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1.
  • Johansson, Gunvi, et al. (author)
  • Measuring oral health from a public health perspective
  • 2008
  • In: Swedish Dental Journal. - Stockholm : Swedish Dental Journal. - 0347-9994. ; 32:3, s. 125-137
  • Journal article (peer-reviewed)abstract
    • The paper aims to analyse measures of oral health-related quality of life (OHQOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health.
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2.
  • Barlow, Lotti, et al. (author)
  • Nationellt fackspråk för vård och omsorg : Slutrapport
  • 2011
  • Reports (pop. science, debate, etc.)abstract
    • SammanfattningEtt tillgängligt och använt nationellt fackspråk ska bidra till en god och säker vård och omsorg. Det ska även medverka till att kvaliteten och resultaten på området ska kunna följas upp och jämföras på ett mer effektivt sätt. Slutrapporten presenterar resultatet av projektet Nationellt fackspråk för vård och omsorg samt förslag till förvaltning och utveckling.ResultatetResultatet innefattar bland annat att det internationella begreppssystemet Snomed CT är översatt till svenska och att det är förberett för förvaltning och distribution. Socialstyrelsen har även tagit fram och testat metoder för förvaltning och utveckling av det nationella fackspråket i sin helhet. Därtill har representanter för målgrupperna informerats och fått kunskap.Rapporten innehåller en utförlig beskrivning av det nationella fackspråkets sammantagna innehåll: Socialstyrelsens termbank, klassifikationer och kodverk, den svenska versionen av Snomed CT, metoder för utveckling och förvaltning samt regler för användning.Förvaltning, införande och resursbehovI rapporten finns förslag till hur hela det nationella fackspråket kan tas omhand av Socialstyrelsen och hur det kan införas i vården och omsorgen. Projektets övergång till en långsiktigt hållbar organisation kräver resurser. Därför redogör rapporten för det förväntade resursbehovet för förvaltning och utveckling. Bland annat föreslås en treårig utbildningsinsats samt stimulansbidrag för införande.Krav på styrning, samordning och förtydligat ansvarRapporten betonar behovet av en samlad och medveten styrning av utvecklingen inom området. Socialstyrelsen vill ha en samordnande roll i utvecklingen och förvaltningen av det nationella fackspråket. Myndigheten föreslås få det initiala ansvaret för att utbilda användare och att driva frågor om det nationella fackspråket.Vidare vill Socialstyrelsen få ett uttalat mandat att samordna de nationella aktiviteter som drivs med koppling till Snomed CT. Rapporten pekar ut några särskilt prioriterade områden som myndigheten borde få i uppdrag att arbeta vidare inom.Kunskapsstyrning och normgivningEn viktig slutsats i rapporten är att användningen av det nationella fackspråket behöver regleras för att målet om ökad säkerhet för klienter och patienter ska kunna uppnås. I dagsläget bedöms föreskrifter vara den metod som bäst kan garantera ett brett genomförande.Målgrupper för slutrapportenSlutrapporten riktar sig till beslutsfattare i kommuner och landsting, vård- och omsorgspersonal med särskilt intresse eller ansvar för dokumentationsfrågor och professionella organisationer. Den riktar sig också till terminologiansvariga i kommuner och landsting, IT-direktörer, IT-leverantörer samt aktörer inom den nationella strategin för eHälsa.
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3.
  • Bjursell, Mikael, 1977, et al. (author)
  • Opposing effects of adiponectin receptors 1 and 2 on energy metabolism
  • 2007
  • In: DIABETES. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 56:3, s. 583-593
  • Journal article (peer-reviewed)abstract
    • The adipocyte-derived hormone adiponectin regulates glucose and lipid metabolism and influences the risk for developing obesity, type 2 diabetes, and cardiovascular disease. Adiponectin binds to two different seven-transmembrane domain receptors termed AdipoR1 and AdipoR2. To study the physiological importance of these receptors, AdipoR1 gene knockout mice (AdipoR1−/−) and AdipoR2 gene knockout mice (AdipoR2−/−) were generated. AdipoR1−/− mice showed increased adiposity associated with decreased glucose tolerance, spontaneous locomotor activity, and energy expenditure. However, AdipoR2−/− mice were lean and resistant to high-fat diet–induced obesity associated with improved glucose tolerance and higher spontaneous locomotor activity and energy expenditure and reduced plasma cholesterol levels. Thus, AdipoR1 and AdipoR2 are clearly involved in energy metabolism but have opposing effects.
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4.
