult socioeconomic status and increased mortality independent of genetic endowment. Thus, we do not find support for indirect social selection as the basis for mortality inequalities in Sweden
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| 9. |
- Finnes, Anna, et al.
(author)
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Cost-Effectiveness of Acceptance and Commitment Therapy and a Workplace Intervention for Employees on Sickness Absence due to Mental Disorders.
- 2017
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In: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 59:12, s. 1211-1220
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to evaluate cost-effectiveness of Acceptance and Commitment Therapy (ACT) and workplace dialogue intervention (WDI), both as stand-alone interventions and in combination, compared with treatment as usual (TAU), for employees on sickness absence with mental disorders.METHODS: Employees (n = 352, 78.4% females) on sickness absence were randomized to one of four groups. Cost-utility analyses were conducted from a health care perspective and a limited societal perspective.RESULTS: All groups reported significant improvements in health-related quality-of-life (HRQoL) and there were no significant differences in HRQoL or costs between groups. The probability of cost-effectiveness for ACT+WDI was 50% compared with ACT, indicating that both treatment alternatives could be considered equally favorable for decision-makers. TAU and WDI were rejected due to less economic efficiency.CONCLUSION: Adding WDI to ACT cannot be recommended on the basis of our study results.
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| 10. |
- Finnes, Anna, et al.
(author)
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Economic evaluation of return-to-work interventions for mental disorder-related sickness absence : two years follow-up of a randomized clinical trial
- 2022
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In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 48:4, s. 264-272
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The objective was to (i) assess the long-term cost-effectiveness of acceptance and commitment therapy (ACT), a workplace dialog intervention (WDI), and ACT+WDI compared to treatment as usual (TAU) for common mental disorders and (ii) investigate any differences in cost-effectiveness between diagnostic groups.METHODS: An economic evaluation from the healthcare and limited welfare perspectives was conducted alongside a randomized clinical trial with a two-year follow-up period. Persons with common mental disorders receiving sickness benefits were invited to the trial. We used registry data for cost analysis alongside participant data collected during the trial and the reduction in sickness absence days as treatment effect. A total of 264 participants with a diagnosis of depression, anxiety, or stress-induced exhaustion disorder participated in a two-year follow-up of a four-arm trial: ACT (N=74), WDI (N=60), ACT+WDI (N=70), and TAU (N=60).RESULTS: For all patients in general, there were no statistically significant differences between interventions in terms of costs or effect. The subgroup analyses suggested that from a healthcare perspective, ACT was a cost-effective option for depression or anxiety disorders and ACT+WDI for stress-induced exhaustion disorder. With a two-year time horizon, the probability of WDI to be cost-saving in terms of sickness benefits costs was 80% compared with TAU.CONCLUSIONS: ACT had a high probability of cost-effectiveness from a healthcare perspective for employees on sick leave due to depression or anxiety disorders. For participants with stress-induced exhaustion disorder, adding WDI to ACT seems to reduce healthcare costs, while WDI as a stand-alone intervention seems to reduce welfare costs.
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| 11. |
- Finnes, Anna, et al.
(author)
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Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders : a systematic review and meta-analysis of randomized-controlled trials
- 2019
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:3, s. 273-293
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Research review (peer-reviewed)abstract
- Purpose: Common mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention.Methods: We reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis.Results: The psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were difficult to interpret as they pointed in different directions.Conclusion: There was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed.
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| 12. |
- Finnes, Anna, et al.
(author)
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Randomized Controlled Trial of Acceptance and Commitment Therapy and a Workplace Intervention for Sickness Absence Due to Mental Disorders.
- 2019
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In: Journal of Occupational Health Psychology. - : Educational Publishing Foundation. - 1076-8998 .- 1939-1307. ; 24:1, s. 198-212
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Journal article (peer-reviewed)abstract
- Mental disorders contribute to high rates of sickness absence (SA) and impaired work functioning. The aim of the present study was to evaluate the efficacy of 3 interventions targeting SA of workers. Participants (n = 352; 78.4% females) of working age with current employment, and SA due to depression, anxiety disorders, or exhaustion disorder, were recruited to the study and randomized to (a) acceptance and commitment therapy (ACT), (b) a workplace dialogue intervention (WDI), (c) a combination of ACT and WDI, or (d) treatment as usual (TAU). For SA days, there was a significant interaction effect for the follow-up period, in which ACT + WDI generated more SA compared with TAU. When diagnostic group was included as a moderator, participants with exhaustion disorder had less SA days in the WDI group compared with TAU. For symptoms of depression, anxiety, and stress-related ill health, there were significant interaction effects for ACT and ACT + WDI, when compared with TAU, from pre- to postmeasurement (small to moderate between-groups effect sizes). Within-group effect sizes pre- to postmeasurement (Cohen’s d) ranged from .55 to 1.17 (ACT), .40 to .94 (WDI), .26 to 1.13 (ACT + WI), and −.06 to .70 (TAU). There were no differences between groups during follow-up for symptoms.
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| 13. |
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| 14. |
- Hjelm, Carina, et al.