  • Forsner, Maria, 1954-, et al. (author)
  • It hurts to get forced : Children's narratives about restraint during medical procedures
  • 2023
  • In: Paediatric and Neonatal Pain. - : John Wiley & Sons. - 2637-3807. ; 5:4, s. 110-118
  • Journal article (peer-reviewed)abstract
    • According to the UN Convention on the Rights of the Child (UNCRC), children have the right to be involved in decisions about medical procedures affecting them. However, research has shown that healthcare professionals sometimes find this difficult to achieve and those procedures then are performed against the will of the child. The aim was to illuminate restraint from the perspective of children’s and young people’s experiences of feeling forced during medical procedures. Following the phenomenological hermeneutic method, a secondary qualitative analysis of narrative data from four datasets collected between 2001 and 2020 was performed. Twelve children and young people aged 6-19 years (three male, nine female) from central and northern Sweden narrated their experiences of restraint related to medical procedures in nine narrative interviews and three short written narratives. The analysis revealed that it hurts to get forced, this being illustrated in six themes: bodily misery, emotional rebellion, feeling disregarded, physically limited, desiring escape, and leaving deep traces. From the perspective of children and young people, restraint was interpreted with inspiration from the philosopher Michel Foucault, as being overpowered - not voluntary submission but offering resistance - and according to the theory of caring and uncaring, a relationship in which the healthcare professional is perceived as indifferent to the patient as a person. In conclusion restraint hurts and means powerlessness to the child, leaving deep traces that remain for a long time. The findings call the healthcare profession to take action to support children’s self-determination, participation, and integrity in healthcare. How children experience restraint in healthcare merits further investigation from the children’s own perspective.
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6.
  • Johansson, Gunvi, et al. (author)
  • Measuring oral health from a public health perspective
  • 2008
  • In: Swedish Dental Journal. - Stockholm : Swedish Dental Association. - 0347-9994. ; 32:3, s. 125-137
  • Journal article (peer-reviewed)abstract
    • The paper aims to analyse measures of oral health-related quality of life (OHOOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health.
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7.
  • Norderyd, Ola, et al. (author)
  • Oral health of individuals aged 3-80 years in Jonkoping, Sweden, during 40 years (1973-2013) : II. Review of clinical and radiographic findings
  • 2015
  • In: Swedish Dental Journal. - : Swedish dental association. - 0347-9994. ; 39:2, s. 57-68
  • Journal article (peer-reviewed)abstract
    • The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city ofionkoping, Sweden, in 1973,1983,1993, 2003, and 2o13.The 1973 study constituted a random sample of L000 individuals evenly distributed in the age groups 3, 5,10,15, 20, 30,40, 50, 6o, and 7o yea rs.The same age groups with addition of a group of 8o-year-olds were included in the 1983,1993, 2003, and 2013 studies, which comprised 1,104;1,078; 987; and 1,010 individuals, respectively. A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period. During the period 1973-2013, a continous increase of individuals in the age group 20-6o years were treated by the Public Dental Service amounting to about 5o%. Almost 7o% of the 70- and 80-year-olds were treated by private practitioners. In 2013,10-20% of the individuals in the age groups 30-40 years did not regularly visit neither Public Dental Service nor a private practitioner.The corresponding figures for the individuals 50-80 years old were 4-7%. Similar number of avoidance was reported in the previous studies. In the survey 2013, about 20-30% of the individuals in the age groups 20-50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist.These findings were in agreement with the results from the surveys 1973-2003. Among the younger age groups, 10-15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series. In 2013, the knowledge of the etiology of caries was known by about 6o% of the individuals which was similar to that reported 1973 zoo3.Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries.This percentage was equivalent during the period 1973-2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day.These frequencies have gradually increased during the 40-year period. Around 40% in the age groups 50-8o years used toothpicks regularly in 2013.This is a about 1/3-1/2 less compared to 2003. In the age groups 20-40 years 3-14% used toothpicks for proximal cleaning in 2013. In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3-20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013
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8.
  • Norderyd, Ola, et al. (author)
  • Oral health of individuals aged 3-80 years in Jonkoping, Sweden during 40 years (1973-2013)
  • 2015
  • In: Swedish Dental Journal. - : Swedish Dental Association. - 0347-9994. ; 39:2, s. 69-86
  • Journal article (peer-reviewed)abstract
    • The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973-2003. In 1973,1983,1993,2003, and 2013 random samples of 1,000;1,104;1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3,5,10,15, 20,30,40,50, 60,70, and 8o years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jonkoping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40-70 years was 16,12, 8,1, and 0.3% in 1973,1983,1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30-80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013.This was higher than earlier surveys,4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10-20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013,43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5-60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40 year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 4o and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups-Jo-30-year-olds a major reduction from about 3o% to 15% in mean plaque score was seen between 1973-2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003-2o13.The percentage of tooth sites with gingivitis was for zo years and older about 4o% in 1973. In 2013, the percentage was about15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years:1973-1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003-2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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9.
  • Norderyd, Ola, et al. (author)
  • Oral health of individuals aged 3-80 years in Jönköping, Sweden, during 40 years (1973-2013) : I. Review of findings on oral care habits and knowledge of oral health.
  • 2015
  • In: Swedish Dental Journal. - 0347-9994. ; 39:2, s. 57-68
  • Journal article (peer-reviewed)abstract
    • The aim of the this study was to present data on oral care habits and knowledge of oral health in 2013, and to compare these data with results from a series of four previous cross-sectional epidemiological studies. All these studies were carried out in the city of Jönköping, Sweden, in 1973, 1983, 1993, 2003, and 2013. The 1973 study constituted a random sample of 1,000 individuals evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, and 70 years. The same age groups with addition of a group of 80-year-olds were included in the 1983, 1993, 2003, and 2013 studies, which comprised 1,104; 1,078; 987; and 1,010 individuals, respectively.A questionnaire about dental care habits and knowledge of oral health was used. The questionnaire contained the same questions in all the five studies, although some had to be slightly modernised during the 40-year period.During the period 1973–2013, a continous increase of individuals in the age group 20–60 years were treated by the Public Dental Service amounting to about 50%. Almost 70% of the 70- and 80-year-olds were treated by private practitioners. In 2013, 10–20% of the individuals in the age groups 30–40 years did not regularly visit neither Public Dental Service nor a private practitioner. The corresponding figures for the individuals 50–80 years old were 4–7%. Similar number of avoidance was reported in the previous studies.In the survey 2013, about 20–30% of the individuals in the age groups 20–50 felt frightened, sick, or ill at ease at the prospect of an appointment with the dentist. These findings were in agreement with the results from the surveys 1973–2003. Among the younger age groups, 10–15 years, a reduction in self-reported "ill at ease" was found in the surveys 2003 and 2013 compared to the previous surveys in this series.In 2013, the knowledge of the etiology of caries was known by about 60% of the individuals which was similar to that reported 1973–2003. Twenty per cent of the individuals stated that they did not know which etiological factors that causes caries. This percentage was equivalent during the period 1973–2013. About 85% of the individuals in all age groups brushed their teeth with fluoride tooth paste at least two times a day. These frequencies have gradually increased during the 40-year period.Around 40% in the age groups 50–80 years used toothpicks regularly in 2013. This is a about 1/3–1/2 less compared to 2003. In the age groups 20–40 years 3–14% used toothpicks for proximal cleaning in 2013.In 2013, about 35% of the individuals never consumed soft drinks, in comparison with 20% in 2003. In the age groups 3–20 years about 20% were consuming soft drinks every day or several times a week, which is a reduction by half compared to 2013
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10.
  • Norderyd, Ola, et al. (author)
  • Oral health of individuals aged 3-80 years in Jönköping, Sweden during 40 years (1973-2013) : II. Review of clinical and radiographic findings
  • 2015
  • In: Swedish Dental Journal. - 0347-9994. ; 39:2, s. 69-86
  • Journal article (peer-reviewed)abstract
    • The aim of this epidemiological study performed in 2013 was to analyze various clinical and radiographic data on oral health and compare the results to those of four cross-sectional studies carried out 1973–2003. In 1973, 1983, 1993, 2003, and 2013 random samples of 1,000; 1,104; 1,078; 987; and 1,010 individuals, respectively, were studied. The individuals were evenly distributed in the age groups 3, 5, 10, 15, 20, 30, 40, 50, 60, 70, and 80 years. Eighty-year-olds were not included in 1973. All subjects were inhabitants of the city of Jönköping, Sweden.The clinical and radiographic examination assessed edentulousness, removable dentures, implants, number of teeth, caries, restorations, oral hygiene, calculus, periodontal status, and endodontic treatment.The frequency of edentulous individuals aged 40–70 years was 16, 12, 8, 1, and 0.3% in 1973, 1983, 1993, 2003, and 2013, respectively. No complete denture wearer younger than 80-years old was found in 2013. During the 40-year period, the mean number of teeth in the age groups 30–80 years increased. In 2013, the 60-year-olds had nearly complete dentitions. Implants were found in all age groups from 30 years of age. The total number of individuals with implants was 36 in 2013. This was higher than earlier surveys, 4 in 1993, and 18 in 2003.The percentage of children and adults without caries and restorations increased during the 40-year period. It was found that the percentage of caries-free 3- and 5-year-olds were 79% and 69%, respectively, of the individuals in 2013. In the age groups 10–20 years, the percentage of caries-free individuals increased between 2003 and 2013. In 2013, 43% of the 15-year-olds were completely free from caries and restorations compared to 20% in 2003. In all age groups 5–60 years, DFS was lower in 2013 compared to the earlier examinations. There was no major change in DFS between 2003 and 2013 in the age groups 70 and 80 years. The most obvious change was the decrease in number of FS over the 40- year period of time. Regarding crowned teeth the most clear changes between 1973 to 2013 were the decrease in percentage of crowned teeth in the age goups 40 and 50-year-olds. The percentage of endodontically treated teeth decreased between 1973 and 2013 in all age groups.In age groups 10–30-year-olds a major reduction from about 30% to 15% in mean plaque score was seen between 1973–2003. Only a minor change in plaque score was seen during the last decade. For the age groups 40 years and older, a decrease in the percentage of surfaces with plaque was observed between 2003–2013. The percentage of tooth sites with gingivitis was for 20 years and older about 40% in 1973. In 2013, the percentage was about 15%. The frequency of sites with gingivitis was generally lower in 2013 compared with the other years, 1973–1993.The percentage of individuals with probing pocket depths >4mm increased with age. Between 2003–2013 a clear reduction was seen in all age groups in frequency of individuals with probing pocket depth >4mm. Over the 40-year period an increase in the number of individuals with no marginal bone loss and a decrease in the number of subjects with moderate alveolar bone loss were seen.The continuous improvement in oral health and the reduced need of restorative treatment will seriously affect the provision of dental helath care and dental delivery system in the near future.