(author)
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Factors associated with increased risk for dementia in individuals age 80 years or older with congestive heart failure
- 2014
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In: Journal of Cardiovascular Nursing. - : Wolters Kluwer. - 0889-4655 .- 1550-5049. ; 29:1, s. 82-90
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Journal article (peer-reviewed)abstract
- Background and research objective: An increasing body of evidence shows that individuals diagnosed with congestive heart failure (CHF) are at a higher risk for dementia. However, the prevalence rate of dementia among persons with CHF in very old individuals has not been previously reported, and little is known about the comorbidities that place old persons with CHF at a higher risk for dementia. The aim of this study was to compare the prevalence of dementia in individuals 80 years or older who have CHF with that in individuals without CHF and to identify factors related to dementia in individuals diagnosed with CHF.Methods: A total of 702 participants from a Swedish population-based longitudinal study (Octogenerian Twin) were included. The group consisted of same-sex twin pairs, age 80 years or older, and 138 participants had CHF. Dementia was diagnosed according to criteria in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Generalized estimating equations including gender, age and educational level, waist circumference, diabetes, hypertension, smoking, depression, and blood values were used in a case-control analysis.Results: Individuals with CHF had a significantly higher prevalence of vascular dementia, 16% vs 6% (P < 0.001), and of all types of dementia, 40% vs 30% (P < 0.01), than those not diagnosed with CHF. The generalized estimating equation models showed that depression, hypertension, and/or increased levels of homocysteine were all associated with a higher risk for dementia in individuals with CHF. Diabetes was specifically associated with an increased risk for vascular dementia.Conclusions: The prevalence of dementia was higher among individuals with CHF than in those without CHF. Diabetes, depression, and hypertension in patients with CHF require special attention from healthcare professionals because these conditions are associated with an elevated risk for dementia. Higher levels of homocysteine were also found to be a marker of dementia in patients with CHF. Further research is needed to identify the factors related to dementia in individuals 80 years or older diagnosed with CHF.
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| 15. |
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| 16. |
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| 17. |
- Hjelm, Carina, et al.
(author)
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The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older
- 2012
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In: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:7-8, s. 994-1003
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Journal article (peer-reviewed)abstract
- Aim. The aim of this study was to examine the relationship between heart failure and specific cognitive abilities in octogenarians with regard to level and change over time.Background. Cognitive impairment is influenced by many factors, and the impact of heart failure is debated. Intact cognitive ability is crucial for successful self-care in patients with heart failure. Middle-aged patients with heart failure seem to have an increased risk of cognitive impairment. No studies have examined the association between heart failure and longitudinal cognitive changes in octogenarians (individuals 80 years and older).Design. A prospective longitudinal design.Methods. Cognitive tests were carried out five times (1991–2002) in 702 octogenarians from the Swedish Twin Registry, including same-sex twin pairs. The test battery included the measurement of processing speed, visuospatial ability, short-term, episodic and semantic memory. Latent growth curve modelling was employed to measure change and performance over time and compares the group diagnosed with heart failure to individuals without a heart failure diagnosis.Results. At baseline, the participants’ mean age was 83·5 years, 67% were women and 13% suffered from heart failure. Individuals diagnosed with heart failure scored significantly lower in spatial abilities and episodic memory than participants not diagnosed with heart failure. Moreover, measures of episodic memory declined more over time in individuals diagnosed with heart failure. There were no significant differences between the groups in other cognitive tests.Conclusion. Spatial problems and episodic memory have implications for everyday life. This might contribute to decreased adherence to prescribed therapy and self-care management and lead to socio-behavioural problems because of an impaired capacity to drive, read and write.Relevance to clinical practice. Nurses should take into account in their assessment that cognitive impairment may restrain elderly heart failure patient’s ability to make decisions and perform self-care actions. Patient education strategies should also be adapted to cognitive ability.
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| 18. |
- Holmberg, Anna, et al.
(author)
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75% success rate after open debridement, exchange of tibial insert, and antibiotics in knee prosthetic joint infections.
- 2015
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In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 86:4, s. 457-462
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Journal article (peer-reviewed)abstract
- Background and purpose - Prosthetic joint infection (PJI) is a leading cause of early revision after total knee arthroplasty (TKA). Open debridement with exchange of tibial insert allows treatment of infection with retention of fixed components. We investigated the success rate of this procedure in the treatment of knee PJIs in a nationwide material, and determined whether the results were affected by microbiology, antibiotic treatment, or timing of debridement. Patients and methods - 145 primary TKAs revised for the first time, due to infection, with debridement and exchange of the tibial insert were identified in the Swedish Knee Arthroplasty Register (SKAR). Staphylococcus aureus was the most common pathogen (37%) followed by coagulase-negative staphylococci (CNS) (23%). Failure was defined as death before the end of antibiotic treatment, revision of major components due to infection, life-long antibiotic treatment, or chronic infection. Results - The overall healing rate was 75%. The type of infecting pathogen did not statistically significantly affect outcome. Staphylococcal infections treated without a combination of antibiotics including rifampin had a higher failure rate than those treated with rifampin (RR = 4, 95% CI: 2-10). In the 16 cases with more than 3 weeks of symptoms before treatment, the healing rate was 62%, as compared to 77% in the other cases (p = 0.2). The few patients with a revision model of prosthesis at primary operation had a high failure rate (5 of 8). Interpretation - Good results can be achieved by open debridement with exchange of tibial insert. It is important to use an antibiotic combination including rifampin in staphylococcal infections.
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| 19. |
- Kvarnung, Malin, et al.