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12.
  • Adelöf, Anna, et al. (author)
  • Förvaltning av SNOMED CT som en del i det nationella fackspråket för vård och omsorg
  • 2011
  • Reports (pop. science, debate, etc.)abstract
    • Förvaltningsrapporten fokuserar på Snomed CT, eftersom det redan i dag finns rutiner för förvaltningar av termbanken och nationella hälsorelaterade klassifikationer. Ett särskilt utvecklingsarbete kommer att krävas för dessa delar.Rapporten tar upp syfte och mål med förvaltningen. Utöver det redogör rapporten för vilka konkreta ansvarsområden som ingår i förvaltningen av Snomed CT. Målet för förvaltningen är att Socialstyrelsen regelbundet ska kunna tillhandahålla en kontrollerad och uppdaterad release av Snomed CT. Det skulle möjliggöra användning inom vård och omsorg. Rapporten tar även upp behovet av kompetens, utbildning och finansiella resurser.
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13.
  • Ahlvin, Anna, et al. (author)
  • Self-perceived oral health among 19-year-olds in a Swedish County - A comparative study between 2004 and 2011
  • 2016
  • In: Swedish Dental Journal. - : SWEDISH DENTAL JOURNAL. - 0347-9994. ; 40:1, s. 53-65
  • Journal article (peer-reviewed)abstract
    • For decades, Swedish dental professionals have collected clinical epidemiological data from the dental records. To supplement the epidemiology, Ostergotland County Council decided to examine patient perceptions of oral health: self-rated knowledge, self-perceived oral health, and opinions about oral health. The aim was to compare self-perceived oral health among 19-year-olds to determine differences between genders, various municipalities and between 2004 and 2011. This study analysed the responses from two cross-sectional surveys of the entire population of 19-year-olds in Ostergotland County, Sweden, performed in 2004 and 2011. Of the 2,413 (53 %) (50 % men, 50 % women) 19-year-olds who responded to the questionnaire in 2004 and the 3,803 (67 %) (50 % men, 50 % women) in 2011, most 19-year-olds (88.1 % [2004] and 87.5 % [am]) reported satisfaction with their oral health. Around half of the respondents rated their knowledge on periodontitis as low. Boys rated their knowledge about avoiding periodontitis higher than girls (p<0.05 in 2004 and p<0.001 in 2011). In 2004, 84.7 % reported shooting pain. In 2011 that figure was 83.7 %. The respondents expressed some uncertainty about the benefits of fluoride toothpaste (7.5 % in 2004 and 9.3 % in 2011), especially the boys (10.3 % in 2004 and 10.5 % in 2011). Girls reported both a higher social impact and greater concern about aesthetics related to their oral health. They also reported headache (27.5 %) nearly twice as often as boys (14.2 %) (p>0.001). Responses between the municipalities did not differ, with the exception of items regarding periodontitis. Thus, this study found indications that perceptions of oral health and knowledge in Ostergotland County complied with Swedish Dental Act. The study also found patient perceptions of oral health among 19-year-olds to be good.
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14.
  • Binsell-Gerdin, Emil, et al. (author)
  • Hemorrhagic stroke the first 30 days after an acute myocardial infarction : incidence, time trends and predictors of risk
  • 2014
  • In: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 176:1, s. 133-138
  • Journal article (peer-reviewed)abstract
    • Background/objectives: Hemorrhagic stroke is a rare but serious complication after an acute myocardial infarction (AMI). The aims of our study were to establish the incidence, time trends and predictors of risk for hemorrhagic stroke within 30 days after an AMI in 1998-2008. Methods: We collected data from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA). All patients with a myocardial infarction 1998-2008 were included, n = 173,233. The data was merged with the National Patient Register in order to identify patients suffering a hemorrhagic stroke. To identify predictors of risk we used Cox models. Results: Overall the incidence decreased from 0.2% (n = 94) in 1998-2000 to 0.1% (n = 41) in 2007-2008. In patients with ST-elevation myocardial infarction the corresponding incidences were 0.4% (n = 76) in 1998-2000 and 0.2% (n = 21) in 2007-2008, and after fibrin specific thrombolytic treatment 0.6% and 1.1%, respectively, with a peak of 1.4% during 2003-2004. In total 375 patients (0.22%) suffered a hemorrhagic stroke within 30 days of the AMI. The preferred method of reperfusion changed from thrombolysis to percutaneous coronary intervention (PCI). Older age (hazard ratio (HR) >65- <= 75 vs <= 65 years 1.84, 95% confidence interval (CI) 1.38-2.45), thrombolysis (HR 6.84, 95% CI 5.51-8.48), history of hemorrhagic stroke (HR 12.52, CI 8.36-18.78) and prior hypertension (HR 1.52, CI 1.23-1.86) independently predicted hemorrhagic stroke within 30 days. Conclusions: The rate of hemorrhagic stroke within 30 days of an AMI has decreased by 50% between 1998 and 2008. The main reason is the shift in reperfusion method from thrombolysis to PCI. 