(author)
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Ataxia in Patients With Bi-Allelic NFASC Mutations and Absence of Full-Length NF186
- 2019
-
In: Frontiers in Genetics. - : Frontiers Media SA. - 1664-8021. ; 10
-
Journal article (peer-reviewed)abstract
- The etiology of hereditary ataxia syndromes is heterogeneous, and the mechanisms underlying these disorders are often unknown. Here, we utilized exome sequencing in two siblings with progressive ataxia and muscular weakness and identified a novel homozygous splice mutation (c.3020-1G > A) in neurofascin (NFASC). In RNA extracted from fibroblasts, we showed that the mutation resulted in inframe skipping of exon 26, with a deprived expression of the full-length transcript that corresponds to NFASC isoform NF186. To further investigate the disease mechanisms, we reprogrammed fibroblasts from one affected sibling to induced pluripotent stem cells, directed them to neuroepithelial stem cells and finally differentiated to neurons. In early neurogenesis, differentiating cells with selective depletion of the NF186 isoform showed significantly reduced neurite outgrowth as well as fewer emerging neurites. Furthermore, whole-cell patch-clamp recordings of patient-derived neuronal cells revealed a lower threshold for openings, indicating altered Na+ channel kinetics, suggesting a lower threshold for openings as compared to neuronal cells without the NFASC mutation. Taken together, our results suggest that loss of the full-length NFASC isoform NF186 causes perturbed neurogenesis and impaired neuronal biophysical properties resulting in a novel early-onset autosomal recessive ataxia syndrome.
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| 20. |
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| 21. |
- Marseglia, Anna, et al.
(author)
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Cognitive Trajectories of Older Adults With Prediabetes and Diabetes : A Population-Based Cohort Study
- 2018
-
In: The journals of gerontology. Series A, Biological sciences and medical sciences. - : Oxford University Press. - 1079-5006 .- 1758-535X. ; 73:3, s. 400-406
-
Journal article (peer-reviewed)abstract
- Background Diabetes has been linked to dementia risk; however, the cognitive trajectories in older adults with diabetes remain unclear. We aimed to investigate the effect of prediabetes and diabetes on cognitive trajectories among cognitively intact older adults in a long-term follow-up study.Methods Within the Swedish Adoption/Twin Study of Aging, 793 cognitively intact older adults aged ≥50 were identified at baseline and followed for up to 23 years. Based on standardized scores from 11 cognitive tests, administered at baseline and up to seven follow-ups, four cognitive domains (verbal abilities, spatial/fluid, memory, perceptual speed) were identified by principal-component analysis. Prediabetes was defined according to blood glucose levels in diabetes-free participants. Diabetes was ascertained based on self-report, hypoglycemic medication use and blood glucose levels. Data were analyzed with linear mixed-effect models adjusting for potential confounders.Results At baseline, 68 participants (8.6%) had prediabetes and 45 (5.7%) had diabetes. Compared to diabetes-free individuals, people with diabetes had a steeper decline over time in perceptual speed and verbal abilities. The annual declines in these domains were greater than the annual decline in memory. Prediabetes was associated with lower performance in memory in middle-age, but also associated with a less steep memory decline over the follow-up.Conclusions Diabetes is associated with a faster decline in perceptual speed and verbal abilities, while prediabetes is associated with lower memory performance in middle-age. However, the detrimental effects of hyperglycemia seem to not affect memory over time.
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| 22. |
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| 23. |
- Ruck, Kate, et al.
(author)
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International access to research infrastructure in the Arctic
- 2022
-
In: Polar Record. - : Cambridge University Press. - 0032-2474 .- 1475-3057. ; 58
-
Journal article (other academic/artistic)abstract
- Reliable access to Arctic research infrastructure is critical to the future of polar science. In cultivating proposals, it is essential that researchers have a deep understanding of existing platforms when selecting the appropriate research site and experimental design for projects. However, Arctic infrastructure platforms are often funded as national assets, and choices for what would be the best platform for the project are sometimes at odds with a researcher’s ability to gain access. Researchers from Arctic and non-Arctic nations are poised to benefit from reducing barriers and increasing cooperation around transnational access to Arctic infrastructure, allowing scientists to successfully execute the research that is most needed rather than what is just logistically feasible. This commentary provides a summary of findings from a workshop held at the 2021 Arctic Science Summit Week to discuss navigating “transnational” or “cross-border” access to national research infrastructure. This workshop brought together users and operators of Arctic infrastructure platforms with the three goals of identifying challenges, best practices, and possible next steps for improved collaboration.
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| 24. |
- Ruggeri, Kai, et al.
(author)
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The globalizability of temporal discounting
- 2022
-
In: Nature Human Behaviour. - : Springer Nature. - 2397-3374. ; 6:10, s. 1386-1397
-
Journal article (peer-reviewed)abstract
- Economic inequality is associated with preferences for smaller, immediate gains over larger, delayed ones. Such temporal discounting may feed into rising global inequality, yet it is unclear whether it is a function of choice preferences or norms, or rather the absence of sufficient resources for immediate needs. It is also not clear whether these reflect true differences in choice patterns between income groups. We tested temporal discounting and five intertemporal choice anomalies using local currencies and value standards in 61 countries (N = 13,629). Across a diverse sample, we found consistent, robust rates of choice anomalies. Lower-income groups were not significantly different, but economic inequality and broader financial circumstances were clearly correlated with population choice patterns. Ruggeri et al. find in a study of 61 countries that temporal discounting patterns are globally generalizable. Worse financial environments, greater inequality and high inflation are associated with extreme or inconsistent long-term decisions.
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| 25. |
- Schuy, Jakob, et al.
(author)
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Partial Monosomy 21 Mirrors Gene Expression of Trisomy 21 in a Patient-Derived Neuroepithelial Stem Cell Model
- 2022
-
In: Frontiers in Genetics. - : Frontiers Media SA. - 1664-8021. ; 12
-
Journal article (peer-reviewed)abstract
- Induced pluripotent stem cells (iPSCs) from patients are an attractive disease model to study tissues with poor accessibility such as the brain. Using this approach, we and others have shown that trisomy 21 results in genome-wide transcriptional dysregulations. The effects of loss of genes on chromosome 21 is much less characterized. Here, we use patient-derived neural cells from an individual with neurodevelopmental delay and a ring chromosome 21 with two deletions spanning 3.8 Mb at the terminal end of 21q22.3, containing 60 protein-coding genes. To investigate the molecular perturbations of the partial monosomy on neural cells, we established patient-derived iPSCs from fibroblasts retaining the ring chromosome 21, and we then induced iPSCs into neuroepithelial stem cells. RNA-Seq analysis of NESCs with the ring chromosome revealed downregulation of 18 genes within the deleted region together with global transcriptomic dysregulations when compared to euploid NESCs. Since the deletions on chromosome 21 represent a genetic “contrary” to trisomy of the corresponding region, we further compared the dysregulated transcriptomic profile in with that of two NESC lines with trisomy 21. The analysis revealed opposed expression changes for 23 genes on chromosome 21 as well as 149 non-chromosome 21 genes. Taken together, our results bring insights into the effects on the global and chromosome 21 specific gene expression from a partial monosomy of chromosome 21qter during early neuronal differentiation.
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| 26. |
- Sundlöv, Anna, et al.
(author)
-
Pituitary function after high-dose 177Lu-DOTATATE therapy and long-term follow-up.
- 2021
-
In: Neuroendocrinology. - : S. Karger AG. - 0028-3835 .- 1423-0194. ; 111:4, s. 344-353
-
Journal article (peer-reviewed)abstract
- The pituitary gland has a high expression of somatostatin receptors (SSTRs) and is therefore a potential organ at risk for radiation-induced toxicity after 177Lu-DOTATATE treatment.To study changes in pituitary function in patients with neuroendocrine tumors (NETs) treated with dosimetry-based 177Lu-DOTATATE to detect possible late toxicity.68 patients from a phase II clinical trial of dosimetry-based, individualized 177Lu-DOTATATE-therapy were included in this analysis. Patients had received a median of 5 (range 3-9) treatment cycles of 7.4 GBq/cycle. Median follow-up was 30 months (range 11-89). The GH/IGF1-axis, gonadotropins, adrenal and thyroid axes were analyzed from baseline and on a yearly basis thereafter. Percent changes in hormonal levels over time were analyzed statistically using a linear mixed model and described graphically using boxplots. The absorbed radiation dose to the pituitary was estimated based on post-therapeutic imaging, and the results analyzed vs % change in IGF1-levels over time.A statistically significant decrease in the levels of IGF1 was found (p<0.005), which was correlated to the number of treatment cycles (p=0.008) and absorbed radiation dose (p=0.03). A similar decrease, although non-significant, was seen in the gonadotropins in post-menopausal women, while in men there was an increase during the first years post-therapy, after which the levels returned to baseline. No change was observed in the adrenal nor thyroid axes.No signs of severe endocrine disorder were detected, although a significant decrease in the GH/IGF1-axis was found, where dosimetric analyses indicate radiation-induced damage to the pituitary gland as a probable cause.
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| 27. |
- Ahlin, Lena, et al.
(author)
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Narrativ teknik och känsla i Hemingways "Hills Like White Elephants"
- 2023
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In: Litteraturdidaktik och känslor: Konferensvolym 2021. - : Stockholm University Press.
-
Book chapter (pop. science, debate, etc.)abstract
- I kapitlet ”Narrativ teknik och känsla i Hemingways ’Hills Like White Elephants’” utgår vi från frågan om det huruvida samtidigt vara känslomässigt berörd av en text och förhålla sig kritiskt till den. I en undersökning av förhållandet mellan estetisk form och känslor argumenterar vi för att kritisk närläsning kan vara ett helt nödvändigt första steg för att uppfatta karaktärers känslor och för att som läsare själv känna känslomässigt engagemang för en text. Analysen fokuserar på de känslor “Hills Like White Elephants” förmedlar genom sin minimalistiska form. Kapitlet diskuterar den effekt formen kan ha på läsaren men snarare än att försöka slå fast vilka känslor som kan eller bör genereras menar vi att pedagogens uppgift främst är att sträva efter att ge studenterna en beredskap för att ta till sig konstverket, det vill säga, arbeta med det som Felski kallar attunement. Vi föreslår tre huvudområden att arbeta med i klassrummet för att uppnå en djupare textförståelse som i sin tur kan leda till attunement. Det första är kulturell och litterär kontext: vad behöver läsaren veta om modernismen för att förstå ”Hills Like White Elephants”? Det andra är analys av miljö, vilket inbegriper bland annat betydelsen av plats men också språkliga konstruktioner och symbolism. Slutligen diskuteras förhållandet mellan karaktärernas känslor och läsarens samt frågan om huruvida det är rimligt att ha som mål att dessa båda parter ska dela känslotillstånd.
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| 28. |
- Ahmed, Zara, et al.