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15.
  • Bjursell, Mikael, 1977, et al. (author)
  • Acutely reduced locomotor activity is a major contributor to Western diet-induced obesity in mice
  • 2008
  • In: American Journal of Physiology-Endocrinology and Metabolism. - : American Physiological Society. - 0193-1849 .- 1522-1555. ; 294:2
  • Journal article (peer-reviewed)abstract
    • The aim of the present study was to investigate the short- and long-term effects of a high-fat Western diet (WD) on intake, storage, expenditure, and fecal loss of energy as well as effects on locomotor activity and thermogenesis. WD for only 24 h resulted in a marked physiological shift in energy homeostasis, including increased body weight gain, body fat, and energy expenditure (EE) but an acutely lowered locomotor activity. The acute reduction in locomotor activity was observed after only 3–5 h on WD. The energy intake and energy absorption were increased during the first 24 h, lower after 72 h, and normalized between 7 and 14 days on WD compared with mice given chow diet. Core body temperature and EE was increased between 48 and 72 h but normalized after 21 days on WD. These changes paralleled plasma T3 levels and uncoupling protein-1 expression in brown adipose tissue. After 21 days of WD, energy intake and absorption, EE, and body temperature were normalized. In contrast, the locomotor activity was reduced and body weight gain was increased over the entire 21-day study period on WD. Calculations based on the correlation between locomotor activity and EE in 2-h intervals at days 21–23 indicated that a large portion of the higher body weight gain in the WD group could be attributed to the reduced locomotor activity. In summary, an acute and persisting decrease in locomotor activity is most important for the effect of WD on body weight gain and obesity in mice.
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20.
  • Graipe, Anna, et al. (author)
  • Incidence, Time Trends, and Predictors of Intracranial Hemorrhage During Long-Term Follow-up After Acute Myocardial Infarction
  • 2015
  • In: Journal of the American Heart Association. - 2047-9980. ; 4:12
  • Journal article (peer-reviewed)abstract
    • BACKGROUND: To address the lack of knowledge regarding the long-term risk of intracranial hemorrhage (ICH) after acute myocardial infarction (AMI), the aims of this study were to: (1) investigate the incidence, time trends, and predictors of ICH in a large population within 1 year of discharge after AMI; (2) investigate the comparative 1-year risk of ICH in AMI patients and a reference group; and (3) study the impact of previous ischemic stroke on ICH risk in patients treated with various antithrombotic therapies.METHODS AND RESULTS: Data about patients whose first AMI occurred between 1998 and 2010 were collected from the Swedish Register of Information and Knowledge about Swedish Heart-Intensive-Care Admissions (RIKS-HIA). Patients with an ICH after discharge were identified in the National Patient Register. Risk was compared against a matched reference population. Of 187 386 patients, 590 had an ICH within 1 year. The 1-year cumulative incidence (0.35%) was approximately twice that of the reference group, and it did not change significantly over time. Advanced age, previous ischemic or hemorrhagic stroke, and reduced glomerular filtration rate were associated with increased ICH risk, whereas female sex was associated with a decreased risk. Previous ischemic stroke did not increase risk of ICH associated with single or dual antiplatelet therapy, but increased risk with anticoagulant therapy.CONCLUSION: The 1-year incidence of ICH after AMI remained stable, at ≈0.35%, over the study period. Advanced age, decreased renal function, and previous ischemic or hemorrhagic stroke are predictive of increased ICH risk.
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22.
  • Larsson Gerdin, Anna, et al. (author)
  • Encountering patients in their homes : A qualitative study of home care nurses’ experiences
  • 2023
  • In: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 43:1
  • Journal article (peer-reviewed)abstract
    • Many ill people want to be cared for at home, and home care nurses face an infinite number of encounters when providing that service. Despite the rising prominence of home care organizations worldwide, little research has been conducted on the encounters between home care nurses and patients and how encounters influence the nursing care provided. The aim of the present study was to describe home care nurses’ experiences of encounters with patients in their homes. In total, 11 home care nurses were selected through purposive sampling. The data consisted of individual interviews, which were analyzed through qualitative content analysis, and reported using COREQ reporting guidelines. The results were based on two categories describing the importance of adapting to each patient's needs and collaborating with the person being cared for. Implementing the findings could enable nurses to care for the patients without reducing them to recipients of objectified care.
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23.