(author)
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Bringing LTL Model Checking to Biologists
- 2017
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In: VMCAI 2017. - Cham : Springer. - 9783319522340 - 9783319522333 ; , s. 1-13
-
Conference paper (peer-reviewed)abstract
- The BioModelAnalyzer (BMA) is a web based tool for the development of discrete models of biological systems. Through a graphical user interface, it allows rapid development of complex models of gene and protein interaction networks and stability analysis without requiring users to be proficient computer programmers. Whilst stability is a useful specification for testing many systems, testing temporal specifications in BMA presently requires the user to perform simulations. Here we describe the LTL module, which includes a graphical and natural language interfaces to testing LTL queries. The graphical interface allows for graphical construction of the queries and presents results visually in keeping with the current style of BMA. The Natural language interface complements the graphical interface by allowing a gentler introduction to formal logic and exposing educational resources.
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| 29. |
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| 30. |
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| 31. |
- Angelin, Anna, et al.
(author)
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Have Nordic welfare regimes adapted to changes in transitions to adulthood? Unemployment insurance and social assistance among young people in the Nordic welfare states
- 2014
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In: Young people and social policy in Europe. - Basingstoke : Palgrave Macmillan. - 9781137370525 - 9781137370518 ; , s. 169-188
-
Book chapter (peer-reviewed)abstract
- Entering adult life consists of several transitions that are related to finding a source of income, establishing an independent household and creating new family formations. This stage of ‘becoming’ entails a move from needing others to living as an autonomous and economically independent citizen (France, 2008; Smeeding and Philips, 2002). This key life stage, where several major transitions and life-course events take place concurrently (Anxo et al., 2010; Müller and Gangl, 2003), results in increasing vulnerability to poverty (Moore, 2005). In the Nordic countries (Finland, Sweden and Norway), economic autonomy has become quite difficult to obtain for many young people; continued financial support from either parents or social assistance is a reality for many. Poverty is central in understanding if and how young people can transition effectively into adulthood. Within the populations of the Nordic countries today, young people are among those most likely to be economically vulnerable.1 Despite being relatively affluent compared with young people in many eastern and southern European countries, it is evident that this life phase is associated with increasing vulnerability in the Nordic countries.
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| 32. |
- Appelgren Engström, Heléne, 1968-
(author)
-
Family formation in two-mother families : Experiences of parental support in antenatal and child health care in Sweden
- 2021
-
Doctoral thesis (other academic/artistic)abstract
- The aim with the thesis was to examine same-sex mothers experiences of forming a family, pregnancy, parenthood and parental support from professionals in antenatal and child health care. An additional purpose was to explore professionals' experiences of meeting and supporting families with two mothers.The results are based on four articles (three studies). The project started with exploratory semi-structured interviews (n = 20) with mothers in same-sex relationships who had children with the help of assisted reproduction at a Swedish clinic. Thereafter, a web survey was designed based on the results from the first sub-study. The survey, as well as a survey on perceived parenting stress (SPSQ), was answered by 146 mothers in same-sex relationships. Finally, focus groups were held with professionals (n = 13) in antenatal and child health care with experience of meeting and supporting families with two mothers.The results showed that the mothers in same-sex relationships experienced the process of forming a family as a stressful journey in a heteronormative world, and that they lacked psychological / emotional support (Articles I, III). The results also showed that the mothers strived for equal parenthood and that they lacked professional support (Articles II, III).Furthermore, the results showed that the non-birth mother experienced a lower degree of acknowledgement from antenatal and child health care than the mother who gave birth, and a lower degree of support from antenatal care but no difference in the experience of support from child health care. The mothers also experienced a low degree of parenting stress (Article III).Professionals strived for an open approach in meeting new parents. They met well-prepared mothers who planned for equal parenting. Professionals expressed that they either gave equal support to all parents, or that they provided tailored support to same-sex mothers (Article IV).The thesis contributes with an in-depth understanding and increased knowledge about mothers in same-sex relationships' experience of family formation as well as their experience of treatment and support from professionals in antenatal and child health care. Furthermore, it also shows professionals' experiences of meeting and supporting families with two mothers.
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| 33. |
- Bai, Ge, et al.
(author)
-
Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
- 2021
-
In: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
-
Journal article (peer-reviewed)abstract
- BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
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| 34. |
- Bannon, Brittany L., et al.