  • Larsson Gerdin, Anna, et al. (author)
  • Nurses’ experiences of encounters in home care : a phenomenological hermeneutic study
  • 2021
  • In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
  • Journal article (peer-reviewed)abstract
    • Purpose: nurses working in home care often encounter patients with multiple diagnoses in unpredictable environments. This may cause ethical and emotional challenges and influence nurses’ daily work. The aim of this study was to illuminate the meaning of nurses’ lived experiences of encountering patients in home care. Methods: narrative interviews were conducted with 11 nurses. These interviews were audiotaped and transcribed verbatim and analysed using a phenomenological hermeneutic approach. Findings: the findings are presented under three main themes: (1)”Being receptive to the other” (with subthemes “Caring about the encounter,” and “Establishing trusting relationships”). (2) “Need to handle Handling the unpredictable” (with subthemes “Being alone in the encounter” and “Being experienced and competent”). (3) “Managing frustration” (with subthemes “Feeling insufficient” and “Feeling restricted”. Having overall nursing responsibility challenged the nurse’s self-confidence in providing care trustfully. Conclusions: encountering patients in home care means relating to the other unconditionally, which aim to highlight patients’ needs. Being a nurse in home care is both emotionally demanding and rewarding. Having the courage to face their own and the patients’ vulnerabilities will entail the promotion of natural receptivity and responsiveness to patients’ needs. 
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24.
  • Larsson Gerdin, Anna (author)
  • Nurses’ experiences of encounters in home care : a phenomenological hermeneutic study
  • 2022
  • In: Caring in a changing world. ; , s. 65-65
  • Conference paper (other academic/artistic)abstract
    • BackgroundHome care has become an increasingly central part of healthcare organizations and in the future, an extended part of health care is expected to be provided in patients’ homes.Because a home represents a safe foundation with high personal integrity, it can cause ethical and emotional challenges for the nurse in encountering the patient. Hence, it is of the utmost importance to understand the emotional and ethical dimensions of encountering patients in home care, and pay more attention to how it impacts the way nurses practice their profession.AimTo illuminate the meaning of nurses’ lived experiences of encountering patients in home care.MethodA qualitative design with a phenomenological hermeneutic approach was used and individual narrative interviews were performed with a purposive sample of 11 RNs working in home care. Ethical approval to perform this research was obtained from the Swedish Ethical Review Authority.FindingsThe findings are presented under three main themes: (1) “Being receptive to the other” (with subthemes “Caring about the encounter,” and “Establishing trusting relationships”). (2) “Handling the unpredictable” (with subthemes “Being alone in the encounter” and “Being experienced and competent”). (3) “Managing frustration” (with subthemes “Feeling insufficient” and “Feeling restricted”. Having overall nursing responsibility challenged the nurses’ self-confidence in providing care trustfully.Conclusions and implicationsThe nurse could not always perceive the needs as conveyed by the patient and respond to the ethical demand. This was facilitated by shifting the focus from efficiency and solutions on parts to getting to know the person in front of them as a whole, perceiving their needs and wishes. By enriching the understanding of the complex encounters between nurses and patients, the patients’ health and well-being can be better supported.
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25.
  • Larsson Gerdin, Anna, et al. (author)
  • Nurses’ experiences of encounters in home care : a phenomenological hermeneutic study
  • 2023
  • In: Abstraktkatalog. ; , s. 48-
  • Conference paper (other academic/artistic)abstract
    • Background: Nurses working in home care often encounter patients with multiple diagnoses in an unpredictable environment, which can cause ethical and emotional challenges and affect their daily work. However, research about encounters in home care is sparse.Aim: To illuminate the meaning of nurses’ lived experiences of encountering patients in home care.Method: The study has a qualitative design and adopts a phenomenological hermeneutic approach. This approach was chosen to shed light on the meaning of the nurses’ everyday experiences by interpreting texts transcribed from lived narrations. After obtaining ethical approval participants (n=11) were recruited through purposive sampling.Findings: The findings are presented under three main themes:1) “Being receptive to the other”, which illustrates the meaning of being open-minded and taking the time to acknowledge the patient.2) “Handling the unpredictable”, which illustrates the meaning of encountering the unknown in the patient’s home.3) “Managing frustration”, which illustrates the meaning of managing your emotions to highlight the needs of the patients. The variety of encounters made different impressions on the nurses which affected the provided care.Discussion: During unpredictable encounters, it was sometimes hard to determine and assess the best care for the patients. The findings highlight that misinterpreting the patients’ needs worried the nurses and caused their consciences to be troubled. Nurses must manage their own and their patients’ vulnerability in order to be receptive to what the patients conveyed. When doing so, nurses will discover a genuine interest in the other and counteract the risk of overlooking the patients. The unilateral ethical demand requires the nurses to take care of the patients’ lives selflessly. We are all in each other’s power because our vulnerability and loneliness will facilitate a natural trust. A trust that we hope will be answered and fulfilled by measures that touch and show care and affection.Conclusions: Although encountering patients in home care means relating to the other unconditionally, it is sometimes hard to perceive the wishes and needs of the patient and to respond to the ethical demand. However, this was facilitated by shifting the focus from problem-solving an deficiency to get to know the person. Additionally, management of vulnerability will also increase the ability of the nurse to encounter the patient in home care more perceptively.
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26.