(author)
-
Confirmatory factor analysis of illness behavior in the Swedish Adoption/Twin Study of Aging (SATSA)
- 2017
-
In: Annals of Behavioral Medicine. - : Springer. - 0883-6612 .- 1532-4796. ; 51:Suppl. 1, s. S2654-S2655
-
Journal article (peer-reviewed)abstract
- Background: Illness behaviors—or affective, cognitive, and behavioral responses to symptoms of illness—predict patient outcomes, including symptom exacerbation and functional recovery, and they account for a large proportion of U.S. healthcare costs. Although priorcross-sectional work has examined illness behaviors like symptom reporting in isolation, the measurement of illness behavior using a longitudinal, multi-indicator approach has yet to be explored.Aim: We evaluated illness behavior as a latent, developmental construct in the Swedish Adoption/Twin Study of Aging (SATSA).Method: Participants were up to 1,886 individuals (from 1,223 twin pairs) ages 29 to 102 years (Mage baseline = 62.32 years; SD =13.69; 59% Female). Illness behavior indicators included somatic complaints, non-prescription medication use, pain-related disability and perceived illness complications. The psychomotor retardation subscale of the CES-D was used to index somatic complaints, and medication use was a simple composite of 9 dichotomous items on participants’ use of non-prescription medications, such as over-the-counter analgesics, in the previous month. Pain-related disability included a simple composite of three dichotomous items on the presence of neck,back, or shoulder pain that prevented participants from performing daily tasks or activities. Perceived illness disability was a composite of difference scores, calculated from subtracting a physician panel’s objective ratings of disability for each of 35 medical conditions (on a 3-pointscale; 1= Little or no disability; 3= Severe disability) from participants’ self-ratings of how much each of the same endorsed medical conditions interfered with their daily lives (on the same 3-point scale; 1= Not at all; 3= A lot). Positive composite scores reflected higher perceived disability relative to what was expected from the objective ratings, whereas a composite score of zero reflected “accuracy” or agreement in perceived illness complications. Confirmatory Factor Analysis (CFA) was used to evaluate invariance in the loadings of these four indicatorson a latent illness behavior factor across four questionnaire waves (1987-2004).Findings: Confirmatory factor analyses revealed moderate factor loadings of the four indicators (standardized loadings ranged from .49 to .52, all ps < .0001). Also, practical fit indices from the nested model comparisons suggested strong factorial invariance in the loadings across time (CFI = .96; TLI = .95, RMSEA= .03, 90% CI: [.026, .035]).Conclusion: Illness behavior as a latent, multi-indicator construct represents a promising focus for longitudinal work on behavior change and maintenance.
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| 35. |
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| 36. |
- Beam, Christopher R., et al.
(author)
-
Estimating Likelihood of Dementia in the Absence of Diagnostic Data : A Latent Dementia Index in 10 Genetically Informed Studies
- 2022
-
In: Journal of Alzheimer's Disease. - : IOS Press. - 1387-2877 .- 1875-8908. ; 90:3, s. 1187-1201
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Epidemiological research on dementia is hampered by differences across studies in how dementia is classified, especially where clinical diagnoses of dementia may not be available. OBJECTIVE: We apply structural equation modeling to estimate dementia likelihood across heterogeneous samples within a multi-study consortium and use the twin design of the sample to validate the results. METHODS: Using 10 twin studies, we implement a latent variable approach that aligns different tests available in each study to assess cognitive, memory, and functional ability. The model separates general cognitive ability from components indicative of dementia. We examine the validity of this continuous latent dementia index (LDI). We then identify cut-off points along the LDI distributions in each study and align them across studies to distinguish individuals with and without probable dementia. Finally, we validate the LDI by determining its heritability and estimating genetic and environmental correlations between the LDI and clinically diagnosed dementia where available. RESULTS: Results indicate that coordinated estimation of LDI across 10 studies has validity against clinically diagnosed dementia. The LDI can be fit to heterogeneous sets of memory, other cognitive, and functional ability variables to extract a score reflective of likelihood of dementia that can be interpreted similarly across studies despite diverse study designs and sampling characteristics. Finally, the same genetic sources of variance strongly contribute to both the LDI and clinical diagnosis. CONCLUSION: This latent dementia indicator approach may serve as a model for other research consortia confronted with similar data integration challenges.
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| 37. |
- Berg, Stig, et al.
(author)
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Cognitive decline and dementia
- 2007
-
In: Geropsychology. - Cambridge, Mass. : Hogrefe & Huber. - 9780889373402 ; , s. 165-182
-
Book chapter (pop. science, debate, etc.)
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| 38. |
- Berg, Stig, et al.
(author)
-
Declive cognitivo y demencia
- 2009
-
In: PsicoGerontología. - Madrid : Pirámide. - 9788436822137 ; , s. 223-243
-
Book chapter (other academic/artistic)
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| 39. |
- Berg, Urban, et al.
(author)
-
Fast-Track Programs in Total Hip and Knee Replacement at Swedish Hospitals-Influence on 2-Year Risk of Revision and Mortality
- 2021
-
In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 10:8
-
Journal article (peer-reviewed)abstract
- Purpose: We aimed to study the influence of fast-track care programs in total hip and total knee replacements (THR and TKR) at Swedish hospitals on the risk of revision and mortality within 2 years after the operation. Methods: Data were collected from the Swedish Hip and Knee Arthroplasty Registers (SHAR and SKAR), including 67,913 THR and 59,268 TKR operations from 2011 to 2015 on patients with osteoarthritis. Operations from 2011 to 2015 Revision and mortality in the fast-track group were compared with non-fast-track using Kaplan-Meier survival analysis and Cox regression analysis with adjustments. Results: The hazard ratio (HR) for revision within 2 years after THR with fast-track was 1.19 (CI: 1.03-1.39), indicating increased risk, whereas no increased risk was found in TKR (HR 0.91; CI: 0.79-1.06). The risk of death within 2 years was estimated with a HR of 0.85 (CI: 0.74-0.97) for TKR and 0.96 (CI: 0.85-1.09) for THR in fast-track hospitals compared to non-fast-track. Conclusions: Fast-track programs at Swedish hospitals were associated with an increased risk of revision in THR but not in TKR, while we found the mortality to be lower (TKR) or similar (THR) as compared to non-fast track.
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| 40. |
- Berg, Urban, et al.