  • Larsson Gerdin, Anna, et al. (author)
  • Older persons' experiences of care encounters in their home : A multiple-case study
  • 2024
  • In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 33:6, s. 2287-2297
  • Journal article (peer-reviewed)abstract
    • AimTo explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.BackgroundThe increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.DesignMultiple-case study.MethodsThe cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.FindingsThe cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.ConclusionsOur research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.Reporting MethodFindings were reported using COREQ guidelines.Patient or Public ContributionPatients were interviewed and contributed with data for this study.Implications for the Profession and Patient CareThis study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.
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27.
  • Melgar, Silvia, et al. (author)
  • Mice with experimental colitis show an altered metabolism with decreased metabolic rate
  • 2007
  • In: AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY. - : American Physiological Society. - 0193-1857 .- 1522-1547. ; 292:1
  • Journal article (peer-reviewed)abstract
    • Patients with inflammatory bowel disease (IBD) suffer from body weight loss, malnutrition, and several other metabolic alterations affecting their quality of life. The aim of this study was to investigate the metabolic changes that may occur during acute and chronic colonic inflammation induced by dextran sulfate sodium (DSS) in mice. Clinical symptoms and inflammatory markers revealed the presence of an ongoing inflammatory response in the DSS-treated mice. Mice with acute inflammation had decreased body weight, respiratory exchange ratios (RER), food intake, and body fat content. Mice with chronic inflammation had decreased nutrient uptake, body fat content, locomotor activity, metabolic rates, and bone mineral density. Despite this, the body weight, food and water intake, lean mass, and RER of these mice returned to values similar to those in healthy controls. Thus, murine experimental colitis is associated with significant metabolic alterations similar to IBD patients. Our data show that the metabolic responses during acute and chronic inflammation are different, although the metabolic rate is reduced in both phases. These observations suggest compensatory metabolic alterations in chronic colitis resulting in a healthy appearance despite gross colon pathology.
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28.
  • Reiser, Erika, et al. (author)
  • Association Between Cleft Size and Crossbite in Children With Cleft Palate and Unilateral Cleft Lip and Palate
  • 2010
  • In: The Cleft Palate-Craniofacial Journal. - : SAGE Publications. - 1055-6656 .- 1545-1569. ; 47:2, s. 175-181
  • Journal article (peer-reviewed)abstract
    • Objective: To investigate the association between cleft size in infancy and crossbite at 5 years of age in children with cleft palate (CP) and unilateral cleft lip and palate (UCLP). Design: Retrospective study. Setting: University Hospital, Uppsala, Sweden. Patients: Dental study models of 80 consecutive children, 51 children with CP and 29 children with UCLP, born between 1990 and 1999 were analyzed. Interventions: Lip repair at 3 to 4 months in UCLP children. Primary soft palate repair at 6 to 10 months and secondary hard palate closure at 25 to 26 months of age. Main Outcome Measures: Maxillary arch dimensions and cleft size were measured on infancy dental casts. At follow-up at 5 years, crossbite scores were registered on dental study models. Results: The cleft dimensions in infancy showed large interindividual variation. Mean posterior cleft width was larger in UCLP children than in children with CP. The UCLP group also had significantly more crossbite at 5 years than the CP group. No significant association was noted between initial cleft size and crossbite scores at 5 years in the CP group. For the UCLP group, larger cleft widths at the level of the cuspid points were significantly associated with less anterior and posterior crossbite. Conclusions: The findings support the hypothesis that cleft size in infancy affects early outcome with respect to crossbite in children with UCLP, but not in children with CP.
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29.
  • Reiser, Erika, 1974- (author)
  • Cleft Size and Maxillary Arch Dimensions in Unilateral Cleft Lip and Palate and Cleft Palate
  • 2011
  • Doctoral thesis (other academic/artistic)abstract
    • The wide variation in infant maxillary morphology and cleft size of children with unilateral cleft lip and palate (UCLP) and isolated cleft palate (CP) raise concerns about their possible influences on treatment outcome. The studies in this thesis aimed to investigate the relation between cleft size in infancy and crossbite at 5 years of age (Paper I); the impact of primary surgery on cleft size and maxillary arch dimensions from infancy to 5 years of age (Paper II); associations between cleft size, maxillary arch dimensions and facial growth in both UCLP and CP children (Paper III); and, to evaluate the relation between infant cleft size and nasal airway size and function in adults treated for UCLP (Paper IV). In homogenously treated groups of children with UCLP and CP, dental casts were used to measure cleft size and maxillary arch dimensions from infancy up to 5 years of age, and for crossbite recording at 5 years. Serial lateral cephalometric radiographs taken between 5 and 19 years of age in the same groups were used to study facial growth. Nasal airway size and function were evaluated by acoustic rhinometry, rhinomanometry, peak nasal inspiratory flow and odour test in a group of adults treated for UCLP. The main findings were: crossbite was a frequent malocclusion at 5 years of age in children with UCLP and large cleft widths at the level of the cuspid points in infancy were associated with less anterior and posterior crossbite in this group (Paper I). Cleft widths decreased after lip closure and/or soft palate closure in both UCLP and CP children. Initially, UCLP children had wider maxillary arch dimensions, but after hard palate closure, the transverse growth was reduced, and at 5 years, they had smaller maxillary arch widths than CP children had (Paper II). Maxillary arch depths and cleft widths in infancy were correlated with maxillary protrusion and sagittal jaw relationships in both UCLP and CP children (Paper III), but cleft width in infancy was not correlated with nasal airway size and function in adults treated for UCLP (Paper IV).