(author)
-
Influence of fast-track programs on patient-reported outcomes in total hip and knee replacement (THR/TKR) at Swedish hospitals 2011-2015: an observational study including 51,169 THR and 8,393 TKR operations
- 2020
-
In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 91:3, s. 306-312
-
Journal article (peer-reviewed)abstract
- Background and purpose - Fast-track care programs have been broadly introduced at Swedish hospitals in elective total hip and knee replacement (THR/TKR). We studied the influence of fast-track programs on patient-reported outcomes (PROs) 1 year after surgery, by exploring outcome measures registered in the Swedish arthroplasty registers. Patients and methods - Data were obtained from the Swedish Knee and Hip Arthroplasty Registers and included TKR and THR operations 2011-2015 on patients with osteoarthritis. Based on questionnaires concerning the clinical pathway and care programs at Swedish hospitals, the patients were divided in 2 groups depending on whether they had been operated in a fast-track program or not. PROs of the fast-track group were compared with not fast-track using regression analysis. EQ-5D, EQ VAS, Pain VAS, and Satisfaction VAS were analyzed for both THR and TKR operations. The PROMs for TKR also included KOOS. Results - The differences of EQ-5D, EQ VAS, Pain VAS, and Satisfaction VAS 1 year after surgery were small but all in favor of fast-track for both THR and TKR, also in subscales of KOOS for TKR except KOOS QoL. However, the effect sizes as measured by Cohens' d formula were < 0.2 for all PROs, in both THR and TKR. Interpretation - Our results indicate that the fast-track programs may be at least as good as conventional care from the perspective of PROs 1-year postoperatively.
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| 41. |
- Bergemalm, Daniel, 1977-, et al.
(author)
-
Systemic Inflammation in Preclinical Ulcerative Colitis
- 2021
-
In: Gastroenterology. - : AGA Institute. - 0016-5085 .- 1528-0012. ; 161:5, s. 1526-1539.e9
-
Journal article (peer-reviewed)abstract
- Background & Aims: Preclinical ulcerative colitis is poorly defined. We aimed to characterize the preclinical systemic inflammation in ulcerative colitis, using a comprehensive set of proteins.Methods: We obtained plasma samples biobanked from individuals who developed ulcerative colitis later in life (n = 72) and matched healthy controls (n = 140) within a population-based screening cohort. We measured 92 proteins related to inflammation using a proximity extension assay. The biologic relevance of these findings was validated in an inception cohort of patients with ulcerative colitis (n = 101) and healthy controls (n = 50). To examine the influence of genetic and environmental factors on these markers, a cohort of healthy twin siblings of patients with ulcerative colitis (n = 41) and matched healthy controls (n = 37) were explored.Results: Six proteins (MMP10, CXCL9, CCL11, SLAMF1, CXCL11 and MCP-1) were up-regulated (P < .05) in preclinical ulcerative colitis compared with controls based on both univariate and multivariable models. Ingenuity Pathway Analyses identified several potential key regulators, including interleukin-1β, tumor necrosis factor, interferon-gamma, oncostatin M, nuclear factor-κB, interleukin-6, and interleukin-4. For validation, we built a multivariable model to predict disease in the inception cohort. The model discriminated treatment-naïve patients with ulcerative colitis from controls with leave-one-out cross-validation (area under the curve = 0.92). Consistently, MMP10, CXCL9, CXCL11, and MCP-1, but not CCL11 and SLAMF1, were significantly up-regulated among the healthy twin siblings, even though their relative abundances seemed higher in incident ulcerative colitis.Conclusions: A set of inflammatory proteins are up-regulated several years before a diagnosis of ulcerative colitis. These proteins were highly predictive of an ulcerative colitis diagnosis, and some seemed to be up-regulated already at exposure to genetic and environmental risk factors.
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| 42. |
- Berglund Kristiansson, Elisabeth, et al.
(author)
-
A qualitative study of older persons’ experiences of getting individual support with digital needs in the context of home ID 281
- 2024
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In: The first Global Conference on Person-Centred Care. - : University of Gothenburg Centre for Person-Centred Care. - 9789153106708 ; , s. 216-216
-
Conference paper (peer-reviewed)abstract
- Background: Digitalization is seen as a necessity to manage the increasing burden on the health care system and is accordingly considered an important tool in the transformation to integrated care (Swedish Nära vård). However, when health care is digitalized older persons are at increased risk of being marginalized and dependent on others due to their generally lower digital competence. To address this, several Swedish municipalities offer individual support to older persons in their own home, a service called Digital Coach (DC). As this service is new, the aim is to describe older persons’ experiences of getting individual support with digital needs in the context of home. Method: Semi-structured interviews (n=14) were conducted with older persons who have had DC support in their home. The focus was on older persons’ experiences of the support. Data was analyzed with qualitative content analysis. Results, preliminary: The overall theme, to be a valued person in the digital society, represents a feeling of being taken seriously and worth investing resources in to gain access to society. Three categories emerged: (1) The need to keep up with the times which means to understand and navigate the new digital landscape with the opportunity for independence and participation, (2) Support and respect in the learning situation, is crucial for feeling comfortable to expose insufficient knowledge, and (3) Increased digital competence empowers autonomy and is manifested as the ability to handle the digital tools and services by your own creates a feeling of joy and satisfaction and increases the opportunity to participate in both social and community activities. Conclusion: The result shows that individual support with digital needs in the context of home increase digital competence in older persons and create feelings of being valued and included in the digital society, which can extend to integrated person-centered care.
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| 43. |
- Björklund Carlstedt, Anita, 1953-, et al.