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30.
  • Schell, Carl Otto, et al. (author)
  • The global need for essential emergency and critical care
  • 2018
  • In: Critical Care. - : BMC. - 1364-8535 .- 1466-609X. ; 22
  • Journal article (other academic/artistic)abstract
    • Critical illness results in millions of deaths each year. Care for those with critical illness is often neglected due to a lack of prioritisation, co-ordination, and coverage of timely identification and basic life-saving treatments. To improve care, we propose a new focus on essential emergency and critical care (EECC)care that all critically ill patients should receive in all hospitals in the world. Essential emergency and critical care should be part of universal health coverage, is appropriate for all countries in the world, and is intended for patients irrespective of age, gender, underlying diagnosis, medical specialty, or location in the hospital. Essential emergency and critical care is pragmatic and low-cost and has the potential to improve care and substantially reduce preventable mortality.
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31.
  • Tedner, Sandra G., et al. (author)
  • Extract and molecular-based early infant sensitization and associated factors-A PreventADALL study
  • 2021
  • In: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 76:9, s. 2730-2739
  • Journal article (peer-reviewed)abstract
    • Background More knowledge about sensitization patterns in early infancy, including impact of molecular allergology, is needed to help predict future allergy development more accurately. Objective We aimed to determine the prevalence and patterns of allergic sensitization at 3 months of age, and explore possible associated factors. Methods From the Scandinavian antenatally recruited PreventADALL mother-child cohort, we included 1110 3-month infants with available serum. Sensitization was defined as s-IgE of >= 0.1 kU(A)/L by Phadiatop Infant(R) (ThermoFisher Scientific) including birch, cat, grass, dog, milk, egg, peanut and wheat. Further ImmunoCAP analyses to ovomucoid, casein, Ara h 1-3, omega-5-gliadin were performed in food extract s-IgE-positive children. Maternal sensitization was defined as s-IgE >= 0.35 kU(A)/L to Phadiatop(R) (inhalant allergen mix) and/or Fx5 (food allergen mix) at 18-week pregnancy. Results Overall 79 (7.3%) infants had specific sensitization, many with low s-IgE-levels (IQR 0.16-0.81 kU(A)/L), with 78 being sensitized to food extract allergens; 41 to egg, 27 to milk, 10 to peanut, and 25 to wheat. A total of 62/78 were further analysed, 18 (29%) had s-IgE to ovomucoid, casein, Ara h 1-3 and/or omega-5-gliadin. Eight infants (0.7%) were sensitized to inhalant allergens. Maternal sensitization to food allergens was associated with infant sensitization, odds ratio 3.64 (95% CI 1.53-8.68). Conclusion Already at 3 months of age, 7% were sensitized to food, mostly without detectable s-IgE to food allergen molecules, and <1% to inhalant allergens. Maternal food sensitization was associated with infants' sensitization.
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32.
  • Wärnberg Gerdin, Sabina, et al. (author)
  • Impaired skin barrier and allergic sensitization in early infancy
  • 2022
  • In: Allergy. European Journal of Allergy and Clinical Immunology. - : John Wiley & Sons. - 0105-4538 .- 1398-9995. ; 77:5, s. 1464-1476
  • Journal article (peer-reviewed)abstract
    • Background: Factors predicting allergic sensitization in the first 6 months of life are poorly understood. We aimed to determine whether eczema, dry skin, and high transepidermal water loss (TEWL) at 3 months were associated with allergic sensitization at 6 months of age and, secondarily, to establish whether these characteristics predicted sensitization from 3 to 6 months of age.Methods: At 3 months of age, 1,994 infants from the population-based PreventADALL birth cohort in Norway and Sweden were assessed for eczema and dry skin on the cheeks and/or extensors; impaired skin barrier function, defined as TEWL in the upper quartile (>9.4 g/m(2)/h), and allergen-specific IgE levels <0.1 kU(A)/L, available in 830. At 6 months, we assessed allergic sensitization to any food (egg, cow's milk, peanut, wheat, soy) or inhalant (birch, timothy grass, dog, and cat) allergen by a skin prick test wheal diameter >= 2 mm larger than negative control.Results: Any sensitization was found in 198 of the 1,994 infants (9.9%), the majority to food allergens (n = 177, 8.9%). Eczema, dry skin, and high TEWL at 3 months increased the risk of sensitization at 6 months; adjusted odds ratios 4.20 (95% CI 2.93-6.04), 2.09 (95% CI 1.51-2.90) and 3.67 (95% CI 2.58-5.22), respectively. Eczema predicted sensitization with 55.6% sensitivity and 68.1% specificity; dry skin with 65.3% sensitivity and 57.3% specificity; and high TEWL with 61.7% sensitivity and 78.1% specificity.Conclusion: Eczema, dry skin, and high TEWL at 3 months predicted allergic sensitization at 6 months of age.
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