(author)
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Older workers and extended working life - Managers' experiences and age management
- 2024
-
In: Work. - : IOS Press. - 1051-9815 .- 1875-9270.
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Journal article (peer-reviewed)abstract
- BACKGROUND: In 2020 the Swedish Government started a gradual raising of the retirement age, but employers have been silent on the issue. Little is known about whether and how they reflect on what it will mean for their organization, or whether they already have, or are going to, make arrangements in order to facilitate and motivate older workers to stay longer.OBJECTIVE: The aim of this study was to explore and describe managers' experiences of older workers and age management in connection with the increase of the retirement age in Sweden.METHODS: Data was collected through semi-structured interviews with fourteen managers from a broad set of organizations in the public and private sectors, and from the Middle and East of Sweden. The transcribed material was analysed in line with qualitative content analysis.RESULTS: The analysis ended up in seven main categories with associated sub-categories: Older Workers, Retirement Ages, Transition Initiatives, Competence Transfer, Competence Development, Increased Retirement Ages, Knowledge Gaps.CONCLUSION: Our findings reveal that there is an ambivalence in addressing the issue of age among the interviewed managers, what we have interpreted and labelled as "silent age discrimination", and it was shown that they do not have elaborated strategies for age management.
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- Bokenberger, Kathleen, et al.
(author)
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Shift work and cognitive aging : A longitudinal study
- 2017
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In: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health (NOROSH). - 0355-3140 .- 1795-990X. ; 43:5, s. 485-493
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Journal article (peer-reviewed)abstract
- Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed.Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986–2012. Night work history (ever/never) from 1998–2002 was available from a subsample (N=320). Early adult cognitive test scores were available for 77 men.Results In latent growth curve modeling, there were no main effects of "any-type" or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand.Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.
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| 47. |
- Bokenberger, Kathleen, et al.
(author)
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Shift work and risk of incident dementia : a study of two population-based cohorts
- 2018
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In: European Journal of Epidemiology. - : Springer. - 0393-2990 .- 1573-7284. ; 33:10, s. 977-987
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Journal article (peer-reviewed)abstract
- This study aimed to investigate the association between shift work and incident dementia in two population-based cohorts from the Swedish Twin Registry (STR). The STR-1973 sample included 13,283 participants born 1926–1943 who received a mailed questionnaire in 1973 that asked about status (ever/never) and duration (years) of shift work employment. The Screening Across the Lifespan Twin (SALT) sample included 41,199 participants born 1900–1958 who participated in a telephone interview in 1998–2002 that asked about night work status and duration. Dementia diagnoses came from Swedish patient registers. Cox proportional-hazards regression was used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Potential confounders such as age, sex, education, diabetes, cardiovascular disease and stroke were included in adjusted models. In genotyped subsamples (n = 2977 in STR-1973; n = 10,366 in SALT), APOE ε4 status was considered in models. A total of 983 (7.4%) and 1979 (4.8%) dementia cases were identified after a median of 41.2 and 14.1 years follow-up in the STR-1973 and SALT sample, respectively. Ever shift work (HR 1.36, 95% CI 1.15–1.60) and night work (HR 1.12, 95% CI 1.01–1.23) were associated with higher dementia incidence. Modest dose-response associations were observed, where longer duration shift work and night work predicted increased dementia risk. Among APOE ε4 carriers, individuals exposed to ≥ 20 years of shift work and night work had increased dementia risk compared to day workers. Findings indicate that shift work, including night shift work, compared to non-shift jobs is associated with increased dementia incidence. Confirmation of findings is needed.
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- Bokenberger, Kathleen, et al.
(author)
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The Type A behavior pattern and cardiovascular disease as predictors of dementia
- 2014
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In: Health Psychology. - : American Psychological Association (APA). - 0278-6133 .- 1930-7810. ; 33:12, s. 1593-1601
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Journal article (peer-reviewed)abstract
- Objective: Research has suggested that greater psychophysiological reactivity to stress increases risk of dementia and that those with the Type A behavior pattern (TABP) are predisposed to elevated stress reactivity and cardiovascular disease (CVD), but no study has evaluated the associations among TABP, CVD, and dementia, prospectively. Hence, the present study aimed to investigate dementia risk in relation to TABP and CVD.Methods: A population-based cohort of 1,069 persons with a baseline mean age of 64.81 years from the Swedish Twin Registry was followed consecutively for up to 23 years. Based on self-reported items, TABP was measured using 6 scales: Ambition, Stress, Hard-driving, Neuroticism, Cynicism, and Paranoia. CVD was self-reported and dementia was diagnosed adhering to Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) or Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria.Results: TABP was generally not associated with dementia risk. However, significant interaction effects of stress, paranoia, and cynicism with CVD on dementia risk were observed. That is, for those with CVD, high scores on stress, paranoia, and cynicism were associated with increased risk of dementia (hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 0.95-2.15; HR = 1.39, 95% CI = 0.83-2.33; HR = 1.25, 95% CI = 0.76-2.06, respectively), whereas for those who did not have CVD, high scores on these measures appeared to be protective (HR = 0.76, 95% CI = 0.50-1.14; HR = 0.55, 95% CI = 0.34-0.89; HR = 0.50, 95% CI = 0.29-0.84, respectively).Conclusion: Some features of TABP confer an increased risk for dementia in those with CVD, whereas those without CVD are protected. When evaluating the risk of dementia, CVD and personality traits should be taken into consideration.
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